1.1 	A bill for an act
1.2 	relating to state government; modifying provisions relating to the Department of 
1.3 	Health, gas resource development, hospital stabilization, health licensing boards, 
1.4 	health care, federal conformity, medical assistance fraud prevention and conforming 
1.5 	changes, children, youth, and families policy, children, youth, and families budget, 
1.6 	the Minnesota African American Family Preservation and Child Welfare 
1.7 	Disproportionality Act, child care center licensing modernization, and family child 
1.8 	care licensing modernization; making forecast adjustments for the Department of 
1.9 	Human Services and Department of Children, Youth, and Families; appropriating 
1.10 	money for the Department of Children, Youth, and Families, Department of Human 
1.11 	Services, and other agencies; requiring reports; authorizing rulemaking; providing 
1.12 	criminal penalties;amending Minnesota Statutes 2024, sections 8.16, subdivision 
1.13 	1; 16A.152, subdivisions 2, 4, by adding subdivisions; 62A.01, by adding a 
1.14 	subdivision; 62A.011, subdivision 3; 62J.17, subdivision 6a; 62J.2930, subdivision 
1.15 	1; 62K.02, subdivision 2; 62K.03, subdivision 6; 62K.075; 62K.105; 62K.14; 
1.16 	62U.04, subdivisions 4, 13, by adding a subdivision; 62V.05, subdivision 7; 62V.13; 
1.17 	93.514; 103I.001; 103I.005, subdivisions 9, 21, by adding subdivisions; 103I.601, 
1.18 	subdivision 1, by adding subdivisions; 116.943, subdivision 2; 116J.035, by adding 
1.19 	a subdivision; 124D.19, by adding a subdivision; 142A.43; 142B.10, subdivision 
1.20 	18; 142B.30, by adding a subdivision; 142B.65, subdivision 7; 142B.70, subdivision 
1.21 	6; 142C.12, subdivision 3; 142D.05, subdivision 8; 142D.21, subdivision 6; 
1.22 	142D.25, subdivision 3; 142E.04, subdivision 4; 144.059, subdivision 8; 144.1222, 
1.23 	subdivision 4, by adding a subdivision; 144.1501, subdivision 2; 144.1503, 
1.24 	subdivision 7; 144.1505, subdivisions 1, 2, 3; 144.1507, subdivisions 1, 2, 4, by 
1.25 	adding a subdivision; 144.1911, subdivisions 1, 5, 6; 144.293, subdivision 7; 
1.26 	144.551, subdivision 1, as amended; 145.56, subdivision 5; 145.561, subdivision 
1.27 	2; 145.882, by adding subdivisions; 145A.04, subdivision 15; 145A.14, subdivision 
1.28 	2a; 148.01, subdivisions 1, 4, by adding subdivisions; 148.09; 148.10, by adding 
1.29 	a subdivision; 148.102, subdivision 3; 148.105, subdivision 1; 148.517, subdivisions 
1.30 	1, 2; 148.5191, subdivision 4; 149A.91, subdivision 3; 149A.94, subdivision 1; 
1.31 	149A.955, subdivision 14; 151.01, subdivision 35, by adding a subdivision; 
1.32 	151.555, subdivision 7; 151.741, subdivision 4; 214.10, subdivision 2a; 214.41; 
1.33 	245A.211, subdivision 1; 245C.04, subdivision 1; 245C.15, subdivisions 2, 3, 4; 
1.34 	256.01, by adding a subdivision; 256.969, subdivisions 2b, 25; 256B.04, subdivision 
1.35 	27; 256B.05, subdivision 5, by adding a subdivision; 256B.055, subdivision 17; 
1.36 	256B.056, subdivisions 1, 2a, 3d, 7, 7a; 256B.0561, subdivision 2; 256B.06, 
1.37 	subdivision 4; 256B.061; 256B.0631, subdivision 1a, by adding subdivisions; 
1.38 	256B.75; 256L.05, subdivision 3; 256L.06, subdivision 3; 259.83, subdivision 1, 
2.1 	as amended; 260.63, subdivision 10; 260.64, subdivision 2; 260.67, subdivision 
2.2 	1; 260.68, subdivision 2; 260.69, subdivision 1; 260.693, subdivision 2; 260C.190, 
2.3 	subdivision 1; 260C.212, subdivisions 1, 4a, by adding a subdivision; 260C.451, 
2.4 	subdivisions 2, 3, 3a; 295.52, subdivision 8; 383B.903, subdivisions 1, 4; 383B.904, 
2.5 	subdivision 1; 383B.908, subdivisions 5, 7; 471.6161, by adding a subdivision; 
2.6 	609.52, subdivision 2; Minnesota Statutes 2025 Supplement, sections 3.732, 
2.7 	subdivision 1; 62K.10, subdivision 2; 144.125, subdivision 1; 145A.061, 
2.8 	subdivision 3; 145C.18, subdivisions 3, 4; 148.108, subdivision 5; 151.741, 
2.9 	subdivision 5; 256.043, subdivision 3; 256.9657, subdivision 2b; 256.969, 
2.10 	subdivision 2f; 256B.0625, subdivision 8; 256B.12; 256B.1973, subdivision 9; 
2.11 	256B.69, subdivision 6d; 256B.695, subdivision 5; 260.691, subdivision 1; 260.692, 
2.12 	subdivisions 1, 2, 3; 260C.451, subdivision 8; 268.19, subdivision 1; 609.531, 
2.13 	subdivision 1; 609.902, subdivision 4; 628.26; Laws 2023, chapter 68, article 1, 
2.14 	sections 2, subdivision 2, as amended; 3, subdivision 2, as amended; Laws 2024, 
2.15 	chapter 117, sections 9; 21; 22; Laws 2024, chapter 127, article 67, section 7; Laws 
2.16 	2025, First Special Session chapter 3, article 8, section 25; article 23, section 2, 
2.17 	subdivision 12; Laws 2026, chapter 88, article 1, section 181; proposing coding 
2.18 	for new law in Minnesota Statutes, chapters 62Q; 103I; 142D; 144; 148; 256B; 
2.19 	260; 609; proposing coding for new law as Minnesota Statutes, chapters 142H; 
2.20 	142I; repealing Minnesota Statutes 2024, sections 13D.08, subdivision 4; 62J.06; 
2.21 	62J.156; 62J.2930, subdivision 4; 62J.57; 62U.10, subdivision 4; 142B.01, 
2.22 	subdivisions 11, 12, 13, 25, 26, 27; 142B.41, subdivisions 4, 6, 7, 8, 10, 11, 12, 
2.23 	13; 142B.54, subdivisions 1, 2, 3; 142B.62; 142B.65, subdivisions 1, 2, 3, 4, 5, 6, 
2.24 	7, 10; 142B.66, subdivisions 1, 2, 4, 5; 142B.70, subdivisions 1, 2, 3, 4, 5, 6, 9, 
2.25 	10, 11, 12; 142B.71; 142B.72; 142B.74; 142B.75; 142B.76; 142B.77; 144.9821; 
2.26 	151.741, subdivisions 2, 3, 6; 256B.198; 256B.69, subdivision 31a; 260.63, 
2.27 	subdivision 9; 609.466; Minnesota Statutes 2025 Supplement, sections 142B.41, 
2.28 	subdivision 9; 142B.65, subdivisions 8, 9; 142B.66, subdivision 3; 142B.70, 
2.29 	subdivisions 7, 8; Minnesota Rules, parts 2500.0100, subparts 5b, 6, 12; 2500.1900; 
2.30 	2500.2020; 2500.2040; 2500.2100; 2500.2110; 6800.0400; 6800.1150; 9502.0300; 
2.31 	9502.0315; 9502.0325; 9502.0335; 9502.0341; 9502.0345; 9502.0355; 9502.0365; 
2.32 	9502.0367; 9502.0375; 9502.0395; 9502.0405; 9502.0415; 9502.0425; 9502.0435; 
2.33 	9502.0445; 9503.0005; 9503.0010; 9503.0015; 9503.0030; 9503.0031; 9503.0032; 
2.34 	9503.0033; 9503.0034; 9503.0040; 9503.0045; 9503.0050; 9503.0055; 9503.0060; 
2.35 	9503.0065; 9503.0070; 9503.0075; 9503.0080; 9503.0085; 9503.0090; 9503.0095; 
2.36 	9503.0100; 9503.0105; 9503.0110; 9503.0115; 9503.0120; 9503.0125; 9503.0130; 
2.37 	9503.0140; 9503.0145; 9503.0150; 9503.0155; 9503.0170.
2.38 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.39 	ARTICLE 1
2.40 	DEPARTMENT OF HEALTH

2.41 	Section 1. Minnesota Statutes 2025 Supplement, section 3.732, subdivision 1, is amended 
2.42 	to read:
2.43 		Subdivision 1.Definitions. As used in this section and section 3.736 the terms defined 
2.44 	in this section have the meanings given them.
2.45 	(1) "State" includes each of the departments, boards, agencies, commissions, courts, and 
2.46 	officers in the executive, legislative, and judicial branches of the state of Minnesota and 
2.47 	includes but is not limited to the Housing Finance Agency, the Minnesota Office of Higher 
2.48 	Education, the Health and Education Facilities Authority, the Health Technology Advisory 
3.1 	Committee, the Armory Building Commission, the Zoological Board, the Department of 
3.2 	Iron Range Resources and Rehabilitation, the Minnesota Historical Society, the State 
3.3 	Agricultural Society, the University of Minnesota, the Minnesota State Colleges and 
3.4 	Universities, state hospitals, and state penal institutions. It does not include a city, town, 
3.5 	county, school district, or other local governmental body corporate and politic.
3.6 	(2) "Employee of the state" means all present or former officers, members, directors, or 
3.7 	employees of the state, members of the Minnesota National Guard, members of a bomb 
3.8 	disposal unit approved by the commissioner of public safety and employed by a municipality 
3.9 	defined in section 466.01 when engaged in the disposal or neutralization of bombs or other 
3.10 	similar hazardous explosives, as defined in section 299C.063, outside the jurisdiction of the 
3.11 	municipality but within the state, or persons acting on behalf of the state in an official 
3.12 	capacity, temporarily or permanently, with or without compensation. It does not include 
3.13 	either an independent contractor except, for purposes of this section and section 3.736 only, 
3.14 	a guardian ad litem acting under court appointment, or members of the Minnesota National 
3.15 	Guard while engaged in training or duty under United States Code, title 10, or title 32, 
3.16 	section 316, 502, 503, 504, or 505, as amended through December 31, 1983. Notwithstanding 
3.17 	sections 43A.02 and 611.263, for purposes of this section and section 3.736 only, "employee 
3.18 	of the state" includes a district public defender or assistant district public defender in the 
3.19 	Second or Fourth Judicial District, a member of the Health Technology Advisory Committee,
3.20 	and any officer, agent, or employee of the state of Wisconsin performing work for the state 
3.21 	of Minnesota pursuant to a joint state initiative.
3.22 	(3) "Scope of office or employment" means that the employee was acting on behalf of 
3.23 	the state in the performance of duties or tasks lawfully assigned by competent authority.
3.24 	(4) "Judicial branch" has the meaning given in section 43A.02, subdivision 25.

3.25 	Sec. 2. Minnesota Statutes 2024, section 62J.17, subdivision 6a, is amended to read:
3.26 		Subd. 6a.Prospective review and approval. (a) No health care provider subject to 
3.27 	prospective review under this subdivision shall make a major spending commitment unless:
3.28 	(1) the provider has filed an application with the commissioner to proceed with the major 
3.29 	spending commitment and has provided all supporting documentation and evidence requested 
3.30 	by the commissioner; and
3.31 	(2) the commissioner determines, based upon this documentation and evidence, that the 
3.32 	major spending commitment is appropriate under the criteria provided in subdivision 5a in 
3.33 	light of the alternatives available to the provider.
4.1 	(b) A provider subject to prospective review and approval shall submit an application 
4.2 	to the commissioner before proceeding with any major spending commitment. The provider 
4.3 	may submit information, with supporting documentation, regarding why the major spending 
4.4 	commitment should be excepted from prospective review under subdivision 7.
4.5 	(c) The commissioner shall determine, based upon the information submitted, whether 
4.6 	the major spending commitment is appropriate under the criteria provided in subdivision 
4.7 	5a, or whether it should be excepted from prospective review under subdivision 7. In making 
4.8 	this determination, the commissioner may also consider relevant information from other 
4.9 	sources. At the request of the commissioner, the health technology advisory committee shall 
4.10 	convene an expert review panel made up of persons with knowledge and expertise regarding 
4.11 	medical equipment, specialized services, health care expenditures, and capital expenditures 
4.12 	to review applications and make recommendations to the commissioner. The commissioner 
4.13 	shall make a decision on the application within 60 days after an application is received.
4.14 	(d) The commissioner of health has the authority to issue fines, seek injunctions, and 
4.15 	pursue other remedies as provided by law.

4.16 	Sec. 3. Minnesota Statutes 2024, section 62J.2930, subdivision 1, is amended to read:
4.17 		Subdivision 1.Establishment. The commissioner of health shall establish an information 
4.18 	clearinghouse within the Department of Health to facilitate the ability of consumers, 
4.19 	employers, providers, health plan companies, and others to obtain information on health 
4.20 	reform activities in Minnesota. The commissioner shall make available through the 
4.21 	clearinghouse updates on federal and state health reform activities, including information 
4.22 	developed or collected by the Department of Health on cost containment or other research 
4.23 	initiatives, the development of voluntary purchasing pools, action plans submitted by health 
4.24 	plan companies, reports or recommendations of the Health Technology Advisory Committee 
4.25 	and other entities on technology assessments, and reports or recommendations from other 
4.26 	formal committees applicable to health reform activities. The clearinghouse shall also refer 
4.27 	requestors to sources of further information or assistance. The clearinghouse is subject to 
4.28 	chapter 13.

4.29 	Sec. 4. Minnesota Statutes 2024, section 62K.02, subdivision 2, is amended to read:
4.30 		Subd. 2.Scope. (a) This chapter applies only to health plans offered in the individual 
4.31 	market or the small group market, including stand-alone dental plans sold on MNsure.
4.32 	(b) This chapter applies to health carriers with respect to individual health plans and 
4.33 	small group health plans, unless otherwise specified.
5.1 	(c) If a health carrier issues or renews individual or small group health plans in other 
5.2 	states, this chapter applies only to health plans issued or renewed in this state to a Minnesota 
5.3 	resident, or to cover a resident of the state, or issued or renewed to a small employer that 
5.4 	is actively engaged in business in this state, unless otherwise specified.
5.5 	(d) This chapter does not apply to short-term coverage as defined in section 62A.65, 
5.6 	subdivision 7, or grandfathered plan coverage as defined in section 62A.011, subdivision 
5.7 	1b.

5.8 	Sec. 5. Minnesota Statutes 2024, section 62K.03, subdivision 6, is amended to read:
5.9 		Subd. 6.Health plan. "Health plan" means a health plan as defined in section 62A.011, 
5.10 	subdivision 3, and includes stand-alone dental plans sold on MNsure.

5.11 	Sec. 6. Minnesota Statutes 2024, section 62K.075, is amended to read:
5.12 	62K.075 PROVIDER NETWORK NOTIFICATIONS.
5.13 	(a) A health carrier must provide on the carrier's website the provider network for each 
5.14 	product offered by the carrier, and must update the carrier's website at least once a month 
5.15 	with any changes to the carrier's provider network, including provider changes from 
5.16 	in-network status to out-of-network status. A health carrier must also provide on the carrier's 
5.17 	website, for each product offered by the carrier, a list of the current waivers of the 
5.18 	requirements in section 62K.10, subdivision 2or 3, in a format that is easily accessed and 
5.19 	searchable by enrollees and prospective enrollees.
5.20 	(b) Upon notification from an enrollee, a health carrier must reprocess any claim for 
5.21 	services provided by a provider whose status has changed from in-network to out-of-network 
5.22 	as an in-network claim if the service was provided after the network change went into effect 
5.23 	but before the change was posted as required under paragraph (a) unless the health carrier 
5.24 	notified the enrollee of the network change prior to the service being provided. This paragraph 
5.25 	does not apply if the health carrier is able to verify that the health carrier's website displayed 
5.26 	the correct provider network status on the health carrier's website at the time the service 
5.27 	was provided.
5.28 	(c) The limitations of section 62Q.56, subdivision 2a, shall apply to payments required 
5.29 	by paragraph (b).

6.1 	Sec. 7. Minnesota Statutes 2025 Supplement, section 62K.10, subdivision 2, is amended 
6.2 	to read:
6.3 		Subd. 2.Time and distance standards. Health carriers must meet the time and distance 
6.4 	standards under Code of Federal Regulations, title 45, section 155.1050, for all covered 
6.5 	health services, including dental, retail pharmacy, and specialty services.

6.6 	Sec. 8. Minnesota Statutes 2024, section 62K.105, is amended to read:
6.7 	62K.105 NETWORK ADEQUACY COMPLAINTS.
6.8 	The commissioner of health shall establish a clear, easily accessible process for accepting 
6.9 	complaints from enrollees regarding health carrier compliance with section 62K.10, 
6.10 	subdivision 2, 3, or 4. Using this process, an enrollee may file a complaint with the 
6.11 	commissioner that a health carrier is not in compliance with the requirements of section 
6.12 	62K.10, subdivision 2, 3, or 4. The commissioner of health shall investigate all complaints 
6.13 	received under this section.

6.14 	Sec. 9. Minnesota Statutes 2024, section 62K.14, is amended to read:
6.15 	62K.14 LIMITED-SCOPE PEDIATRIC DENTAL PLANS.
6.16 	(a) Limited-scope pediatric dental plans must be offered to the extent permitted under 
6.17 	the Affordable Care Act: (1) on a guaranteed issue and guaranteed renewable basis; (2) with 
6.18 	premiums rated on allowable rating factors used for health plans; and (3) without any 
6.19 	exclusions or limitations based on preexisting conditions.
6.20 	(b) Notwithstanding paragraph (a), a health carrier may discontinue a limited scope 
6.21 	pediatric dental plan at the end of a plan year if the health carrier provides written notice to 
6.22 	enrollees before coverage is to be discontinued that the particular plan is being discontinued 
6.23 	and the health carrier offers enrollees other dental plan options that are the same or 
6.24 	substantially similar to the dental plan being discontinued in terms of premiums, benefits, 
6.25 	cost-sharing requirements, and network adequacy. The written notice to enrollees must be 
6.26 	provided at least 105 days before the end of the plan year.
6.27 	(c) Limited-scope pediatric dental plans must ensure primary care dental services are 
6.28 	available within 60 miles or 60 minutes' travel time.
6.29 	(d) (c) If a stand-alone dental plan as defined under the Affordable Care Act or a 
6.30 	limited-scope pediatric dental plan is offered, either separately or in conjunction with a 
6.31 	health plan offered to individuals or small employers, the health plan shall not be considered 
6.32 	in noncompliance with the requirements of the essential benefit package in the Affordable 
7.1 	Care Act because the health plan does not offer coverage of pediatric dental benefits if these 
7.2 	benefits are covered through the stand-alone or limited-scope pediatric dental plan, to the 
7.3 	extent permitted under the Affordable Care Act.
7.4 	(e) (d) Health carriers offering limited-scope pediatric dental plans must comply with 
7.5 	this section and sections 62K.07, 62K.08, 62K.10,62K.13, and 62K.15.
7.6 	(f) (e) The commissioner of commerce shall enforce paragraphs (a) and (b). Any 
7.7 	limited-scope pediatric dental plan that is to be offered to replace a discontinued dental plan 
7.8 	under paragraph (b) must be approved by the commissioner of commerce in terms of cost 
7.9 	and benefit similarity, and the commissioner of health in terms of network adequacy 
7.10 	similarity. The commissioner of health shall enforce paragraph (c).

7.11 	Sec. 10. Minnesota Statutes 2024, section 62U.04, subdivision 4, is amended to read:
7.12 		Subd. 4.Encounter data. (a) All health plan companies, dental organizations, and 
7.13 	third-party administrators shall submit encounter data on a monthly basis to a private entity 
7.14 	designated by the commissioner of health. The data shall be submitted in a form and manner 
7.15 	specified by the commissioner subject to the following requirements:
7.16 	(1) the data must be de-identified data as described under the Code of Federal Regulations, 
7.17 	title 45, section 164.514;
7.18 	(2) the data for each encounter must include an identifier for the patient's health care 
7.19 	home if the patient has selected a health care home, data on contractual value-based payments, 
7.20 	and data deemed necessary by the commissioner to uniquely identify claims in the individual 
7.21 	health insurance market;
7.22 	(3) the data must include enrollee race and ethnicity, to the extent available, for claims 
7.23 	incurred on or after January 1, 2023; and
7.24 	(4) except for the data described in clauses (2) and (3), the data must not include 
7.25 	information that is not included in a health care claim, dental care claim, or equivalent 
7.26 	encounter information transaction that is required under section 62J.536.; and
7.27 	(5) the data must include at least the following data fields for any fully denied claims:
7.28 	(i) an indicator of which claim lines were denied;
7.29 	(ii) the reason for denial of each denied claim line;
7.30 	(iii) the claim line status in terms of adjudication; and
7.31 	(iv) a claim identifier to link the original claim to subsequent action on the claim.
8.1 	(b) The commissioner or the commissioner's designee shall only use the data submitted 
8.2 	under paragraph (a) to carry out the commissioner's responsibilities in this section, including 
8.3 	supplying the data to providers so they can verify their results of the peer grouping process 
8.4 	consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d), 
8.5 	and adopted by the commissioner and, if necessary, submit comments to the commissioner 
8.6 	or initiate an appeal.
8.7 	(c) Data on providers collected under this subdivision are private data on individuals or 
8.8 	nonpublic data, as defined in section 13.02. Notwithstanding the data classifications in this 
8.9 	paragraph, data on providers collected under this subdivision may be released or published 
8.10 	as authorized in subdivision 11. The commissioner or the commissioner's designee shall 
8.11 	establish procedures and safeguards to protect the integrity and confidentiality of any data 
8.12 	that it maintains.
8.13 	(d) The commissioner or the commissioner's designee shall not publish analyses or 
8.14 	reports that identify, or could potentially identify, individual patients.
8.15 	(e) The commissioner shall compile summary information on the data submitted under 
8.16 	this subdivision. The commissioner shall work with its vendors to assess the data submitted 
8.17 	in terms of compliance with the data submission requirements and the completeness of the 
8.18 	data submitted by comparing the data with summary information compiled by the 
8.19 	commissioner and with established and emerging data quality standards to ensure data 
8.20 	quality.

8.21 	Sec. 11. Minnesota Statutes 2024, section 62U.04, subdivision 13, is amended to read:
8.22 		Subd. 13.Expanded access to and use of the all-payer claims data. (a) The 
8.23 	commissioner or the commissioner's designee shall make the data submitted under 
8.24 	subdivisions 4, 5, 5a, and 5b, including data classified as private or nonpublic, available to 
8.25 	individuals and organizations engaged in research on, or efforts to effect transformation in, 
8.26 	health care outcomes, access, quality, disparities, or spending, provided the use of the data 
8.27 	serves a public benefit. Data made available under this subdivision may not be used to:
8.28 	(1) create an unfair market advantage for any participant in the health care market in 
8.29 	Minnesota, including health plan companies, payers, and providers;
8.30 	(2) reidentify or attempt to reidentify an individual in the data; or
8.31 	(3) publicly report contract details between a health plan company and provider and 
8.32 	derived from the data.
8.33 	(b) To implement paragraph (a), the commissioner shall:
9.1 	(1) establish detailed requirements for data access; a process for data users to apply to 
9.2 	access and use the data; legally enforceable data use agreements to which data users must 
9.3 	consent; a clear and robust oversight process for data access and use, including a data 
9.4 	management plan, that ensures compliance with state and federal data privacy laws; 
9.5 	agreements for state agencies and the University of Minnesota to ensure proper and efficient 
9.6 	use and security of data; and technical assistance for users of the data and for stakeholders;
9.7 	(2) develop a assess fees according to the fee schedule in subdivision 14 to support the 
9.8 	cost of expanded access to and use of the data, provided the fees charged under the schedule 
9.9 	do not create a barrier to access or use for those most affected by disparities; and
9.10 	(3) create a research advisory group to advise the commissioner on applications for data 
9.11 	use under this subdivision, including an examination of the rigor of the research approach, 
9.12 	the technical capabilities of the proposed user, and the ability of the proposed user to 
9.13 	successfully safeguard the data.; and
9.14 	(4) annually publish on the Department of Health website a list of projects authorized 
9.15 	under this subdivision.

9.16 	Sec. 12. Minnesota Statutes 2024, section 62U.04, is amended by adding a subdivision to 
9.17 	read:
9.18 		Subd. 14.Fees for expanded access to and use of the all-payer claims database. (a) 
9.19 	For purposes of this section:
9.20 	(1) "custom data set or analysis" means a de-identified data set or report for which a 
9.21 	standard data set or limited use data sets are not appropriate, that only provides the minimum 
9.22 	necessary data, and that is de-identified using the expert determination method as defined 
9.23 	in Code of Federal Regulations, title 45, section 164.514(b)(1);
9.24 	(2) "data file" means a data file derived from medical claims, pharmacy claims, dental 
9.25 	claims, eligibility information, membership information, or provider information for a single 
9.26 	year;
9.27 	(3) "limited use data set" means a data set that meets the requirements in Code of Federal 
9.28 	Regulations, title 45, section 164.514(e)(2), and may include protected health information 
9.29 	from which certain direct identifiers of individuals have been removed under the principle 
9.30 	of minimum information necessary; and
9.31 	(4) "standard data set" means a static data release designed by the commissioner to serve 
9.32 	a wide range of projects in which nearly all de-identified data elements are disclosed in one 
9.33 	release after applying the safe harbor de-identification method defined in Code of Federal 
10.1 	Regulations, title 45, section 164.514(b)(2), and from which protected health information 
10.2 	and any combination of data elements that directly identify any person are excluded.
10.3 	(b) The commissioner must assess fees on an individual or organization that receives 
10.4 	data under subdivision 13 for the cost of accessing or receiving the data. Costs under this 
10.5 	paragraph may include but are not limited to the cost of producing and releasing data to the 
10.6 	individual or organization under subdivision 13 and managing infrastructure and operations. 
10.7 	The commissioner must assess fees according to the following schedule based on the type 
10.8 	of data requested and number of years for which access is requested:
10.9 	(1) the fee for a standard data set is $3,500 per data file per year;
10.10 	(2) the fee for a limited use data set is $7,000 per data file per year; and
10.11 	(3) the fee for a custom data set or analysis is $89 per hour of staff time expended, with 
10.12 	fees not to exceed $5,785.
10.13 	(c) An individual or organization that receives approval to access or receive data under 
10.14 	subdivision 13 must pay all the required fees in full before accessing or receiving the 
10.15 	requested data.
10.16 	(d) The commissioner may grant a partial or full waiver of the fees in paragraph (b) if 
10.17 	the individual or organization requesting the data meets at least one of the following criteria:
10.18 	(1) the fees represent a financial hardship to the individual or organization;
10.19 	(2) the organization is a self-insured data submitter under this section;
10.20 	(3) the individual or organization is affiliated with an academic institution;
10.21 	(4) the individual or organization requests a high volume of data files; or
10.22 	(5) the request is from a Tribal health director for, or the governing body of, one of the 
10.23 	11 federally recognized Tribes in Minnesota.
10.24 	In determining whether to grant a waiver under this paragraph, the commissioner may 
10.25 	consult the research advisory group established under subdivision 13.
10.26 	(e) Fees paid by an individual or organization approved to access or receive data under 
10.27 	subdivision 13 are nonrefundable. Fees collected under this subdivision must be deposited 
10.28 	into an account in the state government special revenue fund. Money in that account does 
10.29 	not cancel.
10.30 	(f) The commissioner must publish the fee schedule in paragraph (b) on the Department 
10.31 	of Health website.

11.1 	Sec. 13. Minnesota Statutes 2024, section 144.059, subdivision 8, is amended to read:
11.2 		Subd. 8.Duties. (a) The council shall consult with and advise the commissioner on 
11.3 	matters related to the establishment, maintenance, operation, and outcomes evaluation of 
11.4 	palliative care initiatives in the state.
11.5 	(b) By February 15 of each odd-numbered year, the council shall submit to the chairs 
11.6 	and ranking minority members of the committees of the senate and the house of 
11.7 	representatives with primary jurisdiction over health care a report containing:
11.8 	(1) the advisory council's assessment of the availability of palliative care in the state;
11.9 	(2) the advisory council's analysis of barriers to greater access to palliative care; and
11.10 	(3) recommendations for legislative action, with draft legislation to implement the 
11.11 	recommendations.
11.12 	(c) The Department of Health shall publish the report each year on the department's 
11.13 	website.

11.14 	Sec. 14. Minnesota Statutes 2024, section 144.1222, is amended by adding a subdivision 
11.15 	to read:
11.16 		Subd. 2e.Private residential pool used for certified swimming classes. Notwithstanding 
11.17 	Minnesota Rules, part 4717.0250, subpart 7, a private residential pool may be used as part 
11.18 	of a business if the private residential pool is used by a paying guest of the homeowner and 
11.19 	the guest is participating in a certified swimming class conducted by the homeowner, 
11.20 	provided that:
11.21 	(1) the homeowner is a certified swimming instructor and is conducting a certified 
11.22 	swimming class on a one-on-one basis;
11.23 	(2) not more than four individuals are in the pool at the same time during the class;
11.24 	(3) prior to each new paying guest beginning participation in a certified swimming class:
11.25 	(i) the guest, or the guest's parent or legal guardian if the guest is a minor, provides 
11.26 	written consent to use of the pool. The written consent must include a statement that the 
11.27 	guest, or the guest's parent or legal guardian if the guest is a minor, has received and read 
11.28 	materials provided by the Department of Health with information on the risk of disease 
11.29 	transmission and other risks associated with pools; and a statement that the Department of 
11.30 	Health does not monitor or inspect the homeowner's pool to ensure compliance with the 
11.31 	requirements in this section or Minnesota Rules, chapter 4717; and
12.1 	(ii) the homeowner tests the pool's water for the concentration of chlorine or bromine, 
12.2 	pH, and alkalinity, and the water in the pool meets the requirements for disinfection residual, 
12.3 	pH, and alkalinity in Minnesota Rules, part 4717.1750, subparts 3 to 6; and
12.4 	(4) the following notice is conspicuously posted at the pool and, prior to each new paying 
12.5 	guest beginning participation in a certified swimming class, is provided to the guest or to 
12.6 	the guest's parent or legal guardian if the guest is a minor:
12.7 	"NOTICE
12.8 	This pool is exempt from state and local anti-entrapment and sanitary requirements that 
12.9 	prevent waterborne diseases and chemical burns and is not subject to inspection.
12.10 	USE AT YOUR OWN RISK"

12.11 	Sec. 15. Minnesota Statutes 2024, section 144.1222, subdivision 4, is amended to read:
12.12 		Subd. 4.Definitions. (a) For purposes of this section, the following terms have the 
12.13 	meanings given them.
12.14 	(b) "ASME/ANSI standard" means a safety standard accredited by the American National 
12.15 	Standards Institute and published by the American Society of Mechanical Engineers.
12.16 	(c) "ASTM standard" means a safety standard issued by ASTM International, formerly 
12.17 	known as the American Society for Testing and Materials.
12.18 	(d) "Public pool" means any pool other than a private residential pool, that is: (1) open 
12.19 	to the public generally, whether for a fee or free of charge; (2) open exclusively to members 
12.20 	of an organization and their guests; (3) open to residents of a multiunit apartment building, 
12.21 	apartment complex, residential real estate development, or other multifamily residential 
12.22 	area; (4) open to patrons of a hotel or lodging or other public accommodation facility; or 
12.23 	(5) operated by a person in a park, school, licensed child care facility, group home, motel, 
12.24 	camp, resort, club, condominium, manufactured home park, or political subdivision with 
12.25 	the exception of swimming pools at family day care homes licensed under section 142B.41, 
12.26 	subdivision 9, paragraph (a).
12.27 	(e) "Unblockable suction outlet or drain" means a drain of any size and shape that a 
12.28 	human body cannot sufficiently block to create a suction entrapment hazard and meets 
12.29 	ASME/ANSI standards.
12.30 	(f) "Certified swimming class" means an infant swimming resource (ISR) class; an 
12.31 	American Red Cross swimming class, swimming lesson, or learn-to-swim class; or any 
13.1 	other swimming class certified by a nationally accredited organization that operates in all 
13.2 	50 states.
13.3 	(g) "Certified swimming instructor" means a certified ISR instructor; a certified American 
13.4 	Red Cross swimming instructor or swim coach; or any other swimming instructor certified 
13.5 	by a nationally accredited organization that operates in all 50 states.

13.6 	Sec. 16. Minnesota Statutes 2025 Supplement, section 144.125, subdivision 1, is amended 
13.7 	to read:
13.8 		Subdivision 1.Duty to perform testing. (a) It is the duty of (1) the administrative officer 
13.9 	or other person in charge of each institution caring for infants 28 days or less of age, (2) the 
13.10 	person required in pursuance of the provisions of section 144.215, to register the birth of a 
13.11 	child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have 
13.12 	administered to every infant or child in its care tests for heritable and congenital disorders 
13.13 	according to subdivision 2 and rules prescribed by the state commissioner of health.
13.14 	(b) Testing, recording of test results, reporting of test results, and follow-up of infants 
13.15 	with heritable congenital disorders, including hearing loss detected through the early hearing 
13.16 	detection and intervention program in section 144.966, shall be performed at the times and 
13.17 	in the manner prescribed by the commissioner of health.
13.18 	(c) The fee to support the newborn screening program, including tests administered 
13.19 	under this section and section 144.966, shall be $184.35 per specimen. This fee amount 
13.20 	shall be deposited in the state treasury and credited to the state government special revenue 
13.21 	fund. If the individual described in paragraph (a) submits to an insurer a claim for 
13.22 	reimbursement for a newborn screening program fee but does not receive reimbursement 
13.23 	from the insurer, the individual may request a special fee exemption form from the newborn 
13.24 	screening program and may apply for an exemption from the fee. To qualify for the 
13.25 	exemption, the individual must provide documentation to the newborn screening program 
13.26 	that the insurer did not reimburse the individual for the fee.
13.27 	(d) The fee to offset the cost of the support services provided under section 144.966, 
13.28 	subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury 
13.29 	and credited to the general fund.

13.30 	Sec. 17. Minnesota Statutes 2024, section 144.1501, subdivision 2, is amended to read:
13.31 		Subd. 2.Availability. (a) The commissioner of health shall use money appropriated for 
13.32 	health professional education loan forgiveness in this section:
14.1 	(1) for medical residents, physicians, mental health professionals, and alcohol and drug 
14.2 	counselors agreeing to practice in designated rural areas or underserved urban communities 
14.3 	or specializing in the area of pediatric psychiatry;
14.4 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
14.5 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
14.6 	at the undergraduate level or the equivalent at the graduate level;
14.7 	(3) for nurses who agree to practice in a Minnesota nursing home; in an intermediate 
14.8 	care facility for persons with developmental disability; in a hospital if the hospital owns 
14.9 	and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked 
14.10 	by the nurse is in the nursing home; in an assisted living facility as defined in section 
14.11 	144G.08, subdivision 7; or for a home care provider as defined in section 144A.43, 
14.12 	subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing 
14.13 	field in a postsecondary program at the undergraduate level or the equivalent at the graduate 
14.14 	level;
14.15 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
14.16 	hours per year in their designated field in a postsecondary program at the undergraduate 
14.17 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
14.18 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
14.19 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
14.20 	technology, radiologic technology, and surgical technology;
14.21 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
14.22 	who agree to practice in designated rural areas;
14.23 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
14.24 	encounters to state public program enrollees or patients receiving sliding fee schedule 
14.25 	discounts through a formal sliding fee schedule meeting the standards established by the 
14.26 	United States Department of Health and Human Services under Code of Federal Regulations, 
14.27 	title 42, section 51c.303; and
14.28 	(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct 
14.29 	care to patients at the nonprofit hospital.
14.30 	(b) Appropriations made for health professional education loan forgiveness in this section 
14.31 	do not cancel and are available until expended, except that at the end of each biennium, any 
14.32 	remaining balance in the account that is not committed by contract and not needed to fulfill 
14.33 	existing commitments shall cancel to the fund.

15.1 	Sec. 18. Minnesota Statutes 2024, section 144.1503, subdivision 7, is amended to read:
15.2 		Subd. 7.Selection process. The commissioner shall determine a maximum award for 
15.3 	grants and loan forgiveness, and shall make selections based on the information provided 
15.4 	in the grant application, including the demonstrated need for an applicant provider to enhance 
15.5 	the education of its workforce, the proposed employee scholarship or loan forgiveness 
15.6 	selection process, the applicant's proposed budget, and other criteria as determined by the 
15.7 	commissioner. Notwithstanding any law or rule to the contrary, amounts appropriated for 
15.8 	purposes of this section do not cancel and are available until expended, except that at the 
15.9 	end of each biennium, any remaining amount that is not committed by contract and not 
15.10 	needed to fulfill existing commitments shall cancel to the general fund.

15.11 	Sec. 19. Minnesota Statutes 2024, section 144.1505, subdivision 1, is amended to read:
15.12 		Subdivision 1.Definitions. For purposes of this section, the following definitions apply:
15.13 	(1) "eligible advanced practice registered nurse program" means a program that is located 
15.14 	in Minnesota and is currently accredited as a master's, doctoral, or postgraduate level 
15.15 	advanced practice registered nurse program by the Commission on Collegiate Nursing 
15.16 	Education or by the Accreditation Commission for Education in Nursing, or is presents a 
15.17 	credible plan as a candidate for accreditation;
15.18 	(2) "eligible dental therapy program" means a dental therapy education program or 
15.19 	advanced dental therapy education program that is located in Minnesota and is either that:
15.20 	(i) is approved by the Board of Dentistry; or
15.21 	(ii) is currently accredited by the Commission on Dental Accreditation; or
15.22 	(iii) presents a credible plan as a candidate for accreditation;
15.23 	(3) "eligible mental health professional program" means a program that is located in 
15.24 	Minnesota and is listedcurrently accredited as a mental health professional program by the 
15.25 	appropriate accrediting body for clinical social work, psychology, marriage and family 
15.26 	therapy, or licensed professional clinical counseling, or is presents a credible plan as a 
15.27 	candidate for accreditation;
15.28 	(4) "eligible pharmacy program" means a program that is located in Minnesota and is 
15.29 	currently accredited as a doctor of pharmacy program by the Accreditation Council on 
15.30 	Pharmacy Education or presents a credible plan as a candidate for accreditation;
15.31 	(5) "eligible physician assistant program" means a program that is located in Minnesota 
15.32 	and is currently accredited as a physician assistant program by the Accreditation Review 
16.1 	Commission on Education for the Physician Assistant, or is presents a credible plan as a 
16.2 	candidate for accreditation;
16.3 	(6) "mental health professional" means an individual providing clinical services in the 
16.4 	treatment of mental illness who meets one of the qualifications under section 245.462, 
16.5 	subdivision 18;
16.6 	(7) "eligible physician training program" means a medical school training program or a 
16.7 	physician residency training program located in Minnesota and that is currently accredited 
16.8 	by the accrediting body or has presented a credible plan as a candidate for accreditation;
16.9 	(8) "eligible dental program" means a dental education program or a dental residency 
16.10 	training program located in Minnesota and that is currently accredited by the accrediting 
16.11 	body or has presented a credible plan as a candidate for accreditation; and
16.12 	(9) "project" means a project to establish or expand(i) plan or implement a new eligible 
16.13 	clinical training for physician assistants, advanced practice registered nurses, pharmacists, 
16.14 	dental therapists, advanced dental therapists, or mental health professionals in Minnesota.
16.15 	program or increase the base number of trainees in an existing eligible clinical training 
16.16 	program, or (ii) add or expand rural rotations or clinical training experiences in an existing 
16.17 	eligible clinical training program;
16.18 	(10) "rural community" means a Tribal Nation, statutory city, home rule charter city, or 
16.19 	township in Minnesota that is outside the seven-county metropolitan area as defined in 
16.20 	section 473.121, subdivision 2; and
16.21 	(11) "underserved community" means a Minnesota area or population included in the 
16.22 	list of designated primary medical care health professional shortage areas, medically 
16.23 	underserved areas, or medically underserved populations maintained and updated by the 
16.24 	United States Department of Health and Human Services.

16.25 	Sec. 20. Minnesota Statutes 2024, section 144.1505, subdivision 2, is amended to read:
16.26 		Subd. 2.Programs. (a) For advanced practice provider clinical training expansion grants, 
16.27 	the commissioner of health shall award health professional training site grants to eligible 
16.28 	physician assistant, advanced practice registered nurse, pharmacy, dental therapy, and mental 
16.29 	health professional programs to plan and implement expandeda new eligible clinical training 
16.30 	program or increase the base number of trainees in an existing eligible clinical training
16.31 	program. Clinical training must take place in communities outside the seven-county 
16.32 	metropolitan area as defined in section 473.121, subdivision 2, or in underserved 
16.33 	communities. A planning grant shall not exceed $75,000, and a three-year training grant 
17.1 	shall not exceed $300,000 per project. The commissioner may provide a one-year, no-cost 
17.2 	extension for grants.
17.3 	(b) For health professional rural and underserved clinical rotations grants, the 
17.4 	commissioner of health shall award health professional training site grants to existing eligible 
17.5 	physician, physician assistant, advanced practice registered nurse, pharmacy, dentistry, 
17.6 	dental therapy, and mental health professional training programs to augment existing clinical 
17.7 	training programs to add, expand, or enhance rural and underserved rotations or clinical 
17.8 	training experiences, such as credential or certificate rural tracks or other specialized training. 
17.9 	Rotations and clinical training experiences must take place in rural communities, excluding 
17.10 	the cities of Duluth, Moorhead, Rochester, and St. Cloud. For physician and dentist training, 
17.11 	the expanded training must include rotations in primary care settings such as community 
17.12 	clinics, hospitals, health maintenance organizations, or practices in rural communities.
17.13 	(c) Advanced practice provider clinical training expansion grant funds may be used for:
17.14 	(1) establishing or expanding rotations planning and implementing a new clinical training
17.15 	program or increasing the base number of trainees in an existing clinical training program 
17.16 	as described in paragraph (a);
17.17 	(2) recruitment, training, and retention of students and, faculty, and preceptors;
17.18 	(3) connecting students with appropriate clinical training sites, internships, practicums, 
17.19 	or externship activities opportunities;
17.20 	(4) travel and lodging for students;
17.21 	(5) faculty, student, and preceptor salaries, incentives, or other financial support;
17.22 	(6) development and implementation of health equity and cultural competency
17.23 	responsiveness training;
17.24 	(7) evaluations of the clinical training program to inform program improvements;
17.25 	(8) training site improvements, fees, equipment, and supplies required to establish, 
17.26 	maintain, or expand a training program; and
17.27 	(9) supporting clinical education in which trainees are part of a primary care team model.; 
17.28 	and
17.29 	(10) onboarding expenses for trainees to meet clinical training site requirements.
17.30 	(d) Health professional rural clinical rotation grant funds may be used for:
18.1 	(1) adding, expanding, or enhancing rural rotations and clinical training experiences in 
18.2 	an existing clinical training program as described in paragraph (b);
18.3 	(2) recruitment, training, and retention of students, faculty, and preceptors;
18.4 	(3) connecting students with appropriate clinical training sites, internships, practicums, 
18.5 	or externship opportunities;
18.6 	(4) travel and lodging for students;
18.7 	(5) faculty, student, and preceptor salaries, stipends, or other financial support;
18.8 	(6) development and implementation of health equity and cultural responsiveness training;
18.9 	(7) evaluations of the rural rotation or clinical training experience to inform program 
18.10 	improvements;
18.11 	(8) training site improvements, fees, equipment, and supplies required to establish or 
18.12 	expand rural rotations or clinical training experiences;
18.13 	(9) supporting clinical education in which trainees are part of a primary care team model; 
18.14 	and
18.15 	(10) onboarding expenses for trainees to meet clinical training site requirements.

18.16 	Sec. 21. Minnesota Statutes 2024, section 144.1505, subdivision 3, is amended to read:
18.17 		Subd. 3.Applications. (a) Eligible physician assistant, advanced practice registered 
18.18 	nurse, pharmacy, dental therapy, dental, physician, and mental health professional programs 
18.19 	seeking a grant shall apply to the commissioner. Applications for advanced practice provider 
18.20 	clinical training expansion grants must include a description of the number of additional 
18.21 	students who will be trained using grant funds;and attestation that funding will be used to 
18.22 	support an increase in the number of clinical training slots;.
18.23 	(b) All applications must include a description of the problem that the proposed project 
18.24 	will address; a description of the project, including all costs associated with the project,;
18.25 	sources of funds for the project,; detailed uses of all funds for the project, and the results 
18.26 	expected; and a plan to maintain or operate any component included in the project after the 
18.27 	grant period, including a description of potential barriers to sustainability. The applicant
18.28 	Applicants must describe achievable objectives, a timetable, and roles and capabilities of 
18.29 	responsible individuals in the organization.
18.30 	Applicants applying under subdivision 2, paragraph (b), (c) Applications for rural clinical 
18.31 	rotation grants must include a description of the new, expanded, or enhanced rural rotations 
19.1 	or clinical training experiences; attestation that funding will be used to support improved 
19.2 	rural clinical training experiences; and information about length of training and training site 
19.3 	settings, geographic location of rural sites, and rural populations expected to be served.

19.4 	Sec. 22. Minnesota Statutes 2024, section 144.1507, subdivision 1, is amended to read:
19.5 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
19.6 	the meanings given.
19.7 	(b) "Eligible program" means a program that meets the following criteria:
19.8 	(1) is located in Minnesota;
19.9 	(2) trains medical residents in the specialties of family medicine, general internal 
19.10 	medicine, general pediatrics, psychiatry, geriatrics, or general surgery in rural residency 
19.11 	training programs or in community-based ambulatory care centers that primarily serve the 
19.12 	underserved, or trains postdoctoral psychology residents; and
19.13 	(3) is accredited by the Accreditation Council for Graduate Medical Education or the 
19.14 	American Psychological Association or presents a credible plan to obtain accreditation.
19.15 	(c) "Rural community" means a Tribal Nation, statutory city, home rule charter city, or 
19.16 	township in Minnesota that is outside the seven-county metropolitan area as defined in 
19.17 	section 473.121, subdivision 2, excluding the cities of Duluth, Mankato, Moorhead, 
19.18 	Rochester, and St. Cloud.
19.19 	(c) (d) "Rural residency training program" means a rural medical residency program or 
19.20 	a rural psychology residency program that provides an initial year of training in an accredited 
19.21 	residency program in Minnesota. The subsequent years of the residency program are At 
19.22 	least two-thirds of the residency training must be based in rural communities, utilizing local 
19.23 	clinics and community hospitals, with specialty rotations in nearby regional medical centers.
19.24 	When specialty rotations cannot take place within rural communities, training may occur 
19.25 	in nonrural sites provided that at least one-half of all training occurs in rural communities. 
19.26 	For residency training programs in general surgery, pediatrics, and psychiatry, at least 
19.27 	one-half of the residency training must be based in communities outside the seven-county 
19.28 	metropolitan area, with rotations in rural communities.
19.29 	(d) (e) "Community-based ambulatory care centers" means federally qualified health 
19.30 	centers, community mental health centers, rural health clinics, health centers operated by 
19.31 	the Indian Health Service, an Indian Tribe or Tribal organization, or an urban American 
19.32 	Indian organization or an entity receiving funds under Title X of the Public Health Service 
19.33 	Act.
20.1 	(e) (f) "Eligible project" means a project to establish and maintain a rural residency 
20.2 	training program.

20.3 	Sec. 23. Minnesota Statutes 2024, section 144.1507, subdivision 2, is amended to read:
20.4 		Subd. 2.Rural residency training program. (a) The commissioner of health shall 
20.5 	award rural residency training program grants to eligible programs to plan, implement, and 
20.6 	sustain rural residency training programs. A rural medical residency training program grant 
20.7 	shall not exceed $250,000 per year for up to three years for planning and development, and 
20.8 	$225,000 per resident per year for each year thereafter to sustain the program. A rural 
20.9 	psychology residency training program grant shall not exceed $150,000 per year for up to 
20.10 	three years for planning and development and $150,000 per resident per year for each year 
20.11 	thereafter to sustain the program. Medical and psychology residency programs that meet 
20.12 	eligibility guidelines and continue to demonstrate financial need shall be granted sustaining 
20.13 	funds, renewable every five years.
20.14 	(b) Funds may be spent to cover the costs of:
20.15 	(1) planning related to establishing accredited rural residency training programs;
20.16 	(2) obtaining accreditation by the Accreditation Council for Graduate Medical Education, 
20.17 	the American Psychological Association, or another national body that accredits rural 
20.18 	residency training programs;
20.19 	(3) establishing new rural residency training programs;
20.20 	(4) recruitment, training, and retention of new residents and faculty related to the new 
20.21 	rural residency training program;
20.22 	(5) travel and lodging for new residents;
20.23 	(6) faculty, new resident, and preceptor salaries related to new rural residency training 
20.24 	programs;
20.25 	(7) training site improvements, fees, equipment, and supplies required for new rural 
20.26 	residency training programs; and
20.27 	(8) supporting clinical education in which trainees are part of a primary care team model.

20.28 	Sec. 24. Minnesota Statutes 2024, section 144.1507, subdivision 4, is amended to read:
20.29 		Subd. 4.Consideration of grant applications. The commissioner shall review each 
20.30 	application to determine if the residency program application is complete, if the proposed 
20.31 	rural residency program and residency slots are eligible for a grant, and if the program is 
21.1 	eligible for federal graduate medical education funding, and when the funding is available. 
21.2 	If eligible programs are not eligible for federal graduate medical education funding, the 
21.3 	commissioner may award continuation funding to the eligible program beyond the initial 
21.4 	grant period without requiring a competitive application. The commissioner shall award 
21.5 	grants to support training programs in family medicine, general internal medicine, general 
21.6 	pediatrics, psychiatry, geriatrics, general surgery, psychology, and other primary care focus 
21.7 	areas.

21.8 	Sec. 25. Minnesota Statutes 2024, section 144.1507, is amended by adding a subdivision 
21.9 	to read:
21.10 		Subd. 6.Clinical training program coordination. The commissioner may award grants 
21.11 	to the University of Minnesota to provide technical assistance to residency training programs 
21.12 	for coordinated development of rural clinical training programs statewide.

21.13 	Sec. 26. Minnesota Statutes 2024, section 144.1911, subdivision 1, is amended to read:
21.14 		Subdivision 1.Establishment. The international medical graduates assistance program 
21.15 	is established to address barriers to practice and facilitate pathways to assist immigrant 
21.16 	international medical graduates to integrate into the Minnesota health care delivery system, 
21.17 	with the goal of increasing access to primary care in rural and underserved areas of the state.
21.18 	Notwithstanding any law to the contrary, appropriations made to the program do not cancel 
21.19 	and are available until expended.

21.20 	Sec. 27. Minnesota Statutes 2024, section 144.1911, subdivision 5, is amended to read:
21.21 		Subd. 5.Clinical preparation. (a) The commissioner shall award grants to support 
21.22 	clinical preparation for Minnesota international medical graduates needing additional clinical 
21.23 	preparation or experience to qualify for residency. The grant program shall include:
21.24 	(1) proposed training curricula;
21.25 	(2) associated policies and procedures for clinical training sites, which must be part of 
21.26 	existing clinical medical education programs in Minnesota; and
21.27 	(3) monthly stipends for international medical graduate participants. Priority shall be 
21.28 	given to primary care sites in rural or underserved areas of the state, and. International 
21.29 	medical graduate participants who receive funding through the international medical graduate 
21.30 	primary care residency grant program must commit to serving at least five years in a rural 
21.31 	or underserved community of the state.
22.1 	(b) The policies and procedures for the clinical preparation grants must be developed 
22.2 	by December 31, 2015, including an implementation schedule that begins awarding grants 
22.3 	to clinical preparation programs beginning in June of 2016.

22.4 	Sec. 28. Minnesota Statutes 2024, section 144.1911, subdivision 6, is amended to read:
22.5 		Subd. 6.International medical graduate primary care residency grant program 
22.6 	and revolving account. (a) The commissioner shall award grants to support primary care 
22.7 	residency positions designated for Minnesota immigrant physicians who are willing to serve 
22.8 	in rural or underserved areas of the state. No grant shall exceed $150,000 per residency 
22.9 	position per year. Eligible primary care residency grant recipients include accredited family 
22.10 	medicine, general surgery, internal medicine, obstetrics and gynecology, psychiatry, and 
22.11 	pediatric residency programs. Eligible primary care residency programs shall apply to the 
22.12 	commissioner. Applications must include the number of anticipated residents to be funded 
22.13 	using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded to 
22.14 	grantees in a grant agreement do not lapse until the grant agreement expires. Before any 
22.15 	funds are distributed, a grant recipient shall provide the commissioner with the following:
22.16 	(1) a copy of the signed contract between the primary care residency program and the 
22.17 	participating international medical graduate;
22.18 	(2) certification that the participating international medical graduate has lived in 
22.19 	Minnesota for at least two years and is certified by the Educational Commission on Foreign 
22.20 	Medical Graduates. Residency programs may also require that participating international 
22.21 	medical graduates hold a Minnesota certificate of clinical readiness for residency, once the 
22.22 	certificates become available; and
22.23 	(3) verification that the participating international medical graduate has executed a 
22.24 	participant agreement pursuant to paragraph (b).
22.25 	(b) Upon acceptance by a participating residency program, international medical graduates 
22.26 	shall enter into an agreement with the commissioner to provide primary care for at least 
22.27 	five years in a rural or underserved area of Minnesota after graduating from the residency 
22.28 	program and make payments to the revolving international medical graduate residency 
22.29 	account for five years beginning in their second year of postresidency employment. 
22.30 	Participants shall pay $15,000 or ten percent of their annual compensation each year, 
22.31 	whichever is less.
22.32 	(c) A revolving international medical graduate residency account is established as an 
22.33 	account in the special revenue fund in the state treasury. The commissioner of management 
23.1 	and budget shall credit to the account appropriations, payments, and transfers to the account. 
23.2 	Earnings, such as interest, dividends, and any other earnings arising from fund assets, must 
23.3 	be credited to the account. Funds in the account are appropriated annually to the 
23.4 	commissioner to award grants and administer the grant program established in paragraph 
23.5 	(a). Notwithstanding any law to the contrary, any funds deposited in the account do not 
23.6 	expire. The commissioner may accept contributions to the account from private sector 
23.7 	entities subject to the following provisions:
23.8 	(1) the contributing entity may not specify the recipient or recipients of any grant issued 
23.9 	under this subdivision;
23.10 	(2) the commissioner shall make public the identity of any private contributor to the 
23.11 	account, as well as the amount of the contribution provided; and
23.12 	(3) a contributing entity may not specify that the recipient or recipients of any funds use 
23.13 	specific products or services, nor may the contributing entity imply that a contribution is 
23.14 	an endorsement of any specific product or service.

23.15 	Sec. 29. Minnesota Statutes 2024, section 144.293, subdivision 7, is amended to read:
23.16 		Subd. 7.Exception to consent. Subdivision 2 does not apply to the release of health 
23.17 	records to the commissioner of health or the Health Data Institute under chapter 62J, provided 
23.18 	that the commissioner encrypts the patient identifier upon receipt of the data.

23.19 	Sec. 30. Minnesota Statutes 2024, section 144.551, subdivision 1, as amended by Laws 
23.20 	2026, chapter 91, section 1, is amended to read:
23.21 		Subdivision 1.Restricted construction or modification. (a) The following construction 
23.22 	or modification may not be commenced:
23.23 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
23.24 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
23.25 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
23.26 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
23.27 	state; and
23.28 	(2) the establishment of a new hospital.
23.29 	(b) This section does not apply to:
23.30 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
23.31 	facility that is a national referral center engaged in substantial programs of patient care, 
24.1 	medical research, and medical education meeting state and national needs that receives more 
24.2 	than 40 percent of its patients from outside the state of Minnesota;
24.3 	(2) a project for construction or modification for which a health care facility held an 
24.4 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
24.5 	certificate;
24.6 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
24.7 	appeal results in an order reversing the denial;
24.8 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
24.9 	section 2;
24.10 	(5) a project involving consolidation of pediatric specialty hospital services within the 
24.11 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
24.12 	of pediatric specialty hospital beds among the hospitals being consolidated;
24.13 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
24.14 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
24.15 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
24.16 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
24.17 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
24.18 	(7) the relocation or redistribution of hospital beds within a hospital building or 
24.19 	identifiable complex of buildings provided the relocation or redistribution does not result 
24.20 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
24.21 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
24.22 	state or a region of the state;
24.23 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
24.24 	involves the transfer of beds from a closed facility site or complex to an existing site or 
24.25 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
24.26 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
24.27 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
24.28 	health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution 
24.29 	does not involve the construction of a new hospital building; and (v) the transferred beds 
24.30 	are used first to replace within the hospital corporate system the total number of beds 
24.31 	previously used in the closed facility site or complex for mental health services and substance 
24.32 	use disorder services. Only after the hospital corporate system has fulfilled the requirements 
24.33 	of this item may the remainder of the available capacity of the closed facility site or complex 
24.34 	be transferred for any other purpose;
25.1 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
25.2 	County that primarily serves adolescents and that receives more than 70 percent of its 
25.3 	patients from outside the state of Minnesota;
25.4 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
25.5 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
25.6 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
25.7 	construction of the initial building or as the result of future expansion, will not exceed 100 
25.8 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
25.9 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
25.10 	the Direct Care and Treatment executive board to a new or existing facility, building, or 
25.11 	complex operated by the Direct Care and Treatment executive board; from one regional 
25.12 	treatment center site to another; or from one building or site to a new or existing building 
25.13 	or site on the same campus;
25.14 	(12) the construction or relocation of hospital beds operated by a hospital having a 
25.15 	statutory obligation to provide hospital and medical services for the indigent that does not 
25.16 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
25.17 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
25.18 	Medical Center to Regions Hospital under this clause;
25.19 	(13) a construction project involving the addition of up to 31 new beds in an existing 
25.20 	nonfederal hospital in Beltrami County;
25.21 	(14) a construction project involving the addition of up to eight new beds in an existing 
25.22 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
25.23 	(15) a construction project involving the addition of 20 new hospital beds in an existing 
25.24 	hospital in Carver County serving the southwest suburban metropolitan area;
25.25 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
25.26 	of up to two psychiatric facilities or units for children provided that the operation of the 
25.27 	facilities or units have received the approval of the commissioner of human services;
25.28 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
25.29 	services in an existing hospital in Itasca County;
25.30 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
25.31 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
25.32 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
25.33 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
26.1 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
26.2 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
26.3 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
26.4 	to the extent that the critical access hospital does not seek to exceed the maximum number 
26.5 	of beds permitted such hospital under federal law;
26.6 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
26.7 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
26.8 	(i) the project, including each hospital or health system that will own or control the entity 
26.9 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
26.10 	Council as of March 1, 2006;
26.11 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
26.12 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
26.13 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
26.14 	have been found to be in the public interest by the commissioner of health as of April 1, 
26.15 	2005;
26.16 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
26.17 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
26.18 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
26.19 	services, and emergency room services;
26.20 	(iv) the new hospital:
26.21 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
26.22 	needs of the Maple Grove service area and the surrounding communities currently being 
26.23 	served by the hospital or health system that will own or control the entity that will hold the 
26.24 	new hospital license;
26.25 	(B) will provide uncompensated care;
26.26 	(C) will provide mental health services, including inpatient beds;
26.27 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
26.28 	occupations and have a commitment to providing clinical training programs for physicians 
26.29 	and other health care providers;
26.30 	(E) will demonstrate a commitment to quality care and patient safety;
26.31 	(F) will have an electronic medical records system, including physician order entry;
26.32 	(G) will provide a broad range of senior services; and
27.1 	(H) will provide emergency medical services that will coordinate care with regional 
27.2 	providers of trauma services and licensed emergency ambulance services in order to enhance 
27.3 	the continuity of care for emergency medical patients; and
27.4 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
27.5 	the control of the entity holding the new hospital license; and
27.6 	(v) as of 30 days following submission of a written plan, the commissioner of health 
27.7 	has not determined that the hospitals or health systems that will own or control the entity 
27.8 	that will hold the new hospital license are unable to meet the criteria of this clause;
27.9 	(21) a project approved under section 144.553;
27.10 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
27.11 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
27.12 	is approved by the Cass County Board;
27.13 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
27.14 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
27.15 	a separately licensed 13-bed skilled nursing facility;
27.16 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
27.17 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
27.18 	who are under 21 years of age on the date of admission. The commissioner conducted a 
27.19 	public interest review of the mental health needs of Minnesota and the Twin Cities 
27.20 	metropolitan area in 2008. No further public interest review shall be conducted for the 
27.21 	construction or expansion project under this clause;
27.22 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
27.23 	commissioner finds the project is in the public interest after the public interest review 
27.24 	conducted under section 144.552 is complete;
27.25 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
27.26 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
27.27 	admission, if the commissioner finds the project is in the public interest after the public 
27.28 	interest review conducted under section 144.552 is complete;
27.29 	(ii) this project shall serve patients in the continuing care benefit program under section 
27.30 	256.9693. The project may also serve patients not in the continuing care benefit program; 
27.31 	and
27.32 	(iii) if the project ceases to participate in the continuing care benefit program, the 
27.33 	commissioner must complete a subsequent public interest review under section 144.552. If 
28.1 	the project is found not to be in the public interest, the license must be terminated six months 
28.2 	from the date of that finding. If the commissioner of human services terminates the contract 
28.3 	without cause or reduces per diem payment rates for patients under the continuing care 
28.4 	benefit program below the rates in effect for services provided on December 31, 2015, the 
28.5 	project may cease to participate in the continuing care benefit program and continue to 
28.6 	operate without a subsequent public interest review;
28.7 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
28.8 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
28.9 	date of admission;
28.10 	(28) a project to add 55 licensed beds in an existing safety net, level I trauma center 
28.11 	hospital in Ramsey County as regulated under section 383A.91, subdivision 5, of which 15 
28.12 	beds are to be used for inpatient mental health and 40 are to be used for other services. In 
28.13 	addition, five unlicensed observation mental health beds shall be added;
28.14 	(29) upon submission of a plan to the commissioner for public interest review under 
28.15 	section 144.552 and the addition of the 15 inpatient mental health beds specified in clause 
28.16 	(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I 
28.17 	trauma center hospital in Ramsey County as regulated under section 383A.91, subdivision 
28.18 	5. Five of the 45 additional beds authorized under this clause must be designated for use 
28.19 	for inpatient mental health and must be added to the hospital's bed capacity before the 
28.20 	remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed 
28.21 	beds under this clause prior to completion of the public interest review, provided the hospital 
28.22 	submits its plan by the 2021 deadline and adheres to the timelines for the public interest 
28.23 	review described in section 144.552;
28.24 	(30) upon submission of a plan to the commissioner for public interest review under 
28.25 	section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital 
28.26 	in Hennepin County that exclusively provides care to patients who are under 21 years of 
28.27 	age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital 
28.28 	may add licensed beds under this clause prior to completion of the public interest review, 
28.29 	provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for 
28.30 	the public interest review described in section 144.552;
28.31 	(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen 
28.32 	County that: (i) is designated as a critical access hospital under section 144.1483, clause 
28.33 	(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of 
28.34 	fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of 
29.1 	licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding 
29.2 	section 144.552, a public interest review is not required for a project authorized under this 
29.3 	clause;
29.4 	(32) upon submission of a plan to the commissioner for public interest review under 
29.5 	section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's 
29.6 	hospital in St. Paul that is part of an independent pediatric health system with freestanding 
29.7 	inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric 
29.8 	inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add 
29.9 	licensed beds under this clause prior to completion of the public interest review, provided 
29.10 	the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public 
29.11 	interest review described in section 144.552;
29.12 	(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda 
29.13 	hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is 
29.14 	in the public interest after the public interest review conducted under section 144.552 is 
29.15 	complete. Following the completion of the construction project, the commissioner of health 
29.16 	shall monitor the hospital, including by assessing the hospital's case mix and payer mix, 
29.17 	patient transfers, and patient diversions. The hospital must have an intake and assessment 
29.18 	area. The hospital must accommodate patients with acute mental health needs, whether they 
29.19 	walk up to the facility, are delivered by ambulances or law enforcement, or are transferred 
29.20 	from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The 
29.21 	hospital must annually submit de-identified data to the department in the format and manner 
29.22 	defined by the commissioner;
29.23 	(34) a project involving the relocation of up to 26 licensed long-term acute care hospital 
29.24 	beds from an existing long-term care hospital located in Hennepin County with a licensed 
29.25 	capacity prior to the relocation of 92 beds to dedicated space on the campus of an existing 
29.26 	safety net, level I trauma center hospital in Ramsey County as regulated under section 
29.27 	383A.91, subdivision 5, provided both the commissioner finds the project is in the public 
29.28 	interest after the public interest review conducted under section 144.552 is complete and 
29.29 	the relocated beds continue to be used as long-term acute care hospital beds after the 
29.30 	relocation; or
29.31 	(35) a project to add 85 licensed beds in an existing safety net, level I trauma center 
29.32 	hospital in Ramsey County as regulated under section 383A.91, subdivision 5.

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

30.1 	Sec. 31. Minnesota Statutes 2024, section 145.56, subdivision 5, is amended to read:
30.2 		Subd. 5.Periodic evaluations; biennial reports. To the extent funds are appropriated 
30.3 	for the purposes of this subdivision, the commissioner shall conduct periodic evaluations 
30.4 	of the impact of and outcomes from implementation of the state's suicide prevention plan 
30.5 	and each of the activities specified in this section. By July 1, 2002, and On July 1 of each 
30.6 	even-numbered year thereafter, the commissioner shall report the results of these evaluations 
30.7 	to the chairs of the policy and finance committees in the house of representatives and senate 
30.8 	with jurisdiction over health and human services issues.

30.9 	Sec. 32. Minnesota Statutes 2024, section 145.561, subdivision 2, is amended to read:
30.10 		Subd. 2.988 Lifeline. (a) The commissioner shall administer the designation of and 
30.11 	oversight for a 988 Lifeline center or a network of 988 Lifeline centers to answer contacts 
30.12 	from individuals accessing the Suicide and Crisis Lifeline from any jurisdiction within the 
30.13 	state 24 hours per day, seven days per week.
30.14 	(b) The designated 988 Lifeline Center must:
30.15 	(1) have an active agreement with the 988 Suicide and Crisis Lifeline program for 
30.16 	participation in the network and the department;
30.17 	(2) meet the 988 Lifeline program requirements and best practice guidelines for 
30.18 	operational and clinical standards;
30.19 	(3) provide data and reports, and participate in evaluations and related quality 
30.20 	improvement activities as required by the 988 Lifeline program and the department;
30.21 	(4) identify or adapt technology that is demonstrated to be interoperable across mobile 
30.22 	crisis and public safety answering points used in the state for the purpose of crisis care 
30.23 	coordination;
30.24 	(5) facilitate crisis and outgoing services, including mobile crisis teams in accordance 
30.25 	with guidelines established by the 988 Lifeline program and the department;
30.26 	(6) actively collaborate and coordinate service linkages with mental health and substance 
30.27 	use disorder treatment providers, local community mental health centers including certified 
30.28 	community behavioral health clinics and community behavioral health centers, mobile crisis 
30.29 	teams, and community based and hospital emergency departments;
30.30 	(7) offer follow-up services to individuals accessing the 988 Lifeline Center that are 
30.31 	consistent with guidance established by the 988 Lifeline program and the department; and
31.1 	(8) meet the requirements set by the 988 Lifeline program and the department for serving 
31.2 	at-risk and specialized populations.
31.3 	(c) The commissioner shall adopt rules to allow appropriate information sharing and 
31.4 	communication between and across crisis and emergency response systems.
31.5 	(d) The commissioner, having primary oversight of suicide prevention, shall work with 
31.6 	the 988 Lifeline program, veterans crisis line, and other SAMHSA-approved networks for 
31.7 	the purpose of ensuring consistency of public messaging about 988 services.
31.8 	(e) The commissioner shall work with representatives from 988 Lifeline Centers and 
31.9 	public safety answering points, other public safety agencies, and the commissioner of public 
31.10 	safety to facilitate the development of protocols and procedures for interactions between 
31.11 	988 and 911 services across Minnesota. Protocols and procedures shall be developed 
31.12 	following available national standards and guidelines.
31.13 	(f) The commissioner shall provide an annual a biennial public report on 988 Lifeline 
31.14 	usage by July 1 of each even-numbered year, including data on answer rates, abandoned 
31.15 	calls, and referrals to 911 emergency response. The biennial report may be included as a 
31.16 	section within the state suicide prevention report required under section 145.56.

31.17 	Sec. 33. Minnesota Statutes 2024, section 145.882, is amended by adding a subdivision 
31.18 	to read:
31.19 		Subd. 9.Contracting and procurement. The commissioner is exempt from the contract 
31.20 	term limits in chapter 16C for issuance of benefits under the Special Supplemental Nutrition 
31.21 	Program for Women, Infants and Children (WIC) through an electronic benefit transfer 
31.22 	(EBT) system and related services and contracts. The contracts may have an initial term of 
31.23 	up to five years, with extensions not to exceed a ten-year total contract duration.

31.24 	Sec. 34. Minnesota Statutes 2024, section 145.882, is amended by adding a subdivision 
31.25 	to read:
31.26 		Subd. 10.Management information systems; contracting and procurement. WIC 
31.27 	is exempt from the contract term limits in chapter 16C for the management information 
31.28 	systems used for issuance of supplemental nutrition benefits and the WIC EBT systems 
31.29 	used for processing the redemptions of supplemental nutrition benefits. These contracts 
31.30 	may have an initial term of up to five years, with extensions not to exceed a ten-year total 
31.31 	contract duration.

32.1 	Sec. 35. Minnesota Statutes 2024, section 145A.04, subdivision 15, is amended to read:
32.2 		Subd. 15.State and local advisory committees. (a) A state community health services 
32.3 	advisory committee is established to advise, consult with, and make recommendations to 
32.4 	the commissioner on the development, maintenance, funding, and evaluation of local and 
32.5 	Tribal public health services. Each community health board may appoint a member to serve 
32.6 	on the committee. Each of Minnesota's federally recognized Tribal Nations may appoint a 
32.7 	member to serve on the committee. The committee must meet at least quarterly, and special 
32.8 	meetings may be called by the committee chair or a majority of the members. A Tribal 
32.9 	Nation may elect to participate at any time. Members or their alternates may be reimbursed 
32.10 	for travel and other necessary expenses while engaged in their official duties.
32.11 	(b) Notwithstanding section 15.059, the State Community Health Services Advisory 
32.12 	Committee does not expire.
32.13 	(c) The city boards or county boards that have established or are members of a community 
32.14 	health board may appoint a community health advisory committee to advise, consult with, 
32.15 	and make recommendations to the community health board on the duties under subdivision 
32.16 	1a.

32.17 	Sec. 36. Minnesota Statutes 2024, section 145A.14, subdivision 2a, is amended to read:
32.18 		Subd. 2a.Tribal governments. (a) Of the funding available for local public health 
32.19 	grants, $1,500,000 per year is available to Tribal governments for:
32.20 	(1) maternal and child health activities under section 145.882, subdivision 7;
32.21 	(2) activities to reduce health disparities under section 145.928, subdivision 10; and
32.22 	(3) emergency preparedness; and
32.23 	(4) additional public health activities identified by each Tribal government.
32.24 	(b) The commissioner, in consultation with Tribal governments, shall establish a formula 
32.25 	for distributing the funds and developing the outcomes to be measured.

32.26 	Sec. 37. Minnesota Statutes 2024, section 148.517, subdivision 1, is amended to read:
32.27 		Subdivision 1.Applicability. An applicant who applies for licensure as a speech-language 
32.28 	pathologist or audiologist by reciprocity must meet the requirements of subdivisions 2 and 
32.29 	3. An applicant who applies for licensure as an audiologist by reciprocity must pass the 
32.30 	practical exam required under section 148.515, subdivision 6.

33.1 	Sec. 38. Minnesota Statutes 2024, section 148.517, subdivision 2, is amended to read:
33.2 		Subd. 2.Current credentials required. An applicant applying for licensure by 
33.3 	reciprocity must provide evidence to the commissioner that the applicant holds a current 
33.4 	and unrestricted credential for the practice of speech-language pathology or audiology in 
33.5 	another jurisdiction that has requirements equivalent to or higher than those in effect for 
33.6 	determining whether an applicant in this state is qualified to be licensed as a speech-language 
33.7 	pathologist or audiologist. An applicant who provides sufficient evidence need not meet 
33.8 	the requirements of section 148.515, except for section 148.515, subdivision 6, for applicants 
33.9 	for licensure as an audiologist, provided that the applicant otherwise meets all other 
33.10 	requirements of section 148.514.

33.11 	Sec. 39. Minnesota Statutes 2024, section 148.5191, subdivision 4, is amended to read:
33.12 		Subd. 4.Renewal deadline. Each license, including a temporary license provided under 
33.13 	section 148.5161, must state an expiration date. An application for licensure renewal must 
33.14 	be received by the Department of Health or postmarked at least 30 days before the expiration 
33.15 	date. If the postmark is illegible, the application shall be considered timely if received at 
33.16 	least 21 days before the expiration date.
33.17 	When the commissioner establishes the renewal schedule for an applicant, licensee, or 
33.18 	temporary licensee, if the period before the expiration date is less than two years, the fee 
33.19 	shall be prorated.

33.20 	Sec. 40. Minnesota Statutes 2024, section 149A.91, subdivision 3, is amended to read:
33.21 		Subd. 3.Embalming or refrigeration required. (a) A dead human body must be 
33.22 	embalmed by a licensed mortician or registered intern or practicum student or clinical 
33.23 	student, refrigerated, or packed in dry ice in the following circumstances:
33.24 	(1) if the body will be transported by public transportation, pursuant to section 149A.93, 
33.25 	subdivision 7;
33.26 	(2) if final disposition will not be accomplished within 72 hours after death or release 
33.27 	of the body by a competent authority with jurisdiction over the body or the body will be 
33.28 	lawfully stored for final disposition in the future, except as provided in section 149A.94, 
33.29 	subdivision 1;
33.30 	(3) if the body will be publicly viewed subject to paragraph (b); or
33.31 	(4) if so ordered by the commissioner of health for the control of infectious disease and 
33.32 	the protection of the public health.
34.1 	(b) For purposes of this subdivision, "publicly viewed" means reviewal of a dead human 
34.2 	body by anyone other than those mentioned in section 149A.80, subdivision 2, and their 
34.3 	minor children. Dry ice may only be used when the dead human body is publicly viewed 
34.4 	within private property.
34.5 	(c) A body may not be kept in refrigeration for a period that exceeds six 14 calendar 
34.6 	days, or packed in dry ice for a period that exceeds four calendar days, from the time and 
34.7 	release of the body from the place of death or from the time of release from the coroner or 
34.8 	medical examiner.

34.9 	Sec. 41. Minnesota Statutes 2024, section 149A.94, subdivision 1, is amended to read:
34.10 		Subdivision 1.Generally. Every dead human body lying within the state, except 
34.11 	unclaimed bodies delivered for dissection by the medical examiner, those delivered for 
34.12 	anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through 
34.13 	the state for the purpose of disposition elsewhere; and the remains of any dead human body 
34.14 	after dissection or anatomical study, shall be decently buried or entombed in a public or 
34.15 	private cemetery, alkaline hydrolyzed, cremated, or, effective July 1, 2025, naturally reduced 
34.16 	within a reasonable time 14 calendar days after death or release of the body by a competent 
34.17 	authority with jurisdiction over the body. Where final disposition of a body will not be 
34.18 	accomplished, or, effective July 1, 2025, when natural organic reduction will not be initiated, 
34.19 	within 72 hours following death or release of the body by a competent authority with 
34.20 	jurisdiction over the body, the body must be properly embalmed, refrigerated, or packed 
34.21 	with dry ice. A body may not be kept in refrigeration for a period exceeding six 14 calendar 
34.22 	days, or packed in dry ice for a period that exceeds four calendar days, from the time of 
34.23 	death or release of the body from the coroner or medical examiner.

34.24 	Sec. 42. Minnesota Statutes 2024, section 149A.955, subdivision 14, is amended to read:
34.25 		Subd. 14.Bodies awaiting natural organic reduction. A dead human body must be 
34.26 	placed in the natural organic reduction vessel to initiate the natural reduction process within 
34.27 	24 hours 14 calendar days after the natural organic reduction facility accepts legal and 
34.28 	physical custody of the body. A natural organic reduction facility must keep the body in 
34.29 	refrigeration while awaiting natural reduction. If a natural organic reduction facility does 
34.30 	not initiate natural reduction within 14 calendar days after accepting legal and physical 
34.31 	custody of the body, the facility must arrange final disposition of the body by burial or 
34.32 	cremation. The person or persons with the right to control and duty of disposition of the 
35.1 	body must determine whether the body is buried or cremated, and the body must be buried 
35.2 	or cremated within five calendar days after the end of the 14-day period.

35.3 	Sec. 43. REVISOR INSTRUCTION.
 35.4 	The revisor of statutes shall renumber Minnesota Statutes, section 62Q.075, as Minnesota 
35.5 	Statutes, section 62D.081. The revisor shall also make necessary cross-reference changes 
35.6 	consistent with the renumbering.

35.7 	Sec. 44. REPEALER.
 35.8 	Minnesota Statutes 2024, sections 13D.08, subdivision 4; 62J.06; 62J.156; 62J.2930, 
35.9 	subdivision 4; 62J.57; and 144.9821, are repealed.

35.10 	ARTICLE 2
35.11 	GAS RESOURCE DEVELOPMENT

35.12 	Section 1. Minnesota Statutes 2024, section 93.514, is amended to read:
35.13 	93.514 GAS AND OIL PRODUCTION RULEMAKING.
35.14 	(a) The following agencies may adopt rules governing gas and oil exploration or 
35.15 	production, as applicable:
35.16 	(1) the commissioner of the Pollution Control Agency may adopt or amend rules 
35.17 	regulating air emissions; water discharges, including stormwater management; and storage 
35.18 	tanks as they pertain to gas and oil production;
35.19 	(2) the commissioner of health may adopt or amend rules on groundwater and surface 
35.20 	water protection, exploratory boring construction, drilling registration and licensure, and 
35.21 	inspections as they pertain to the exploration and appraisal of gas and oil resources;
35.22 	(3) (2) the Environmental Quality Board may adopt or amend rules to establish mandatory 
35.23 	categories for environmental review as they pertain to gas and oil production;
35.24 	(4) (3) the commissioner of natural resources must adopt or amend rules pertaining to 
35.25 	the conversion of an exploratory boring to a production well, pooling, spacing, unitization, 
35.26 	well abandonment, siting, financial assurance, and reclamation for the production of gas 
35.27 	and oil; and
35.28 	(5) (4) the commissioner of labor and industry may adopt or amend rules to protect 
35.29 	workers from exposure and other potential hazards from gas and oil production.
36.1 	(b) An agency adopting rules under this section must use the expedited procedure in 
36.2 	section 14.389. Rules adopted or amended under this authority are exempt from the 18-month 
36.3 	time limit under section 14.125. The agency must publish notice of intent to adopt expedited 
36.4 	rules within 24 months of May 22, 2024.
36.5 	(c) For purposes of this section, "gas" includes both hydrocarbon and nonhydrocarbon 
36.6 	gases. "Production" includes extraction and beneficiation of gas or oil from consolidated 
36.7 	or unconsolidated formations in the state.
36.8 	(d) Any grant of rulemaking authority in this section is in addition to existing rulemaking 
36.9 	authority and does not replace, impair, or interfere with any existing rulemaking authority.
36.10 	(e) An entity adopting rules under this section is subject to the Tribal consultation 
36.11 	requirements under section 10.65.

36.12 	Sec. 2. Minnesota Statutes 2024, section 103I.001, is amended to read:
36.13 	103I.001 LEGISLATIVE INTENT.
36.14 	This chapter is intended to protect the health and general welfare by providing a means 
36.15 	for the development and protection of the natural resource of groundwater in an orderly, 
36.16 	healthful, and reasonable manner.

36.17 	Sec. 3. Minnesota Statutes 2024, section 103I.005, subdivision 9, is amended to read:
36.18 		Subd. 9.Exploratory boring. "Exploratory boring" means a surface drilling done to 
36.19 	explore or prospect for oil, natural gas, apatite, diamonds, graphite, gemstones, kaolin clay, 
36.20 	and metallic minerals, including iron, copper, zinc, lead, gold, silver, titanium, vanadium, 
36.21 	nickel, cadmium, molybdenum, chromium, manganese, cobalt, zirconium, beryllium, 
36.22 	thorium, uranium, aluminum, platinum, palladium, radium, tantalum, tin, and niobium, and 
36.23 	a drilling or boring for petroleum.

36.24 	Sec. 4. Minnesota Statutes 2024, section 103I.005, is amended by adding a subdivision 
36.25 	to read:
36.26 		Subd. 10a.Gas. "Gas" includes both hydrocarbon and nonhydrocarbon gases.

36.27 	Sec. 5. Minnesota Statutes 2024, section 103I.005, is amended by adding a subdivision 
36.28 	to read:
36.29 		Subd. 10b.Gas well. "Gas well" means an excavation that is constructed to locate, 
36.30 	extract, or produce gas.

37.1 	Sec. 6. Minnesota Statutes 2024, section 103I.005, is amended by adding a subdivision 
37.2 	to read:
37.3 		Subd. 10c.Gas well contractor. "Gas well contractor" means a person with a gas well 
37.4 	contractor's license issued by the commissioner.

37.5 	Sec. 7. Minnesota Statutes 2024, section 103I.005, is amended by adding a subdivision 
37.6 	to read:
37.7 		Subd. 11a.Hydraulic fracturing treatment. "Hydraulic fracturing treatment" means 
37.8 	all stages of the treatment of a gas well by the application of fluid under pressure that is 
37.9 	expressly intended to initiate or propagate fractures in a target geologic formation to enhance 
37.10 	production of oil and gas.

37.11 	Sec. 8. Minnesota Statutes 2024, section 103I.005, subdivision 21, is amended to read:
37.12 		Subd. 21.Well. "Well" means an excavation that is drilled, cored, bored, washed, driven, 
37.13 	dug, jetted, or otherwise constructed if the excavation is intended for the location, diversion, 
37.14 	artificial recharge, monitoring, testing, remediation, or acquisition of groundwater. Well 
37.15 	includes environmental wells, drive point wells, and dewatering wells. "Well" does not 
37.16 	include:
37.17 	(1) an excavation by backhoe, or otherwise for temporary dewatering of groundwater 
37.18 	for nonpotable use during construction, if the depth of the excavation is 25 feet or less;
37.19 	(2) an excavation made to obtain or prospect for oil, natural gas, minerals, or products 
37.20 	of mining or quarrying;
37.21 	(3) an excavation to insert media to repressure oil or natural gas bearing formations or 
37.22 	to store petroleum, natural gas, or other products;
37.23 	(4) an excavation for nonpotable use for wildfire suppression activities; or
37.24 	(5) borings; or
37.25 	(6) gas and oil wells.

37.26 	Sec. 9. Minnesota Statutes 2024, section 103I.601, subdivision 1, is amended to read:
37.27 		Subdivision 1.Definitions. (a) For the purposes of this section, the following words 
37.28 	have the meanings given them.
37.29 	(b) "Data" includes samples and factual noninterpreted data obtained from exploratory 
37.30 	borings and samples including analytical results.
38.1 	(c) "Parcel" means a government section, fractional section, or government lot.
38.2 	(d) "Samples" means at least a one-quarter portion of all samples from exploratory 
38.3 	borings that are customarily collected by the explorer. When the exploratory borings are 
38.4 	being done to explore or prospect for kaolin clay, "samples" means a representative sample 
38.5 	of at least two cubic inches of material per foot from exploratory borings of the material 
38.6 	that is customarily collected by the explorer.
38.7 	(e) "Encounter gas" means a sustained presence of gas in an exploratory boring for at 
38.8 	least 24 hours and in which gas has not dissipated prior to sealing.

38.9 	Sec. 10. Minnesota Statutes 2024, section 103I.601, is amended by adding a subdivision 
38.10 	to read:
38.11 		Subd. 10.Exploratory borings encountering gas. (a) Requirements in this subdivision 
38.12 	apply only for exploratory borings encountering gas.
38.13 	(b) An explorer must notify the commissioners of health and natural resources:
38.14 	(1) within 24 hours of drilling an exploratory boring encountering gas; and
38.15 	(2) prior to beginning a permanent sealing of an exploratory boring encountering gas.
38.16 	(c) An explorer must submit a permanent sealing notification and fee of $125 to the 
38.17 	commissioner prior to permanently sealing an exploratory boring encountering gas.
38.18 	(d) An explorer must begin permanently sealing an exploratory boring encountering gas 
38.19 	within ten days of encountering gas.
38.20 	(e) An exploratory boring encountering gas is exempt from paragraph (d) if the boring 
38.21 	is constructed to prevent movement of gas and water within and from one geological 
38.22 	formation to another. The boring must be permanently sealed according to rules adopted 
38.23 	by the commissioner.
38.24 	(f) An exploratory boring encountering gas must be permanently sealed from the bottom 
38.25 	of the boring to within two feet of the established ground surface.
38.26 	(g) A permanent sealing report as required by subdivision 9 must also contain information 
38.27 	indicating gas was encountered during construction and at what depth it was encountered.
38.28 	(h) A person must not use an exploratory boring to extract gas for production.

39.1 	Sec. 11. Minnesota Statutes 2024, section 103I.601, is amended by adding a subdivision 
39.2 	to read:
39.3 		Subd. 11.Conversion of a gas well prohibited. A person must not convert a gas well 
39.4 	to any other type of well or boring.

39.5 	Sec. 12. Minnesota Statutes 2024, section 103I.601, is amended by adding a subdivision 
39.6 	to read:
39.7 		Subd. 12.Conversion of a well or boring to a gas well. A person must not convert a 
39.8 	well or boring to a gas well, except that an exploratory boring may be converted to a gas 
39.9 	well if the exploratory boring was constructed:
39.10 	(1) with innermost casing meeting API Specification 5CT;
39.11 	(2) before July 1, 2025; and
39.12 	(3) in compliance with provisions of this chapter.

39.13 	Sec. 13. [103I.706] GAS WELLS.
39.14 		Subdivision 1.Rulemaking authority. The commissioner of health must adopt rules 
39.15 	for gas wells including requirements for exploratory borings for gas, and drilling, 
39.16 	construction, sealing, use, reporting, and rig registration; and for licensing and certifying 
39.17 	persons constructing, repairing, and sealing gas wells. These rules must include a prohibition 
39.18 	against hydraulic fracturing treatment and a prohibition against the injection or disposal of 
39.19 	surface water, groundwater, or any other liquid, gas, or chemical except for approved drilling 
39.20 	fluids. In adopting rules under this section, the commissioner must use the expedited 
39.21 	procedure in section 14.389. These rules must distinguish between types of gas based on 
39.22 	the risks they pose to groundwater quality, health, and safety, and must specify the 
39.23 	requirements that apply when an exploratory boring or gas well encounters a gas different 
39.24 	from that for which exploration, prospecting, location, extraction, or production was 
39.25 	proposed. Rules adopted or amended under this authority are exempt from the 18-month 
39.26 	time limit under section 14.125. The commissioner must publish notice of intent to adopt 
39.27 	expedited rules within 24 months after May 22, 2026. In adopting rules under this 
39.28 	subdivision, the commissioner is subject to the Tribal consultation requirements under 
39.29 	section 10.65.
39.30 		Subd. 2.Fees. (a) License, certification, and registration renewals are not prorated and 
39.31 	expire on December 31 of each year.
40.1 	(b) An applicant must meet the gas well contractor license requirements and fee 
40.2 	requirements to construct, repair, or seal a gas well. The fee for a gas well contractor license 
40.3 	is $300. The annual renewal fee for a gas well contractor license is $300.
40.4 	(c) A gas well contractor must designate a certified representative. The certified 
40.5 	representative must meet the application and fee requirements. The application fee for a 
40.6 	certified representative is $100. The annual renewal fee for a certified representative is 
40.7 	$100.
40.8 	(d) A gas well contractor must meet the registration and fee requirements for rigs used 
40.9 	to construct, repair, service, or seal a gas well. The fee to register gas well rigs is $125. The 
40.10 	annual renewal fee for gas well rig registration is $125.
40.11 	(e) If a gas well contractor or certified representative under paragraphs (b) and (c) fails 
40.12 	to submit all information required for renewal or submits the application and information 
40.13 	after the required renewal date:
40.14 	(1) the gas well contractor or certified representative must include a late fee of $75; and
40.15 	(2) the gas well contractor or certified representative may not conduct activities authorized 
40.16 	by the gas well contractor's license or certified representative's certification until the renewal 
40.17 	application, renewal application fee, and all other information required is submitted.
40.18 	(f) A gas well contractor must submit a notification for construction of a proposed gas 
40.19 	well on a form prescribed by the commissioner, with a fee of $10,000.
40.20 	(g) A gas well contractor must submit a notification for sealing a gas well on a form 
40.21 	prescribed by the commissioner, with a fee of $7,500.
40.22 		Subd. 3.Rig registration. (a) Rigs used to drill, maintain, repair, or seal a gas well, 
40.23 	including drilling rigs and workover rigs, must be registered with the commissioner.
40.24 	(b) A person must file an application to register a rig on a form provided by the 
40.25 	commissioner with the fee under subdivision 2, paragraph (d), with the commissioner.
40.26 	(c) A registration is valid until the date prescribed by the commissioner in the registration.
40.27 	(d) A person must file an application with the fee under subdivision 2, paragraph (d), to 
40.28 	renew the registration by the date prescribed by the commissioner in the registration.
40.29 		Subd. 4.Gas well contractor's license. (a) A person must not construct, repair, or seal 
40.30 	a gas well without a gas well contractor's license issued by the commissioner.
40.31 	(b) A person must file a complete application for a gas well contractor's license on a 
40.32 	form provided by the commissioner with the fee under subdivision 2, paragraph (b), with 
41.1 	the commissioner. The person applying must meet the qualifications for a gas well contractor 
41.2 	license.
41.3 	(c) A gas well contractor's license is valid until the date prescribed by the commissioner 
41.4 	in the license.
41.5 	(d) A gas well contractor must file a complete application with the fee under subdivision 
41.6 	2, paragraph (b), to renew the license by the date prescribed by the commissioner in the 
41.7 	license. A person must not construct, repair, or seal a gas well until a gas well contractor's 
41.8 	license is renewed. The commissioner may not renew a license until the renewal fee is paid.
41.9 	(e) A gas well contractor must include information at the time of renewal that the 
41.10 	applicant has met the continuing education requirements established by the commissioner 
41.11 	for gas wells.
41.12 	(f) A gas well contractor must designate a certified representative to supervise and 
41.13 	oversee regulated work on gas wells.
41.14 	(g) A person must file a complete application on a form provided by the commissioner 
41.15 	with the fee under subdivision 2, paragraph (c), to qualify as a certified representative.
41.16 	(h) A certified representative must file an application with the fee under subdivision 2, 
41.17 	paragraph (c), to renew the certification by the expiration date prescribed by the commissioner 
41.18 	on the certification. A certified representative may not supervise or oversee regulated work 
41.19 	on a gas well until the renewal application and application fee are submitted. The 
41.20 	commissioner may not review a certification until the renewal fee is paid.
41.21 	(i) A certified representative must include information at the time of renewal that the 
41.22 	applicant has met the continuing education requirements established by the commissioner 
41.23 	for gas wells.
41.24 	(j) The commissioner of natural resources may require a bond, security, or other assurance 
41.25 	from a gas well contractor if the commissioner of natural resources has reasonable doubts 
41.26 	about the person's financial ability to comply with the requirements of law relating to 
41.27 	reclamation of a gas well and the process to restore the land disturbed by a gas well drilling 
41.28 	and production operations back to the condition of original state.
41.29 	(k) The commissioner may suspend or revoke a licensee's license according to section 
41.30 	144.99.
41.31 		Subd. 5.Construction notification. (a) A gas well contractor must not begin drilling 
41.32 	or constructing a gas well unless it is included in a valid gas resource development permit 
41.33 	issued by the commissioner of natural resources.
42.1 	(b) After receiving permit approval from the commissioner of natural resources and 
42.2 	prior to drilling or constructing a gas well, the gas well contractor must submit a notification 
42.3 	to construct a gas well:
42.4 	(1) to the commissioner, along with the fee under subdivision 2, paragraph (f); and
42.5 	(2) to any Tribal Nation for which the gas well will be located within five miles of the 
42.6 	Tribal Nation's exterior boundary, or to the nearest Tribal Nation if the gas well will not be 
42.7 	located within five miles of any Tribal Nation's exterior boundary.
42.8 		Subd. 6.Access to drill sites. (a) The commissioner of health shall have access to gas 
42.9 	well sites to inspect gas wells, including the drilling, construction, and sealing of gas wells.
42.10 	(b) The commissioner of health has enforcement authority according to section 144.99.
42.11 		Subd. 7.Emergency notification. In the event of an occurrence during construction, 
42.12 	repair, or sealing of a gas well that has a potential for significant adverse public health or 
42.13 	environmental effects, the person drilling or constructing a gas or well must promptly:
42.14 	(1) take reasonable action to minimize the adverse effects; and
42.15 	(2) notify the commissioners of health, natural resources, and the Pollution Control 
42.16 	Agency immediately by informing the Minnesota Duty Officer.
42.17 		Subd. 8.Sealing notification. (a) A gas well, including an unsuccessful gas well, that 
42.18 	is not in use must be sealed by a gas well contractor.
42.19 	(b) A gas well contractor must file a notification and fee with the commissioner prior 
42.20 	to sealing a gas well.
42.21 		Subd. 9.Report of work. Within 60 days after completion or sealing of a gas well, the 
42.22 	gas well contractor must submit a verified report to the commissioner on a form prescribed 
42.23 	by the commissioner or in a format approved by the commissioner.

42.24 	Sec. 14. [103I.707] MORATORIUM ON GAS WELL CONVERSION AND 
42.25 	CONSTRUCTION.
42.26 	A person shall not drill, convert under section 103I.601, subdivision 12, or construct a 
42.27 	gas well for the primary purpose of extracting or producing gas until:
42.28 	(1) rules are adopted under section 103I.706;
42.29 	(2) the legislature enacts a statute specifically authorizing the issuance of gas resource 
42.30 	development permits; and
42.31 	(3) the legislature enacts fees for gas resource development permits.

43.1 	Sec. 15. [103I.708] WELLS; RESTRICTIONS.
43.2 	(a) Notwithstanding any provision of this chapter or chapter 93, or the rules adopted 
43.3 	thereunder, to the contrary, a person shall not explore, prospect, or construct an oil well.
43.4 	(b) Notwithstanding any provision of this chapter or chapter 93, or the rules adopted 
43.5 	thereunder, to the contrary, a person shall not construct a gas well for the primary purpose 
43.6 	of extracting or producing a gas other than helium. Gas wells constructed for the primary 
43.7 	purpose of extracting or producing helium may only be constructed in Cook County, Lake 
43.8 	County, and St. Louis County. Nothing in this paragraph shall be construed to prevent:
43.9 	(1) the drilling or construction of an exploratory boring; or
43.10 	(2) the sale of carbon dioxide extracted in the ordinary course of extracting or producing 
43.11 	helium.

43.12 	Sec. 16. [103I.709] GAS WELLS; PROHIBITIONS.
43.13 		Subdivision 1.Injection prohibited. A gas well must not be used to inject or dispose 
43.14 	surface water, groundwater, or any other liquid, gas, or chemical. This does not prohibit 
43.15 	injection:
43.16 	(1) of approved drilling fluids; or
43.17 	(2) if a class 2 injection well permit is obtained for a gas well, as authorized by the 
43.18 	Environmental Protection Agency.
43.19 		Subd. 2.Hydraulic fracturing treatment prohibited. Hydraulic fracturing treatment 
43.20 	is prohibited in a gas well.

43.21 	Sec. 17. TRIBAL CONSULTATION; REPORT.
 43.22 	An entity adopting rules under Minnesota Statutes, section 93.514 or 103I.706, must 
43.23 	submit a report to the chairs and ranking minority members of the legislative committees 
43.24 	with jurisdiction over health and the environment and natural resources, the Native American 
43.25 	caucuses of the legislature, and the Minnesota Indian Affairs Council that details the process 
43.26 	and results of meeting the requirements of Minnesota Statutes, section 10.65, for purposes 
43.27 	of the rulemaking. The report must be submitted within 90 days of adoption of the rules.

43.28 	Sec. 18. EFFECTIVE DATE.
 43.29 	This article is effective the day following final enactment.

44.1 	ARTICLE 3
44.2 	HOSPITAL STABILIZATION

44.3 	Section 1. Minnesota Statutes 2024, section 16A.152, is amended by adding a subdivision 
44.4 	to read:
44.5 		Subd. 1c.Hospital stabilization reserve. A hospital stabilization reserve account is 
44.6 	created in the general fund in the state treasury. Amounts in the hospital stabilization reserve 
44.7 	are appropriated to the commissioner of management and budget for the uses authorized in 
44.8 	subdivision 1d. Any balance remaining in the account on June 30, 2031, is canceled to the 
44.9 	general fund.

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

44.11 	Sec. 2. Minnesota Statutes 2024, section 16A.152, is amended by adding a subdivision to 
44.12 	read:
44.13 		Subd. 1d.Hospital stabilization reserve uses. The commissioner of management and 
44.14 	budget, in consultation with the commissioner of health and after review by the Legislative 
44.15 	Advisory Commission as required in subdivision 1e, may make payments to an eligible 
44.16 	hospital as defined in section 144.7051.

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

44.18 	Sec. 3. Minnesota Statutes 2024, section 16A.152, is amended by adding a subdivision to 
44.19 	read:
44.20 		Subd. 1e.Hospital stabilization reserve Legislative Advisory Commission review. (a) 
44.21 	The Legislative Advisory Commission established under section 3.30 must review proposed 
44.22 	allocations from the hospital stabilization reserve account.
44.23 	(b) The commissioner of management and budget must submit proposed expenditures 
44.24 	from the hospital stabilization reserve account to the Legislative Advisory Commission for 
44.25 	its review and recommendation. Upon receiving a submission, the commission has seven 
44.26 	days after the request is submitted to review the proposed expenditures submitted under 
44.27 	this subdivision.
44.28 	(c) Commission members may make a positive recommendation, a negative 
44.29 	recommendation, or no recommendation on a proposed expenditure. If a majority of the 
44.30 	commission members from the senate and a majority of the commission members from the 
44.31 	house of representatives make a negative recommendation on a proposed expenditure, the 
44.32 	commissioner is prohibited from expending the money. If a majority of the commission 
45.1 	members from the senate and a majority of the commission members from the house of 
45.2 	representatives do not make a negative recommendation, or if the commission makes no 
45.3 	recommendation, the commissioner may expend the money.
45.4 	(d) The commission may hold a public meeting to approve or disapprove a proposed 
45.5 	expenditure from the hospital stabilization reserve account. Notwithstanding section 3.055, 
45.6 	the commission may conduct a public meeting remotely. The commission may approve or 
45.7 	disapprove proposed expenditures without a public meeting. The commission members 
45.8 	may approve or disapprove proposed expenditures via written communication sent to the 
45.9 	commissioner of management and budget.

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

45.11 	Sec. 4. Minnesota Statutes 2024, section 16A.152, subdivision 2, is amended to read:
45.12 		Subd. 2.Additional revenues; priority. (a) If on the basis of a forecast of general fund 
45.13 	revenues and expenditures, the commissioner of management and budget determines that 
45.14 	there will be a positive unrestricted budgetary general fund balance at the close of the 
45.15 	biennium, the commissioner of management and budget must allocate money to the following 
45.16 	accounts and purposes in priority order:
45.17 	(1) the cash flow account established in subdivision 1 until that account reaches 
45.18 	$350,000,000;
45.19 	(2) the budget reserve account established in subdivision 1a until that account reaches 
45.20 	$2,852,098,000 $3,421,764,000;
45.21 	(3) the amount necessary to increase the aid payment schedule for school district aids 
45.22 	and credits payments in section 127A.45 to not more than 90 percent rounded to the nearest 
45.23 	tenth of a percent without exceeding the amount available and with any remaining funds 
45.24 	deposited in the budget reserve; and
45.25 	(4) the amount necessary to restore all or a portion of the net aid reductions under section 
45.26 	127A.441 and to reduce the property tax revenue recognition shift under section 123B.75, 
45.27 	subdivision 5, by the same amount.
45.28 	(b) The amounts necessary to meet the requirements of this section are appropriated 
45.29 	from the general fund within two weeks after the forecast is released or, in the case of 
45.30 	transfers under paragraph (a), clauses (3) and (4), as necessary to meet the appropriations 
45.31 	schedules otherwise established in statute.
46.1 	(c) The commissioner of management and budget shall certify the total dollar amount 
46.2 	of the reductions under paragraph (a), clauses (3) and (4), to the commissioner of education. 
46.3 	The commissioner of education shall increase the aid payment percentage and reduce the 
46.4 	property tax shift percentage by these amounts and apply those reductions to the current 
46.5 	fiscal year and thereafter.

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

46.7 	Sec. 5. Minnesota Statutes 2024, section 16A.152, subdivision 4, is amended to read:
46.8 		Subd. 4.Reduction. (a) If the commissioner determines that probable receipts for the 
46.9 	general fund will be less than anticipated, and that the amount available for the remainder 
46.10 	of the biennium will be less than needed, the commissioner shall, with the approval of the 
46.11 	governor, and after consulting the Legislative Advisory Commission, reduce the amount in 
46.12 	the budget reserve account and the hospital stabilization reserve as needed to balance 
46.13 	expenditures with revenue.
46.14 	(b) An additional deficit shall, with the approval of the governor, and after consulting 
46.15 	the Legislative Advisory Commission, be made up by reducing unexpended allotments of 
46.16 	any prior appropriation or transfer. Notwithstanding any other law to the contrary, the 
46.17 	commissioner is empowered to defer or suspend prior statutorily created obligations which 
46.18 	would prevent effecting such reductions.
46.19 	(c) If the commissioner determines that probable receipts for any other fund, 
46.20 	appropriation, or item will be less than anticipated, and that the amount available for the 
46.21 	remainder of the term of the appropriation or for any allotment period will be less than 
46.22 	needed, the commissioner shall notify the agency concerned and then reduce the amount 
46.23 	allotted or to be allotted so as to prevent a deficit.
46.24 	(d) In reducing allotments, the commissioner may consider other sources of revenue 
46.25 	available to recipients of state appropriations and may apply allotment reductions based on 
46.26 	all sources of revenue available.
46.27 	(e) In like manner, the commissioner shall reduce allotments to an agency by the amount 
46.28 	of any saving that can be made over previous spending plans through a reduction in prices 
46.29 	or other cause.
46.30 	(f) The commissioner is prohibited from reducing an allotment or appropriation made 
46.31 	to the legislature.

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

47.1 	Sec. 6. [144.7051] HOSPITAL STABILIZATION RESERVE.
47.2 		Subdivision 1.Eligibility. A hospital is eligible to receive payment under section 
47.3 	16A.152, subdivision 1d, if 40 percent of the hospital's total acute care admissions in each 
47.4 	of calendar years 2022, 2023, and 2024 were medical assistance or MinnesotaCare enrollees, 
47.5 	the hospital provided 15 percent or more of Minnesota's total uncompensated care in calendar 
47.6 	year 2024 as determined by the commissioner of health, and costs incurred for uncompensated 
47.7 	care were at least three percent of the hospital's operating revenue in calendar year 2024.
47.8 		Subd. 2.Quarterly financial statements. An eligible hospital under subdivision 1 must 
47.9 	submit a quarterly report to the commissioner of health beginning on October 1, 2026. Each 
47.10 	report must provide the following information:
47.11 	(1) the hospital's monthly cash position for the current quarter;
47.12 	(2) the hospital's net operating margin for the previous quarter;
47.13 	(3) updates to the hospital's net operating margin for the last four quarters that reflect 
47.14 	adjustments and any completed audits since the prior quarterly report; and
47.15 	(4) information necessary to support clauses (1) to (3).
47.16 		Subd. 3.Eligibility certification. (a) If the chief executive officer of an eligible hospital 
47.17 	under subdivision 1 provides written notice to the commissioner of health that the hospital 
47.18 	had less than 60 days of operating cash at any time during the preceding 12 months, and 
47.19 	that the hospital had an operating margin loss of at least 1.5 percent at any time  during the 
47.20 	preceding 12 months, the commissioner must review and certify whether the hospital is 
47.21 	eligible to receive a payment from the hospital stabilization reserve to maintain stable 
47.22 	operations and avoid substantial negative operating effects for the next 12 months. If the 
47.23 	information provided to the commissioner is insufficient to make a certification of eligibility 
47.24 	determination, the commissioner may request additional information to support the 
47.25 	certification request. In making a certification determination, the commissioner must not 
47.26 	include payments received from the hospital stabilization reserve established in section 
47.27 	16A.152, subdivision 1c, or any fiscal year 2026 and 2027 appropriations.
47.28 	(b) The commissioner must make a certification decision within 30 days of receiving 
47.29 	the written notice and associated documentation from the chief executive officer. The 
47.30 	commissioner must provide a written response to the chief executive officer within 45 days 
47.31 	of receiving the written notice and associated documentation. If the commissioner certifies 
47.32 	that the hospital should receive a payment from the hospital stabilization reserve, the 
48.1 	commissioner must notify the commissioner of management and budget within 15 days of 
48.2 	making that certification.
48.3 		Subd. 4.Payment. (a) If the commissioner of management and budget receives 
48.4 	notification from the commissioner of health under subdivision 3 that a hospital is certified 
48.5 	to receive a payment from the hospital stabilization reserve, the commissioner of management 
48.6 	and budget must submit the proposed payment to the Legislative Advisory Commission 
48.7 	under section 16A.152, subdivision 1e, for the commission's review.
48.8 	(b) A certified hospital must submit sufficient information determined by the 
48.9 	commissioner of management and budget to support the submission of the certified payment 
48.10 	to the Legislative Advisory Commission.
48.11 	(c) If a negative review from the Legislative Advisory Commission is not received, the 
48.12 	commissioner of management and budget must pay the eligible hospital from the hospital 
48.13 	stabilization reserve under section 16A.152, subdivision 1d.

48.14 	EFFECTIVE DATE. This section is effective July 15, 2027.

48.15 	Sec. 7. Minnesota Statutes 2024, section 383B.903, subdivision 1, is amended to read:
48.16 		Subdivision 1.Governance. The corporation shall be governed by a board of directors 
48.17 	consisting that consists of between 11 and 15 directors and that includes members with the 
48.18 	professional training and expertise needed to govern a health system and safety net hospital. 
48.19 	Two of the directors on the board of the corporation must be county commissioners currently 
48.20 	serving as elected officials on the county board who are chosen and may be removed by a 
48.21 	majority vote of the county board.

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

48.23 	Sec. 8. Minnesota Statutes 2024, section 383B.903, subdivision 4, is amended to read:
48.24 		Subd. 4.Qualifications. Members of the board shall must possess a high degree of 
48.25 	experience and knowledge in relevant fields needed to govern a health system and safety 
48.26 	net hospital and must possess a high degree of interest in the corporation and support for 
48.27 	its mission. Members shall be appointed based in part on the objective of ensuring that the 
48.28 	corporation includes diverse and beneficial perspectives and experience including, but not 
48.29 	limited to, those of medical or other health professionals, At least 75 percent of the board's 
48.30 	noncounty commissioner members must have expertise in hospital administration, finance, 
48.31 	business management, law, or health equity, or have other experience relevant to the 
48.32 	administration of a health system and safety net hospital, with a preference for members 
49.1 	with experience working in an urban setting with diverse cultural communities. Up to 25 
49.2 	percent of the board's noncounty commissioner members may represent urban, cultural,
49.3 	and ethnic perspectives of the population served by the corporation, business management, 
49.4 	law, finance, health sector employees, public health, serving the uninsured, health 
49.5 	professional training, and the patient or consumer perspective. The corporation shall provide 
49.6 	a public announcement of vacancies on the board of the corporation in the manner normally 
49.7 	used by Hennepin County to provide public notice of open appointments.

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

49.9 	Sec. 9. Minnesota Statutes 2024, section 383B.904, subdivision 1, is amended to read:
49.10 		Subdivision 1.Election. (a) The officers of the board of the corporation shall consist of 
49.11 	the chair, vice-chair, secretary, treasurer, and other officers as the board shall from time to 
49.12 	time deem necessary. The board shall elect officers by a majority vote of the board at the 
49.13 	annual meeting, or in the case of the initial board, at the first meeting following appointment 
49.14 	by the county board. The county commissioner members of the corporate board are not 
49.15 	eligible to serve as officers of the corporate board.
49.16 	(b) Any of the offices or functions, with the exception of the chair and vice-chair, may 
49.17 	be held or exercised by the same person.

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

49.19 	Sec. 10. Minnesota Statutes 2024, section 383B.908, subdivision 5, is amended to read:
49.20 		Subd. 5.Financial oversight. The county board shall must approve the annual budget 
49.21 	of the corporation as presented by the corporate board and shall receive an annual audited 
49.22 	financial statement. The annual budget shall address how efficiencies and revenues contribute 
49.23 	to stabilize or reduce county liabilities for indigent care. The county board shall also retain 
49.24 	the right:
49.25 	(1) to conduct an independent audit of the finances of the corporation.; and
49.26 	(2) in sustained conditions of financial distress, to modify the corporation's annual budget 
49.27 	as needed to respond to the corporation's financial condition while preserving access to 
49.28 	essential health services provided by HCMC.

49.29 	Sec. 11. Minnesota Statutes 2024, section 383B.908, subdivision 7, is amended to read:
49.30 		Subd. 7.Dissolution or reorganization of corporation. The county board shall retain 
49.31 	the right to dissolve the corporation, reorganize the corporation, or remove the entire 
50.1 	corporate board in order to resume management of and financial oversight over Hennepin 
50.2 	County Medical Center upon a two-thirds vote of the entire county board. if:
50.3 	(1) the corporation experiences sustained conditions of financial distress, such as but 
50.4 	not limited to the corporation meeting at least two of the following conditions:
50.5 	(i) a negative operating margin of more than $30,000,000 for two consecutive years;
50.6 	(ii) a decline in net assets of more than ten percent in the most recent year; or
50.7 	(iii) a negative cash flow margin of more than ten percent in the most recent year;
50.8 	(2) prior to taking any steps to dissolve the corporation, reorganize the corporation, or 
50.9 	remove the entire corporate board, the county board and the corporate board engage in 
50.10 	mediation in good faith. The attorney general may select an individual to serve as a mediator. 
50.11 	In the mediation, the parties must attempt to address the corporation's conditions of financial 
50.12 	distress through means other than dissolving the corporation, reorganizing the corporation, 
50.13 	or removing the entire corporate board; and
50.14 	(3) the county board and corporate board are not able to agree on another means to 
50.15 	address the corporation's financial distress.

50.16 	Sec. 12. Laws 2023, chapter 68, article 1, section 2, subdivision 2, as amended by Laws 
50.17 	2025, First Special Session chapter 8, article 1, section 13, is amended to read:

50.18	Subd. 2.Multimodal Systems
 					
50.19 	(a) Aeronautics

50.20	(1) Airport Development and Assistance
		69,598,000
		18,598,000

50.21	Appropriations by Fund
	
50.22		2024
	2025
	
50.23	General
	36,000,000
	-0-
	
50.24	Airports
	33,598,000
	18,598,000
	
50.25 	The appropriation from the state airports fund 
50.26 	must be spent according to Minnesota Statutes, 
50.27 	section 360.305, subdivision 4.
50.28 	$36,000,000 in fiscal year 2024 is from the 
50.29 	general fund for matches to federal aid and 
50.30 	state investments related to airport 
50.31 	infrastructure projects. This is a onetime 
51.1 	appropriation and is available until June 30, 
51.2 	2027.
51.3 	$15,000,000 in fiscal year 2024 is from the 
51.4 	state airports fund for system maintenance of 
51.5 	critical airport safety systems, equipment, and 
51.6 	essential airfield technology.
51.7 	Notwithstanding Minnesota Statutes, section 
51.8 	16A.28, subdivision 6, the appropriation from 
51.9 	the state airports fund is available for five 
51.10 	years after the year of the appropriation. If the 
51.11 	appropriation for either year is insufficient, 
51.12 	the appropriation for the other year is available 
51.13 	for it.
51.14 	If the commissioner of transportation 
51.15 	determines that a balance remains in the state 
51.16 	airports fund following the appropriations 
51.17 	made in this article and that the appropriations 
51.18 	made are insufficient for advancing airport 
51.19 	development and assistance projects, an 
51.20 	amount necessary to advance the projects, not 
51.21 	to exceed the balance in the state airports fund, 
51.22 	is appropriated in each year to the 
51.23 	commissioner and must be spent according to 
51.24 	Minnesota Statutes, section 360.305, 
51.25 	subdivision 4. Within two weeks of a 
51.26 	determination under this contingent 
51.27 	appropriation, the commissioner of 
51.28 	transportation must notify the commissioner 
51.29 	of management and budget and the chairs, 
51.30 	ranking minority members, and staff of the 
51.31 	legislative committees with jurisdiction over 
51.32 	transportation finance concerning the funds 
51.33 	appropriated. Funds appropriated under this 
51.34 	contingent appropriation do not adjust the base 
51.35 	for fiscal years 2026 and 2027.

52.1	(2) Aviation Support Services
		15,397,000
		8,431,000

52.2	Appropriations by Fund
	
52.3		2024
	2025
	
52.4	General
	8,707,000
	1,741,000
	
52.5	Airports
	6,690,000
	6,690,000
	
52.6 	$7,000,000 in fiscal year 2024 is from the 
52.7 	general fund to purchase two utility aircraft 
52.8 	for the Department of Transportation.

52.9	(3) Civil Air Patrol
		80,000
		80,000
	
52.10 	This appropriation is from the state airports 
52.11 	fund for the Civil Air Patrol.

52.12	(b) Transit and Active Transportation
		58,478,000
		18,374,000
	
52.13 	This appropriation is from the general fund.
52.14 	$200,000 in fiscal year 2024 and $50,000 in 
52.15 	fiscal year 2025 are for a grant to the city of 
52.16 	Rochester to implement demand response 
52.17 	transit service using electric transit vehicles. 
52.18 	The money is available for mobile software 
52.19 	application development; vehicles and 
52.20 	equipment, including accessible vehicles; 
52.21 	associated charging infrastructure; and capital 
52.22 	and operating costs.
52.23 	$40,000,000 in fiscal year 2024 is for matches 
52.24 	to federal aid and state investments related to 
52.25 	transit and active transportation projects. This 
52.26 	is a onetime appropriation and is available 
52.27 	until June 30, 2027.

52.28	(c) Safe Routes to School
		15,297,000
		10,500,000
	
52.29 	This appropriation is from the general fund 
52.30 	for the safe routes to school program under 
52.31 	Minnesota Statutes, section 174.40.
52.32 	If the appropriation for either year is 
52.33 	insufficient, the appropriation for the other 
53.1 	year is available for it. The appropriations in 
53.2 	each year are available until June 30, 2027.
53.3 	The base for this appropriation is $1,500,000 
53.4 	in each of fiscal years 2026 and 2027.

53.5	(d) Passenger Rail
		197,521,000
		4,226,000
	
53.6 	This appropriation is from the general fund 
53.7 	for passenger rail activities under Minnesota 
53.8 	Statutes, sections 174.632 to 174.636.
53.9 	$194,700,000 in fiscal year 2024 is for capital 
53.10 	improvements and betterments for the 
53.11 	Minneapolis-Duluth Northern Lights Express 
53.12 	intercity passenger rail project, including 
53.13 	preliminary engineering, design, engineering, 
53.14 	environmental analysis and mitigation, 
53.15 	acquisition of land and right-of-way, 
53.16 	equipment and rolling stock, and construction. 
53.17 	From this appropriation, the amount necessary 
53.18 	is for: (1) Coon Rapids station improvements 
53.19 	to establish a joint station that provides for 
53.20 	Amtrak train service on the Empire Builder 
53.21 	line between Chicago and Seattle; and (2) 
53.22 	acquisition of equipment and rolling stock for 
53.23 	purposes of participation in the Midwest fleet 
53.24 	pool to provide for service on Northern Lights 
53.25 	Express and expanded Amtrak train service 
53.26 	between Minneapolis and St. Paul and 
53.27 	Chicago. The commissioner of transportation 
53.28 	must not approve additional stops or stations 
53.29 	beyond those included in the Federal Railroad 
53.30 	Administration's January 2018 Finding of No 
53.31 	Significant Impact and Section 4(f) 
53.32 	Determination if the commissioner determines 
53.33 	that the resulting speed reduction would 
53.34 	negatively impact total ridership. This 
53.35 	appropriation is onetime and is available until 
54.1 	June 30, 2028. Any remaining balance must 
54.2 	cancel to the hospital stabilization reserve 
54.3 	account under Minnesota Statutes, section 
54.4 	16A.152, subdivision 1c.
54.5 	$1,833,000 in fiscal year 2024 and $3,238,000 
54.6 	in fiscal year 2025 are for a match to federal 
54.7 	aid for capital and operating costs for 
54.8 	expanded Amtrak train service between 
54.9 	Minneapolis and St. Paul and Chicago. These 
54.10 	amounts are available until June 30, 2028.
54.11 	The base from the general fund is $5,742,000 
54.12 	in each of fiscal years 2026 and 2027.

54.13	(e) Freight
		14,650,000
		9,066,000

54.14	Appropriations by Fund
	
54.15		2024
	2025
	
54.16	General
	8,283,000
	2,400,000
	
54.17	Trunk Highway
	6,367,000
	6,666,000
	
54.18 	$5,000,000 in fiscal year 2024 is from the 
54.19 	general fund for matching federal aid grants 
54.20 	for improvements, engineering, and 
54.21 	administrative costs for the Stone Arch Bridge 
54.22 	in Minneapolis. This is a onetime 
54.23 	appropriation and is available until June 30, 
54.24 	2027.
54.25 	$1,000,000 in each year is from the general 
54.26 	fund for staff, operating costs, and 
54.27 	maintenance related to weight and safety 
54.28 	enforcement systems.
54.29 	$974,000 in fiscal year 2024 is from the 
54.30 	general fund for procurement costs of a 
54.31 	statewide freight network optimization tool 
54.32 	under Laws 2021, First Special Session 
54.33 	chapter 5, article 4, section 133. This is a 
55.1 	onetime appropriation and is available until 
55.2 	June 30, 2025.

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

55.4 	Sec. 13. Laws 2023, chapter 68, article 1, section 3, subdivision 2, as amended by Laws 
55.5 	2024, chapter 127, article 1, section 11, is amended to read:

55.6	Subd. 2.Transit System Operations
 		75,654,000
		32,654,000
	
55.7 	This appropriation is for transit system 
55.8 	operations under Minnesota Statutes, sections 
55.9 	473.371 to 473.449.
55.10 	$40,000,000 in fiscal year 2024 is for a grant 
55.11 	to Hennepin County for the Blue Line light 
55.12 	rail transit extension project, including but not 
55.13 	limited to predesign, design, engineering, 
55.14 	environmental analysis and mitigation, 
55.15 	right-of-way acquisition, construction, and 
55.16 	acquisition of rolling stock. Of this amount, 
55.17 	$30,000,000 is available only upon entering 
55.18 	a full funding grant agreement with the Federal 
55.19 	Transit Administration by June 30, 2027. This 
55.20 	is a onetime appropriation and is available 
55.21 	until June 30, 2030. If a full funding grant 
55.22 	agreement with the Federal Transit 
55.23 	Administration is not reached by June 30, 
55.24 	2027, this appropriation cancels to the hospital 
55.25 	stabilization reserve under Minnesota Statutes, 
55.26 	section 16A.152, subdivision 1c.
55.27 	$3,000,000 in fiscal year 2024 is for highway 
55.28 	bus rapid transit project development in the 
55.29 	marked U.S. Highway 169 and marked Trunk 
55.30 	Highway 55 corridors, including but not 
55.31 	limited to feasibility study, predesign, design, 
55.32 	engineering, environmental analysis and 
55.33 	remediation, and right-of-way acquisition.

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

56.2 	Sec. 14. HOSPITAL STABILIZATION RESERVE; TRANSFER.
 56.3 	(a) By July 15, 2027, the commissioner of management and budget must transfer 
56.4 	$354,000,000 from the general fund budget reserve account to the hospital stabilization 
56.5 	reserve account. This is a onetime transfer.
56.6 	(b) By July 15, 2028, the commissioner of management and budget must transfer up to 
56.7 	$146,000,000 from the general fund budget reserve account to the hospital stabilization 
56.8 	reserve account. This is a onetime transfer.
56.9 	(c) The total transfers and cancellations credited to the hospital stabilization reserve 
56.10 	account must not exceed $500,000,000.

56.11 	EFFECTIVE DATE. This section is effective July 1, 2027.

56.12 	Sec. 15. HOSPITAL STABILIZATION PROGRAM.
56.13 		Subdivision 1.Establishment. The commissioner of health must establish a hospital 
56.14 	stabilization program to provide financial relief to critical access hospitals, rural emergency 
56.15 	hospitals, and hospitals that provide a disproportionate level of uncompensated care.
56.16 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
56.17 	meanings given.
56.18 	(b) "Commissioner" means the commissioner of health.
56.19 	(c) "Qualifying hospital" means a hospital:
56.20 	(1) licensed under section 144.50;
56.21 	(2) located within the state;
56.22 	(3) that has filed a Medicare cost report in the Healthcare Cost Report Information 
56.23 	System; and
56.24 	(4) that is a Medicaid disproportionate share hospital, excluding a hospital that qualifies 
56.25 	as a Medicaid disproportionate share hospital solely based upon providing transplant services.
56.26 	(d) "Qualifying uncompensated episode of care" means the provision by a qualifying 
56.27 	hospital of one or more services that are covered under medical assistance to an individual 
56.28 	during a single patient encounter or episode of care when the:
56.29 	(1) individual is not enrolled in medical assistance, MinnesotaCare, or Medicare and 
56.30 	does not have other health coverage;
57.1 	(2) individual is determined to be ineligible for medical assistance and MinnesotaCare 
57.2 	for the date of service following any retroactive eligibility determination; and
57.3 	(3) total cumulative reimbursement amount for the services provided, if paid under 
57.4 	medical assistance payment methodologies using a cost to charge methodology as defined 
57.5 	in the Minnesota Health Care Cost Information System, would be at least $2,000 but not 
57.6 	more than $50,000.
57.7 		Subd. 3.Payments to critical access hospitals and rural emergency hospitals. The 
57.8 	commissioner must make a onetime payment of $50,000 to each of the critical access 
57.9 	hospitals and rural emergency hospitals in the state. Payments shall be made in a form and 
57.10 	manner determined by the commissioner.
57.11 		Subd. 4.Application for payments; qualifying hospitals. (a) A qualifying hospital 
57.12 	seeking payment under this section must submit to the commissioner documentation 
57.13 	identifying qualifying uncompensated episodes of care within a reporting period.
57.14 	(b) The reporting periods are:
57.15 	(1) January 1 through June 30; and
57.16 	(2) July 1 through December 31.
57.17 	(c) The initial reporting period begins January 1, 2026.
57.18 	(d) For services provided during the January 1 through June 30 reporting period, a 
57.19 	qualifying hospital must submit the required documentation to the commissioner by 
57.20 	September 15 of the same calendar year.
57.21 	(e) For services provided during the July 1 through December 31 reporting period, a 
57.22 	qualifying hospital must submit the required documentation to the commissioner by March 
57.23 	15 of the next calendar year.
57.24 	(f) Qualifying hospitals must submit documentation in a form and manner specified by 
57.25 	the commissioner and must provide supporting documentation as requested by the 
57.26 	commissioner.
57.27 		Subd. 5.Calculation of payments; qualifying hospitals. (a) For each reporting period, 
57.28 	the commissioner must determine each qualifying hospital's share of the total value of 
57.29 	qualifying uncompensated episodes of care submitted under subdivision 4.
57.30 	(b) The commissioner must distribute payments proportionally based on each qualifying 
57.31 	hospital's share of the statewide total among qualifying hospitals.
58.1 	(c) A qualifying hospital must not receive more than ten percent of the money available 
58.2 	for a reporting period.
58.3 	(d) If money remains after the payment limitation in paragraph (c), the commissioner 
58.4 	must redistribute the remaining money among qualifying hospitals that have not reached 
58.5 	the limit in paragraph (c) in proportion to their share of the value of qualifying 
58.6 	uncompensated episodes of care.
58.7 	(e) The commissioner may establish procedures to reconcile adjustments, corrected 
58.8 	claims, or late submissions in a subsequent reporting period.
58.9 		Subd. 6.Distribution of payments; qualifying hospitals. (a) The amount available for 
58.10 	payments to qualifying hospitals is the amount appropriated for this section that remains 
58.11 	after payments are made under subdivision 3. One-half of the amount available for payments 
58.12 	to qualifying hospitals must be allocated to each reporting period.
58.13 	(b) For the January 1 through June 30 reporting period, the commissioner must distribute 
58.14 	payments no later than November 15 of the same calendar year.
58.15 	(c) For the July 1 through December 31 reporting period, the commissioner must 
58.16 	distribute payments no later than May 15 of the next calendar year.
58.17 		Subd. 7.Reporting requirements; qualifying hospitals. (a) A qualifying hospital 
58.18 	receiving payment under this section must submit to the commissioner any information 
58.19 	necessary to evaluate the appropriate use of funds. The information must include, at 
58.20 	minimum, by June 30, 2027, a detailed analysis of how the funds were used to preserve 
58.21 	regional and local access to essential health care services, including emergency care, inpatient 
58.22 	hospital care, maternal care and obstetrical services, behavioral and mental health care, and 
58.23 	primary care and clinic services.
58.24 	(b) A qualifying hospital receiving payment under this section must submit to the 
58.25 	commissioner, by June 30, 2027, an organizational chart presenting the identities of and 
58.26 	interrelationships among affiliated entities within the hospital system. No subsidiary of an 
58.27 	entity specified on the chart need be shown if the equity or membership interest of the 
58.28 	subsidiary held by the entity is less than ten percent of the subsidiary. As to each entity 
58.29 	specified in the chart, the qualifying hospital must indicate the type of organization and the 
58.30 	state of domicile.
58.31 	(c) Upon receipt of notice by a qualifying hospital receiving payment under this section 
58.32 	submitted pursuant to section 144.555, the commissioner must provide notice of the hospital's 
59.1 	planned actions and documentation of the amount of any payment distributed to the hospital 
59.2 	under this section to:
59.3 	(1) the chairs and ranking minority members of the legislative committees with 
59.4 	jurisdiction over health and human services finance and policy; and
59.5 	(2) the majority and minority leaders of the senate and house of representatives.
59.6 	(d) The commissioner must determine the reporting requirement for payments under 
59.7 	this section in addition to the reporting requirements under section 16B.98, subdivision 12.
59.8 		Subd. 8.Prohibited uses. Funds received under this section must not be used to:
59.9 	(1) supplant any other funding sources; or
59.10 	(2) increase the salary, benefits, or other discretionary payment to an officer, director, 
59.11 	manager, or any other executive.
59.12 		Subd. 9.Hospital stabilization program ineligibility. Hennepin Healthcare System, 
59.13 	Inc., is ineligible for payment under this section.

59.14 	Sec. 16. CORPORATE BOARD OF HENNEPIN HEALTHCARE SYSTEM, INC.; 
59.15 	RECONSTITUTED AND OPERATIONAL.
 59.16 	(a) For purposes of this section, "Hennepin Healthcare System, Inc.," means the public 
59.17 	corporation created under Minnesota Statutes, section 383B.901.
59.18 	(b) By January 15, 2027, the Hennepin County Board of Commissioners must:
59.19 	(1) reconstitute the corporate board of Hennepin Healthcare System, Inc., with members 
59.20 	who meet the requirements in Minnesota Statutes, section 383B.903, subdivision 4; and
59.21 	(2) complete the transition of governance of Hennepin Healthcare System, Inc., to the 
59.22 	reconstituted corporate board.

59.23 	Sec. 17. HENNEPIN HEALTHCARE SYSTEM, INC.; STABILIZATION 
59.24 	PAYMENTS.
 59.25 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
59.26 	the meanings given.
59.27 	(b) "Commissioner" means the commissioner of health.
59.28 	(c) "HCMC" has the meaning given in Minnesota Statutes, section 383B.902.
60.1 	(d) "Hennepin Healthcare System, Inc.," means the public corporation created under 
60.2 	Minnesota Statutes, section 383B.901.
60.3 		Subd. 2.Annual stabilization payments. The commissioner of health must award 
60.4 	stabilization payments to Hennepin Healthcare System, Inc., in fiscal years 2026 and 2027 
60.5 	to stabilize HCMC operations, avoid the closure of HCMC, ensure that HCMC continues 
60.6 	to provide high-quality care to patients, and preserve access to essential services at HCMC 
60.7 	that support the health care needs of the communities served by HCMC and of the state of 
60.8 	Minnesota.
60.9 		Subd. 3.Accountability requirements. (a) To ensure that Hennepin Healthcare System, 
60.10 	Inc., is meeting the requirements of this section, the commissioner must collect from HCMC 
60.11 	the information necessary to complete the commissioner's reporting requirements under 
60.12 	subdivision 4 and must collect from HCMC the following information in fiscal year 2027:
60.13 	(1) a comprehensive financial analysis that describes the financial stability of HCMC. 
60.14 	The report must consider the core financial metrics of HCMC, including expenses and 
60.15 	staffing data; revenue, including payer mix; utilization data; and necessary data as determined 
60.16 	by the commissioner; and
60.17 	(2) quarterly updates of financial information submitted under the hospital annual report 
60.18 	according to Minnesota Statutes, sections 144.695 to 144.703, on a schedule to be determined 
60.19 	by the commissioner, and long-term capital spending priorities, including mandatory 
60.20 	maintenance and replacement of existing facilities and equipment.
60.21 	(b) Upon receipt of notice by Hennepin Healthcare System, Inc., provided according to 
60.22 	Minnesota Statutes, section 144.555, the commissioner must provide notice of Hennepin 
60.23 	Healthcare System, Inc.'s planned actions to:
60.24 	(1) the chairs and ranking minority members of the legislative committees with 
60.25 	jurisdiction over health and human services finance and policy; and
60.26 	(2) the majority and minority leaders of the senate and house of representatives.
60.27 		Subd. 4.Reporting requirement. (a) By January 15, 2028, the commissioner must 
60.28 	report to the legislative committees with jurisdiction over health and human services finance 
60.29 	and policy on the financial stabilization of Hennepin Healthcare System, Inc.
60.30 	(b) Hennepin Healthcare System, Inc., must provide the commissioner with all 
60.31 	information and documents requested by the commissioner, including nonpublic data from 
60.32 	HCMC, for purposes of this subdivision and subdivision 3. For purposes of this subdivision 
61.1 	and subdivision 3, "nonpublic data" has the meaning given in Minnesota Statutes, section 
61.2 	13.02, subdivision 9.

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

61.4 	Sec. 18. ADVISORY TASK FORCE ON GOVERNANCE AND FINANCING OF 
61.5 	HENNEPIN HEALTHCARE SYSTEM, INC.
 61.6 		Subdivision 1.Establishment. An advisory task force on governance and financing of 
61.7 	Hennepin Healthcare System, Inc., is established to develop recommendations to the 
61.8 	legislature on the ownership, governance, and financing of Hennepin Healthcare System, 
61.9 	Inc., including its integrated system of health care facilities and services that includes 
61.10 	Hennepin County Medical Center. The advisory task force must evaluate options that 
61.11 	recognize Hennepin County Medical Center as a regional and statewide public health and 
61.12 	public safety asset that:
61.13 	(1) provides critical health care services to:
61.14 	(i) complex patients with high medical needs;
61.15 	(ii) a large proportion of the state's medical assistance, MinnesotaCare, and uninsured 
61.16 	populations; and
61.17 	(iii) patients from health care providers and health systems across Minnesota and the 
61.18 	surrounding region. These services include level I trauma care, hyperbaric medicine, 
61.19 	treatment services for burns and complex wounds, comprehensive cancer care, and accredited 
61.20 	poison control services; and
61.21 	(2) supports Minnesota's future health care workforce through education and training.
61.22 		Subd. 2.Membership. (a) The advisory task force shall consist of the following nine 
61.23 	members appointed by the governor. Members shall be direct appointments as defined in 
61.24 	Minnesota Statutes, section 15.0597, subdivision 1:
61.25 	(1) one individual from the Health Subcabinet under Minnesota Statutes, section 4.047;
61.26 	(2) the chief executive officer of Hennepin County Medical Center;
61.27 	(3) one individual representing Hennepin County;
61.28 	(4) one individual with expertise in academic medicine, clinical and public health 
61.29 	research, hospital operations, or health system finance;
61.30 	(5) one individual with professional experience in public health;
62.1 	(6) one individual with professional experience in safety net hospital and clinical system 
62.2 	operations;
62.3 	(7) two individuals with professional experience in health care finance and public health 
62.4 	care programs; and
62.5 	(8) one individual with professional experience in public sector governance and public 
62.6 	authorities.
62.7 	(b) Members must be appointed to the advisory task force by August 1, 2026, and serve 
62.8 	until the advisory task force expires.
62.9 		Subd. 3.Governance; first meeting; chairperson. (a) Compensation and removal of 
62.10 	members appointed under subdivision 2 are governed by Minnesota Statutes, section 15.059.
62.11 	(b) The individual from the Health Subcabinet who is appointed to the advisory task 
62.12 	force must convene the first meeting of the advisory task force by September 1, 2026, and 
62.13 	shall serve as the chairperson of the advisory task force.
62.14 		Subd. 4.Duties. The advisory task force must:
62.15 	(1) evaluate the current governance structure, payer mix, and financing of Hennepin 
62.16 	Healthcare System, Inc.;
62.17 	(2) evaluate whether public health care program reimbursement rates adequately 
62.18 	reimburse Hennepin County Medical Center for the cost of care provided;
62.19 	(3) evaluate labor and workforce needs and challenges at Hennepin County Medical 
62.20 	Center;
62.21 	(4) identify and evaluate Hennepin County Medical Center's capital, infrastructure, and 
62.22 	technology needs;
62.23 	(5) evaluate governance and ownership models of health systems comparable to Hennepin 
62.24 	Healthcare System, Inc.;
62.25 	(6) evaluate financing and funding mechanisms that would allow Hennepin Healthcare 
62.26 	System, Inc., to achieve sustainable, long-term financial stability while ensuring the continued 
62.27 	operation of critical specialized services by Hennepin County Medical Center that are 
62.28 	essential to Minnesota's comprehensive statewide hospital network of rural, regional, and 
62.29 	safety net hospitals;
62.30 	(7) engage with public health leaders throughout the state and professionals and 
62.31 	individuals with the following qualifications or with expertise in the following areas:
63.1 	(i) rural hospitals and rural health systems;
63.2 	(ii) urban, nonprofit hospitals other than Hennepin County Medical Center;
63.3 	(iii) physicians licensed and practicing in Minnesota with experience in emergency 
63.4 	medicine, trauma care, critical care, or hospital medicine;
63.5 	(iv) registered nurses;
63.6 	(v) organized labor representing hospital workers or health care workers;
63.7 	(vi) ambulance service providers or emergency medical services;
63.8 	(vii) local public health departments or community health boards;
63.9 	(viii) federally qualified health centers or other community clinics serving low-income 
63.10 	patients;
63.11 	(ix) consumer or patient advocates with experience accessing services from a safety net 
63.12 	hospital; and
63.13 	(x) state legislators, county commissioners, and state agency commissioners; and
63.14 	(8) develop specific recommendations for an ownership structure, governance and 
63.15 	oversight, and sustainable, long-term funding for Hennepin Healthcare System, Inc. In 
63.16 	developing these recommendations, the task force must consider how to maintain Hennepin 
63.17 	County Medical Center as a public hospital and whether ownership of Hennepin Healthcare 
63.18 	System, Inc., should be transferred to an entity other than solely Hennepin County. These 
63.19 	recommendations must identify legislative changes needed to implement the 
63.20 	recommendations, provide legislative language for the needed legislative changes, and 
63.21 	specify a process to implement changes to ownership, governance and oversight, and funding.
63.22 		Subd. 5.Data. (a) The advisory task force may request data and technical assistance 
63.23 	from state agencies, hospital systems, and other stakeholders as necessary to carry out its 
63.24 	duties.
63.25 	(b) Data provided to the advisory task force under this subdivision retains its classification 
63.26 	under Minnesota Statutes, chapter 13, and any other applicable state or federal law.
63.27 		Subd. 6.Administrative support and cooperation. The Health Subcabinet must provide 
63.28 	meeting space and administrative services for the advisory task force. State agencies must 
63.29 	provide technical assistance upon the request of the advisory task force.
63.30 		Subd. 7.Findings and recommendations. (a) By January 15, 2027, the advisory task 
63.31 	force must submit preliminary findings and recommendations to the chairs and ranking 
64.1 	minority members of the legislative committees with jurisdiction over health and human 
64.2 	services finance and policy. The preliminary findings and recommendations must include 
64.3 	information on the meetings and activities of the advisory task force to date, identification 
64.4 	of priority focus areas and preliminary findings and recommendations on the subjects listed 
64.5 	in subdivision 4, recommendations on steps to improve the stabilization of Hennepin 
64.6 	Healthcare System, Inc., and plans for future meetings and work.
64.7 	(b) By January 15, 2028, the advisory task force must submit final findings and 
64.8 	recommendations to the chairs and ranking minority members of the legislative committees 
64.9 	with jurisdiction over health finance and policy and human services finance and policy. The 
64.10 	final findings and recommendations must address the subjects listed in subdivision 4.
64.11 		Subd. 8.Expiration. The advisory task force expires June 30, 2028.

64.12 	ARTICLE 4
64.13 	HEALTH LICENSING BOARDS

64.14 	Section 1. Minnesota Statutes 2024, section 148.01, subdivision 1, is amended to read:
64.15 		Subdivision 1.Definitions. For the purposes of sections 148.01 to 148.10:
64.16 	(1) "abnormal articulation" means the condition of opposing bony joint surfaces and 
64.17 	their related soft tissues that do not function normally, including subluxation, fixation, 
64.18 	adhesion, degeneration, deformity, dislocation, or other pathology that results in pain or 
64.19 	disturbances within the nervous system, results in postural alteration, inhibits motion, allows 
64.20 	excessive motion, alters direction of motion, or results in loss of axial loading efficiency, 
64.21 	or a combination of these;
64.22 	(2) "acupuncture" means a modality of treating abnormal physical conditions by 
64.23 	stimulating various points of the body or interruption of the cutaneous integrity by needle 
64.24 	insertion to secure a reflex relief of the symptoms by nerve stimulation as utilized as an 
64.25 	adjunct to chiropractic adjustment;
64.26 	(3) "animal chiropractic diagnosis and treatment" means treatment that includes 
64.27 	identification and resolution of vertebral subluxation complexes, spinal manipulation, and 
64.28 	manipulation of the extremity articulations of nonhuman vertebrates. Animal chiropractic 
64.29 	diagnosis and treatment does not include:
64.30 	(i) performing surgery;
64.31 	(ii) dispensing or administering medications; or
64.32 	(iii) performing traditional veterinary care and diagnosis;
65.1 	(1)(4) "chiropractic" means the health care discipline that recognizes the innate 
65.2 	recuperative power of the body to heal itself without the use of drugs or surgery by identifying 
65.3 	and caring for vertebral subluxations and other abnormal articulations by emphasizing the 
65.4 	relationship between structure and function as coordinated by the nervous system and how 
65.5 	that relationship affects the preservation and restoration of health;
65.6 	(2) (5) "chiropractic services" means the evaluation and facilitation of structural, 
65.7 	biomechanical, and neurological function and integrity through the use of adjustment, 
65.8 	manipulation, mobilization, or other procedures accomplished by manual or mechanical 
65.9 	forces applied to bones or joints and their related soft tissues for correction of vertebral 
65.10 	subluxation, other abnormal articulations, neurological disturbances, structural alterations, 
65.11 	or biomechanical alterations, and includes, but is not limited to, manual therapy and 
65.12 	mechanical therapy as defined in section 146.23;
65.13 	(3) "abnormal articulation" means the condition of opposing bony joint surfaces and 
65.14 	their related soft tissues that do not function normally, including subluxation, fixation, 
65.15 	adhesion, degeneration, deformity, dislocation, or other pathology that results in pain or 
65.16 	disturbances within the nervous system, results in postural alteration, inhibits motion, allows 
65.17 	excessive motion, alters direction of motion, or results in loss of axial loading efficiency, 
65.18 	or a combination of these;
65.19 	(4) (6) "diagnosis" means the physical, clinical, and laboratory examination of the patient, 
65.20 	and the use of diagnostic services for diagnostic purposes within the scope of the practice 
65.21 	of chiropractic described in sections 148.01 to 148.10;
65.22 	(5) (7) "diagnostic services" means clinical, physical, laboratory, and other diagnostic 
65.23 	measures, including diagnostic imaging that may be necessary to determine the presence 
65.24 	or absence of a condition, deficiency, deformity, abnormality, or disease as a basis for 
65.25 	evaluation of a health concern, diagnosis, differential diagnosis, treatment, further 
65.26 	examination, or referral;
65.27 	(8) "good standing" means that a license is not the subject of current disciplinary action 
65.28 	under section 148.10 or an equivalent disciplinary law in another jurisdiction;
65.29 	(9) "reinstatement" means the process by which a board-terminated license or voluntarily 
65.30 	retired license returns to active license status under section 148.071 or 148.076;
65.31 	(6) (10) "therapeutic services" means rehabilitative therapy as defined in Minnesota 
65.32 	Rules, part 2500.0100, subpart 11, and all of the therapeutic, rehabilitative, and preventive 
65.33 	sciences and procedures for which the licensee was subject to examination under section 
65.34 	148.06. When provided, therapeutic services must be performed within a practice where 
66.1 	the primary focus is the provision of chiropractic services, to prepare the patient for 
66.2 	chiropractic services, or to complement the provision of chiropractic services. The 
66.3 	administration of therapeutic services is the responsibility of the treating chiropractor and 
66.4 	must be rendered under the direct supervision of qualified staff; and
66.5 	(7) "acupuncture" means a modality of treating abnormal physical conditions by 
66.6 	stimulating various points of the body or interruption of the cutaneous integrity by needle 
66.7 	insertion to secure a reflex relief of the symptoms by nerve stimulation as utilized as an 
66.8 	adjunct to chiropractic adjustment. Acupuncture may not be used as an independent therapy 
66.9 	or separately from chiropractic services. Acupuncture is permitted under section 148.01
66.10 	only after registration with the board which requires completion of a board-approved course 
66.11 	of study and successful completion of a board-approved national examination on acupuncture. 
66.12 	Renewal of registration shall require completion of board-approved continuing education 
66.13 	requirements in acupuncture. The restrictions of section 147B.02, subdivision 2, apply to 
66.14 	individuals registered to perform acupuncture under this section; and
66.15 	(8) "animal chiropractic diagnosis and treatment" means treatment that includes 
66.16 	identifying and resolving vertebral subluxation complexes, spinal manipulation, and 
66.17 	manipulation of the extremity articulations of nonhuman vertebrates. Animal chiropractic 
66.18 	diagnosis and treatment does not include:
66.19 	(i) performing surgery;
66.20 	(ii) dispensing or administering of medications; or
66.21 	(iii) performing traditional veterinary care and diagnosis.
66.22 	(11) "voluntarily retired license" means a license held by a chiropractor who has changed 
66.23 	the chiropractor's license status to a voluntarily retired license under section 148.075.

66.24 	Sec. 2. Minnesota Statutes 2024, section 148.01, subdivision 4, is amended to read:
66.25 		Subd. 4.Practice of chiropractic. An individual licensed to practice under section 
66.26 	148.06 is authorized to perform chiropractic services, acupuncture, and therapeutic services, 
66.27 	and to provide diagnosis and to render opinions pertaining to those services for the purpose 
66.28 	of determining a course of action in the best interests of the patient, such as a treatment 
66.29 	plan, appropriate referral, or both.

67.1 	Sec. 3. Minnesota Statutes 2024, section 148.01, is amended by adding a subdivision to 
67.2 	read:
67.3 		Subd. 5.Practice of therapeutic services. Therapeutic services must be performed 
67.4 	within a practice where the primary focus is the provision of chiropractic services, preparing 
67.5 	the patient for chiropractic services, or complementing the provision of chiropractic services. 
67.6 	The administration of therapeutic services is the responsibility of the treating chiropractor 
67.7 	and must be rendered under the direct supervision of qualified staff.

67.8 	Sec. 4. Minnesota Statutes 2024, section 148.01, is amended by adding a subdivision to 
67.9 	read:
67.10 		Subd. 6.Practice of acupuncture. Acupuncture must not be used as an independent 
67.11 	therapy or separately from chiropractic services. Acupuncture is permitted under this section 
67.12 	only after registration with the board, which requires completing a board-approved course 
67.13 	of study and a board-approved national examination on acupuncture. Renewal of registration 
67.14 	requires completing board-approved continuing education requirements in acupuncture. 
67.15 	The restrictions of section 147B.02, subdivision 2, apply to individuals registered to perform 
67.16 	acupuncture under this section.

67.17 	Sec. 5. [148.071] REINSTATEMENT OF A LICENSE TERMINATED FOR 
67.18 	FAILING TO RENEW OR TO COMPLETE CONTINUING EDUCATION.
67.19 		Subdivision 1.Scope. This section applies to a chiropractor whose Minnesota license 
67.20 	was terminated by the board for failing to timely renew the license or complete annual 
67.21 	continuing education requirements.
67.22 		Subd. 2.Application requirements. At the time of application for reinstatement, the 
67.23 	applicant must:
67.24 	(1) submit an application for reinstatement and pay the application fee;
67.25 	(2) pay the current renewal fee;
67.26 	(3) complete a criminal background check as prescribed under section 214.075 and pay 
67.27 	the required fee;
67.28 	(4) submit license verification from each jurisdiction where the applicant holds or has 
67.29 	held a chiropractic license;
67.30 	(5) submit evidence of passing the board's jurisprudence exam;
68.1 	(6) submit evidence of correcting any outstanding requirements and paying any 
68.2 	outstanding fees that existed at the time the license was terminated; and
68.3 	(7) complete any additional applicable requirements established in subdivisions 3, 4, 5, 
68.4 	6, and 9.
68.5 		Subd. 3.Reinstatement of terminated license for licensee in good standing in another 
68.6 	jurisdiction. The board must reinstate the license of an applicant who is currently licensed 
68.7 	and in good standing in another jurisdiction if the applicant:
68.8 	(1) completes all requirements in subdivision 2;
68.9 	(2) provides verification of the active chiropractic license in good standing in another 
68.10 	jurisdiction; and
68.11 	(3) provides verification of completing 20 continuing education hours in the year 
68.12 	immediately preceding the application for reinstatement.
68.13 		Subd. 4.Reinstatement of terminated license after five years or less. The board must 
68.14 	reinstate the license of an applicant who does not meet the requirements of subdivision 3 
68.15 	and who applies for reinstatement five years or less after license termination in Minnesota 
68.16 	or another jurisdiction if the applicant:
68.17 	(1) completes all requirements in subdivision 2; and
68.18 	(2) provides verification of:
68.19 	(i) completing 20 continuing education hours for each year since the applicant last held 
68.20 	an active license in good standing in Minnesota or another jurisdiction and 20 continuing 
68.21 	education hours in the year immediately preceding the application for reinstatement; or
68.22 	(ii) passing the Special Purposes Examination for Chiropractic, or an alternate 
68.23 	examination the board determines is equivalent, within 12 months after application.
68.24 		Subd. 5.Reinstatement of terminated license after more than five years. The board 
68.25 	must reinstate the license of an applicant who does not meet the requirements of subdivision 
68.26 	3 and who applies for reinstatement more than five years after license termination in 
68.27 	Minnesota or another jurisdiction if the applicant:
68.28 	(1) completes all requirements in subdivision 2;
68.29 	(2) provides verification of completing 20 continuing education hours for each year 
68.30 	since the applicant last held an active license in good standing in Minnesota or another 
68.31 	jurisdiction and 20 continuing education hours in the year immediately preceding the 
69.1 	application for reinstatement, not to exceed a maximum of 100 required continuing education 
69.2 	hours; and
69.3 	(3) provides verification of passing the Special Purposes Examination for Chiropractic, 
69.4 	or an alternate examination the board determines is equivalent, within 12 months after 
69.5 	application.
69.6 		Subd. 6.Reinstatement within the same calendar year of continuing education 
69.7 	termination. The board must reinstate the license of an applicant whose license was 
69.8 	terminated for failing to submit the required number of continuing education hours if within 
69.9 	the same calendar year of termination the applicant:
69.10 	(1) completes the required number of continuing education hours and outstanding penalty 
69.11 	hours imposed by the board; and
69.12 	(2) pays all application fees and penalty fees.
69.13 		Subd. 7.Board authority. Applications for reinstatement and licenses reinstated under 
69.14 	this section are subject to the same board authority under sections 148.10 and 214.103 as 
69.15 	other applications and licenses issued by the board to deny, refuse to issue, revoke, suspend, 
69.16 	condition, or limit a license or to take disciplinary or corrective action against a licensee or 
69.17 	applicant for conduct that violates applicable law or professional standards.
69.18 		Subd. 8.Continuing education in year of reinstatement. A licensee must not use 
69.19 	continuing education hours obtained for the purpose of applying for reinstatement of a 
69.20 	terminated license under this section to meet the annual hour requirement for the year in 
69.21 	which the license is reinstated.
69.22 		Subd. 9.Previously terminated licenses. If a chiropractor's license was terminated 
69.23 	before July 1, 2026, and the chiropractor applies for reinstatement under this section, the 
69.24 	chiropractor is not required to repay any renewal fees that accrued before the license 
69.25 	reinstatement.

69.26 	Sec. 6. [148.075] VOLUNTARILY RETIRED LICENSE.
69.27 		Subdivision 1.Application. A Minnesota licensed chiropractor in good standing and 
69.28 	with no continuing education audit deficiencies may apply to the board to voluntarily retire 
69.29 	a license by submitting an application on a form provided by the board and a signed affidavit 
69.30 	stating that the applicant will no longer actively practice chiropractic in Minnesota.
70.1 		Subd. 2.Grounds for denial. The board may deny an application to voluntarily retire 
70.2 	a license if the applicant's Minnesota license or license issued in another jurisdiction is not 
70.3 	in good standing or is subject to a pending disciplinary action.

70.4 	Sec. 7. [148.076] REINSTATEMENT OF A VOLUNTARILY RETIRED LICENSE.
70.5 		Subdivision 1.Scope. This section applies to a chiropractor who voluntarily retired a 
70.6 	Minnesota chiropractic license under section 148.075.
70.7 		Subd. 2.Application requirements. At the time of application for reinstatement, the 
70.8 	applicant must:
70.9 	(1) submit an application for reinstatement;
70.10 	(2) pay the current renewal fee;
70.11 	(3) complete a criminal background check as prescribed under section 214.075 and pay 
70.12 	the required fee;
70.13 	(4) submit license verification from each jurisdiction where the applicant holds or has 
70.14 	held a chiropractic license;
70.15 	(5) submit evidence of passing the board's jurisprudence exam;
70.16 	(6) submit evidence of correcting any outstanding requirements and paying any 
70.17 	outstanding fees that existed at the time the license was voluntarily retired; and
70.18 	(7) complete any additional applicable requirements in subdivisions 3, 4, 5, and 7.
70.19 		Subd. 3.Reinstatement of voluntarily retired license for licensee in good standing 
70.20 	in another jurisdiction. The board must reinstate the license of an applicant who is currently 
70.21 	licensed and in good standing in another jurisdiction if the applicant:
70.22 	(1) completes all requirements in subdivision 2;
70.23 	(2) provides verification of the active chiropractic license in good standing in another 
70.24 	jurisdiction; and
70.25 	(3) provides verification of completing 20 continuing education hours in the year 
70.26 	immediately preceding the application for reinstatement.
70.27 		Subd. 4.Reinstatement of voluntarily retired license after five years or less. The 
70.28 	board must reinstate the license of an applicant who does not meet the requirements of 
70.29 	subdivision 3 and who applies for reinstatement five years or less after voluntary license 
70.30 	retirement in Minnesota or the equivalent in another jurisdiction if the applicant:
71.1 	(1) completes all requirements in subdivision 2; and
71.2 	(2) provides verification of:
71.3 	(i) completing 20 continuing education hours for each year since the applicant last held 
71.4 	an active license in good standing in Minnesota or another jurisdiction and 20 continuing 
71.5 	education hours in the year immediately preceding the application for reinstatement; or
71.6 	(ii) passing the Special Purposes Examination for Chiropractic, or an alternate 
71.7 	examination the board determines is equivalent, within 12 months after application.
71.8 		Subd. 5.Reinstatement of voluntarily retired license after more than five years. The 
71.9 	board must reinstate the license of an applicant who does not meet the requirements of 
71.10 	subdivision 3 and who applies for reinstatement more than five years after voluntary license 
71.11 	retirement in Minnesota or the equivalent in another jurisdiction if the applicant:
71.12 	(1) completes all requirements in subdivision 2;
71.13 	(2) provides verification of completing 20 continuing education hours for each year 
71.14 	since the applicant last held an active license in good standing in Minnesota or another 
71.15 	jurisdiction and 20 continuing education hours in the year immediately preceding the 
71.16 	application for reinstatement, not to exceed a maximum of 100 required continuing education 
71.17 	hours; and
71.18 	(3) provides verification of passing the Special Purposes Examination for Chiropractic, 
71.19 	or an alternate examination the board determines is equivalent, within 12 months after 
71.20 	application.
71.21 		Subd. 6.Board authority. Applications for reinstatement and licenses reinstated under 
71.22 	this section are subject to the same board authority under sections 148.10 and 214.103 as 
71.23 	other applications and licenses issued by the board to deny, refuse to issue, revoke, suspend, 
71.24 	condition, or limit a license or to take disciplinary or corrective action against a licensee or 
71.25 	applicant for conduct that violates applicable law or professional standards.
71.26 		Subd. 7.Continuing education in year of reinstatement. A licensee must not use 
71.27 	continuing education hours obtained for the purpose of applying for reinstatement of a 
71.28 	voluntarily retired license under this section to meet the annual hour requirement for the 
71.29 	year the license is reinstated.
71.30 		Subd. 8.Previously voluntarily retired licensees. (a) If a chiropractor who voluntarily 
71.31 	retired before July 1, 2026, applies for reinstatement under this section, the chiropractor is 
71.32 	not required to repay any renewal fees that accrued before the license reinstatement.
72.1 	(b) Before reinstatement under this subdivision, the voluntarily retired licensee must 
72.2 	complete any outstanding continuing education hours due at the time the license was 
72.3 	voluntarily retired.

72.4 	Sec. 8. Minnesota Statutes 2024, section 148.09, is amended to read:
72.5 	148.09 INDEPENDENT EXAMINATION.
72.6 		Subdivision 1.Requirements for examiners. (a) A doctor of chiropractic conducting 
72.7 	a physical examination of a patient or a review of records by a doctor of chiropractic, for 
72.8 	the purpose of generating a report or opinion to aid a reparation obligor under chapter 65B 
72.9 	in making a determination regarding the condition or further treatment of the patient, shall 
72.10 	meet the following requirements:
72.11 	(1) the doctor of chiropractic must either be an instructor at an accredited school of 
72.12 	chiropractic or have devoted not less than 50 percent of practice time to direct patient care 
72.13 	during the two years immediately preceding the examination;
72.14 	(2) the doctor of chiropractic must have completed any annual continuing education 
72.15 	requirements for chiropractors prescribed by the Board of Chiropractic Examiners;
72.16 	(3) the doctor of chiropractic must not accept a fee of more than $500 for each 
72.17 	independent exam conducted; and
72.18 	(4) the doctor of chiropractic must register with the Board of Chiropractic Examiners 
72.19 	as an independent examiner and adhere to all rules governing the practice of chiropractic.
72.20 	(b) The examiner must identify in the written report the source of all records reviewed 
72.21 	and the dates or period of services covered by those records. The examiner's notes and a 
72.22 	copy of the final written report must be retained for at least four years following the 
72.23 	examination.
72.24 	(c) Before conducting an independent examination, the examiner must provide written 
72.25 	disclosures to the examinee that clearly state the purpose of the examination and the 
72.26 	examinee's right to have a third party present under subdivision 2.
72.27 		Subd. 2.Third-party presence during examinations. (a) An examiner performing an 
72.28 	independent examination under this section must not prohibit the examinee from having a 
72.29 	third party of the examinee's choice present during the consultation and examination. The 
72.30 	examiner must not bar the presence of a third party based on the third party's training or 
72.31 	credentials. Advance notice to the examiner or to any other person, organization, or agency 
72.32 	is not required for the presence of a third party under this subdivision.
73.1 	(b) The third party must provide their name to the examiner. The examiner must document 
73.2 	the presence and stated identity of any third party in the written report of the examination.
73.3 	(c) A third party may make a written or audio recording of the consultation or examination 
73.4 	if the recording does not obstruct the conduct of the examination. A third party must not 
73.5 	make a video recording of the consultation or examination.
73.6 	(d) An examiner must not consider the examinee's exercise of rights under this subdivision 
73.7 	as failing to cooperate with the examination. If an examiner determines that the examination 
73.8 	has been obstructed, the examiner must describe in detail the nature of the obstruction in 
73.9 	the body of the written report. For purposes of this subdivision, "obstruct" means to hinder 
73.10 	the examination to the degree that the examination cannot be completed, unless the 
73.11 	obstruction is necessary for the safety or well-being of the patient.
73.12 		Subd. 3.Violation. A violation of this section constitutes unprofessional conduct under 
73.13 	section 148.10, subdivision 1, paragraph (e).

73.14 	Sec. 9. [148.095] ADMINISTRATIVE HOLD DURING COMPLAINT RESOLUTION 
73.15 	PROCESS.
73.16 		Subdivision 1.Administrative hold. (a) If there is a pending complaint against a licensee 
73.17 	and the licensee fails to pay required renewal fees, fails to renew the license, or fails to 
73.18 	complete required continuing education hours within the time prescribed by law, the board 
73.19 	must place the license on an administrative hold.
73.20 	(b) A license on an administrative hold:
73.21 	(1) is expired and does not authorize the licensee to engage in the practice of chiropractic; 
73.22 	and
73.23 	(2) remains under the board's full jurisdiction for all purposes under sections 148.10 and 
73.24 	214.103, including investigation, adjudication, and imposition of discipline.
73.25 		Subd. 2.Prohibition on status change while on administrative hold. (a) If the board 
73.26 	places a license on administrative hold, the board must not:
73.27 	(1) accept an application to voluntarily retire the license under section 148.075;
73.28 	(2) terminate the license for failing to renew or to complete continuing education 
73.29 	requirements; or
73.30 	(3) otherwise change the license status of the licensee in a manner that allows the licensee 
73.31 	to delay, avoid, or terminate the complaint resolution process.
74.1 	(b) The board must remove the administrative hold upon the resolution of all pending 
74.2 	complaints against the licensee.
74.3 		Subd. 3.Licensee obligations not suspended. An administrative hold on a license does 
74.4 	not relieve a licensee of the legal obligation to timely renew the license, pay renewal or 
74.5 	other required fees, or complete continuing education hours according to law.

74.6 	Sec. 10. Minnesota Statutes 2024, section 148.10, is amended by adding a subdivision to 
74.7 	read:
74.8 		Subd. 8.Loss and restoration of good standing. The pendency of a complaint does 
74.9 	not cause a license to lose good standing unless: (1) the complaint results in disciplinary 
74.10 	action under this section or an equivalent disciplinary law in another jurisdiction; or (2) a 
74.11 	stipulation and order or an equivalent order in another jurisdiction provides for the loss of 
74.12 	good standing. A license is restored to good standing upon the satisfactory completion, 
74.13 	expiration, or other agreed-upon termination of all terms of a stipulation and order or an 
74.14 	equivalent order in another jurisdiction. An agreement for corrective action as described 
74.15 	under section 214.103, subdivision 6, does not cause a license to lose good standing.

74.16 	Sec. 11. Minnesota Statutes 2024, section 148.102, subdivision 3, is amended to read:
74.17 		Subd. 3.Insurers. Two times each year(a) Every January 1 and July 1, each insurer 
74.18 	authorized to sell insurance described in section 60A.06, subdivision 1, clause (13), and 
74.19 	providing professional liability insurance to chiropractors shall submit to the board a report 
74.20 	concerning the chiropractors against whom malpractice settlements or awards have been 
74.21 	made to the plaintiff. The report must contain at least the following information:
74.22 	(1) the total number of malpractice settlements or awards made to the plaintiff;
74.23 	(2) the date the malpractice settlements or awards to the plaintiff were made;
74.24 	(3) the allegations contained in the claim or complaint leading to the settlements or 
74.25 	awards made to the plaintiff;
74.26 	(4) the dollar amount of each malpractice settlement or award;
74.27 	(5) the regular address of the practice of the doctor of chiropractic against whom an 
74.28 	award was made or with whom a settlement was made; and
74.29 	(6) the name of the doctor of chiropractic against whom an award was made or with 
74.30 	whom a settlement was made.
75.1 	(b) The insurance company shall, in addition to the above information, report to the 
75.2 	board any information it possesses which tends to substantiate a charge that a doctor of 
75.3 	chiropractic may have engaged in conduct violating section 148.10 and this section.

75.4 	Sec. 12. Minnesota Statutes 2024, section 148.105, subdivision 1, is amended to read:
75.5 		Subdivision 1.Generally. Any person who practices, or attempts to practice, chiropractic 
75.6 	or who uses any of the terms or letters "Doctors of Chiropractic," "Chiropractor," "DC," or 
75.7 	any other title or letters under any circumstances as to lead the public to believe that the 
75.8 	person who so uses the terms is engaged in the practice of chiropractic, without having 
75.9 	complied with the provisions of sections 148.01 to 148.104, is guilty of a gross misdemeanor; 
75.10 	and, upon conviction, fined not less than $1,000 nor more than $10,000 or be imprisoned 
75.11 	in the county jail for not less than 30 days nor more than six months or punished by both 
75.12 	fine and imprisonment, in the discretion of the court. It is the duty of the county attorney 
75.13 	of the county in which the person practices to prosecute. Nothing in sections 148.01 to 
75.14 	148.105 148.108 shall be considered as interfering with any person:
75.15 	(1) licensed by a health-related licensing board, as defined in section 214.01, subdivision 
75.16 	2, including psychological practitioners with respect to the use of hypnosis;
75.17 	(2) registered or licensed by the commissioner of health under section 214.13; or
75.18 	(3) engaged in other methods of healing regulated by law in the state of Minnesota;
75.19 	provided that the person confines activities within the scope of the license or other regulation 
75.20 	and does not practice or attempt to practice chiropractic.

75.21 	Sec. 13. Minnesota Statutes 2025 Supplement, section 148.108, subdivision 5, is amended 
75.22 	to read:
75.23 		Subd. 5.Chiropractic license fees. Fees for chiropractic licensure are the following 
75.24 	amounts but may be adjusted lower by board action:
75.25 	(1) initial application for licensure fee, $300;
75.26 	(2) annual renewal of an active license fee, $250;
75.27 	(3) annual renewal of an inactive license fee, 75 percent of the current active license 
75.28 	renewal fee under clause (2);
75.29 	(4) (3) late renewal penalty fee, $150 per month late; and
75.30 	(5) (4) application for reinstatement of a voluntarily retired or inactive terminated license 
75.31 	fee, $187.50. $100; and
76.1 	(5) penalty for failure to complete CE requirements at the time of license renewal:
76.2 	(i) at the first failure to complete CE requirements at the time of license renewal, the 
76.3 	amount of the fee for annual renewal of an active license under clause (2);
76.4 	(ii) at the second failure to complete CE requirements at the time of license renewal, 
76.5 	two times the amount of the fee for annual renewal of an active license under clause (2); 
76.6 	and
76.7 	(iii) at the third failure to complete CE requirements at the time of license renewal and 
76.8 	every subsequent failure, three times the amount of the fee for annual renewal of an active 
76.9 	license under clause (2).

76.10 	Sec. 14. Minnesota Statutes 2024, section 151.01, subdivision 35, is amended to read:
76.11 		Subd. 35.Compounding. "Compounding" means preparing, mixing, assembling, 
76.12 	packaging, and labeling a drug for an identified individual patient as a result of a practitioner's 
76.13 	prescription drug order. Compounding also includes anticipatory compounding, as defined 
76.14 	in this section, and the preparation of drugs in which all bulk drug substances and components 
76.15 	are nonprescription substances. Compounding does not include mixing or reconstituting a 
76.16 	drug according to the product's labeling or to the manufacturer's directions, provided that 
76.17 	such labeling has been approved by the United States Food and Drug Administration (FDA) 
76.18 	or the manufacturer is licensed under section 151.252. Compounding does not include the 
76.19 	preparation of a drug for the purpose of, or incident to, research, teaching, or chemical 
76.20 	analysis, provided that the drug is not prepared for dispensing or administration to patients. 
76.21 	All compounding, regardless of the type of product, must be done pursuant to a prescription 
76.22 	drug order unless otherwise permitted in this chapter or by the rules of the board. 
76.23 	Compounding does not include a minor deviation from such directions with regard to 
76.24 	radioactivity, volume, or stability, which is made by or under the supervision of a licensed 
76.25 	nuclear pharmacist or a physician, and which is necessary in order to accommodate 
76.26 	circumstances not contemplated in the manufacturer's instructions, such as the rate of 
76.27 	radioactive decay or geographical distance from the patient. Compounding does not include 
76.28 	the use of a flavoring agent to flavor a drug.

76.29 	Sec. 15. Minnesota Statutes 2024, section 151.01, is amended by adding a subdivision to 
76.30 	read:
76.31 		Subd. 44.Flavoring agent. "Flavoring agent" means a therapeutically inert, nonallergenic 
76.32 	substance consisting of inactive ingredients that is added to a drug to improve the drug's 
76.33 	taste and palatability.

77.1 	Sec. 16. Minnesota Statutes 2024, section 151.555, subdivision 7, is amended to read:
77.2 		Subd. 7.Standards and procedures for inspecting and storing donated drugs and 
77.3 	supplies. (a) A pharmacist or authorized practitioner who is employed by or under contract 
77.4 	with the central repository or a local repository shall inspect all donated drugs and supplies 
77.5 	before the drug or supply is dispensed to determine, to the extent reasonably possible in the 
77.6 	professional judgment of the pharmacist or practitioner, that the drug or supply is not 
77.7 	adulterated or misbranded, has not been tampered with, is safe and suitable for dispensing, 
77.8 	has not been subject to a recall, and meets the requirements for donation. If a local repository 
77.9 	receives drugs and supplies from the central repository, the local repository does not need 
77.10 	to reinspect the drugs and supplies.
77.11 	(b) The central repository and local repositories shall store donated drugs and supplies 
77.12 	in a secure storage area under environmental conditions appropriate for the drug or supply 
77.13 	being stored. Donated drugs and supplies may not be stored with nondonated inventory.
77.14 	(c) The central repository and local repositories shall dispose of all drugs and medical 
77.15 	supplies that are not suitable for donation in compliance with applicable federal and state 
77.16 	statutes, regulations, and rules concerning hazardous waste.
77.17 	(d) In the event that controlled substances or drugs that can only be dispensed to a patient 
77.18 	registered with the drug's manufacturer are shipped or delivered to a central or local repository 
77.19 	for donation, the shipment delivery must be documented by the repository and returned 
77.20 	immediately to the donor or the donor's representative that provided the drugs.
77.21 	(e) Each repository must develop drug and medical supply recall policies and procedures. 
77.22 	If a repository receives a recall notification, the repository shall destroy all of the drug or 
77.23 	medical supply in its inventory that is the subject of the recall and complete a record of 
77.24 	destruction form in accordance with paragraph (f). If a drug or medical supply that is the 
77.25 	subject of a Class I or Class II recall has been dispensed, the repository shall immediately 
77.26 	notify the recipient of the recalled drug or medical supply. A drug that potentially is subject 
77.27 	to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug 
77.28 	is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
77.29 	(f) A record of destruction of accepted donated drugs and supplies that are not dispensed 
77.30 	under subdivision 8, are subject to a recall under paragraph (e), or are not suitable for 
77.31 	donation or are subject to a recall under paragraph (e) shall be maintained by the repository 
77.32 	for at least two years. For each drug or supply destroyed, The record shall include the 
77.33 	following information:
77.34 	(1) the date of destruction;
78.1 	(2) the name, strength, and quantity of the drug destroyed; and
78.2 	(3) the name of the person or firm that destroyed the drug.
78.3 	No other record of destruction is required.

78.4 	Sec. 17. Minnesota Statutes 2024, section 151.741, subdivision 4, is amended to read:
78.5 		Subd. 4.Insulin safety net program account. (a) The insulin safety net program account 
78.6 	is established in the special revenue fund in the state treasury. Money in the account is 
78.7 	appropriated each fiscal year to:
78.8 	(1) the MNsure board in an amount sufficient to carry out assigned duties under section 
78.9 	151.74, subdivision 7; and
78.10 	(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board 
78.11 	in assessing and collecting the registration fee under this section and in administering the 
78.12 	insulin safety net program under section 151.74.
78.13 	(b) The commissioner of management and budget shall annually transfer from the health 
78.14 	care access fund to the insulin safety net program account an amount sufficient to implement 
78.15 	paragraph (a).

78.16 	Sec. 18. Minnesota Statutes 2025 Supplement, section 151.741, subdivision 5, is amended 
78.17 	to read:
78.18 		Subd. 5.Insulin repayment account; annual transfer from health care access fund. (a) 
78.19 	The insulin repayment account is established in the special revenue fund in the state treasury. 
78.20 	Money in the account is appropriated each fiscal year to the commissioner of administration 
78.21 	to reimburse manufacturers for insulin dispensed under the insulin safety net program in 
78.22 	section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6, 
78.23 	paragraph (h), and to cover costs incurred by the commissioner in providing these 
78.24 	reimbursement payments.
78.25 	(b) By June 30, 2025, and Each June 30 thereafter, the commissioner of administration 
78.26 	shall certify to the commissioner of management and budget the total amount expended in 
78.27 	the prior fiscal year for:
78.28 	(1) reimbursement to manufacturers for insulin dispensed under the insulin safety net 
78.29 	program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph 
78.30 	(h), and 6, paragraph (h); and
79.1 	(2) costs incurred by the commissioner of administration in providing the reimbursement 
79.2 	payments described in clause (1).
79.3 	(c) Each July 1, the commissioner of management and budget shall transfer from the 
79.4 	health care access fund to the insulin repayment account, beginning July 1, 2025, and each 
79.5 	July 1 thereafter, an amount equal to the amount to which the commissioner of administration 
79.6 	certified pursuant to paragraph (b).

79.7 	Sec. 19. Minnesota Statutes 2024, section 214.41, is amended to read:
79.8 	214.41 PHYSICIAN HEALTH CARE PROVIDER WELLNESS PROGRAM.
79.9 		Subdivision 1.Definition Definitions. (a) For the purposes of this section, the following 
79.10 	terms have the meanings given.
79.11 	(b) "Health care provider" or "provider" means an individual who is licensed or registered 
79.12 	by the state to perform health care services within the provider's scope of practice and in 
79.13 	accordance with state law.
79.14 	(c) "physician Health care provider wellness program" means a program for health care 
79.15 	providers of evaluation, counseling, or other modality to address an issue related to career 
79.16 	fatigue or wellness related to work stress for physicians licensed under chapter 147 that is 
79.17 	administered by a statewide association that is exempt from taxation under United States 
79.18 	Code, title 26, section 501(c)(6), and that primarily represents physicians and osteopaths 
79.19 	of multiple specialties. Physician Health care provider wellness program does not include 
79.20 	the provision of services intended to monitor for impairment under the authority of section 
79.21 	214.31.
79.22 		Subd. 2.Confidentiality. Any record of a person's health care provider's participation 
79.23 	in a physician health care provider wellness program is confidential and not subject to 
79.24 	discovery, subpoena, or a reporting requirement to the applicable health-related licensing 
79.25 	board or to the commissioner of health, unless the person provider voluntarily provides for 
79.26 	written release of the information or the disclosure is required to meet the licensee's provider's
79.27 	obligation to report certain information to the applicable health-related licensing board or 
79.28 	the commissioner of health according to section 147.111 law governing the practice of the 
79.29 	provider's profession.
79.30 		Subd. 3.Civil liability. Any person, agency, institution, facility, or organization employed 
79.31 	by, contracting with, or operating a physician health care provider wellness program is 
79.32 	immune from civil liability for any action related to their duties in connection with a 
79.33 	physician health care provider wellness program when acting in good faith.

80.1 	Sec. 20. Laws 2025, First Special Session chapter 3, article 23, section 2, subdivision 12, 
80.2 	is amended to read:

80.3	Subd. 12.Board of Pharmacy

80.4	Appropriations by Fund
	
80.5	General
	937,000
	937,000
	
80.6
80.7	State Government 
Special Revenue
	6,280,000
	6,280,000
	
80.8 	Medication Repository Program. $450,000 
80.9 	in fiscal year 2026 and $450,000 in fiscal year 
80.10 	2027 are from the general fund for the 
80.11 	medication repository program to purchase 
80.12 	prescription drugs under Minnesota Statutes, 
80.13 	section 151.555, subdivision 6, paragraph (g).

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

80.15 	Sec. 21. TRANSITION OF INACTIVE LICENSES.
 80.16 	On July 1, 2026, the Board of Chiropractic Examiners must administratively change all 
80.17 	chiropractic licenses put on inactive license status under Minnesota Rules, part 2500.2020, 
80.18 	before that date to a voluntarily retired license under Minnesota Statutes, section 148.075.

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

80.20 	Sec. 22. INTERIM CHIROPRACTIC ACUPUNCTURE REGISTRATION 
80.21 	REINSTATEMENT PROCEDURES.
 80.22 		Subdivision 1.Scope. This section applies to a chiropractor whose Minnesota chiropractic 
80.23 	acupuncture registration was canceled.
80.24 		Subd. 2.Application requirements. At the time of application for reinstatement of an 
80.25 	acupuncture registration, the applicant must:
80.26 	(1) hold an active Minnesota chiropractic license;
80.27 	(2) submit an application for reinstatement;
80.28 	(3) pay the current renewal fee;
80.29 	(4) submit license verification from each jurisdiction where the applicant holds or has 
80.30 	held a chiropractic license; and
81.1 	(5) complete any additional applicable requirements as established in subdivisions 3, 4, 
81.2 	and 5.
81.3 		Subd. 3.Reinstatement of canceled registration for registrant in good standing in 
81.4 	another jurisdiction. The Board of Chiropractic Examiners must reinstate the chiropractic 
81.5 	acupuncture registration of an applicant in good standing in another jurisdiction if the 
81.6 	applicant:
81.7 	(1) completes all requirements in subdivision 2;
81.8 	(2) provides verification of a chiropractic acupuncture credential in good standing from 
81.9 	each jurisdiction where the applicant is authorized to perform chiropractic acupuncture; and
81.10 	(3) provides verification of completing two continuing education units in acupuncture 
81.11 	or acupuncture-related subjects in the year immediately preceding the application for 
81.12 	reinstatement.
81.13 		Subd. 4.Reinstatement of canceled registration after five years or less. The board 
81.14 	must reinstate the chiropractic acupuncture registration of an applicant who does not meet 
81.15 	the requirements of subdivision 3 and who applies for reinstatement five years or less after 
81.16 	the Minnesota registration cancellation if the applicant:
81.17 	(1) completes all requirements in subdivision 2; and
81.18 	(2) provides verification of:
81.19 	(i) completing two continuing education hours in acupuncture or acupuncture-related 
81.20 	subjects for each year since the applicant last held an active chiropractic acupuncture 
81.21 	registration in Minnesota or credential in another jurisdiction; or
81.22 	(ii) passing the National Board of Chiropractic Examiners Acupuncture Examination or 
81.23 	the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) 
81.24 	Examination, or an alternate examination the board determines is equivalent, within 12 
81.25 	months after application.
81.26 		Subd. 5.Reinstatement of canceled registration license after more than five 
81.27 	years. The board must reinstate the chiropractic acupuncture registration of an applicant 
81.28 	who does not meet the requirements of subdivision 3 and who applies for reinstatement 
81.29 	more than five years after the Minnesota registration cancellation if the applicant:
81.30 	(1) completes all requirements in subdivision 2; and
82.1 	(2) provides verification of passing either the National Board of Chiropractic Examiners 
82.2 	Acupuncture Examination or the NCCAOM Examination, or an alternative examination 
82.3 	the board determines is equivalent, within 12 months after application.
82.4 		Subd. 6.Continuing education in year of reinstatement. A licensee must not use 
82.5 	continuing education units obtained for the purpose of applying for reinstatement of a 
82.6 	canceled registration under this section to meet the annual requirement for the year the 
82.7 	license is reinstated.
82.8 		Subd. 7.Board authority. Applications for reinstatement and registrations reinstated 
82.9 	under this section are subject to the same board authority under Minnesota Statutes, sections 
82.10 	148.10 and 214.103, as other applications and registrations issued by the board to deny, 
82.11 	refuse to issue, revoke, suspend, condition, or limit a license or to take disciplinary or 
82.12 	corrective action against a registrant or applicant for conduct that violates applicable law 
82.13 	or professional standards.
82.14 		Subd. 8.Expiration. This section expires on the date that rules adopted by the board 
82.15 	removing the inactive status for chiropractic acupuncture registration reinstatement and 
82.16 	establishing new chiropractic acupuncture registration reinstatement procedures become 
82.17 	effective.

82.18 	Sec. 23. INTERIM ANIMAL CHIROPRACTIC REGISTRATION 
82.19 	REINSTATEMENT PROCEDURES.
 82.20 		Subdivision 1.Scope. This section applies to a chiropractor whose Minnesota animal 
82.21 	chiropractic registration was canceled.
82.22 		Subd. 2.Application requirements. At the time of application for reinstatement of an 
82.23 	animal chiropractic registration, the applicant must:
82.24 	(1) hold an active Minnesota chiropractic license;
82.25 	(2) submit an application for reinstatement;
82.26 	(3) pay the current renewal fee;
82.27 	(4) submit license verification from each jurisdiction where the applicant holds or has 
82.28 	held a chiropractic license; and
82.29 	(5) complete any additional applicable requirements as established in subdivisions 3 and 
82.30 	4.
82.31 		Subd. 3.Reinstatement of canceled registration for registrant in good standing in 
82.32 	another jurisdiction. The Board of Chiropractic Examiners must reinstate the animal 
83.1 	chiropractic registration of an applicant who holds an animal chiropractic credential that is 
83.2 	equivalent to a Minnesota registration and in good standing in another jurisdiction if the 
83.3 	applicant:
83.4 	(1) completes all requirements in subdivision 2;
83.5 	(2) provides verification of an animal acupuncture credential in good standing from each 
83.6 	jurisdiction where the applicant is authorized to perform animal acupuncture; and
83.7 	(3) provides verification of completing six continuing education units in animal 
83.8 	chiropractic diagnosis and treatment in the year immediately preceding the application for 
83.9 	reinstatement.
83.10 		Subd. 4.Reinstatement of canceled registration for registrant with no animal 
83.11 	chiropractic credential in good standing in another jurisdiction. The board must reinstate 
83.12 	the registration of an applicant who does not meet the requirements of subdivision 3 if the 
83.13 	applicant:
83.14 	(1) completes all requirements in subdivision 2; and
83.15 	(2) provides verification of completing six continuing education units related to animal 
83.16 	chiropractic diagnosis and treatment for each year the applicant cannot verify an active 
83.17 	animal chiropractic credential that is equivalent to a Minnesota registration and in good 
83.18 	standing.
83.19 		Subd. 5.Continuing education in year of reinstatement. A licensee must not use 
83.20 	continuing education hours obtained for the purposes of applying for reinstatement of a 
83.21 	canceled registration under this section to meet the annual hour requirement for the year 
83.22 	the license is reinstated.
83.23 		Subd. 6.Board authority. Applications for reinstatement and registrations reinstated 
83.24 	under this section are subject to the same board authority under Minnesota Statutes, sections 
83.25 	148.10 and 214.103, as other applications and registrations issued by the board to deny, 
83.26 	refuse to issue, revoke, suspend, condition, or limit a license or to take disciplinary or 
83.27 	corrective action against a registrant or applicant for conduct that violates applicable law 
83.28 	or professional standards.
83.29 		Subd. 7.Expiration. This section expires on the date that rules adopted by the board 
83.30 	removing the inactive status for animal chiropractic registration reinstatement and establishing 
83.31 	new animal chiropractic registration reinstatement procedures become effective.

84.1 	Sec. 24. REVISOR INSTRUCTION.
 84.2 	The revisor of statutes shall renumber each provision of Minnesota Statutes listed in 
84.3 	column A to the number listed in column B. The revisor shall also make necessary 
84.4 	cross-reference changes consistent with the renumbering:

84.5	Column A
	Column B
	
84.6	148.01, subdivision 1a
	148.032, subdivision 1
	
84.7	148.01, subdivision 1b
	148.032, subdivision 2
	
84.8	148.01, subdivision 1c
	148.032, subdivision 3
	
84.9	148.01, subdivision 1d
	148.032, subdivision 4
	
84.1184.10
	148.032, paragraphs (a) and (b)
	148.032, subdivision 5, paragraphs (a) and 
(b)
	
84.1384.12
	148.032, paragraphs (c) and (d)
	148.032, subdivision 6, paragraphs (a) and 
(b)
	
84.14	148.032, paragraph (e)
	148.032, subdivision 7

84.15 	Sec. 25. REPEALER.
 84.16 	(a) Minnesota Statutes 2024, section 151.741, subdivisions 2, 3, and 6, are repealed.
84.17 	(b) Minnesota Rules, parts 2500.0100, subparts 5b, 6, and 12; 2500.1900; 2500.2020; 
84.18 	2500.2040; 2500.2100; 2500.2110; 6800.0400; and 6800.1150, are repealed.

84.19 	ARTICLE 5
84.20 	HEALTH CARE

84.21 	Section 1. Minnesota Statutes 2024, section 62V.05, subdivision 7, is amended to read:
84.22 		Subd. 7.Agreements; consultation. (a) The board shall:
84.23 	(1) establish and maintain an agreement with the commissioner of human services for 
84.24 	cost allocation and services regarding eligibility determinations and enrollment for public 
84.25 	health care programs that use a modified adjusted gross income standard to determine 
84.26 	program eligibility. The board may establish and maintain an agreement with the 
84.27 	commissioner of human services for other services;
84.28 	(2) establish and maintain an agreement with the commissioners of commerce and health 
84.29 	for services regarding enforcement of MNsure certification requirements for health plans 
84.30 	and dental plans offered through MNsure. The board may establish and maintain agreements 
84.31 	with the commissioners of commerce and health for other services; and
85.1 	(3) establish interagency agreements to transfer funds to other state agencies for their 
85.2 	costs related to implementing and operating MNsure, excluding medical assistance allocatable 
85.3 	costs.
85.4 	(b) The board shall consult with the commissioners of commerce and health regarding 
85.5 	the operations of MNsure.
85.6 	(c) The board shall consult with Indian tribes and organizations regarding the operation 
85.7 	of MNsure.
85.8 	(d) Beginning March 15, 2016, and each March 15 thereafter, the board shall submit a 
85.9 	report to the chairs and ranking minority members of the committees in the senate and house 
85.10 	of representatives with primary jurisdiction over commerce, health, and human services on 
85.11 	all the agreements entered into with the chief information officer of the Department of 
85.12 	Information Technology Services, or the commissioners of human services, health, or 
85.13 	commerce in accordance with this subdivision. The report shall include the agency in which 
85.14 	the agreement is with; the time period of the agreement; the purpose of the agreement; and 
85.15 	a summary of the terms of the agreement. A copy of the agreement must be submitted to 
85.16 	the extent practicable.

85.17 	Sec. 2. Minnesota Statutes 2024, section 62V.13, is amended to read:
85.18 	62V.13 EASY ENROLLMENT HEALTH INSURANCE OUTREACH PROGRAM.
85.19 		Subdivision 1.Establishment. The board, in cooperation with the commissioner of 
85.20 	revenue, must establish the easy enrollment health insurance outreach program to:
85.21 	(1) reduce the number of uninsured Minnesotans and increase access to affordable health 
85.22 	insurance coverage;
85.23 	(2) allow the commissioner of revenue to provide return information, at the request of 
85.24 	the taxpayer, to MNsure to provide the taxpayer with information about the taxpayer's 
85.25 	potential eligibility for financial assistance and health insurance enrollment options through 
85.26 	MNsure;
85.27 	(3) allow MNsure to estimate taxpayer potential eligibility for financial assistance for 
85.28 	health insurance coverage provide general information regarding potential eligibility for 
85.29 	health insurance programs and financial assistance available through MNsure; and
85.30 	(4) allow MNsure to conduct targeted outreach to assist interested taxpayer households 
85.31 	in applying for and enrolling in affordable health insurance options through MNsure, 
86.1 	including connecting interested taxpayer households with a navigator or broker for free 
86.2 	enrollment assistance.
86.3 		Subd. 2.Screening for eligibility for insurance assistance. Upon receipt of and based 
86.4 	on return information received from the commissioner of revenue under section 270B.14, 
86.5 	subdivision 22, MNsure may make a projected assessment on whether the interested 
86.6 	taxpayer's household may qualify for a financial assistance program for health insurance 
86.7 	coverage review the information to identify households that may benefit from health coverage 
86.8 	through MNsure and provide general information on available coverage and financial 
86.9 	assistance programs.
86.10 		Subd. 3.Outreach letter and special enrollment period. (a) MNsure must provide a 
86.11 	written letter of the projected assessment under subdivision 2 with general information 
86.12 	about health insurance coverage and financial assistance available through MNsure to a 
86.13 	taxpayer who indicates to the commissioner of revenue that the taxpayer is interested in 
86.14 	obtaining information on access to health insurance.
86.15 	(b) MNsure must allow a special enrollment period for taxpayers who receive the outreach 
86.16 	letter in paragraph (a) and are determined eligible to enroll in a qualified health plan through 
86.17 	MNsure. The triggering event for the special enrollment period is the day the outreach letter 
86.18 	under this subdivision is mailed to the taxpayer. An eligible individual, and their dependents, 
86.19 	have 65 days from the triggering event to select a qualifying health plan and coverage for 
86.20 	the qualifying health plan is effective the first day of the month after plan selection.
86.21 	(c) Taxpayers who have a member of the taxpayer's household currently enrolled in a 
86.22 	qualified health plan through MNsure are not eligible for the special enrollment under 
86.23 	paragraph (b).
86.24 	(d) MNsure must provide information to the general public about the easy enrollment 
86.25 	health insurance outreach program and the special enrollment period described in this 
86.26 	subdivision.
86.27 		Subd. 4.Appeals. (a) Projected Any eligibility assessments for financial assistance under 
86.28 	this section are not appealable information provided under this section is not appealable.
86.29 	(b) Qualification for the special enrollment period under this section is appealable to 
86.30 	MNsure under this chapter and Minnesota Rules, chapter 7700.

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

87.1 	Sec. 3. Minnesota Statutes 2025 Supplement, section 256.9657, subdivision 2b, is amended 
87.2 	to read:
87.3 		Subd. 2b.Hospital assessment. (a) For purposes of this subdivision, the following terms 
87.4 	have the meanings given:
87.5 	(1) "eligible hospital" means:
87.6 	(i) PrairieCare psychiatric hospital; or
87.7 	(ii) a hospital licensed under section 144.50, located in Minnesota, and with a Medicare 
87.8 	cost report filed and showing in the Healthcare Cost Report Information System (HCRIS), 
87.9 	except for the following:
87.10 	(A) federal Indian Health Service facilities;
87.11 	(B) state-owned or state-operated regional treatment centers and all state-operated 
87.12 	services;
87.13 	(C) federal Veterans Administration Medical Centers; and
87.14 	(D) long-term acute care hospitals;
87.15 	(2) "net outpatient revenue" means total outpatient revenue less Medicare revenue as 
87.16 	calculated from:
87.17 	(i) values on Worksheet G of the hospital's Medicare cost report; or
87.18 	(ii) for PrairieCare psychiatric hospital, data available to the commissioner; and
87.19 	(3) "total patient days" means total hospital inpatient days as reported on:
87.20 	(i) Worksheet S-3 of the hospital's Medicare cost report; or
87.21 	(ii) for PrairieCare psychiatric hospital, data available to the commissioner.
87.22 	(b) Subject to paragraphs (m) to (o) (p), each eligible hospital must pay assessments to 
87.23 	the hospital directed payment program account in the special revenue fund, with an aggregate 
87.24 	annual assessment amount equal to the sum of the following:
87.25 	(1) $120.22 multiplied by total patient days; and
87.26 	(2) 5.96 percent of the hospital's net outpatient revenue.
87.27 	(c) The assessment amount for calendar years 2026 and 2027 must be based on the total 
87.28 	patient days and net outpatient revenue reflected on an eligible hospital's Medicare cost 
87.29 	report as follows:
88.1 	(1) an eligible hospital with a fiscal year ending on March 31 or June 30 must use data 
88.2 	from a cost report from the hospital's fiscal year 2022; and
88.3 	(2) an eligible hospital with a fiscal year ending on September 30 or December 31 must 
88.4 	use data from a cost report from the hospital's fiscal year 2021.
88.5 	(d) The annual assessment amount for calendar years after 2027 must be set for a two-year 
88.6 	period and must be based on the total patient days and net outpatient revenue reflected on 
88.7 	an eligible hospital's most recent Medicare cost report filed and showing in HCRIS as of 
88.8 	August 1 of the year prior to the subsequent two-year period.
88.9 	(e) The commissioner may, after consultation with the Minnesota Hospital Association, 
88.10 	modify the rates of assessment in paragraph (b) as necessary to comply with federal law, 
88.11 	obtain or maintain a waiver under Code of Federal Regulations, title 42, section 433.72, or 
88.12 	otherwise maximize under this section federal financial participation for medical assistance. 
88.13 	Notwithstanding the foregoing authorization to maximize federal financial participation for 
88.14 	medical assistance, the commissioner must reduce the rates of assessment in paragraph (b) 
88.15 	as necessary to ensure:
88.16 	(1) the state's aggregated health care-related taxes on inpatient hospital services do not 
88.17 	exceed 5.75 percent of the net patient revenue attributable to those services; and
88.18 	(2) the state's aggregated health care-related taxes on outpatient hospital services do not 
88.19 	exceed 5.75 percent of the net patient revenue attributable to those services.
88.20 	(f) Eligible hospitals must pay the annual assessment amount under paragraph (b) to the 
88.21 	commissioner by paying four equal, quarterly assessments. Eligible hospitals must pay the 
88.22 	quarterly assessments by January 1, April 1, July 1, and October 1 each year. Assessments 
88.23 	must be paid in the form and manner specified by the commissioner. An eligible hospital 
88.24 	is prohibited from paying a quarterly assessment until the eligible hospital has received the 
88.25 	applicable invoice under paragraph (g).
88.26 	(g) The commissioner must provide eligible hospitals with an invoice by December 1 
88.27 	for the assessment due January 1, March 1 for the assessment due April 1, June 1 for the 
88.28 	assessment due July 1, and September 1 for the assessment due October 1 each year.
88.29 	(h) The commissioner must notify each eligible hospital of the hospital's estimated annual 
88.30 	assessment amount for the subsequent calendar year by October 15 each year.
88.31 	(i) If any of the dates for assessments or invoices in paragraphs (f) to (h) fall on a holiday, 
88.32 	the applicable date is the next business day.
89.1 	(j) A hospital that has merged with another hospital must have the surviving hospital's 
89.2 	assessment revised at the start of the hospital's first full fiscal year after the merger is 
89.3 	complete. A closed hospital is retroactively responsible for assessments owed for services 
89.4 	provided through the final date of operations.
89.5 	(k) If the commissioner determines that a hospital has underpaid or overpaid an 
89.6 	assessment, the commissioner must notify the hospital of the unpaid assessment or of any 
89.7 	refund due. The commissioner must refund a hospital's overpayment from the hospital 
89.8 	directed payment program account created in section 256B.1975, subdivision 1.
89.9 	(l) Revenue from an assessment under this subdivision must only be used by the 
89.10 	commissioner to pay the nonfederal share of the directed payment program under section 
89.11 	256B.1974.
89.12 	(m) The commissioner is prohibited from collecting any assessment under this subdivision 
89.13 	during any period of time when:
89.14 	(1) federal financial participation is unavailable or disallowed, or if the approved 
89.15 	aggregate federal financial participation for the directed payment under section 256B.1974 
89.16 	is less than 51 percent; or
89.17 	(2) a directed payment under section 256B.1974 is not approved by the Centers for 
89.18 	Medicare and Medicaid Services.
89.19 	(n) The commissioner must make the following discounts from the inpatient portion of 
89.20 	the assessment under paragraph (b), clause (1), in the stated amount or as necessary to 
89.21 	achieve federal approval of the assessment in this section:
89.22 	(1) Hennepin Healthcare, with a discount of 25 percent;
89.23 	(2) Mayo Rochester, with a discount of ten percent;
89.24 	(3) Gillette Children's Hospital, with a discount of 90 percent;
89.25 	(4) each hospital not included in another discount category, and with greater than 
89.26 	$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service 
89.27 	and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service 
89.28 	and managed care claims data, with a discount of five percent; and
89.29 	(5) any hospital responsible for greater than 12 percent of the total assessment annually 
89.30 	collected statewide, with a discount in the amount necessary such that the hospital is 
89.31 	responsible for 12 percent of the total assessment annually collected statewide.
90.1 	(o) The commissioner must make the following discounts from the outpatient portion 
90.2 	of the assessment under paragraph (b), clause (2), in the stated amount or as necessary to 
90.3 	achieve federal approval of the assessment in this section:
90.4 	(1) each critical access hospital or independent hospital located outside a city of the first 
90.5 	class and paid under the Medicare prospective payment system, with a discount of 40 percent;
90.6 	(2) Gillette Children's Hospital, with a discount of 90 percent;
90.7 	(3) Hennepin Healthcare, with a discount of 60 percent;
90.8 	(4) Mayo Rochester, with a discount of 20 percent; and
90.9 	(5) each hospital not included in another discount category, and with greater than 
90.10 	$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service 
90.11 	and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service 
90.12 	and managed care claims data, with a discount of ten percent.
90.13 	(p) The commissioner must not impose any assessment under this subdivision on a 
90.14 	hospital that does not receive payments under section 256B.1974.
90.15 	(p) (q) If the federal share of the hospital directed payment program under section 
90.16 	256B.1974 is increased as the result of an increase to the federal medical assistance 
90.17 	percentage, the commissioner must reduce the assessment on a uniform percentage basis 
90.18 	across eligible hospitals on which the assessment is imposed, such that the aggregate amount 
90.19 	collected from hospitals under this subdivision does not exceed the total amount needed to 
90.20 	maintain the same aggregate state and federal funding level for the directed payments 
90.21 	authorized by section 256B.1974.
90.22 	(q) (r) Eligible hospitals must submit to the commissioner on an annual basis, in the 
90.23 	form and manner specified by the commissioner in consultation with the Minnesota Hospital 
90.24 	Association, all documentation necessary to determine the assessment amounts under this 
90.25 	subdivision.

90.26 	EFFECTIVE DATE. This section is effective the date that Laws 2025, First Special 
90.27 	Session chapter 3, article 8, section 4, becomes effective.

90.28 	Sec. 4. Minnesota Statutes 2024, section 256.969, subdivision 2b, is amended to read:
90.29 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
90.30 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
90.31 	to the following:
91.1 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
91.2 	methodology;
91.3 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
91.4 	under subdivision 25;
91.5 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
91.6 	distinct parts as defined by Medicare shall be paid according to the methodology under 
91.7 	subdivision 12; and
91.8 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
91.9 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
91.10 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
91.11 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
91.12 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
91.13 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
91.14 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
91.15 	period as other hospitals.
91.16 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
91.17 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
91.18 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
91.19 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
91.20 	manner similar to Medicare. The base year or years for the rates effective November 1, 
91.21 	2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, 
91.22 	ensuring that the total aggregate payments under the rebased system are equal to the total 
91.23 	aggregate payments that were made for the same number and types of services in the base 
91.24 	year. Separate budget neutrality calculations shall be determined for payments made to 
91.25 	critical access hospitals and payments made to hospitals paid under the DRG system. Only 
91.26 	the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being 
91.27 	rebased during the entire base period shall be incorporated into the budget neutrality 
91.28 	calculation.
91.29 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
91.30 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
91.31 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
91.32 	a five percent increase or decrease from the base year payments for any hospital. Any 
91.33 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
91.34 	shall maintain budget neutrality as described in paragraph (c).
92.1 	(e) For discharges occurring on or after November 1, 2014, the commissioner may make 
92.2 	additional adjustments to the rebased rates, and when evaluating whether additional 
92.3 	adjustments should be made, the commissioner shall consider the impact of the rates on the 
92.4 	following:
92.5 	(1) pediatric services;
92.6 	(2) behavioral health services;
92.7 	(3) trauma services as defined by the National Uniform Billing Committee;
92.8 	(4) transplant services;
92.9 	(5) obstetric services, newborn services, and behavioral health services provided by 
92.10 	hospitals outside the seven-county metropolitan area;
92.11 	(6) outlier admissions;
92.12 	(7) low-volume providers; and
92.13 	(8) services provided by small rural hospitals that are not critical access hospitals.
92.14 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
92.15 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
92.16 	admission is standardized by the applicable Medicare wage index and adjusted by the 
92.17 	hospital's disproportionate population adjustment;
92.18 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
92.19 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
92.20 	October 31, 2014;
92.21 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
92.22 	inpatient services covered by medical assistance; and
92.23 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
92.24 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
92.25 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
92.26 	program in effect during the base year or years. In determining hospital payment rates for 
92.27 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
92.28 	methods and allowable costs of the Medicare program in effect during the base year or 
92.29 	years.
92.30 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
92.31 	the rates established under paragraph (c), and any adjustments made to the rates under 
93.1 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
93.2 	total aggregate payments for the same number and types of services under the rebased rates 
93.3 	are equal to the total aggregate payments made during calendar year 2013.
93.4 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
93.5 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
93.6 	in hospital costs between the existing base year or years and the next base year or years. In 
93.7 	any year that inpatient claims volume falls below the threshold required to ensure a 
93.8 	statistically valid sample of claims, the commissioner may combine claims data from two 
93.9 	consecutive years to serve as the base year. Years in which inpatient claims volume is 
93.10 	reduced or altered due to a pandemic or other public health emergency shall not be used as 
93.11 	a base year or part of a base year if the base year includes more than one year. Changes in 
93.12 	costs between base years shall be measured using the lower of the hospital cost index defined 
93.13 	in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
93.14 	claim. The commissioner shall establish the base year for each rebasing period considering 
93.15 	the most recent year or years for which filed Medicare cost reports are available, except 
93.16 	that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019. 
93.17 	The estimated change in the average payment per hospital discharge resulting from a 
93.18 	scheduled rebasing must be calculated and made available to the legislature by January 15 
93.19 	of each year in which rebasing is scheduled to occur, and must include by hospital the 
93.20 	differential in payment rates compared to the individual hospital's costs.
93.21 	(i) Effective for discharges occurring on or after July 1, 2015, through December 31, 
93.22 	2026, inpatient payment rates for critical access hospitals located in Minnesota or the local 
93.23 	trade area shall be determined using a new cost-based methodology. The commissioner 
93.24 	shall establish within the methodology tiers of payment designed to promote efficiency and 
93.25 	cost-effectiveness. Payment rates for hospitals under this paragraph shall be set at a level 
93.26 	that does not exceed the total cost for critical access hospitals as reflected in base year cost 
93.27 	reports. Until the next rebasing that occurs, the new methodology shall result in no greater 
93.28 	than a five percent decrease from the base year payments for any hospital, except a hospital 
93.29 	that had payments that were greater than 100 percent of the hospital's costs in the base year 
93.30 	shall have their rate set equal to 100 percent of costs in the base year. The rates paid for 
93.31 	discharges on and after July 1, 2016, covered under this paragraph shall be increased by the 
93.32 	inflation factor in subdivision 1, paragraph (a). The new cost-based rate shall be the final 
93.33 	rate and shall not be settled to actual incurred costs. Hospitals shall be assigned a payment 
93.34 	tier based on the following criteria:
94.1 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
94.2 	shall have a rate set that equals 85 percent of their base year costs;
94.3 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
94.4 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
94.5 	base year costs; and
94.6 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
94.7 	shall have a rate set that equals 100 percent of their base year costs.
94.8 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
94.9 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
94.10 	methodology may include, but are not limited to:
94.11 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
94.12 	hospital's charges to the medical assistance program;
94.13 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
94.14 	hospital's payments received from the medical assistance program for the care of medical 
94.15 	assistance patients;
94.16 	(3) the ratio between the hospital's charges to the medical assistance program and the 
94.17 	hospital's payments received from the medical assistance program for the care of medical 
94.18 	assistance patients;
94.19 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
94.20 	(5) the proportion of that hospital's costs that are administrative and trends in 
94.21 	administrative costs; and
94.22 	(6) geographic location.
94.23 	(j) Effective for discharges occurring on or after January 1, 2027, inpatient payment 
94.24 	rates for critical access hospitals located in Minnesota or the local trade area must be 
94.25 	determined using 100 percent of each hospital's base year costs. The base year costs must 
94.26 	be increased by the percentage change in the Centers for Medicare and Medicaid Services 
94.27 	Inpatient Hospital Market Basket between the base year and the payment year. Effective 
94.28 	January 1, 2027, payments made by managed care plans and county-based purchasing plans 
94.29 	must be at least equivalent to those paid by fee-for-service.
94.30 	(k) Subject to subdivision 2g, effective for discharges occurring on or after January 1, 
94.31 	2024, the rates paid to hospitals described in paragraph (a), clauses (2) to (4), must include 
95.1 	a rate factor specific to each hospital that qualifies for a medical education and research 
95.2 	cost distribution under section 62J.692, subdivision 4, paragraph (a).

95.3 	Sec. 5. Minnesota Statutes 2025 Supplement, section 256.969, subdivision 2f, is amended 
95.4 	to read:
95.5 		Subd. 2f.Alternate inpatient payment rate. (a) Effective January 1, 2022, for a hospital 
95.6 	eligible to receive disproportionate share hospital payments under subdivision 9, paragraph 
95.7 	(d), clause (6), the commissioner shall reduce the amount calculated under subdivision 9, 
95.8 	paragraph (d), clause (6), by 99 one percent and compute an alternate inpatient payment 
95.9 	rate. The alternate payment rate shall be structured to target a total aggregate reimbursement 
95.10 	amount equal to what the hospital would have received for providing fee-for-service inpatient 
95.11 	services under this section to patients enrolled in medical assistance had the hospital received 
95.12 	the entire amount calculated under subdivision 9, paragraph (d), clause (6). This paragraph 
95.13 	expires when paragraph (b) becomes effective.
95.14 	(b) For hospitals eligible to receive payment under section 256B.1973 or 256B.1974 
95.15 	and meeting the criteria in subdivision 9, paragraph (d), the commissioner must may reduce 
95.16 	the amount calculated under subdivision 9, paragraph (d), by one percent and compute an 
95.17 	alternate inpatient payment rate. The alternate payment rate must be structured to target a 
95.18 	total aggregate reimbursement amount equal to the amount that the hospital would have 
95.19 	received for providing fee-for-service inpatient services under this section to patients enrolled 
95.20 	in medical assistance had the hospital received 99 percent of the entire amount calculated 
95.21 	under subdivision 9, paragraph (d). Hospitals that do not meet federal requirements for 
95.22 	Medicaid disproportionate share hospitals are not eligible for the alternate payment rate.

95.23 	EFFECTIVE DATE. This section is effective upon the date that Laws 2025, First 
95.24 	Special Session chapter 3, article 8, section 5, becomes effective.

95.25 	Sec. 6. Minnesota Statutes 2024, section 256.969, subdivision 25, is amended to read:
95.26 		Subd. 25.Long-term hospital rates. (a) Long-term hospitals shall be paid on a per diem 
95.27 	basis.
95.28 	(b) For admissions occurring on or after April 1, 1995, a long-term hospital as designated 
95.29 	by Medicare that does not have admissions in the base year shall have inpatient rates 
95.30 	established at the average of other hospitals with the same designation. For subsequent 
95.31 	rate-setting periods in which base years are updated, the hospital's base year shall be the 
95.32 	first Medicare cost report filed with the long-term hospital designation and shall remain in 
95.33 	effect until it falls within the same period as other hospitals.
96.1 	(c) For admissions occurring on or after July 1, 2023, long-term hospitals must be paid 
96.2 	the higher of a per diem amount computed using the methodology described in subdivision 
96.3 	2b, paragraph (i), or the per diem rate as of July 1, 2021., or a per diem amount computed 
96.4 	as follows:
96.5 	(1) hospitals that had payments at or below 80 percent of the hospital's costs in the base 
96.6 	year must have a rate set that equals 85 percent of the hospital's base year costs;
96.7 	(2) hospitals that had payments that were above 80 percent up to and including 90 percent 
96.8 	of the hospital's costs in the base year must have a rate set that equals 95 percent of the 
96.9 	hospital's base year costs; and
96.10 	(3) hospitals that had payments that were above 90 percent of the hospital's costs in the 
96.11 	base year must have a rate set that equals 100 percent of the hospital's base year costs.

96.12 	Sec. 7. Minnesota Statutes 2024, section 256B.056, subdivision 1, is amended to read:
96.13 		Subdivision 1.Residency. (a) To be eligible for medical assistance, a person must reside 
96.14 	in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota, in 
96.15 	accordance with Code of Federal Regulations, title 42, section 435.403. A child who is 
96.16 	placed in a family foster home in Minnesota by another state is a Minnesota resident in 
96.17 	accordance with Minnesota's interstate agreements and Code of Federal Regulations, title 
96.18 	42, section 435.403(k). For the purposes of this paragraph, "family foster home" has the 
96.19 	meaning given in section 260C.007, subdivision 16b.
96.20 	(b) The commissioner shall identify individuals who are enrolled in medical assistance 
96.21 	and who are absent from the state for more than 30 consecutive days, but who continue to 
96.22 	qualify for medical assistance in accordance with paragraph (a).
96.23 	(c) If the individual is absent from the state for more than 30 consecutive days but still 
96.24 	deemed a resident of Minnesota in accordance with paragraph (a), any covered service 
96.25 	provided to the individual must be paid through the fee-for-service system and not through 
96.26 	the managed care capitated rate payment system under section 256B.69 or 256L.12.

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

96.28 	Sec. 8. Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 8, is amended 
96.29 	to read:
96.30 		Subd. 8.Physical therapy. (a) Medical assistance covers physical therapy and related 
96.31 	services. Specialized maintenance therapy is covered for recipients age 20 and under.
97.1 	(b) Services provided by a physical therapy assistant shall be reimbursed at the same 
97.2 	rate as services performed by a physical therapist when the services of the physical therapy 
97.3 	assistant are provided under the direction of a physical therapist who is on the premises. 
97.4 	Services provided by a physical therapy assistant that are provided under the direction of a 
97.5 	physical therapist who is not on the premises shall be reimbursed at 65 percent of the physical 
97.6 	therapist rate.
97.7 	(c) Payment for physical therapy and related services is limited to 14 visits per year 
97.8 	unless prior authorization of a greater number of visits is obtained. This paragraph expires 
97.9 	upon the effective date of paragraph (d).
97.10 	(d) Effective January 1, 2027, or upon federal approval, whichever is later, payment for 
97.11 	physical therapy and related services is limited to the following number of visits per year 
97.12 	unless prior authorization of a greater number of visits is obtained:
97.13 	(1) for children following an inpatient or outpatient hospital-based surgery, 30 visits; 
97.14 	and
97.15 	(2) for all other recipients, 14 visits.

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

97.17 	Sec. 9. Minnesota Statutes 2025 Supplement, section 256B.1973, subdivision 9, is amended 
97.18 	to read:
97.19 		Subd. 9.Interaction with other directed payments. (a) An eligible provider under 
97.20 	subdivision 3 may participate in the hospital directed payment program under section 
97.21 	256B.1974 for inpatient hospital services, outpatient hospital services, or both. A provider 
97.22 	participating in the hospital directed payment program must not receive a directed payment 
97.23 	under this section for any provider classes paid via the hospital directed payment program. 
97.24 	A hospital subject to this section must notify the commissioner in writing no later than 30 
97.25 	days after enactment of this subdivision of the hospital's intention to participate in the 
97.26 	hospital directed payment program under section 256B.1974 for inpatient hospital services, 
97.27 	outpatient hospital services, or both.
97.28 	(b) The election under this subdivision is a onetime election, except that if an eligible 
97.29 	provider elects to participate in the hospital directed payment program, and the hospital 
97.30 	directed payment program expires or is not federally approved, the eligible provider may 
97.31 	subsequently elect to participate in the directed payment under this section.
97.32 	(c) If an eligible provider elects not to participate in the hospital directed payment 
97.33 	program under section 256B.1974 and the federal statutes or regulations related to hospital 
98.1 	directed payment programs are subsequently substantially changed, the eligible provider 
98.2 	may elect to participate in the hospital directed payment program under section 256B.1974.
98.3 	(d) The effective date of the election to participate in the hospital directed payment 
98.4 	program under this section must align with the beginning of the calendar year in which 
98.5 	payment rates under this section are updated. The eligible provider must notify the 
98.6 	commissioner of the eligible provider's intention to make the election ten months before 
98.7 	the effective date of the election.

98.8 	Sec. 10. Minnesota Statutes 2025 Supplement, section 256B.69, subdivision 6d, is amended 
98.9 	to read:
98.10 		Subd. 6d.Prescription drugs. (a) The commissioner may exclude or modify coverage 
98.11 	for prescription drugs from the prepaid managed care contracts entered into under this 
98.12 	section in order to increase savings to the state by collecting additional prescription drug 
98.13 	rebates.
98.14 	(b) The contracts must maintain incentives for the managed care plan to manage drug 
98.15 	costs and utilization and may require that the managed care plans maintain an open drug 
98.16 	formulary. In order to manage drug costs and utilization, the contracts may authorize the 
98.17 	managed care plans to use preferred drug lists and prior authorization. The contracts must 
98.18 	require that the managed care plans enter into contracts with the state's selected pharmacy 
98.19 	benefit manager vendor to administer the pharmacy benefit.
98.20 	(c) This subdivision is contingent on federal approval of the managed care contract 
98.21 	changes and the collection of additional prescription drug rebates.
98.22 	(d) The commissioner must require that the final reimbursement to a pharmacy from 
98.23 	managed care and county-based purchasing plans and any pharmacy benefit managers under 
98.24 	contract with these entities be at least a dispensing fee of $11.55 per claim for prescriptions 
98.25 	filled with drugs meeting the definition of covered outpatient drugs. The commissioner 
98.26 	must require the payment of a dispensing fee of at least $3.65 for drugs not meeting the 
98.27 	definition of covered outpatient drug.
98.28 	(e) In addition to the dispensing fee set forth in paragraph (d), the commissioner must 
98.29 	require that the final reimbursement to a pharmacy from managed care and county-based 
98.30 	purchasing plans and any pharmacy benefit managers under contract with these entities be 
98.31 	equal to the ingredient cost for a drug as either:
98.32 	(1) the lower of the National Average Drug Acquisition Cost (NADAC) or the Minnesota 
98.33 	actual acquisition cost (MNAAC) under section 256B.0625, subdivision 13, paragraph (g);
99.1 	(2) the maximum allowable cost, if a drug ingredient cost is unreported in the NADAC 
99.2 	and the MNAAC; or
99.3 	(3) the wholesale acquisition cost minus two percent, if a drug ingredient cost is 
99.4 	unreported in the NADAC and the MNAAC and a maximum allowable cost is unavailable.
99.5 	(f) The commissioner must monitor the effect of this requirement on access to 
99.6 	pharmaceutical services in rural and underserved areas of the state. If, for any contract year, 
99.7 	federal approval is not received for paragraphs (d) and (e), the commissioner must adjust 
99.8 	the capitation rates paid to managed care plans and county-based purchasing plans for that 
99.9 	contract year to reflect removal of paragraphs (d) and (e). A contract between a managed 
99.10 	care plan or county-based purchasing plan, or any pharmacy benefit manager under contract 
99.11 	with one of those entities, and a provider to whom paragraphs (d) and (e) apply must allow 
99.12 	recovery of payments from those providers if capitation rates are adjusted in accordance 
99.13 	with this paragraph. Payment recoveries must not exceed the amount equal to any increase 
99.14 	in rates that results from paragraphs (d) and (e). This subdivision expires if federal approval 
99.15 	is not received for paragraphs (d) and (e) at any time.
99.16 	(g) Paragraphs (d) to (g) expire upon the effective date of a master contract under section 
99.17 	256B.696. The commissioner shall notify the revisor of statutes of the effective date.

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

99.19 	Sec. 11. Minnesota Statutes 2025 Supplement, section 256B.695, subdivision 5, is amended 
99.20 	to read:
99.21 		Subd. 5.CARMA enrollment. (a) Subject to paragraphs paragraph (d) and (e), eligible 
99.22 	individuals must be automatically enrolled in CARMA, but may decline enrollment. Eligible 
99.23 	individuals may enroll in fee-for-service medical assistance. Eligible individuals may change 
99.24 	their CARMA elections on an annual basis.
99.25 	(b) Eligible individuals must be able to enroll in CARMA through the selection process 
99.26 	in accordance with the election period established in section 256B.69, subdivision 4, 
99.27 	paragraph (e).
99.28 	(c) Enrollees who were not previously enrolled in the medical assistance program or 
99.29 	MinnesotaCare can change their selection once within the first year after enrollment in 
99.30 	CARMA. Enrollees who were not previously enrolled in CARMA have 90 days to make a 
99.31 	change and changes are allowed for additional special circumstances.
99.32 	(d) The commissioner may not offer a second health plan to eligible individuals other 
99.33 	than, and or in addition to, CARMA except that the commissioner may offer a second health 
100.1 	plan to eligible individuals when another health plan is enrolling in MinnesotaCare, if
100.2 	required by federal law or rule. Eligible individuals who do not select a health plan at the 
100.3 	time of enrollment must automatically be enrolled in CARMA.
100.4 	(e) The commissioner may offer a replacement plan to eligible individuals, as determined 
100.5 	by the commissioner, when counties administering CARMA have their contract terminated 
100.6 	for cause.
100.7 	(e) (f) The commissioner may, on a county-by-county basis, offer a health plan other 
100.8 	than, and in addition to, CARMA to individuals who are eligible for both Medicare and 
100.9 	medical assistance due to age, income, or disability if the commissioner deems it necessary 
100.10 	for enrollees to have another choice of health plan. Factors the commissioner must consider 
100.11 	when determining if the other health plan is necessary include the number of available 
100.12 	Medicare Advantage Plan options that are not special needs plans in the county, the size of 
100.13 	the enrolling population, the additional administrative burden placed on providers and 
100.14 	counties by multiple health plan options in a county, the need to ensure the viability and 
100.15 	success of the CARMA program, and the impact to the medical assistance program there 
100.16 	is not already a health plan available under CARMA.
100.17 	(f) In counties where the commissioner is required by federal law or elects to offer a 
100.18 	second health plan other than CARMA pursuant to paragraphs (d) and (e), eligible enrollees 
100.19 	who do not select a health plan at the time of enrollment must automatically be enrolled in 
100.20 	CARMA.
100.21 	(g) This subdivision supersedes section 256B.694.

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

100.23 	Sec. 12. Minnesota Statutes 2024, section 256B.75, is amended to read:
100.24 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
100.25 	(a) For outpatient hospital facility fee payments for services rendered on or after October 
100.26 	1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, 
100.27 	or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for 
100.28 	which there is a federal maximum allowable payment. Effective for services rendered on 
100.29 	or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and 
100.30 	emergency room facility fees shall be increased by eight percent over the rates in effect on 
100.31 	December 31, 1999, except for those services for which there is a federal maximum allowable 
100.32 	payment. Services for which there is a federal maximum allowable payment shall be paid 
100.33 	at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total 
101.1 	aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare 
101.2 	upper limit. If it is determined that a provision of this section conflicts with existing or 
101.3 	future requirements of the United States government with respect to federal financial 
101.4 	participation in medical assistance, the federal requirements prevail. The commissioner 
101.5 	may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial 
101.6 	participation resulting from rates that are in excess of the Medicare upper limitations.
101.7 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory 
101.8 	surgery hospital facility fee services for critical access hospitals designated under section 
101.9 	144.1483, clause (9), shall be paid on a cost-based payment system that is based on the 
101.10 	cost-finding methods and allowable costs of the Medicare program. Effective for services 
101.11 	provided on or after July 1, 2015, rates established for critical access hospitals under this 
101.12 	paragraph for the applicable payment year shall be the final payment and shall not be settled 
101.13 	to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal 
101.14 	year ending in 2017, the rate for outpatient hospital services shall be computed using 
101.15 	information from each hospital's Medicare cost report as filed with Medicare for the year 
101.16 	that is two years before the year that the rate is being computed. Rates shall be computed 
101.17 	using information from Worksheet C series until the department finalizes the medical 
101.18 	assistance cost reporting process for critical access hospitals. After the cost reporting process 
101.19 	is finalized, rates shall be computed using information from Title XIX Worksheet D series. 
101.20 	The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs 
101.21 	related to rural health clinics and federally qualified health clinics, divided by ancillary 
101.22 	charges plus outpatient charges, excluding charges related to rural health clinics and federally 
101.23 	qualified health clinics. Effective for services delivered on or after January 1, 2024, the 
101.24 	rates paid to critical access hospitals under this section must be adjusted to include the 
101.25 	amount of any distributions under section 62J.692, subdivision 4, paragraph (a), that were 
101.26 	not included in the rate adjustment described under section 256.969, subdivision 2b, 
101.27 	paragraph (k).
101.28 	(c) Effective for services provided on or after July 1, 2003, rates that are based on the 
101.29 	Medicare outpatient prospective payment system shall be replaced by a budget neutral 
101.30 	prospective payment system that is derived using medical assistance data. The commissioner 
101.31 	shall provide a proposal to the 2003 legislature to define and implement this provision. 
101.32 	When implementing prospective payment methodologies, the commissioner shall use general 
101.33 	methods and rate calculation parameters similar to the applicable Medicare prospective 
101.34 	payment systems for services delivered in outpatient hospital and ambulatory surgical center 
101.35 	settings unless other payment methodologies for these services are specified in this chapter.
102.1 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
102.2 	before third-party liability and spenddown, made to hospitals for outpatient hospital facility 
102.3 	services is reduced by .5 percent from the current statutory rate.
102.4 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
102.5 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility 
102.6 	services before third-party liability and spenddown, is reduced five percent from the current 
102.7 	statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from 
102.8 	this paragraph.
102.9 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
102.10 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
102.11 	hospital facility services before third-party liability and spenddown, is reduced three percent 
102.12 	from the current statutory rates. Mental health services and facilities defined under section 
102.13 	256.969, subdivision 16, are excluded from this paragraph.
102.14 	(g) Critical access hospitals that convert to rural emergency hospitals in accordance with 
102.15 	section 1861(kkk) of the Social Security Act must be paid the rate described in paragraph 
102.16 	(b). The rate must be classified as either an outpatient hospital rate or a clinic rate as 
102.17 	determined upon federal approval.

102.18 	Sec. 13. Minnesota Statutes 2024, section 256L.05, subdivision 3, is amended to read:
102.19 		Subd. 3.Effective date of coverage. (a) The effective date of coverage is the first day 
102.20 	of the month following the month in which eligibility is approved and the first premium 
102.21 	payment has been received. The effective date of coverage for new members added to the 
102.22 	family is the first day of the month following the month in which the change is reported. 
102.23 	All eligibility criteria must be met by the family at the time the new family member is added. 
102.24 	The income of the new family member is included with the family's modified adjusted gross 
102.25 	income and the adjusted premium begins in the month the new family member is added.
102.26 	(b) The initial premium must be received by the last working day of the month for 
102.27 	coverage to begin the first day of the following month.
102.28 	(c) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to 
102.29 	256L.18 are secondary to a plan of insurance or benefit program under which an eligible 
102.30 	person may have coverage and the commissioner shall use cost avoidance techniques to 
102.31 	ensure coordination of any other health coverage for eligible persons. The commissioner 
102.32 	shall identify eligible persons who may have coverage or benefits under other plans of 
102.33 	insurance or who become eligible for medical assistance.
103.1 	(d) The effective date of coverage for individuals or families who are exempt from 
103.2 	paying premiums under section 256L.15, subdivision subdivisions 1, paragraph (c) and 2, 
103.3 	is the first day of the month following the month in which eligibility is approved.

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

103.5 	Sec. 14. Minnesota Statutes 2024, section 256L.06, subdivision 3, is amended to read:
103.6 		Subd. 3.Commissioner's duties and payment. (a) Premiums are dedicated to the 
103.7 	commissioner for MinnesotaCare.
103.8 	(b) The commissioner shall develop and implement procedures to: (1) require enrollees 
103.9 	to report changes in income; (2) adjust sliding scale premium payments, based upon both 
103.10 	increases and decreases in enrollee income, at the time the change in income is reported; 
103.11 	and (3) disenroll enrollees from MinnesotaCare for failure to pay required premiums. Failure 
103.12 	to pay includes payment with a dishonored check, a returned automatic bank withdrawal, 
103.13 	or a refused credit card or debit card payment. The commissioner may demand a guaranteed 
103.14 	form of payment, including a cashier's check or a money order, as the only means to replace 
103.15 	a dishonored, returned, or refused payment.
103.16 	(c) Premiums are calculated on a calendar month basis and may be paid on a monthly, 
103.17 	quarterly, or semiannual basis, with the first payment due upon notice from the commissioner 
103.18 	of the premium amount required. The commissioner shall inform applicants and enrollees 
103.19 	of these premium payment options. Premium payment is required before enrollment is 
103.20 	complete and to maintain eligibility coverage in MinnesotaCare. Premium payments received 
103.21 	before noon are credited the same day. Premium payments received after noon are credited 
103.22 	on the next working day.
103.23 	(d) Nonpayment of the premium will result in disenrollment from the plan effective for 
103.24 	the calendar month following the month for which the premium was due. Persons disenrolled 
103.25 	for nonpayment may not reenroll prior to the first day of the month following the payment 
103.26 	of an amount equal to two months' premiums one monthly premium.
103.27 	(e) The commissioner shall forgive the past-due premium for persons disenrolled under 
103.28 	paragraph (d) prior to issuing a premium invoice for the fourthnext month following 
103.29 	disenrollment.

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

104.1 	Sec. 15. Minnesota Statutes 2024, section 295.52, subdivision 8, is amended to read:
104.2 		Subd. 8.Contingent reduction in tax rate. (a) By December 1 of each year, beginning 
104.3 	in 2011, the commissioner of management and budget shall determine the projected balance 
104.4 	in the health care access fund for the biennium.
104.5 	(b) If the commissioner of management and budget determines that the projected balance 
104.6 	in the health care access fund for the biennium reflects a ratio of revenues to expenditures 
104.7 	and transfers greater than 125 percent, and if the actual cash balance in the fund is adequate, 
104.8 	as determined by the commissioner of management and budget, the commissioner, in 
104.9 	consultation with the commissioner commissioners of revenue and human services, shall 
104.10 	reduce the tax rates levied under subdivisions 1, 1a, 2, 3, and 4, for the subsequent calendar 
104.11 	year sufficient to reduce the structural balance in the fund. The rate may be reduced to the 
104.12 	extent that the projected revenues for the biennium do not exceed 125 percent of expenditures 
104.13 	and transfers. The new rate shall be rounded to the nearest one-tenth of one percent. The 
104.14 	rate reduction under this paragraph expires at the end of each calendar year and is subject 
104.15 	to an annual redetermination by the commissioner of management and budget.
104.16 	(c) For purposes of the analysis defined in paragraph (b), the commissioner of 
104.17 	management and budget shall include projected revenues.

104.18 	Sec. 16. Laws 2025, First Special Session chapter 3, article 8, section 25, the effective 
104.19 	date, is amended to read:

104.20 	EFFECTIVE DATE. This section is effective January 1, 2027 2028, or upon federal 
104.21 	approval, whichever is later. The commissioner of human services shall notify the revisor 
104.22 	of statutes when federal approval is obtained.

104.23 	Sec. 17. REPEALER.
 104.24 	Minnesota Statutes 2024, section 256B.198, is repealed.

104.25 	ARTICLE 6
104.26 	FEDERAL CONFORMITY

104.27 	Section 1. Minnesota Statutes 2024, section 116J.035, is amended by adding a subdivision 
104.28 	to read:
104.29 		Subd. 9.Disclosure to the commissioner of human services. The commissioner may 
104.30 	disclose workforce program participation data gathered under chapter 116L to the 
105.1 	commissioner of human services for the purpose of administering section 256B.0562 without 
105.2 	the consent of the subject of the data.

105.3 	Sec. 2. Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to 
105.4 	read:
105.5 		Subd. 46.Health care eligibility oversight unit. (a) The commissioner shall establish 
105.6 	and maintain a Department of Human Services health care eligibility oversight unit 
105.7 	responsible for collaboration at a regional level to ensure federal and state Medicaid eligibility 
105.8 	requirements are consistently applied by all processing entities.
105.9 	(b) The oversight unit must monitor compliance, identify systemic issues, and provide 
105.10 	guidance and technical assistance to lead agencies.
105.11 	(c) The commissioner shall require lead agencies to work directly with the oversight 
105.12 	unit on corrective action planning and implementation to achieve compliance and strengthen 
105.13 	performance outcomes.

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

105.15 	Sec. 3. Minnesota Statutes 2024, section 256B.04, subdivision 27, is amended to read:
105.16 		Subd. 27.Disenrollment under medical assistance and MinnesotaCare. (a) The 
105.17 	commissioner shall regularly obtain and use information from reliable data sources, including 
105.18 	but not limited to managed care and county-based purchasing plans, state health and human 
105.19 	services programs, mail returned  by the United States Postal Service with a forwarding 
105.20 	address, and the National Change of Address database maintained by the United States 
105.21 	Postal Service, to update mailing addresses and other contact information for medical 
105.22 	assistance and MinnesotaCare enrollees in cases of returned mail and nonresponse using 
105.23 	information available through managed care and county-based purchasing plans, state health 
105.24 	and human services programs, and other sources.
105.25 	(b) The commissioner shall not disenroll an individual from medical assistance or 
105.26 	MinnesotaCare in cases of returned mail until the commissioner makes at least two attempts 
105.27 	by phone, email, or other methods to contact the individual. The commissioner may disenroll 
105.28 	the individual after providing no less than 30 days for the individual to respond to the most 
105.29 	recent contact attempt.

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

106.1 	Sec. 4. Minnesota Statutes 2024, section 256B.05, subdivision 5, is amended to read:
106.2 		Subd. 5.Obligation of local agency to process medical assistance applications within 
106.3 	established timelines. (a) The local agency must act on an application for medical assistance 
106.4 	within ten working days of receipt of all information needed to act on the application but 
106.5 	no later than required under Minnesota Rules, part 9505.0090, subparts 2 and 3.
106.6 	(b) A local agency must notify the commissioner within five calendar days when the 
106.7 	local agency fails to meet at least 80 percent of the local agency's monthly application and 
106.8 	redetermination deadlines.

106.9 	Sec. 5. Minnesota Statutes 2024, section 256B.05, is amended by adding a subdivision to 
106.10 	read:
106.11 		Subd. 6.Authority to intervene. Upon receiving a notice from a local agency pursuant 
106.12 	to subdivision 5, paragraph (b), the commissioner may provide support to the local agency 
106.13 	to timely process the local agency's outstanding applications and redeterminations.

106.14 	Sec. 6. Minnesota Statutes 2024, section 256B.056, subdivision 2a, is amended to read:
106.15 		Subd. 2a.Home equity limit for medical assistance payment of long-term care 
106.16 	services. (a) Effective for requests of medical assistance payment of long-term care services 
106.17 	filed on or after July 1, 2006, and for renewals on or after July 1, 2006, for persons who 
106.18 	received payment of long-term care services under a request filed on or after January 1, 
106.19 	2006, the equity interest in the home of a person whose eligibility for long-term care services 
106.20 	is determined on or after January 1, 2006, shall not exceed $500,000, unless it is the lawful 
106.21 	residence of the person's spouse or child who is under age 21, or a child of any age who is 
106.22 	blind or permanently and totally disabled as defined in the Supplemental Security Income 
106.23 	program. The amount specified in this paragraph shall be increased beginning in year 2011, 
106.24 	from year to year based on the percentage increase in the Consumer Price Index for all urban 
106.25 	consumers (all items; United States city average), rounded to the nearest $1,000.
106.26 	(b) Effective January 1, 2028, the amount specified in paragraph (a) must not exceed 
106.27 	$1,000,000.
106.28 	(b) (c) For purposes of this subdivision, a "home" means any real or personal property 
106.29 	interest, including an interest in an agricultural homestead as defined under section 273.124, 
106.30 	subdivision 1, that, at the time of the request for medical assistance payment of long-term 
106.31 	care services, is the primary dwelling of the person or was the primary dwelling of the 
106.32 	person before receipt of long-term care services began outside of the home.
107.1 	(c) (d) A person denied or terminated from medical assistance payment of long-term 
107.2 	care services because the person's home equity exceeds the home equity limit may seek a 
107.3 	waiver based upon a hardship by filing a written request with the county agency. Hardship 
107.4 	is an imminent threat to the person's health and well-being that is demonstrated by 
107.5 	documentation of no alternatives for payment of long-term care services. The county agency 
107.6 	shall make a decision regarding the written request to waive the home equity limit within 
107.7 	30 days if all necessary information has been provided. The county agency shall send the 
107.8 	person and the person's representative a written notice of decision on the request for a 
107.9 	demonstrated hardship waiver that also advises the person of appeal rights under the fair 
107.10 	hearing process of section 256.045.

107.11 	Sec. 7. Minnesota Statutes 2024, section 256B.056, subdivision 3d, is amended to read:
107.12 		Subd. 3d.Reduction of excess assets. Assets in excess of the limits in subdivisions 3 
107.13 	to 3c may be reduced to allowable limits as follows:
107.14 	(a) Assets may be reduced in any of the three either one or two calendar months before 
107.15 	the month of application in which the applicant seeks coverage, according to the applicant's 
107.16 	retroactive eligibility under section 256B.061 by paying bills for health services that are 
107.17 	incurred in the retroactive period for which the applicant seeks eligibility, starting with the 
107.18 	oldest bill. After assets are reduced to allowable limits, eligibility begins with the next dollar 
107.19 	of MA-covered health services incurred in the retroactive period. Applicants reducing assets 
107.20 	under this subdivision who also have excess income shall first spend excess assets to pay 
107.21 	health service bills and may meet the income spenddown on remaining bills.
107.22 	(b) Assets may be reduced beginning the month of application by paying bills for health 
107.23 	services that are incurred during the period specified in Minnesota Rules, part 9505.0090, 
107.24 	subpart 2, that would otherwise be paid by medical assistance. After assets are reduced to 
107.25 	allowable limits, eligibility begins with the next dollar of medical assistance covered health 
107.26 	services incurred in the period. Applicants reducing assets under this subdivision who also 
107.27 	have excess income shall first spend excess assets to pay health service bills and may meet 
107.28 	the income spenddown on remaining bills.

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

107.30 	Sec. 8. Minnesota Statutes 2024, section 256B.056, subdivision 7, is amended to read:
107.31 		Subd. 7.Period of eligibility. (a) Except as provided in paragraphs (b), (c), and (e), 
107.32 	medical assistance enrollees are eligible for 12 months. Until December 31, 2027, eligibility 
107.33 	is available for the month of application and for three months prior to application if the 
108.1 	person was eligible in those prior months. A redetermination of eligibility must occur every 
108.2 	12 months. Effective January 1, 2028, eligibility is available for the month of application 
108.3 	and for:
108.4 	(b) Notwithstanding any other law to the contrary:
108.5 	(1) a child under 19 years of age who is determined eligible for medical assistance must 
108.6 	remain eligible for a period of 12 months;
108.7 	(2) a child 19 years of age and older but under 21 years of age who is determined eligible 
108.8 	for medical assistance must remain eligible for a period of 12 months; and
108.9 	(1) one month prior to application for an individual described in paragraph (e) if the 
108.10 	individual was eligible for medical assistance in the prior month; or
108.11 	(2) two months prior to application for all other individuals eligible for medical assistance 
108.12 	if the individual was eligible in those prior months.
108.13 	(3)(b) A child under six years of age who is determined eligible for medical assistance 
108.14 	must remain eligible through the month in which the child reaches six years of age.
108.15 	(c) A child's eligibility under paragraph (b) may be terminated earlier if:
108.16 	(1) the child or the child's representative requests voluntary termination of eligibility;
108.17 	(2) the child ceases to be a resident of this state;
108.18 	(3) the child dies;
108.19 	(4) the child attains the maximum age; or
108.20 	(5) the agency determines eligibility was erroneously granted at the most recent eligibility 
108.21 	determination due to agency error or fraud, abuse, or perjury attributed to the child or the 
108.22 	child's representative.
108.23 	(d) For a person an individual eligible for an insurance affordability program as defined 
108.24 	in section 256B.02, subdivision 19, who reports a change that makes the person individual
108.25 	eligible for medical assistance, eligibility is available for the month the change was reported 
108.26 	and for three months prior to the month the change was reported, if the person was eligible 
108.27 	in those prior months.:
108.28 	(1) until December 31, 2027, for three months prior to the month the change was reported; 
108.29 	and
108.30 	(2) effective January 1, 2028, for:
109.1 	(i) one month prior to the month the change was reported for an individual described in 
109.2 	paragraph (e); or
109.3 	(ii) two months prior to the month the change was reported for all other individuals 
109.4 	eligible for medical assistance if the individual was eligible in the prior month or months.
109.5 	(e) The period of eligibility for a person subject to six-month eligibility redeterminations 
109.6 	under Public Law 119-21, section 71107, is six months.

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

109.8 	Sec. 9. Minnesota Statutes 2024, section 256B.056, subdivision 7a, is amended to read:
109.9 		Subd. 7a.Periodic renewal of eligibility. (a) Except as provided in paragraphs (d) and 
109.10 	(e), the commissioner shall make an annual redetermination of eligibility based on 
109.11 	information contained in the enrollee's case file and other information available to the 
109.12 	agency, including but not limited to information accessed through an electronic database, 
109.13 	without requiring the enrollee to submit any information when sufficient data is available 
109.14 	for the agency to renew eligibility.
109.15 	(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the 
109.16 	commissioner must provide the enrollee with a prepopulated renewal form containing 
109.17 	eligibility information available to the agency and permit the enrollee to submit the form 
109.18 	with any corrections or additional information to the agency and sign the renewal form via 
109.19 	any of the modes of submission specified in section 256B.04, subdivision 18.
109.20 	(c) An enrollee who is terminated for failure to complete the renewal process may 
109.21 	subsequently submit the renewal form and required information within four months after 
109.22 	the date of termination and have coverage reinstated without a lapse, if otherwise eligible 
109.23 	under this chapter. The local agency may close the enrollee's case file if the required 
109.24 	information is not submitted within four months of termination.
109.25 	(d) Notwithstanding paragraph (a), A person who is eligible under subdivision 5 shall 
109.26 	be is subject to a review of the person's income every six months.
109.27 	(e) A person subject to six-month eligibility redeterminations under Public Law 119-21, 
109.28 	section 71107, is subject to a redetermination of eligibility every six months.

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

110.1 	Sec. 10. Minnesota Statutes 2024, section 256B.0561, subdivision 2, is amended to read:
110.2 		Subd. 2.Periodic data matching. (a) The commissioner shall conduct periodic data 
110.3 	matching to identify recipients who, based on available electronic data, may not meet 
110.4 	eligibility criteria for the public health care program in which the recipient is enrolled. The 
110.5 	commissioner shall conduct data matching for medical assistance or MinnesotaCare recipients 
110.6 	at least once during a recipient's 12-month period of eligibility, except as provided in 
110.7 	paragraph (f).
110.8 	(b) If data matching indicates a recipient may no longer qualify for medical assistance 
110.9 	or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no 
110.10 	more than 30 days to confirm the information obtained through the periodic data matching 
110.11 	or provide a reasonable explanation for the discrepancy to the state or county agency directly 
110.12 	responsible for the recipient's case. If a recipient does not respond within the advance notice 
110.13 	period or does not respond with information that demonstrates eligibility or provides a 
110.14 	reasonable explanation for the discrepancy within the 30-day time period, the commissioner 
110.15 	shall terminate the recipient's eligibility in the manner provided for by the laws and 
110.16 	regulations governing the health care program for which the recipient has been identified 
110.17 	as being ineligible.
110.18 	(c) The commissioner shall not terminate eligibility for a recipient who is cooperating 
110.19 	with the requirements of paragraph (b) and needs additional time to provide information in 
110.20 	response to the notification.
110.21 	(d) A recipient whose eligibility was terminated according to paragraph (b) may be 
110.22 	eligible for medical assistance no earlier than the first day of the month in which the recipient 
110.23 	provides information that demonstrates the recipient's eligibility.
110.24 	(e) Any termination of eligibility for benefits under this section may be appealed as 
110.25 	provided for in sections 256.045 to 256.0451, and the laws governing the health care 
110.26 	programs for which eligibility is terminated.
110.27 	(f) Effective January 1, 2027, a person subject to six-month eligibility redeterminations 
110.28 	under Public Law 119-21, section 71107, is exempt from periodic data matching under this 
110.29 	subdivision.

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

110.31 	Sec. 11. [256B.0562] WORK OR COMMUNITY ENGAGEMENT REQUIREMENTS.
110.32 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
110.33 	the meanings given.
111.1 	(b) "Applicable individual" has the meaning given in Public Law 119-21, section 71119, 
111.2 	paragraph (9).
111.3 	(c) "Short-term hardship event" means an event in which a person:
111.4 	(1) receives inpatient hospital or nursing facility services, services in an intermediate 
111.5 	care facility for individuals with intellectual disabilities, inpatient psychiatric hospital 
111.6 	services, or other services of similar acuity;
111.7 	(2) resides in a county in which there is an emergency or disaster declared by the President 
111.8 	of the United States pursuant to the National Emergencies Act or the Robert T. Stafford 
111.9 	Disaster Relief and Emergency Assistance Act;
111.10 	(3) resides in a county that has an unemployment rate at or above the lesser of:
111.11 	(i) eight percent; or
111.12 	(ii) 1.5 times the national unemployment rate; or
111.13 	(4) must travel, or the person's dependent must travel, outside of the person's community 
111.14 	for an extended period of time to receive medical services that are not available within the 
111.15 	community of residence necessary to treat a serious or complex medical condition of the 
111.16 	person or the person's dependent.
111.17 		Subd. 2.Application. To be eligible for medical assistance, an applicable individual 
111.18 	applying for medical assistance must either demonstrate work or community engagement 
111.19 	or meet an exemption in accordance with Public Law 119-21, section 71119, for the month 
111.20 	immediately preceding the month during which the person submits an application for medical 
111.21 	assistance.
111.22 		Subd. 3.Renewal requirement. (a) To renew eligibility, an applicable individual must 
111.23 	either demonstrate work or community engagement or meet an exemption in accordance 
111.24 	with Public Law 119-21, section 71119, for at least one month during the person's previous 
111.25 	period of eligibility.
111.26 	(b) The commissioner must notify an applicable individual of the renewal requirement 
111.27 	in paragraph (a) at least 75 days prior to the individual's renewal date.
111.28 		Subd. 4.Short-term hardship events. A person is deemed to have met the requirement 
111.29 	to demonstrate work or community engagement for a given month under subdivisions 2 
111.30 	and 3 if (1) the person experiences a short-term hardship event for part or all of that month, 
111.31 	and (2) for purposes of a short-term hardship described in subdivision 1, paragraph (c), 
111.32 	clause (1) or (4), the person submits a request to the commissioner.
112.1 		Subd. 5.Noncompliance procedure. Before denying or terminating medical assistance 
112.2 	eligibility for failure to demonstrate work or community engagement or meet an exemption, 
112.3 	the commissioner must comply with the procedures in the case of noncompliance set forth 
112.4 	in Public Law 119-21, section 71119, paragraph (6).
112.5 		Subd. 6.Interpretation of federal law. (a) In all cases where an obligation imposed on 
112.6 	the commissioner under Public Law 119-21, section 71119, is materially ambiguous, the 
112.7 	commissioner must construe the ambiguity in the light most favorable to the applicant, 
112.8 	enrollee, or disenrollee, as applicable. For purposes of this subdivision, an obligation on 
112.9 	the commissioner includes but is not limited to an obligation respecting the following:
112.10 	(1) enrollee notice and outreach;
112.11 	(2) demonstration of work or community engagement;
112.12 	(3) medical frailty;
112.13 	(4) fair hearing rights;
112.14 	(5) the provision of medical assistance benefits or coverage;
112.15 	(6) submission documentation, including self-attestations of eligibility or exemption;
112.16 	(7) eligibility or termination determinations;
112.17 	(8) short-term hardship requests; and
112.18 	(9) timing.
112.19 	(b) Paragraph (a) does not require the commissioner to take any action that the 
112.20 	commissioner determines:
112.21 	(1) is more likely than not to result in a loss of federal financial participation;
112.22 	(2) would be clearly impractical, absurd, or unreasonably detrimental to the medical 
112.23 	assistance program or another insurance affordability program; or
112.24 	(3) relies on an unreasonable interpretation of federal law.
112.25 	(c) Prior to the interpretation of an ambiguity under paragraph (a), the commissioner 
112.26 	must, in order to determine the reasonable interpretation of the applicable federal law most 
112.27 	favorable to an applicant, enrollee, or disenrollee:
112.28 	(1) consult with the health care eligibility oversight unit established in section 256.01;
112.29 	(2) consult with the chairs and ranking minority members of the legislative committees 
112.30 	with jurisdiction over health and human services finance and policy; and
113.1 	(3) take best efforts to consult with, and receive guidance from, the Centers for Medicare 
113.2 	and Medicaid Services.
113.3 		Subd. 7.Expedited rulemaking authority. The commissioner may adopt rules necessary 
113.4 	to implement and administer this section using the expedited rulemaking process under 
113.5 	section 14.389. The 18-month time limit under section 14.125 does not apply to the 
113.6 	rulemaking authority under this subdivision.

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

113.8 	Sec. 12. [256B.0563] REVIEW OF DEATH MASTER FILE.
113.9 		Subdivision 1.Definition. For purposes of this section, "death master file" means 
113.10 	information about deceased individuals maintained by the Social Security Administration 
113.11 	under United States Code, title 42, section 1306c(d), or any successor system.
113.12 		Subd. 2.Review of the death master file. (a) Beginning January 1, 2027, the 
113.13 	commissioner must review the death master file at least quarterly to identify any medical 
113.14 	assistance recipients who are deceased.
113.15 	(b) If review of the death master file or any other source indicates that a recipient is 
113.16 	deceased, the commissioner must:
113.17 	(1) terminate the recipient's eligibility for medical assistance in the manner provided for 
113.18 	by the laws and regulations governing medical assistance;
113.19 	(2) notify the recipient and the recipient's representative no later than the date of the 
113.20 	termination; and
113.21 	(3) discontinue any payments to providers under this chapter made on behalf of the 
113.22 	recipient as of the date of the termination.
113.23 	(c) If the commissioner determines that a recipient was misidentified as deceased and 
113.24 	erroneously disenrolled from medical assistance based on information obtained from the 
113.25 	death master file or any other source, the commissioner must immediately re-enroll the 
113.26 	individual in medical assistance retroactive to the date of termination under paragraph (b).
113.27 		Subd. 3.Review of other sources. Nothing in this section prevents the commissioner 
113.28 	from reviewing other sources to identify recipients of medical assistance who are deceased, 
113.29 	provided the commissioner is in compliance with this section and all other requirements 
113.30 	under this chapter related to medical assistance eligibility determination and redetermination.

114.1 	Sec. 13. Minnesota Statutes 2024, section 256B.06, subdivision 4, is amended to read:
114.2 		Subd. 4.Citizenship requirements. (a) Except as provided in paragraph (c), eligibility 
114.3 	for medical assistance is limited to citizens and nationals of the United States, qualified 
114.4 	noncitizens as defined in this subdivision, and other persons residing lawfully in the United 
114.5 	States and noncitizens who are eligible for coverage with federal financial participation 
114.6 	provided by Medicaid or the Children's Health Insurance Program. Noncitizens who are 
114.7 	eligible for federal financial participation include but are not limited to:
114.8 	(1) children and pregnant women who are lawfully residing in the United States as 
114.9 	provided by section 214 of the federal Children's Health Insurance Program Reauthorization 
114.10 	Act of 2009, Public Law 111-3, and who otherwise meet eligibility requirements of this 
114.11 	chapter; and
114.12 	(2) pregnant noncitizens who are ineligible for federal financial participation because 
114.13 	of immigration status; who are not covered by a group health plan or health insurance 
114.14 	coverage according to Code of Federal Regulations, title 42, section 457.310; and who 
114.15 	otherwise meet the eligibility requirements of this chapter. These individuals are eligible 
114.16 	for medical assistance through the period of pregnancy, including labor and delivery, and 
114.17 	12 months postpartum.
114.18 	(b) Citizens or nationals of the United States must cooperate in obtaining satisfactory 
114.19 	documentary evidence of citizenship or nationality according to the requirements of the 
114.20 	federal Deficit Reduction Act of 2005, Public Law 109-171.
114.21 	(c) Beginning October 1, 2003, persons who are receiving care and rehabilitation services 
114.22 	from a nonprofit center established to serve victims of torture and who are otherwise 
114.23 	ineligible for medical assistance under this chapter are eligible for medical assistance without 
114.24 	federal financial participation. These individuals are eligible only for the period during 
114.25 	which they are receiving services from the center. Individuals eligible under this paragraph 
114.26 	are not required to participate in prepaid medical assistance. The nonprofit center referenced 
114.27 	in this paragraph may establish itself as a provider of mental health targeted case management 
114.28 	services through a county contract under section 256.0112, subdivision 6. If the nonprofit 
114.29 	center is unable to secure a contract with a lead county in its service area, then, 
114.30 	notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner 
114.31 	may negotiate a contract with the nonprofit center for provision of mental health targeted 
114.32 	case management services. When serving clients who are not the financial responsibility 
114.33 	of their contracted lead county, the nonprofit center must gain the concurrence of the county 
115.1 	of financial responsibility prior to providing mental health targeted case management services 
115.2 	for those clients.
115.3 	(b) "Qualified noncitizen" means a person who meets one of the following immigration 
115.4 	criteria:
115.5 	(1) admitted for lawful permanent residence according to United States Code, title 8;
115.6 	(2) admitted to the United States as a refugee according to United States Code, title 8, 
115.7 	section 1157;
115.8 	(3) granted asylum according to United States Code, title 8, section 1158;
115.9 	(4) granted withholding of deportation according to United States Code, title 8, section 
115.10 	1253(h);
115.11 	(5) paroled for a period of at least one year according to United States Code, title 8, 
115.12 	section 1182(d)(5);
115.13 	(6) granted conditional entrant status according to United States Code, title 8, section 
115.14 	1153(a)(7);
115.15 	(7) determined to be a battered noncitizen by the United States Attorney General 
115.16 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
115.17 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
115.18 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United States 
115.19 	Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility 
115.20 	Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 
115.21 	or
115.22 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
115.23 	Law 96-422, the Refugee Education Assistance Act of 1980.
115.24 	(c) All qualified noncitizens who were residing in the United States before August 22, 
115.25 	1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical 
115.26 	assistance with federal financial participation.
115.27 	(d) Beginning December 1, 1996, qualified noncitizens who entered the United States 
115.28 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
115.29 	chapter are eligible for medical assistance with federal participation for five years if they 
115.30 	meet one of the following criteria:
115.31 	(1) refugees admitted to the United States according to United States Code, title 8, section 
115.32 	1157;
116.1 	(2) persons granted asylum according to United States Code, title 8, section 1158;
116.2 	(3) persons granted withholding of deportation according to United States Code, title 8, 
116.3 	section 1253(h);
116.4 	(4) veterans of the United States armed forces with an honorable discharge for a reason 
116.5 	other than noncitizen status, their spouses and unmarried minor dependent children; or
116.6 	(5) persons on active duty in the United States armed forces, other than for training, 
116.7 	their spouses and unmarried minor dependent children.
116.8 	Beginning July 1, 2010, children and pregnant women who are noncitizens described 
116.9 	in paragraph (b) or who are lawfully present in the United States as defined in Code of 
116.10 	Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements 
116.11 	of this chapter, are eligible for medical assistance with federal financial participation as 
116.12 	provided by the federal Children's Health Insurance Program Reauthorization Act of 2009, 
116.13 	Public Law 111-3.
116.14 	(e) (d) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
116.15 	are eligible for the benefits as provided in paragraphs (f) (e) to (h) (g). For purposes of this 
116.16 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States Code, 
116.17 	title 8, section 1101(a)(15).
116.18 	(f) (e) Payment shall also be made for care and services that are furnished to noncitizens, 
116.19 	regardless of immigration status, who otherwise meet the eligibility requirements of this 
116.20 	chapter, if such care and services are necessary for the treatment of an emergency medical 
116.21 	condition.
116.22 	(g) (f) For purposes of this subdivision, the term "emergency medical condition" means 
116.23 	a medical condition that meets the requirements of United States Code, title 42, section 
116.24 	1396b(v).
116.25 	(h) (g)(1) Notwithstanding paragraph (g) (f), services that are necessary for the treatment 
116.26 	of an emergency medical condition are limited to the following:
116.27 	(i) services delivered in an emergency room or by an ambulance service licensed under 
116.28 	chapter 144E that are directly related to the treatment of an emergency medical condition;
116.29 	(ii) services delivered in an inpatient hospital setting following admission from an 
116.30 	emergency room or clinic for an acute emergency condition; and
117.1 	(iii) follow-up services that are directly related to the original service provided to treat 
117.2 	the emergency medical condition and are covered by the global payment made to the 
117.3 	provider.
117.4 	(2) Services for the treatment of emergency medical conditions do not include:
117.5 	(i) services delivered in an emergency room or inpatient setting to treat a nonemergency 
117.6 	condition;
117.7 	(ii) organ transplants, stem cell transplants, and related care;
117.8 	(iii) services for routine prenatal care;
117.9 	(iv) continuing care, including long-term care, nursing facility services, home health 
117.10 	care, adult day care, day training, or supportive living services;
117.11 	(v) elective surgery;
117.12 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part 
117.13 	of an emergency room visit;
117.14 	(vii) preventative health care and family planning services;
117.15 	(viii) rehabilitation services;
117.16 	(ix) physical, occupational, or speech therapy;
117.17 	(x) transportation services;
117.18 	(xi) case management;
117.19 	(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
117.20 	(xiii) dental services;
117.21 	(xiv) hospice care;
117.22 	(xv) audiology services and hearing aids;
117.23 	(xvi) podiatry services;
117.24 	(xvii) chiropractic services;
117.25 	(xviii) immunizations;
117.26 	(xix) vision services and eyeglasses;
117.27 	(xx) waiver services;
117.28 	(xxi) individualized education programs; or
118.1 	(xxii) substance use disorder treatment.
118.2 	(i) Pregnant noncitizens who are ineligible for federally funded medical assistance 
118.3 	because of immigration status, are not covered by a group health plan or health insurance 
118.4 	coverage according to Code of Federal Regulations, title 42, section 457.310, and who 
118.5 	otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance 
118.6 	through the period of pregnancy, including labor and delivery, and 12 months postpartum.
118.7 	(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services 
118.8 	from a nonprofit center established to serve victims of torture and are otherwise ineligible 
118.9 	for medical assistance under this chapter are eligible for medical assistance without federal 
118.10 	financial participation. These individuals are eligible only for the period during which they 
118.11 	are receiving services from the center. Individuals eligible under this paragraph shall not 
118.12 	be required to participate in prepaid medical assistance. The nonprofit center referenced 
118.13 	under this paragraph may establish itself as a provider of mental health targeted case 
118.14 	management services through a county contract under section 256.0112, subdivision 6. If 
118.15 	the nonprofit center is unable to secure a contract with a lead county in its service area, then, 
118.16 	notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner 
118.17 	may negotiate a contract with the nonprofit center for provision of mental health targeted 
118.18 	case management services. When serving clients who are not the financial responsibility 
118.19 	of their contracted lead county, the nonprofit center must gain the concurrence of the county 
118.20 	of financial responsibility prior to providing mental health targeted case management services 
118.21 	for those clients.
118.22 	(k) (h) Notwithstanding paragraph (h) (g), clause (2), the following services are covered 
118.23 	as emergency medical conditions under paragraph (f) (e) except where coverage is prohibited 
118.24 	under federal law for services under clauses (1) and (2):
118.25 	(1) dialysis services provided in a hospital or freestanding dialysis facility;
118.26 	(2) surgery and the administration of chemotherapy, radiation, and related services 
118.27 	necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and 
118.28 	requires surgery, chemotherapy, or radiation treatment; and
118.29 	(3) kidney transplant if the person has been diagnosed with end stage renal disease, is 
118.30 	currently receiving dialysis services, and is a potential candidate for a kidney transplant.
118.31 	(l) (i) Effective July 1, 2013, recipients of emergency medical assistance under this 
118.32 	subdivision are eligible for coverage of the elderly waiver services provided under chapter 
118.33 	256S, and coverage of rehabilitative services provided in a nursing facility. The age limit 
118.34 	for elderly waiver services does not apply. In order to qualify for coverage, a recipient of 
119.1 	emergency medical assistance is subject to the assessment and reassessment requirements 
119.2 	of section 256B.0911. Initial and continued enrollment under this paragraph is subject to 
119.3 	the limits of available funding.

119.4 	Sec. 14. Minnesota Statutes 2024, section 256B.061, is amended to read:
119.5 	256B.061 ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.
119.6 	(a) If any individual has been determined to be eligible for medical assistance and is 
119.7 	subject to six-month eligibility redeterminations under Public Law 119-21, section 71107, 
119.8 	it medical assistance will be made available for care and services included under the plan 
119.9 	and furnished in or after the third first month before the month in which the individual made 
119.10 	application for such assistance, if such individual was, or upon application would have been, 
119.11 	eligible for medical assistance at the time the care and services were furnished.
119.12 	(b) If any individual has been determined to be eligible for medical assistance and is not 
119.13 	subject to six-month eligibility redeterminations under Public Law 119-21, section 71107, 
119.14 	medical assistance will be made available for care and services included under the plan and 
119.15 	furnished in or after the second month before the month in which the individual made 
119.16 	application for such assistance if such individual was, or upon application would have been, 
119.17 	eligible for medical assistance at the time the care and services were furnished.
119.18 	(c) The commissioner may limit, restrict, or suspend the eligibility of an individual for 
119.19 	up to one year upon that individual's conviction of a criminal offense related to application 
119.20 	for or receipt of medical assistance benefits.

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

119.22 	Sec. 15. Minnesota Statutes 2024, section 256B.0631, subdivision 1a, is amended to read:
119.23 		Subd. 1a.Prohibition on cost-sharing and deductibles. Effective January 1, 2024
119.24 	Except for recipients eligible under section 256B.055, subdivision 15, the medical assistance 
119.25 	benefit plan must not include cost-sharing or deductibles for any medical assistance recipient 
119.26 	or benefit.

119.27 	Sec. 16. Minnesota Statutes 2024, section 256B.0631, is amended by adding a subdivision 
119.28 	to read:
119.29 		Subd. 5.Cost sharing. (a) Effective for services provided on or after October 1, 2028, 
119.30 	except as provided in subdivision 6, the medical assistance benefit plan includes the following 
120.1 	cost sharing for recipients eligible under section 256B.055, subdivision 15, with income 
120.2 	above 100 percent of the federal poverty level:
120.3 	(1) $3 per nonpreventive visit, except as provided in paragraph (c). For purposes of this 
120.4 	subdivision, a visit means an episode of service that is required because of a recipient's 
120.5 	symptoms, diagnosis, or established illness, and that is delivered in an ambulatory setting 
120.6 	by a physician or physician assistant, chiropractor, podiatrist, nurse midwife, advanced 
120.7 	practice nurse, audiologist, optician, or optometrist;
120.8 	(2) $3.50 for nonemergency visits to a hospital-based emergency room; and
120.9 	(3) $3 per brand-name drug prescription, $1 per generic drug prescription, and $1 per 
120.10 	prescription for a brand-name multisource drug listed in preferred status on the preferred 
120.11 	drug list, subject to a $12 maximum per month for prescription drug co-payments. No 
120.12 	co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness.
120.13 	(b) Cost sharing for prescription drugs and related medical supplies to treat chronic 
120.14 	disease must comply with the requirements of section 62Q.481.
120.15 	(c) A person eligible for medical assistance under section 256B.055, subdivision 15, is 
120.16 	responsible for all co-payments and deductibles in this subdivision.

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

120.18 	Sec. 17. Minnesota Statutes 2024, section 256B.0631, is amended by adding a subdivision 
120.19 	to read:
120.20 		Subd. 6.Exceptions. Co-payments and deductibles are subject to the exceptions and 
120.21 	limits required by Public Law 119-21, section 71120.

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

120.23 	Sec. 18. Minnesota Statutes 2024, section 256B.0631, is amended by adding a subdivision 
120.24 	to read:
120.25 		Subd. 7.Collection. (a) The medical assistance reimbursement to the provider must be 
120.26 	reduced by the amount of the co-payment or deductible, except that reimbursements must 
120.27 	not be reduced:
120.28 	(1) once a recipient has reached the $12 maximum per month for prescription drug 
120.29 	co-payments; or
120.30 	(2) for a recipient who has met the recipient's monthly five percent cost-sharing limit.
121.1 	(b) The provider collects the co-payment or deductible from the recipient. Providers 
121.2 	must not deny services to recipients who are unable to pay the co-payment or deductible.

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

121.4 	Sec. 19. Minnesota Statutes 2025 Supplement, section 268.19, subdivision 1, is amended 
121.5 	to read:
121.6 		Subdivision 1.Use of data. (a) Except as provided by this section, data gathered from 
121.7 	any person under the administration of the Minnesota Unemployment Insurance Law are 
121.8 	private data on individuals or nonpublic data not on individuals as defined in section 13.02, 
121.9 	subdivisions 9 and 12, and may not be disclosed except according to a district court order 
121.10 	or section 13.05. A subpoena is not considered a district court order. These data may be 
121.11 	disseminated to and used by the following agencies without the consent of the subject of 
121.12 	the data:
121.13 	(1) state and federal agencies specifically authorized access to the data by state or federal 
121.14 	law;
121.15 	(2) any agency of any other state or any federal agency charged with the administration 
121.16 	of an unemployment insurance program;
121.17 	(3) any agency responsible for the maintenance of a system of public employment offices 
121.18 	for the purpose of assisting individuals in obtaining employment;
121.19 	(4) the public authority responsible for child support in Minnesota or any other state in 
121.20 	accordance with section 518A.83;
121.21 	(5) human rights agencies within Minnesota that have enforcement powers;
121.22 	(6) the Department of Revenue to the extent necessary for its duties under Minnesota 
121.23 	laws;
121.24 	(7) public and private agencies responsible for administering publicly financed assistance 
121.25 	programs for the purpose of monitoring the eligibility of the program's recipients;
121.26 	(8) the Department of Labor and Industry, the Department of Commerce, and the Bureau 
121.27 	of Criminal Apprehension for uses consistent with the administration of their duties under 
121.28 	Minnesota law;
121.29 	(9) the Department of Human Services and the Office of Inspector General and its agents 
121.30 	within the Department of Human Services, including county fraud investigators, for 
121.31 	investigations related to recipient or provider fraud and employees of providers when the 
121.32 	provider is suspected of committing public assistance fraud;
122.1 	(10) the Department of Human Services for the purpose of evaluating medical assistance 
122.2 	services and, supporting program improvement, and administering section 256B.0562;
122.3 	(11) local and state welfare agencies for monitoring the eligibility of the data subject 
122.4 	for assistance programs, or for any employment or training program administered by those 
122.5 	agencies, whether alone, in combination with another welfare agency, or in conjunction 
122.6 	with the department or to monitor and evaluate the statewide Minnesota family investment 
122.7 	program and other cash assistance programs, the Supplemental Nutrition Assistance Program, 
122.8 	and the Supplemental Nutrition Assistance Program Employment and Training program by 
122.9 	providing data on recipients and former recipients of Supplemental Nutrition Assistance 
122.10 	Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child 
122.11 	care assistance under chapter 142E, or medical programs under chapter 256B or 256L or 
122.12 	formerly codified under chapter 256D;
122.13 	(12) local and state welfare agencies for the purpose of identifying employment, wages, 
122.14 	and other information to assist in the collection of an overpayment debt in an assistance 
122.15 	program;
122.16 	(13) local, state, and federal law enforcement agencies for the purpose of ascertaining 
122.17 	the last known address and employment location of an individual who is the subject of a 
122.18 	criminal investigation;
122.19 	(14) the United States Immigration and Customs Enforcement has access to data on 
122.20 	specific individuals and specific employers provided the specific individual or specific 
122.21 	employer is the subject of an investigation by that agency;
122.22 	(15) the Department of Health for the purposes of epidemiologic investigations;
122.23 	(16) the Department of Corrections for the purposes of case planning and internal research 
122.24 	for preprobation, probation, and postprobation employment tracking of offenders sentenced 
122.25 	to probation and preconfinement and postconfinement employment tracking of committed 
122.26 	offenders;
122.27 	(17) the state auditor to the extent necessary to conduct audits of job opportunity building 
122.28 	zones as required under section 469.3201;
122.29 	(18) the Office of Higher Education for purposes of supporting program improvement, 
122.30 	system evaluation, and research initiatives including the Statewide Longitudinal Education 
122.31 	Data System;
122.32 	(19) the Family and Medical Benefits Division of the Department of Employment and 
122.33 	Economic Development to be used as necessary to administer chapter 268B; and
123.1 	(20) the executive director or interim executive director of the Minnesota Secure Choice 
123.2 	Retirement Program established under chapter 187 for the purposes of assisting with 
123.3 	communication with employers and to verify employer compliance with chapter 187.
123.4 	(b) Data on individuals and employers that are collected, maintained, or used by the 
123.5 	department in an investigation under section 268.182 are confidential as to data on individuals 
123.6 	and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3
123.7 	and 13, and must not be disclosed except under statute or district court order or to a party 
123.8 	named in a criminal proceeding, administrative or judicial, for preparation of a defense.
123.9 	(c) Data gathered by the department in the administration of the Minnesota unemployment 
123.10 	insurance program must not be made the subject or the basis for any suit in any civil 
123.11 	proceedings, administrative or judicial, unless the action is initiated by the department.

123.12 	Sec. 20. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; 
123.13 	NOTIFICATION TO MEDICAL ASSISTANCE RECIPIENTS.
 123.14 	By October 1, 2026, the commissioner of human services must notify medical assistance 
123.15 	recipients who are enrolled under Minnesota Statutes, section 256B.055, subdivision 15, 
123.16 	that they may be eligible for medical assistance under a disability determination. The 
123.17 	notification must include information about how the recipient can request a determination 
123.18 	of disability and an explanation about the changes to medical assistance eligibility that go 
123.19 	into effect January 1, 2027.

123.20 	ARTICLE 7
123.21 	MEDICAL ASSISTANCE FRAUD PREVENTION

123.22 	Section 1. Minnesota Statutes 2024, section 8.16, subdivision 1, is amended to read:
123.23 		Subdivision 1.Authority. (a) The attorney general, or any deputy, assistant, or special 
123.24 	assistant attorney general whom the attorney general authorizes in writing, has the authority 
123.25 	in any county of the state to subpoena and require the production of: (1) any records of: (i)
123.26 	telephone companies, cellular phone companies, and paging companies,; (ii) subscribers of 
123.27 	private computer networks, including Internet service providers or computer bulletin board 
123.28 	systems,; (iii) electric companies, gas companies, and water utilities,; (iv) chemical suppliers,; 
123.29 	(v) hotels and motels,; (vi) pawn shops,; (vii) airlines, buses, taxis, and other entities engaged 
123.30 	in the business of transporting people,; and (viii) freight companies, self-service storage 
123.31 	facilities, warehousing companies, package delivery companies, and other entities engaged 
123.32 	in the businesses of transport, storage, or delivery, and; (2) wage and employment records 
123.33 	relating to an investigation conducted under the attorney general's authority under section 
124.1 	256B.12; (3) records of the existence of safe deposit box account numbers and customer 
124.2 	savings and checking account numbers maintained by financial institutions and safe deposit 
124.3 	companies; (4) insurance records related to claim settlement relating to an investigation 
124.4 	conducted under the attorney general's authority under section 256B.12; and (5) banking, 
124.5 	credit card, and financial records, including but not limited to a safe deposit, loan and account 
124.6 	application and agreement, signature card, statement, check, transfer, account authorization, 
124.7 	safe deposit access record, and documentation of fraud, that belong to the subject of an 
124.8 	investigation conducted pursuant to the attorney general's authority under section 256B.12, 
124.9 	whether the record is held in the investigation subject's name or in another person's name.
124.10 	(b) Subpoenas may only be issued for records that are relevant to an ongoing legitimate 
124.11 	law enforcement investigation.

124.12 	Sec. 2. Minnesota Statutes 2025 Supplement, section 256B.12, is amended to read:
124.13 	256B.12 LEGAL REPRESENTATION.
124.14 	The attorney general or the appropriate county attorney appearing at the direction of the 
124.15 	attorney general shall be the attorney for the state agency, and the county attorney of the 
124.16 	appropriate county shall be the attorney for the county agency in all matters pertaining 
124.17 	hereto. To prosecute under this chapter or sections 609.466 609.467; 609.52, subdivision 
124.18 	2; and 609.542 or to recover payments wrongfully made under this chapter, the attorney 
124.19 	general or the appropriate county attorney, acting independently or at the direction of the 
124.20 	attorney general may institute a criminal or civil action.

124.21 	Sec. 3. [609.467] MEDICAL ASSISTANCE FRAUD.
124.22 		Subdivision 1.Medical assistance fraud prohibited. A person who does any of the 
124.23 	following is guilty of medical assistance fraud and may be sentenced as provided in 
124.24 	subdivision 2:
124.25 	(1) acting with intent to defraud, executes or participates in, or attempts or conspires to 
124.26 	execute or participate in, a scheme or artifice to obtain, by means of any false or fraudulent 
124.27 	pretenses, representations, or promises, or concealment of any material fact, any money or 
124.28 	credits relating to the payment of medical assistance funds under chapter 256B;
124.29 	(2) acting with intent to defraud, presents, submits, tenders, offers, or participates in, or 
124.30 	attempts or conspires to execute or participate in, the preparation of a claim for payment, 
124.31 	claim for reimbursement, cost report, or rate application, knowing or having reason to know 
124.32 	that any part of the claim, report, or application is ineligible for payment or reimbursement;
125.1 	(3) acting with intent to defraud, knowingly provides false information or intentionally 
125.2 	omits material information as part of any enrollment application, provider agreement, or 
125.3 	ownership and management disclosure required by any state or federal law as a medical 
125.4 	assistance provider under chapter 245A or 256B;
125.5 	(4) owns, operates, manages, or exercises control over any entity receiving medical 
125.6 	assistance money, while knowing or having reason to know that the person has been 
125.7 	suspended or prohibited from enrolling as a medical assistance provider by any state agency 
125.8 	or under any state law or is excluded or prohibited from enrolling as a medical assistance 
125.9 	provider by any federal agency or under any federal law;
125.10 	(5) knowingly and intentionally permits another person to own, operate, manage, or 
125.11 	exercise control over any entity receiving medical assistance money, while knowing or 
125.12 	having reason to know the other person is suspended or prohibited from enrolling as a 
125.13 	medical assistance provider by any state agency or under any state law or is excluded or 
125.14 	prohibited from enrolling as a medical assistance provider by any federal agency or under 
125.15 	any federal law;
125.16 	(6) falsely makes or alters any record relating to the delivery of medical assistance 
125.17 	services so that the record purports to have been made by another person or by the maker 
125.18 	or alterer under an assumed or fictitious name, or at another time, or with different provisions, 
125.19 	or by the authority of a person who did not give such authority;
125.20 	(7) acting with intent to defraud, presents, submits, tenders, offers, or participates in, or 
125.21 	attempts or conspires to participate in, the preparation of a claim for reimbursement for 
125.22 	personal care assistance services under section 256B.0659 or community first services and 
125.23 	supports under section 256B.85, knowing or having reason to know that required conditions 
125.24 	for payment under chapter 256B were not met, including applicable service authorization, 
125.25 	service delivery plan, documentation, training, supervision, evaluation, or other program 
125.26 	requirements; or
125.27 	(8) after receiving a lawful request for records by any state agency or law enforcement 
125.28 	agency, intentionally destroys, or attempts or conspires to destroy, medical, health care, and 
125.29 	financial records required to be maintained under chapter 245A or 256B or rules adopted 
125.30 	pursuant to those chapters.
125.31 		Subd. 2.Penalties. (a) A person who is convicted under subdivision 1 may be sentenced 
125.32 	to imprisonment for not more than ten years or to payment of not more than $20,000, or 
125.33 	both.
126.1 	(b) A person who is convicted under subdivision 1 may be sentenced to imprisonment 
126.2 	for not more than 20 years or to payment of not more than $100,000, or both, if the violation 
126.3 	causes a loss to any victim in an aggregate amount of more than $100,000, but not more 
126.4 	than $1,000,000.
126.5 	(c) A person who is convicted under subdivision 1 may be sentenced to imprisonment 
126.6 	for not more than 30 years or to payment of not more than $1,000,000, or both, if the violation 
126.7 	causes a loss to any victim in an aggregate amount of more than $1,000,000.
126.8 		Subd. 3.Failure to keep or maintain medical assistance records. A person who 
126.9 	submits a claim for reimbursement, claim for payment, claim for reimbursement cost report, 
126.10 	or rate application and knowingly and intentionally fails to maintain medical, health care, 
126.11 	and financial records as required under chapter 245A or 256B or rules adopted pursuant to 
126.12 	those chapters is guilty of a gross misdemeanor.
126.13 		Subd. 4.Continuing offense. For purposes of calculating the statute of limitations 
126.14 	identified in section 628.26, any violation of subdivision 1 or 3 is a continuing offense. Any 
126.15 	violation of subdivision 1 or 3 extends to any act committed during the course of the scheme, 
126.16 	conspiracy, or conduct and is within the statute of limitations identified in section 628.26 
126.17 	so long as any part of the continuing scheme, conspiracy, or conduct comprising a violation 
126.18 	occurred within the identified statute of limitations.
126.19 		Subd. 5.Venue. Notwithstanding anything to the contrary in section 627.01, a violation 
126.20 	of this section may be prosecuted in:
126.21 	(1) the county where any part of the offense occurred; or
126.22 	(2) the county where the entity that received a claim for payment, claim for 
126.23 	reimbursement, cost report, or rate application is located.
126.24 		Subd. 6.Restitution. The court may order a person convicted of violating this section 
126.25 	to pay restitution for any costs, expenses, or losses resulting from the crime and for costs, 
126.26 	expenses, or losses resulting from similar conduct that was related to the offense but was 
126.27 	not charged. The court may order restitution for similar conduct that was related to the 
126.28 	offense if the related conduct occurred within the applicable statute of limitations and the 
126.29 	prosecutor provides notice of intent to seek restitution for that conduct at least five business 
126.30 	days before the sentencing hearing. The offender may challenge restitution as provided in 
126.31 	section 611A.045, subdivision 3. A dispute as to whether restitution is for similar conduct 
126.32 	that was related to the offense must be resolved by the court by the preponderance of the 
126.33 	evidence. The burden of demonstrating that the court may order restitution for any cost, 
126.34 	expense, or loss described in this subdivision is on the prosecution.

127.1 	EFFECTIVE DATE. This section is effective August 1, 2026, and applies to crimes 
127.2 	committed on or after that date.

127.3 	Sec. 4. Minnesota Statutes 2024, section 609.52, subdivision 2, is amended to read:
127.4 		Subd. 2.Acts constituting theft. (a) Whoever does any of the following commits theft 
127.5 	and may be sentenced as provided in subdivision 3:
127.6 	(1) intentionally and without claim of right takes, uses, transfers, conceals or retains 
127.7 	possession of movable property of another without the other's consent and with intent to 
127.8 	deprive the owner permanently of possession of the property; or
127.9 	(2) with or without having a legal interest in movable property, intentionally and without 
127.10 	consent, takes the property out of the possession of a pledgee or other person having a 
127.11 	superior right of possession, with intent thereby to deprive the pledgee or other person 
127.12 	permanently of the possession of the property; or
127.13 	(3) obtains for the actor or another the possession, custody, or title to property of or 
127.14 	performance of services by a third person by intentionally deceiving the third person with 
127.15 	a false representation which is known to be false, made with intent to defraud, and which 
127.16 	does defraud the person to whom it is made. "False representation" includes without 
127.17 	limitation:
127.18 	(i) the issuance of a check, draft, or order for the payment of money, except a forged 
127.19 	check as defined in section 609.631, or the delivery of property knowing that the actor is 
127.20 	not entitled to draw upon the drawee therefor or to order the payment or delivery thereof; 
127.21 	or
127.22 	(ii) a promise made with intent not to perform. Failure to perform is not evidence of 
127.23 	intent not to perform unless corroborated by other substantial evidence; or
127.24 	(iii) the preparation or filing of a claim for reimbursement, a rate application, or a cost 
127.25 	report used to establish a rate or claim for payment for medical care provided to a recipient 
127.26 	of medical assistance under chapter 256B, which intentionally and falsely states the costs 
127.27 	of or actual services provided by a vendor of medical care; or
127.28 	(iv) (iii) the preparation or filing of a claim for reimbursement for providing treatment 
127.29 	or supplies required to be furnished to an employee under section 176.135 which intentionally 
127.30 	and falsely states the costs of or actual treatment or supplies provided; or
127.31 	(v) (iv) the preparation or filing of a claim for reimbursement for providing treatment 
127.32 	or supplies required to be furnished to an employee under section 176.135 for treatment or 
128.1 	supplies that the provider knew were medically unnecessary, inappropriate, or excessive; 
128.2 	or
128.3 	(4) by swindling, whether by artifice, trick, device, or any other means, obtains property 
128.4 	or services from another person; or
128.5 	(5) intentionally commits any of the acts listed in this subdivision but with intent to 
128.6 	exercise temporary control only and:
128.7 	(i) the control exercised manifests an indifference to the rights of the owner or the 
128.8 	restoration of the property to the owner; or
128.9 	(ii) the actor pledges or otherwise attempts to subject the property to an adverse claim; 
128.10 	or
128.11 	(iii) the actor intends to restore the property only on condition that the owner pay a 
128.12 	reward or buy back or make other compensation; or
128.13 	(6) finds lost property and, knowing or having reasonable means of ascertaining the true 
128.14 	owner, appropriates it to the finder's own use or to that of another not entitled thereto without 
128.15 	first having made reasonable effort to find the owner and offer and surrender the property 
128.16 	to the owner; or
128.17 	(7) intentionally obtains property or services, offered upon the deposit of a sum of money 
128.18 	or tokens in a coin or token operated machine or other receptacle, without making the 
128.19 	required deposit or otherwise obtaining the consent of the owner; or
128.20 	(8) intentionally and without claim of right converts any article representing a trade 
128.21 	secret, knowing it to be such, to the actor's own use or that of another person or makes a 
128.22 	copy of an article representing a trade secret, knowing it to be such, and intentionally and 
128.23 	without claim of right converts the same to the actor's own use or that of another person. It 
128.24 	shall be a complete defense to any prosecution under this clause for the defendant to show 
128.25 	that information comprising the trade secret was rightfully known or available to the 
128.26 	defendant from a source other than the owner of the trade secret; or
128.27 	(9) leases or rents personal property under a written instrument and who:
128.28 	(i) with intent to place the property beyond the control of the lessor conceals or aids or 
128.29 	abets the concealment of the property or any part thereof; or
128.30 	(ii) sells, conveys, or encumbers the property or any part thereof without the written 
128.31 	consent of the lessor, without informing the person to whom the lessee sells, conveys, or 
129.1 	encumbers that the same is subject to such lease or rental contract with intent to deprive the 
129.2 	lessor of possession thereof; or
129.3 	(iii) does not return the property to the lessor at the end of the lease or rental term, plus 
129.4 	agreed-upon extensions, with intent to wrongfully deprive the lessor of possession of the 
129.5 	property; or
129.6 	(iv) returns the property to the lessor at the end of the lease or rental term, plus 
129.7 	agreed-upon extensions, but does not pay the lease or rental charges agreed upon in the 
129.8 	written instrument, with intent to wrongfully deprive the lessor of the agreed-upon charges.
129.9 	For the purposes of items (iii) and (iv), the value of the property must be at least $100.
129.10 	Evidence that a lessee used a false, fictitious, or not current name, address, or place of 
129.11 	employment in obtaining the property or fails or refuses to return the property or pay the 
129.12 	rental contract charges to lessor within five days after written demand for the return has 
129.13 	been served personally in the manner provided for service of process of a civil action or 
129.14 	sent by certified mail to the last known address of the lessee, whichever shall occur later, 
129.15 	shall be evidence of intent to violate this clause. Service by certified mail shall be deemed 
129.16 	to be complete upon deposit in the United States mail of such demand, postpaid and addressed 
129.17 	to the person at the address for the person set forth in the lease or rental agreement, or, in 
129.18 	the absence of the address, to the person's last known place of residence; or
129.19 	(10) alters, removes, or obliterates numbers or symbols placed on movable property for 
129.20 	purpose of identification by the owner or person who has legal custody or right to possession 
129.21 	thereof with the intent to prevent identification, if the person who alters, removes, or 
129.22 	obliterates the numbers or symbols is not the owner and does not have the permission of 
129.23 	the owner to make the alteration, removal, or obliteration; or
129.24 	(11) with the intent to prevent the identification of property involved, so as to deprive 
129.25 	the rightful owner of possession thereof, alters or removes any permanent serial number, 
129.26 	permanent distinguishing number or manufacturer's identification number on personal 
129.27 	property or possesses, sells or buys any personal property knowing or having reason to 
129.28 	know that the permanent serial number, permanent distinguishing number or manufacturer's 
129.29 	identification number has been removed or altered; or
129.30 	(12) intentionally deprives another of a lawful charge for cable television service by:
129.31 	(i) making or using or attempting to make or use an unauthorized external connection 
129.32 	outside the individual dwelling unit whether physical, electrical, acoustical, inductive, or 
129.33 	other connection; or by
130.1 	(ii) attaching any unauthorized device to any cable, wire, microwave, or other component 
130.2 	of a licensed cable communications system as defined in chapter 238. Nothing herein shall 
130.3 	be construed to prohibit the electronic video rerecording of program material transmitted 
130.4 	on the cable communications system by a subscriber for fair use as defined by Public Law 
130.5 	94-553, section 107; or
130.6 	(13) except as provided in clauses (12) and (14), obtains the services of another with 
130.7 	the intention of receiving those services without making the agreed or reasonably expected 
130.8 	payment of money or other consideration; or
130.9 	(14) intentionally deprives another of a lawful charge for telecommunications service 
130.10 	by:
130.11 	(i) making, using, or attempting to make or use an unauthorized connection whether 
130.12 	physical, electrical, by wire, microwave, radio, or other means to a component of a local 
130.13 	telecommunication system as provided in chapter 237; or
130.14 	(ii) attaching an unauthorized device to a cable, wire, microwave, radio, or other 
130.15 	component of a local telecommunication system as provided in chapter 237.
130.16 	The existence of an unauthorized connection is prima facie evidence that the occupier 
130.17 	of the premises:
130.18 	(A) made or was aware of the connection; and
130.19 	(B) was aware that the connection was unauthorized;
130.20 	(15) with intent to defraud, diverts corporate property other than in accordance with 
130.21 	general business purposes or for purposes other than those specified in the corporation's 
130.22 	articles of incorporation; or
130.23 	(16) with intent to defraud, authorizes or causes a corporation to make a distribution in 
130.24 	violation of section 302A.551, or any other state law in conformity with it; or
130.25 	(17) takes or drives a motor vehicle without the consent of the owner or an authorized 
130.26 	agent of the owner, knowing or having reason to know that the owner or an authorized agent 
130.27 	of the owner did not give consent; or
130.28 	(18) intentionally, and without claim of right, takes motor fuel from a retailer without 
130.29 	the retailer's consent and with intent to deprive the retailer permanently of possession of 
130.30 	the fuel by driving a motor vehicle from the premises of the retailer without having paid 
130.31 	for the fuel dispensed into the vehicle; or
130.32 	(19) commits wage theft under subdivision 1, clause (13).
131.1 	(b) Proof that the driver of a motor vehicle into which motor fuel was dispensed drove 
131.2 	the vehicle from the premises of the retailer without having paid for the fuel permits the 
131.3 	factfinder to infer that the driver acted intentionally and without claim of right, and that the 
131.4 	driver intended to deprive the retailer permanently of possession of the fuel. This paragraph 
131.5 	does not apply if: (1) payment has been made to the retailer within 30 days of the receipt 
131.6 	of notice of nonpayment under section 604.15; or (2) a written notice as described in section 
131.7 	604.15, subdivision 4, disputing the retailer's claim, has been sent. This paragraph does not 
131.8 	apply to the owner of a motor vehicle if the vehicle or the vehicle's license plate has been 
131.9 	reported stolen before the theft of the fuel.

131.10 	EFFECTIVE DATE. This section is effective August 1, 2026, and applies to crimes 
131.11 	committed on or after that date.

131.12 	Sec. 5. Minnesota Statutes 2025 Supplement, section 609.902, subdivision 4, is amended 
131.13 	to read:
131.14 		Subd. 4.Criminal act. "Criminal act" means conduct constituting, or a conspiracy or 
131.15 	attempt to commit, a felony violation of chapter 152, or a felony violation of section 299F.79; 
131.16 	299F.80; 299F.82; 609.185; 609.19; 609.195; 609.20; 609.205; 609.221; 609.222; 609.223; 
131.17 	609.2231; 609.228; 609.235; 609.245; 609.25; 609.27; 609.322; 609.342; 609.343; 609.344; 
131.18 	609.345; 609.42; 609.467;609.48; 609.485; 609.495; 609.496; 609.497; 609.498; 609.52, 
131.19 	subdivision 2, if the offense is punishable under subdivision 3, clause (1), if the property is 
131.20 	a firearm, clause (3)(b), or clause (3)(d)(v); section 609.52, subdivision 2, paragraph (a), 
131.21 	clause (1) or (4); 609.527, if the crime is punishable under subdivision 3, clause (4); 609.528, 
131.22 	if the crime is punishable under subdivision 3, clause (4); 609.53; 609.561; 609.562; 609.582, 
131.23 	subdivision 1 or 2; 609.668, subdivision 6, paragraph (a); 609.67; 609.687; 609.713; 609.86; 
131.24 	609.894, subdivision 3 or 4; 609.895; 624.713; 624.7191; or 626A.02, subdivision 1, if the 
131.25 	offense is punishable under section 626A.02, subdivision 4, paragraph (a). "Criminal act" 
131.26 	also includes conduct constituting, or a conspiracy or attempt to commit, a felony violation 
131.27 	of section 609.52, subdivision 2, clause (3), (4), (15), or (16), if the violation involves an 
131.28 	insurance company as defined in section 60A.02, subdivision 4, a nonprofit health service 
131.29 	plan corporation regulated under chapter 62C, a health maintenance organization regulated 
131.30 	under chapter 62D, or a fraternal benefit society regulated under chapter 64B, or any state 
131.31 	agency.

132.1 	Sec. 6. Minnesota Statutes 2025 Supplement, section 628.26, is amended to read:
132.2 	628.26 LIMITATIONS.
132.3 	(a) Indictments or complaints for any crime resulting in the death of the victim may be 
132.4 	found or made at any time after the death of the person killed.
132.5 	(b) Indictments or complaints for a violation of section 609.25 may be found or made 
132.6 	at any time after the commission of the offense.
132.7 	(c) Indictments or complaints for violation of section 609.282 may be found or made at 
132.8 	any time after the commission of the offense if the victim was under the age of 18 at the 
132.9 	time of the offense.
132.10 	(d) Indictments or complaints for violation of section 609.282 where the victim was 18 
132.11 	years of age or older at the time of the offense, or 609.42, subdivision 1, clause (1) or (2), 
132.12 	shall be found or made and filed in the proper court within six years after the commission 
132.13 	of the offense.
132.14 	(e) Indictments or complaints for violation of sections 609.322, 609.342 to 609.345, and 
132.15 	609.3458 may be found or made at any time after the commission of the offense.
132.16 	(f) Indictments or complaints for a violation of section 609.561 shall be found or made 
132.17 	and filed in the proper court within ten years after the commission of the offense.
132.18 	(g) Indictments or complaints for violation of sections 609.466 609.467 and 609.52, 
132.19 	subdivision 2, paragraph (a), clause (3), item (iii), shall be found or made and filed in the 
132.20 	proper court within six years after the commission of the offense.
132.21 	(h) Indictments or complaints for violation of section 609.2335, 609.52, subdivision 2, 
132.22 	paragraph (a), clause (3), items (i) and (ii), (4), (15), or (16), 609.631, or 609.821, where 
132.23 	the value of the property or services stolen is more than $35,000, or for violation of section 
132.24 	609.527 where the offense involves eight or more direct victims or the total combined loss 
132.25 	to the direct and indirect victims is more than $35,000, shall be found or made and filed in 
132.26 	the proper court within five years after the commission of the offense.
132.27 	(i) Except for violations relating to false material statements, representations or omissions, 
132.28 	indictments or complaints for violations of section 609.671 shall be found or made and filed 
132.29 	in the proper court within five years after the commission of the offense.
132.30 	(j) Indictments or complaints for violation of sections 609.562 and 609.563, shall be 
132.31 	found or made and filed in the proper court within five years after the commission of the 
132.32 	offense.
133.1 	(k) Indictments or complaints for violation of section 609.746 shall be found or made 
133.2 	and filed in the proper court within the later of three years after the commission of the 
133.3 	offense or three years after the offense was reported to law enforcement authorities.
133.4 	(l) In all other cases, indictments or complaints shall be found or made and filed in the 
133.5 	proper court within three years after the commission of the offense.
133.6 	(m) The limitations periods contained in this section shall exclude any period of time 
133.7 	during which the defendant was not an inhabitant of or usually resident within this state.
133.8 	(n) The limitations periods contained in this section for an offense shall not include any 
133.9 	period during which the alleged offender participated under a written agreement in a pretrial 
133.10 	diversion program relating to that offense.
133.11 	(o) The limitations periods contained in this section shall not include any period of time 
133.12 	during which physical evidence relating to the offense was undergoing DNA analysis, as 
133.13 	defined in section 299C.155, unless the defendant demonstrates that the prosecuting or law 
133.14 	enforcement agency purposefully delayed the DNA analysis process in order to gain an 
133.15 	unfair advantage.

133.16 	Sec. 7. REPEALER.
 133.17 	Minnesota Statutes 2024, section 609.466, is repealed.

133.18 	ARTICLE 8
133.19 	MEDICAL ASSISTANCE FRAUD PREVENTION CONFORMING CHANGES

133.20 	Section 1. Minnesota Statutes 2025 Supplement, section 145A.061, subdivision 3, is 
133.21 	amended to read:
133.22 		Subd. 3.Denial of service. The commissioner may deny an application from any 
133.23 	applicant who has been convicted of any of the following crimes:
133.24 	Section 609.185 (murder in the first degree); section 609.19 (murder in the second 
133.25 	degree); section 609.195 (murder in the third degree); section 609.20 (manslaughter in the 
133.26 	first degree); section 609.205 (manslaughter in the second degree); section 609.25 
133.27 	(kidnapping); section 609.2661 (murder of an unborn child in the first degree); section 
133.28 	609.2662 (murder of an unborn child in the second degree); section 609.2663 (murder of 
133.29 	an unborn child in the third degree); section 609.342 (criminal sexual conduct in the first 
133.30 	degree); section 609.343 (criminal sexual conduct in the second degree); section 609.344 
133.31 	(criminal sexual conduct in the third degree); section 609.345 (criminal sexual conduct in 
133.32 	the fourth degree); section 609.3451 (criminal sexual conduct in the fifth degree); section 
134.1 	609.3453 (criminal sexual predatory conduct); section 609.352 (solicitation of children to 
134.2 	engage in sexual conduct); section 609.352 (communication of sexually explicit materials 
134.3 	to children); section 609.365 (incest); section 609.377 (felony malicious punishment of a 
134.4 	child); section 609.378 (felony neglect or endangerment of a child); section 609.561 (arson 
134.5 	in the first degree); section 609.562 (arson in the second degree); section 609.563 (arson in 
134.6 	the third degree); section 609.749, subdivision 3, 4, or 5 (felony harassment or stalking); 
134.7 	section 152.021 (controlled substance crimes in the first degree); section 152.022 (controlled 
134.8 	substance crimes in the second degree); section 152.023 (controlled substance crimes in the 
134.9 	third degree); section 152.024 (controlled substance crimes in the fourth degree); section 
134.10 	152.025 (controlled substance crimes in the fifth degree); section 243.166 (violation of 
134.11 	predatory offender registration law); section 617.23, subdivision 2, clause (1), or subdivision 
134.12 	3, clause (1) (indecent exposure involving a minor); section 617.246 (use of minors in sexual 
134.13 	performance); section 617.247 (possession of child sexual abuse material); section 609.221
134.14 	(assault in the first degree); section 609.222 (assault in the second degree); section 609.223
134.15 	(assault in the third degree); section 609.2231 (assault in the fourth degree); section 609.224
134.16 	(assault in the fifth degree); section 609.2242 (domestic assault); section 609.2247 (domestic 
134.17 	assault by strangulation); section 609.228 (great bodily harm caused by distribution of 
134.18 	drugs); section 609.23 (mistreatment of persons confined); section 609.231 (mistreatment 
134.19 	of residents or patients); section 609.2325 (criminal abuse); section 609.233 (criminal 
134.20 	neglect); section 609.2335 (financial exploitation of a vulnerable adult); section 609.234 
134.21 	(failure to report); section 609.24 (simple robbery); section 609.245 (aggravated robbery); 
134.22 	section 609.247 (carjacking); section 609.255 (false imprisonment); section 609.322 
134.23 	(solicitation, inducement, and promotion of prostitution and sex trafficking); section 609.324, 
134.24 	subdivision 1 (hiring or engaging minors in prostitution); section 609.465 (presenting false 
134.25 	claims to a public officer or body); Minnesota Statutes 2024, section 609.466or section 
134.26 	609.467 (medical assistance fraud); section 609.52 (felony theft); section 609.82 (felony 
134.27 	fraud in obtaining credit); section 609.527 (felony identity theft); section 609.582 (felony 
134.28 	burglary); section 609.611 (felony insurance fraud); section 609.625 (aggravated forgery); 
134.29 	section 609.63 (forgery); section 609.631 (felony check forgery); section 609.66, subdivision 
134.30 	1e (felony drive-by shooting); section 609.71 (felony riot); section 609.713 (terroristic 
134.31 	threats); section 609.72, subdivision 3 (disorderly conduct by a caregiver against a vulnerable 
134.32 	adult); section 609.821 (felony financial transaction card fraud); section 609.855, subdivision 
134.33 	5 (shooting at or in a public transit vehicle or facility); or aiding and abetting, attempting, 
134.34 	or conspiring to commit any of the offenses in this subdivision.

135.1 	Sec. 2. Minnesota Statutes 2024, section 214.10, subdivision 2a, is amended to read:
135.2 		Subd. 2a.Proceedings. A board shall initiate proceedings to suspend or revoke a license 
135.3 	or shall refuse to renew a license of a person licensed by the board who is convicted in a 
135.4 	court of competent jurisdiction of violating section 609.2231, subdivision 8, 609.23, 609.231, 
135.5 	609.2325, 609.233, 609.2335, 609.234, 609.465, Minnesota Statutes 2024, section609.466,
135.6 	section 609.467,609.52, or 609.72, subdivision 3.

135.7 	Sec. 3. Minnesota Statutes 2024, section 245C.15, subdivision 2, is amended to read:
135.8 		Subd. 2.15-year disqualification. (a) An individual is disqualified under section 245C.14 
135.9 	if: (1) less than 15 years have passed since the discharge of the sentence imposed, if any, 
135.10 	for the offense; and (2) the individual has committed a felony-level violation of any of the 
135.11 	following offenses: sections 152.021, subdivision 1 or 2b, (aggravated controlled substance 
135.12 	crime in the first degree; sale crimes); 152.022, subdivision 1 (controlled substance crime 
135.13 	in the second degree; sale crimes); 152.023, subdivision 1 (controlled substance crime in 
135.14 	the third degree; sale crimes); 152.024, subdivision 1 (controlled substance crime in the 
135.15 	fourth degree; sale crimes); 256.98 (wrongfully obtaining assistance); 268.182 (fraud); 
135.16 	393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 518B.01, subdivision 14 
135.17 	(violation of an order for protection); 609.165 (felon ineligible to possess firearm); 609.2112, 
135.18 	609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.215 (suicide); 609.223 
135.19 	or 609.2231 (assault in the third or fourth degree); repeat offenses under 609.224 (assault 
135.20 	in the fifth degree); 609.229 (crimes committed for benefit of a gang); 609.2325 (criminal 
135.21 	abuse of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 609.235 
135.22 	(use of drugs to injure or facilitate crime); 609.24 (simple robbery); 609.247, subdivision 
135.23 	4 (carjacking in the third degree); 609.255 (false imprisonment); 609.2664 (manslaughter 
135.24 	of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the 
135.25 	second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault 
135.26 	of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the 
135.27 	commission of a crime); 609.27 (coercion); 609.275 (attempt to coerce); Minnesota Statutes 
135.28 	2024, section 609.466or section 609.467 (medical assistance fraud); 609.495 (aiding an 
135.29 	offender); 609.498, subdivision 1 or 1b (aggravated first-degree or first-degree tampering 
135.30 	with a witness); 609.52 (theft); 609.521 (possession of shoplifting gear); 609.522 (organized 
135.31 	retail theft); 609.525 (bringing stolen goods into Minnesota); 609.527 (identity theft); 609.53
135.32 	(receiving stolen property); 609.535 (issuance of dishonored checks); 609.562 (arson in the 
135.33 	second degree); 609.563 (arson in the third degree); 609.582 (burglary); 609.59 (possession 
135.34 	of burglary tools); 609.611 (insurance fraud); 609.625 (aggravated forgery); 609.63 (forgery); 
135.35 	609.631 (check forgery; offering a forged check); 609.635 (obtaining signature by false 
136.1 	pretense); 609.66 (dangerous weapons); 609.67 (machine guns and short-barreled shotguns); 
136.2 	609.687 (adulteration); 609.71 (riot); 609.713 (terroristic threats); 609.746 (interference 
136.3 	with privacy); 609.82 (fraud in obtaining credit); 609.821 (financial transaction card fraud); 
136.4 	617.23 (indecent exposure), not involving a minor; repeat offenses under 617.241 (obscene 
136.5 	materials and performances; distribution and exhibition prohibited; penalty); or 624.713
136.6 	(certain persons not to possess firearms).
136.7 	(b) An individual is disqualified under section 245C.14 if less than 15 years has passed 
136.8 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
136.9 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
136.10 	(c) An individual is disqualified under section 245C.14 if less than 15 years has passed 
136.11 	since the termination of the individual's parental rights under section 260C.301, subdivision 
136.12 	1, paragraph (b), or subdivision 3.
136.13 	(d) An individual is disqualified under section 245C.14 if less than 15 years has passed 
136.14 	since the discharge of the sentence imposed for an offense in any other state or country, the 
136.15 	elements of which are substantially similar to the elements of the offenses listed in paragraph 
136.16 	(a) or since the termination of parental rights in any other state or country, the elements of 
136.17 	which are substantially similar to the elements listed in paragraph (c).
136.18 	(e) If the individual studied commits one of the offenses listed in paragraph (a), but the 
136.19 	sentence or level of offense is a gross misdemeanor or misdemeanor, the individual is 
136.20 	disqualified but the disqualification look-back period for the offense is the period applicable 
136.21 	to the gross misdemeanor or misdemeanor disposition.
136.22 	(f) When a disqualification is based on a judicial determination other than a conviction, 
136.23 	the disqualification period begins from the date of the court order. When a disqualification 
136.24 	is based on an admission, the disqualification period begins from the date of an admission 
136.25 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
136.26 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
136.27 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
136.28 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
136.29 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

136.30 	Sec. 4. Minnesota Statutes 2024, section 245C.15, subdivision 3, is amended to read:
136.31 		Subd. 3.Ten-year disqualification. (a) An individual is disqualified under section 
136.32 	245C.14 if: (1) less than ten years have passed since the discharge of the sentence imposed, 
136.33 	if any, for the offense; and (2) the individual has committed a gross misdemeanor-level 
137.1 	violation of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 
137.2 	260B.425 (criminal jurisdiction for contributing to status as a juvenile petty offender or 
137.3 	delinquency); 260C.425 (criminal jurisdiction for contributing to need for protection or 
137.4 	services); 268.182 (fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 
137.5 	609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.221 or 609.222 
137.6 	(assault in the first or second degree); 609.223 or 609.2231 (assault in the third or fourth 
137.7 	degree); 609.224 (assault in the fifth degree); 609.224, subdivision 2, paragraph (c) (assault 
137.8 	in the fifth degree by a caregiver against a vulnerable adult); 609.2242 and 609.2243 
137.9 	(domestic assault); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of 
137.10 	residents or patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal 
137.11 	neglect of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 
137.12 	609.234 (failure to report maltreatment of a vulnerable adult); 609.265 (abduction); 609.275 
137.13 	(attempt to coerce); 609.324, subdivision 1a (other prohibited acts; minor engaged in 
137.14 	prostitution); 609.33 (disorderly house); 609.377 (malicious punishment of a child); 609.378 
137.15 	(neglect or endangerment of a child); Minnesota Statutes 2024, section 609.466or section 
137.16 	609.467 (medical assistance fraud); 609.52 (theft); 609.522 (organized retail theft); 609.525
137.17 	(bringing stolen goods into Minnesota); 609.527 (identity theft); 609.53 (receiving stolen 
137.18 	property); 609.535 (issuance of dishonored checks); 609.582 (burglary); 609.59 (possession 
137.19 	of burglary tools); 609.611 (insurance fraud); 609.631 (check forgery; offering a forged 
137.20 	check); 609.66 (dangerous weapons); 609.71 (riot); 609.72, subdivision 3 (disorderly conduct 
137.21 	against a vulnerable adult); 609.749, subdivision 2 (harassment); 609.82 (fraud in obtaining 
137.22 	credit); 609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving 
137.23 	a minor; 617.241 (obscene materials and performances); 617.243 (indecent literature, 
137.24 	distribution); 617.293 (harmful materials; dissemination and display to minors prohibited); 
137.25 	or Minnesota Statutes 2012, section 609.21; or violation of an order for protection under 
137.26 	section 518B.01, subdivision 14.
137.27 	(b) An individual is disqualified under section 245C.14 if less than ten years has passed 
137.28 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
137.29 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
137.30 	(c) An individual is disqualified under section 245C.14 if less than ten years has passed 
137.31 	since the discharge of the sentence imposed for an offense in any other state or country, the 
137.32 	elements of which are substantially similar to the elements of any of the offenses listed in 
137.33 	paragraph (a).
138.1 	(d) If the individual studied commits one of the offenses listed in paragraph (a), but the 
138.2 	sentence or level of offense is a misdemeanor disposition, the individual is disqualified but 
138.3 	the disqualification lookback period for the offense is the period applicable to misdemeanors.
138.4 	(e) When a disqualification is based on a judicial determination other than a conviction, 
138.5 	the disqualification period begins from the date of the court order. When a disqualification 
138.6 	is based on an admission, the disqualification period begins from the date of an admission 
138.7 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
138.8 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
138.9 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
138.10 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
138.11 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

138.12 	Sec. 5. Minnesota Statutes 2024, section 245C.15, subdivision 4, is amended to read:
138.13 		Subd. 4.Seven-year disqualification. (a) An individual is disqualified under section 
138.14 	245C.14 if: (1) less than seven years has passed since the discharge of the sentence imposed, 
138.15 	if any, for the offense; and (2) the individual has committed a misdemeanor-level violation 
138.16 	of any of the following offenses: sections 256.98 (wrongfully obtaining assistance); 260B.425 
138.17 	(criminal jurisdiction for contributing to status as a juvenile petty offender or delinquency); 
138.18 	260C.425 (criminal jurisdiction for contributing to need for protection or services); 268.182 
138.19 	(fraud); 393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 609.2112, 609.2113, 
138.20 	or 609.2114 (criminal vehicular homicide or injury); 609.221 (assault in the first degree); 
138.21 	609.222 (assault in the second degree); 609.223 (assault in the third degree); 609.2231 
138.22 	(assault in the fourth degree); 609.224 (assault in the fifth degree); 609.2242 (domestic 
138.23 	assault); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure to report 
138.24 	maltreatment of a vulnerable adult); 609.2672 (assault of an unborn child in the third degree); 
138.25 	609.27 (coercion); violation of an order for protection under 609.3232 (protective order 
138.26 	authorized; procedures; penalties); Minnesota Statutes 2024, section 609.466or section 
138.27 	609.467 (medical assistance fraud); 609.52 (theft); 609.522 (organized retail theft); 609.525
138.28 	(bringing stolen goods into Minnesota); 609.527 (identity theft); 609.53 (receiving stolen 
138.29 	property); 609.535 (issuance of dishonored checks); 609.611 (insurance fraud); 609.66
138.30 	(dangerous weapons); 609.665 (spring guns); 609.746 (interference with privacy); 609.79
138.31 	(obscene or harassing telephone calls); 609.795 (letter, telegram, or package; opening; 
138.32 	harassment); 609.82 (fraud in obtaining credit); 609.821 (financial transaction card fraud); 
138.33 	617.23 (indecent exposure), not involving a minor; 617.293 (harmful materials; dissemination 
138.34 	and display to minors prohibited); or Minnesota Statutes 2012, section 609.21; or violation 
138.35 	of an order for protection under section 518B.01 (Domestic Abuse Act).
139.1 	(b) An individual is disqualified under section 245C.14 if less than seven years has 
139.2 	passed since a determination or disposition of the individual's:
139.3 	(1) failure to make required reports under section 260E.06 or 626.557, subdivision 3, 
139.4 	for incidents in which: (i) the final disposition under section 626.557 or chapter 260E was 
139.5 	substantiated maltreatment, and (ii) the maltreatment was recurring or serious; or
139.6 	(2) substantiated serious or recurring maltreatment of a minor under chapter 260E, a 
139.7 	vulnerable adult under section 626.557, or serious or recurring maltreatment in any other 
139.8 	state, the elements of which are substantially similar to the elements of maltreatment under 
139.9 	section 626.557 or chapter 260E for which: (i) there is a preponderance of evidence that 
139.10 	the maltreatment occurred, and (ii) the subject was responsible for the maltreatment.
139.11 	(c) An individual is disqualified under section 245C.14 if less than seven years has 
139.12 	passed since the individual's aiding and abetting, attempt, or conspiracy to commit any of 
139.13 	the offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota 
139.14 	Statutes.
139.15 	(d) An individual is disqualified under section 245C.14 if less than seven years has 
139.16 	passed since the discharge of the sentence imposed for an offense in any other state or 
139.17 	country, the elements of which are substantially similar to the elements of any of the offenses 
139.18 	listed in paragraphs (a) and (b).
139.19 	(e) When a disqualification is based on a judicial determination other than a conviction, 
139.20 	the disqualification period begins from the date of the court order. When a disqualification 
139.21 	is based on an admission, the disqualification period begins from the date of an admission 
139.22 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
139.23 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
139.24 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
139.25 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
139.26 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
139.27 	(f) An individual is disqualified under section 245C.14 if less than seven years has passed 
139.28 	since the individual was disqualified under section 256.98, subdivision 8.

139.29 	Sec. 6. Minnesota Statutes 2025 Supplement, section 609.531, subdivision 1, is amended 
139.30 	to read:
139.31 		Subdivision 1.Definitions. For the purpose of sections 609.531 to 609.5318, the 
139.32 	following terms have the meanings given.
140.1 	(a) "Conveyance device" means a device used for transportation and includes, but is not 
140.2 	limited to, a motor vehicle, trailer, snowmobile, airplane, and vessel and any equipment 
140.3 	attached to it. The term "conveyance device" does not include property which is, in fact, 
140.4 	itself stolen or taken in violation of the law.
140.5 	(b) "Weapon used" means a dangerous weapon as defined under section 609.02, 
140.6 	subdivision 6, that the actor used or had in possession in furtherance of a crime.
140.7 	(c) "Property" means property as defined in section 609.52, subdivision 1, clause (1).
140.8 	(d) "Contraband" means property which is illegal to possess under Minnesota law.
140.9 	(e) "Appropriate agency" means the Bureau of Criminal Apprehension, the Minnesota 
140.10 	Division of Driver and Vehicle Services, the Minnesota State Patrol, a county sheriff's 
140.11 	department, the Three Rivers Park District Department of Public Safety, the Department of 
140.12 	Natural Resources Division of Enforcement, the University of Minnesota Police Department, 
140.13 	the Department of Corrections Fugitive Apprehension Unit, a city, metropolitan transit, or 
140.14 	airport police department; or a multijurisdictional entity established under section 299A.642
140.15 	or 299A.681.
140.16 	(f) "Designated offense" includes:
140.17 	(1) for weapons used: any violation of this chapter, chapter 152 or 624;
140.18 	(2) for driver's license or identification card transactions: any violation of section 171.22; 
140.19 	and
140.20 	(3) for all other purposes: a felony violation of, or a felony-level attempt or conspiracy 
140.21 	to violate, section 325E.17; 325E.18; 609.185; 609.19; 609.195; 609.2112; 609.2113; 
140.22 	609.2114; 609.221; 609.222; 609.223; 609.2231; 609.2335; 609.24; 609.245; 609.247; 
140.23 	609.25; 609.255; 609.282; 609.283; 609.322; 609.342, subdivision 1, or subdivision 1a, 
140.24 	clauses (a) to (f) and (i); 609.343, subdivision 1, or subdivision 1a, clauses (a) to (f) and (i); 
140.25 	609.344, subdivision 1, or subdivision 1a, clauses (a) to (e), (h), or (i); 609.345, subdivision 
140.26 	1, or subdivision 1a, clauses (a) to (e), (h), and (i); 609.352; 609.42; 609.425; Minnesota 
140.27 	Statutes 2024, section609.466; section 609.467;609.485; 609.487; 609.52; 609.525; 609.527; 
140.28 	609.528; 609.53; 609.54; 609.551; 609.561; 609.562; 609.563; 609.582; 609.59; 609.595; 
140.29 	609.611; 609.631; 609.66, subdivision 1e; 609.671, subdivisions 3, 4, 5, 8, and 12; 609.687; 
140.30 	609.821; 609.825; 609.86; 609.88; 609.89; 609.893; 609.895; 617.246; 617.247; or a gross 
140.31 	misdemeanor or felony violation of section 609.891 or 624.7181; or any violation of section 
140.32 	609.324; or a felony violation of, or a felony-level attempt or conspiracy to violate, Minnesota 
140.33 	Statutes 2012, section 609.21.
141.1 	(g) "Controlled substance" has the meaning given in section 152.01, subdivision 4.
141.2 	(h) "Prosecuting authority" means the attorney who is responsible for prosecuting an 
141.3 	offense that is the basis for a forfeiture under sections 609.531 to 609.5318.
141.4 	(i) "Asserting person" means a person, other than the driver alleged to have used a vehicle 
141.5 	in the transportation or exchange of a controlled substance intended for distribution or sale, 
141.6 	claiming an ownership interest in a vehicle that has been seized or restrained under this 
141.7 	section.

141.8 	Sec. 7. Laws 2026, chapter 88, article 1, section 181, is amended to read:
141.9 	Sec. 181. Minnesota Statutes 2025 Supplement, section 299C.061, subdivision 1, is 
141.10 	amended to read:
141.11 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
141.12 	the meanings given.
141.13 	(b) "Fraud involving state funded or administered programs or services" includes any 
141.14 	violation of section 609.445, 609.465, Minnesota Statutes 2024, section609.466, section 
141.15 	609.467,609.52, 609.611, 609.651, 609.7475, or 609.821 involving a state agency or 
141.16 	state-funded or administered program or service.
141.17 	(c) "Peace officer" has the meaning given in section 626.84, subdivision 1, paragraph 
141.18 	(c).
141.19 	(d) "Section" means the Financial Crimes and Fraud Section of the Bureau of Criminal 
141.20 	Apprehension.
141.21 	(e) "State agency" has the meaning given in section 13.02, subdivision 17.
141.22 	(f) "Superintendent" means the superintendent of the Bureau of Criminal Apprehension.

141.23 	ARTICLE 9
141.24 	CHILDREN, YOUTH, AND FAMILIES POLICY

141.25 	Section 1. Minnesota Statutes 2024, section 124D.19, is amended by adding a subdivision 
141.26 	to read:
141.27 		Subd. 13a.School-age care programs; priority for children in foster care. Each 
141.28 	district operating a school-age care, youth after-school enrichment, or other before- and 
141.29 	after-school community education program under this section must ensure that children in 
141.30 	foster care, as defined under section 260C.007, subdivision 18, or in a voluntary or 
142.1 	involuntary foster care placement under the Minnesota Indian Family Preservation Act 
142.2 	receive priority for enrollment in community education programs. In order to give a child 
142.3 	priority under this paragraph, the district may require a letter or other documentation from 
142.4 	a responsible social services agency or child-placing agency verifying that the child is in 
142.5 	foster care.

142.6 	Sec. 2. Minnesota Statutes 2024, section 142A.43, is amended to read:
142.7 	142A.43 GRANTS-IN-AID GRANTS TO YOUTH INTERVENTION PROGRAMS.
142.8 		Subdivision 1.Grants. (a) The commissioner may must make grants to nonprofit agencies 
142.9 	administering youth intervention programs in communities where the programs are or may 
142.10 	be established. Grants under this section are limited to available appropriations. No grant 
142.11 	may exceed $75,000.
142.12 	(b) "Youth intervention program" means a nonresidential community-based program 
142.13 	providing advocacy, education, counseling, mentoring, and referral services to youth and 
142.14 	their families experiencing personal, familial, school, legal, or chemical problems with the 
142.15 	goal of resolving the present problems and preventing the occurrence of the problems in 
142.16 	the future. The intent of the youth intervention program is to provide an ongoing stable 
142.17 	funding source to community-based early intervention programs for youth. Program design 
142.18 	may be different for the grantees depending on youth service needs of the communities 
142.19 	being served.
142.20 	(c) A grant under this section is contingent upon the agency obtaining local matching 
142.21 	money equal to the amount of the grant from the community in which the youth intervention 
142.22 	program is established. The matching requirement is intended to leverage the investment 
142.23 	of state and community money in supporting the efforts of the grantees to provide early 
142.24 	intervention services to youth and their families.
142.25 		Subd. 2.Applications. Applications for a grant-in-aid shall grant must be made submitted
142.26 	by the administering agency to the commissioner. The commissioner must provide the 
142.27 	application form, procedures for submitting application forms, criteria for review of the 
142.28 	application, and a description of the kinds of contributions in addition to cash that qualify 
142.29 	as local matching money.
142.30 	The grant-in-aid is contingent upon the agency having obtained from the community in 
142.31 	which the youth intervention program is established local matching money equal to the 
142.32 	amount of the grant that is sought. The matching requirement is intended to leverage the 
143.1 	investment of state and community dollars in supporting the efforts of the grantees to provide 
143.2 	early intervention services to youth and their families.
143.3 	The commissioner shall provide the application form, procedures for making application 
143.4 	form, criteria for review of the application, and kinds of contributions in addition to cash 
143.5 	that qualify as local matching money. No grant to any agency may exceed $75,000.
143.6 		Subd. 3.Grant allocation formula Youth Intervention Programs Association 
143.7 	grant. Up to five six percent of the appropriations to the grants-in-aid to the youth 
143.8 	intervention program may appropriation for grants under this section must be used for a 
143.9 	grant to the Minnesota Youth Intervention Programs Association for expenses in providing 
143.10 	collaboration, program development, professional development training, technical assistance, 
143.11 	and tracking, and analyzing, and reporting outcome data for the community-based grantees 
143.12 	of the program. The Minnesota Youth Intervention Programs Association is not required 
143.13 	to meet the match obligation matching requirement under subdivision 2 1, paragraph (c).
143.14 		Subd. 4.Report. On or before March 31 of each year, the Minnesota Youth Intervention 
143.15 	Programs Association shall report to the chairs and ranking minority members of the 
143.16 	committees and divisions with jurisdiction over public safety policy and finance children 
143.17 	and youth on the implementation, use, and administration of the grant program created
143.18 	under this section. The report shall include information sent by agencies administering youth 
143.19 	intervention programs to the Minnesota Youth Intervention Programs Association and the 
143.20 	Office of Justice Programs. At a minimum, the report must identify:
143.21 	(1) the grant recipients;
143.22 	(2) the geographic location of the grant recipients;
143.23 	(3) the total number of individuals served by all grant recipients, disaggregated by race, 
143.24 	ethnicity, and gender;
143.25 	(4) the total number of individuals served by all grant recipients who successfully 
143.26 	completed programming, disaggregated by age, race, ethnicity, and gender;
143.27 	(5) the total amount of money awarded in grants and the total amount remaining to be 
143.28 	awarded from each appropriation;
143.29 	(6) the amount of money granted to each recipient;
143.30 	(7) grantee grant recipient workplan objectives;
143.31 	(8) how the grant was used based on grantee grant recipient quarterly narrative reports 
143.32 	and financial reports; and
144.1 	(9) summarized relevant youth intervention program outcome survey data measuring 
144.2 	the developmental assets of participants, based on Search Institute's Developmental Assets 
144.3 	Framework.
144.4 		Subd. 5.Administrative costs. The commissioner may use up to ten percent of the 
144.5 	biennial appropriation for grants-in-aid to the youth intervention program to pay costs 
144.6 	incurred by the department in administering the youth intervention program.

144.7 	Sec. 3. Minnesota Statutes 2024, section 142B.10, subdivision 18, is amended to read:
144.8 		Subd. 18.Adoption agency; additional requirements. In addition to the other 
144.9 	requirements of this section, an individual or organization applying for a license to place 
144.10 	children for adoption must:
144.11 	(1) incorporate as a nonprofit corporation under chapter 317A or a nonprofit limited 
144.12 	liability company under chapter 322C;
144.13 	(2) file with the application for licensure a copy of the disclosure form required under 
144.14 	section 259.37, subdivision 2;
144.15 	(3) provide evidence that a bond has been obtained and will be continuously maintained 
144.16 	throughout the entire operating period of the agency, to cover the cost of transfer of records 
144.17 	to and storage of records by the agency which has agreed, according to rule established by 
144.18 	the commissioner, to receive the applicant agency's records if the applicant agency voluntarily 
144.19 	or involuntarily ceases operation and fails to provide for proper transfer of the records. The 
144.20 	bond must be made in favor of the agency which has agreed to receive the records; and
144.21 	(4) submit a financial review completed by an accountant to the commissioner each year 
144.22 	the license is renewed as required under section 142B.05, subdivision 1.

144.23 	Sec. 4. Minnesota Statutes 2024, section 142B.30, is amended by adding a subdivision to 
144.24 	read:
144.25 		Subd. 9a.Child foster care licensing agency information to applicants. In addition 
144.26 	to the requirements in Minnesota Rules, part 9543.0040, subpart 1, the licensing agency 
144.27 	must provide information to child foster care license applicants on the background study 
144.28 	process and the procedure for reconsideration of a background study disqualification.

145.1 	Sec. 5. Minnesota Statutes 2024, section 142B.65, subdivision 7, is amended to read:
145.2 		Subd. 7.Abusive head trauma training. (a) Before caring for children under school 
145.3 	age, the director, staff persons, substitutes, and unsupervised volunteers must receive training 
145.4 	on the risk of abusive head trauma during orientation and each calendar year thereafter.
145.5 	(b) Abusive head trauma training under this subdivision must be at least one-half hour 
145.6 	in length. At a minimum, the training must address the risk factors related to shaking infants 
145.7 	and young children, means to reduce the risk of abusive head trauma in child care, and 
145.8 	license holder communication with parents regarding reducing the risk of abusive head 
145.9 	trauma. The training must be interactive and not only consist of reading or viewing 
145.10 	information.
145.11 	(c) Except if completed during orientation, training taken under this subdivision may 
145.12 	be used to meet the in-service training requirements under subdivision 9.
145.13 	(d) The commissioner shall make available for viewing a video presentation on the 
145.14 	dangers associated with shaking infants and young children, which may be used in 
145.15 	conjunction with the annual training required under paragraph (b).

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

145.17 	Sec. 6. Minnesota Statutes 2024, section 142B.70, subdivision 6, is amended to read:
145.18 		Subd. 6.Sudden unexpected infant death and abusive head trauma training. (a) 
145.19 	License holders must ensure and document that before the license holder, second adult 
145.20 	caregivers, substitutes, and helpers assist in the care of infants, they are instructed on the 
145.21 	standards in section 142B.46 and receive training on reducing the risk of sudden unexpected 
145.22 	infant death. In addition, license holders must ensure and document that before the license 
145.23 	holder, second adult caregivers, substitutes, and helpers assist in the care of infants and 
145.24 	children under school age, they receive training on reducing the risk of abusive head trauma 
145.25 	from shaking infants and young children. The training in this subdivision may be provided 
145.26 	as initial training under subdivision 1 or ongoing annual training under subdivision 8.
145.27 	(b) Sudden unexpected infant death reduction training required under this subdivision 
145.28 	must, at a minimum, address the risk factors related to sudden unexpected infant death, 
145.29 	means of reducing the risk of sudden unexpected infant death in child care, and license 
145.30 	holder communication with parents regarding reducing the risk of sudden unexpected infant 
145.31 	death.
145.32 	(c) Abusive head trauma training required under this subdivision must, at a minimum, 
145.33 	address the risk factors related to shaking infants and young children, means of reducing 
146.1 	the risk of abusive head trauma in child care, and license holder communication with parents 
146.2 	regarding reducing the risk of abusive head trauma. The training must be interactive and 
146.3 	not only consist of reading or viewing information.
146.4 	(d) Training for family and group family child care providers must be developed by the 
146.5 	commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved 
146.6 	by the Minnesota Center for Professional Development. Sudden unexpected infant death 
146.7 	reduction training and abusive head trauma training may be provided in a single course of 
146.8 	no more than two hours in length.
146.9 	(e) Sudden unexpected infant death reduction training and abusive head trauma training 
146.10 	required under this subdivision must be completed in person or as allowed under subdivision 
146.11 	11, clause (1) or (2), at least once every two years. On the years when the individual receiving 
146.12 	training is not receiving training in person or as allowed under subdivision 11, clause (1) 
146.13 	or (2), the individual receiving training in accordance with this subdivision must receive 
146.14 	sudden unexpected infant death reduction training and abusive head trauma training through 
146.15 	a video of no more than one hour in length. The video must be developed or approved by 
146.16 	the commissioner or online each calendar year.
146.17 	(f) An individual who is related to the license holder as defined in section 142B.01, 
146.18 	subdivision 15, and who is involved only in the care of the license holder's own infant or 
146.19 	child under school age and who is not designated to be a second adult caregiver, helper, or 
146.20 	substitute for the licensed program, is exempt from the sudden unexpected infant death and 
146.21 	abusive head trauma training.

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

146.23 	Sec. 7. Minnesota Statutes 2024, section 142C.12, subdivision 3, is amended to read:
146.24 		Subd. 3.Abusive head trauma. A certified center that cares for a child under school 
146.25 	age must ensure that the director and all staff persons, including substitutes and unsupervised 
146.26 	volunteers, receive training on abusive head trauma before assisting in the care of a child 
146.27 	under school age. The training must be interactive and not only consist of reading or viewing 
146.28 	information.

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

146.30 	Sec. 8. Minnesota Statutes 2024, section 142D.05, subdivision 8, is amended to read:
146.31 		Subd. 8.Eligibility. (a) A child is eligible to participate in a school readiness program 
146.32 	if the child:
147.1 	(1) is at least three years old on September 1;
147.2 	(2) has completed health and developmental screening within 90 days of program 
147.3 	enrollment under sections 142D.09 to 142D.093; and
147.4 	(3) has one or more of the following risk factors:
147.5 	(i) qualifies for free or reduced-price meals;
147.6 	(ii) is an English learner;
147.7 	(iii) is homeless;
147.8 	(iv) has an individualized education program (IEP) or standardized written plan;
147.9 	(v) is identified, through health and developmental screenings under sections 142D.09
147.10 	to 142D.093, with a potential risk factor that may influence learning; or
147.11 	(vi) is in foster care; or
147.12 	(vii) is defined as at risk by the school district.
147.13 	(b) The commissioner may require a letter or other documentation from a responsible 
147.14 	social services agency or child-placing agency for a child eligible under paragraph (a), 
147.15 	clause (3), item (vi), verifying that the child is in foster care, as defined in section 260C.007, 
147.16 	subdivision 18, or in a voluntary or involuntary foster care placement under the Minnesota 
147.17 	Indian Family Preservation Act. The commissioner must process a verification letter or 
147.18 	other documentation within five business days of receiving the letter or documentation.

147.19 	Sec. 9. [142D.095] PRESCHOOL ASSESSMENT.
147.20 	(a) For programs serving children under section 142D.08, the commissioner of children, 
147.21 	youth, and families must implement a preschool assessment of children's development in 
147.22 	the year prior to kindergarten entry that is:
147.23 	(1) aligned to the state early childhood indicators of progress and based on the criteria 
147.24 	for an early learning assessment approved by the commissioner; and
147.25 	(2) based in part on information collected from teachers, early learning professionals, 
147.26 	families, and other partners.
147.27 	(b) The commissioner must evaluate and approve assessment tools that meet the 
147.28 	requirements in paragraph (a). School districts and charter schools operating a program 
147.29 	under section 142D.08 must choose an assessment tool approved under this paragraph.
148.1 	(c) The commissioner may provide technical assistance and professional development 
148.2 	related to the assessment to educators, school districts, and charter schools.

148.3 	Sec. 10. Minnesota Statutes 2024, section 142D.21, subdivision 6, is amended to read:
148.4 		Subd. 6.Payments. (a) The commissioner shall provide payments under this section to 
148.5 	all eligible programs on a noncompetitive basis. The payment amounts shall be based on 
148.6 	the number of full-time equivalent staff who regularly care for children in the program, 
148.7 	including any employees, sole proprietors, or independent contractors.
148.8 	(b) For purposes of this section, "one full-time equivalent" is defined as an individual 
148.9 	caring for children 32 hours per week, including associated required paid break time. An 
148.10 	individual can count as more or less than one full-time equivalent staff, but as no more than 
148.11 	two full-time equivalent staff.
148.12 	(c) The commissioner must establish an amount to award per full-time equivalent 
148.13 	individual who regularly cares for children in the program.
148.14 	(d) Payments must be increased by ten percent for programs receiving child care 
148.15 	assistance payments under section 142E.08 or 142E.17 or early learning scholarships under 
148.16 	section 142D.25, or for programs located in a child care access equity area. The commissioner 
148.17 	must develop a method for establishing child care access equity areas. For purposes of this 
148.18 	section, "child care access equity area" means an area with low access to child care, high 
148.19 	poverty rates, high unemployment rates, low homeownership rates, and low median 
148.20 	household incomes.
148.21 	(e) The commissioner shall establish the form, frequency, and manner for making 
148.22 	payments under this section.

148.23 	Sec. 11. Minnesota Statutes 2024, section 142D.25, subdivision 3, is amended to read:
148.24 		Subd. 3.Applications; priorities. (a) The commissioner shall establish application 
148.25 	timelines and determine the schedule for awarding scholarships that meet the operational 
148.26 	needs of eligible families and programs.
148.27 	(b) The commissioner must give highest priority on an equal basis to applications from 
148.28 	children who:
148.29 	(1) are not yet four years of age;
148.30 	(2) have a parent under age 21 who is pursuing a high school diploma or a course of 
148.31 	study for a high school equivalency test;
149.1 	(3) are in foster care;
149.2 	(4) have been referred as in need of child protection services;
149.3 	(5) have an incarcerated parent;
149.4 	(6) are in or have a parent in a substance use treatment program;
149.5 	(7) are in or have a parent in a mental health treatment program;
149.6 	(8) have experienced domestic violence;
149.7 	(9) have an individualized education program or individualized family service plan; or
149.8 	(10) have experienced homelessness in the last 24 months, as defined under the federal 
149.9 	McKinney-Vento Homeless Assistance Act, United States Code, title 42, section 1143a.
149.10 	(c) Notwithstanding paragraph (b), beginning July 1, 2025, the commissioner must give 
149.11 	highest priority to applications from children in families with income equal to or less than 
149.12 	the rate specified under subdivision 2, paragraph (a), clause (1), item (i), and within this 
149.13 	group must prioritize children who meet one or more of the criteria listed in paragraph (b).
149.14 	(d) The commissioner may prioritize applications on additional factors, including but 
149.15 	not limited to availability of funding, family income, geographic location, and whether the 
149.16 	child's family is on a waiting list for a publicly funded program providing early education 
149.17 	or child care services.
149.18 	(e) The commissioner may require a letter or other documentation from a responsible 
149.19 	social services agency or child-placing agency for a child receiving priority as a child in 
149.20 	foster care verifying that the child is in foster care, as defined in section 260C.007, 
149.21 	subdivision 18, or in a voluntary or involuntary foster care placement under the Minnesota 
149.22 	Indian Family Preservation Act. The commissioner must process a verification letter or 
149.23 	other documentation within five business days of receiving the letter or documentation.

149.24 	Sec. 12. Minnesota Statutes 2024, section 142E.04, subdivision 4, is amended to read:
149.25 		Subd. 4.Funding priorities. (a) In the event that inadequate funding necessitates the 
149.26 	use of waiting lists, priority for child care assistance under the basic sliding fee assistance 
149.27 	program shall be determined according to this subdivision.
149.28 	(b) First priority must be given to eligible non-MFIP families who do not have a high 
149.29 	school diploma or commissioner of education-selected high school equivalency certification 
149.30 	or who need remedial and basic skill courses in order to pursue employment or to pursue 
149.31 	education leading to employment and who need child care assistance to participate in the 
150.1 	education program. This includes student parents as defined under section 142E.01, 
150.2 	subdivision 26. Within this priority, the following subpriorities must be used:
150.3 	(1) child care needs of minor parents;
150.4 	(2) child care needs of parents under 21 years of age; and
150.5 	(3) child care needs of other parents within the priority group described in this paragraph.
150.6 	(c) Second priority must be given to families in which at least one parent is a veteran, 
150.7 	as defined under section 197.447.
150.8 	(d) Third priority must be given to eligible foster parents providing care to a child placed 
150.9 	in a family foster home under section 260C.007, subdivision 16b; eligible relative custodians 
150.10 	to whom permanent legal and physical custody of a child has been transferred pursuant to 
150.11 	section 260C.515, subdivision 4; or eligible individuals with whom an Indian child has been 
150.12 	placed under section 260.773.
150.13 	(e) Fourth priority must be given to eligible families who do not meet the specifications 
150.14 	of paragraph (b), (c), (e) (d), (f), or (f) (g).
150.15 	(e) Fourth (f) Fifth priority must be given to families who are eligible for portable basic 
150.16 	sliding fee assistance through the portability pool under subdivision 10.
150.17 	(f) Fifth (g) Sixth priority must be given to eligible families receiving services under 
150.18 	section 142E.01, subdivision 27, if the parents have completed their MFIP transition year.
150.19 	(g) (h) Families under paragraph (f) (g) must be added to the basic sliding fee waiting 
150.20 	list on the date they complete their transition year under section 142E.01, subdivision 28.

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

150.22 	Sec. 13. Minnesota Statutes 2024, section 245C.04, subdivision 1, is amended to read:
150.23 		Subdivision 1.Licensed programs; other child care programs. (a) The commissioner 
150.24 	shall conduct a background study of an individual required to be studied under section 
150.25 	245C.03, subdivision 1, at least upon application for initial license for all license types.
150.26 	(b) The commissioner shall conduct a background study of an individual required to be 
150.27 	studied under section 245C.03, subdivision 1, including a child care background study 
150.28 	subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed 
150.29 	child care center, certified license-exempt child care center, or legal nonlicensed child care 
150.30 	provider, on a schedule determined by the commissioner. Except as provided in section 
150.31 	245C.05, subdivision 5a, a child care background study must include submission of 
151.1 	fingerprints for a national criminal history record check and a review of the information 
151.2 	under section 245C.08. A background study for a child care program must be repeated 
151.3 	within five years from the most recent study conducted under this paragraph.
151.4 	(c) At reauthorization or When a new background study is needed under section 142E.16, 
151.5 	subdivision 2, for a legal nonlicensed child care provider authorized under chapter 142E:
151.6 	(1) for a background study affiliated with a legal nonlicensed child care provider, the 
151.7 	individual shall provide information required under section 245C.05, subdivision 1, 
151.8 	paragraphs (a), (b), and (d), to the commissioner and be fingerprinted and photographed 
151.9 	under section 245C.05, subdivision 5; and
151.10 	(2) the commissioner shall verify the information received under clause (1) and submit 
151.11 	the request in NETStudy 2.0 to complete the background study.
151.12 	(d) At reapplication for a family child care license:
151.13 	(1) for a background study affiliated with a licensed family child care center, the 
151.14 	individual shall provide information required under section 245C.05, subdivision 1, 
151.15 	paragraphs (a), (b), and (d), to the county agency, and be fingerprinted and photographed 
151.16 	under section 245C.05, subdivision 5;
151.17 	(2) the county agency shall verify the information received under clause (1) and forward 
151.18 	the information to the commissioner and submit the request in NETStudy 2.0 to complete 
151.19 	the background study; and
151.20 	(3) the background study conducted by the commissioner under this paragraph must 
151.21 	include a review of the information required under section 245C.08.
151.22 	(e) The commissioner is not required to conduct a study of an individual at the time of 
151.23 	reapplication for a license if the individual's background study was completed by the 
151.24 	commissioner of human services and the following conditions are met:
151.25 	(1) a study of the individual was conducted either at the time of initial licensure or when 
151.26 	the individual became affiliated with the license holder;
151.27 	(2) the individual has been continuously affiliated with the license holder since the last 
151.28 	study was conducted; and
151.29 	(3) the last study of the individual was conducted on or after October 1, 1995.
151.30 	(f) The commissioner of human services shall conduct a background study of an 
151.31 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), 
151.32 	who is newly affiliated with a child foster family setting license holder:
152.1 	(1) the county or private agency shall collect and forward to the commissioner the 
152.2 	information required under section 245C.05, subdivisions 1 and 5, when the child foster 
152.3 	family setting applicant or license holder resides in the home where child foster care services 
152.4 	are provided; and
152.5 	(2) the background study conducted by the commissioner of human services under this 
152.6 	paragraph must include a review of the information required under section 245C.08, 
152.7 	subdivisions 1, 3, and 4.
152.8 	(g) The commissioner shall conduct a background study of an individual specified under 
152.9 	section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated 
152.10 	with an adult foster care or family adult day services and with a family child care license 
152.11 	holder or a legal nonlicensed child care provider authorized under chapter 142E and:
152.12 	(1) except as provided in section 245C.05, subdivision 5a, the county shall collect and 
152.13 	forward to the commissioner the information required under section 245C.05, subdivision 
152.14 	1, paragraphs (a) and (b), and subdivision 5, paragraph (b), for background studies conducted 
152.15 	by the commissioner for all family adult day services, for adult foster care when the adult 
152.16 	foster care license holder resides in the adult foster care residence, and for family child care 
152.17 	and legal nonlicensed child care authorized under chapter 142E;
152.18 	(2) the license holder shall collect and forward to the commissioner the information 
152.19 	required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs 
152.20 	(a) and (b), for background studies conducted by the commissioner for adult foster care 
152.21 	when the license holder does not reside in the adult foster care residence; and
152.22 	(3) the background study conducted by the commissioner under this paragraph must 
152.23 	include a review of the information required under section 245C.08, subdivision 1, paragraph 
152.24 	(a), and subdivisions 3 and 4.
152.25 	(h) Applicants for licensure, license holders, and other entities as provided in this chapter 
152.26 	must submit completed background study requests to the commissioner using the electronic 
152.27 	system known as NETStudy before individuals specified in section 245C.03, subdivision 
152.28 	1, begin positions allowing direct contact in any licensed program.
152.29 	(i) For an individual who is not on the entity's active roster, the entity must initiate a 
152.30 	new background study through NETStudy when:
152.31 	(1) an individual returns to a position requiring a background study following an absence 
152.32 	of 120 or more consecutive days; or
153.1 	(2) a program that discontinued providing licensed direct contact services for 120 or 
153.2 	more consecutive days begins to provide direct contact licensed services again.
153.3 	The license holder shall maintain a copy of the notification provided to the commissioner 
153.4 	under this paragraph in the program's files. If the individual's disqualification was previously 
153.5 	set aside for the license holder's program and the new background study results in no new 
153.6 	information that indicates the individual may pose a risk of harm to persons receiving 
153.7 	services from the license holder, the previous set-aside shall remain in effect.
153.8 	(j) For purposes of this section, a physician licensed under chapter 147, advanced practice 
153.9 	registered nurse licensed under chapter 148, or physician assistant licensed under chapter 
153.10 	147A is considered to be continuously affiliated upon the license holder's receipt from the 
153.11 	commissioner of health or human services of the physician's, advanced practice registered 
153.12 	nurse's, or physician assistant's background study results.
153.13 	(k) For purposes of family child care, a substitute caregiver must receive repeat 
153.14 	background studies at the time of each license renewal.
153.15 	(l) A repeat background study at the time of license renewal is not required if the family 
153.16 	child care substitute caregiver's background study was completed by the commissioner on 
153.17 	or after October 1, 2017, and the substitute caregiver is on the license holder's active roster 
153.18 	in NETStudy 2.0.
153.19 	(m) Before and after school programs authorized under chapter 142E, are exempt from 
153.20 	the background study requirements under section 123B.03, for an employee for whom a 
153.21 	background study under this chapter has been completed.

153.22 	Sec. 14. Minnesota Statutes 2024, section 256B.055, subdivision 17, is amended to read:
153.23 		Subd. 17.Adults who were in foster care at the age of 18, 19, or 20. (a) Medical 
153.24 	assistance may be paid for a person under 26 years of age who was in foster care under the 
153.25 	commissioner's responsibility on the date of attaining 18, 19, or 20 years of age or receiving 
153.26 	foster care benefits past 18 years of age under section 260C.451, and who was enrolled in 
153.27 	medical assistance under the state plan or a waiver of the plan while in foster care, in 
153.28 	accordance with section 2004 of the Affordable Care Act.
153.29 	(b) Medical assistance may be paid for a person under 26 years of age who was in foster 
153.30 	care and enrolled in any state's Medicaid program as provided by Public Law 115-271, 
153.31 	section 1002.
153.32 	(c) The commissioner shall must seek federal waiver approval under United States Code, 
153.33 	title 42, section 1315, to include youth who were in a state's foster care program and who 
154.1 	turned age 18 prior to January 1, 2023, without regard to potential eligibility under a Medicaid 
154.2 	mandatory group.

154.3 	Sec. 15. Minnesota Statutes 2024, section 259.83, subdivision 1, as amended by Laws 
154.4 	2026, chapter 88, article 1, section 159, is amended to read:
154.5 		Subdivision 1.Services provided. (a) Agencies shall must provide assistance and 
154.6 	counseling services upon receiving a request for current information from adoptive parents, 
154.7 	birth parents, adopted persons aged 18 years of age and older, or adult siblings of adopted 
154.8 	persons. The agency shall must contact the other adult persons or the adoptive parents of a 
154.9 	minor child in a personal and confidential manner to determine whether there is a desire to 
154.10 	receive or share information or to have contact. If there is such a desire, the agency shall
154.11 	must provide the services requested. The agency shall must complete the search request 
154.12 	within six months of the request being made. If the agency is unable to complete the search 
154.13 	request within the specified time frame, the agency shall must inform the requester of the 
154.14 	status of the request and include a reasonable estimate of when the request can be completed.
154.15 	(b) Upon a request for assistance or services from an adoptive parent of a minor child, 
154.16 	birth parent, or an adopted person 18 years of age or older, the agency must inform the 
154.17 	person:
154.18 	(1) about the right of an adopted person to request and obtain a copy of the adopted 
154.19 	person's original birth record at the age and circumstances specified in section 144.2252; 
154.20 	and
154.21 	(2) about the right of the birth parent named on the adopted person's original birth record 
154.22 	to file a contact preference form with the state registrar pursuant to section 144.2253.
154.23 	When making or supervising an adoptive placement, the agency must provide in writing to 
154.24 	the birth parents listed on the original birth record the information required under this 
154.25 	paragraph and section 259.37, subdivision 2, clause (7).

154.26 	Sec. 16. Minnesota Statutes 2024, section 260.67, subdivision 1, is amended to read:
154.27 		Subdivision 1.Preference for permanency placement with a relative. Consistent with 
154.28 	section 260C.513, if an African American or disproportionately represented child cannot 
154.29 	be returned to the child's parent, permanency placement with a relative is preferred. The 
154.30 	court shallmust consider the requirements of and responsibilities under section 260.012, 
154.31 	paragraph (a), and, if possible and if requirements under section 260C.515, subdivision 4, 
154.32 	are met, transfer permanent legal and physical custody of the child to:
155.1 	(1) a noncustodial parent under section 260C.515, subdivision 4, if the child cannot 
155.2 	return to the care of the parent or custodian from whom the child was removed or who had 
155.3 	legal custody at the time that the child was placed in foster care; or
155.4 	(2) a willing and able relative, according to the requirements of section 260C.515, 
155.5 	subdivision 4. When the responsible social services agency is the petitioner, prior to the 
155.6 	court ordering a transfer of permanent legal and physical custody to a relative, the responsible 
155.7 	social services agency must inform the relative of Northstar kinship assistance benefits and 
155.8 	eligibility requirements and of the relative's ability to apply for benefits on behalf of the 
155.9 	child under chapter 256N sections 142A.60 to 142A.612.

155.10 	Sec. 17. Minnesota Statutes 2024, section 260C.190, subdivision 1, is amended to read:
155.11 		Subdivision 1.Placement. (a) An agency with legal responsibility for a child under 
155.12 	section 260C.178, subdivision 1, paragraph (c), or legal custody of a child under section 
155.13 	260C.201, subdivision 1, paragraph (a), clause (3) (2), may colocate a child with a parent 
155.14 	who is receiving services in a licensed residential family-based substance use disorder 
155.15 	treatment program for up to 12 months.
155.16 	(b) During the child's placement under paragraph (a), the agency: (1) may visit the child 
155.17 	as the agency deems necessary and appropriate; (2) shallmust continue to have access to 
155.18 	information under section 260C.208; and (3) shallmust continue to provide appropriate 
155.19 	services to both the parent and the child.
155.20 	(c) The agency may terminate the child's placement under paragraph (a) to protect the 
155.21 	child's health, safety, or welfare and may remove the child to foster care without a prior 
155.22 	court order or authorization.

155.23 	Sec. 18. Minnesota Statutes 2024, section 260C.212, subdivision 1, is amended to read:
155.24 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan shall 
155.25 	be prepared within 30 days after any child is placed in foster care by court order or a 
155.26 	voluntary placement agreement between the responsible social services agency and the 
155.27 	child's parent pursuant to section 260C.227 or chapter 260D.
155.28 	(b) An out-of-home placement plan means a written document individualized to the 
155.29 	needs of the child and the child's parents or guardians that is prepared by the responsible 
155.30 	social services agency jointly with the child's parents or guardians and in consultation with 
155.31 	the child's guardian ad litem; the child's tribe, if the child is an Indian child; the child's foster 
155.32 	parent or representative of the foster care facility; and, when appropriate, the child. When 
156.1 	a child is age 14 or older, the child may include two other individuals on the team preparing 
156.2 	the child's out-of-home placement plan. The child may select one member of the case 
156.3 	planning team to be designated as the child's advisor and to advocate with respect to the 
156.4 	application of the reasonable and prudent parenting standards. The responsible social services 
156.5 	agency may reject an individual selected by the child if the agency has good cause to believe 
156.6 	that the individual would not act in the best interest of the child. For a child in voluntary 
156.7 	foster care for treatment under chapter 260D, preparation of the out-of-home placement 
156.8 	plan shall additionally include the child's mental health treatment provider. For a child 18 
156.9 	years of age or older, the responsible social services agency shall involve the child and the 
156.10 	child's parents as appropriate. As appropriate, the plan shall be:
156.11 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
156.12 	(2) ordered by the court, either as presented or modified after hearing, under section 
156.13 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
156.14 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem, 
156.15 	a representative of the child's tribe, the responsible social services agency, and, if possible, 
156.16 	the child.
156.17 	(c) The out-of-home placement plan shall be explained by the responsible social services 
156.18 	agency to all persons involved in the plan's implementation, including the child who has 
156.19 	signed the plan, and shall set forth:
156.20 	(1) a description of the foster care home or facility selected, including how the 
156.21 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
156.22 	least restrictive, most family-like setting available that is in close proximity to the home of 
156.23 	the child's parents or guardians when the case plan goal is reunification; and how the 
156.24 	placement is consistent with the best interests and special needs of the child according to 
156.25 	the factors under subdivision 2, paragraph (b);
156.26 	(2) the specific reasons for the placement of the child in foster care, and when 
156.27 	reunification is the plan, a description of the problems or conditions in the home of the 
156.28 	parent or parents that necessitated removal of the child from home and the changes the 
156.29 	parent or parents must make for the child to safely return home;
156.30 	(3) a description of the services offered and provided to prevent removal of the child 
156.31 	from the home and to reunify the family including:
157.1 	(i) the specific actions to be taken by the parent or parents of the child to eliminate or 
157.2 	correct the problems or conditions identified in clause (2), and the time period during which 
157.3 	the actions are to be taken; and
157.4 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to 
157.5 	achieve a safe and stable home for the child including social and other supportive services 
157.6 	to be provided or offered to the parent or parents or guardian of the child, the child, and the 
157.7 	residential facility during the period the child is in the residential facility;
157.8 	(4) a description of any services or resources that were requested by the child or the 
157.9 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
157.10 	in the residential facility, and whether those services or resources were provided and if not, 
157.11 	the basis for the denial of the services or resources;
157.12 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined in 
157.13 	section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not 
157.14 	placed together in foster care, and whether visitation is consistent with the best interest of 
157.15 	the child, during the period the child is in foster care;
157.16 	(6) when a child cannot return to or be in the care of either parent, documentation of 
157.17 	steps to finalize adoption as the permanency plan for the child through reasonable efforts 
157.18 	to place the child for adoption pursuant to section 260C.605. At a minimum, the 
157.19 	documentation must include consideration of whether adoption is in the best interests of 
157.20 	the child and child-specific recruitment efforts such as a relative search, consideration of 
157.21 	relatives for adoptive placement, and the use of state, regional, and national adoption 
157.22 	exchanges to facilitate orderly and timely placements in and outside of the state. A copy of 
157.23 	this documentation shall be provided to the court in the review required under section 
157.24 	260C.317, subdivision 3, paragraph (b);
157.25 	(7) when a child cannot return to or be in the care of either parent, documentation of 
157.26 	steps to finalize the transfer of permanent legal and physical custody to a relative as the 
157.27 	permanency plan for the child. This documentation must support the requirements of the 
157.28 	kinship placement agreement under section 142A.605 and must include the reasonable 
157.29 	efforts used to determine that it is not appropriate for the child to return home or be adopted, 
157.30 	and reasons why permanent placement with a relative through a Northstar kinship assistance 
157.31 	arrangement is in the child's best interest; how the child meets the eligibility requirements 
157.32 	for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's 
157.33 	relative foster parent and reasons why the relative foster parent chose not to pursue adoption, 
157.34 	if applicable; and agency efforts to discuss with the child's parent or parents the permanent 
158.1 	transfer of permanent legal and physical custody or the reasons why these efforts were not 
158.2 	made;
158.3 	(8) efforts to ensure the child's educational stability while in foster care for a child who 
158.4 	attained the minimum age for subject to compulsory school attendance under state law
158.5 	section 120A.22 and is enrolled full time in elementary or secondary school, or instructed 
158.6 	in elementary or secondary education at home, or instructed in an independent study 
158.7 	elementary or secondary program, or incapable of attending school on a full-time basis due 
158.8 	to a medical condition that is documented and supported by regularly updated information 
158.9 	in the child's case plan. Educational stability efforts include:
158.10 	(i) efforts to ensure that the child remains in the same school in which the child was 
158.11 	enrolled prior to placement or upon the child's move from one placement to another, including 
158.12 	efforts to work with the local education authorities to ensure the child's educational stability 
158.13 	and attendance; or
158.14 	(ii) if it is not in the child's best interest to remain in the same school that the child was 
158.15 	enrolled in prior to placement or move from one placement to another, efforts to ensure 
158.16 	immediate and appropriate enrollment for the child in a new school;
158.17 	(9) for a child not yet subject to compulsory school attendance under section 120A.22, 
158.18 	efforts to ensure the child's educational stability while in foster care if the child is enrolled 
158.19 	in an early childhood education or child care program. If enrollment in an early childhood 
158.20 	education or child care program is not feasible or not in the child's best interest, the 
158.21 	out-of-home placement plan must state specific reasons for discontinuing the child's 
158.22 	enrollment in the same program or not seeking enrollment in a similar program. Early 
158.23 	childhood education or child care stability efforts include:
158.24 	(i) efforts to ensure that the child remains in the same program in which the child was 
158.25 	enrolled prior to placement or upon the child's move from one placement to another, if in 
158.26 	the child's best interest, including efforts to work with the program to ensure the child's 
158.27 	educational stability and attendance; or
158.28 	(ii) if it is not feasible or not in the child's best interest for the child to remain in the same 
158.29 	program that the child was enrolled in prior to placement or to a move from one placement 
158.30 	to another, efforts to ensure enrollment for the child in a similar program;
158.31 	(9) (10) the educational, child care, or early childhood education program records of the 
158.32 	child including the most recent information available regarding:
158.33 	(i) the names and addresses of the child's educational providers;
159.1 	(ii) the child's grade level performance, if applicable;
159.2 	(iii) the child's school or program record;
159.3 	(iv) a statement about how the child's placement in foster care takes into account 
159.4 	proximity to the school or program in which the child is enrolled at the time of placement; 
159.5 	and
159.6 	(v) any other relevant educational information;
159.7 	(10) (11) the efforts by the responsible social services agency to ensure the oversight 
159.8 	and continuity of health care services for the foster child, including:
159.9 	(i) the plan to schedule the child's initial health screens;
159.10 	(ii) how the child's known medical problems and identified needs from the screens, 
159.11 	including any known communicable diseases, as defined in section 144.4172, subdivision 
159.12 	2, shall be monitored and treated while the child is in foster care;
159.13 	(iii) how the child's medical information shall be updated and shared, including the 
159.14 	child's immunizations;
159.15 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
159.16 	including the role of the parent, the agency, and the foster parent;
159.17 	(v) who is responsible for oversight of the child's prescription medications;
159.18 	(vi) how physicians or other appropriate medical and nonmedical professionals shall be 
159.19 	consulted and involved in assessing the health and well-being of the child and determine 
159.20 	the appropriate medical treatment for the child; and
159.21 	(vii) the responsibility to ensure that the child has access to medical care through either 
159.22 	medical insurance or medical assistance;
159.23 	(11) (12) the health records of the child including information available regarding:
159.24 	(i) the names and addresses of the child's health care and dental care providers;
159.25 	(ii) a record of the child's immunizations;
159.26 	(iii) the child's known medical problems, including any known communicable diseases 
159.27 	as defined in section 144.4172, subdivision 2;
159.28 	(iv) the child's medications; and
159.29 	(v) any other relevant health care information such as the child's eligibility for medical 
159.30 	insurance or medical assistance;
160.1 	(12) (13) an independent living plan for a child 14 years of age or older, developed in 
160.2 	consultation with the child. The child may select one member of the case planning team to 
160.3 	be designated as the child's advisor and to advocate with respect to the application of the 
160.4 	reasonable and prudent parenting standards in subdivision 14. The plan should include, but 
160.5 	not be limited to, the following objectives:
160.6 	(i) educational, vocational, or employment planning;
160.7 	(ii) health care planning and medical coverage;
160.8 	(iii) transportation including, where appropriate, assisting the child in obtaining a driver's 
160.9 	license;
160.10 	(iv) money management, including the responsibility of the responsible social services 
160.11 	agency to ensure that the child annually receives, at no cost to the child, a consumer report 
160.12 	as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies 
160.13 	in the report;
160.14 	(v) planning for housing;
160.15 	(vi) social and recreational skills;
160.16 	(vii) establishing and maintaining connections with the child's family and community; 
160.17 	and
160.18 	(viii) regular opportunities to engage in age-appropriate or developmentally appropriate 
160.19 	activities typical for the child's age group, taking into consideration the capacities of the 
160.20 	individual child;
160.21 	(13) (14) for a child in voluntary foster care for treatment under chapter 260D, diagnostic 
160.22 	and assessment information, specific services relating to meeting the mental health care 
160.23 	needs of the child, and treatment outcomes;
160.24 	(14) (15) for a child 14 years of age or older, a signed acknowledgment that describes 
160.25 	the child's rights regarding education, health care, visitation, safety and protection from 
160.26 	exploitation, and court participation; receipt of the documents identified in section 260C.452; 
160.27 	and receipt of an annual credit report. The acknowledgment shall state that the rights were 
160.28 	explained in an age-appropriate manner to the child; and
160.29 	(15) (16) for a child placed in a qualified residential treatment program, the plan must 
160.30 	include the requirements in section 260C.708.
160.31 	(d) The parent or parents or guardian and the child each shall have the right to legal 
160.32 	counsel in the preparation of the case plan and shall be informed of the right at the time of 
161.1 	placement of the child. The child shall also have the right to a guardian ad litem. If unable 
161.2 	to employ counsel from their own resources, the court shall appoint counsel upon the request 
161.3 	of the parent or parents or the child or the child's legal guardian. The parent or parents may 
161.4 	also receive assistance from any person or social services agency in preparation of the case 
161.5 	plan.
161.6 	(e) Before an out-of-home placement plan is signed by the parent or parents or guardian 
161.7 	of the child, the responsible social services agency must provide the parent or parents or 
161.8 	guardian with a one- to two-page summary of the plan using a form developed by the 
161.9 	commissioner. The out-of-home placement plan summary must clearly summarize the plan's 
161.10 	contents under paragraph (c) and list the requirements and responsibilities for the parent or 
161.11 	parents or guardian using plain language. The summary must be updated and provided to 
161.12 	the parent or parents or guardian when the out-of-home placement plan is updated under 
161.13 	subdivision 1a.
161.14 	(f) After the plan has been agreed upon by the parties involved or approved or ordered 
161.15 	by the court, the foster parents shall be fully informed of the provisions of the case plan and 
161.16 	shall be provided a copy of the plan.
161.17 	(g) Upon the child's discharge from foster care, the responsible social services agency 
161.18 	must provide the child's parent, adoptive parent, or permanent legal and physical custodian, 
161.19 	and the child, if the child is 14 years of age or older, with a current copy of the child's health 
161.20 	and education record. If a child meets the conditions in subdivision 15, paragraph (b), the 
161.21 	agency must also provide the child with the child's social and medical history. The responsible 
161.22 	social services agency may give a copy of the child's health and education record and social 
161.23 	and medical history to a child who is younger than 14 years of age, if it is appropriate and 
161.24 	if subdivision 15, paragraph (b), applies.

161.25 	Sec. 19. Minnesota Statutes 2024, section 260C.212, subdivision 4a, is amended to read:
161.26 		Subd. 4a.Monthly caseworker visits. (a) Every child in foster care or on a trial home 
161.27 	visit shallmust be visited by the child's caseworker or another person who has responsibility 
161.28 	for visitation of the child on a monthly basis, with the majority of visits occurring in the 
161.29 	child's residence. The responsible social services agency may designate another person 
161.30 	responsible for monthly case visits. For the purposes of this section, the following definitions 
161.31 	apply:
161.32 	(1) "visit" is defined as a face-to-face contact between a child and the child's caseworker. 
161.33 	For a youth 18 years of age or older, a visit may be conducted via video conference with 
161.34 	the youth's informed consent;
162.1 	(2) "visited on a monthly basis" is defined as at least one visit per calendar month;
162.2 	(3) "the child's caseworker" is defined as the person who has responsibility for managing 
162.3 	the child's foster care placement case as assigned by the responsible social services agency;
162.4 	(4) "another person" means the professional staff whom the responsible social services 
162.5 	agency has assigned in the out-of-home placement plan or case plan. Another person must 
162.6 	be professionally trained to assess the child's safety, permanency, well-being, and case 
162.7 	progress. The agency may not designate the guardian ad litem, the child foster care provider, 
162.8 	residential facility staff, or a qualified individual as defined in section 260C.007, 
162.9 	subdivision26b, as another person; and
162.10 	(5) "the child's residence" is defined as the home where the child is residing, and can 
162.11 	include the foster home, child care institution, or the home from which the child was removed 
162.12 	if the child is on a trial home visit.
162.13 	(b) Caseworker visits shallmust be of sufficient substance and duration to address issues 
162.14 	pertinent to case planning and service delivery to ensure the safety, permanency, and 
162.15 	well-being of the child, including whether the child is enrolled and attending school as 
162.16 	required by law.
162.17 	(c) Every effort shallmust be made by the responsible social services agency and 
162.18 	professional staff to have the monthly visit with the child outside the presence of the child's 
162.19 	parents, foster parents, or facility staff. There may be situations related to the child's needs 
162.20 	when a caseworker visit cannot occur with the child alone. The reason the caseworker visit 
162.21 	occurred in the presence of others must be documented in the case record and may include:
162.22 	(1) that the child exhibits intense emotion or behavior indicating that visiting without 
162.23 	the presence of the parent, foster parent, or facility staff would be traumatic for the child;
162.24 	(2) that despite a caseworker's efforts, the child declines to visit with the caseworker 
162.25 	outside the presence of the parent, foster parent, or facility staff; and
162.26 	(3) that the child has a specific developmental delay, physical limitation, incapacity, 
162.27 	medical device, or significant medical need, such that the parent, foster parent, or facility 
162.28 	staff is required to be present with the child during the visit.

162.29 	Sec. 20. Minnesota Statutes 2024, section 260C.212, is amended by adding a subdivision 
162.30 	to read:
162.31 		Subd. 14a.Information on early childhood education and child care for children 
162.32 	in foster care. For a child not yet subject to compulsory school attendance under section 
163.1 	120A.22, the responsible social services agency; licensed child-placing agency, if applicable; 
163.2 	and the child's guardian ad litem must provide information to the foster parent about:
163.3 	(1) early childhood education and child care program options in the foster parent's 
163.4 	geographic area;
163.5 	(2) the Northstar foster care benefits child care allowance;
163.6 	(3) eligibility requirements for the child care assistance program and early learning 
163.7 	scholarships; and
163.8 	(4) application processes for the child care assistance program and early learning 
163.9 	scholarships.

163.10 	Sec. 21. Minnesota Statutes 2024, section 260C.451, subdivision 2, is amended to read:
163.11 		Subd. 2.Independent living plan. Upon the request of (a) For any child in foster care 
163.12 	who is 14 years of age or older, the responsible social services agency must, in conjunction 
163.13 	with the child and other appropriate parties, develop and update the child's independent 
163.14 	living plan required under section 260C.212, subdivision 1, paragraph (c), clause (12).
163.15 	(b) For any child in foster care immediately prior to the child's 18th birthday and who 
163.16 	is in foster care at the time of the request, the responsible social services agency shall must, 
163.17 	in conjunction with the child and other appropriate parties, update the child's independent 
163.18 	living plan required under section 260C.212, subdivision 1, paragraph (c), clause (12), 
163.19 	related to the child's employment, vocational, educational, social, or maturational needs and 
163.20 	submit the updated plan to the court as part of the required review under section 260C.202, 
163.21 	subdivision 3. The agency shall must provide continued services and foster care for the 
163.22 	child including those services that are necessary to implement the independent living plan.

163.23 	Sec. 22. Minnesota Statutes 2024, section 260C.451, subdivision 3, is amended to read:
163.24 		Subd. 3.Eligibility to continue in foster care. A child in foster care immediately prior 
163.25 	to the child's 18th birthday may continue in foster care past age 18 unless:
163.26 	(1) the child can safely return home; or
163.27 	(2) the child is in placement pursuant to the agency's duties under section 256B.092 and 
163.28 	Minnesota Rules, parts 9525.0004 to 9525.0016, to meet the child's needs due to a 
163.29 	developmental disability or related condition, and the child will be served as an adult under 
163.30 	section 256B.092 and Minnesota Rules, parts 9525.0004 to 9525.0016; or
164.1 	(3) the child can be adopted or have permanent legal and physical custody transferred 
164.2 	to a relative prior to the child's 18th birthday.

164.3 	Sec. 23. Minnesota Statutes 2024, section 260C.451, subdivision 3a, is amended to read:
164.4 		Subd. 3a.Eligibility criteria. The child must meet at least one of the following conditions 
164.5 	to be considered eligible to continue in or return to foster care and remain there to age 21. 
164.6 	The child must be:
164.7 	(1) completing secondary education or a program leading to an equivalent credential, 
164.8 	including transition programs through a public or private school;
164.9 	(2) enrolled in an institution that provides postsecondary or vocational education;
164.10 	(3) participating in a program or activity designed to promote or remove barriers to 
164.11 	employment;
164.12 	(4) employed for at least 80 hours per month, including receiving benefits under chapter 
164.13 	268B; or
164.14 	(5) incapable of doing any of the activities described in clauses (1) to (4) due to a medical 
164.15 	condition.

164.16 	Sec. 24. Minnesota Statutes 2025 Supplement, section 260C.451, subdivision 8, is amended 
164.17 	to read:
164.18 		Subd. 8.Notice of termination of foster care. When a child in foster care between the 
164.19 	ages of 18 and 21 ceases to meet one of the eligibility criteria of subdivision 3a, the 
164.20 	responsible social services agency shall must give the child written notice that foster care 
164.21 	will terminate 30 days from the date the notice is sent. The agency must send a copy of the 
164.22 	written notice to the commissioner of children, youth, and families. The child or the child's 
164.23 	guardian ad litem may file a motion asking the court to review the agency's determination 
164.24 	within 15 days of receiving the notice. The child shall must not be discharged from foster 
164.25 	care until the motion is heard. The agency shall work must engage with the child to develop 
164.26 	a transition out of foster care plan as required under section 260C.452, subdivision 4, 
164.27 	paragraph (d), that addresses the goals listed in section 260C.203, subdivision 4, clause (2). 
164.28 	The written notice of termination of benefits shall must be on a form prescribed by the 
164.29 	commissioner and shall must also give notice of the right to have the agency's determination 
164.30 	reviewed by the court in the proceeding where the court conducts the reviews required under 
164.31 	section 260C.203, 260C.317, or 260C.515, subdivision 5 or 6. A copy of the termination 
164.32 	notice shall must be sent to the child and the child's attorney, if any, the foster care provider, 
165.1 	the child's guardian ad litem, the commissioner of children, youth, and families, and the 
165.2 	court. The agency is not responsible for paying foster care benefits for any period of time 
165.3 	after the child actually leaves foster care.

165.4 	ARTICLE 10
165.5 	CHILDREN, YOUTH, AND FAMILIES BUDGET

165.6 	Section 1. REGIONAL FOOD BANK GRANTS.
 165.7 		Subdivision 1.Establishment. The commissioner of children, youth, and families must 
165.8 	establish regional food bank grants to increase the availability of food to individuals and 
165.9 	families in need.
165.10 		Subd. 2.Distribution of appropriation. The commissioner must distribute money 
165.11 	appropriated under this section to regional food banks and Minnesota Tribal governments, 
165.12 	as defined in Minnesota Statutes, section 10.65, using a formula based on the number of 
165.13 	persons in households having incomes below the federal poverty level and the number of 
165.14 	unemployed persons in the service area of the food bank or Minnesota Tribal government.
165.15 		Subd. 3.Allowable use of money. (a) Grant money distributed under this section must 
165.16 	be used to purchase, transport, and coordinate the distribution of food to sites approved by 
165.17 	the commissioner. Grant money distributed under this section may also be used to purchase 
165.18 	personal hygiene products, including but not limited to diapers and toilet paper.
165.19 	(b) Food and other allowable products purchased with grant money under this section 
165.20 	must be available at no cost at sites approved by the commissioner.
165.21 	(c) Grant money distributed under this section must not be used for the compensation 
165.22 	of officers, directors, trustees, key employees, and highest compensated employees as 
165.23 	reported on Internal Revenue Service Form 990.
165.24 		Subd. 4.Reporting. (a) Food banks and Minnesota Tribal governments receiving grant 
165.25 	money under this section must retain records documenting expenditures of the grant money 
165.26 	and comply with any additional documentation requirements imposed by the commissioner.
165.27 	(b) Food banks and Minnesota Tribal governments must report on the use of grant money 
165.28 	received under this section to the commissioner. The commissioner must determine the 
165.29 	timing and form required for the reports.
165.30 		Subd. 5.Ineligible expenditures. If the commissioner determines that ineligible 
165.31 	expenditures were made by a food bank or Minnesota Tribal government under this section, 
166.1 	the ineligible amount must be repaid by the food bank or Tribal government to the 
166.2 	commissioner and deposited in the general fund.

166.3 	Sec. 2. DIRECTION TO COMMISSIONER OF CHILDREN, YOUTH, AND 
166.4 	FAMILIES; CRISIS NURSERY LICENSING.
 166.5 	The commissioner of children, youth, and families must develop a licensing framework 
166.6 	for crisis nurseries. The framework must include pathways for organizations to become 
166.7 	licensed crisis nurseries, a definition for crisis nurseries, background study and training 
166.8 	requirements, and ways to reduce redundancy and resolve conflicting requirements between 
166.9 	Minnesota Rules, parts 2960.0510 to 2960.0530, 2960.3000 to 2960.3100, and chapter 9502, 
166.10 	and Minnesota Statutes, chapter 142B. In developing the framework, the commissioner 
166.11 	must work with stakeholders seeking to develop a crisis nursery license. By January 15, 
166.12 	2028, the commissioner must submit a report to the chairs and ranking minority members 
166.13 	of the legislative committees with jurisdiction over children, youth, and families licensing. 
166.14 	The report must contain an overview of the licensing framework, a detailed explanation of 
166.15 	the framework, and proposed legislation to make any statutory changes that are needed to 
166.16 	implement the new license for crisis nurseries.

166.17 	ARTICLE 11
166.18 	MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD 
166.19 	WELFARE DISPROPORTIONALITY ACT CHANGES

166.20 	Section 1. Minnesota Statutes 2024, section 260.63, subdivision 10, is amended to read:
166.21 		Subd. 10.Disproportionately represented child. (a) "Disproportionately represented 
166.22 	child" means a person who is under the age of 18 and who is a member of a community 
166.23 	whose race, culture, ethnicity, disability status, or low-income socioeconomic status is 
166.24 	disproportionately encountered, engaged, or identified in the child welfare system as 
166.25 	compared to the representation in the state's total child population, as determined on an 
166.26 	annual basis by the commissioner under section 260.631. A child's race, culture, or ethnicity, 
166.27 	disability status, or low-income socioeconomic status is determined based upon by a child's 
166.28 	self-identification or identification of a child's race, culture, or ethnicity, disability status, 
166.29 	or low-income socioeconomic status as reported by the child's parent or guardian.
166.30 	(b) For the purposes of this subdivision:
166.31 	(1) disability means a physical, sensory, or mental impairment that materially limits one 
166.32 	or more major life activities, including an impairment that is episodic or in remission and 
166.33 	would materially limit a major life activity when active; and
167.1 	(2) low-income socioeconomic status is established by the child's household income 
167.2 	being below 300 percent of the federal poverty guidelines published by the United States 
167.3 	Department of Health and Human Services. For purposes of this subdivision, low-income 
167.4 	socioeconomic status is also established when a child or a member of the child's household 
167.5 	receives benefits from one or more means-tested public assistance programs, or when a 
167.6 	child meets income and resource requirements to be eligible for title IV-E foster care 
167.7 	maintenance payments under the federal Social Security Act.

167.8 	Sec. 2. [260.631] DETERMINATIONS.
167.9 		Subdivision 1.Determination of disproportionate overrepresentation. (a) The 
167.10 	commissioner must determine the communities that are disproportionately overrepresented 
167.11 	in Minnesota's child protection system pursuant to this section for the purposes of the 
167.12 	Minnesota African American Family Preservation and Child Welfare Disproportionality 
167.13 	Act. In making this determination, the commissioner may consider the recommendations 
167.14 	provided under paragraph (d). The commissioner's determination under this paragraph is 
167.15 	in effect until the effective date of the next determination issued by the commissioner.
167.16 	(b) The commissioner must make the initial determination under paragraph (a) by 
167.17 	September 1, 2026, and then by September 1 on every even-numbered year thereafter.
167.18 	(c) A responsible social services agency must use the commissioner's determination 
167.19 	under paragraph (a) to determine whether a child meets the definition of a disproportionately 
167.20 	represented child under section 260.63, subdivision 10.
167.21 	(d) The African American Child and Family Well-Being Advisory Council must submit 
167.22 	recommendations to the commissioner on the disproportionate overrepresentation of African 
167.23 	American children in Minnesota's child protection system using state and federal census 
167.24 	data. The council must provide its initial recommendations to the commissioner by August 
167.25 	1, 2026, and then provide recommendations by August 1 on every even-numbered year 
167.26 	thereafter.
167.27 	(e) If the commissioner makes a determination under paragraph (a) that differs from the 
167.28 	recommendations provided by the African American Child and Family Well-Being Advisory 
167.29 	Council under paragraph (d) regarding the disproportionate overrepresentation of African 
167.30 	American children in Minnesota's child protection system, the commissioner must provide 
167.31 	the reasons for diverging from the council's recommendations and identify the data the 
167.32 	commissioner relied upon in making the determination of disproportionate overrepresentation. 
167.33 	The commissioner must provide the information required under this paragraph to:
168.1 	(1) the chairs and ranking minority members of the legislative committees with 
168.2 	jurisdiction over the Minnesota African American Family Preservation and Child Welfare 
168.3 	Disproportionality Act;
168.4 	(2) the African American Child and Family Well-Being Advisory Council;
168.5 	(3) the Children's Justice Initiative; and
168.6 	(4) responsible social services agencies statewide.
168.7 	(f) By September 15, 2026, and every even-numbered year thereafter, the commissioner 
168.8 	must notify responsible social services agencies, the African American Child and Family 
168.9 	Well-Being Advisory Council, and the Children's Justice Initiative of the commissioner's 
168.10 	determination under paragraph (a). The notification must include but is not limited to:
168.11 	(1) a list of the communities the commissioner determined are disproportionately 
168.12 	represented in Minnesota's child protection system and whether there are any changes from 
168.13 	the previous notification;
168.14 	(2) how a responsible social services agency must implement the commissioner's 
168.15 	determination;
168.16 	(3) the effective date of the commissioner's determination; and
168.17 	(4) the method or methods the commissioner used, or the data the commissioner relied 
168.18 	upon, to make the determination.
168.19 		Subd. 2.Determination of child's status. The responsible social services agency must 
168.20 	document the efforts the agency takes when determining whether a child meets or does not 
168.21 	meet the definition of a disproportionately represented child under section 260.63, subdivision 
168.22 	10, and must provide that information to the commissioner upon the commissioner's request.
168.23 		Subd. 3.Exempt from rulemaking. Chapter 14 does not apply to determinations under 
168.24 	this section.

168.25 	Sec. 3. Minnesota Statutes 2024, section 260.64, subdivision 2, is amended to read:
168.26 		Subd. 2.Safety plan. (a) Prior to petitioning the court to remove an African American 
168.27 	or a disproportionately represented child from the child's home under section 260.66, a 
168.28 	responsible social services agency must work with the child's family to allow the child to 
168.29 	remain in the child's home while implementing a safety plan based on the family's needs. 
168.30 	The responsible social services agency must:
169.1 	(1) make active efforts to engage the child's parent or custodian and the child, when 
169.2 	appropriate;
169.3 	(2) assess the family's cultural and economic needs and, if applicable, needs and services 
169.4 	related to the child's disability;
169.5 	(3) hold a family group consultation meeting and connect the family with supports to 
169.6 	establish a safety network for the family; and
169.7 	(4) provide support, guidance, and input to assist the family and the family's safety 
169.8 	network with developing the safety plan.
169.9 	(b) The safety plan must:
169.10 	(1) address the specific allegations impacting the child's safety in the home. If neglect, 
169.11 	as defined in section 260E.03, subdivision 15, is alleged, the safety plan must incorporate 
169.12 	economic services and supports for the child and the child's family, if eligible, to address 
169.13 	the family's specific needs and prevent neglect;
169.14 	(2) incorporate family and community support to ensure the child's safety while keeping 
169.15 	the family intact; and
169.16 	(3) be adjusted as needed to address the child's and family's ongoing needs and support.
169.17 	(c) The responsible social services agency is not required to establish a safety plan:
169.18 	(1) in a case with allegations of sexual abuse or egregious harm;
169.19 	(2) when the parent is not willing to follow a safety plan;
169.20 	(3) when the parent has abandoned the child or is unavailable to follow a safety plan; 
169.21 	or
169.22 	(4) when the parent has chronic substance use disorder issues and is unable to parent 
169.23 	the child.

169.24 	Sec. 4. Minnesota Statutes 2024, section 260.68, subdivision 2, is amended to read:
169.25 		Subd. 2.Case review. (a) Each responsible social services agency shall conduct a review 
169.26 	of all child welfare cases for African American and other disproportionately represented 
169.27 	children handled by the agency. Each responsible social services agency shall create a 
169.28 	summary report of trends identified under paragraphs (b) and (c), a remediation plan as 
169.29 	provided in paragraph (d), and an update on implementation of any previous remediation 
169.30 	plans. The first report shall be provided to the African American Child Well-Being Advisory 
169.31 	Council, the commissioner, and the chairs and ranking minority members of the legislative 
170.1 	committees with jurisdiction over child welfare by October 1, 2029, and annually thereafter. 
170.2 	For purposes of determining outcomes in this subdivision, responsible social services 
170.3 	agencies shall use guidance from the commissioner. The commissioner shall provide guidance 
170.4 	starting on November 1, 2028, and annually thereafter.
170.5 	(b) The case review must include:
170.6 	(1) the number of African American and disproportionately represented children 
170.7 	represented in the county child welfare protection system;
170.8 	(2) the number and sources of maltreatment reports received and reports screened in for 
170.9 	investigation or referred for family assessment and the race of the children and parents or 
170.10 	custodians involved in each report;
170.11 	(3) the number and race of children and parents or custodians who receive in-home 
170.12 	preventive case management services;
170.13 	(4) the number and race of children whose parents or custodians are referred to 
170.14 	community-based, culturally appropriate, strength-based, or trauma-informed services;
170.15 	(5) the number and race of children removed from their homes;
170.16 	(6) the number and race of children reunified with their parents or custodians;
170.17 	(7) the number and race of children whose parents or custodians are offered family group 
170.18 	decision-making services;
170.19 	(8) the number and race of children whose parents or custodians are offered the parent 
170.20 	support outreach program;
170.21 	(9) the number and race of children in foster care or out-of-home placement at the time 
170.22 	that the data is gathered;
170.23 	(10) the number and race of children who achieve permanency through a transfer of 
170.24 	permanent legal and physical custody to a relative or an adoption; and
170.25 	(11) the number and race of children who are under the guardianship of the commissioner 
170.26 	or awaiting a permanency disposition.
170.27 	(c) The required case review must also:
170.28 	(1) identify barriers to reunifying children with their families;
170.29 	(2) identify the family conditions that led to the out-of-home placement;
170.30 	(3) identify any barriers to accessing culturally informed mental health or substance use 
170.31 	disorder treatment services for the parents or children;
171.1 	(4) document efforts to identify fathers and maternal and paternal relatives and to provide 
171.2 	services to custodial and noncustodial fathers, if appropriate; and
171.3 	(5) document and summarize court reviews of active efforts.
171.4 	(d) Any responsible social services agency that has a case review showing 
171.5 	disproportionality and disparities in child welfare outcomes for African American and other 
171.6 	disproportionately represented children and the children's families, compared to the agency's 
171.7 	overall outcomes, must include in their case review summary report a remediation plan with 
171.8 	measurable outcomes to identify, address, and reduce the factors that led to the 
171.9 	disproportionality and disparities in the agency's child welfare outcomes. The remediation 
171.10 	plan shall also include information about how the responsible social services agency will 
171.11 	achieve and document trauma-informed, positive child well-being outcomes through 
171.12 	remediation efforts.

171.13 	Sec. 5. Minnesota Statutes 2024, section 260.69, subdivision 1, is amended to read:
171.14 		Subdivision 1.Applicability. (a) The commissioner of children, youth, and families 
171.15 	must collaborate with the Children's Justice Initiative to ensure that cultural competency 
171.16 	training is given or made available to individuals working in the child welfare system, 
171.17 	including child welfare workers and supervisors. Training must developed by the Child 
171.18 	Welfare Training Academy may also be made available to attorneys, juvenile court judges, 
171.19 	guardians ad litem, and family law judges. The commissioner must give priority to child 
171.20 	welfare workers and supervisors for in-person trainings or other trainings with limited 
171.21 	attendance or availability.
171.22 	(b) This subdivision does not require the commissioner or the Child Welfare Training 
171.23 	Academy to develop or provide training specifically for attorneys, juvenile court judges, 
171.24 	guardians ad litem, family law judges, or any other individuals beyond the primary training 
171.25 	audiences required to be served under Laws 2019, First Special Session chapter 9, article 
171.26 	1, section 37, subdivision 2, paragraph (e).

171.27 	Sec. 6. Minnesota Statutes 2025 Supplement, section 260.691, subdivision 1, is amended 
171.28 	to read:
171.29 		Subdivision 1.Establishment and duties. (a) The African American Child and Family 
171.30 	Well-Being Advisory Council is established for the Department of Children, Youth, and 
171.31 	Families.
172.1 	(b) The council shall consist of 31 members appointed by the commissioner and must 
172.2 	include representatives with lived personal or professional experience within African 
172.3 	American communities. Members may include but are not limited to youth who have exited 
172.4 	the child welfare system; parents; legal custodians; relative and kinship caregivers or foster 
172.5 	care providers; community service providers, advocates, and members; county and private 
172.6 	social services agency case managers; representatives from faith-based institutions; academic 
172.7 	professionals; a representative from the Council for Minnesotans of African Heritage; the 
172.8 	Ombudsperson for African American Families; and other individuals with experience and 
172.9 	knowledge of African American communities. Council members must be selected through 
172.10 	an open appointments process under section 15.0597. The terms, compensation, and removal 
172.11 	of council members are governed by section 15.059.
172.12 	(c) The council must:
172.13 	(1) review annual reports related to African American children involved in the child 
172.14 	welfare system. These reports may include but are not limited to the maltreatment, 
172.15 	out-of-home placement, and permanency of African American children;
172.16 	(2) assist with and make recommendations to the commissioner for developing strategies 
172.17 	to reduce maltreatment determinations, prevent unnecessary out-of-home placement, promote 
172.18 	culturally appropriate foster care and shelter or facility placement decisions and settings for 
172.19 	African American children in need of out-of-home placement, ensure timely achievement 
172.20 	of permanency, and improve child welfare outcomes for African American children and 
172.21 	their families;
172.22 	(3) review summary reports on targeted case reviews prepared by the commissioner to 
172.23 	ensure that responsible social services agencies meet the needs of African American children 
172.24 	and their families. Based on data collected from those reviews, the council shall assist the 
172.25 	commissioner with developing strategies needed to improve any identified child welfare 
172.26 	outcomes, including but not limited to maltreatment, out-of-home placement, and permanency 
172.27 	for African American children;
172.28 	(4) make recommendations to the commissioner and the legislature for public policy 
172.29 	and statutory changes that specifically consider the needs of African American children and 
172.30 	their families involved in the child welfare system;
172.31 	(5) advise the commissioner on stakeholder engagement strategies and actions that the 
172.32 	commissioner and responsible social services agencies may take to improve child welfare 
172.33 	outcomes for African American children and their families;
173.1 	(6) assist the commissioner with developing strategies for public messaging and 
173.2 	communication related to racial disproportionality and disparities in child welfare outcomes 
173.3 	for African American children and their families;
173.4 	(7) assist the commissioner with identifying and developing internal and external 
173.5 	partnerships to support adequate access to services and resources for African American 
173.6 	children and their families, including but not limited to housing assistance, employment 
173.7 	assistance, food and nutrition support, health care, child care assistance, and educational 
173.8 	support and training; and
173.9 	(8) assist the commissioner with developing strategies to promote the development of 
173.10 	a culturally diverse and representative child welfare workforce in Minnesota that includes 
173.11 	professionals who are reflective of the community served and who have been directly 
173.12 	impacted by lived experiences within the child welfare system. The council must also assist 
173.13 	the commissioner with exploring strategies and partnerships to address education and training 
173.14 	needs, hiring, recruitment, retention, and professional advancement practices.

173.15 	Sec. 7. Minnesota Statutes 2025 Supplement, section 260.692, subdivision 1, is amended 
173.16 	to read:
173.17 		Subdivision 1.Duties. The African American Child and Family Well-Being Unit, 
173.18 	currently established by the commissioner, must:
173.19 	(1) assist with the development of African American cultural competency training and 
173.20 	review child welfare curriculum in the Minnesota Child Welfare Training Academy to 
173.21 	ensure that responsible social services agency staff and other child welfare professionals 
173.22 	are appropriately prepared to engage with African American children and their families and 
173.23 	to support family preservation and reunification;
173.24 	(2) provide technical assistance, including on-site technical assistance, and case 
173.25 	consultation to responsible social services agencies to assist agencies with implementing 
173.26 	and complying with the Minnesota African American Family Preservation and Child Welfare 
173.27 	Disproportionality Act;
173.28 	(3) monitor individual county and statewide disaggregated and nondisaggregated data 
173.29 	to identify trends and patterns in child welfare outcomes, including but not limited to 
173.30 	reporting, maltreatment, out-of-home placement, and permanency of African American 
173.31 	children and develop strategies to address disproportionality and disparities in the child 
173.32 	welfare system;
174.1 	(4) develop and implement a system for conducting case reviews when the commissioner 
174.2 	receives reports of noncompliance with the Minnesota African American Family Preservation 
174.3 	and Child Welfare Disproportionality Act or when requested by the parent or custodian of 
174.4 	an African American child. Case reviews may include but are not limited to a review of 
174.5 	placement prevention efforts, safety planning, case planning and service provision by the 
174.6 	responsible social services agency, relative placement consideration, and permanency 
174.7 	planning;
174.8 	(5) establish and administer a request for proposals process for African American and 
174.9 	disproportionately represented family preservation grants under section 260.693, monitor 
174.10 	grant activities, and provide technical assistance to grantees;
174.11 	(6) in coordination with the African American Child and Family Well-Being Advisory 
174.12 	Council, coordinate services and create internal and external partnerships to support adequate 
174.13 	access to services and resources for African American children and their families, including 
174.14 	but not limited to housing assistance, employment assistance, food and nutrition support, 
174.15 	health care, child care assistance, and educational support and training; and
174.16 	(7) develop public messaging and communication to inform the public about racial 
174.17 	disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities, 
174.18 	and resources available to African American children and their families involved in the 
174.19 	child welfare system.

174.20 	Sec. 8. Minnesota Statutes 2025 Supplement, section 260.692, subdivision 2, is amended 
174.21 	to read:
174.22 		Subd. 2.Case reviews. (a) The African American Child and Family Well-Being Unit 
174.23 	must conduct systemic case reviews to monitor targeted child welfare outcomes, including 
174.24 	but not limited to maltreatment, out-of-home placement, and permanency of African 
174.25 	American children.
174.26 	(b) The reviews under this subdivision must be conducted using a random sampling of 
174.27 	representative child welfare protection cases stratified for certain case related factors, 
174.28 	including but not limited to case type, maltreatment type, if the case involves out-of-home 
174.29 	placement, and other demographic variables. In conducting the reviews, unit staff may use 
174.30 	court records and documents, information from the social services information system, and 
174.31 	other available case file information to complete the case reviews.
174.32 	(c) The frequency of the reviews and the number of cases, child welfare outcomes, and 
174.33 	selected counties reviewed shall be determined by the unit in consultation with the African 
175.1 	American Child and Family Well-Being Advisory Council, with consideration given to the 
175.2 	availability of unit resources needed to conduct the reviews.
175.3 	(d) The unit must monitor all case reviews and use the collective case review information 
175.4 	and data to generate summary case review reports, ensure compliance with the Minnesota 
175.5 	African American Family Preservation and Child Welfare Disproportionality Act, and 
175.6 	identify trends or patterns in child welfare outcomes for African American children.
175.7 	(e) The unit must review information from members of the public received through the 
175.8 	compliance and feedback portal, including policy and practice concerns related to individual 
175.9 	child welfare protection cases. After assessing a case concern, the unit may determine if 
175.10 	further necessary action should be taken, which may include coordinating case remediation 
175.11 	with other relevant child welfare agencies in accordance with data privacy laws, including 
175.12 	the African American Child and Family Well-Being Advisory Council, and offering case 
175.13 	consultation and technical assistance to the responsible local social services agency as 
175.14 	needed or requested by the agency.

175.15 	Sec. 9. Minnesota Statutes 2025 Supplement, section 260.692, subdivision 3, is amended 
175.16 	to read:
175.17 		Subd. 3.Reports. (a) The African American Child and Family Well-Being Unit must 
175.18 	provide regular updates on unit activities, including summary reports of case reviews, to 
175.19 	the African American Child and Family Well-Being Advisory Council, and must publish 
175.20 	an annual census of African American children in out-of-home placements statewide. The 
175.21 	annual census must include data on the types of placements, age and sex of the children, 
175.22 	how long the children have been in out-of-home placements, and other relevant demographic 
175.23 	information.
175.24 	(b) The African American Child and Family Well-Being Unit shall gather summary data 
175.25 	about the practice and policy inquiries and individual case concerns received through the 
175.26 	compliance and feedback portal under subdivision 2, paragraph (e). The unit shall provide 
175.27 	regular reports of the nonidentifying compliance and feedback portal summary data to the 
175.28 	African American Child and Family Well-Being Advisory Council to identify child welfare 
175.29 	trends and patterns to assist with developing policy and practice recommendations to support 
175.30 	eliminating disparity and disproportionality disparities for African American children.

175.31 	Sec. 10. Minnesota Statutes 2024, section 260.693, subdivision 2, is amended to read:
175.32 		Subd. 2.Eligible services. (a) Services eligible for grants under this section include but 
175.33 	are not limited to:
176.1 	(1) child out-of-home placement prevention and reunification services;
176.2 	(2) family-based services and reunification therapy;
176.3 	(3) culturally specific individual and family counseling;
176.4 	(4) court advocacy;
176.5 	(5) training for and consultation to responsible social services agencies and private social 
176.6 	services agencies regarding this act;
176.7 	(6) development and promotion of culturally informed, affirming, and responsive 
176.8 	community-based prevention and family preservation services that target the children, youth, 
176.9 	families, and communities of African American and African heritage experiencing the 
176.10 	highest disparities, disproportionality, and overrepresentation in the Minnesota child welfare 
176.11 	system;
176.12 	(7) culturally affirming and responsive services that work with children and families in 
176.13 	their communities to address their needs and ensure child and family safety and well-being 
176.14 	within a culturally appropriate lens and framework;
176.15 	(8) services to support informal kinship care arrangements; and
176.16 	(9) other activities and services approved by the commissioner that further the goals of 
176.17 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
176.18 	Act, including but not limited to the recruitment of African American staff and staff from 
176.19 	other communities disproportionately represented in the child welfare system to work for 
176.20 	responsible social services agencies and licensed child-placing agencies.
176.21 	(b) The commissioner may specify the priority of an activity and service based on its 
176.22 	success in furthering these goals. The commissioner shall give preference to programs and 
176.23 	service providers that are located in or serve counties with the highest rates of child welfare 
176.24 	disproportionality disproportionate representation for African American and other 
176.25 	disproportionately represented children and their families and employ staff who represent 
176.26 	the population primarily served.

176.27 	Sec. 11. [260.694] MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION 
176.28 	AND CHILD WELFARE DISPROPORTIONALITY GRANT ALLOCATION.
176.29 		Subdivision 1.Formula for county staffing and services funds. (a) The commissioner 
176.30 	shall allocate state funds appropriated under this section to each county board on a calendar 
176.31 	year basis in an amount determined according to the following formula:
177.1 	(1) 50 percent must be distributed on the basis of the child population residing in the 
177.2 	county as determined by the most recent data of the state demographer;
177.3 	(2) 25 percent must be distributed on the basis of the number of screened-in reports of 
177.4 	child maltreatment under chapter 260E, and in the county as determined by the most recent 
177.5 	data of the commissioner; and
177.6 	(3) 25 percent must be distributed on the basis of the number of open child protection 
177.7 	case management cases in the county as determined by the most recent data of the 
177.8 	commissioner.
177.9 	(b) Notwithstanding this subdivision, no county shall be awarded an allocation of less 
177.10 	than $100,000.
177.11 		Subd. 2.Prohibition on supplanting existing funds. Funds received under this section 
177.12 	must be used to address staffing and services needed for child protection and expansion of 
177.13 	child protection services, including making active efforts to prevent entry into the child 
177.14 	protection system, prevent out-of-home placement, reunify children with families, and 
177.15 	finalize alternative permanency arrangements if reunification is not an option. Funds must 
177.16 	not be used to supplant current county expenditures for these purposes but may be used to 
177.17 	maintain staff and services paid for by temporary funding.

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

177.19 	Sec. 12. Laws 2024, chapter 117, section 9, the effective date, is amended to read:

177.20 	EFFECTIVE DATE. This section is effective January 1, 2027, except subdivision 2 
177.21 	is effective July 1, 2027, and except as provided under section 20.

177.22 	Sec. 13. Laws 2024, chapter 117, section 21, is amended to read:
177.23 	Sec. 21. MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND 
177.24 	CHILD WELFARE DISPROPORTIONALITY ACT; WORKING GROUP.
 177.25 	(a) The commissioner of human services must establish a working group to provide 
177.26 	guidance and oversight for the Minnesota African American Family Preservation and Child 
177.27 	Welfare Disproportionality Act phase-in program.
177.28 	(b) The members of the working group must include representatives from the Minnesota 
177.29 	Association of County Social Service Administrators, the Association of Minnesota Counties, 
177.30 	the Minnesota Inter-County Association, the Minnesota County Attorneys Association, 
177.31 	Hennepin County, Ramsey County, the Department of Human Services, and community 
178.1 	organizations with experience in child welfare. The legislature may provide recommendations 
178.2 	to the commissioner on the selection of the representatives from the community organizations.
178.3 	(c) The working group must provide oversight of the phase-in program and evaluate the 
178.4 	cost of the phase-in program. The working group must also assess future costs of 
178.5 	implementing the Minnesota African American Family Preservation and Child Welfare 
178.6 	Disproportionality Act statewide.
178.7 	(d) By January 1, 2026, the working group must develop and submit an interim report 
178.8 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
178.9 	over child welfare detailing initial needs for the implementation of the Minnesota African 
178.10 	American Family Preservation and Child Welfare Disproportionality Act. The interim report 
178.11 	must also include recommendations for any statutory or policy changes necessary to 
178.12 	implement the act.
178.13 	(e) By September 1, 2026, the working group must develop an implementation plan and 
178.14 	best practices for the Minnesota African American Family Preservation and Child Welfare 
178.15 	Disproportionality Act to go into effect statewide.
178.16 	(f) The working group under this section expires December 31, 2026.

178.17 	Sec. 14. REPEALER.
 178.18 	Minnesota Statutes 2024, section 260.63, subdivision 9, is repealed.

178.19 	ARTICLE 12
178.20 	CHILD CARE CENTER LICENSING MODERNIZATION

178.21 	Section 1. [142H.01] DEFINITIONS.
178.22 		Subdivision 1.Scope. For the purposes of this chapter, the terms in this section have 
178.23 	the meanings given.
178.24 		Subd. 2.Accessible to children. "Accessible to children" means capable of being reached 
178.25 	or utilized by a child without the aid of an adult.
178.26 		Subd. 3.Accredited. "Accredited" means a postsecondary institution or technical college 
178.27 	recognized and listed in The Database of Accredited Postsecondary Institutions and Programs 
178.28 	maintained by the United States Department of Education.
178.29 		Subd. 4.Age categories.  (a) "Infant" means a child who is at least six weeks old but 
178.30 	less than 16 months old.
178.31 	(b) "Toddler" means a child who is at least 16 months old but less than 33 months old.
179.1 	(c) "Preschooler" means a child who is at least 33 months old up to school age.
179.2 	(d) "School age" means a child who is at least of sufficient age to have attended the first 
179.3 	day of kindergarten, or is eligible to enter kindergarten within the next four months, but is 
179.4 	younger than 13 years of age. A child who becomes 13 during the school year may continue 
179.5 	to be considered a school-age child for the remainder of the school year.
179.6 		Subd. 5.Applicant. "Applicant" has the meaning given in section 142B.01, subdivision 
179.7 	4.
179.8 		Subd. 6.Arrival and departure times. "Arrival and departure times" means the times 
179.9 	when children typically arrive at or depart from a center. A center cannot designate more 
179.10 	than 25 percent of licensed hours of operation as arrival and departure times. The designated 
179.11 	arrival and departure times must be used at the beginning or end of a center's licensed hours 
179.12 	of operation.
179.13 		Subd. 7.Building official. "Building official" means the person appointed pursuant to 
179.14 	section 326B.133 to administer the State Building Code or the building official's authorized 
179.15 	representative.
179.16 		Subd. 8.Center. "Center" means a child care program that is not excluded by section 
179.17 	142B.05, subdivision 2, and is not a family child care program, as defined in section 142I.01, 
179.18 	subdivision 22.
179.19 		Subd. 9.Child. "Child" means a person receiving child care services who falls within 
179.20 	the age categories in subdivision 4.
179.21 		Subd. 10.Child care program. "Child care program" means the organization or 
179.22 	arrangement of activities, personnel, materials, and equipment in a facility to promote the 
179.23 	physical, intellectual, social, and emotional development of a child in the absence of the 
179.24 	parent for a period of less than 24 hours a day.
179.25 		Subd. 11.Child care program plan. "Child care program plan" means the written 
179.26 	document that states specific activities that will be provided by the license holder to promote 
179.27 	the physical, intellectual, social, and emotional development of the children enrolled in the 
179.28 	center.
179.29 		Subd. 12.Clean. "Clean" means free from dirt or other contaminants that can be detected 
179.30 	by sight, smell, or touch.
179.31 		Subd. 13.Commissioner. "Commissioner" means the commissioner of children, youth, 
179.32 	and families or the commissioner's designated representative, including county agencies 
179.33 	and private agencies.
180.1 		Subd. 14.Day program. "Day program" means a nonresidential child care program 
180.2 	that operates during waking hours and does not provide overnight care.
180.3 		Subd. 15.Department. "Department" means the Department of Children, Youth, and 
180.4 	Families.
180.5 		Subd. 16.Direct contact. "Direct contact" has the meaning given in section 245C.02, 
180.6 	subdivision 11.
180.7 		Subd. 17.Disinfected. "Disinfected" means the chemical process to kill most germs and 
180.8 	viruses on surfaces and objects after they have been cleaned.
180.9 		Subd. 18.Drop-in child care program. "Drop-in child care program" means a 
180.10 	nonresidential program of child care in which children participate on a onetime only or 
180.11 	occasional basis up to a maximum of 90 hours per child, per month.
180.12 		Subd. 19.Experience. "Experience" means paid or unpaid employment:
180.13 	(1) caring for children as a teacher, assistant teacher, aide, or student intern:
180.14 	(i) in a licensed child care center, a licensed family child care program, or a Tribally 
180.15 	licensed child care program in any United States state or territory; or
180.16 	(ii) in a public or nonpublic school;
180.17 	(2) caring for children as a staff person or unsupervised volunteer in a certified 
180.18 	license-exempt child care center under chapter 142C; or
180.19 	(3) providing direct contact services in a home or residential facility serving children 
180.20 	with disabilities that requires a background study under section 245C.03.
180.21 		Subd. 20.Facility. "Facility" means the indoor and outdoor space where a child care 
180.22 	program is provided.
180.23 		Subd. 21.Fire marshal. "Fire marshal" means the person designated by section 299F.011 
180.24 	to administer and enforce the State Fire Code or the fire marshal's authorized representative.
180.25 		Subd. 22.Health care provider. "Health care provider" means a physician or physician's 
180.26 	assistant licensed to practice medicine under chapter 147 or an advanced practice registered 
180.27 	nurse licensed under chapter 148.
180.28 		Subd. 23.Health consultant. "Health consultant" means a registered nurse, a public 
180.29 	health nurse, or a health care provider as defined in subdivision 22 who performs health 
180.30 	consultation services for a child care center pursuant to section 142H.29, subdivision 2.
181.1 		Subd. 24.Inaccessible to children. "Inaccessible to children" means not capable of 
181.2 	being reached or utilized by a child without the aid of an adult.
181.3 		Subd. 25.License. "License" has the meaning given in section 142B.01, subdivision 
181.4 	16.
181.5 		Subd. 26.License holder. "License holder" has the meaning given in section 142B.01, 
181.6 	subdivision 17.
181.7 		Subd. 27.Licensed capacity. "Licensed capacity" means the maximum number of 
181.8 	children permitted at any one time in the program for which the license holder is licensed 
181.9 	to operate.
181.10 		Subd. 28.Medication. "Medication" means any substance or preparation that is used 
181.11 	to prevent or treat a wound, injury, infection, and disease; maintain health; heal; or relieve 
181.12 	pain. This includes medication that is over the counter, or prescribed by a physician, physician 
181.13 	assistant, dentist, or advance practice registered nurse certified to prescribe medication, and 
181.14 	permitted by the parent for administration or application. This term applies to medication 
181.15 	taken internally or applied externally.
181.16 		Subd. 29.Night care program. "Night care program" means a nonresidential child care 
181.17 	program that provides overnight care to children during sleeping hours, approximately 11:00 
181.18 	p.m. to 5:00 a.m. Night care programs are subject to the requirements in section 142H.16.
181.19 		Subd. 30.Parent. "Parent" means the person or persons who has the legal responsibility 
181.20 	for a child such as the child's mother, father, or legally appointed guardian.
181.21 		Subd. 31.Program staff person. "Program staff person" means an employee of the 
181.22 	child care center who  carries out the child care program plan and has direct contact with 
181.23 	children. This includes unsupervised volunteers and substitutes.
181.24 		Subd. 32.Sick care program. "Sick care program" means a nonresidential child care 
181.25 	program that exclusively cares for sick children. Sick care programs are subject to the 
181.26 	requirements in section 142H.19.
181.27 		Subd. 33.Staff supervision. "Staff supervision" means responsibility to hire, train, 
181.28 	assign duties, and direct staff in day-to-day activities and evaluate staff performance. A 
181.29 	"supervisor" is a person with staff supervision responsibility.
181.30 		Subd. 34.State Building Code. "State Building Code" means the codes and regulations 
181.31 	adopted by the commissioner of the administration according to section 326B.101, and 
181.32 	contained in Minnesota Rules, chapter 1300.
182.1 		Subd. 35.State Fire Code. "State Fire Code" means the codes and regulations adopted 
182.2 	by the state fire marshal pursuant to section 299F.011, and contained in Minnesota Rules, 
182.3 	chapter 7511.
182.4 		Subd. 36.Student intern. "Student intern" means a student of a postsecondary institution 
182.5 	assigned by that institution for a supervised experience with children. The experience must 
182.6 	be in a licensed center, an elementary school operated by the commissioner of education 
182.7 	or a legally constituted local school board, or a private school approved under rules 
182.8 	administered by the commissioner of education. Student intern includes a person who is 
182.9 	practice teaching, student teaching, or carrying out a practicum or internship.
182.10 		Subd. 37.Substitute. "Substitute" means a person who is temporarily filling a position 
182.11 	as a director, teacher, assistant teacher, or aide in a licensed child care center for less than 
182.12 	500 hours total in a calendar year due to the absence of a regularly employed program staff 
182.13 	person.
182.14 		Subd. 38.Supervision of children. "Supervision of children" means when a program 
182.15 	staff person:
182.16 	(1) is accountable for the child's care;
182.17 	(2) is able to intervene to protect the health and safety of the child; and
182.18 	(3) is within sight and hearing of the child at all times, except as described in section 
182.19 	142H.24, subdivision 1.
182.20 		Subd. 39.Variance. "Variance" means written permission by the department for a license 
182.21 	holder or applicant to depart from the provisions of a requirement in this chapter pursuant 
182.22 	to section 142B.10, subdivision 16.
182.23 		Subd. 40.Volunteer. (a) "Volunteer" means an individual who assists in the care of a 
182.24 	child and is not employed by the child care center.
182.25 	(b) "Supervised volunteer" means a volunteer who may only have direct contact with 
182.26 	children when a program staff person is able to intervene to protect the health and safety of 
182.27 	children.
182.28 	(c) "Unsupervised volunteer" means a volunteer who may have direct contact with 
182.29 	children without a program staff person present, must receive the training required under 
182.30 	section 142H.08, and may be counted in the staff-to-child ratios under section 142H.10.

183.1 	Sec. 2. [142H.02] APPLICABILITY AND LICENSING PROCESS.
183.2 	(a) No child care center may operate in Minnesota without a license pursuant to this 
183.3 	chapter and chapter 142B. An applicant for a license and the license holder is governed by, 
183.4 	and must comply with, the general requirements in this chapter and chapters 142B, 245C, 
183.5 	and 260E.
183.6 	(b) The department may grant variances to the requirements in this chapter if the 
183.7 	conditions in section 142B.10, subdivision 16, are met.

183.8 	Sec. 3. [142H.03] OPERATING OPTIONS.
183.9 	A license holder must operate a day program, drop-in child care program, night care 
183.10 	program, sick child care program, or a combination of two or more kinds of programs.

183.11 	Sec. 4. [142H.04] POLICIES AND PROCEDURES FOR PROGRAM 
183.12 	ADMINISTRATION.
183.13 	(a) The license holder must maintain and enforce program policies and procedures 
183.14 	necessary to comply with licensing requirements under Minnesota Statutes and Minnesota 
183.15 	Rules.
183.16 	(b) The license holder must:
183.17 	(1) provide training to employees and volunteers related to their duties in implementing 
183.18 	the program's policies and procedures developed under paragraph (a);
183.19 	(2) document the provision of this training; and
183.20 	(3) monitor implementation of policies and procedures by employees and volunteers.
183.21 	(c) The license holder must keep program policies and procedures readily accessible to 
183.22 	employees and volunteers and index the policies and procedures with a table of contents or 
183.23 	another method approved by the commissioner.

183.24 	Sec. 5. [142H.05] DIRECTORS.
183.25 		Subdivision 1.General requirements for a director. (a) A center must have a director 
183.26 	who is responsible for overseeing implementation of written policies relating to the 
183.27 	management and control of the daily activities of the program, ensuring the health and safety 
183.28 	of program participants, and supervising staff and volunteers.
183.29 	(b) A director must:
183.30 	(1) be at least 21 years old;
184.1 	(2) be a graduate of a high school or hold an equivalent diploma attained through 
184.2 	successful completion of the commissioner of education-selected high school equivalency 
184.3 	test pursuant to section 124D.549;
184.4 	(3) have at least 1,040 hours of paid or unpaid staff supervision experience; and
184.5 	(4) have at least 12 semester credits in accredited coursework in postsecondary child 
184.6 	development education, supervision, management, administration, or leadership or 120 
184.7 	hours of training earned in the topics of child development, supervision, management, 
184.8 	administration, or leadership.
184.9 	(c) Paragraph (b), clauses (3) and (4), are satisfied if an individual has completed a 
184.10 	Minnesota Association for the Education of Young Children early childhood director's 
184.11 	credential; Child Care Aware Minnesota director's credential; Montessori administrator 
184.12 	credential; or diploma issued by the American Montessori Society, Association Montessori 
184.13 	International, or an institution accredited by the Montessori Accreditation Council for 
184.14 	Teacher Education.
184.15 		Subd. 2.Director or designee on site. (a) The director or a designee must be on site 
184.16 	while the center is in operation.
184.17 	(b) Any program staff person who is at least 18 years old may serve as the designee. 
184.18 	The designee does not have to meet the director qualifications in subdivision 1 but must be 
184.19 	aware of the designation and be able to perform the responsibilities.
184.20 		Subd. 3.Director functioning as a teacher. Notwithstanding section 142H.06, a director 
184.21 	may be used as a teacher in any classroom as needed.
184.22 		Subd. 4.Incumbent director recognition. Notwithstanding subdivision 1, an individual 
184.23 	who is designated as the director of a licensed child care center on July 1, 2027, meets the 
184.24 	director qualification requirements of this section as long as the individual continues to 
184.25 	work at the program.

184.26 	Sec. 6. [142H.06] TEACHERS.
184.27 		Subdivision 1.Teacher general qualifications. A teacher must:
184.28 	(1) be at least 18 years old; and
184.29 	(2) be a graduate of a high school or hold an equivalent diploma attained through 
184.30 	successful completion of the commissioner of education-selected high school equivalency 
184.31 	test pursuant to section 124D.549.
185.1 		Subd. 2.Teacher education and experience requirements. In addition to the general 
185.2 	requirements in subdivision 1, a teacher must have at least one of:
185.3 	(1) 12 postsecondary semester credits and 480 hours of experience;
185.4 	(2) 100 hours of commissioner-approved training within the previous five years and 480 
185.5 	hours of experience. After initial qualification, a teacher qualified under this clause must 
185.6 	fulfill at least 50 percent of in-service training requirements under section 142H.09, 
185.7 	subdivision 10, with commissioner-approved trainings;
185.8 	(3) a credential or diploma from the American Montessori Society, Association 
185.9 	Montessori International, or an institution accredited by the Montessori Accreditation 
185.10 	Council for Teacher Education;
185.11 	(4) an accredited certificate in child development or early childhood education from a 
185.12 	postsecondary institution;
185.13 	(5) an accredited diploma, associate's degree, or bachelor's degree in child development 
185.14 	or early childhood education from a postsecondary institution; or
185.15 	(6) a Child Development Associate (CDA) credential;

185.16 	Sec. 7. [142H.07] ASSISTANT TEACHERS.
185.17 		Subdivision 1.Assistant teacher general qualifications. An assistant teacher must 
185.18 	work under the supervision of a teacher and be:
185.19 	(1) at least 18 years old; and
185.20 	(2) a graduate of a high school or hold an equivalent diploma attained through successful 
185.21 	completion of the commissioner of education-selected high school equivalency test.
185.22 		Subd. 2.Assistant teacher education and experience requirements. In addition to 
185.23 	the general requirements in subdivision 1, an assistant teacher must have at least one of:
185.24 	(1) at least six postsecondary semester credits;
185.25 	(2) at least 50 hours of commissioner-approved training within the previous five years. 
185.26 	After initial qualification, an assistant teacher qualified under this clause must fulfill at least 
185.27 	50 percent of in-service training requirements under section 142H.09, subdivision 10, with 
185.28 	commissioner-approved trainings; or
185.29 	(3) at least 160 hours of experience and be making progress toward any of the teacher 
185.30 	qualifications in section 142H.06, subdivision 2, clauses (3) to (6). An assistant teacher 
185.31 	qualified under this clause must be able to provide:
186.1 	(i) documentation of current enrollment; and
186.2 	(ii) evidence of working toward the successful completion of the credential.

186.3 	Sec. 8. [142H.08] AIDES, VOLUNTEERS, AND SUBSTITUTES.
186.4 		Subdivision 1.Aide qualifications. (a) An aide must work under the supervision of a 
186.5 	teacher or assistant teacher, except when performing the tasks in paragraph (b). An aide 
186.6 	must be used pursuant to the staff distribution requirements in section 142H.10, subdivision 
186.7 	2.
186.8 	(b) An aide may work without being supervised by a teacher or assistant teacher when 
186.9 	they are assisting with the supervision of sleeping children; assisting children with washing, 
186.10 	toileting, and diapering; or accompanying children to and from the bus stop.
186.11 	(c) An aide must be at least 16 years old.
186.12 		Subd. 2.Volunteers. (a) A volunteer may work as a teacher, assistant teacher, aide, or 
186.13 	substitute if the volunteer meets the requirements of that position.
186.14 	(b) The license holder must maintain a list of all volunteers with relevant information, 
186.15 	including first and last name, whether the volunteer must be supervised at all times or may 
186.16 	occasionally be unsupervised, and the first date of direct contact with children.
186.17 	(c) Unsupervised volunteers must successfully complete training as required in section 
186.18 	142H.09.
186.19 	(d) Supervised volunteers must successfully complete the training required in section 
186.20 	142H.09, subdivision 7.
186.21 		Subd. 3.Substitutes. (a) A substitute must either meet the requirements for the assigned 
186.22 	staff position or be designated as an unqualified substitute by the director or the director 
186.23 	designee. A director or director designee can designate a substitute as unqualified if:
186.24 	(1) a teacher is continuously on site, except as provided in section 142H.10, subdivision 
186.25 	2, paragraph (e);
186.26 	(2) when substituting as a teacher or assistant teacher, the unqualified substitute is aware 
186.27 	of the unqualified substitute's designated staffing position; and
186.28 	(3) the unqualified substitute is at least 18 years of age.
186.29 	(b) All substitutes must successfully complete the required training under section 
186.30 	142H.09.
187.1 		Subd. 4.Tracking unqualified substitute hours. (a) The license holder must document 
187.2 	the use of unqualified substitute hours on the day the unqualified substitute works.
187.3 	(b) In a calendar year, a license holder must not use unqualified substitutes more than 
187.4 	60 hours multiplied by the number of the center's classrooms.
187.5 	(c) A license holder must maintain a log of the use of unqualified substitutes in the center 
187.6 	administrative record for review by the commissioner. The log must be on a form prescribed 
187.7 	by the commissioner.

187.8 	Sec. 9. [142H.09] STAFF ORIENTATION AND TRAINING.
187.9 		Subdivision 1.Orientation training. (a) Program staff persons must complete orientation 
187.10 	training before providing direct contact services to a child.
187.11 	(b) The orientation training must include the following topics:
187.12 	(1) abusive head trauma for staff working with a child under school age pursuant to 
187.13 	subdivision 8;
187.14 	(2) the center's policy on administration of medication pursuant to section 142H.29, 
187.15 	subdivision 5;
187.16 	(3) the center's policy on allergy prevention and response pursuant to section 142H.15, 
187.17 	subdivision 5;
187.18 	(4) the center's policy on behavior guidance pursuant to section 142H.13;
187.19 	(5) child passenger restraint systems pursuant to subdivision 9;
187.20 	(6) the center's child care program plan pursuant to section 142H.11;
187.21 	(7) the center's policy on cleaning, sanitizing, and disinfecting pursuant to section 
187.22 	142H.31;
187.23 	(8) the center's emergency preparedness plan and procedures pursuant to section 142H.23, 
187.24 	subdivision 1;
187.25 	(9) procedures for the handling and disposal of bodily fluids pursuant to section 142H.29, 
187.26 	subdivision 10;
187.27 	(10) the center's emergency and accident policies pursuant to section 142H.23, subdivision 
187.28 	2;
187.29 	(11) the center's health policies pursuant to section 142H.29;
188.1 	(12) individual child care program plan or plans pursuant to section 142H.15, if 
188.2 	applicable;
188.3 	(13) job responsibilities specific to the individual's position at the center;
188.4 	(14) prevention and control of infectious diseases pursuant to section 142H.18;
188.5 	(15) the center's policy on research, cameras, and social media participation procedures 
188.6 	pursuant to section 142H.22;
188.7 	(16) the center's policy on the use of alcohol, drugs, and tobacco products pursuant to 
188.8 	section 142B.10, subdivision 1, paragraph (c);
188.9 	(17) recognition and reporting of maltreatment, abuse and neglect pursuant to chapter 
188.10 	260E;
188.11 	(18) the center's risk reduction plan pursuant to section 142H.24;
188.12 	(19) reduction of risk of sudden unexpected infant death pursuant to the requirements 
188.13 	of subdivision 7 and section 142B.46; and
188.14 	(20) transportation and field trip safety procedures pursuant to section 142H.33.
188.15 	(c) Training for orientation may be used to meet in-service training requirements.
188.16 		Subd. 2.Child care basics training. (a) Any program staff person hired after July 1, 
188.17 	2027, must complete child care licensing basics training no more than 90 days after the first 
188.18 	date of direct contact with a child, unless the person has completed the training within the 
188.19 	previous two years.
188.20 	(b) Child care basics training covers information on effectively working in a child care 
188.21 	center setting in Minnesota. Child care basics training must be developed and updated by 
188.22 	the commissioner. Child care basics training may be used to meet in-service training 
188.23 	requirements.
188.24 		Subd. 3.Child development and learning training. (a) Program staff persons must 
188.25 	complete at least two hours of child development and learning training within 90 days after 
188.26 	the first date of direct contact with a child and every two calendar years thereafter. For the 
188.27 	purposes of this subdivision, "child development and learning training" means any training 
188.28 	in understanding how children develop physically, cognitively, emotionally, and socially 
188.29 	and learn as part of the children's family, culture, and community.
188.30 	(b) An individual is exempt from this subdivision if the individual:
189.1 	(1) has taken a three-credit college course on early childhood development within the 
189.2 	past five years;
189.3 	(2) has received a bachelor's or master's degree in early childhood education or school-age 
189.4 	child care within the past five years;
189.5 	(3) is licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
189.6 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
189.7 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
189.8 	(4) has received a Montessori certificate or diploma issued by American Montessori 
189.9 	Society, Association Montessori International, or an institution accredited by the Montessori 
189.10 	Accreditation Council for Teacher Education within the past five years.
189.11 		Subd. 4.Pediatric first aid.  (a) Before direct contact with a child, a program staff person 
189.12 	must satisfactorily complete pediatric first aid. Pediatric first aid training completed within 
189.13 	the previous two calendar years meets this requirement.
189.14 	(b) Notwithstanding paragraph (a), a program staff person who has yet to complete initial 
189.15 	pediatric first aid training may provide direct contact services within 90 days after the first 
189.16 	date of direct contact with a child while under the continuous direct supervision of an 
189.17 	individual who has met the pediatric first aid training requirements of this subdivision. For 
189.18 	purposes of this paragraph, "continuous direct supervision" means the program staff person 
189.19 	is within sight or hearing of the program's supervising individual and the program's 
189.20 	supervising individual is capable at all times of intervening to protect the health and safety 
189.21 	of the children served by the program.
189.22 	(c) The first aid training must have been provided by an individual approved to provide 
189.23 	pediatric first aid instruction.
189.24 	(d) A program staff person must complete training in pediatric first aid every two calendar 
189.25 	years. Documentation of the training must be maintained at the center.
189.26 	(e) Online training reviewed and approved by the commissioner satisfies the training 
189.27 	requirement of this subdivision.
189.28 	(f) Pediatric first aid training in this subdivision must not be used to meet in-service 
189.29 	training requirements under subdivision 10.
189.30 		Subd. 5.Pediatric cardiopulmonary resuscitation. (a) Before direct contact with a 
189.31 	child, a program staff person must satisfactorily complete pediatric cardiopulmonary 
189.32 	resuscitation (CPR) training, including CPR techniques for infants and children and the 
190.1 	treatment of obstructed airways. Pediatric CPR training completed within the previous two 
190.2 	calendar years meets this requirement.
190.3 	(b) Notwithstanding paragraph (a), a program staff person who has yet to complete initial 
190.4 	pediatric CPR training may provide direct contact services within 90 days after the first 
190.5 	date of direct contact with a child, if they are under the continuous direct supervision of an 
190.6 	individual who has met pediatric CPR training requirements under this subdivision. For the 
190.7 	purposes of this paragraph, "continuous direct supervision" means the individual is within 
190.8 	sight or hearing of the program's supervising individual to the extent that the program's 
190.9 	supervising individual is capable at all times of intervening to protect the health and safety 
190.10 	of the children served by the program.
190.11 	(c) A program staff person must complete training in pediatric CPR every two calendar 
190.12 	years. A center must maintain documentation of the trainings on site.
190.13 	(d) A pediatric CPR training under this subdivision must incorporate a hands-on skill 
190.14 	session to support the instruction and have been developed:
190.15 	(1) by the American Heart Association or the American Red Cross; or
190.16 	(2) using nationally recognized, evidence-based guidelines for pediatric CPR training.
190.17 	(e) Pediatric CPR training must not be used to meet in-service training requirements 
190.18 	under subdivision 10.
190.19 		Subd. 6.Sudden unexpected infant death training. (a) Before direct contact with 
190.20 	infants, program staff persons and volunteers must receive training on the standards under 
190.21 	section 142B.46 and on reducing the risk of sudden unexpected infant death during orientation 
190.22 	and each calendar year thereafter.
190.23 	(b) Sudden unexpected infant death reduction training required under this subdivision 
190.24 	must be at least one-half hour in length and include at minimum the infant sleep standards 
190.25 	under section 142B.46, the risk factors related to sudden unexpected infant death, methods 
190.26 	of reducing the risk of sudden unexpected infant death in child care, and license holder 
190.27 	communication with parents regarding reducing the risk of sudden unexpected infant death.
190.28 	(c) Training taken under this subdivision may be used to meet the in-service training 
190.29 	requirements under subdivision 10.
190.30 		Subd. 7.Abusive head trauma training. (a) Before direct contact with children under 
190.31 	school age, a program staff person must receive training on the risk of abusive head trauma 
190.32 	during orientation and each calendar year thereafter.
191.1 	(b) Abusive head trauma training under this subdivision must be at least one-half hour 
191.2 	in length and include at minimum the risk factors related to shaking infants and young 
191.3 	children, methods of reducing the risk of abusive head trauma in child care, and license 
191.4 	holder communication with parents regarding reducing the risk of abusive head trauma.
191.5 	(c) training taken under this subdivision may be used to meet the in-service training 
191.6 	requirements under subdivision 10.
191.7 		Subd. 8.Child passenger restraint systems; training requirement. (a) Before a license 
191.8 	holder transports a child or children under age nine in a motor vehicle, the person placing 
191.9 	the child or children in a passenger restraint must satisfactorily complete training on the 
191.10 	proper use and installation of child restraint systems in motor vehicles.
191.11 	(b) Training required under this subdivision must be repeated at least once every five 
191.12 	years and include at minimum the proper use of child restraint systems based on the size, 
191.13 	weight, and age of the child and the proper installation of a car seat or booster seat in the 
191.14 	motor vehicle used by the license holder to transport the child or children.
191.15 	(c) Training required under this subdivision must be provided by individuals who are 
191.16 	certified and approved by the Department of Public Safety, Office of Traffic Safety.
191.17 	(d) Training completed under this subdivision may be used to meet in-service training 
191.18 	requirements under subdivision 10. Staff training completed within the previous five years 
191.19 	is transferable upon change in employment to another child care center.
191.20 		Subd. 9.In-service training requirements. (a) A license holder must ensure that program 
191.21 	staff persons complete in-service training.
191.22 	(b) In-service training completed within the past 12 months by a program staff person 
191.23 	that is not specific to a child care center is transferable upon the program staff person's 
191.24 	change in employment to another child care program. The program staff person must provide 
191.25 	documentation of the completed training to the new child care program.
191.26 	(c) All program staff persons, except substitutes and unsupervised volunteers, who work 
191.27 	more than 20 hours per week must complete at least 20 hours of in-service training each 
191.28 	calendar year.
191.29 	(d) All program staff persons, except substitutes and unsupervised volunteers, who work 
191.30 	20 hours or less per week must complete at least ten hours of in-service training each calendar 
191.31 	year.
192.1 	(e) Substitutes and unsupervised volunteers must complete a minimum of two hours of 
192.2 	training each calendar year and the training must include the topics identified under 
192.3 	subdivision 11.
192.4 	(f) The number of in-service training hours may be prorated for center directors and 
192.5 	program staff persons not employed for an entire year or on a documented leave of absence.
192.6 	(g) Pediatric first aid and pediatric CPR training must not be used to meet in-service 
192.7 	training requirements.
192.8 		Subd. 10.In-service content. (a) Each calendar year, in-service training must include 
192.9 	the following:
192.10 	(1) abusive head trauma training of at least one-half hour duration for individuals working 
192.11 	with a child under school age pursuant to subdivision 8;
192.12 	(2) the center policies and procedures for maintaining health and safety, including:
192.13 	(i) allergy prevention and response training pursuant to section 142H.15, subdivision 5;
192.14 	(ii) emergency preparedness and procedures pursuant to section 142H.23, subdivision 
192.15 	1;
192.16 	(iii) handling emergencies, accidents, incidents, and injuries pursuant to section 142H.23, 
192.17 	subdivision 2; and
192.18 	(iv) handling and disposal of bodily fluids pursuant to section 142H.29, subdivision 10;
192.19 	(3) maltreatment, abuse, and neglect reporting pursuant to chapter 260E;
192.20 	(4) reduction of risk of sudden unexpected infant death training of at least one-half hour 
192.21 	duration for individuals working with infants pursuant to the requirements of subdivision 
192.22 	7 and section 142B.46;
192.23 	(5) a risk reduction plan pursuant to section 142H.24;
192.24 	(6) the center policies and procedures on behavior guidance pursuant to section 142H.13; 
192.25 	and
192.26 	(7) the center policies and procedures on supervision pursuant to section 142H.24.
192.27 	(b) At least once every two calendar years, in-service training must include the following:
192.28 	(1) child development and learning pursuant to subdivision 4;
192.29 	(2) at least one hour on cultural awareness and inclusion;
192.30 	(3) pediatric first aid that meets the requirements of subdivision 5;
193.1 	(4) pediatric cardiopulmonary resuscitation training that meets the requirements of 
193.2 	subdivision 5; and
193.3 	(5) at least one hour on identifying and supporting children with special needs.
193.4 	(c) At least once every five calendar years, training must include child passenger restraint 
193.5 	systems pursuant to subdivision 9, if applicable.
193.6 	(d) The remaining hours of the in-service training requirement must be met by completing 
193.7 	training in the Minnesota knowledge and competency framework areas.
193.8 		Subd. 11.Documentation required. (a) The license holder must document completed 
193.9 	training for program staff persons in a manner prescribed by the commissioner.
193.10 	(b) For pediatric first aid and CPR trainings, the license holder must maintain copies of 
193.11 	training cards or certificates issued by the training organization.

193.12 	Sec. 10. [142H.10] STAFF RATIOS, GROUP SIZE, AND STAFF DISTRIBUTION.
193.13 		Subdivision 1.Staff-to-child ratios and maximum group size. (a) Except as provided 
193.14 	in this subdivision and section 142H.12 regarding naps and rest, the minimally acceptable 
193.15 	staff-to-child ratios and the maximum group size within each age category are:

193.16	Age Category
	Staff-to-Child Ratio
	Maximum Group Size
	
193.17	Infant
	1:4
	8
	
193.18	Toddler
	1:7
	14
	
193.19	Preschooler
	1:10
	20
	
193.20	School-age child
	1:15
	30
	
193.21 	(b) Except for groups that include an infant, the staff-to-child ratio may be doubled for 
193.22 	no more than two hours during nap time. During the nap time, there must be enough program 
193.23 	staff persons in the facility to meet staff-to-child ratio and staff distribution requirements 
193.24 	under paragraph (a) and subdivision 2 for the groups in case of an emergency. The program 
193.25 	must return to following the staff-to-child ratios and staff distribution requirements under 
193.26 	paragraph (a) and subdivision 2 when the number of awake children exceeds the number 
193.27 	of children who could be supervised by one program staff person under subdivision 1.
193.28 	(c) The maximum group size applies at all times except during meals, outdoor activities, 
193.29 	field trips, naps and rest, and special activities at the center such as guest speakers and 
193.30 	holiday programs.
194.1 		Subd. 2.Staff distribution. (a) The license holder must ensure that the following 
194.2 	requirements for staff distribution are met and a documented staff schedule is kept in the 
194.3 	administrative record.
194.4 	(b) Except as provided in paragraphs (d) and (e), staff distribution within each age 
194.5 	category must be as follows:
194.6 	(1) the first staff member needed to meet the required staff child ratio must be a teacher;
194.7 	(2) the second staff member must have at least the qualifications of an aide;
194.8 	(3) the third staff member must have at least the qualifications of an assistant teacher; 
194.9 	and
194.10 	(4) the fourth staff member must have at least the qualifications of an aide.
194.11 	(c) Only a program staff person can be included in meeting the staff-to-child ratios in 
194.12 	this section.
194.13 	(d) An aide must not work alone with a child unless the aide is performing certain duties 
194.14 	as specified in section 142H.08, subdivision 1, paragraph (b).
194.15 	(e) An assistant teacher or an aide may be substituted for a teacher during arrival and 
194.16 	departure times if the total arrival and departure time does not exceed 25 percent of the 
194.17 	center's daily hours of operation. For an aide to be substituted for a teacher under this 
194.18 	subdivision, the aide must:
194.19 	(1) be 18 years of age or older;
194.20 	(2) have been employed by the child care center for a minimum of 30 days; and
194.21 	(3) have completed the training required under section 142H.09, including orientation 
194.22 	and the training required within the first 90 days of the first date of direct contact with a 
194.23 	child.
194.24 	(f) A volunteer who is included in the staff-to-child ratio must meet the requirements 
194.25 	for the assigned staff position in sections 142H.06 to 142H.08.
194.26 	(g) The pattern in paragraph (e) must be repeated until the number of staff needed to 
194.27 	meet the staff-to-child ratio for each age category has been achieved.
194.28 		Subd. 3.Age category grouping. (a) Each center must specify arrival and departure 
194.29 	times of the day in their program's policies. Children in different age categories may be 
194.30 	grouped according to paragraphs (b) and (c).
195.1 	(b) During arrival and departure times, children in different age categories may be 
195.2 	grouped together if:
195.3 	(1) the staff-to-child ratio, group size, and staff distribution applied are for the age 
195.4 	category of the youngest child present; and
195.5 	(2) the group is divided when the number of children present reaches the maximum 
195.6 	group size of the youngest child present.
195.7 	(c) Outside of arrival and departure times, children in different age categories may be 
195.8 	mixed within a group if:
195.9 	(1) infants are not grouped with children of other age categories;
195.10 	(2) there is no more than a 36-month range in age among children in a group, unless all 
195.11 	children in the group are school age; and
195.12 	(3) the staff-to-child ratios, group size, and staff distribution applied are for the youngest 
195.13 	child present.
195.14 		Subd. 4.Age designation. (a) Except as provided in this subdivision, a child must be 
195.15 	designated as a member of the age category that is consistent with the date of birth of the 
195.16 	child.
195.17 	(b) A child with special health care needs must be included in the group that best meets 
195.18 	the child's developmental needs, best interest of the child, and in accordance with the 
195.19 	individual child care program plan for the child.
195.20 	(c) A child may be designated as an "infant" up to the age of 18 months if the parent, 
195.21 	teacher, and director determine that such a designation is in the best interest of the child. 
195.22 	The center must document the determination and designation in the file of the child.
195.23 	(d) A child may be designated as a "toddler" up to the age of 35 months if the parent, 
195.24 	teacher, and director determine that the designation is in the best interest of the child. The 
195.25 	center must document the determination and designation in the file of the child.
195.26 	(e) A child may be designated as a "preschooler" at the age of 31 months if the parent, 
195.27 	teacher, and director determine that the designation is in the best interest of the child. The 
195.28 	center must document the determination and designation in the file of the child.
195.29 	(f) When a child is transitioning age groups pursuant to subdivision 5 and with the child's 
195.30 	new class, the child must be designated as if the child has already aged into the class.
196.1 		Subd. 5.Transitioning children. (a) Transitions to the next age group may occur up to 
196.2 	two weeks prior to the child aging into the next age group. The transition must be planned 
196.3 	in advance based on the child's readiness and in consultation with parents and program staff.
196.4 	(b) A center must develop a written policy on transitioning children to the next age 
196.5 	group.

196.6 	Sec. 11. [142H.11] CHILD CARE PROGRAM PLAN AND ACTIVITIES.
196.7 		Subdivision 1.General requirements. The child care program plan must:
196.8 	(1) include a statement mandating that children are supervised at all times as defined in 
196.9 	section 142H.01, subdivision 38, and pursuant to the requirements of section 142H.24, 
196.10 	subdivision 1;
196.11 	(2) specify the age categories and number of children to be served by the program;
196.12 	(3) specify the days and hours of operation of the program;
196.13 	(4) describe the general educational methods to be used by the program and the religious, 
196.14 	political, or philosophical basis, if any;
196.15 	(5) be developed and evaluated in writing each calendar year by a program staff person 
196.16 	qualified as a teacher or director under sections 142H.05 and 142H.06. Documentation of 
196.17 	the evaluation, the date of the evaluation, and the signature of the teacher or director 
196.18 	completing the evaluation must be maintained in the center administrative records;
196.19 	(6) specify planned activities designed to support and nurture the whole child in all areas 
196.20 	of the development and learning of the child, including but not limited to the following: 
196.21 	intellectual, social, emotional, and physical development. The activities must be in a manner 
196.22 	consistent with the cultural and ethnic backgrounds of a child, as feasible;
196.23 	(7) specify that the intellectual, social, emotional, and physical development of each 
196.24 	child be documented in the record of the child and conveyed to the parent during the 
196.25 	conferences specified under section 142H.20, subdivision 2;
196.26 	(8) include a daily schedule of planned indoor and outdoor activities for each age category 
196.27 	served;
196.28 	(9) specify activities that are quiet, active, teacher directed, and child initiated;
196.29 	(10) specify a variety of activities that require the use of varied equipment and materials;
196.30 	(11) include a schedule if equipment is rotated between groups of children;
196.31 	(12) describe use of technology and screen time for each age category; and
197.1 	(13) be available to a parent for review upon request.
197.2 		Subd. 2.Outdoor activities. (a) Child care activities must promote the physical, 
197.3 	intellectual, social, and emotional development of the child. To facilitate child development, 
197.4 	programs must include daily outdoor activities when weather conditions allow, as defined 
197.5 	in this subdivision.
197.6 	(b) The applicant must develop a written outdoor weather and activity policy. The license 
197.7 	holder must ensure that the policies and procedures are carried out. The policies and 
197.8 	procedures must incorporate guidance from national, state, or local authorities in public 
197.9 	health and at a minimum require the provider to consider the following conditions when 
197.10 	determining if outdoor play poses a health and safety risk:
197.11 	(1) heat in excess of 100 degrees Fahrenheit accounting for heat index, or pursuant to 
197.12 	advice of the local authority;
197.13 	(2) cold less than 15 degrees Fahrenheit accounting for wind chill, or pursuant to advice 
197.14 	of the local authority;
197.15 	(3) extreme weather, including but not limited to a lightning storm, blizzard, tornado, 
197.16 	or flooding;
197.17 	(4) an air quality emergency order by a local or state authority on air quality or public 
197.18 	health; or
197.19 	(5) a lockdown notification ordered by a public safety authority.
197.20 	(c) The center's outdoor weather and activity policy must specify, if children are to go 
197.21 	outside beyond the temperature range specified in paragraph (b), clauses (1) and (2), what 
197.22 	procedures will be used to keep the children safe, including but not limited to ensuring 
197.23 	children have appropriate clothing, providing frequent indoor breaks, or matching the 
197.24 	intensity of the activity level to the weather conditions.
197.25 	(d) For toddlers, preschool, and school-age children attending four or more hours per 
197.26 	day, the license holder must provide at least one opportunity for outdoor activity per day 
197.27 	pursuant to paragraph (b).
197.28 	(e) For infants attending four or more hours per day, the license holder must provide at 
197.29 	least one opportunity for outdoor activity per day as practicable, pursuant to paragraph (b) 
197.30 	and the individual needs of the infants in care.
197.31 	(f) Programs operating three or fewer hours per day are exempt from the daily outdoor 
197.32 	activity requirement.
198.1 	(g) If the weather is not suitable for outdoor activities, the program must provide indoor 
198.2 	gross motor play activities that support physical development.

198.3 	Sec. 12. [142H.12] NAPS AND REST.
198.4 		Subdivision 1.Naps and rest policy. An applicant must develop and a license holder 
198.5 	must implement a policy for naps and rest that is consistent with the developmental level 
198.6 	of the children enrolled in the center. The policy must include but is not limited to the 
198.7 	requirements in this section, as applicable.
198.8 		Subd. 2.Parent consultation.  The parent of each child must be informed at the time 
198.9 	the child is enrolled of the center's policy on naps and rest and be offered the opportunity 
198.10 	to provide information specific to their child.
198.11 		Subd. 3.General nap and rest requirements.  (a) The child care center must provide 
198.12 	a quiet space for children to nap and rest.
198.13 	(b) Nap and rest time must be in accordance with the developmental needs of the child. 
198.14 	A child care center may not withhold sleep or rest from a child, including at a parent's 
198.15 	request, if such time is allowed in the child care center's naps and rest policy.
198.16 	(c) Nap and rest areas must be lighted to allow for visual supervision of all children at 
198.17 	all times.
198.18 	(d) Evacuation routes must not be blocked by resting or napping children. Each child 
198.19 	must have a free and direct means of escape, and the staff must have a clear path to each 
198.20 	resting child, including full access to at least one long side of a crib, cot, or mat.
198.21 	(e) A crib that meets the safety requirements of section 142B.45 must be provided for 
198.22 	each infant for whom the center is licensed to provide care.
198.23 	(f) The license holder must follow the infant safe sleep requirements under section 
198.24 	142B.46.
198.25 	(g) Cribs, cots, and mats must be placed directly on the floor and must not be stacked 
198.26 	when in use.
198.27 		Subd. 4.Monitoring napping infants. (a) An infant must be supervised as defined in 
198.28 	section 142H.01, subdivision 38, and pursuant to section 142H.24, subdivision 1, paragraph 
198.29 	(b).
198.30 	(b) Staff must conduct in-person checks of the sleeping infant every 15 minutes.
199.1 	(c) When a baby monitor or other mechanical equipment is used to hear or see infants 
199.2 	during sleep, the monitoring equipment must be:
199.3 	(1) able to pick up the sounds of all infants in the separate room;
199.4 	(2) actively monitored by program staff at all times; and
199.5 	(3) checked daily prior to use to ensure it is working correctly. If equipment is 
199.6 	malfunctioning, a program staff person must put in place an alternate means of supervision 
199.7 	until the equipment can be fixed.
199.8 		Subd. 5.Confinement limitation. A child who has completed a nap or rested quietly 
199.9 	for 30 minutes must not be required to remain on a cot, mat, or in a crib. Any child who 
199.10 	does not fall asleep during a designated nap time must have the opportunity to engage in 
199.11 	quiet activities.
199.12 		Subd. 6.Bedding and sleeping equipment. Separate bedding must be provided and 
199.13 	stored separately for each child in care.

199.14 	Sec. 13. [142H.13] BEHAVIOR GUIDANCE.
199.15 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
199.16 	the meanings given.
199.17 	(b) "Behavior guidance" means an ongoing process where a program staff person offers 
199.18 	constructive, positive, and developmentally appropriate guidance to a child to help manage 
199.19 	the child's behavior in a socially acceptable manner.
199.20 	(c) "Persistent unacceptable behavior" means when a child:
199.21 	(1) exhibits behaviors that present a serious safety risk for the child or others and the 
199.22 	program is not able to reduce or eliminate the safety concern; or
199.23 	(2) significantly disrupts the learning environment and requires an increased amount of 
199.24 	staff guidance and time to address the child's behavior. Significantly disruptive behavior 
199.25 	may include physical aggression, verbal threats, or repetitive behaviors that have been 
199.26 	addressed through standard behavior guidance techniques without improvement.
199.27 	(d) "Redirection" means a positive guidance technique where a program staff person 
199.28 	intervenes and guides a child away from potential problems toward constructive activity or 
199.29 	talks with a child to help the child calm down and self-regulate.
199.30 	(e) "Separation" means a form of behavior guidance that involves interruption of 
199.31 	unacceptable behavior by the removal of a child from a situation with the intention of 
200.1 	allowing the child an opportunity to pause and gain self-control. During a separation a child 
200.2 	is isolated from participating in activities with other children. Separation of children must 
200.3 	be done pursuant to subdivision 7.
200.4 		Subd. 2.Behavior guidance policies and procedures. The applicant must develop 
200.5 	written behavior guidance policies and procedures approved by the commissioner. The 
200.6 	license holder must ensure that the policies and procedures are carried out. The policies and 
200.7 	procedures must include:
200.8 	(1) methods of promoting positive behavior as specified under subdivision 3;
200.9 	(2) prohibited actions as specified under subdivision 4;
200.10 	(3) addressing persistent unacceptable behavior as specified under subdivision 6; and
200.11 	(4) separation from the group as specified in subdivision 7.
200.12 		Subd. 3.Methods of promoting positive behavior. A license holder must promote 
200.13 	positive behavior by:
200.14 	(1) ensuring that each child is provided with a positive model of acceptable behavior;
200.15 	(2) tailoring methods of promoting positive behavior to the developmental level of the 
200.16 	children the center is licensed to serve;
200.17 	(3) ensuring redirection is used, as appropriate in addressing the behavior of a child, to 
200.18 	guide a child away from potential problems and toward constructive activity or to talk with 
200.19 	a child to help them calm down and self-regulate;
200.20 	(4) teaching children how to use acceptable alternatives to problem behavior to reduce 
200.21 	conflict;
200.22 	(5) protecting the safety and well-being of children, employees, and volunteers; and
200.23 	(6) providing immediate and directly related consequences for the unacceptable behavior 
200.24 	of a child.
200.25 		Subd. 4.Prohibited actions. A license holder must prohibit the following actions by or 
200.26 	at the direction of employees or volunteers:
200.27 	(1) subjecting a child to corporal or physical punishment, including but not limited to 
200.28 	rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, 
200.29 	spitting, hitting, or spanking;
201.1 	(2) subjecting a child to name calling, ostracism, shaming, derogatory remarks about 
201.2 	the child or the child's family, cultural or racial slurs, yelling, or profane language that 
201.3 	threatens, humiliates, or frightens the child;
201.4 	(3) forcing a child to maintain an uncomfortable position or to continuously repeat 
201.5 	physical movements;
201.6 	(4) utilizing group punishments for the behavior of an individual child;
201.7 	(5) separation of a child from the group except as provided in subdivision 7;
201.8 	(6) punishment for not resting, napping, or sleeping; toileting accidents; failing to eat 
201.9 	all or part of meals or snacks; or failing to complete an activity;
201.10 	(7) denial of food or drink or forcing food or drink upon a child;
201.11 	(8) denial of light, warmth, clothing, or medical care as a punishment for unacceptable 
201.12 	behavior;
201.13 	(9) the use of physical restraint other than to physically hold a child when containment 
201.14 	is necessary to protect the child or others from harm;
201.15 	(10) the use of mechanical restraints, including tying a child up, or any device or 
201.16 	equipment intended to restrict or prevent movement as a means of discipline or for reasons 
201.17 	unrelated to the child's care, safety, or planned activity;
201.18 	(11) the use of prone or contraindicated restraints as prohibited in section 245A.211;
201.19 	(12) the use of any substance given to a child to subdue or restrict movement or behavior;
201.20 	(13) discipline and punishment must not be delegated to another child; and
201.21 	(14) punishing or shaming a child for the actions of a parent, including but not limited 
201.22 	to failure to pay fees, failure to provide appropriate clothing, failure to provide materials 
201.23 	for an activity, or any conflict between the license holder or staff and the parent.
201.24 		Subd. 5.Additional provisions. (a) When providing services to a child with a 
201.25 	developmental disability or related condition, the license holder must follow section 142B.63.
201.26 	(b) A program that cares for a child with a developmental disability or related condition 
201.27 	must comply with the individual child care program plan requirements under section 142H.15.
201.28 		Subd. 6.Persistent unacceptable behavior.  (a) A program staff person who observes 
201.29 	persistent unacceptable behavior must document the behavior of the child and staff response 
201.30 	to the behavior, including:
202.1 	(1) information on where the child was, what activity the child was doing, and the 
202.2 	employees or volunteers present when the incident occurred; and
202.3 	(2) staff actions, including the positive guidance techniques that were tried.
202.4 	(b) When persistent unacceptable behavior as defined in subdivision 1, paragraph (c), 
202.5 	occurs, a behavior plan must be developed to address the behavior documented in paragraph 
202.6 	(a) in consultation with the child's parent, the program staff, and other professionals involved 
202.7 	in the care and treatment of the child, as appropriate. The behavior plan must include but 
202.8 	is not limited to the following:
202.9 	(1) a description of the specific behavior;
202.10 	(2) the planned behavior management method to be used in response to the behavior 
202.11 	pursuant to subdivision 3 or any other previously approved methods; and
202.12 	(3) an area to document the effectiveness of the plan and progress of the child.
202.13 	(c) The plan must be signed and dated by the child's parent, the director, and other 
202.14 	professionals involved in the care and treatment of the child, as applicable, and kept in the 
202.15 	child's record.
202.16 	(d) The plan and the child's progress must be reviewed at least twice each calendar year, 
202.17 	or more frequently as needed, and changes must be made based on the child's needs and 
202.18 	the input of the child's parent, program staff, or other individuals involved in the provision 
202.19 	of care and treatment of the child. Documentation of the review must be kept in the child's 
202.20 	record. If the child's parent and the program staff agree that the behavior plan is no longer 
202.21 	needed, the license holder must document the date the behavior plan is no longer in effect.
202.22 	(e) The license holder must ensure that all staff who work directly with the child are 
202.23 	trained on the behavior plan prior to working with the child or when a new behavior plan 
202.24 	is developed. Documentation of staff training must be maintained on file.
202.25 	(f) The license holder must ensure that all staff who work directly with the child are 
202.26 	trained on the behavior plan prior to working with the child or when a new behavior plan 
202.27 	is developed. Documentation of staff training must be maintained on file.
202.28 		Subd. 7.Separation time from the group. No child may be separated from the group 
202.29 	unless the license holder has tried less intrusive methods of guiding the child's behavior 
202.30 	that have been ineffective and the behavior of the child threatens the well-being of the child 
202.31 	or other children in the center. Separation from the group must meet the following 
202.32 	requirements:
203.1 	(1) the separation time must be limited to the amount of time necessary for the child to 
203.2 	gain self-control and rejoin the group;
203.3 	(2) the duration of separation of the child must be documented, including the beginning 
203.4 	and end time of the separation;
203.5 	(3) infants and toddlers must not be separated from the group as a means of behavior 
203.6 	guidance. Positive behavior guidance techniques such as redirection may be used with 
203.7 	toddlers; and
203.8 	(4) the child must be supervised as defined under section 142H.01, subdivision 38, while 
203.9 	separated.

203.10 	Sec. 14. [142H.14] FURNISHINGS, EQUIPMENT, MATERIALS AND SUPPLIES.
203.11 		Subdivision 1.General requirements. (a) Each center must have on the premises the 
203.12 	quantity and type of equipment and materials necessary to implement the child care program 
203.13 	plan under section 142H.11 and the indoor and outdoor equipment requirements in 
203.14 	subdivisions 2 and 3.
203.15 	(b) Equipment and furniture must be durable, in good repair, structurally sound, stable, 
203.16 	and free of sharp edges, dangerous protrusions, points where extremities of a child could 
203.17 	be pinched or crushed, and openings or angles that could trap part of a child.
203.18 	(c) License holders and program staff must ensure equipment and furnishings are not 
203.19 	hazardous objects as specified in section 142H.34, subdivision 17.
203.20 	(d) Equipment designed and marketed for use by children must be appropriate to the 
203.21 	age and size of children and used in accordance with the manufacturer's instructions. 
203.22 	Equipment and play materials not designed or marketed for use by children, including but 
203.23 	not limited to repurposed, homemade, and open-ended items, must be appropriate to the 
203.24 	age and size of children, in good repair, and used under the supervision of a program staff 
203.25 	person. Such equipment and play materials are not required to have manufacturer's 
203.26 	instructions and are subject to the requirements of this subdivision.
203.27 		Subd. 2.Indoor play equipment. The license holder must provide sufficient indoor 
203.28 	play equipment and materials so that at any point in the day when children are indoors and 
203.29 	using equipment every child can choose from at least three activities involving equipment 
203.30 	or materials. The quantity of indoor equipment provided must be based on the maximum 
203.31 	licensed capacity of the classroom and must be accessible to children as specified in 
203.32 	subdivision 5.
204.1 		Subd. 3.Outdoor play equipment. The license holder must provide sufficient outdoor 
204.2 	play equipment and materials so that when all children are outdoors every child can choose 
204.3 	from at least one activity involving equipment or materials. The quantity of outdoor 
204.4 	equipment and materials provided must be based on the maximum licensed capacity and 
204.5 	must be accessible to children as specified in subdivision 5.
204.6 		Subd. 4.Interest areas. The license holder must have equipment and materials in each 
204.7 	of the following developmental and interest areas to support a child's learning and growth:
204.8 	(1) creative arts and crafts;
204.9 	(2) construction and building;
204.10 	(3) social interaction, dramatic play, or practical life activities;
204.11 	(4) math and science;
204.12 	(5) music;
204.13 	(6) fine motor skills;
204.14 	(7) physical and movement activities;
204.15 	(8) sensory exploration activities; and
204.16 	(9) language and literacy.
204.17 		Subd. 5.Equipment rotation and accessibility. A child care program may rotate 
204.18 	equipment throughout the day as specified in the child care program plan if the number of 
204.19 	choices required in subdivisions 2 and 3 is available for each child in attendance. Equipment 
204.20 	and materials from each interest area must be accessible to children at least once per day.
204.21 		Subd. 6.Furnishings. The license holder must ensure that each child has access to 
204.22 	furniture that is developmentally appropriate and the appropriate size, including at a 
204.23 	minimum:
204.24 	(1) one diaper changing table for every 12 infants or 14 toddlers. The same table may 
204.25 	not be counted to fulfill the requirement under this clause for both infants and toddlers;
204.26 	(2) one hands-free covered diaper container per diaper changing table;
204.27 	(3) one crib and waterproof mattress per infant, including enough cribs with wheels to 
204.28 	evacuate the number of infants the program is licensed to serve;
204.29 	(4) one cot or mat per toddler or preschooler. This clause does not apply to programs 
204.30 	operating for less than five hours per day if rest is not indicated as part of the center's child 
204.31 	care program;
205.1 	(5) for infants, one nonfolding seating option per child based on licensed capacity; and
205.2 	(6) for toddlers, preschoolers, and school-age children, one nonfolding seating option 
205.3 	per child based on licensed capacity, with a corresponding amount of table space to allow 
205.4 	the child to do table work or eat a meal while seated.
205.5 		Subd. 7.Supplies. (a) The license holder must maintain enough diapers, disposable 
205.6 	paper for the diaper changing table, facial tissues, liquid hand soap, and single-service towels 
205.7 	to maintain cleanliness and sanitation for children in care.
205.8 	(b) The license holder must provide at least two sets of sheets for each crib.

205.9 	Sec. 15. [142H.141] NATURAL ELEMENTS AND MATERIALS.
205.10 		Subdivision 1.Natural elements and materials. A license holder may provide children 
205.11 	with access to natural elements and materials as equipment and play materials. Natural 
205.12 	elements and materials and appropriate uses of natural elements and materials include, but 
205.13 	are not limited to:
205.14 	(1) natural loose parts, such as sticks, leaves, pine cones, acorns, seeds, pods, bark, and 
205.15 	moss for construction, art, sensory exploration, and imaginative play;
205.16 	(2) natural materials, such as dirt, mud, sand, water, ice, and snow for sensory play and 
205.17 	exploration;
205.18 	(3) plants, flowers, seeds, vegetables, and gardening materials for science exploration 
205.19 	and learning;
205.20 	(4) rocks, pebbles, stones, and minerals for counting, sorting, building, and art;
205.21 	(5) natural areas such as gardens, prairie, forest, wetlands, and ponds for exploration 
205.22 	and learning; and
205.23 	(6) other natural elements as appropriate to age and development of children.
205.24 		Subd. 2.Supervision. A program staff person must supervise a child's use of natural 
205.25 	elements and materials and provide guidance on safe and appropriate use. Natural elements 
205.26 	and materials that are a choking hazard must not be accessible to children under the age of 
205.27 	three without direct supervision of a program staff person.
205.28 		Subd. 3.Other uses. Natural elements and materials may qualify as equipment and 
205.29 	materials from interest areas under section 142H.14, subdivision 4.

206.1 	Sec. 16. [142H.15] CHILDREN WITH SPECIAL HEALTH CARE NEEDS OR 
206.2 	DISABILITIES.
206.3 		Subdivision 1.Child with special health care needs or disabilities. For the purposes 
206.4 	of this section, "child with special health care needs or disabilities" means a child who:
206.5 	(1) has developmental disabilities or is otherwise eligible for case management pursuant 
206.6 	to Minnesota Rules, parts 9525.0004 to 9525.0036;
206.7 	(2) has been identified by the local school district as a child with a disability as defined 
206.8 	in section 125A.02, subdivision 1; or
206.9 	(3) has been determined by a health care provider as defined in section 142H.01, 
206.10 	subdivision 22; licensed psychiatrist; licensed psychologist; or licensed consulting 
206.11 	psychologist as having a special health care need or disability relating to physical, social, 
206.12 	or emotional development.
206.13 		Subd. 2.Report to parent.  The license holder must inform the parent when there is a 
206.14 	developmental concern or potential special health care need of a child that was not previously 
206.15 	identified.
206.16 		Subd. 3.Individual child care program plan.  (a) When a license holder admits a child 
206.17 	with a disability or special health care need or a special need is identified, the license holder 
206.18 	must ensure that an individual child care program plan (ICCPP) is developed in a form and 
206.19 	manner prescribed by the commissioner to meet the child's individual needs.
206.20 	(b) When developing or updating the ICCPP, the license holder must obtain relevant 
206.21 	information from the child's parent and program staff who work directly with the child.
206.22 	(c) For a child who meets the criteria in subdivision 1, clause (1), the ICCPP must be 
206.23 	coordinated with the child's individual service plan (ISP).
206.24 	(d) For a child who meets the criteria in subdivision 1, clause (2), the ICCPP must be 
206.25 	coordinated with the child's individualized educational plan (IEP).
206.26 	(e) For a child who meets the criteria in subdivision 1, clause (3), the ICCPP must be 
206.27 	coordinated with the child's health care provider or other necessary medical professionals.
206.28 	(f) The license holder must ensure that all program staff who work directly with the 
206.29 	child are trained on the ICCPP prior to working with the child. Documentation of staff 
206.30 	training must be maintained on file.
206.31 	(g) Before the ICCPP is implemented, the parent and the director must sign and date the 
206.32 	form. The ICCPP must be kept in the child's record.
207.1 	(h) The ICCPP must be reviewed and updated at least once each calendar year and more 
207.2 	frequently if needed. The ICCPP must be signed and dated by the parent and the director 
207.3 	upon their yearly review.
207.4 	(i) The most recent ICCPP must be available at all times to program staff when the child 
207.5 	is in care.
207.6 		Subd. 4.Inclusion. All activities must be designed to include all children unless a specific 
207.7 	medical contraindication exists or an exclusion is otherwise specified in a child's ICCPP.
207.8 		Subd. 5.Allergy prevention and response.  (a) An applicant must develop a written 
207.9 	policy on allergy prevention and response. A license holder must ensure the policy is carried 
207.10 	out and provided to parents at the time of enrollment.
207.11 	(b) Before admitting a child for care, the license holder must obtain documentation of 
207.12 	any known allergy from the child's parent or the child's health care provider.
207.13 	(c) If a child has a known allergy, the license holder must maintain current information 
207.14 	about the allergy in the child's record and develop an ICCPP pursuant to subdivision 3, 
207.15 	including:
207.16 	(1) a description of the allergy;
207.17 	(2) specific triggers and avoidance techniques;
207.18 	(3) symptoms of an allergic reaction;
207.19 	(4) procedures for responding to an allergic reaction, including medication to be 
207.20 	administered in an emergency situation and dosages; and
207.21 	(5) the child's health care provider contact information.
207.22 	(d) If a child has an ICCPP related to a food allergy, the ICCPP must be readily available 
207.23 	to the person in the area where food is prepared and served to the child. If food is prepared 
207.24 	off site, the center must notify the person or entity preparing the food of any food allergies 
207.25 	of children in their care. Food allergy information for all children in care must be readily 
207.26 	available to staff in the classroom and wherever food is served.
207.27 	(e) The license holder must contact the parent of the child immediately after any instance 
207.28 	of exposure or allergic reaction.
207.29 	(f) The license holder must call 911 when epinephrine is administered to a child in care.
207.30 		Subd. 6.Temporary physical needs. If a child has a temporary physical need as 
207.31 	identified by their health care provider, including but not limited to a brace, cast, or helmet, 
208.1 	the license holder must maintain current documentation about the temporary physical need 
208.2 	from the child's health care provider and any necessary accommodations in the child's record. 
208.3 	The license holder must ensure staff who work with the child are aware of the child's 
208.4 	temporary physical need and follow the identified necessary accommodations. An ICCPP 
208.5 	is not required for documenting a temporary physical need under this subdivision and the 
208.6 	accommodation.

208.7 	Sec. 17. [142H.16] NIGHT CARE PROGRAM.
208.8 		Subdivision 1.Applicability. A license holder providing overnight care must comply 
208.9 	with this section.
208.10 		Subd. 2.Furnishings. Each child enrolled in a night care program must be provided 
208.11 	with a crib or bed, described as follows:
208.12 	(1) a crib that meets the requirements under section 142B.45 and two sets of sheets must 
208.13 	be provided for each infant and meet the requirements under section 142H.14;
208.14 	(2) an individual age-appropriate bed with two sets of sheets and a blanket or quilt must 
208.15 	be provided for each toddler, preschooler, or school-age child;
208.16 	(3) each bed or crib must have a waterproof mattress or mattress pad that can be cleaned 
208.17 	and disinfected;
208.18 	(4) bedding and sleeping equipment must be cleaned and disinfected as specified in 
208.19 	section 142H.31, subdivision 4, clause (3); and
208.20 	(5) separate bedding must be provided and stored separately for each child in care.
208.21 		Subd. 3.Clothing intended for sleeping. The license holder must ensure that all children 
208.22 	are put to bed in clothing for sleeping as designated by the parent of the child.
208.23 		Subd. 4.Personal care items. The license holder must ensure that all children have 
208.24 	personal items needed to clean up and prepare for sleep. The items must include an individual 
208.25 	washcloth, towel, toothbrush, toothpaste, and liquid hand soap.
208.26 		Subd. 5.Meals and snacks. (a) The license holder must ensure that a child who will be 
208.27 	present in the center has had or will be provided with an evening meal. A bedtime snack 
208.28 	must be available for all children in attendance. Eating times and schedules for the individual 
208.29 	child must be consistent with patterns established in consultation with the parent of the 
208.30 	child.
208.31 	(b) Night care programs are exempt from the requirements of section 142H.32, 
208.32 	subdivision 7.
209.1 		Subd. 6.Staffing. At least two program staff persons, one of whom must qualify as a 
209.2 	teacher under section 142H.06, must be present in the center at all times during the hours 
209.3 	the night program is in operation. When more than 80 percent of the children present are 
209.4 	asleep, the remaining program staff persons needed to meet the required staff-to-child ratio 
209.5 	must have at least the qualifications of an aide. Program staff must be awake, dressed, and 
209.6 	provide supervision as specified in sections 142H.01, subdivision 38, and 142H.12 to 
209.7 	children who are sleeping.
209.8 		Subd. 7.Hygiene assistance.  The license holder must ensure that children have the 
209.9 	opportunity to wash up and brush their teeth before bedtime. Program staff must assist 
209.10 	children during washing and changing clothes according to the developmental needs of the 
209.11 	child.
209.12 		Subd. 8.Showers and bathtubs. The license holder must ensure bathtubs and showers 
209.13 	are equipped to prevent slipping, if the center provides bathing.
209.14 		Subd. 9.Bathing procedures. The center must have written permission from the parent 
209.15 	prior to allowing the child to bathe and ensure bathtubs and showers are cleaned and 
209.16 	disinfected after each use. The tub or showers do not have to be disinfected between uses 
209.17 	if the children are siblings and the parent has provided written consent. All children must 
209.18 	bathe separately unless the children are siblings and the parent has provided written consent 
209.19 	that the children can be bathed together.
209.20 		Subd. 10.Privacy. To ensure privacy, school-age boys and girls must be separated 
209.21 	during bedtime washing and changing activities.
209.22 		Subd. 11.Sleeping arrangements. The center must provide sleeping arrangements so 
209.23 	that sleeping children are cared for separately from children who are awake and so that 
209.24 	sleeping children are not disturbed by arrivals and departures. Infants must have a sleep 
209.25 	area separate from the center's play and activity areas.
209.26 		Subd. 12.Bedtime. A child's bedtime must be scheduled in consultation with the child's 
209.27 	parent.
209.28 		Subd. 13.Light. The center must provide adequate lighting indoors in all areas, including 
209.29 	bathrooms, hallways, and sleeping rooms to ensure that staff are able to see all children at 
209.30 	all times.
209.31 		Subd. 14.Outdoor illumination. The center must ensure that parking areas, outdoor 
209.32 	walkways, and all building entrances are adequately lighted for safety and security.
210.1 		Subd. 15.Program emphasis. A license holder operating a night care program must 
210.2 	comply with the child care program standards in 142H.11.
210.3 		Subd. 16.Exceptions. The outdoor activity area required by section 142H.34, subdivision 
210.4 	7; outdoor activities required by section 142H.11, subdivision 2; and outdoor equipment 
210.5 	required by section 142H.14 need not be provided for children enrolled in a night care 
210.6 	program.

210.7 	Sec. 18. [142H.17] DROP-IN CHILD CARE PROGRAMS.
210.8 		Subdivision 1.Drop-in child care programs. If a license holder chooses to operate as 
210.9 	a drop-in child care program, the license holder must comply with the requirements in this 
210.10 	section.
210.11 		Subd. 2.Exemptions. (a) Drop-in child care programs that meet one of the requirements 
210.12 	in paragraph (b) are exempt from:
210.13 	(1) section 142H.10;
210.14 	(2) section 142H.11, subdivision 1, clauses (6) and (7); and
210.15 	(3) section 142H.12, subdivisions 3 and 5, except for infants and toddlers.
210.16 	(b) A drop-in child care program is exempt from the requirements in paragraph (a) if 
210.17 	the program operates:
210.18 	(1) in a child care center that houses no child care program except the drop-in child care 
210.19 	program;
210.20 	(2) in the same child care center but not during the same hours as a regularly scheduled 
210.21 	ongoing child care program with a stable enrollment; or
210.22 	(3) in a child care center at the same time as a regularly scheduled ongoing child care 
210.23 	program with a stable enrollment, but activities, except for bathroom use and outdoor play, 
210.24 	are conducted separately from each other.
210.25 		Subd. 3.Staffing requirements. (a) A drop-in child care program must have at least 
210.26 	two program staff persons on site whenever the program is operating: the director or a 
210.27 	designee and a program staff member who is qualified as a teacher.
210.28 	(b) If the drop-in child care program has additional staff who are on call as a mandatory 
210.29 	condition of their employment, the minimum child-to-staff ratio may be exceeded only for 
210.30 	preschool and school-age children by a maximum of four children for no more than 20 
210.31 	minutes while additional staff are in transit. If the ratio is exceeded for more than 20 minutes, 
211.1 	the license holder must review the mandatory on-call staff procedures and revise as necessary 
211.2 	to ensure compliance with this section, including hiring additional on-call staff as needed.
211.3 	(c) Whenever there is a total of 20 children or more at a drop-in child care center, children 
211.4 	that are younger than 30 months must be cared for in a separate group. The group may 
211.5 	contain children up to 60 months old. The group must be cared for in an area that is physically 
211.6 	separated from older children.
211.7 	(d) In drop-in care programs that serve both infants and older children, children up to 
211.8 	30 months old may be supervised by assistant teachers as long as other staff are present in 
211.9 	appropriate ratios.
211.10 	(e) A drop-in child care program may care for siblings who are all at least 16 months 
211.11 	old together in any group. For purposes of this section, "sibling" is defined as sister or 
211.12 	brother, half sister or half brother, or stepsister or stepbrother.
211.13 		Subd. 4.Staff-to-child ratio requirements in a drop-in program. The minimum 
211.14 	staff-to-child ratio that a license holder may maintain in a drop-in program is:
211.15 	(1) for infants, one program staff person for every four infants;
211.16 	(2) for toddlers, one program staff person for every seven children;
211.17 	(3) for preschoolers, one program staff person for every ten children; and
211.18 	(4) for school-age children, one program staff person for every 15 children.
211.19 		Subd. 5.Staff distribution. (a) The minimum staff distribution pattern for a drop-in 
211.20 	child care program is:
211.21 	(1) the first staff member needed to meet the required staff-to-child ratio must be a 
211.22 	teacher;
211.23 	(2) the second and third staff members must have at least the qualifications of a child 
211.24 	care aide; and
211.25 	(3) the fourth staff member must have at least the qualifications of an assistant teacher.
211.26 	(b) The pattern in paragraph (a) must be repeated until the number of staff needed to 
211.27 	meet the staff-to-child ratio for each age category has been achieved.

211.28 	Sec. 19. [142H.18] EXCLUSION OF SICK CHILDREN .
211.29 		Subdivision 1.Care of sick children. If a child becomes sick while at the center, the 
211.30 	child must be isolated from other children in care and the child's parent called immediately. 
211.31 	When determining if a child is sick and exclusion is necessary, license holders must follow:
212.1 	(1) the requirements on reportable diseases in Minnesota Rules, parts 4605.7040, 
212.2 	4605.7070, and 4605.7080; and
212.3 	(2) guidelines from the commissioner of health on infectious diseases in child care 
212.4 	settings.
212.5 		Subd. 2.Notification. (a) A child care center's program policies must require a parent 
212.6 	to inform the center within 24 hours, exclusive of weekends and holidays, when a child is 
212.7 	diagnosed by a child's health care provider or dental care provider as having a reportable 
212.8 	or infectious disease as specified in subdivision 1.
212.9 	(b) The license holder must ensure that the commissioner of health is notified of any 
212.10 	suspected case of reportable disease as specified in Minnesota Rules, parts 4605.7040, 
212.11 	4605.7050, or 4605.7080, within 24 hours of receiving the parent's or staff report. 
212.12 	Documentation of the notification must be kept at the center.
212.13 	(c) The license holder must notify the parents of exposed children within 24 hours of 
212.14 	when a parent, employee, or volunteer notifies the center of a reportable disease under 
212.15 	subdivision 1, lice, scabies, impetigo, ringworm, or chicken pox. The notice must be posted 
212.16 	in a clearly visible, accessible place or provided individually to each parent of a child who 
212.17 	was exposed.
212.18 		Subd. 3.Return to center. Children with a reportable or infectious disease as specified 
212.19 	in subdivision 1 must be excluded from the center for a length of time as specified in the 
212.20 	commissioner of health guidelines on infectious diseases in child care settings and until the 
212.21 	child can participate in routine activities without more staff supervision than usual. The 
212.22 	center must exclude a child for a longer period if the child's health care provider determines 
212.23 	that it is necessary.

212.24 	Sec. 20. [142H.19] SICK CARE PROGRAM.
212.25 		Subdivision 1.Licensure of sick care programs. If a license holder chooses to operate 
212.26 	as a sick care program, the license holder must operate a sick care program that complies 
212.27 	with the requirements in this section.
212.28 		Subd. 2.Review of admission and health policies and practices. (a) A licensed 
212.29 	physician, physician assistant, or advanced practice registered nurse with a specialization 
212.30 	in pediatric care must review and approve a sick care program's admission policy at the 
212.31 	time of initial license application, after the first six months of initial operation, and at least 
212.32 	once each calendar year.
213.1 	(b) The review must include consultation with the licensed registered nurse or physician 
213.2 	responsible for admissions.
213.3 	(c) A report of the findings must be sent to the commissioner with the initial application 
213.4 	for licensure, and subsequent reports must be placed in the center's administrative record.
213.5 		Subd. 3.Evaluation of a sick child. (a) A license holder that operates a sick care program 
213.6 	must evaluate the condition of a sick child before admitting the child to the center.
213.7 	(b) The evaluation must be based on the physical symptoms of the child each day of 
213.8 	admission, the probable contagion and risk to the health of others present, the ability of the 
213.9 	program to provide the care the child requires, and whether the child can be grouped together 
213.10 	with other children in care with contagious or noncontagious illnesses. Documentation of 
213.11 	the evaluation must be placed in the child's record.
213.12 	(c) Before admitting a child to a sick care program:
213.13 	(1) a parent must describe the child's symptoms over the phone;
213.14 	(2) a health care provider affiliated with the center must  tell the parent whether the parent 
213.15 	may bring the child to the center for further evaluation; and
213.16 	(3) the health care provider must conduct a physical assessment of the child and obtain 
213.17 	a health history from the parent at the center.
213.18 		Subd. 4.Information to parents. A summary of the sick care program's health care 
213.19 	policies and practices and the center's procedures for notification of parents in the event of 
213.20 	an emergency must be given to the parent the first time a child is admitted and every 
213.21 	admission following a change to any of the information.
213.22 		Subd. 5.Parent conference exception. Centers licensed to provide child care exclusively 
213.23 	to sick children are not required to provide parent conferences under section 142H.20, 
213.24 	subdivision 2.
213.25 		Subd. 6.Child care program emphasis exception. A sick care program does not need 
213.26 	to meet the child care program plan requirements under section 142H.11. However, the 
213.27 	child care program plan for the care of sick children must emphasize quiet activities.
213.28 		Subd. 7.Group size and age category grouping exceptions. The maximum group 
213.29 	sizes specified under section 142H.10, subdivision 1, and the age category grouping 
213.30 	restrictions under section 142H.10, subdivision 3, do not apply to sick care programs. There 
213.31 	must be no more than 16 children in sick care in the same room at the same time.
214.1 		Subd. 8.Staff-to-child ratios and staff distribution requirements. (a) A one-to-four 
214.2 	staff-to-child ratio must be maintained at all times in a room used to care for sick children.
214.3 	(b) At least two program staff persons must be present in a center operating a sick care 
214.4 	program whenever sick children are in care.
214.5 	(c) The first program staff person must be a registered nurse. The remaining program 
214.6 	staff persons must at least meet the qualifications and follow the staff distribution pattern 
214.7 	under section 142H.10.
214.8 		Subd. 9.Limitation on staff assignment. Staff must not care for nonsick children or 
214.9 	prepare food for nonsick children on the same day as sick children. Staff caring for sick 
214.10 	children must not enter the kitchen used to prepare food for nonsick children.
214.11 		Subd. 10.Food preparation. Food provided by the license holder and prepared at the 
214.12 	center must be prepared in a room separate from rooms where sick care is provided and 
214.13 	must be delivered to each sick care room in individual servings and in covered containers. 
214.14 	Procedures for preparing, handling, and serving food and washing food, utensils, and 
214.15 	equipment must comply with the requirements in the Minnesota Food Code, Minnesota 
214.16 	Rules, chapter 4626.
214.17 		Subd. 11.Menus. Menus for sick children must be modified to meet the individual needs 
214.18 	of the child.
214.19 		Subd. 12.Additional facility requirements. A license holder operating a sick care 
214.20 	program must provide:
214.21 	(1) a room or rooms that are exclusively used to care for sick children and that are not 
214.22 	used at any time for any other child care purpose; and
214.23 	(2) toilets and hand sinks that are within or immediately adjacent to the room or rooms 
214.24 	used for sick care and are not used by well children in care.
214.25 		Subd. 13.Outdoor activity area, activities, and equipment exception. Sick care 
214.26 	programs under this section are exempt from the requirements for an outdoor activity area 
214.27 	under section 142H.34, subdivision 7; outdoor activities under section 142H.11, subdivision 
214.28 	2; and outdoor equipment under section 142H.14.
214.29 		Subd. 14.Cleaning and disinfection. Floors in rooms where sick care is provided and 
214.30 	all linens, toileting equipment, sinks, furnishings, objects, and equipment used by sick 
214.31 	children must be cleaned and disinfected at least daily and as needed pursuant to the 
214.32 	requirements under section 142H.31.
215.1 		Subd. 15.Bedding and sleeping equipment. (a) Each sick child must be provided 
215.2 	appropriate bedding and sleeping equipment, depending on the age of the child, as follows:
215.3 	(1) a crib and crib sheets pursuant to the requirements of section 142B.45, cot, mat, or 
215.4 	bed, depending on the age of the child;
215.5 	(2) a pillow, except if the child is an infant;
215.6 	(3) a pillowcase, except if the child is an infant; and
215.7 	(4) a blanket or quilt, except if the child is an infant.
215.8 	(b) Bedding provided by the center must be laundered after each use. Sleeping equipment 
215.9 	must be cleaned and disinfected after each use.

215.10 	Sec. 21. [142H.20] INFORMATION TO PARENTS.
215.11 		Subdivision 1.Policies provided to parents. At the time of a child's enrollment, the 
215.12 	center must provide the parent with written notification of the:
215.13 	(1) ages and numbers of children the center is licensed to serve;
215.14 	(2) hours and days of operation;
215.15 	(3) child care program options the center is licensed to operate, including a description 
215.16 	of the program's educational methods; the program's religious, political, or philosophical 
215.17 	basis, if any; and how parents may review the center's child care program plan;
215.18 	(4) policy on parent conferences and notification to a parent of a child's intellectual, 
215.19 	physical, social, and emotional development;
215.20 	(5) policy requiring a health care summary and immunization record of a child;
215.21 	(6) policies and procedures for the care of children who become sick at the center and 
215.22 	parent notification practices for the onset of or exposure to a contagious illness or condition 
215.23 	pursuant to section 142H.18 or when there is an emergency or injury requiring medical 
215.24 	attention;
215.25 	(7) policies and procedures for administering first aid and sources of care to be used in 
215.26 	case of emergencies;
215.27 	(8) policies on the administration of medicine;
215.28 	(9) procedures for obtaining written parental permission for transportation of children 
215.29 	and field trips as required in section 142H.33, subdivision 4, paragraph (d);
216.1 	(10) procedures for obtaining written parental consent for research, cameras, and social 
216.2 	media participation pursuant to section 142H.22;
216.3 	(11) policies on transitioning a child to the next age group, pursuant to section 142H.10;
216.4 	(12) policies on the provision of meals and snacks;
216.5 	(13) behavior guidance policies and procedures;
216.6 	(14) presence of pets;
216.7 	(15) policy on visitation and parental access to children pursuant to section 142H.21;
216.8 	(16) policy on the prohibition of smoking, use of tobacco products, vaping, electronic 
216.9 	cigarettes, alcohol, and drugs on the premises of the program pursuant to section 142H.29, 
216.10 	subdivision 11;
216.11 	(17) policy on use of technology and screen time pursuant to section 142H.11, subdivision 
216.12 	1, clause (12);
216.13 	(18) telephone number of the Department of Children, Youth, and Families, Division 
216.14 	of Licensing;
216.15 	(19) policy on naps and rest pursuant to section 142H.12; and
216.16 	(20) procedures for notifying parents of an evacuation, including procedures for 
216.17 	reunification with families.
216.18 		Subd. 2.Parent conferences. The license holder must inform the parent of a child's 
216.19 	progress and:
216.20 	(1) complete individual assessments of each child's intellectual, physical, social, and 
216.21 	emotional development at least twice a year. Individual assessments for school-age children 
216.22 	must be completed at least once a year;
216.23 	(2) plan and offer parent conferences by program staff at least twice a year to review 
216.24 	and discuss the child's assessment. Parent conferences for school-age children must be 
216.25 	planned and offered at least once a year; and
216.26 	(3) maintain documentation of the child's assessment and that individual parent 
216.27 	conferences were planned and offered in each child's record.
216.28 		Subd. 3.Daily reports for infants and toddlers. Daily written individualized reports 
216.29 	must be provided to the parent of an infant or toddler about the child's food intake, 
216.30 	elimination, sleeping patterns, and general behavior.

217.1 	Sec. 22. [142H.21] PARENT VISITATION AND ACCESS TO PROGRAM.
217.2 	(a) The center must have a parent visitation and access policy that meets the requirements 
217.3 	of this section at a minimum.
217.4 	(b) An enrolled child's parent must be allowed access to their child at any time while 
217.5 	the child is in care unless a legal restriction or court order restricts access.
217.6 	(c) A copy of the order or other legal restriction in paragraph (b) must be kept in the 
217.7 	child's record.

217.8 	Sec. 23. [142H.22] CONSENT FOR RESEARCH, CAMERAS, AND SOCIAL MEDIA 
217.9 	PARTICIPATION.
217.10 		Subdivision 1.Policy. A center must have and follow a policy governing the center's 
217.11 	use of social media and the use of photos and videos of children in care. The policy must 
217.12 	include:
217.13 	(1) procedures for obtaining written consent from parents for release of photos and 
217.14 	videos of children for promotional or publicity purposes, including on social media accounts 
217.15 	or public digital platforms; and
217.16 	(2) a statement prohibiting any employee or volunteer from posting content of children 
217.17 	in care or enrolled families on a personal social media account or public digital platform, 
217.18 	including photos, videos, or personal identifying information of the children.
217.19 		Subd. 2.Participation in research, fundraising, or public relations projects. (a) The 
217.20 	license holder must obtain written permission from a parent before a child is involved in 
217.21 	research, fundraising, or public relations projects while at the center. A separate written 
217.22 	permission form must be obtained before each occasion of a research, fundraising, or public 
217.23 	relations activity.
217.24 	(b) The permission form must be maintained in the child's record.

217.25 	Sec. 24. [142H.23] EMERGENCY AND ACCIDENT POLICIES AND RECORDS.
217.26 		Subdivision 1.Emergency preparedness plan. (a) An applicant must develop a written 
217.27 	plan for emergencies that require evacuation, relocation, sheltering in place, or lockdown 
217.28 	resulting from a fire, blizzard, tornado or other natural disaster, or other threatening situations 
217.29 	that may pose a health or safety hazard to a child, such as an intruder or violence at the 
217.30 	facility. A license holder must carry out the emergency plan during emergencies. The plan 
217.31 	must be written on a form developed by the commissioner and include:
218.1 	(1) procedures for an evacuation, including building evacuation routes and identification 
218.2 	of primary and secondary exits;
218.3 	(2) procedures for relocation, including a designated relocation site;
218.4 	(3) procedures for sheltering in place and lockdown;
218.5 	(4) procedures for notifying a child's parent of an evacuation, relocation, sheltering in 
218.6 	place, or lockdown, including procedures for reunification with families;
218.7 	(5) accommodations for a child with a disability or a chronic medical condition;
218.8 	(6) accommodations for infants and toddlers;
218.9 	(7) procedures for storing a child's medically necessary medicine that facilitates easy 
218.10 	removal during an evacuation or relocation;
218.11 	(8) procedures for continuing operations in the period during and after a crisis; and
218.12 	(9) procedures for communicating with local emergency management officials, law 
218.13 	enforcement officials, or other appropriate state or local authorities.
218.14 	(b) A license holder must review and update the emergency plan at least once each 
218.15 	calendar year and as needed when changes to the circumstances or facilities necessitate an 
218.16 	updated plan. Documentation of the yearly review and when changes are made must be 
218.17 	maintained in the program's administrative records.
218.18 	(c) Program staff must be trained on the emergency plan at orientation as specified under 
218.19 	section 142H.09 when changes are made to the plan and at least once each calendar year. 
218.20 	Training must be documented and maintained on site.
218.21 	(d) A center must have an operable on-site flashlight for use in an emergency situation. 
218.22 	A cell phone may not be used to meet this requirement.
218.23 	(e) A license holder must conduct fire drills every month and hold tornado drills monthly 
218.24 	from April 1 through September 30. Fire and tornado drills must be documented and include 
218.25 	the date of the drill, the start and end time of the drill, and the name of the program staff 
218.26 	person completing the documentation. Documentation must be maintained in the program's 
218.27 	administrative records.
218.28 	(f) Primary and secondary exits and evacuation routes must remain unblocked.
218.29 		Subd. 2.Emergencies, accidents, incidents, and injuries. (a) The policies and 
218.30 	procedures for emergencies, accidents, incidents, and injuries must include:
218.31 	(1) procedures for administering first aid;
219.1 	(2) procedures for the daily inspection of potential hazards;
219.2 	(3) procedures for fire prevention and procedures to follow in the event of a fire, persons 
219.3 	responsible for the evacuation of children and areas for which they are responsible, instruction 
219.4 	on how to use a fire extinguisher, and instructions on how to close off the fire area;
219.5 	(4) procedures to follow when a child is missing, including when a school-age child 
219.6 	does not arrive at the center when expected after school;
219.7 	(5) procedures to follow if a person who is unknown, unauthorized, incapacitated, or 
219.8 	suspected of abuse attempts to pick up a child or if no one comes to pick up a child. The 
219.9 	procedure must include a practice for verifying a person's identity;
219.10 	(6) procedures for obtaining emergency medical care; and
219.11 	(7) procedures for recording emergencies, accidents, incidents, and injuries involving a 
219.12 	child enrolled in the center. The written record must include:
219.13 	(i) the name and age of the child involved;
219.14 	(ii) the name of employees or volunteers present;
219.15 	(iii) the date, time, and place of the emergency, accident, incident, or injury;
219.16 	(iv) the type of injury;
219.17 	(v) actions taken by staff; and
219.18 	(vi) to whom the emergency, accident, incident, or injury was reported.
219.19 	(b) At a minimum, the emergency, accident, incident, or injury must be reported in 
219.20 	writing to the parent and as otherwise required in section 142H.28.
219.21 	(c) Each calendar year, the license holder must conduct an analysis of the emergencies, 
219.22 	accidents, incidents, and injuries that have been documented pursuant to paragraph (a), 
219.23 	clause (7). Documentation of the yearly analysis and any modification of the center's policies 
219.24 	based on the analysis must be maintained in the program's administrative records.
219.25 	(d) The license holder must post a facility floor plan in a visible location in each classroom 
219.26 	and other areas in the facility where child care is provided. The posted floor plan in each 
219.27 	area must include:
219.28 	(1) identification of primary and secondary exits;
219.29 	(2) building evacuation routes;
219.30 	(3) identification of tornado shelter and other shelter-in-place locations;
220.1 	(4) identification of staff positions responsible for the evacuation or sheltering of children;
220.2 	(5) the name and address of the designated relocation site; and
220.3 	(6) phone numbers and sources of emergency medical services, the poison control center, 
220.4 	the fire department, and the department's licensing division.
220.5 	(e) The license holder must ensure program staff are trained on the emergency, accident, 
220.6 	incident, and injury policies and procedures at orientation as required in section 142H.09 
220.7 	when changes are made to the policies and procedures and at least once each calendar year. 
220.8 	Training must be documented and maintained on site.

220.9 	Sec. 25. [142H.24] SUPERVISION AND RISK REDUCTION.
220.10 		Subdivision 1.Supervision; sight and hearing exceptions. (a) A child is still supervised 
220.11 	as defined in section 142H.01, subdivision 38, when:
220.12 	(1) an infant is placed in a crib to sleep and a program staff person is within sight or 
220.13 	hearing of the infant pursuant to section 142H.12, subdivision 4;
220.14 	(2) a single school-age child uses a restroom that is not available to the public when the 
220.15 	child care center is operating and serving children and a program staff person has knowledge 
220.16 	of the child's activity and location and checks on the child at least every five minutes. When 
220.17 	services are provided away from the child care facility, including but not limited to field 
220.18 	trips, a school-age child who uses a restroom that is available to the public must be 
220.19 	accompanied by a program staff person;
220.20 	(3) a school-age child leaves the classroom but remains within the licensed child care 
220.21 	center space to deliver or retrieve items from the child's personal storage space and a program 
220.22 	staff person has knowledge of the child's activity and location and checks on the child at 
220.23 	least every five minutes; or
220.24 	(4) a single preschool child uses an individual, private restroom within the classroom 
220.25 	with the door closed and a program staff person has knowledge of the child's activity and 
220.26 	location, can hear the child, and checks on the child at least every five minutes.
220.27 	(b) A program must account for each exception in paragraph (a) in the risk reduction 
220.28 	plan under subdivision 2.
220.29 		Subd. 2.Risk reduction plan. (a) The license holder must develop a risk reduction plan 
220.30 	that identifies the general risks to children served by the child care center in a form and 
220.31 	manner prescribed by the commissioner.
221.1 	(b) The license holder must establish procedures to minimize identified risks, train staff 
221.2 	on the procedures, and review the procedures each calendar year.
221.3 	(c) The risk reduction plan must include an assessment of risk to children the center 
221.4 	serves or intends to serve and identify specific risks based on the outcome of the assessment. 
221.5 	The assessment of risk must be composed of:
221.6 	(1) an assessment of the risks presented by the facility where the licensed services are 
221.7 	provided, including an evaluation of:
221.8 	(i) the condition and design of the facility and its outdoor space, bathrooms, and storage 
221.9 	areas;
221.10 	(ii) the accessibility of medications and cleaning products that are harmful to children; 
221.11 	and
221.12 	(iii) the existence of areas that are difficult to supervise, including restrooms with multiple 
221.13 	entrances; and
221.14 	(2) an assessment of the risks presented by the environment for each facility and for 
221.15 	each site, including an evaluation of the type of grounds and terrain surrounding the building 
221.16 	and the proximity to hazards, busy roads, and publicly accessed businesses.
221.17 	(d) The risk reduction plan must include a statement of measures that will be taken to 
221.18 	minimize the risk of harm presented to children for each risk identified in the assessment 
221.19 	under paragraph (c) related to the facility and environment.
221.20 	(e) In addition to any program-specific risks identified in paragraph (c), the plan must 
221.21 	include specific policies and procedures that minimize the risk of harm or injury to children, 
221.22 	including from:
221.23 	(1) closing children's fingers in doors, including cabinet doors;
221.24 	(2) leaving children in the community without supervision;
221.25 	(3) children leaving the facility without supervision;
221.26 	(4) dislocation of children's elbows by program staff pulling or lifting children by the 
221.27 	hands or wrists or swinging by the arms;
221.28 	(5) burns, including from hot food or beverages, whether served to children or being 
221.29 	consumed by program staff, and devices used to warm food and beverages;
221.30 	(6) injuries from equipment, such as scissors and glue guns;
221.31 	(7) sunburn;
222.1 	(8) feeding children foods to which they are allergic;
222.2 	(9) children falling from changing tables;
222.3 	(10) children accessing dangerous items or chemicals or coming into contact with residue 
222.4 	from harmful cleaning products;
222.5 	(11) traffic and pedestrian accidents, including when walking with children on 
222.6 	neighborhood walks, to an off-site outdoor play area, or in areas with heavy traffic or difficult 
222.7 	terrain such as railroad tracks; and
222.8 	(12) children choking or suffocating.
222.9 	(f) The plan must ensure hazardous objects as defined in section 142H.34, subdivision 
222.10 	17, are inaccessible to children.
222.11 	(g) The plan must include specific policies and procedures to ensure adequate supervision 
222.12 	of children at all times as defined in subdivision 1 and section 142H.01, subdivision 38, 
222.13 	and pursuant to the staffing requirements of section 142H.10, subdivision 1, with particular 
222.14 	emphasis on:
222.15 	(1) times when children are transitioned from one area within the facility to another, 
222.16 	including the use of a name-to-face check during transition time;
222.17 	(2) nap-time supervision, including infant sleep supervision;
222.18 	(3) child arrival and departure times, including when children arrive or depart from the 
222.19 	center by bus;
222.20 	(4) supervision during outdoor play, outdoor learning activities, and community activities, 
222.21 	including but not limited to field trips and neighborhood walks;
222.22 	(5) supervision of children in hallways;
222.23 	(6) supervision of preschool children when using an individual private restroom within 
222.24 	the classroom; and
222.25 	(7) supervision of school-age children when using the restroom and visiting the child's 
222.26 	personal storage space.
222.27 		Subd. 3.Yearly review of risk reduction plan. (a) The license holder must review the 
222.28 	risk reduction plan each calendar year and document the review.
222.29 	(b) When conducting the review, the license holder must consider incidents that have 
222.30 	occurred in the center since the last review, including:
222.31 	(1) incidents covered by the assessment factors in subdivision 2;
223.1 	(2) the internal reviews conducted under section 142H.36, if any;
223.2 	(3) substantiated maltreatment findings, if any; and
223.3 	(4) any other incidents that caused injury or harm to a child.
223.4 	(c) Within ten days following any change to the risk reduction plan, the license holder 
223.5 	must train program staff on the change and document that the staff were trained on the 
223.6 	change.

223.7 	Sec. 26. [142H.25] CENTER ADMINISTRATIVE RECORDS.
223.8 	(a) In addition to the personnel records requirements under section 142B.03, subdivision 
223.9 	1, paragraph (a), a center must maintain the following records:
223.10 	(1) a record of the information given to parents specified in section 142H.20;
223.11 	(2) the personnel records specified in section 142H.26;
223.12 	(3) the children's records specified in section 142H.27;
223.13 	(4) health consultant reviews of the center's health policies and practices as specified in 
223.14 	section 142H.29, subdivision 2;
223.15 	(5) the child care program plan specified in section 142H.11;
223.16 	(6) the emergencies, accidents, incidents, and injuries records specified in section 
223.17 	142H.23, subdivision 2;
223.18 	(7) the child separation reports mandated in section 142H.13;
223.19 	(8) daily center and classroom attendance records specified in section 142H.30; and
223.20 	(9) staffing schedules.
223.21 	(b) The requirements in section 142B.03, subdivisions 1 and 2, apply to records retained 
223.22 	pursuant to this section.

223.23 	Sec. 27. [142H.26] PERSONNEL RECORDS.
223.24 	A license holder must maintain a current personnel record for each program staff person 
223.25 	in a manner prescribed by the commissioner and consistent with section 142B.03. The 
223.26 	personnel record for each program staff person must contain:
223.27 	(1) the program staff person's name, home address, telephone number, date of birth, and 
223.28 	emergency contact information;
224.1 	(2) the program staff person's first date of direct contact and first date of unsupervised 
224.2 	direct contact with a child;
224.3 	(3) documentation indicating that the program staff person meets the requirements of 
224.4 	the staff person's job in sections 142H.05 to 142H.08; and
224.5 	(4) the program staff person's hire date and last day of employment, as applicable.

224.6 	Sec. 28. [142H.27] CHILDREN'S RECORDS.
224.7 		Subdivision 1.Requirements. Prior to or on the day of enrollment in the center, the 
224.8 	license holder must maintain a record on site for each child served by the program. The 
224.9 	record must contain:
224.10 	(1) the child's full name, date of birth, and current home address;
224.11 	(2) the child's date of enrollment in the program;
224.12 	(3) the name, address, and telephone number of the child's parent;
224.13 	(4) the name and telephone number of at least one emergency contact person who can 
224.14 	be contacted if a parent cannot be reached in an emergency or when there is an injury 
224.15 	requiring medical attention;
224.16 	(5) the names and telephone numbers of any additional persons authorized by the parent 
224.17 	to pick up the child from the center;
224.18 	(6) the child's health and immunization information required by section 142H.29, 
224.19 	subdivisions 3 and 4;
224.20 	(7) written authorization for the license holder to act in an emergency or when a parent 
224.21 	or designee cannot be reached or is delayed;
224.22 	(8) the hours and days of the week the child will attend the center;
224.23 	(9) for infants and toddlers, a description of the child's eating, sleeping, toileting, and 
224.24 	communication habits and effective methods for comforting the child;
224.25 	(10) documentation of any dietary or medical needs of the child;
224.26 	(11) documentation of a child's individual child care program plan as required by section 
224.27 	142H.15; and
224.28 	(12) the date of parent conferences and a summary of the information provided to the 
224.29 	parent at the conferences.
225.1 		Subd. 2.Disclosure. The license holder must not disclose a child's record to any person 
225.2 	other than the child, the child's parent, the child's legal representative, employees of the 
225.3 	license holder, or the commissioner unless the child's parent has given written consent. This 
225.4 	subdivision does not apply to information needed by a first responder in the case of an 
225.5 	emergency.

225.6 	Sec. 29. [142H.28] REPORTING REQUIREMENTS.
225.7 		Subdivision 1.Maltreatment, abuse, and neglect reporting. The license holder must 
225.8 	comply with the reporting requirements for abuse and neglect specified in chapter 260E.
225.9 		Subd. 2.Other reporting. Within 24 hours, the license holder must notify the 
225.10 	commissioner of the following in a manner prescribed by the commissioner:
225.11 	(1) of the death or notification of the death of a child enrolled in the center as required 
225.12 	under section 142B.10, subdivision 24;
225.13 	(2) of the occurrence or notification of any injury to a child in care in the program that 
225.14 	required treatment by a dentist or health care provider as defined in section 142H.01, 
225.15 	subdivision 22. Treatment does not include application of or recommendation to use 
225.16 	nonprescription medication or diagnostic testing;
225.17 	(3) of the occurrence of structural damage to the building or a fire that requires the 
225.18 	service of a fire department; and
225.19 	(4) of the provision of any emergency medical service to a child while in care.

225.20 	Sec. 30. [142H.29] HEALTH.
225.21 		Subdivision 1.Health policies. An applicant must develop written health policies 
225.22 	approved by the commissioner.
225.23 		Subd. 2.Health consultation. (a) The center must have a health consultant as defined 
225.24 	in section 142H.01, subdivision 23, review the center's health policies and practices in 
225.25 	person and certify that the policies and practices are adequate to protect the health of children 
225.26 	in care.
225.27 	(b) The health consultant's review, including an on-site visit, must be done before initial 
225.28 	licensure and must be repeated each calendar year.
225.29 	(c) For programs serving infants, an in-person review must be done before initial licensure 
225.30 	and at least quarterly thereafter. At least every other quarter, a health consultant may conduct 
225.31 	the health review visit virtually.
226.1 	(d) A health consultant must review the center's health policies and practices before 
226.2 	implementing a change in the center's health policies or practices and after an outbreak of 
226.3 	a contagious reportable illness as specified in Minnesota Rules, parts 4605.7040, 4605.7050, 
226.4 	and 4605.7080.
226.5 	(e) The consultant must review and approve:
226.6 	(1) the emergencies, accidents, incidents, and injuries policies and procedures required 
226.7 	by section 142H.23, subdivision 2;
226.8 	(2) the diapering procedures and practices specified in subdivision 6;
226.9 	(3) the programs' cleaning and disinfecting products and procedures; and
226.10 	(4) the sanitation procedures and practices for food catered in or provided by the child's 
226.11 	parent as specified in section 142H.32, subdivision 6, and for infants as specified in section 
226.12 	142H.32, subdivision 11.
226.13 		Subd. 3.Health information at admission. Before a child is admitted to a center or 
226.14 	within 30 days of admission, the license holder must obtain a report on a current physical 
226.15 	examination of the child signed by the child's health care provider.
226.16 		Subd. 4.Immunizations. (a) Before a child is admitted to a center, the license holder 
226.17 	must obtain documentation of current immunization records according to section 121A.15 
226.18 	and Minnesota Rules, chapter 4604; a signed notarized statement of parental objection to 
226.19 	the immunization; or a medical exemption. The license holder must maintain record of 
226.20 	current immunizations, a signed notarized statement of parental objection to the 
226.21 	immunization, or a medical exemption throughout the child's enrollment at the center.
226.22 	(b) License holders must file an immunization report each calendar year with the 
226.23 	Department of Health, as required under the Minnesota School and Child Care Immunization 
226.24 	Law, section 121A.15, subdivision 8, and Minnesota Rules, part 4604.0410.
226.25 		Subd. 5.Administration of medication. (a) A license holder that administers medication 
226.26 	must:
226.27 	(1) get written permission from the child's parent before administering medication;
226.28 	(2) get written permission from the child's parent before administering items that may 
226.29 	be applied externally, including but not limited to diapering products, sunscreen lotions, 
226.30 	hand sanitizer, lip balm, body lotion, and insect repellents. Items under this clause must be 
226.31 	administered according to the manufacturer's instructions unless a dentist or health care 
226.32 	provider gives alternative written instructions;
227.1 	(3) get and follow written instructions from a dentist or a health care provider before 
227.2 	administering each prescription. Medication with the child's name and current prescription 
227.3 	information on the label constitutes instructions;
227.4 	(4) follow written dosage instructions from a child's parent or health care provider for 
227.5 	over-the-counter medication that is intended to be ingested and does not include dosage 
227.6 	information within the manufacturer's instructions;
227.7 	(5) keep all medication in its original container and have a legible label stating the child's 
227.8 	first and last name. The medication must be given only to the child whose name is on the 
227.9 	label, unless as described in paragraph (b);
227.10 	(6) not give medication after an expiration date on the label, return any unused portion 
227.11 	to the child's parent if possible, and destroy any unused portion that cannot be returned;
227.12 	(7) document the administration of any ingested nonprescription medication and all 
227.13 	prescription medication. The documentation must include the first and last name of the 
227.14 	child, name of the medication or prescription number, date, time, dosage, and printed name 
227.15 	and signature or initials of the person who administered the medication. This documentation 
227.16 	must be available to the parent and maintained in the child's record;
227.17 	(8) store all medications, insect repellents, sunscreen lotions, and diaper rash control 
227.18 	products according to directions on the original container and in a place inaccessible to 
227.19 	children; and
227.20 	(9) not use herbal remedies and essential oils, unless prescribed or recommended by a 
227.21 	dentist or a health care provider. If these are administered, they must be administered in 
227.22 	compliance with the requirements of this subdivision.
227.23 	(b) Sunscreen lotions and insect repellents supplied by the license holder may be used 
227.24 	on more than one child and must be labeled for use for all children. A product to control or 
227.25 	prevent diaper rash, including premoistened commercial wipes that cannot be dispensed in 
227.26 	a manner that prevents cross contamination of the product and container as determined by 
227.27 	the health consultant, must be labeled with the child's first and last name and used only for 
227.28 	the individual child whose name is written on the label.
227.29 		Subd. 6.Diapers, changing areas, and disposal. Sanitary diaper procedures must be 
227.30 	used to reduce the spread of communicable disease. A license holder must:
227.31 	(1) make an adequate supply of clean diapers available for each child and store the 
227.32 	diapers in a clean place;
228.1 	(2) change diapers following the diaper changing procedure reviewed and approved by 
228.2 	the center's health consultant pursuant to subdivision 2, paragraph (e), clause (2);
228.3 	(3) post diaper changing procedures reviewed and certified by the center's health 
228.4 	consultant in the diaper changing area;
228.5 	(4) keep children in diapers clean and dry. Diapers and clothing must be changed 
228.6 	immediately or as soon as practicable when wet or soiled. Soiled clothing must be placed 
228.7 	in a plastic bag and sent home with the parent daily;
228.8 	(5) use single-service wipes for cleaning a wet or soiled child;
228.9 	(6) clean and disinfect changing tables and changing pads between children;
228.10 	(7) use smooth, nonabsorbent surfaces for the diaper changing area and flooring;
228.11 	(8) require the program staff person to maintain a hand on the child at all times during 
228.12 	diapering. Children must not be left unattended on the changing table;
228.13 	(9) clean and disinfect diaper changing areas, including but not limited to counters, sinks, 
228.14 	and floors, daily or immediately when soiled;
228.15 	(10) keep a covered diaper disposal receptacle lined with a disposable plastic bag in the 
228.16 	diaper changing area. Diapers cannot be disposed of in a kitchen disposal area;
228.17 	(11) empty, clean, and disinfect diaper receptacles daily or more often as needed; and
228.18 	(12) only change a diaper in the diaper changing area. The diaper changing area must 
228.19 	be separate from areas used for food storage, food preparation, and eating.
228.20 		Subd. 7.Hand washing; child. (a) A child's hands must be washed with soap and water 
228.21 	after a diaper change, after use of a toilet or toilet training chair, and immediately before 
228.22 	eating a meal or snack.
228.23 	(b) Program staff must monitor hand washing and assist a child who needs help.
228.24 	(c) The use of a common basin or a hand sink filled with standing water is prohibited.
228.25 	(d) Hands must be dried on a single-use towel or warm air hand dryer. The use of a 
228.26 	common or shared cloth or towel is prohibited.
228.27 	(e) In sinks accessible to children, the water temperature must not exceed 120 degrees 
228.28 	Fahrenheit to prevent children from scalding themselves while washing.
228.29 	(f) A hand sanitizer with at least 60 percent alcohol may be used to clean a child's hands 
228.30 	when soap and water are unavailable.
229.1 		Subd. 8.Hand washing; program staff. Program staff must wash their hands with soap 
229.2 	and water after changing a child's diaper, after assisting a child on the toilet, after washing 
229.3 	the diapering surface, after using toilet facilities, and before handling food or eating. Hands 
229.4 	must be dried on a single-use towel or warm air hand dryer. The use of a common or shared 
229.5 	cloth or towel is prohibited. Program staff may use a hand sanitizer with at least 60 percent 
229.6 	alcohol when soap and water are unavailable.
229.7 		Subd. 9.First aid kit. The license holder must have a first aid kit that is accessible in 
229.8 	the center at all times and whenever children are off site that includes:
229.9 	(1) adhesive bandages in assorted sizes and tape;
229.10 	(2) sterile compresses;
229.11 	(3) elastic bandage wrap;
229.12 	(4) scissors;
229.13 	(5) ice bag or cold pack;
229.14 	(6) digital thermometer;
229.15 	(7) mild liquid soap or hand sanitizer that is at least 60 percent alcohol;
229.16 	(8) bottled water;
229.17 	(9) disposable powder-free, latex-free gloves;
229.18 	(10) face shield or protective barrier for giving CPR; and
229.19 	(11) first aid instructions.
229.20 		Subd. 10.Handling and disposal of bodily fluids. A license holder must comply with 
229.21 	the following procedures for safely handling and disposing of bodily fluids:
229.22 	(1) surfaces that come in contact with urine, feces, vomit, and blood must be cleaned 
229.23 	and disinfected;
229.24 	(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
229.25 	(3) sharp items used for a child with special care needs must be disposed of in a sharps 
229.26 	container. The sharps container must be inaccessible to a child when stored;
229.27 	(4) the license holder must have bodily fluid disposal supplies in the center, including 
229.28 	disposable gloves, disposal bags, and eye protection; and
229.29 	(5) each employee and volunteer must follow universal precautions to reduce the risk 
229.30 	of spreading infectious disease.
230.1 		Subd. 11.Tobacco products, vaping, drugs, and alcohol use prohibitions. (a) A 
230.2 	license holder must comply with the drug and alcohol policy requirements in section 142B.10, 
230.3 	subdivision 1, paragraph (c), including ensuring that no employee, subcontractor, or volunteer 
230.4 	is under the influence of a chemical that impairs the individual's ability to provide services 
230.5 	or care.
230.6 	(b) The possession or use of marijuana, products containing THC, alcohol, and illegal 
230.7 	drugs is prohibited on the premises of the program during operating hours, including all 
230.8 	indoor and outdoor licensed program environments and in any vehicles used by the program.
230.9 	(c) The use of tobacco products, vaping devices, and electronic cigarettes is prohibited 
230.10 	indoors, in vehicles used by the program, and in outdoor areas where children are present.
230.11 	(d) The license holder must post in a prominent location at the main entrance of the 
230.12 	center a notice stating that use of tobacco products is prohibited inside the building and in 
230.13 	outdoor areas where children are present.

230.14 	Sec. 31. [142H.30] ATTENDANCE RECORDS.
230.15 		Subdivision 1.Attendance records. A child care center must maintain documentation 
230.16 	of actual attendance for each child receiving care. The records must be accessible to the 
230.17 	commissioner during the program's hours of operation, be completed on the actual day of 
230.18 	attendance, and include:
230.19 	(1) the first and last name of the child;
230.20 	(2) the time of day that the child was dropped off; and
230.21 	(3) the time of day that the child was picked up.
230.22 		Subd. 2.Daily classroom tracking. (a) A license holder must ensure that program staff 
230.23 	track children in their classroom on a daily basis to ensure the center has an active roster 
230.24 	of children present in their classroom.
230.25 	(b) Children must be tracked as they arrive in and depart from the classroom.
230.26 	(c) Tracking must include the first and last name of each child.
230.27 	(d) The classroom tracking documentation must remain with each group at all times 
230.28 	throughout the day including outdoor play, emergency evacuations, field trips, and when 
230.29 	groups are combined.

231.1 	Sec. 32. [142H.31] CLEANING, SANITIZING, AND DISINFECTING.
231.2 		Subdivision 1.Products and procedures. Cleaning and disinfecting must be done in 
231.3 	accordance with policies, procedures, and products approved by the program's health 
231.4 	consultant as specified in section 142H.29, subdivision 2.
231.5 		Subd. 2.Indoor and outdoor equipment. (a) The indoor and outdoor space and 
231.6 	equipment of the program must be clean.
231.7 	(b) Natural elements and materials used as equipment and play materials under section 
231.8 	142H.141; natural features used for outdoor play under section 142H.34, subdivision 7, 
231.9 	paragraph (h); and play materials used in outdoor settings are exempt from being clean, as 
231.10 	defined under section 142H.01, subdivision 12. A program staff person must inspect natural 
231.11 	elements and materials, natural features, and play materials used for outdoor play for 
231.12 	hazardous objects and other safety hazards, including animal feces, and remove or mitigate 
231.13 	the hazard before a child's use.
231.14 		Subd. 3.Pacifiers. Pacifiers must be labeled with each child's name or other individual 
231.15 	identifier and stored separately.
231.16 		Subd. 4.Cleaning frequency. The license holder must develop and follow a cleaning 
231.17 	schedule that requires:
231.18 	(1) cleaning and sanitizing food preparation areas, tables, high chairs, and food service 
231.19 	counters before and after each meal and snack. Sanitizing must be done by using an 
231.20 	Environmental Protection Agency-registered sanitizer or a bleach solution or by heating to 
231.21 	temperatures sufficient to destroy most germs, pursuant to guidelines from the commissioner 
231.22 	of health on infectious diseases in child care settings;
231.23 	(2) cleaning and sanitizing items that have been inside a child's mouth or come into 
231.24 	contact with bodily fluids prior to being used by another child;
231.25 	(3) cleaning sleeping equipment and bedding, including:
231.26 	(i) washing bedding used by a child before being used by another child;
231.27 	(ii) washing bedding used by the same child weekly or when soiled;
231.28 	(iii) cleaning and disinfecting sleeping equipment used by a child before being used by 
231.29 	another child; and
231.30 	(iv) cleaning and disinfecting sleeping equipment used by the same child weekly or 
231.31 	when soiled;
231.32 	(4) cleaning toileting areas daily, including:
232.1 	(i) emptying and disinfecting toilet training chairs after each use; and
232.2 	(ii) disinfecting toilets and seats when soiled or at least daily; and
232.3 	(5) emptying garbage cans and diaper receptacles on a daily basis and cleaning and 
232.4 	disinfecting the cans and receptacles as needed.

232.5 	Sec. 33. [142H.32] FOOD, DRINKING WATER, AND NUTRITION.
232.6 		Subdivision 1.On-site food preparation. A license holder that prepares, handles, or 
232.7 	serves food or washes food, utensils, or equipment on site must comply with applicable 
232.8 	requirements for food and beverage service establishments in chapter 157 and Minnesota 
232.9 	Rules, chapter 4626, and local health department requirements.
232.10 		Subd. 2.Off-site food preparation. (a) Meals or snacks may be provided by an off-site, 
232.11 	licensed food and beverage service establishment.
232.12 	(b) The center must maintain on file a copy of the off-site food and beverage service 
232.13 	establishment's current license and the contract to provide food for the center.
232.14 		Subd. 3.Providing food. A license holder must provide meals and snacks to the children 
232.15 	in attendance. The license holder must supplement food provided by the parent if it does 
232.16 	not meet United States Department of Agriculture Child and Adult Care Food Program 
232.17 	(CACFP) nutritional requirements.
232.18 		Subd. 4.Drinking water. (a) The center must have a safe supply of drinking water 
232.19 	pursuant to section 142H.35.
232.20 	(b) Drinking water must be available to children throughout the hours of operation and 
232.21 	offered at frequent intervals. Drinking water for children must be provided in single-service 
232.22 	drinking cups, in reusable water bottles, in reusable cups, or from drinking fountains 
232.23 	accessible to children.
232.24 	(c) A license holder may provide drinking water to a child in a reusable water bottle or 
232.25 	reusable cup if the center develops and ensures implementation of a written policy that at 
232.26 	a minimum includes the following procedures:
232.27 	(1) each day the water bottle or cup is used, the license holder must clean the water bottle 
232.28 	or cup or allow the child's parent to bring the water bottle or cup home to clean it;
232.29 	(2) a water bottle or cup must be assigned to a specific child and labeled with the child's 
232.30 	first and last name;
233.1 	(3) water bottles and cups must be stored in a manner that reduces the risk of a child 
233.2 	using the wrong water bottle or cup; and
233.3 	(4) a water bottle or cup must be used only for water.
233.4 		Subd. 5.Menus. The license holder must ensure:
233.5 	(1) meals and snacks prepared or provided by the license holder or catered by a licensed 
233.6 	food and beverage caterer comply with the meal pattern and nutritional requirements 
233.7 	contained in the most current edition of the CACFP standards in Code of Federal Regulations, 
233.8 	title 7, section 226.20;
233.9 	(2) menus comply with the meal pattern and nutritional requirements contained in the 
233.10 	most current edition of the CACFP standards in Code of Federal Regulations, title 7, section 
233.11 	226.20;
233.12 	(3) the current menu is posted or made readily available to parents; and
233.13 	(4) any food substitutions are noted on the menu at the time of the change.
233.14 		Subd. 6.Sanitation. (a) Procedures for preparing, handling, storing, and serving food 
233.15 	and washing food, utensils, and equipment must comply with the requirements for food and 
233.16 	beverage establishments in Minnesota Rules, chapter 4626.
233.17 	(b) If the food is prepared off site by another facility or if food service is provided 
233.18 	according to a contract with a food service provider, the facility or license holder must 
233.19 	ensure that food is prepared in compliance with Minnesota Rules, chapter 4626.
233.20 	(c) The license holder must provide refrigeration for dairy products and other perishable 
233.21 	foods, whether supplied by the license holder or supplied by the parent. The refrigeration 
233.22 	must have a temperature of 41 degrees Fahrenheit or less.
233.23 		Subd. 7.Meals and snacks. Except for infants under subdivision 11, the license holder 
233.24 	must serve meals and snacks to children as follows:
233.25 	(1) one snack for a child in attendance for two to five hours;
233.26 	(2) one meal and two snacks or two meals and one snack for a child in attendance for 
233.27 	five to ten hours;
233.28 	(3) a minimum of two meals and two snacks for a child in attendance for more than ten 
233.29 	hours; and
233.30 	(4) a minimum of three meals and two snacks for a child in attendance for more than 14 
233.31 	hours.
234.1 		Subd. 8.Prescribed diet requirements. (a) If a child is unable to follow the CACFP 
234.2 	meal pattern requirements due to a diet-related medical condition, a prescribed diet 
234.3 	accommodation is required.
234.4 	(b) The license holder must obtain documentation from the child's health care provider 
234.5 	about the child's special dietary needs and keep that information current. The license holder 
234.6 	must use this information to accommodate the child's dietary needs.
234.7 	(c) When a license holder enrolls a child who requires a prescribed diet, the license 
234.8 	holder must ensure that an individual child care program plan is developed and maintained 
234.9 	in the child's record, pursuant to sections 142H.15, subdivision 3, and 142H.27.
234.10 	(d) The license holder must provide for a child's prescribed dietary needs or require the 
234.11 	parent to provide the prescribed diet items that are not part of the center's menu plan.
234.12 		Subd. 9.Cultural or religious diet accommodations. (a) When special diets are 
234.13 	requested for cultural or religious reasons, the center must obtain written, dated, and signed 
234.14 	instructions from the child's parent on how to accommodate the diet.
234.15 	(b) The license holder must provide for a child's special diet for cultural or religious 
234.16 	reasons or require the parent to provide the food items that are not part of the center's menu 
234.17 	plan.
234.18 		Subd. 10.Food allergy information. Information about food allergies of the children 
234.19 	in the center must follow the requirements in section 142H.15, subdivision 5.
234.20 		Subd. 11.Infant food and feeding schedule. The diet and feeding schedule of an infant 
234.21 	must be determined by the infant's parent. The license holder of a center serving infants 
234.22 	must:
234.23 	(1) obtain written dietary instructions from the parent of the child that are used to develop 
234.24 	the infant's feeding schedule and are updated as needed as the child's feeding needs change;
234.25 	(2) have each individual infant's feeding schedule available in the food preparation area;
234.26 	(3) offer the child formula or milk and nutritionally adequate solid foods in quantities 
234.27 	at specified time intervals as determined by the parent;
234.28 	(4) ensure infants are held or fed sitting up for bottled feedings until the infant can 
234.29 	independently sit up and feed themselves. A bottle must not be propped at any time for an 
234.30 	infant or fed to an infant in a crib, infant seat, or playpen;
234.31 	(5) use sanitary procedures and practices to prepare, handle, and store formula, milk, 
234.32 	breast milk, solid foods, and supplements, including having procedures to ensure bottles 
235.1 	are matched to the correct infant. Procedures must be reviewed and certified by a health 
235.2 	consultant;
235.3 	(6) not warm or heat bottles in a microwave;
235.4 	(7) not allow children access to bottle-warming devices; and
235.5 	(8) label all bottles, breast milk, or prepared parent-provided food with the child's first 
235.6 	and last name and date of preparation. All formula must be refrigerated immediately after 
235.7 	preparation or upon arrival if the formula is prepared by the parent.
235.8 		Subd. 12.Additional requirements. (a) The center must serve food that is not a choking 
235.9 	hazard and that is developmentally appropriate in size, amount, and texture.
235.10 	(b) Program staff must be seated with the children during meal and snack times.

235.11 	Sec. 34. [142H.33] TRANSPORTATION AND FIELD TRIP REQUIREMENTS.
235.12 		Subdivision 1.Requirements. A license holder that provides transportation for children 
235.13 	or that takes children off site must comply with the requirements in this section.
235.14 		Subd. 2.Driver requirements. (a) A driver who transports children for a license holder 
235.15 	must:
235.16 	(1) be at least 18 years old;
235.17 	(2) hold a current and valid driver's license appropriate to the vehicle used to transport 
235.18 	children;
235.19 	(3) have a copy of the driver's current driver's license on file at the center;
235.20 	(4) be free from the influence of any substance that could impair driving abilities; and
235.21 	(5) follow seat belt and child passenger restraint system requirements under sections 
235.22 	169.685 and 169.686.
235.23 	(b) Parents who are not employed by the center who use personal vehicles for 
235.24 	transportation to occasional field trips do not have to meet the requirements of paragraph 
235.25 	(a), clause (3). For the purposes of this subdivision, "occasional" means three or fewer times 
235.26 	per calendar year.
235.27 		Subd. 3.Requirements during transportation. (a) One program staff is required per 
235.28 	vehicle when transporting school-age children. Two program staff are required per vehicle 
235.29 	when transporting infants, toddlers, and preschoolers. An additional program staff person 
235.30 	is required in the vehicle if there are 12 or more infants and toddlers. The driver of the 
236.1 	vehicle is considered a program staff person, unless the driver is employed by a contractor 
236.2 	or third party.
236.3 	(b) A two-way communication system and first aid kit must be present in the vehicle 
236.4 	during transportation.
236.5 	(c) Once children have exited, the vehicle must be checked to ensure that no child has 
236.6 	been left in the vehicle.
236.7 	(d) When the license holder provides transportation to and from the center, children 
236.8 	must not be transported more than one hour per one-way trip.
236.9 	(e) When children board or exit the vehicle, the license holder must ensure that each 
236.10 	child safely boards and exits the vehicle from the curb side of the street whenever physically 
236.11 	possible and out of the path of moving vehicles.
236.12 	(f) Drop off or pick up must be conducted in a safe manner with supervision by the 
236.13 	program staff responsible for the child.
236.14 		Subd. 4.Field trip requirements. (a) For the purposes of this section, a field trip is 
236.15 	defined as any time the center takes children off the property, including routine outings 
236.16 	such as walking around the neighborhood. A center providing transportation for children 
236.17 	to and from the center is not considered a field trip.
236.18 	(b) Staff-to-child ratios must be maintained on all field trips.
236.19 	(c) Written permission must be obtained from each child's parent before taking a child 
236.20 	on a field trip. The written permission form must be obtained before each field trip or on a 
236.21 	form that yearly summarizes all field trips that will be taken. The permission forms must 
236.22 	be kept on file at the center.
236.23 	(d) The parent's written permission form must include:
236.24 	(1) the date and destination of the field trip;
236.25 	(2) the times of departure from and return to the facility;
236.26 	(3) the method of transportation; and
236.27 	(4) if the method of transportation is walking, an estimated total distance of the walk.
236.28 	(e) Unscheduled neighborhood walks may be taken, provided the program has obtained 
236.29 	advance written parental permission for the general plan for neighborhood walks.
236.30 	(f) A child care program that includes daily or regular off-site outdoor activities in its 
236.31 	child care program plan may use an annual permission form for these activities. Parents 
237.1 	must be informed of specific destinations and any substantial changes to the general plan 
237.2 	outlined in the annual permission form through the child care program's regular 
237.3 	communication methods. The annual permission form must include the following 
237.4 	information:
237.5 	(1) the general geographic area or areas where the off-site outdoor activities will occur;
237.6 	(2) the general hours during which off-site activities may occur;
237.7 	(3) the typical method of transportation; and
237.8 	(4) the typical maximum distance of walks, if the method of transportation is walking.
237.9 	(g) When centers take children on a walk or field trip, program staff must bring:
237.10 	(1) a first aid kit as required under section 142H.29, subdivision 9;
237.11 	(2) a child's allergy information as required under section 142H.15, including the 
237.12 	individual child care program plan;
237.13 	(3) the name and telephone number of each child's parent and at least one emergency 
237.14 	contact person;
237.15 	(4) medication and supplies needed for a child who has a health condition that could 
237.16 	need medication, special procedures, or precautions during the course of the trip; and
237.17 	(5) a working cell phone or other means of immediate communication.

237.18 	Sec. 35. [142H.34] FACILITY.
237.19 		Subdivision 1.Occupancy designation. (a) At initial licensure, an applicant must 
237.20 	demonstrate compliance with the standards specified by the State Building Code and any 
237.21 	applicable local building ordinances.
237.22 	(b) Prior to the child care facility being remodeled, substantially improved, renovated, 
237.23 	or reconstructed, the license holder must verify whether approval from the applicable state 
237.24 	or local building officials is needed. If needed, the license holder must obtain written 
237.25 	verification of compliance with the State Building Code and any applicable local building 
237.26 	ordinances.
237.27 		Subd. 2.Fire inspection. (a) The center must be inspected by a fire marshal within 12 
237.28 	months prior to initial licensure. The commissioner must not grant an initial license until 
237.29 	receiving written approval of compliance with the State Fire Code from the fire marshal 
237.30 	with jurisdiction.
238.1 	(b) Pursuant to the time frames in paragraph (d), the center must have a fire inspection 
238.2 	at least once every five calendar years from the date of the last fire inspection report. The 
238.3 	fire inspection must include written approval of compliance with the State Fire Code from 
238.4 	the fire marshal with jurisdiction.
238.5 	(c) Prior to the use of any areas of the structure not previously inspected and approved 
238.6 	for child care use, the center must:
238.7 	(1) receive written confirmation from the state fire marshal that approval from the state 
238.8 	fire marshal is not needed; or
238.9 	(2) conduct a fire inspection, which must include written approval of compliance with 
238.10 	the State Fire Code from the fire marshal with jurisdiction.
238.11 	(d) For centers holding a valid license as of July 1, 2029:
238.12 	(1) centers initially licensed before January 1, 1998, must meet the requirement under 
238.13 	paragraph (b) no later than July 1, 2029;
238.14 	(2) centers initially licensed on or after January 1, 1998, but before January 1, 2013, 
238.15 	must meet the requirement under paragraph (b) no later than July 1, 2030;
238.16 	(3) centers initially licensed on or after January 1, 2013, but before January 1, 2021, 
238.17 	must meet the requirement under paragraph (b) no later than July 1, 2031; and
238.18 	(4) centers initially licensed on or after January 1, 2021, must meet the requirement 
238.19 	under paragraph (b) no later than July 1, 2032.
238.20 	(e) Centers that have already completed a fire inspection within five years of July 1, 
238.21 	2029, are exempt from paragraph (d).
238.22 		Subd. 3.Reinspection for cause. If the commissioner has reasonable cause to believe 
238.23 	that a potential hazard exists or the license holder is operating out of compliance with 
238.24 	applicable codes, the commissioner may request another inspection and written report by 
238.25 	a fire marshal, building official, or health authority.
238.26 		Subd. 4.Facility floor plan and designated areas. (a) Indoor and outdoor space to be 
238.27 	used for child care must be designated on a facility floor plan.
238.28 	(b) Space designated on a facility floor plan must be exclusively used for child care by 
238.29 	the center during the hours of operation.
238.30 	(c) The initial application for licensure and the center's administrative record must contain 
238.31 	a floor plan of the center. Precise scale drawings are not required. The plan must indicate:
239.1 	(1) the dimensions and location of all areas of the center designated for the provision of 
239.2 	child care including planned use of each area; and
239.3 	(2) the size and location of areas used for outdoor activity.
239.4 		Subd. 5.Child's personal storage space. A center must have storage space for each 
239.5 	child's clothing and personal belongings. The space must be at a height appropriate for the 
239.6 	age of the child.
239.7 		Subd. 6.Space for children who become sick. (a) Space must be provided in the center 
239.8 	for a child who becomes sick at a center not licensed to operate a sick care program under 
239.9 	section 142H.19.
239.10 	(b) The space must be separate from activity areas used by other children but may still 
239.11 	be within the classroom.
239.12 	(c) A cot, mat, or crib and blanket must be provided as appropriate to the developmental 
239.13 	level of the child.
239.14 	(d) The space must be supervised by a program staff person when occupied by a sick 
239.15 	child.
239.16 		Subd. 7.Outdoor learning environment and play space. (a) A center must provide 
239.17 	or have available an outdoor activity area that complies with this subdivision unless licensed 
239.18 	to exclusively provide night care as specified under section 142H.16, licensed to provide 
239.19 	drop-in care as specified under section 142H.17, licensed to provide sick care as specified 
239.20 	under section 142H.19, or operating for fewer than three hours a day.
239.21 	(b) A center must have an outdoor activity area of at least 1,500 square feet, and there 
239.22 	must be at least 75 square feet of space per child within the outdoor play area at any given 
239.23 	time during use.
239.24 	(c) The outdoor activity area must be enclosed if it is located adjacent to a hazard, 
239.25 	including but not limited to traffic, rail, water, or machinery, unless the area is a public park 
239.26 	or playground.
239.27 	(d) An outdoor activity area used daily by children under school age must be within 
239.28 	2,000 feet of the center or transportation must be provided by the license holder. The outdoor 
239.29 	activity area must not be farther than one-half mile from the center.
239.30 	(e) The area must contain the outdoor equipment required under section 142H.14.
239.31 	(f) The play area must be free of potential hazards, including but not limited to broken 
239.32 	glass, toxic materials, machinery, unlocked vehicles, feces, and sewage contaminants.
240.1 	(g) An energy-absorbing surface is required under installed climbing equipment, swings, 
240.2 	and slides. An energy-absorbing surface can be loose sand, pea gravel, or mulch in a depth 
240.3 	of at least nine inches; any material that meets ASTM F1292 specifications; or shredded 
240.4 	rubber and poured energy-absorbing surfacing installed to manufacturer's specifications 
240.5 	based on the height of the equipment. A fall zone is required around the equipment.
240.6 	(h) Natural features used for outdoor play that are not installed as equipment are not 
240.7 	subject to the requirements of paragraph (g). When a child uses natural features for outdoor 
240.8 	play, a program staff person must remove hazardous objects as specified in subdivision 17 
240.9 	and mitigate hazards whenever possible from the surrounding area where children might 
240.10 	fall. Natural features used for outdoor play must be appropriate to the age and size of children, 
240.11 	in safe condition, and used under the supervision of a program staff person.
240.12 		Subd. 8.Indoor space. A center must have a minimum of 35 square feet of indoor space 
240.13 	available per child in attendance. Hallways, stairways, closets, utility rooms, restrooms, 
240.14 	kitchens, and space occupied by cribs are not indoor space for the purposes of this 
240.15 	subdivision. Twenty-five percent of the space occupied by furniture or equipment used by 
240.16 	staff or children may be counted as indoor space.
240.17 		Subd. 9.Shielding of hot surfaces. Heating appliances must be installed and maintained 
240.18 	in accordance with the manufacturer's instruction and the State Building Code. Radiators, 
240.19 	fireplaces, hot pipes, and other hot surfaces in areas used by children must be shielded or 
240.20 	insulated to prevent burns.
240.21 		Subd. 10.Electrical outlets. Except in a center that serves only school-age children, 
240.22 	electrical outlets must be tamper proof or shielded when not in use.
240.23 		Subd. 11.Water hazards. Bodies of water within or adjacent to the center must be 
240.24 	inaccessible to children. When using a pool or beach, children must be supervised at all 
240.25 	times.
240.26 		Subd. 12.Room temperature. An indoor temperature of 68 degrees Fahrenheit to 82 
240.27 	degrees Fahrenheit must be maintained in all rooms used by children.
240.28 		Subd. 13.Hazardous areas. Kitchens, stairs, and other hazardous areas must be 
240.29 	inaccessible to children except during periods of supervised use.
240.30 		Subd. 14.Fire extinguisher inspection. Fire extinguishers must be serviced by a qualified 
240.31 	inspector at least once every 365 days. The name of the inspector and date of the inspection 
240.32 	must be written on a tag attached to the extinguisher.
241.1 		Subd. 15.Toilet articles.  As needed, a license holder must provide and make available 
241.2 	toilet paper, liquid hand soap, facial tissues, and single-use paper towels or warm air hand 
241.3 	dryers.
241.4 		Subd. 16.Toilets and hand sinks. (a) The center must have at least one hand sink for 
241.5 	every 15 children in the center's licensed capacity.
241.6 	(b) The center must have at least one toilet for every 15 children, excluding infants, in 
241.7 	the center's licensed capacity. Toilet training chairs may be used for toddlers in lieu of a 
241.8 	toilet.
241.9 	(c) The center must provide handwashing sinks within three feet of the diaper changing 
241.10 	surface. The sink must have hot and cold running water. In newly constructed centers or 
241.11 	those undergoing major remodeling to the plumbing system, foot- or wrist-operated sinks 
241.12 	must be provided in the diaper changing area.
241.13 	(d) Any hand sink required for children other than infants must be in the toilet area. The 
241.14 	temperature of hot water in the hand sinks used by children must not exceed 120 degrees 
241.15 	Fahrenheit. Hand sinks for children must not be used for custodial work or food preparation, 
241.16 	including preparing infant bottles. Single-service towels or air dryers must be available to 
241.17 	dry hands and designed for easy use by children.
241.18 	(e) Toilets, sinks, faucets, and hand-drying devices in the toilet area used by children 
241.19 	under school age other than infants must be placed at a height appropriate to the ages of the 
241.20 	children. A sturdy nonslip platform on which children may stand may be used to meet the 
241.21 	height requirement in this paragraph for toddlers and preschoolers.
241.22 	(f) Plungers and toilet-cleaning devices must be inaccessible to children.
241.23 		Subd. 17.Hazardous objects. (a) The license holder must prevent children from 
241.24 	accessing hazardous objects, including any item that could reasonably cause injury, choking, 
241.25 	poisoning, burning, cutting, or other harm to a child, or any item designated by the 
241.26 	manufacturer to be stored out of reach of children.
241.27 	(b) Activities that are part of the program plan may include the use of hazardous objects 
241.28 	when supervised by program staff.
241.29 	(c) Supplies and materials used by children must be labeled "nontoxic" by the 
241.30 	manufacturer.
241.31 		Subd. 18.Telephone. (a) A working telephone that is capable of making outgoing calls 
241.32 	and receiving incoming calls must be located within the licensed child care center at all 
242.1 	times. The telephone must be accessible to staff as needed and be sufficiently charged for 
242.2 	use at all times.
242.3 	(b) Program staff must have access to a working telephone while providing care and 
242.4 	supervision to children in care outside of the child care facility.
242.5 		Subd. 19.Animals. A license holder must:
242.6 	(1) keep each animal housed in the program up to date on vaccines required for that 
242.7 	species under state law or local ordinance and maintain documentation of vaccinations, if 
242.8 	any;
242.9 	(2) notify parents prior to their child's enrollment of the presence of animals in the 
242.10 	program, before new animals are housed, and prior to any animals visiting the program;
242.11 	(3) not let children handle animals without adult supervision; and
242.12 	(4) notify the parent of a child whose skin is broken by an animal bite or scratch or who 
242.13 	is otherwise injured by an animal in writing of the injury.
242.14 		Subd. 20.Pest control. (a) Effective measures must be taken to protect the center against 
242.15 	rodents and insects. If rodents, insects, or other pests are found, the license holder must take 
242.16 	steps to remove or exterminate them. Chemicals, baits, and traps for insect and rodent control 
242.17 	must not be used in areas accessible to children when children are present and must be used 
242.18 	according to the manufacturer's instructions.
242.19 	(b) Chemicals to control weeds, rodents, insects, and other pests must be used only after 
242.20 	other means have been used for control, such as eliminating harborages, removing access 
242.21 	to food, and sealing points of entry. These compounds must be used according to labeled 
242.22 	instructions. If chemicals are used, the license holder must notify the parents of enrolled 
242.23 	children what pesticide will be applied and where it will be applied no less than 48 hours 
242.24 	before application, unless in cases of emergency. Only approved, United States 
242.25 	Environmental Protection Agency-registered insecticides, rodenticides, and herbicides may 
242.26 	be used. Application must strictly follow all label instructions and must be authorized by 
242.27 	the director.
242.28 		Subd. 21.Posting license. A license holder must post the license in a clearly visible 
242.29 	place within the child care center that is accessible to parents and guardians.

242.30 	Sec. 36. [142H.35] ENVIRONMENTAL HEALTH.
242.31 		Subdivision 1.Water supply. A child care center must have a safe water supply. Child 
242.32 	care centers that obtain water from privately owned wells or sources must test any water 
243.1 	used for cooking or drinking by a Department of Health-certified laboratory to verify safety. 
243.2 	License holders must follow the lead testing requirements in section 145.9273.
243.3 		Subd. 2.Radon testing. (a) The license holder must notify parents whether radon testing 
243.4 	has been conducted in the program upon enrollment and within 30 days of any subsequent 
243.5 	testing done after enrollment.
243.6 	(b) When notifying parents, the license holder must use a form prescribed by the 
243.7 	commissioner. The notice must include information from the Department of Health about 
243.8 	what radon is and the potential risks associated with radon exposure. If testing has been 
243.9 	completed, the notice must include:
243.10 	(1) the date of the most recent test;
243.11 	(2) the rooms or areas tested; and
243.12 	(3) the detected radon level or levels, stated in picocuries per liter.
243.13 	(c) A license holder must keep a copy of the most recent notice to parents and the radon 
243.14 	test results on site and make the notice and results available to parents and the commissioner 
243.15 	upon request. The provider may meet this requirement by posting the radon testing results 
243.16 	in a conspicuous place.

243.17 	Sec. 37. [142H.36] MALTREATMENT OF MINORS INTERNAL REVIEW.
243.18 	If a license holder has reason to know that an internal or external report of alleged or 
243.19 	suspected maltreatment has been made, the license holder must:
243.20 	(1) establish and maintain policies and procedures to ensure that an internal review is 
243.21 	completed within 30 calendar days and that corrective action is taken if necessary to protect 
243.22 	the health and safety of children in care. The review must include an evaluation of whether:
243.23 	(i) related policies and procedures were followed;
243.24 	(ii) the policies and procedures were adequate;
243.25 	(iii) there is a need for additional staff training;
243.26 	(iv) the reported event is similar to past events with the children or the services involved; 
243.27 	and
243.28 	(v) there is a need for corrective action by the license holder to protect the health and 
243.29 	safety of children in care;
244.1 	(2) develop, document, and implement a corrective action plan designed to correct any 
244.2 	current lapses and prevent future lapses in performance by individuals or the license holder, 
244.3 	based on the results of the review;
244.4 	(3) identify the primary and secondary person or position who will ensure that, when 
244.5 	required, internal reviews are completed. The secondary person must be involved when 
244.6 	there is reason to believe that the primary person was involved in the alleged or suspected 
244.7 	maltreatment; and
244.8 	(4) document and make internal reviews accessible to the commissioner immediately 
244.9 	upon the commissioner's request. For the purposes of this section, the documentation provided 
244.10 	to the commissioner by the license holder may consist of a completed checklist that verifies 
244.11 	completion of each of the requirements of the review.

244.12 	Sec. 38. Minnesota Statutes 2024, section 245A.211, subdivision 1, is amended to read:
244.13 		Subdivision 1.Applicability. This section applies to all programs licensed or certified 
244.14 	under this chapter, chapters 142C, 142H, 142I, 245D, 245F, 245G, and sections 245I.20
244.15 	and 245I.23. The requirements in this section are in addition to any applicable requirements 
244.16 	for the use of holds or restraints for each license or certification type.

244.17 	Sec. 39. REVISOR INSTRUCTION.
 244.18 	(a) The revisor of statutes must renumber Minnesota Statutes, section 142B.68, as 
244.19 	Minnesota Statutes, section 142H.37.
244.20 	(b) The revisor of statutes must make any necessary changes to statutory cross-references 
244.21 	to reflect the changes in this article.
244.22 	(c) The revisor of statutes must replicate the statutory history for all sections and 
244.23 	subdivisions repealed and reenacted in this article.

244.24 	Sec. 40. REPEALER.
 244.25 	(a) Minnesota Rules, parts 9503.0005; 9503.0010; 9503.0015; 9503.0030; 9503.0031; 
244.26 	9503.0032; 9503.0033; 9503.0034; 9503.0040; 9503.0045; 9503.0050; 9503.0055; 
244.27 	9503.0060; 9503.0065; 9503.0070; 9503.0075; 9503.0080; 9503.0085; 9503.0090; 
244.28 	9503.0095; 9503.0100; 9503.0105; 9503.0110; 9503.0115; 9503.0120; 9503.0125; 
244.29 	9503.0130; 9503.0140; 9503.0145; 9503.0150; 9503.0155; and 9503.0170, are repealed.
245.1 	(b) Minnesota Statutes 2024, sections 142B.01, subdivisions 11, 12, 25, 26, and 27; 
245.2 	142B.41, subdivisions 6, 7, 10, 11, 12, and 13; 142B.54, subdivisions 1, 2, and 3; 142B.65, 
245.3 	subdivisions 1, 2, 3, 4, 5, 6, 7, and 10; and 142B.66, subdivisions 1, 2, 4, and 5, are repealed.
245.4 	(c) Minnesota Statutes 2025 Supplement, sections 142B.65, subdivisions 8 and 9; and 
245.5 	142B.66, subdivision 3, are repealed.

245.6 	Sec. 41. EFFECTIVE DATE.
 245.7 	This article is effective July 1, 2027.

245.8 	ARTICLE 13
245.9 	FAMILY CHILD CARE LICENSING MODERNIZATION

245.10 	Section 1. [142I.01] DEFINITIONS.
245.11 		Subdivision 1.Scope. For the purposes of this chapter, the terms in this section have 
245.12 	the meanings given.
245.13 		Subd. 2.Accessible to children. "Accessible to children" means capable of being reached 
245.14 	or used by a child without the aid of an adult.
245.15 		Subd. 3.Accredited. "Accredited" means a postsecondary institution or technical college 
245.16 	recognized and listed in the database of accredited postsecondary institutions and programs 
245.17 	maintained by the federal Department of Education.
245.18 		Subd. 4.Adult. "Adult" means a person at least 18 years of age.
245.19 		Subd. 5.Age categories. (a) "Newborn" means a child from birth up to six weeks old.
245.20 	(b) "Infant" means a child who is at least six weeks old but less than 12 months old.
245.21 	(c) "Toddler" means a child who is at least 12 months old but less than 24 months old.
245.22 	(d) "Preschooler" means a child who is at least 24 months old but less than five years 
245.23 	of age.
245.24 	(e) "School age" means a child who is at least five years of age but is less than 11 years 
245.25 	of age.
245.26 		Subd. 6.Agency. "Agency" means a county or multicounty social or human services 
245.27 	agency governed by a county board or a multicounty human services board.
245.28 		Subd. 7.Annual or annually. "Annual" or "annually" means at least once each calendar 
245.29 	year.
246.1 		Subd. 8.Applicant. "Applicant" has the same meaning as section 142B.01, subdivision 
246.2 	4.
246.3 		Subd. 9.Behavior guidance. "Behavior guidance" means an ongoing process whereby 
246.4 	caregivers offer constructive, positive, and developmentally appropriate guidance to children 
246.5 	to help them manage their own behavior in a socially acceptable manner.
246.6 		Subd. 10.Bodily fluid. "Bodily fluid" means urine, feces, vomit, blood, and other bodily 
246.7 	fluids with blood present.
246.8 		Subd. 11.Building official. "Building official" means the person appointed pursuant to 
246.9 	section 326B.133 to administer the State Building Code or the building official's authorized 
246.10 	representative.
246.11 		Subd. 12.Caregiver. "Caregiver" means the license holder, primary provider of care, 
246.12 	second adult caregiver, intermittent caregiver, helper, or substitute.
246.13 		Subd. 13.Child. "Child" means a person receiving child care services who falls within 
246.14 	the age categories in subdivision 5.
246.15 		Subd. 14.Child care. "Child care" means the care of a child in a family child care 
246.16 	program. This includes the children of the license holder and any other caregivers in the 
246.17 	family child care program who receive child care during child care hours.
246.18 		Subd. 15.Child with special health care needs or disabilities. "Child with special 
246.19 	health care needs or disabilities" means a child who:
246.20 	(1) has developmental disabilities or is otherwise eligible for case management as 
246.21 	specified in Minnesota Rules, parts 9525.0004 to 9525.0036;
246.22 	(2) has been identified by the local school district as a child with a disability as specified 
246.23 	in section 125A.02, subdivision 1; or
246.24 	(3) has been determined to be a child with a disability by a health care provider as defined 
246.25 	in subdivision 25.
246.26 		Subd. 16.Clean. "Clean" means free from dirt or other contaminants that can be detected 
246.27 	by sight, smell, or touch.
246.28 		Subd. 17.Commissioner. "Commissioner" means the commissioner of children, youth, 
246.29 	and families or the commissioner's designated representative, including county agencies 
246.30 	and private agencies.
247.1 		Subd. 18.Community-based family child care program. "Community-based family 
247.2 	child care program" means a  family child care program that operates at a location other than 
247.3 	the primary residence of the license holder.
247.4 		Subd. 19.Department. "Department" means the Department of Children, Youth, and 
247.5 	Families.
247.6 		Subd. 20.Disinfect. "Disinfect" means the chemical process to kill most germs and 
247.7 	viruses on surfaces and objects after the surfaces and objects have been cleaned.
247.8 		Subd. 21.Emergency replacement. "Emergency replacement" means an adult who 
247.9 	supervises children in a family child care program due to an emergency and who has not 
247.10 	completed the training requirements under this chapter or the background study requirements 
247.11 	under chapter 245C.
247.12 		Subd. 22.Family child care program. "Family child care program" means a child care 
247.13 	program licensed under this chapter and chapter 142B operating from the license holder's 
247.14 	residence or other approved space that serves up to 18 children and is provided for less than 
247.15 	24 hours a day.
247.16 		Subd. 23.Fire marshal. "Fire marshal" means the person designated by section 299F.011 
247.17 	to administer and enforce the State Fire Code or a local fire code inspector approved by the 
247.18 	fire marshal.
247.19 		Subd. 24.Hazardous materials. "Hazardous materials" means any item that could 
247.20 	reasonably cause injury, choking, poisoning, burning, cutting, or other harm to a child, or 
247.21 	any item designated by the manufacturer to be stored out of reach of children.
247.22 		Subd. 25.Health care provider. "Health care provider" means a physician or physician's 
247.23 	assistant licensed to practice medicine under chapter 147; an advanced practice registered 
247.24 	nurse licensed under section 148.171; or a licensed psychiatrist, licensed psychologist, or 
247.25 	licensed consulting psychologist.
247.26 		Subd. 26.Helper. "Helper" means a minor, 14 through 17 years of age, who assists an 
247.27 	adult caregiver with the care of children.
247.28 		Subd. 27.Inaccessible to children. "Inaccessible to children" means not capable of 
247.29 	being reached or utilized by a child without the aid of an adult.
247.30 		Subd. 28.Intermittent caregiver. "Intermittent caregiver" means an adult who cares 
247.31 	for children in a family child care program alongside another adult caregiver for a cumulative 
247.32 	total of no more than 500 hours annually.
248.1 		Subd. 29.License. "License" has the meaning given in section 142B.01, subdivision 
248.2 	16.
248.3 		Subd. 30.License holder. "License holder" has the meaning given in section 142B.01, 
248.4 	subdivision 17, for a family child care program.
248.5 		Subd. 31.Licensed capacity. "Licensed capacity" means the total number of children 
248.6 	ten years of age or younger permitted at any one time on the premises of a family child care 
248.7 	program. All children ten years of age or younger on the premises count toward the capacity 
248.8 	of the family child care program.
248.9 		Subd. 32.Medication. "Medication" means any substance or preparation that is used 
248.10 	to prevent or treat a wound, injury, infection, or disease; maintain health; heal; or relieve 
248.11 	pain, including substances purchased over the counter or prescribed by a health care provider 
248.12 	or dentist. Medication includes substances taken internally or applied externally.
248.13 		Subd. 33.Owner or renter. "Owner" or "renter" means the individual, individuals, 
248.14 	organization, or government entity listed in the property title, deed, lease, or equivalent 
248.15 	legal document.
248.16 		Subd. 34.Parent. "Parent" means a person who has the legal responsibility for a child, 
248.17 	such as the child's mother, father, or legally appointed guardian.
248.18 		Subd. 35.Pests. "Pests" means any animals, insects, or other living creatures that are 
248.19 	not housed within the family child care program and are considered harmful or detrimental 
248.20 	to the health, safety, and well-being of individuals within a family child care program. This 
248.21 	includes but is not limited to ants, rodents, cockroaches, bedbugs, or bats.
248.22 		Subd. 36.Pets. "Pets" means all animals housed at the family child care program or that 
248.23 	have contact with children.
248.24 		Subd. 37.Premises. "Premises" means  the indoor and outdoor space in which a family 
248.25 	child care program is located.
248.26 		Subd. 38.Primary provider of care. "Primary provider of care" means the person 
248.27 	responsible for providing care to children during the hours of operation and operating a 
248.28 	family child care program in compliance with all applicable laws and regulations under this 
248.29 	chapter and chapters 142B and 245C. All individual license holders are primary providers 
248.30 	of care, as are individuals designated under section 142I.22, paragraph (f).
248.31 		Subd. 39.Radon testing. "Radon testing" means the measurement of radon gas levels 
248.32 	in the indoor air of the building.
249.1 		Subd. 40.Related. "Related" means any of the following relationships by marriage, 
249.2 	blood, or adoption: a spouse, a parent, an adoptive parent, a birth or adopted child or 
249.3 	stepchild, a stepparent, a stepbrother, a stepsister, a niece, a nephew, a grandparent, a 
249.4 	grandchild, a sibling, an aunt, an uncle, or a legal guardian.
249.5 		Subd. 41.Second adult caregiver. "Second adult caregiver'' means an adult who cares 
249.6 	for children in the family child care program for a cumulative total of more than 500 hours 
249.7 	annually along with the primary provider of care or substitute caregiver.
249.8 		Subd. 42.Separation. "Separation" is a form of behavior guidance that involves 
249.9 	interruption of unacceptable behavior by the removal of a child from a situation with the 
249.10 	intention of allowing the child an opportunity to pause and gain self-control. During a 
249.11 	separation a child is not allowed to participate in activities with other children.
249.12 		Subd. 43.State Building Code. "State Building Code" means the codes and regulations 
249.13 	adopted by the commissioner of administration pursuant to section 326B.107 and contained 
249.14 	in Minnesota Rules, chapter 1300.
249.15 		Subd. 44.State Fire Code. "State Fire Code" means the codes and regulations adopted 
249.16 	by the state fire marshal pursuant to section 299F.011 and contained in Minnesota Rules, 
249.17 	chapter 7511.
249.18 		Subd. 45.Substitute. "Substitute" means an adult who is responsible for the duties of 
249.19 	a primary provider of care when the primary provider of care is not present at the family 
249.20 	child care program. A substitute may not provide care for more than 500 hours per calendar 
249.21 	year.
249.22 		Subd. 46.Supervision. "Supervision" means:
249.23 	(1) caregivers must be within sight or hearing of newborns, infants, toddlers, and 
249.24 	preschoolers at all times and must intervene in an effort to protect the health and safety of 
249.25 	the child. Electronic monitoring devices can only be used to monitor infants, toddlers, and 
249.26 	preschoolers when they are asleep;
249.27 	(2) for a school-age child, a caregiver must be available and in close enough proximity 
249.28 	to provide in-person assistance and care to ensure the child's health and safety is protected. 
249.29 	Electronic devices may be used to support supervision, but must not replace the caregiver's 
249.30 	ability to provide assistance or care in person; and
249.31 	(3) the caregiver has an awareness of and responsibility for the activity of each child 
249.32 	and is near enough to respond and reach children immediately, including responding to the 
249.33 	child's basic needs and intervening to protect them from harm.
250.1 		Subd. 47.Variance. "Variance" means written permission from the department pursuant 
250.2 	to the requirements in section 142B.10, subdivision 16, paragraph (c), for a license holder 
250.3 	or applicant to depart from a specific requirement in this chapter or chapter 142B.

250.4 	Sec. 2. [142I.02] LICENSING OF PROGRAMS.
250.5 		Subdivision 1.Purpose. The purpose of this chapter is to establish procedures and 
250.6 	standards for licensing family child care and community-based family child care programs 
250.7 	to ensure that minimum standards of care and service are given and the protection, care, 
250.8 	health, safety, and development of the children are assured.
250.9 		Subd. 2.Applicability. A family child care program must be licensed under this chapter 
250.10 	and chapter 142B to operate in Minnesota.

250.11 	Sec. 3. [142I.03] LICENSING PROCESS.
250.12 		Subdivision 1.License application. (a) An applicant for a family child care license 
250.13 	must follow the requirements of this section and section 142B.10.
250.14 	(b) Applicants must use the application issued by the department. The application must 
250.15 	be made in the county where the family child care program will operate.
250.16 	(c) Applicants must be the proposed license holders of the family child care program.
250.17 	(d) An application for licensure is complete and ready for the agency's review after the 
250.18 	applicant completes, signs, and submits all department forms and documentation needed 
250.19 	for licensure to the agency and the agency receives all inspection, zoning, evaluation, and 
250.20 	investigative reports, documentation, and information required to verify compliance with 
250.21 	this chapter and applicable statutes, including a completed background study for individuals 
250.22 	subject to a study, as required under chapter 245C.
250.23 		Subd. 2.Licensing study. (a) The applicant must give the agency access to the family 
250.24 	child care program for a licensing study to determine compliance with all applicable rules 
250.25 	and statutes.
250.26 	(b) If the commissioner determines a potentially hazardous condition exists due to 
250.27 	noncompliance with this chapter or local ordinances, the applicant must obtain an inspection 
250.28 	from a fire marshal, building official, or authorized community health board agent under 
250.29 	section 145A.04 to verify the absence of hazard or identify needed corrections. Any condition 
250.30 	cited as hazardous and creating an immediate danger of fire or threat to life or safety must 
250.31 	be corrected.
251.1 	(c) An applicant must undergo an initial inspection of the family child care program by 
251.2 	a fire marshal to determine compliance with the State Fire Code and compliance with orders 
251.3 	issued if the program:
251.4 	(1) has freestanding solid-fuel-heating appliances;
251.5 	(2) will operate in a manufactured or mobile home;
251.6 	(3) will use a basement for child care;
251.7 	(4) is located in mixed- or multiple-occupancy buildings. For the purposes of this clause, 
251.8 	"mixed-occupancy building" means a structure that contains nonresidential occupancies, 
251.9 	such as an attached garage, and "multiple-occupancy building" means a structure with two 
251.10 	or more residential dwelling units, such as a duplex, apartment building, or townhome; or
251.11 	(5) is located in a commercial space.
251.12 		Subd. 3.Ineligibility factors. (a) An applicant, caregiver, or any person who resides 
251.13 	where the family child care program operates and who is present when children are in care 
251.14 	or works with the children in care is prohibited from:
251.15 	(1) abusing prescribed or nonprescribed drugs or use alcohol or controlled substances 
251.16 	specified in chapter 152 to the extent that the use or abuse has or may have a negative effect 
251.17 	on the ability of the primary provider of care to give care or is apparent during the hours of 
251.18 	operation;
251.19 	(2) having had a child placed in foster care within the prior 12 months for reasons that 
251.20 	the agency determines reflect on the ability of the license holder or the primary provider of 
251.21 	care to safely provide family child care. This clause does not apply if the primary reason 
251.22 	for the placement was due to a physical illness of the parent due to a disability of the child, 
251.23 	including developmental disability of the child; or for the temporary care of a newborn or 
251.24 	infant being relinquished for adoption;
251.25 	(3) having had a child placed in a residential facility within the prior 12 months for 
251.26 	reasons that the agency determines reflect on the ability of the license holder or the primary 
251.27 	provider of care to safely provide family child care; or
251.28 	(4) exhibiting behavior that could pose a risk to children being served in the family child 
251.29 	care program. Additional assessments or documentation may be requested to determine the 
251.30 	impact on the provider's ability to provide care.
251.31 	(b) Caregivers who have abused prescribed or nonprescribed drugs or have been 
251.32 	dependent on alcohol or controlled substances specified in chapter 152, such that the use, 
252.1 	abuse, or dependency has negatively affected the ability to give care, was apparent during 
252.2 	the hours of operation, or required treatment or therapy, must have 12 months of verified 
252.3 	abstinence before licensure.
252.4 		Subd. 4.Variances. The department may grant variances to this chapter. Upon receipt 
252.5 	of a variance request, the department must make a determination on the variance request 
252.6 	within 30 business days.
252.7 		Subd. 5.Posting license. The license holder must post the license in the family child 
252.8 	care program in a location where parents, visitors, and authorized representatives of the 
252.9 	commissioner can easily access and view the license.
252.10 		Subd. 6.Change in license terms. A license holder must submit a new application form 
252.11 	in accordance with section 142B.10 before:
252.12 	(1) relocating the family child care program;
252.13 	(2) changing from family child care to community-based family child care;
252.14 	(3) changing from community-based family child care to family child care;
252.15 	(4) changing between any class A and class C license type; or
252.16 	(5) changing a current C license class to a higher C license class.
252.17 		Subd. 7.Number of licenses. Each individual applicant is limited to one family child 
252.18 	care license.
252.19 		Subd. 8.Access to program. As required in section 142B.10, subdivision 12, caregivers 
252.20 	must give authorized representatives of the commissioner access to the family child care 
252.21 	program premises during the hours of operation.
252.22 		Subd. 9.Disposal of license. When a family child care program is closed, or if a license 
252.23 	is revoked, suspended, or not renewed, the license holder must remove the license from 
252.24 	being posted in the home within 14 days of ceasing operation or upon the final order of 
252.25 	revocation, denial, or suspension of license; stop all advertising; and refrain from providing 
252.26 	care to children as required in section 142B.05, subdivision 1.
252.27 		Subd. 10.Local government authority. The authority of local units of government to 
252.28 	establish requirements for family child care programs is limited by section 299F.011, 
252.29 	subdivision 4a, paragraph (a), clauses (1) and (2).
252.30 		Subd. 11.Background studies. All individuals subject to a background study must 
252.31 	comply with the requirements of chapter 245C.
253.1 		Subd. 12.Child care license holder insurance. (a) The license holder must complete 
253.2 	and provide to parents a form prescribed by the commissioner that includes information 
253.3 	about the license holder's liability insurance status. The license holder must update the form 
253.4 	and obtain each parent's signature whenever insurance coverage changes, a policy lapses, 
253.5 	or a new policy takes effect. If the license holder has a continuous insurance policy that 
253.6 	renews each year, the license holder may indicate the policy's renewal date in the initial 
253.7 	written notice to parents, and no further notices are required until the insurance coverage 
253.8 	changes or the policy lapses.
253.9 	(b) The form under this subdivision must include the date of the policy's expiration or 
253.10 	renewal or indicate if the license holder does not carry liability insurance.
253.11 	(c) A copy of the current certificate of liability insurance must be made available upon 
253.12 	request to parents, the commissioner, and agency licensing staff.

253.13 	Sec. 4. [142I.04] AGENCY RECORDS.
253.14 		Subdivision 1.Agency records. An agency must maintain the following records for 
253.15 	each license holder:
253.16 	(1) a copy of the completed licensing application form signed by the applicant and the 
253.17 	agency;
253.18 	(2) a physical health report on any adult caregiver that was submitted prior to giving 
253.19 	care in the family child care program. The physical health report must verify that the adult 
253.20 	caregiver is physically able to care for children;
253.21 	(3) any written reports from a fire marshal, building official, or agent of a community 
253.22 	health board authorized under chapter 145A;
253.23 	(4) if the applicant has been licensed through another jurisdiction, a reference from the 
253.24 	licensing authority in that jurisdiction;
253.25 	(5) the initial and annual inspection by the agency of the license holder. Any comments 
253.26 	of the license holder about the inspections by the agency must also be noted in the agency 
253.27 	record;
253.28 	(6) a copy of the notification given to parents, prior to a child's admission, indicating 
253.29 	that pets are present in the residence and documentation as required in section 142I.19, 
253.30 	subdivision 4;
253.31 	(7) documentation of any variance requests and the approval or denial of the request in 
253.32 	accordance with section 142I.03; and
254.1 	(8) the results of each background study required under chapter 245C.
254.2 		Subd. 2.Data privacy. The agency, commissioner, and authorized agent as defined in 
254.3 	section 142B.01, subdivision 5, must have access to license holder records on children in 
254.4 	care to determine compliance with this chapter. All caregivers must maintain the privacy 
254.5 	of records on children by refraining from discussing or disclosing any records, including 
254.6 	electronic records, or information on children in care to any persons other than the parent 
254.7 	of the child, the agency, the commissioner, and medical or public safety persons if the 
254.8 	information is necessary to protect the health and safety of the child.

254.9 	Sec. 5. [142I.05] REPORTING TO AGENCY.
254.10 		Subdivision 1.Maltreatment, abuse, and neglect reporting. All caregivers who suspect, 
254.11 	know, or have reason to believe a child is being or has been maltreated under section 260E.03, 
254.12 	subdivision 12, must immediately report the information to the local welfare agency, agency 
254.13 	responsible for assessing or investigating the report, police department, county sheriff, 
254.14 	Tribal social services agency, or Tribal police as required by chapter 260E.
254.15 		Subd. 2.Other reporting. Primary providers of care must notify the agency:
254.16 	(1) prior to anyone moving into the residence where family child care services are 
254.17 	provided. A background study must be completed in accordance with section 245C.13, 
254.18 	subdivision 2;
254.19 	(2) within ten calendar days after a household member has moved out of the residence 
254.20 	where family child care services are provided;
254.21 	(3) before a new caregiver provides direct contact services for the first time, unless an 
254.22 	individual is acting as an emergency replacement according to section 142I.09, subdivision 
254.23 	2;
254.24 	(4) of any damage to the premises that may affect compliance with this chapter or any 
254.25 	incident at the premises that results in the loss of utility services, within 24 hours after the 
254.26 	occurrence;
254.27 	(5) within 24 hours after the occurrence of any serious injury, head injury, hospitalization, 
254.28 	or death of a child in care. For the purposes of this clause, "serious injury" means an injury 
254.29 	that reasonably requires the care of a health care provider or dentist; and
254.30 	(6) within 24 hours after the occurrence of an animal bite in accordance with section 
254.31 	142I.19, subdivision 4.

255.1 	Sec. 6. [142I.06] ADMISSIONS; RECORDS; REPORTING.
255.2 		Subdivision 1.Admission and ongoing information. (a) Prior to admission of a child 
255.3 	and annually while the child is enrolled, the parents and primary provider of care must 
255.4 	discuss family child care program policies and licensing requirements.
255.5 	(b) The license holder must not disclose a child's record to any person other than the 
255.6 	child, the child's parent or guardian, the child's legal representative, employees of the license 
255.7 	holder, and the agency unless the child's parent or guardian has given written consent or as 
255.8 	otherwise required by law.
255.9 		Subd. 2.Statutory summary for parents. A descriptive summary of this chapter must 
255.10 	be distributed to the parent by the license holder at the time a child is admitted to care. The 
255.11 	summary must be provided by the department to the agencies for distribution to license 
255.12 	holders and must:
255.13 	(1) state that this chapter and chapter 142B govern the licensing of family child care 
255.14 	programs;
255.15 	(2) specify the section headings contained in this chapter; and
255.16 	(3) state that a complete copy of this chapter is available at the family child care program, 
255.17 	agency, department, or State Law Library or through the revisor of statutes website.
255.18 		Subd. 3.Parental access. A parent who has enrolled a child must be allowed access to 
255.19 	the child and the licensed space at any time while the child is in care unless a court order 
255.20 	or other legal documentation restricts access. A copy of the order or other legal 
255.21 	documentation must be kept in the child's record at the family child care program.
255.22 		Subd. 4.Attendance records. A license holder must maintain documentation of 
255.23 	attendance for each child receiving care for a minimum of five years. The records must be 
255.24 	accessible to the commissioner during the family child care program's hours of operation, 
255.25 	must be completed on the day of attendance, and must include:
255.26 	(1) the first and last name of the child;
255.27 	(2) the time of day that the child was dropped off; and
255.28 	(3) the time of day that the child was picked up.
255.29 		Subd. 5.License holder policies. (a) The license holder must follow and monitor 
255.30 	implementation of the policies and procedures by all caregivers as required in section 
255.31 	142B.10, subdivision 21.
256.1 	(b) When applicable for the program, the license holder must have written policies 
256.2 	available for discussion with parents and the commissioner and provide an electronic or 
256.3 	hard copy to the parent at the time of admission or upon request. The policies must include, 
256.4 	at a minimum:
256.5 	(1) program operation policies, including:
256.6 	(i) the ages and numbers of children the family child care program is licensed to serve;
256.7 	(ii) the hours and days of operation, including plans for holiday closings, personal time, 
256.8 	and policies for inclement weather closings;
256.9 	(iii) fees, including payment schedule, overtime charges, and registration fees as 
256.10 	applicable;
256.11 	(iv) parental access to the family child care program that states a parent who enrolls a 
256.12 	child must be allowed access to the child and the licensed space at any time while the child 
256.13 	is in care;
256.14 	(v) nondiscrimination practices to comply with section 142I.21;
256.15 	(vi) the termination of child care and expulsion notice procedures; and
256.16 	(vii) the use of a helper, a substitute for personal leave or holidays, and an emergency 
256.17 	substitute according to the licensing requirements in section 142I.09;
256.18 	(2) health and safety policies, including on:
256.19 	(i) allergy prevention and response;
256.20 	(ii) the administration and storage of medication and topical products;
256.21 	(iii) the care of ill children, isolation precautions, symptoms for discharge and return, 
256.22 	immunizations, medicine permission policies, and whether the license holder will care for 
256.23 	an ill child;
256.24 	(iv) disease notification procedures, including notifying the parents of exposed children 
256.25 	within 24 hours of a parent or caregiver notifying the license holder of a reportable disease 
256.26 	under section 142I.19, subdivision 9. The notice must be posted in a clearly visible, accessible 
256.27 	place or provided individually to each parent of a child who was exposed;
256.28 	(v) meals, snacks, infant formula, breast milk, and supplemental foods to be provided, 
256.29 	including labeling requirements for food brought from the child's home;
256.30 	(vi) sleeping and resting arrangements;
257.1 	(vii) emergency procedures, fire and storm plans, and transportation in an emergency, 
257.2 	including whether parent permission is required;
257.3 	(viii) how the license holder prevents abuse of prescription medication or being in any 
257.4 	manner under the influence of a chemical that impairs the caregiver's ability to provide 
257.5 	services or care as required under section 142B.10, subdivision 1, paragraph (c); and
257.6 	(ix) the legal requirements for firearms in a family child care program through a statement 
257.7 	that must include the language under section 142I.19, subdivision 7; and
257.8 	(3) program environment policies, including:
257.9 	(i) behavior guidance and discipline;
257.10 	(ii) field trips, including by foot, and whether parent permission is required;
257.11 	(iii) the presence of pets in the family child care program, including notification prior 
257.12 	to the introduction of a new pet to the program;
257.13 	(iv) the use of screen time; and
257.14 	(v) the use of social media, images, and video in accordance with subdivision 7.
257.15 		Subd. 6.Records for each child. (a) The license holder must obtain the records in this 
257.16 	subdivision from parents prior to the admission of a child. The license holder must keep 
257.17 	this information up to date and on file for each child.  The license holder must have a parent 
257.18 	annually review the information in a child's record, update the information as necessary, 
257.19 	and keep the information on file.
257.20 	(b) For each enrolled child, the license holder must maintain a signed and completed 
257.21 	admission and arrangement form, as prescribed by the commissioner, and a completed 
257.22 	enrollment form, as developed and approved by the commissioner.
257.23 	(c) Immunization records must be kept in accordance with section 121A.15 and Minnesota 
257.24 	Rules, chapter 4604. Prior to enrollment, a license holder must request a child's immunization 
257.25 	record. The record must be kept on file and updated as follows:
257.26 	(1) for an infant, every six months;
257.27 	(2) for a toddler, annually;
257.28 	(3) for a preschooler, every 18 months; and
257.29 	(4) for a school-age child, every three years.
258.1 	(d) For each enrolled child, the license holder must obtain signed written consent from 
258.2 	a parent allowing the license holder to obtain emergency medical care or treatment for the 
258.3 	child.
258.4 	(e) A license holder must release a child from care only to a parent or other person 
258.5 	authorized in writing by the parent. The information must be reviewed at least annually by 
258.6 	the parent and updated when information changes.
258.7 		Subd. 7.Social media, images, and video sharing. (a) Caregivers are prohibited from 
258.8 	sharing photos, videos, or other personal identifying information of enrolled children, except 
258.9 	to provide updates to parents who have provided written consent. If a license holder wishes 
258.10 	to use photos or videos of the family child care program and the enrolled children for 
258.11 	promotional or publicity purposes, including on social media accounts or public digital 
258.12 	platforms, the license holder must obtain written consent from parents prior to use.
258.13 	(b) Notwithstanding paragraph (a), the license holder must share photos, videos, and 
258.14 	other personal identifying information of enrolled children with the commissioner upon 
258.15 	request.
258.16 		Subd. 8.Nondiscrimination. A caregiver is prohibited from discriminating in relation 
258.17 	to enrollment in their program based on race, color, creed, religion, national origin, sex, 
258.18 	gender identity, marital status, disability, sexual orientation, or familial status.

258.19 	Sec. 7. [142I.07] CAPACITY AND RATIOS.
258.20 		Subdivision 1.Capacity limits. License holders must be licensed for the total number 
258.21 	of children ten years of age or younger who are present on the premises of the family child 
258.22 	care program at any one time during child care hours, including the caregiver's own children 
258.23 	and foster children.
258.24 		Subd. 2.Capacity, ratios, and age distribution restrictions. (a) The commissioner 
258.25 	must issue licenses based on the capacity and ratios in this subdivision.
258.26 	(b) License holders with a class A license must meet the following requirements:

258.27258.28
258.29258.30	Class
	Capacity
	Minimum 
Adult 
Caregivers
	Maximum 
Children 
Under School 
Age
	Maximum 
Total Infants 
and Toddlers
	Maximum 
Infants
	
258.31	A
	10
	1
	6
	3
	2
	
258.32 	(c) License holders with a class C license must meet the following requirements:

259.1259.2
259.3259.4	Class
	Capacity
	Minimum 
Adult 
Caregivers
	Maximum 
Children 
Under School 
Age
	Maximum 
Total Infants 
and Toddlers
	Maximum 
Infants
	
259.5	C1
	5
	1
	5
	3
	3
	
259.6	C2
	10
	1
	8
	4
	2
	
259.7	C3
	12
	1
	10
	3
	2
	
259.8	C4
	14
	2
	10
	6
	4
	
259.9	C5
	18
	2
	12
	5
	2
	
259.10 		Subd. 3.Newborn care. When a newborn is in care and only one adult caregiver is 
259.11 	present, the newborn must be the only child under 12 months of age present, and the license 
259.12 	holder must not care for more than two other children at the same time unless the newborn 
259.13 	is the license holder's child. When a second adult caregiver is also present or the newborn 
259.14 	is the child of the license holder, then the newborn is considered an infant for the purposes 
259.15 	of child-to-adult ratios and age distribution restrictions.
259.16 		Subd. 4.Supervision, primary provider of care, and use of substitutes. (a) Children 
259.17 	in care must be supervised by an adult caregiver. The adult caregiver must have knowledge 
259.18 	of each child's needs, including but not limited to developmental and behavioral needs and 
259.19 	parental preferences, and be accountable for each child's care at all times. A caregiver must 
259.20 	be within sight or hearing of newborns, infants, toddlers, and preschoolers at all times 
259.21 	without the use of monitoring devices, except as provided in section 142I.18.
259.22 	(b) The primary provider of care must be the primary caregiver in the family child care 
259.23 	program unless a substitute is being used in accordance with section 142I.09. A helper may 
259.24 	be used in place of a second adult caregiver when there is no more than one newborn, infant, 
259.25 	or toddler present.
259.26 	(c) The use of a substitute caregiver must be in accordance with section 142I.09.
259.27 		Subd. 5.Overnight care. When a family child care program has a child in care after 11 
259.28 	p.m. and before 5 a.m.:
259.29 	(1) at least one adult caregiver must remain awake and available to respond to children's 
259.30 	needs at all times. The program must maintain required caregiver-to-child ratios. Additional 
259.31 	caregivers may sleep when ratios are maintained and must be available to resume supervision 
259.32 	when needed;
259.33 	(2) all awake children must be given the opportunity to engage in age-appropriate 
259.34 	activities in a separate room away from sleeping children; and
259.35 	(3) the child care emergency plan must include a plan tailored to sleeping children.
260.1 		Subd. 6.Class C5 licenses. (a) Class C5 licenses must always operate at the level of 
260.2 	exit discharge.
260.3 	(b) A family child care program with a class C license may operate as a lower C-class 
260.4 	level family child care program on days when the adult-to-child ratios allow it to operate 
260.5 	at a lower capacity.
260.6 		Subd. 7.Care of the license holder's own child or children. (a) With the license 
260.7 	holder's consent, an individual may be present in the licensed space and care for the license 
260.8 	holder's own child both inside and outside of the licensed space and is exempt from the 
260.9 	training and supervision requirements of section 142I.10 if the individual:
260.10 	(1) is related to the license holder or to the license holder's child, as defined in section 
260.11 	142I.01, subdivision 40, or is a household member who the license holder has reported to 
260.12 	the county agency;
260.13 	(2) is not a caregiver for the family child care program at the time that they are supervising 
260.14 	the license holder's own child;
260.15 	(3) only cares for the license holder's own child; and
260.16 	(4) does not have direct, unsupervised contact with any nonrelative children in care.
260.17 	(b) If the individual in paragraph (a) is not a household member, the individual is also 
260.18 	exempt from background study requirements under chapter 245C.
260.19 	(c) Where a caregiver is also a parent providing care to their own child in the family 
260.20 	child care program, sections 142I.13; 142I.17; 142I.20, subdivisions 1 to 3; and 142I.21 do 
260.21 	not apply to caregivers with regards to the care of their own children.
260.22 	(d) Notwithstanding paragraph (c), family child care programs with license holders or 
260.23 	caregivers providing care to their own child are not exempt from the capacity, ratio, and 
260.24 	age distribution requirements under this section. License holders and caregivers remain 
260.25 	subject to chapters 260E and 609 and other applicable statutes and rules.
260.26 	(e) Notwithstanding paragraph (c), the agency may enforce the standards in sections 
260.27 	142I.13; 142I.17; 142I.20, subdivisions 1 to 3; and 142I.21 when the caregiver's actions 
260.28 	with regards to the care of their own children affect the other children in the caregiver's 
260.29 	care.

260.30 	Sec. 8. [142I.08] QUALIFICATIONS.
260.31 		Subdivision 1.Age. An applicant for a family child care license must be an adult at the 
260.32 	time of application.
261.1 		Subd. 2.Physical and behavioral health. (a) An adult caregiver must be physically 
261.2 	and mentally able to care for children. An applicant or primary provider of care must provide 
261.3 	documentation to the agency along with the license application verifying that the applicant 
261.4 	has had a physical examination by a licensed physician, advanced practice registered nurse, 
261.5 	or physician assistant within 12 months prior to the application for initial licensure and that 
261.6 	the applicant or primary provider of care is physically able to care for children. Prior to 
261.7 	assisting in the care of children, the applicant must also provide documentation verifying 
261.8 	that any adult caregiver has had a physical examination by a licensed physician, advanced 
261.9 	practice registered nurse, or physician assistant within the past 12 months and is physically 
261.10 	able to care for children.
261.11 	(b) The commissioner may require a caregiver to provide reports on the caregiver's 
261.12 	physical or mental health from a health care provider when there is reason to believe that 
261.13 	a caregiver exhibits physical or mental health symptoms that could impair the caregiver's 
261.14 	ability to ensure the health and safety of children. The reports must not be used for any other 
261.15 	purpose than to determine whether the caregiver's physical or mental health impacts the 
261.16 	health and safety of children.
261.17 		Subd. 3.Additional class C5 license requirements. (a) An applicant or primary provider 
261.18 	of care receiving a class C5 license must have at least one of:
261.19 	(1) a minimum of one year of substantial compliance with this chapter as a 
261.20 	Minnesota-licensed family child care license holder, primary provider of care, or second 
261.21 	adult caregiver and a minimum of 1500 hours of direct care in a family child care program 
261.22 	serving children;
261.23 	(2) a minimum of six months of substantial compliance with this chapter as a family 
261.24 	child care license holder, primary provider of care, or second adult caregiver in Minnesota 
261.25 	and:
261.26 	(i) a minimum of 520 hours of experience as an assistant teacher, student teacher, or 
261.27 	intern in an elementary school, after-school program, or Minnesota-licensed child care 
261.28 	center or as an adult caregiver in a Minnesota-licensed family child care program and 30 
261.29 	hours of child care, health, and nutrition training as specified in section 142I.10; or
261.30 	(ii) a minimum of 520 hours of experience as a licensed practical or registered nurse, 
261.31 	and 30 hours of child development or early childhood education training, as specified in 
261.32 	section 142I.10;
261.33 	(3) certification or licensure indicating completion of one of the following:
262.1 	(i) a two-year child development or early childhood education associate or certificate 
262.2 	program at an accredited college or university;
262.3 	(ii) a child development associate certification;
262.4 	(iii) a certification from a recognized Montessori organization;
262.5 	(iv) a bachelor's degree or higher in early childhood education from an accredited college 
262.6 	or university; or
262.7 	(v) an elementary education degree from an accredited college or university that includes 
262.8 	a minimum of 30 hours of child development training; or
262.9 	(4) six months' experience working an average of 30 hours a week or more as a teacher, 
262.10 	as defined in section 142H.06, at a Minnesota-licensed child care center.
262.11 	(b) An applicant or primary provider of care must complete an additional large group 
262.12 	training created by the commissioner as a condition of receiving a class C5 license.

262.13 	Sec. 9. [142I.09] SUBSTITUTE CAREGIVERS AND REPLACEMENTS.
262.14 		Subdivision 1.Total hours allowed. The use of a substitute caregiver in a family child 
262.15 	care program is limited to a cumulative total of not more than 500 hours annually. When a 
262.16 	substitute is used, prior to the end of each business day the license holder must document 
262.17 	the name, date, and number of hours of each substitute who provided care.
262.18 		Subd. 2.Emergency replacement supervision. (a) In an emergency, a license holder 
262.19 	may allow an adult who has not completed the training requirements under this chapter or 
262.20 	the background study requirements under chapter 245C to supervise children in a family 
262.21 	child care program. For purposes of this subdivision, "emergency" means a situation in 
262.22 	which the license holder has begun operating the family child care program for the day and 
262.23 	for reasons beyond the control of the license holder, including but not limited to a serious 
262.24 	illness or injury, accident, or situation requiring the immediate attention of the license holder, 
262.25 	the license holder needs to leave the licensed space and close the program for the day.
262.26 	(b) To the extent practicable, the license holder must attempt to arrange for emergency 
262.27 	care by a substitute caregiver before using an emergency replacement.
262.28 	(c) When an emergency occurs:
262.29 	(1) the license holder or emergency replacement must contact the parents of the children 
262.30 	attending the family child care program and inform the parents that the program is closing 
262.31 	for the day and that the children need to be picked up as soon as practicable;
263.1 	(2) the license holder must not knowingly use a person as an emergency replacement 
263.2 	who has committed an action or has been convicted of a crime that would cause the person 
263.3 	to be disqualified from providing care to children if a background study was conducted 
263.4 	under chapter 245C;
263.5 	(3) the license holder must make reasonable efforts to minimize the amount of time the 
263.6 	emergency replacement has unsupervised contact with the children in care not to exceed 
263.7 	12 hours per emergency incident;
263.8 	(4) the family child care program must be closed for the day once the last unrelated child 
263.9 	has left the program; and
263.10 	(5) the license holder must notify the county licensing agency within seven days that an 
263.11 	emergency replacement was used and specify the circumstances that led to the use of the 
263.12 	emergency replacement.
263.13 	(d) The county licensing agency must notify the commissioner within three business 
263.14 	days after receiving the license holder's notice that an emergency replacement was used and 
263.15 	specify to the commissioner the circumstances that led to the use of the emergency 
263.16 	replacement.
263.17 	(e) A license holder is not required to provide the names of persons who may be used 
263.18 	as replacements in emergencies to parents or the county licensing agency. However, once 
263.19 	an emergency replacement has been used, the license holder must provide the name of the 
263.20 	individual used to the county licensing agency.

263.21 	Sec. 10. [142I.10] APPLICANT, PRIMARY PROVIDER OF CARE, AND SECOND 
263.22 	ADULT CAREGIVER TRAINING REQUIREMENTS.
263.23 		Subdivision 1.Initial training; applicant, primary provider of care, and second 
263.24 	adult caregiver. (a) Before providing care, an applicant, a primary provider of care, and 
263.25 	each second adult caregiver must have completed all required initial training within the 
263.26 	prior 24 months.
263.27 	(b) Initial training does not need to be completed before providing care in the following 
263.28 	circumstances:
263.29 	(1) a primary provider of care who voluntarily closes a license and reopens within 12 
263.30 	months has one year from the new license's effective date to complete annual and ongoing 
263.31 	training and is exempt from repeating initial training;
264.1 	(2) a primary provider of care who relocates within the state has until the end of the 
264.2 	calendar year to complete annual and ongoing training and is not required to repeat initial 
264.3 	training previously completed; and
264.4 	(3) a primary provider of care who relocates to a new county must not be required by 
264.5 	the new county to complete orientation or other training required for new applicants.
264.6 	(c) Each applicant, primary provider of care, and second adult caregiver must complete 
264.7 	and document the following before providing care:
264.8 	(1) at least four hours of child development, learning, or behavior guidance training. An 
264.9 	individual is exempt if the individual provides documentation verifying that the individual:
264.10 	(i) has completed a three-credit early childhood development course within the past five 
264.11 	years;
264.12 	(ii) holds a baccalaureate or master's degree in early childhood education or school-age 
264.13 	child care;
264.14 	(iii) holds a Minnesota teaching license in early childhood education, kindergarten 
264.15 	through grade 6, or special education; or
264.16 	(iv) holds a Montessori certificate;
264.17 	(2) the six-hour supervising for safety for family child care course developed by the 
264.18 	commissioner;
264.19 	(3) pediatric first aid training provided by an instructor certified to teach pediatric first 
264.20 	aid. Current training documentation must be maintained at the family child care program 
264.21 	and made available upon request. Online training reviewed and approved by the county 
264.22 	licensing agency satisfies this requirement;
264.23 	(4) pediatric cardiopulmonary resuscitation (CPR) training that:
264.24 	(i) is instructor led or blended with a hands-on skills component. Online-only CPR 
264.25 	courses without a hands-on component do not meet this requirement;
264.26 	(ii)(A) is developed by the American Heart Association or the American Red Cross; or
264.27 	(B) uses nationally recognized, evidence-based guidelines for CPR training; and
264.28 	(iii) is provided by an instructor approved by the commissioner to teach CPR;
264.29 	(5) for programs licensed for children younger than school age, training on reducing the 
264.30 	risk of sudden unexpected infant death and abusive head trauma, which may be combined 
264.31 	in a single commissioner-approved course. This training must, at a minimum, address the 
265.1 	risk factors related to sudden unexpected infant death and abusive head trauma and the 
265.2 	means of reducing the risk of each;
265.3 	(6) training on proper use and installation of child passenger restraint systems under 
265.4 	section 169.685 of at least one hour in length that is provided by an instructor certified and 
265.5 	approved by the Department of Public Safety. At a minimum, the training must address the 
265.6 	proper use of child restraint systems based on the child's size, weight, and age and the proper 
265.7 	installation of a car seat or booster seat in the motor vehicle used by the caregiver to transport 
265.8 	the child or children. This requirement does not apply to family child care programs that 
265.9 	transport only school-age children as defined in section 142I.01, subdivision 5, paragraph 
265.10 	(e), in child care buses as defined in section 169.448, subdivision 1, paragraph (e);
265.11 	(7) training on the child care emergency plan required under section 142I.19, subdivision 
265.12 	2;
265.13 	(8) training on allergy prevention and response required under section 142I.06, 
265.14 	subdivision 5, paragraph (b);
265.15 	(9) training on the community-based family child care program plan required under 
265.16 	section 142I.22, if applicable;
265.17 	(10) training on the family child care program policies and procedures required under 
265.18 	section 142I.06;
265.19 	(11) training on reporting suspected maltreatment of children as required under chapter 
265.20 	260E; and
265.21 	(12) swimming pool training under section 142I.14, subdivision 6, if a pool at the family 
265.22 	child care program is used by children in care.
265.23 	(d) County licensing staff must accept approved training on the primary provider of care 
265.24 	or second adult caregiver's learning record in the Develop data system for early education 
265.25 	and school-age care.
265.26 		Subd. 2.Annual training; primary provider of care and second adult caregiver. (a) 
265.27 	A primary provider of care and each second adult caregiver must annually complete and 
265.28 	document the following training:
265.29 	(1) at least two hours of child development, learning, or behavior guidance training. A 
265.30 	three-credit early childhood development course completed within the calendar year meets 
265.31 	this requirement;
265.32 	(2) a two-hour active supervision course developed or approved by the commissioner;
266.1 	(3) training on reducing the risk of sudden unexpected infant death if caring for infants 
266.2 	and training on reducing the risk of abusive head trauma if caring for children under school 
266.3 	age, which must:
266.4 	(i) be completed in person or online at least once every two years; and
266.5 	(ii) in alternating years, be completed through a commissioner-approved video not 
266.6 	exceeding one hour in length; and
266.7 	(4) at least four hours of ongoing training each calendar year that must include topics 
266.8 	identified in the Minnesota knowledge and competency framework. Repeat of topical training 
266.9 	requirements in subdivision 1 counts toward the annual ten-hour requirement.
266.10 	(b) A caregiver who is approved as a trainer through the Develop data system may count 
266.11 	up to two hours of training instruction toward the annual ten-hour training requirement in 
266.12 	paragraph (a), clause (4), if:
266.13 	(1) the training is the first instance in which the caregiver delivers a particular 
266.14 	content-specific training during each training year;
266.15 	(2) the caregiver is a Develop-approved active trainer; and
266.16 	(3) the hours counted as training instruction are approved through the Develop data 
266.17 	system with attendance verified on the trainer's individual learning record and are in the 
266.18 	knowledge and competency framework content areas VII A, establishing healthy practices, 
266.19 	or B, ensuring safety.
266.20 	(c) Unless specifically authorized in this section, one training does not fulfill two different 
266.21 	training requirements. Courses within the identified knowledge and competency areas that 
266.22 	are specific to child care centers or legal nonlicensed programs do not fulfill the requirements 
266.23 	of this section.
266.24 	(d) County licensing staff must accept training designated by the commissioner as 
266.25 	satisfying training requirements if the training is within the knowledge and competency 
266.26 	framework for child development and learning, behavior guidance, and active supervision 
266.27 	as indicated on the department's website.
266.28 		Subd. 3.Ongoing training; primary provider of care and second adult caregiver. (a) 
266.29 	A primary provider of care and each second adult caregiver must complete and document 
266.30 	the following training:
266.31 	(1) pediatric cardiopulmonary resuscitation training that meets the requirements of 
266.32 	subdivision 1, paragraph (c), clause (4), and is repeated every two years within 90 days of 
267.1 	the second anniversary of the previous training. Documentation must be maintained at the 
267.2 	family child care program or electronically and made available upon request;
267.3 	(2) pediatric first aid training by a certified instructor repeated every two years within 
267.4 	90 days of the second anniversary of the previous training. Documentation of the training 
267.5 	must be maintained at the family child care program or electronically and made available 
267.6 	upon request;
267.7 	(3) commissioner-developed Health and Safety I and Health and Safety II training at 
267.8 	least once every five years. Completion of either course in a given year meets the annual 
267.9 	active supervision training requirement in subdivision 2, paragraph (a), clause (2);
267.10 	(4) proper use and installation of child passenger restraint systems under section 169.685 
267.11 	that meets the requirements of subdivision 1, paragraph (c), clause (6), and is repeated at 
267.12 	least once every five years. This requirement does not apply to family child care programs 
267.13 	that transport only school-age children as defined in section 142I.01, subdivision 5, paragraph 
267.14 	(e), in child care buses as defined in section 169.448, subdivision 1, paragraph (e); and
267.15 	(5) fire safety training developed by the State Fire Marshal's Office that must be 
267.16 	completed once every five years.
267.17 	(b) If a license holder changes any of the policies and procedures under section 142I.06, 
267.18 	subdivision 5, the primary provider of care and each second adult caregiver must review 
267.19 	the revised policies and procedures within ten days of the change.
267.20 	(c) The license holder must maintain documentation of each review of the revised policies 
267.21 	and procedures at the family child care program. The documentation requirements under 
267.22 	this paragraph may be met by a date noted on the revised policies or procedures.
267.23 		Subd. 4.Commissioner designated training. Training designated by the commissioner 
267.24 	satisfies the training requirements under this section if the training is within the knowledge 
267.25 	and competency framework for child development and learning, behavior guidance, and 
267.26 	active supervision, as indicated on the department's website.

267.27 	Sec. 11. [142I.11] SUBSTITUTE AND INTERMITTENT CAREGIVER TRAINING 
267.28 	REQUIREMENTS.
267.29 		Subdivision 1.Initial training; substitute and intermittent caregiver. (a) Before 
267.30 	providing care, each substitute and intermittent caregiver must complete the following 
267.31 	training requirements within the previous 12 months:
268.1 	(1) the four-hour basics of family child care for substitutes course developed by the 
268.2 	commissioner;
268.3 	(2) pediatric first aid training provided by an instructor certified to teach pediatric first 
268.4 	aid. Current training documentation must be maintained at the family child care program 
268.5 	and made available upon request. Online training reviewed and approved by the county 
268.6 	licensing agency satisfies this requirement;
268.7 	(3) pediatric cardiopulmonary resuscitation  training that meets the requirements of 
268.8 	section 142I.10, subdivision 1, paragraph (c), clause (4);
268.9 	(4) for programs licensed for children younger than school age, training on reducing the 
268.10 	risk of sudden unexpected infant death and abusive head trauma, which may be combined 
268.11 	in a single commissioner-approved course. This training must, at a minimum, address the 
268.12 	risk factors related to sudden unexpected infant death and abusive head trauma and the 
268.13 	means of reducing the risk of each;
268.14 	(5) training on proper use and installation of child passenger restraint systems under 
268.15 	section 169.685 of at least one hour in length, provided by an instructor certified and 
268.16 	approved by the Department of Public Safety. This requirement does not apply to family 
268.17 	child care programs that transport only school-age children as defined in section 142I.01, 
268.18 	subdivision 5, paragraph (e), in child care buses as defined in section 169.448, subdivision 
268.19 	1, paragraph (e). At a minimum, the training must address the proper use of child restraint 
268.20 	systems based on the child's size, weight, and age and the proper installation of a car seat 
268.21 	or booster seat in the motor vehicle used by the caregiver to transport the child or children;
268.22 	(6) training on the child care emergency plan required under section 142I.19, subdivision 
268.23 	2;
268.24 	(7) training on allergy prevention and response required under section 142I.06, 
268.25 	subdivision 5, paragraph (b);
268.26 	(8) training on the community-based family child care program plan required under 
268.27 	section 142I.22, if applicable;
268.28 	(9) training on the family child care program policies and procedures required under 
268.29 	section 142I.06;
268.30 	(10) training on reporting suspected maltreatment of children as required under chapter 
268.31 	260E; and
268.32 	(11) swimming pool training under section 142I.14, subdivision 6, if a pool at the family 
268.33 	child care program is used by children in care.
269.1 	(b) County licensing staff must accept approved training on the substitute or intermittent 
269.2 	caregiver's learning record in the Develop data system for early education and school-age 
269.3 	care.
269.4 		Subd. 2.Annual training; substitute and intermittent caregiver. (a) Substitutes and 
269.5 	intermittent caregivers must complete a minimum of one hour of training each calendar 
269.6 	year, and the training must include the requirements in this section.
269.7 	(b) Each calendar year, a substitute or intermittent caregiver must receive training on 
269.8 	reducing the risk of abusive head trauma from shaking infants and young children if caring 
269.9 	for children under school age and reducing the risk of sudden unexpected infant death if 
269.10 	caring for infants. A substitute must complete each applicable course at least once every 
269.11 	two years either in person or online. In a year a substitute or intermittent caregiver is not 
269.12 	completing an applicable course under this paragraph in person or online, the individual 
269.13 	must watch a video on the respective topic of no more than one hour in length. The video 
269.14 	must be developed or approved by the commissioner. A license holder must maintain 
269.15 	documentation of compliance with this paragraph for each substitute and intermittent 
269.16 	caregiver employed.
269.17 		Subd. 3.Ongoing training; substitute and intermittent caregiver. (a) At least once 
269.18 	every three years, a substitute or intermittent caregiver must complete the four-hour basics 
269.19 	of family child care for substitutes course.
269.20 	(b) A substitute or intermittent caregiver must complete the following training:
269.21 	(1) pediatric cardiopulmonary resuscitation training  that meets the requirements of 
269.22 	section 142I.10, subdivision 1, paragraph (c), clause (4), and is repeated every two years 
269.23 	within 90 days of the second anniversary of the previous training. Documentation must be 
269.24 	maintained at the family child care program or electronically and made available upon 
269.25 	request;
269.26 	(2) pediatric first aid that is given by an instructor certified to provide pediatric first aid 
269.27 	and is repeated every two years within 90 days of the second anniversary of the previous 
269.28 	training. Documentation of the training must be maintained at the family child care program 
269.29 	or electronically and made available upon request; and
269.30 	(3) proper use and installation of child passenger restraint systems under section 169.685 
269.31 	that meets the requirements of section 142I.10, subdivision 1, paragraph (c), clause (6), and 
269.32 	is repeated at least once every five years. This requirement does not apply to family child 
269.33 	care programs that transport only school-age children as defined in section 142I.01, 
270.1 	subdivision 5, paragraph (e), in child care buses as defined in section 169.448, subdivision 
270.2 	1, paragraph (e).

270.3 	Sec. 12. [142I.12] HELPER TRAINING REQUIREMENTS.
270.4 		Subdivision 1.Initial training; helper. (a) Before assisting in care, a helper who assists 
270.5 	with care must complete a minimum of four hours of training within the previous 12 months. 
270.6 	The four hours must include courses on:
270.7 	(1) reducing the risk of sudden unexpected infant death if the program is licensed to care 
270.8 	for infants;
270.9 	(2) abusive head trauma if the program is licensed to care for children younger than 
270.10 	school age; and
270.11 	(3) reporting suspected maltreatment of children as required under chapter 260E.
270.12 	(b) The trainings required under paragraph (a) may be combined in a single 
270.13 	commissioner-approved course.
270.14 	(c) A license holder must maintain written or electronic documentation showing that 
270.15 	each helper has complied with this subdivision.
270.16 		Subd. 2.Annual training; helper. (a) Each calendar year, a helper who assists in the 
270.17 	care of children must receive training on reducing the risk of sudden unexpected infant 
270.18 	death if the program is licensed to care for infants, and abusive head trauma if the program 
270.19 	is licensed to care for children younger than school age. The trainings under this paragraph 
270.20 	may be combined in a single commissioner-approved course and must, at a minimum, 
270.21 	address risk factors, methods of risk reduction in child care, and communication with parents 
270.22 	regarding risk reduction.
270.23 	(b) A license holder must maintain documentation showing each helper has complied 
270.24 	with this subdivision.
270.25 	(c) County licensing staff must accept approved training on the helper's learning record 
270.26 	in the Develop data system.

270.27 	Sec. 13. [142I.13] BEHAVIOR GUIDANCE.
270.28 		Subdivision 1.Methods of promoting positive behavior. A license holder must:
270.29 	(1) positively role model acceptable behavior to each child;
271.1 	(2) tailor methods of promoting positive behavior to the developmental level of the 
271.2 	children the family child care program is licensed to serve;
271.3 	(3) ensure redirection is used as appropriate in addressing a child's behavior, to guide a 
271.4 	child away from potential challenges toward constructive activity. For the purposes of this 
271.5 	clause, "redirection" means when a caregiver intervenes and guides a child toward 
271.6 	constructive activity through positive techniques;
271.7 	(4) teach children how to use acceptable alternatives to reduce conflict; and
271.8 	(5) protect the safety and well-being of children and caregivers.
271.9 		Subd. 2.Prohibited actions. A license holder must prohibit every caregiver from:
271.10 	(1) subjecting a child to corporal or physical punishment. This includes but is not limited 
271.11 	to rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, 
271.12 	pinching, spitting, hitting, and spanking;
271.13 	(2) subjecting a child to name calling, ostracism, shaming, making derogatory remarks 
271.14 	about the child or the child's family, cultural or racial slurs, and yelling or using profane 
271.15 	language that threatens, humiliates, or frightens the child;
271.16 	(3) forcing a child to maintain an uncomfortable position or to continuously repeat 
271.17 	physical movements;
271.18 	(4) separating a child from the group except as provided in subdivision 3;
271.19 	(5) punishing a child for:
271.20 	(i) not resting, napping, or sleeping;
271.21 	(ii) toileting accidents;
271.22 	(iii) failing to eat all or part of meals or snacks; or
271.23 	(iv) failing to complete an activity;
271.24 	(6) denying a child food or drink or forcing food or drink upon a child;
271.25 	(7) denying light, warmth, clothing, or medical care as a punishment for unacceptable 
271.26 	behavior;
271.27 	(8) the use of physical restraint other than to physically hold a child when containment 
271.28 	is necessary to protect a child or others from harm;
271.29 	(9) the use of prone restraints, as prohibited by section 245A.211;
272.1 	(10) the use of mechanical restraints, such as tying, or any device or equipment intended 
272.2 	to restrict or prevent movement as a means of discipline or for reasons unrelated to the 
272.3 	child's care, safety, or planned activity;
272.4 	(11) giving a child any nonprescribed substance to subdue or restrict movement or 
272.5 	behavior;
272.6 	(12) delegating the discipline or punishment of a child to another child; and
272.7 	(13) punishing or shaming a child for the actions of a parent. This includes but is not 
272.8 	limited to failure to pay fees, failure to provide appropriate clothing, failure to provide 
272.9 	materials for an activity, or any conflict between the license holder or caregiver and the 
272.10 	parent.
272.11 		Subd. 3.Separation time from the group. A caregiver must not separate a child from 
272.12 	the child's group as a means of behavior guidance unless the caregiver has tried less intrusive 
272.13 	methods of guiding the child's behavior that have been ineffective and the child's behavior 
272.14 	threatens the well-being of the child or other children in the family child care program. 
272.15 	Separation from the group must meet the following requirements:
272.16 	(1) children younger than three years old must not be separated from the group as a 
272.17 	means of behavior guidance;
272.18 	(2) the separation time must be limited to the amount of time necessary for the child to 
272.19 	gain self-control and rejoin the group while being supported by the caregiver;
272.20 	(3) the child must be supervised;
272.21 	(4) the child must not be placed in a locked room to separate the child from the group; 
272.22 	and
272.23 	(5) the caregiver must provide the separation time in an age-appropriate, nonhumiliating 
272.24 	manner for the child.

272.25 	Sec. 14. [142I.14] PHYSICAL SPACE REQUIREMENTS.
272.26 		Subdivision 1.Indoor space. (a) The licensed capacity of the family child care program 
272.27 	must be limited by the amount of usable indoor space available to children. A minimum of 
272.28 	35 square feet of usable indoor space is required per child.
272.29 	(b) Bathrooms, closets, space occupied by major appliances, and other space not used 
272.30 	by children may not be counted as usable space. Space occupied by adult furniture, if it is 
272.31 	used by children, may be counted as usable indoor space.
273.1 	(c) Usable indoor space may include a basement if it has been inspected and approved 
273.2 	by a fire marshal, is free of hazards, and meets the requirements of subdivision 4.
273.3 	(d) All exits leading from indoor to outdoor space must be fully clear of obstruction.
273.4 		Subd. 2.Escape routes. (a) The main means of escape must be a stairway or door leading 
273.5 	to the floor with an exit to the outside.
273.6 	(b) Any room that has sleeping children must have an escape route separate from the 
273.7 	main exit referenced in paragraph (a). This escape route must be a door or an egress window 
273.8 	leading directly outside.
273.9 	(c) When the basement is used for care, the basement must have at least one escape route 
273.10 	separate from the main exit under paragraph (a). This escape route must be a door or an 
273.11 	egress window leading directly outside.
273.12 	(d) Required escape routes must not be obstructed and must be accessible and openable 
273.13 	without special knowledge.
273.14 		Subd. 3.Outdoor learning environment and play space. (a) A family child care 
273.15 	program must have an outdoor play space of at least 50 square feet per child the program 
273.16 	is licensed to serve for regular use or a park, playground, or play space within 1,500 feet of 
273.17 	the family child care program.
273.18 	(b) During outdoor play:
273.19 	(1) the adult caregiver must remain outdoors with infants, toddlers, and preschoolers at 
273.20 	all times;
273.21 	(2) school-age children may be permitted in the approved outdoor play space at the 
273.22 	family child care program without a caregiver if:
273.23 	(i) the children are engaged in age-appropriate activities using age-appropriate equipment; 
273.24 	and
273.25 	(ii) a caregiver remains accessible to provide supervision when needed in accordance 
273.26 	with section 142I.01, subdivision 46; and
273.27 	(3) when the outdoor play space is not at the family child care program, a caregiver must 
273.28 	accompany and supervise all children in transit and at the outdoor play space.
273.29 	(c) Caregivers must prevent children from accessing hazardous materials.
273.30 	(d) Outdoor play areas must be protected from traffic and nearby hazards. If traffic or 
273.31 	other hazards are present, the family child care program must have:
274.1 	(1) a continuous fence in good condition with functioning gates or a continuous natural 
274.2 	barrier or a combination of fence and naturally occurring or landscaping barrier. The fence 
274.3 	or natural barrier must ensure that children are not able to leave the outdoor play area 
274.4 	unsupervised; or
274.5 	(2) a supervision and safety plan if a fence is not used that includes alternative methods 
274.6 	to ensure the health, safety, and protection of children in care.
274.7 	(e) Electrical fences must be inaccessible to children in care.
274.8 	(f) Caregivers must take measures to protect children from the dangers of sun exposure, 
274.9 	extreme heat or cold, and air quality.
274.10 	(g) Outdoor equipment, whether stationary or portable, must be safe, be in good repair, 
274.11 	be assembled according to the manufacturer's guidelines, and meet the developmental needs 
274.12 	of the age groups of children using the space.
274.13 	(h) Equipment including but not limited to climbing gyms, swings, and slides must:
274.14 	(1) not have openings between 3-1/2 inches and nine inches in size to prevent entrapment 
274.15 	of the head or other body parts;
274.16 	(2) have guardrails or protective barriers on platforms that are 30 inches or higher. A 
274.17 	protective barrier is a continuous structure surrounding the platform that is designed to 
274.18 	prevent a person from falling or passing through, whether intentionally or accidentally; and
274.19 	(3) be assembled, installed, and utilized according to the manufacturer's guidelines.
274.20 		Subd. 4.Conditions of the program. The licensed space must be maintained in a manner 
274.21 	that protects the health and safety of children in care. The license holder must ensure that:
274.22 	(1) the family child care program space is free from conditions that endanger the health 
274.23 	or safety of children, including unsanitary conditions or excessive accumulation of materials 
274.24 	that can start a fire or create other safety hazards;
274.25 	(2) the furnishings, equipment, and materials are arranged and stored so that hallways, 
274.26 	stairways, doors, and exit routes remain unobstructed and usable for safe exit; and
274.27 	(3) the amount and placement of stored items do not create an increased risk of fire or 
274.28 	injury or impede the safe supervision of children.
274.29 		Subd. 5.Portable wading pools. (a) A child must not use a portable wading pool as 
274.30 	defined in section 144.1222, subdivision 2a, at a family child care program unless the parent 
274.31 	of the child has provided written consent. The written consent must include a statement that 
274.32 	the parent has received and read material provided by the Department of Health on wading 
275.1 	pool safety for parents related to the risk of disease transmission as well as other health 
275.2 	risks associated with the use of portable wading pools.
275.3 	(b) The license holder must empty wading pools daily.
275.4 	(c) A caregiver must supervise children at all times while a wading pool is in use and 
275.5 	must be able to clearly see all parts of the wading area. When not in use under the supervision 
275.6 	of a caregiver, wading pools must be inaccessible to children.
275.7 		Subd. 6.Swimming pools. (a) For the purposes of this subdivision, "swimming pool" 
275.8 	has the meaning in section 144.1222, subdivision 2b, and does not include a portable wading 
275.9 	pool as defined in section 144.1222, subdivision 2a, or a spa pool as defined in Minnesota 
275.10 	Rules, part 4717.0250.
275.11 	(b) A license holder must comply with the following requirements in order for children 
275.12 	in the program to use a swimming pool located at the program:
275.13 	(1) not have had a licensing sanction under section 142B.18 or a correction order or 
275.14 	conditional license under section 142B.16 relating to the supervision or health and safety 
275.15 	of children during the prior 24 months;
275.16 	(2) notify the county agency before initial use of the swimming pool each calendar year;
275.17 	(3) obtain written consent from a child's parent allowing the child to use the swimming 
275.18 	pool and renew the parent's written consent at least annually. The written consent must 
275.19 	include a statement that the parent has received and read materials provided by the 
275.20 	Department of Health related to the risk of disease transmission as well as other health risks 
275.21 	associated with swimming pools. The written consent must also include a statement that 
275.22 	neither the Department of Health nor the county agency will monitor or inspect the license 
275.23 	holder's swimming pool;
275.24 	(4) attend and successfully complete a swimming pool supervision training course 
275.25 	annually;
275.26 	(5) attend and successfully complete one of the following swimming pool operator 
275.27 	training courses once every five years:
275.28 	(i) both of the National Spa and Pool Institute Tech I and Tech II courses; or
275.29 	(ii) the National Recreation and Park Association aquatic facility operator course;
275.30 	(6) ensure all toilet-trained children use the bathroom before the children enter the 
275.31 	swimming pool;
276.1 	(7) require all children who are not toilet trained to wear swim diapers while in the 
276.2 	swimming pool;
276.3 	(8) if fecal material enters the swimming pool water, add three times the normal shock 
276.4 	treatment to the pool water to raise the chlorine level to at least 20 parts per million and 
276.5 	close the pool to swimming for the 24 hours following the entrance of fecal material into 
276.6 	the water or until the water pH and disinfectant concentration levels have returned to the 
276.7 	standards specified in clause (10), whichever is later;
276.8 	(9) prevent any person from entering the swimming pool who has an open wound or has 
276.9 	or is suspected of having a communicable disease;
276.10 	(10) maintain the swimming pool water at a pH of not less than 7.2 and not more than 
276.11 	8.0, maintain the disinfectant concentration between two and five parts per million for 
276.12 	chlorine or between 2.3 and 4.5 parts per million for bromine, and maintain a daily record 
276.13 	of the swimming pool's operation with pH and disinfectant concentration readings on days 
276.14 	when children cared for at the family child care program are present;
276.15 	(11) have a disinfectant feeder or feeders;
276.16 	(12) have a recirculation system that will clarify and disinfect the swimming pool volume 
276.17 	of water in ten hours or less;
276.18 	(13) maintain the swimming pool's water clarity so that an object on the pool floor at 
276.19 	the pool's deepest point is easily visible;
276.20 	(14) comply with the provisions in section 144.1222, subdivisions 1c and 1d;
276.21 	(15) have in place and enforce written safety rules and swimming pool policies;
276.22 	(16) have in place at all times a safety rope that divides the shallow and deep portions 
276.23 	of the swimming pool;
276.24 	(17) maintain compliance with any existing local ordinances regarding swimming pool 
276.25 	installation, decks, and fencing;
276.26 	(18) maintain a water temperature of not more than 104 degrees Fahrenheit and not less 
276.27 	than 70 degrees Fahrenheit;
276.28 	(19) cover the swimming pool when not in use;
276.29 	(20) follow the requirements of subdivision 7; and
277.1 	(21) for lifesaving equipment, have a United States Coast Guard-approved life ring 
277.2 	attached to a rope, an exit ladder, and a shepherd's hook available at all times to the caregiver 
277.3 	supervising the swimming pool.
277.4 		Subd. 7.Water hazards. (a) Swimming and wading pools, beaches, wells, or other 
277.5 	bodies of water on or adjacent to the site of the family child care program must be 
277.6 	inaccessible to children except during periods of supervised use.
277.7 	(b) All water hazards, such as inground or aboveground swimming pools, hot tubs, 
277.8 	stationary wading pools, fish ponds, and water retention or detention basins on the site of 
277.9 	the family child care program must be enclosed with a permanent fence, wall, building wall, 
277.10 	other physical barrier, or combination thereof that is at least four feet in height.  A house 
277.11 	exterior wall can constitute one side of a fence if the wall has no openings capable of 
277.12 	providing direct access to the hazard, including but not limited to doors or windows.
277.13 	(c) The family child care program may not allow a child in care to use a swimming pool 
277.14 	or beach without an adult caregiver trained in first aid and CPR present.
277.15 	(d) Bodies of water must be separated from the play area by a fence or other physical 
277.16 	barrier that prevents children from accessing the water. The house door alone is not a 
277.17 	sufficient barrier.
277.18 		Subd. 8.Water play. (a) Parental permission is not required for children to use splash 
277.19 	pads, sprinklers, or other water toys that spray or jet water on the users and do not have 
277.20 	standing water. Splash pads, sprinklers, or other water toys that retain water are considered 
277.21 	wading pools and are required to meet the requirements of subdivision 5.
277.22 	(b) Water tables designed for children to play with their hands must be emptied daily. 
277.23 	The caregiver must supervise children at all times while a water table is in use and must be 
277.24 	able to clearly see all parts of the water table. When not in use under the supervision of a 
277.25 	caregiver, water tables must be inaccessible to children.
277.26 		Subd. 9.Separation between attached garage and family child care program. The 
277.27 	separation wall between the residence and garage must meet the requirements of Minnesota 
277.28 	Rules, part 1309.0302.
277.29 		Subd. 10.Ventilation, heating, and cooling systems. (a) Heating, ventilation, and air 
277.30 	conditioning systems must be operated according to the manufacturer's instructions and in 
277.31 	good repair. Gas, coal, wood, kerosene, or oil heaters must be vented to the outside in 
277.32 	accordance with the State Building Code.
278.1 	(b) Items that can be ignited and support combustion, including but not limited to plastic, 
278.2 	fabric, and wood products, must not be located within:
278.3 	(1) 18 inches of a gas or fuel-oil heater or furnace; or
278.4 	(2) 36 inches of a solid-fuel-burning appliance.
278.5 	(c) If a license holder produces manufacturer instructions listing a distance closer than 
278.6 	the requirements under paragraph (b), the manufacturer instructions control the required 
278.7 	distance of combustible items from gas, fuel-oil, or solid-fuel-burning heaters or furnaces.
278.8 	(d) When in use, fireplaces, wood-burning stoves, solid-fuel-burning appliances, space 
278.9 	heaters, steam radiators, outdoor fire pits, and other potentially hot surfaces, such as steam 
278.10 	pipes, must be protected by guards or protective covering to keep hands and bodies away, 
278.11 	prevent burns, and prevent fires. All fireplaces, wood-burning stoves, space heaters, steam 
278.12 	radiators, and furnaces must be installed according to the State Building Code. The furnace, 
278.13 	hot water heater, and utility rooms must be inaccessible to children.
278.14 	(e) Ventilation of usable space must meet the requirements of the State Building Code. 
278.15 	Outside doors and windows used for ventilation in summer months must be screened when 
278.16 	biting insects are prevalent. The screens must be in good repair. Sources of harmful and 
278.17 	unpleasant odors including urine and pet waste must be removed to the extent possible by 
278.18 	removing the source of the odor or by removing odors through cleaning and ventilation.
278.19 		Subd. 11.Temperature. A minimum temperature of 62 degrees Fahrenheit must be 
278.20 	maintained in indoor areas used by children.
278.21 		Subd. 12.Sewage disposal. Family child care programs must have working toilets and 
278.22 	a sewage disposal system that conform to the State Building Code or local septic system 
278.23 	ordinances. Toilet training equipment must be emptied and cleaned after each use. Outdoor 
278.24 	toilets, including compostable toilets, are permissible in accordance with local septic system 
278.25 	ordinances.
278.26 		Subd. 13.Construction or remodeling. During construction or remodeling, children 
278.27 	must not have access to construction or remodeling areas within or around the premises.
278.28 		Subd. 14.Interior walls and ceilings. The walls and ceilings within a family child care 
278.29 	program, including those in corridors, stairways, and lobbies, must have a flame spread 
278.30 	rating of 200 or less.
278.31 		Subd. 15.Electrical services. (a) All electric outlets in a family child care program 
278.32 	accessible to children must be tamper-proof or shielded when not in use. All major electrical 
279.1 	appliances must be properly installed and grounded in accordance with the State Electrical 
279.2 	Code and in good working order.
279.3 	(b) Electrical wiring must be sized to provide for the load and be in good repair. Extension 
279.4 	cords must not be used as a substitute for permanent wiring.
279.5 		Subd. 16.Fire extinguisher. A portable, operational, multipurpose, and dry chemical 
279.6 	fire extinguisher with a minimum 2-A 10-BC rating must be located near the required exit 
279.7 	door of the program at all times. The fire extinguisher must be serviced annually by a 
279.8 	qualified inspector and evidence of annual service must be documented. All caregivers must 
279.9 	know how to properly use the fire extinguisher.
279.10 		Subd. 17.Carbon monoxide and smoke alarms. (a) A family child care program must 
279.11 	have an approved and operational carbon monoxide alarm installed within ten feet of each 
279.12 	area used for sleeping children in care.
279.13 	(b) A family child care program must properly install and maintain smoke alarms models 
279.14 	that have been approved by the Underwriter Laboratory on all levels, including basements, 
279.15 	and in hallways outside rooms used for sleeping children in care. Smoke alarms are not 
279.16 	required in crawl spaces and uninhabitable attics. For family child care programs in buildings 
279.17 	that began construction on or after March 31, 2020, smoke alarms must be installed and 
279.18 	maintained in each room used for children in care to sleep.
279.19 		Subd. 18.Stairways. All family child care programs with stairways must:
279.20 	(1) have handrails on at least one side of stairways of four or more steps;
279.21 	(2) enclose any open area between the handrail and stair tread with a protective guardrail 
279.22 	as specified in the State Building Code. The back of the stair risers must also be enclosed;
279.23 	(3) use gates at the top and bottom of stairways when children who are six to 18 months 
279.24 	old are in care; and
279.25 	(4) keep stairways well lit, in good repair, and free of clutter and obstructions.
279.26 		Subd. 19.Lofted spaces. Decks, balconies, or lofts that are used by children and are 
279.27 	more than 30 inches above the ground or floor must be surrounded by a protective guardrail 
279.28 	and be constructed in compliance with the State Building Code. The State Building Code 
279.29 	allows appropriate openings for access to the spaces under this subdivision, such as a 
279.30 	doorway or a gate. Wooden decks must be free of splinters and in good repair.
280.1 		Subd. 20.Locks and latches. (a) A door latch on a closet or other confining space must 
280.2 	be able to be unlatched so that the door can be opened from inside the closet or other 
280.3 	confining space.
280.4 	(b) Every interior door lock must permit opening of the locked door from the outside 
280.5 	and the opening device must be readily accessible to all caregivers.
280.6 	(c) Exit doors must not have double cylinder locks where a key is required on both sides.
280.7 	(d) Locks may not be used in place of supervision.
280.8 		Subd. 21.Tobacco products, cannabis, vaping, drugs, and alcohol use 
280.9 	prohibitions. (a) Smoking of tobacco, cannabis, or any other product, including through 
280.10 	electronic delivery devices, is prohibited in both indoor and outdoor family child care 
280.11 	program environments and in any vehicles used by the family child care program during 
280.12 	hours of operation.
280.13 	(b) The use of alcohol or illegal or recreational drugs is prohibited on the premises of a 
280.14 	family child care program during hours of operation.
280.15 	(c) If the license holder allows smoking of tobacco, cannabis, or any other product, 
280.16 	including through electronic delivery devices, on the premises outside of child care hours, 
280.17 	the license holder must verbally provide notice to parents and must post written notice in 
280.18 	an obvious location disclosing this information.
280.19 	(d) While caring for children, a caregiver must not be under the influence of any substance 
280.20 	that impairs the individual's ability to supervise children or perform the individual's duties.

280.21 	Sec. 15. [142I.15] CLEANING AND DISINFECTING.
280.22 		Subdivision 1.General requirements. (a) The family child care program must be free 
280.23 	from accumulations of dirt, peeling paint, visible or known debris, soiled items, hazardous 
280.24 	clutter, and pet waste.
280.25 	(b) Disinfectants must:
280.26 	(1) not be used prior to or in place of cleaning compounds;
280.27 	(2) be mixed and used according to the manufacturer's instructions; and
280.28 	(3) be used on surfaces that are contaminated with bodily fluids.
280.29 		Subd. 2.Toys. A caregiver must clean and disinfect a toy that has been in a child's mouth 
280.30 	prior to use by another child. Toys that come into contact with bodily fluids must be cleaned 
281.1 	and disinfected prior to next use. Toys must be cleaned and disinfected as needed if there 
281.2 	are visible or known contaminants or debris on them.
281.3 		Subd. 3.Food and eating areas. Surfaces and tools that are used for preparing or serving 
281.4 	food must be cleaned.
281.5 		Subd. 4.Indoor and outdoor equipment. (a) The indoor and outdoor space and 
281.6 	equipment of the family child care program must be clean.
281.7 	(b) Natural features, elements, and materials used as equipment and play materials for 
281.8 	outdoor play under section 142I.14, subdivision 3, are exempt from being clean, as defined 
281.9 	under section 142I.01, subdivision 16. A caregiver must inspect natural features, elements, 
281.10 	and materials used for outdoor play for hazardous objects and other safety hazards, including 
281.11 	animal feces, and remove or mitigate the hazard before a child's use.
281.12 		Subd. 5.Sleeping. Bedding, as defined in section 142I.17, subdivision 10, must be 
281.13 	cleaned and disinfected at least weekly or when visibly dirty.
281.14 		Subd. 6.Toilet training equipment. Toilet training chairs and seats must be cleaned 
281.15 	and disinfected after each use.
281.16 		Subd. 7.Hand washing. (a) A child's hands must be washed with soap and running 
281.17 	water when soiled, after the use of a toilet or toilet training chair, and before eating a meal 
281.18 	or snack. The caregiver must monitor and assist a child who needs help. Children's hands 
281.19 	must be dried on a separate or single-use towel.
281.20 	(b) In sinks and tubs accessible to children, the water temperature must not be able to 
281.21 	exceed 120 degrees Fahrenheit.
281.22 	(c) Caregivers must wash their hands with soap and water after each diaper change, after 
281.23 	assisting a child on the toilet, after washing the diapering surface, and before food 
281.24 	preparation. The caregiver's hands must be dried on a separate or single-use towel.
281.25 		Subd. 8.Diapers, changing areas, and disposal. (a) An adequate supply of clean diapers 
281.26 	must be available for each child who uses diapers. Diapers may be disposable or made of 
281.27 	cloth. Diapers must be stored in a clean space that is inaccessible to children.
281.28 	(b) If a family child care program uses cloth diapers, then:
281.29 	(1) the cloth diapers must have an absorbent inner layer that is completely covered with 
281.30 	an outer waterproof layer that has a waist closure;
281.31 	(2) the cloth diaper and waterproof layer must be changed at the same time; and
282.1 	(3) the cloth diapers supplied by parents, except those supplied by a commercial diaper 
282.2 	service, must be labeled with the child's name and must be placed in a plastic bag after 
282.3 	removal with any soiled clothing and sent home with the parent daily.
282.4 	(c) Single-service disposable wipes or clean washcloths must be used for washing a 
282.5 	soiled child before rediapering.
282.6 	(d) The diaper changing area must be covered with a smooth, nonabsorbent surface. 
282.7 	Changing tables, changing pads, and other diaper changing areas must be cleaned and 
282.8 	disinfected between children, even if using a nonabsorbent covering that is discarded after 
282.9 	each use. Diapering must not take place in a food preparation area.
282.10 	(e) Disposable diapers must be disposed of in a covered container located in the diaper 
282.11 	changing area and lined with a disposable plastic bag or directly outdoors in a garbage can.

282.12 	Sec. 16. [142I.16] ENVIRONMENTAL HEALTH.
282.13 		Subdivision 1.Water supply. (a) All family child care programs must have a safe water 
282.14 	supply.
282.15 	(b) Family child care programs that draw water from privately owned wells must test 
282.16 	the water annually by a Department of Health-certified laboratory for coliform bacteria and 
282.17 	nitrate nitrogen and receive confirmation that the water is safe. The family child care program 
282.18 	must submit a copy of the test results with the agency. Retesting and corrective measures 
282.19 	may be required by the agency if results do not meet state drinking water standards or where 
282.20 	the supply may be subject to off-site contamination. A copy of the most recent water testing 
282.21 	results must be kept on the licensed premises. If the water test results are at or above 
282.22 	Department of Health-recommended levels or if the license holder declines to test the water 
282.23 	supply in the program, the license holder must:
282.24 	(1) supply bottled or packaged water;
282.25 	(2) use water filtration devices that have been certified by the National Science 
282.26 	Foundation or American National Standards Institute to remove the contaminant. The water 
282.27 	filtration device must be attached directly to water faucets, inserted into the refrigerator 
282.28 	water dispenser, or inserted into water pitchers or bottles. The water filtration device must 
282.29 	be maintained according to manufacturer guidelines; or
282.30 	(3) close the family child care program to prevent children from using or consuming 
282.31 	unsafe water.
283.1 		Subd. 2.Radon testing. (a) The license holder must notify parents whether radon testing 
283.2 	has been conducted in the family child care program upon enrollment and within 30 days 
283.3 	of any subsequent testing done after enrollment.
283.4 	(b) When notifying parents, the license holder must use a form prescribed by the 
283.5 	commissioner. The notice must include information from the Department of Health about 
283.6 	what radon is and the potential risks associated with radon exposure. If testing has been 
283.7 	completed, the notice must include:
283.8 	(1) the date of the most recent test;
283.9 	(2) the rooms or areas tested; and
283.10 	(3) the detected radon level or levels, stated in picocuries per liter (pCi/L).
283.11 	(c) A copy of the most recent notice to parents and the radon test results must be kept 
283.12 	on site and made available to parents and the commissioner upon request.
283.13 	(d) The notification requirements under this subdivision may be met by posting the form 
283.14 	in a prominent place.

283.15 	Sec. 17. [142I.17] ACTIVITIES AND EQUIPMENT.
283.16 		Subdivision 1.General activities. Child care activities must provide for the physical, 
283.17 	intellectual, emotional, and social development of the children in care at a family child care 
283.18 	program. Activities must include infants, toddlers, preschoolers, and school-age children 
283.19 	and:
283.20 	(1) be scheduled indoors and outdoors daily, weather permitting. When determining if 
283.21 	the weather permits outdoor play, a license holder must defer to weather advisory 
283.22 	notifications, including air quality emergencies, provided by local weather experts, local or 
283.23 	state authority on air quality, or public health;
283.24 	(2) be appropriate to the age and developmental stage of the child;
283.25 	(3) include active and quiet activity; and
283.26 	(4) include both caregiver- and child-directed activities.
283.27 		Subd. 2.Equipment. (a) A license holder must provide children in a family child care 
283.28 	program with:
283.29 	(1) sufficient play equipment to allow each child a choice of at least three activities 
283.30 	involving equipment when all children are using equipment;
284.1 	(2) early learning materials, play equipment, and space that are age and developmentally 
284.2 	appropriate and support understanding of the culturally diverse world; and
284.3 	(3) play equipment that is safe, in good repair, and used in accordance with the 
284.4 	manufacturer's instructions, if applicable. Equipment and play materials not designed or 
284.5 	marketed for use by children, including but not limited to repurposed, homemade, and 
284.6 	open-ended items, must be appropriate to the age and size of children, in good repair, and 
284.7 	used under the supervision of a caregiver. Such equipment and play materials are not required 
284.8 	to have manufacturer's instructions and are subject to the requirements of this subdivision.
284.9 	(b) Equipment provided to children under this section may be new, used, commercially 
284.10 	made, or homemade. The equipment must be appropriate for the ages of the children and 
284.11 	for the activities for which it will be used. As appropriate, nature material may be used in 
284.12 	place of any equipment.
284.13 		Subd. 3.Newborn or infant activities. A caregiver must:
284.14 	(1) hold a newborn or infant during feedings until the child can hold the bottle. A bottle 
284.15 	cannot be propped up for a newborn or infant;
284.16 	(2) respond to a newborn's or infant's attempts to communicate;
284.17 	(3) develop infant language and communication by responding to a newborn's or infant's 
284.18 	attempts to communicate by mirroring similar sounds, sharing the child's focus of attention, 
284.19 	talking to the newborn or infant, naming objects, and describing actions;
284.20 	(4) provide a newborn or infant with freedom of movement to sit safely and comfortably, 
284.21 	crawl, toddle, walk, and play both indoors and outdoors throughout the day;
284.22 	(5) provide a newborn or infant an opportunity to stimulate the senses by providing a 
284.23 	variety of activities and objects to see, touch, feel, smell, hear, and taste;
284.24 	(6) provide activities for a newborn or infant that develop the child's manipulative and 
284.25 	fine motor skills;
284.26 	(7) provide activities for self-awareness;
284.27 	(8) provide activities to support a newborn or infant to develop social-emotional skills;
284.28 	(9) provide activities to support a newborn or infant to develop gross motor skills; and
284.29 	(10) allow a newborn or infant actively supervised tummy time. For the purposes of this 
284.30 	clause, "tummy time" means placing a newborn or infant in a nonrestrictive prone position, 
284.31 	lying on their stomach. Tummy time should occur throughout the day when a newborn or 
285.1 	infant is awake. A newborn or infant must not be wearing anything to restrict movement 
285.2 	during tummy time.
285.3 		Subd. 4.Newborn and infant equipment. When caring for newborns or infants, a 
285.4 	license holder must provide:
285.5 	(1) an infant seat or high chair, as appropriate, for each newborn and infant in attendance;
285.6 	(2) a crib or portable crib with a mattress or pad for each newborn and infant in attendance 
285.7 	that is in compliance with current Consumer Product Safety Commission safety standards 
285.8 	and chapter 142B.45. The license holder must maintain documentation on site that the 
285.9 	equipment used meets these requirements and provide it to the commissioner and parents 
285.10 	as requested;
285.11 	(3) books and literacy materials;
285.12 	(4) gross motor activity equipment; and
285.13 	(5) fine motor activity materials.
285.14 		Subd. 5.Toddler activities. When caring for toddlers, a license holder must:
285.15 	(1) provide the toddler with freedom of movement and freedom to explore outside the 
285.16 	crib or portable crib and allow the toddler to comfortably sit, crawl, toddle, walk, and play 
285.17 	according to the toddler's stage of development;
285.18 	(2) talk to, listen to, and interact with the toddler to encourage language development;
285.19 	(3) provide the toddler with activities that develop the toddler's fine and gross motor 
285.20 	skills;
285.21 	(4) give the toddler opportunities to stimulate the senses by providing a variety of 
285.22 	age-appropriate activities and objects to see, touch, feel, smell, hear, and taste; and
285.23 	(5) provide activities to support the toddler to develop social-emotional skills.
285.24 		Subd. 6.Toddler equipment. When caring for toddlers, a license holder must provide:
285.25 	(1) separate sleeping equipment for each toddler such as a mat, crib, cot, bed, sofa, or 
285.26 	sleeping bag that is cleaned and maintained as required in subdivision 10 and section 142I.15, 
285.27 	subdivision 5;
285.28 	(2) gross motor play equipment;
285.29 	(3) books and literacy materials;
285.30 	(4) fine motor, math, and science materials; and
286.1 	(5) music, movement, and art activity materials.
286.2 		Subd. 7.Preschooler activities. When caring for preschoolers, a license holder must:
286.3 	(1) encourage conversation between the preschooler and other children and adults;
286.4 	(2) provide opportunity to play near and with other children, provide time and space for 
286.5 	individual and group play, allow for quiet times to talk or rest, and allow for unplanned 
286.6 	time and individual play time;
286.7 	(3) foster understanding of personal and peer feelings and actions and allow for the 
286.8 	constructive release of a range of feelings through discussion or play;
286.9 	(4) give assistance in toileting and provide time to carry out self-help skills and provide 
286.10 	opportunities to be responsible for activities;
286.11 	(5) provide opportunities for each preschooler to make decisions about daily activities 
286.12 	and to learn from the decision-making experiences;
286.13 	(6) provide time and areas for age-appropriate gross motor play;
286.14 	(7) provide learning, fine-motor, manipulative, creative, or sensory activities; and
286.15 	(8) read stories, look at books, and talk about new words and ideas with the preschooler.
286.16 		Subd. 8.Preschooler equipment. When caring for preschoolers, a license holder must 
286.17 	provide:
286.18 	(1) separate sleeping equipment for each preschooler such as a mat, bed, cot, sofa, or 
286.19 	sleeping bag for each preschooler that is cleaned and maintained as required under 
286.20 	subdivision 10 and section 142I.15, subdivision 5;
286.21 	(2) dramatic play equipment;
286.22 	(3) books and literacy materials;
286.23 	(4) fine motor materials;
286.24 	(5) gross motor play equipment;
286.25 	(6) math materials;
286.26 	(7) science materials;
286.27 	(8) music and movement materials; and
286.28 	(9) art materials.
287.1 		Subd. 9.School-age activities and equipment. When caring for school-age children, 
287.2 	a license holder must:
287.3 	(1) provide opportunities for individual discussion about the day and planning for 
287.4 	activities;
287.5 	(2) provide space, opportunities, and materials or equipment for games, activities, or 
287.6 	sports using the whole body;
287.7 	(3) have available space, bedding materials, and opportunities for individual rest and 
287.8 	quiet time required under subdivision 10;
287.9 	(4) allow increased freedom as the school-age child demonstrates increased responsibility;
287.10 	(5) provide opportunities for group experiences with other children;
287.11 	(6) provide opportunities to develop or expand self-help skills or real-life experiences; 
287.12 	and
287.13 	(7) provide opportunities and materials for creative and dramatic activity, arts, and crafts.
287.14 		Subd. 10.Bedding. Clean, separate, and individual bedding such as sheets, towels, 
287.15 	blankets, or sleeping bags must be available for each child in care. For children not using 
287.16 	cribs or portable cribs, the license holder must provide developmentally appropriate mats, 
287.17 	cots, or other sleep equipment that can be cleaned and disinfected according to section 
287.18 	142I.15. Mats, cots, and other sleep equipment used in the family child care program must 
287.19 	be in good condition and have no tears or holes and be covered in individual bedding.
287.20 		Subd. 11.Separation of personal articles. Separate towels, wash cloths, water bottles, 
287.21 	and drinking cups must be used for each child and labeled appropriately.

287.22 	Sec. 18. [142I.171] NATURAL ELEMENTS AND MATERIALS.
287.23 		Subdivision 1.Natural elements and materials. A license holder may provide children 
287.24 	with access to natural elements and materials as equipment and play materials. Natural 
287.25 	elements and materials and appropriate uses of natural elements and materials include, but 
287.26 	are not limited to:
287.27 	(1) natural loose parts, such as sticks, leaves, pine cones, acorns, seeds, pods, bark, and 
287.28 	moss for construction, art, sensory exploration, and imaginative play;
287.29 	(2) natural materials, such as dirt, mud, sand, water, ice, and snow for sensory play and 
287.30 	exploration;
288.1 	(3) plants, flowers, seeds, vegetables, and gardening materials for science exploration 
288.2 	and learning;
288.3 	(4) rocks, pebbles, stones, and minerals for counting, sorting, building, and art;
288.4 	(5) natural areas such as gardens, prairie, forest, wetlands, and ponds for exploration 
288.5 	and learning; and
288.6 	(6) other natural elements as appropriate to age and development of children.
288.7 		Subd. 2.Supervision. A caregiver must supervise a child's use of natural elements and 
288.8 	materials and provide guidance on safe and appropriate use. Natural elements and materials 
288.9 	that are a choking hazard must not be accessible to children under the age of three without 
288.10 	direct supervision of a caregiver.
288.11 		Subd. 3.Other uses. Natural elements and materials may qualify as equipment and 
288.12 	materials under section 142I.17, subdivisions 4, 6, 8, and 9.

288.13 	Sec. 19. [142I.18] INFANT SLEEP AND CRIB REQUIREMENTS.
288.14 		Subdivision 1.Safety. All caregivers must follow the crib safety requirements in section 
288.15 	142B.45 and the requirements to reduce the risk of sudden unexpected infant deaths in 
288.16 	section 142B.46. During routine licensing inspections and when investigating complaints 
288.17 	regarding alleged violations of this section, the commissioner must review the license 
288.18 	holder's documentation required under section 142B.45.
288.19 		Subd. 2.Monitoring sleeping newborns and infants. (a) Caregivers must directly 
288.20 	supervise newborns once they are placed in a crib or portable crib.
288.21 	(b) License holders of programs that serve infants are encouraged to monitor sleeping 
288.22 	infants by conducting in-person checks on each infant in the license holder's care every 30 
288.23 	minutes.
288.24 	(c) Upon enrollment of an infant, the license holder is encouraged to conduct in-person 
288.25 	checks on the sleeping infant every 15 minutes during the first four months of care.
288.26 	(d) When an infant has an upper respiratory infection, the license holder is encouraged 
288.27 	to conduct in-person checks on the sleeping infant every 15 minutes throughout the hours 
288.28 	of sleep.
288.29 	(e) Monitors may be used to supervise infants when the infants are sleeping. However, 
288.30 	the use of monitors does not replace the in-person checks encouraged under paragraphs (b) 
288.31 	to (d). When in use, monitors must meet the following conditions:
289.1 	(1) the sound monitoring equipment must be able to pick up the sounds of all infants in 
289.2 	the separate room;
289.3 	(2) the receiver of the sound monitoring equipment must be actively monitored by the 
289.4 	adult caregiver at all times; and
289.5 	(3) sound monitoring equipment must be checked daily prior to use to ensure it is working 
289.6 	correctly. If the sound equipment is not functioning, infants must sleep in the same room 
289.7 	as the adult caregiver.
289.8 	(f) If music or other sounds are played in the infant sleep area, the music or other sound 
289.9 	equipment must not be played at a volume that would prevent infants from being heard by 
289.10 	the adult caregiver. This paragraph applies to fans used to create sound.

289.11 	Sec. 20. [142I.19] HEALTH POLICIES AND SAFETY REQUIREMENTS.
289.12 		Subdivision 1.Handling and disposal of bodily fluids. (a) Surfaces that come in contact 
289.13 	with bodily fluids must be cleaned and disinfected as described in section 142I.15.
289.14 	(b) Blood-contaminated material must be disposed of in a plastic bag and securely tied.
289.15 	(c) If a program cares for a child with a health care need that requires injectable 
289.16 	medication, the program must have a sharps container available.
289.17 	(d) A license holder must keep disposable gloves, disposal bags, and eye protection 
289.18 	available. Prescription eyewear does not meet the requirements of this paragraph.
289.19 		Subd. 2.Emergencies. (a) A license holder must have a written child care emergency 
289.20 	plan for emergencies that require evacuation, sheltering, or other protection of children, 
289.21 	including for fires, natural disasters, intruders, or other threatening situations that may pose 
289.22 	a health or safety hazard to children. The plan must be written on a form prescribed by the 
289.23 	commissioner and updated at least annually. The plan must include:
289.24 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
289.25 	(2) a designated relocation site and evacuation route;
289.26 	(3) procedures for notifying a child's parent of an evacuation, shelter-in-place, or 
289.27 	lockdown, including procedures for reunification with families;
289.28 	(4) accommodations for a child with a disability or a medical condition;
289.29 	(5) procedures for storing a child's medically necessary medicine that facilitate easy 
289.30 	removal during an evacuation or relocation;
289.31 	(6) procedures for continuing operations in the period during and after a crisis;
290.1 	(7) procedures for communicating with local emergency management officials, law 
290.2 	enforcement officials, or other appropriate state or local authorities; and
290.3 	(8) accommodations for infants and toddlers.
290.4 	(b) The license holder must train each caregiver on the child care emergency plan before 
290.5 	the caregiver provides care and document this training. The information must be reviewed 
290.6 	at least annually and updated when information changes.
290.7 	(c) The child care emergency plan must be available for review by the agency during 
290.8 	inspections.
290.9 	(d) In addition to the emergency plan required under paragraph (a), the license holder 
290.10 	must maintain preparedness for emergencies. An operable telephone must be located in the 
290.11 	family child care program. A cellular telephone may be used if it is sufficiently charged for 
290.12 	use at all times. Emergency phone numbers for parents must be readily available within the 
290.13 	program and taken on all emergency drills and evacuations.
290.14 	(e) For severe storms and tornadoes, the license holder must have a designated area that 
290.15 	children can go to for shelter, a battery-operated flashlight, and a portable radio or TV 
290.16 	available. An application on a smartphone may be used to meet the requirements of this 
290.17 	paragraph. The license holder must follow guidance and instructions from the Emergency 
290.18 	Alert System or local alerting systems.
290.19 	(f) The license holder must have a written fire escape plan that includes:
290.20 	(1) the address of the family child care program;
290.21 	(2) emergency phone numbers;
290.22 	(3) a designated place to meet and confirm that all children in attendance are present;
290.23 	(4) fire extinguisher locations;
290.24 	(5) plans for monthly fire and storm drills; and
290.25 	(6) escape routes to the outside from all levels used by children. In buildings with three 
290.26 	or more dwelling units, enclosed exit stairs must be indicated.
290.27 	(g) The license holder must complete a monthly fire and storm drill and have 
290.28 	documentation of completed fire drills available for review by the agency during inspections. 
290.29 	The log must include the date of the drill, the time of day the drill occurred, the name of 
290.30 	the caregiver who conducted the drill, and the length of time taken to evacuate all children 
290.31 	safely.
291.1 		Subd. 3.Transporting children. Children must only be transported in an enclosed 
291.2 	passenger vehicle capable of using car seats or a bus operated by a common carrier. When 
291.3 	transporting children in an enclosed passenger vehicle other than a bus operated by a common 
291.4 	carrier, a license holder must:
291.5 	(1) ensure compliance with all seat belt and child passenger restraint system requirements 
291.6 	under sections 169.685 and 169.686;
291.7 	(2) ensure that the child is fastened in a safety seat, seat belt, or harness appropriate to 
291.8 	the age and weight of the child and the restraint is installed and used in accordance with the 
291.9 	manufacturer's instructions;
291.10 	(3) only use a vehicle licensed in accordance with the laws of the state and driven by a 
291.11 	caregiver with a current, valid driver's license. A copy of the current driver's license for 
291.12 	each caregiver who transports a child in care must be kept at the family child care program;
291.13 	(4) receive written permission to transport children from parents prior to transport; and
291.14 	(5) not allow a child to remain unattended in any vehicle.
291.15 		Subd. 4.Pets and animals. When keeping pets or animals on the site of a family child 
291.16 	care program or allowing children to have contact with pets or animals, the primary provider 
291.17 	of care must:
291.18 	(1) maintain the pets or animals in good health and proper housing. Pets or animals must 
291.19 	be appropriately immunized, and rabies vaccinations must be documented with a current 
291.20 	certificate from a veterinarian when appropriate;
291.21 	(2) follow all local and state ordinances regarding the keeping, licensing, number, and 
291.22 	health status of animals;
291.23 	(3) restrict any animals that pose a risk of injury or illness to children from indoor and 
291.24 	outdoor areas used by children;
291.25 	(4) inform parents in writing of the presence of pets and animals on the premises. If pets 
291.26 	or animals are allowed to roam in areas occupied by children, the license holder must obtain 
291.27 	written acknowledgment from parents. Parents must be notified in writing prior to the 
291.28 	introduction of a new pet;
291.29 	(5) keep any reptiles, amphibians, ferrets, poisonous animals, psittacine birds, exotic 
291.30 	animals, and wild animals inaccessible to children. Licensed animal exhibitions, such as 
291.31 	mobile petting zoos, reptile shows, and educational presentations are exempt from this 
291.32 	clause with written parental notice and consent;
292.1 	(6) not allow any contact between children and pets or animals that is not directly 
292.2 	supervised by an adult caregiver who is in close physical proximity and able to immediately 
292.3 	intervene if the child or animal shows distress or aggression or if the child is treating the 
292.4 	animal inappropriately;
292.5 	(7) immediately intervene to protect a child when necessary;
292.6 	(8) prevent pets and animals from accessing food preparation, storage, and serving areas 
292.7 	when food is being prepared or served, unless confined in a cage or kennel. Litter boxes 
292.8 	are prohibited in any food preparation, storage, or serving areas;
292.9 	(9) keep indoor and outdoor areas accessible to children free of animal waste, including 
292.10 	litter boxes and their contents. Pet cages, enclosures, and aquariums accessible to children 
292.11 	must be located and cleaned away from food areas;
292.12 	(10) immediately notify a parent of a child who receives an animal bite or scratch;
292.13 	(11) notify the local animal authority whenever an individual is bitten by an animal on 
292.14 	the day of injury. The notification must be made before any steps are taken to euthanize the 
292.15 	animal, and the license holder must take reasonable steps to confine the animal; and
292.16 	(12) notify the licensing agency within 24 hours of any animal bite from an animal 
292.17 	housed at the family child care program.
292.18 		Subd. 5.Pest control. (a) A license holder must take effective measures to protect the 
292.19 	family child care program against pests. The license holder must take steps to prevent 
292.20 	attracting pests and, if pests are present inside the family child care program, to remove or 
292.21 	exterminate the pests.
292.22 	(b) Chemicals for pest control must not be applied in areas accessible to children when 
292.23 	children are present. The license holder must use chemicals according to manufacturer 
292.24 	instructions. Only approved, Environmental Protection Agency-registered insecticides, 
292.25 	rodenticides, and herbicides may be used. Application must strictly follow all label 
292.26 	instructions.
292.27 		Subd. 6.Garbage. Garbage must be inaccessible to infants and toddlers. Garbage is 
292.28 	considered inaccessible when the garbage container has a lid on.
292.29 		Subd. 7.Firearms. Ammunition and firearms must be stored in locked areas separated 
292.30 	from areas accessible to children. Firearms must be unloaded while stored.
293.1 		Subd. 8.First aid kit. A license holder must have a first aid kit that is accessible to 
293.2 	caregivers in the family child care program at all times and taken on field trips. A caregiver 
293.3 	must have access to first aid instructions. The first aid kit must contain:
293.4 	(1) adhesive bandages in assorted sizes and tape;
293.5 	(2) sterile compresses;
293.6 	(3) scissors;
293.7 	(4) an ice bag or cold pack;
293.8 	(5) a thermometer;
293.9 	(6) mild liquid soap, hand sanitizer, or alcohol wipes; and
293.10 	(7) disposable powder-free, latex-free gloves.
293.11 		Subd. 9.Care of sick children. (a) If the child becomes sick while at the family child 
293.12 	care program, the child must be separated from other children in care to the extent possible 
293.13 	while still maintaining appropriate supervision, and the child's parent must be called 
293.14 	immediately. When determining if a child is sick and exclusion is necessary, a license holder 
293.15 	must follow:
293.16 	(1) the requirements on reportable diseases in Minnesota Rules, parts 4605.7040, 
293.17 	4605.7070, and 4605.7080; and
293.18 	(2) the guidelines from the commissioner of health on infectious diseases in child care 
293.19 	settings.
293.20 	(b) When notified a child in care is sick with a reportable disease under Minnesota Rules, 
293.21 	part 4605.7040, 4605.7050, or 4605.7080, the license holder must:
293.22 	(1) follow the family child care program policies on reportable or infectious diseases; 
293.23 	and
293.24 	(2) notify the commissioner of health within 24 hours of receiving the parent or staff 
293.25 	report. Documentation of the notification must be kept at the family child care program.
293.26 	(c) Children with a reportable disease in paragraph (b) must be excluded from the family 
293.27 	child care program for the length of time specified in the commissioner of health guidelines 
293.28 	on infectious diseases in child care settings, until the child can participate in routine activities 
293.29 	without more caregiver supervision than usual or until the child's health care provider 
293.30 	determines that exclusion is no longer necessary, whichever is longer.
294.1 		Subd. 10.Medication administration requirements. (a) A license holder must obtain 
294.2 	written permission from the parent of a child prior to administering nonprescription medicine, 
294.3 	diapering products, sunscreen lotions, and insect repellents. These items must be administered 
294.4 	according to the manufacturer instructions unless written instructions for their use are 
294.5 	provided by a health care provider.
294.6 	(b) A license holder must obtain and follow written instructions from a health care 
294.7 	provider or dentist prior to administering each prescribed medication. For the purposes of 
294.8 	this paragraph, "instructions" means the label on a medicine container with the child's name 
294.9 	and current prescription information.

294.10 	Sec. 21. [142I.20] FOOD AND NUTRITION.
294.11 		Subdivision 1.Feeding. (a) Bottles of frozen breast milk or formula must be thawed 
294.12 	under warm running water, in a container of warm water, with a warming device, or in a 
294.13 	refrigerator. Thawed milk must be used, sent home, or disposed of the same day it is thawed.
294.14 	(b) Caregivers must not warm plastic bottles, sippy cups, or other plastic food containers 
294.15 	in a microwave.
294.16 	(c) Once bottle feeding is complete, any unused portion must be disposed of or stored 
294.17 	inaccessible to children in care. Bottles provided by or stored at the family child care program 
294.18 	must be washed prior to the next use.
294.19 	(d) Caregivers must not serve food to infants or toddlers using polystyrene foam 
294.20 	(Styrofoam) cups, bowls, or plates.
294.21 		Subd. 2.Milk. Cow's milk served to children in care must be pasteurized. Milk 
294.22 	alternatives that are nutritionally equivalent to cow's milk can be served in place of milk 
294.23 	for children who require it.
294.24 		Subd. 3.Drinking water. Drinking water from a safe source according to section 142I.16 
294.25 	must be readily available and offered to the children throughout the day in indoor and 
294.26 	outdoor areas.
294.27 		Subd. 4.Meals and snacks. (a) Well-balanced meals and snacks must be supplied by 
294.28 	the license holder or parents daily. Every meal and snack served to children in care must 
294.29 	meet the following requirements:
294.30 	(1) breakfast must contain at least three of the following:
294.31 	(i) pasteurized milk or milk alternatives;
294.32 	(ii) vegetables;
295.1 	(iii) fruit; or
295.2 	(iv) grains;
295.3 	(2) lunch and dinner must contain at least four of the following:
295.4 	(i) pasteurized milk or milk alternatives;
295.5 	(ii) meat or meat alternatives;
295.6 	(iii) vegetables;
295.7 	(iv) fruit; or
295.8 	(v) grains; and
295.9 	(3) snacks must contain at least two of the following:
295.10 	(i) pasteurized milk or milk alternatives;
295.11 	(ii) meat or meat alternatives;
295.12 	(iii) vegetables;
295.13 	(iv) fruit; or
295.14 	(v) grains.
295.15 	(b) Food, liquids, and bottles brought from home must be labeled with the first and last 
295.16 	name of each child.
295.17 	(c) Flexible feeding schedules must be provided for infants.
295.18 	(d) When special diets are required for cultural, religious, or medical reasons, the provider 
295.19 	must obtain written, dated, and signed instructions from the child's parent.
295.20 		Subd. 5.Food and liquid safety. (a) Food and liquids must be handled and stored 
295.21 	properly to prevent contamination and spoilage. Foods and liquids requiring refrigeration 
295.22 	must be refrigerated and maintained at no more than 40 degrees Fahrenheit. Food requiring 
295.23 	heating must be maintained at no less than 140 degrees Fahrenheit until ready to serve. 
295.24 	Frozen foods must be kept frozen until use and cooked according to the manufacturer's 
295.25 	instructions.
295.26 	(b) Appliances used in food and liquid storage and preparation must be safe and clean.
295.27 	(c) All canned food provided by the license holder must be commercially processed. 
295.28 	Locally grown fresh and frozen fruits and vegetables may be served at the family child care 
295.29 	program. Food canned or preserved at home and home-butchered meats, poultry, and fish 
295.30 	may not be served to children in care.

296.1 	Sec. 22. [142I.21] CHILDREN WITH SPECIAL HEALTH CARE NEEDS OR 
296.2 	DISABILITIES.
296.3 	(a) For children with disabilities who require therapy, additional behavior guidance, 
296.4 	programming, or alternative accommodations, a parent or health care provider must provide 
296.5 	written instructions for the license holder to follow.
296.6 	(b) All activities must be designed to include all children unless a specific medical 
296.7 	contraindication exists.
296.8 	(c) All caregivers responsible for the care of a child with a disability or special health 
296.9 	care need must explain to a parent and the agency how the child's specific needs are being 
296.10 	met.
296.11 	(d) Before enrolling a child for care, the license holder must obtain documentation of 
296.12 	any known allergies on a form prescribed by the commissioner. The form must be readily 
296.13 	available to all caregivers and reviewed by the license holder and each caregiver annually 
296.14 	and when any updates or changes are made.
296.15 	(e) If a child has a known allergy, the primary provider of care must maintain current 
296.16 	information about the allergy in the child's record, ensure that required medication is on 
296.17 	hand, and follow the allergy plan signed by a treating medical professional. The child's plan 
296.18 	must include:
296.19 	(1) a description of the allergy;
296.20 	(2) specific triggers and avoidance techniques;
296.21 	(3) symptoms of an allergic reaction; and
296.22 	(4) procedures for responding to an allergic reaction, including any medication and 
296.23 	dosage to be administered in an emergency situation.
296.24 	(f) A caregiver must call emergency medical services when epinephrine is administered 
296.25 	to a child in the license holder's care.
296.26 	(g) The caregiver must contact the child's parent immediately after any instance of 
296.27 	exposure to an allergen or allergic reaction.

296.28 	Sec. 23. [142I.22] COMMUNITY-BASED FAMILY CHILD CARE.
296.29 	(a) A family child care program located on a site other than the license holder's primary 
296.30 	residence must be licensed under this section if:
297.1 	(1) the family child care program is conducted in a dwelling on a residential lot or in a 
297.2 	commercial space other than the license holder's primary residence;
297.3 	(2) the license holder is an organization, employer, church, or religious entity; or
297.4 	(3) the license holder is a community collaborative child care provider. For purposes of 
297.5 	this clause, a "community collaborative child care provider" is a provider participating in 
297.6 	a cooperative agreement with a community action agency as defined in section 142F.301.
297.7 	(b) Programs licensed under paragraph (a) must comply with local zoning regulations, 
297.8 	the applicable State Fire Code, and the State Building Code. Any age and capacity limitations 
297.9 	established by the fire code must be printed on the license.
297.10 	(c) A license holder under this section must designate at least one primary provider of 
297.11 	care as follows:
297.12 	(1) one individual for programs operating eight or fewer hours per day;
297.13 	(2) up to two individuals for programs operating more than eight but no more than 16 
297.14 	hours per day; and
297.15 	(3) up to three individuals for programs operating more than 16 hours per day.
297.16 	(d) The license issued under this section must include the statement: "This 
297.17 	community-based family child care license holder is not licensed as a child care center."
297.18 	(e) The commissioner may approve up to six licenses at the same location or under one 
297.19 	contiguous roof if each license holder independently meets all applicable requirements and 
297.20 	the program location site does not have an R-2 residential occupancy designation. Each 
297.21 	family child care program must operate as a distinct family child care program within its 
297.22 	licensed capacity, age, and ratio limits as determined by the state fire marshal. Only one 
297.23 	license may be issued per single-family residential home.
297.24 	(f) The license holder must notify the commissioner in writing before any change in the 
297.25 	persons designated as primary providers of care. A primary provider of care is authorized 
297.26 	to communicate with the commissioner on licensing matters.
297.27 	(g) Each license holder must complete the commissioner-developed community-based 
297.28 	family child care program plan at the time of initial application, review the plan each calendar 
297.29 	year, and update the plan before any change in program information occurs.

298.1 	Sec. 24. REVISOR INSTRUCTION.
 298.2 	(a) The revisor of statutes must make any necessary changes to statutory cross-references 
298.3 	to reflect the changes in this article.
298.4 	(b) The revisor of statutes must replicate the statutory history for all sections and 
298.5 	subdivisions repealed and reenacted in this article.

298.6 	Sec. 25. REPEALER.
 298.7 	(a) Minnesota Statutes 2024, sections 142B.01, subdivision 13; 142B.41, subdivisions 
298.8 	4 and 8; 142B.62; 142B.70, subdivisions 1, 2, 3, 4, 5, 6, 9, 10, 11, and 12; 142B.71; 142B.72; 
298.9 	142B.74; 142B.75; 142B.76; and 142B.77, are repealed.
298.10 	(b) Minnesota Statutes 2025 Supplement, sections 142B.41, subdivision 9; and 142B.70, 
298.11 	subdivisions 7 and 8, are repealed.
298.12 	(c) Minnesota Rules, parts 9502.0300; 9502.0315; 9502.0325; 9502.0335; 9502.0341; 
298.13 	9502.0345; 9502.0355; 9502.0365; 9502.0367; 9502.0375; 9502.0395; 9502.0405; 
298.14 	9502.0415; 9502.0425; 9502.0435; and 9502.0445, are repealed.

298.15 	Sec. 26. EFFECTIVE DATE.
 298.16 	This article is effective July 1, 2027.

298.17 	ARTICLE 14
298.18 	MISCELLANEOUS

298.19 	Section 1. Minnesota Statutes 2024, section 62A.01, is amended by adding a subdivision 
298.20 	to read:
298.21 		Subd. 5.Direct primary care service agreements. (a) A direct primary care service 
298.22 	agreement under section 62Q.20 is not insurance and is not subject to this chapter. Entering 
298.23 	into a direct primary care service agreement is not the business of insurance and is not 
298.24 	subject to this chapter or chapter 60A.
298.25 	(b) A health care provider or agent of a health care provider is not required to obtain a 
298.26 	certificate of authority or license under this chapter or chapter 60A, 62C, 62D, or 62N to 
298.27 	market, sell, or offer to sell a direct primary care service agreement that meets the 
298.28 	requirements of section 62Q.20.

299.1 	Sec. 2. Minnesota Statutes 2024, section 62A.011, subdivision 3, is amended to read:
299.2 		Subd. 3.Health plan. "Health plan" means a policy or certificate of accident and sickness 
299.3 	insurance as defined in section 62A.01 offered by an insurance company licensed under 
299.4 	chapter 60A; a subscriber contract or certificate offered by a nonprofit health service plan 
299.5 	corporation operating under chapter 62C; a health maintenance contract or certificate offered 
299.6 	by a health maintenance organization operating under chapter 62D; a health benefit certificate 
299.7 	offered by a fraternal benefit society operating under chapter 64B; or health coverage offered 
299.8 	by a joint self-insurance employee health plan operating under chapter 62H. Health plan 
299.9 	means individual and group coverage, unless otherwise specified. Health plan does not 
299.10 	include coverage that is:
299.11 	(1) limited to disability or income protection coverage;
299.12 	(2) automobile medical payment coverage;
299.13 	(3) liability insurance, including general liability insurance and automobile liability 
299.14 	insurance, or coverage issued as a supplement to liability insurance;
299.15 	(4) designed solely to provide payments on a per diem, fixed indemnity, or 
299.16 	non-expense-incurred basis, including coverage only for a specified disease or illness or 
299.17 	hospital indemnity or other fixed indemnity insurance, if the benefits are provided under a 
299.18 	separate policy, certificate, or contract for insurance; there is no coordination between the 
299.19 	provision of benefits and any exclusion of benefits under any group health plan maintained 
299.20 	by the same plan sponsor; and the benefits are paid with respect to an event without regard 
299.21 	to whether benefits are provided with respect to such an event under any group health plan 
299.22 	maintained by the same plan sponsor;
299.23 	(5) credit accident and health insurance as defined in section 62B.02;
299.24 	(6) designed solely to provide hearing, dental, or vision care;
299.25 	(7) blanket accident and sickness insurance as defined in section 62A.11;
299.26 	(8) accident-only coverage;
299.27 	(9) a long-term care policy as defined in section 62A.46 or 62S.01;
299.28 	(10) issued as a supplement to Medicare, as defined in sections 62A.3099 to 62A.44, or 
299.29 	policies, contracts, or certificates that supplement Medicare issued by health maintenance 
299.30 	organizations or those policies, contracts, or certificates governed by section 1833 or 1876, 
299.31 	section 1851, et seq.; or section 1860D-1, et seq., of title XVIII of the federal Social Security 
299.32 	Act, et seq., as amended;
300.1 	(11) workers' compensation insurance;
300.2 	(12) issued solely as a companion to a health maintenance contract as described in section 
300.3 	62D.12, subdivision 1a, so long as the health maintenance contract meets the definition of 
300.4 	a health plan;
300.5 	(13) coverage for on-site medical clinics; or
300.6 	(14) coverage supplemental to the coverage provided under United States Code, title 
300.7 	10, chapter 55, Civilian Health and Medical Program of the Uniformed Services 
300.8 	(CHAMPUS).; or
300.9 	(15) coverage provided under a direct primary care service agreement described under 
300.10 	section 62Q.20.

300.11 	Sec. 3. [62Q.20] DIRECT PRIMARY CARE SERVICE AGREEMENT.
300.12 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
300.13 	the meanings given.
300.14 	(b) "Direct fee" means a fee charged by a direct primary care practice as consideration 
300.15 	for being available to provide and for providing primary care services  to a direct patient as 
300.16 	specified in the direct agreement.
300.17 	(c) "Direct patient" means an individual who is party to a direct agreement and is entitled 
300.18 	to receive primary care services under the direct agreement from the direct primary care 
300.19 	practice.
300.20 	(d) "Direct primary care practice" or "direct practice" means a primary care provider 
300.21 	who furnishes primary care services through a direct agreement.
300.22 	(e) "Direct primary care service agreement" or "direct agreement" means a written 
300.23 	agreement  entered into between a direct primary care practice and a direct patient, or the 
300.24 	direct patient's legal representative, in which the primary care direct practice charges a direct 
300.25 	fee as consideration for being available to provide and for providing direct primary care 
300.26 	services to the direct patient.
300.27 	(f) "Primary care provider" means a physician who is licensed under chapter 147 or an 
300.28 	advanced practice registered nurse licensed under chapter 148, who is authorized to engage 
300.29 	in independent practice, and who is qualified to provide primary care services. This term 
300.30 	includes an individual primary care provider or a group of primary care providers.
300.31 	(g) "Primary care services" means:
301.1 	(1) routine health care services, including screening, assessment, diagnosis, and treatment 
301.2 	for the purpose of the promotion of health, and the detection and management of disease 
301.3 	or injury within the competency and training of the primary care provider;
301.4 	(2) medical supplies and prescription drugs that are administered or dispensed in the 
301.5 	primary care provider's office or clinic; and
301.6 	(3) laboratory work, including routine blood screening and routine pathology screening 
301.7 	performed by a laboratory that is either associated with the direct primary care practice or 
301.8 	is not associated with the direct primary care practice but has entered into a contract with 
301.9 	the practice to provide laboratory work without charging a fee to the patient for the laboratory 
301.10 	work.
301.11 		Subd. 2.Direct primary care services agreement requirements. (a) To be considered 
301.12 	a direct primary care service agreement for purposes of this section, the direct agreement 
301.13 	must:
301.14 	(1) be in writing;
301.15 	(2) be signed by the primary care provider or agent of the primary care practice and the 
301.16 	direct patient or the patient's legal representative;
301.17 	(3) allow either party to terminate the direct agreement upon written notice to the other 
301.18 	party according to subdivision 3;
301.19 	(4) describe the scope of the primary care services that are to be covered under the direct 
301.20 	agreement;
301.21 	(5) specify the fee to be paid on a monthly basis or as specified in the direct agreement; 
301.22 	and
301.23 	(6) specify the duration of the direct agreement.
301.24 	(b) The direct agreement must clearly state that a direct primary care service agreement: 
301.25 	is not considered health insurance; does not meet the requirements of federal law mandating 
301.26 	individuals to purchase health insurance; and the fees charged in the agreement may not be 
301.27 	reimbursed or applied toward a deductible under a health plan offered through a health plan 
301.28 	company.
301.29 		Subd. 3.Acceptance and discontinuance of patients. (a) A direct practice may not 
301.30 	decline to accept a new patient or discontinue care to an existing patient solely on the basis 
301.31 	of the patient's health status. A direct practice may decline to accept a patient if:
301.32 	(1) the practice has reached its maximum capacity;
302.1 	(2) the patient's medical condition is such that the practice is unable to provide the level 
302.2 	and type of primary care services the patient requires; or
302.3 	(3) the patient has previously terminated a direct agreement with the direct practice 
302.4 	within the preceding year.
302.5 	(b) A direct patient or the patient's legal representative may terminate a direct agreement 
302.6 	for any reason by providing written notice to the direct practice. Termination of the direct 
302.7 	agreement is effective the first day of the month following the month the termination notice 
302.8 	is provided to the direct practice. A direct practice may subsequently decline to accept the 
302.9 	direct patient as a patient if the patient has terminated a previous direct agreement with the 
302.10 	direct practice within the preceding year.
302.11 	(c) A direct practice may terminate a direct agreement for any reason by providing 
302.12 	written notice to the direct patient or the direct patient's representative. A direct practice 
302.13 	must provide notice of termination at least 30 days prior to the effective date of termination.
302.14 	(d) A direct practice may discontinue care to a direct patient if the direct practice 
302.15 	discontinues operation as a direct primary care practice. Notice must be provided to the 
302.16 	direct patient or the patient's legal representative specifying the effective date of termination. 
302.17 	Notice must be sufficient to provide the patient with the opportunity to obtain care from 
302.18 	another provider.
302.19 		Subd. 4.Direct fees. (a) The direct fee charged must represent the total amount due for 
302.20 	all primary care services specified in the direct agreement provided to the direct patient 
302.21 	within the specified time period. The direct fee must not vary from patient to patient based 
302.22 	on the patient's health status or sex. The direct fee may be paid by the direct patient, by the 
302.23 	patient's legal representative, or on the patient's behalf by a third party. The direct fee may 
302.24 	be billed at the end of each monthly period or may be paid in advance for a period not to 
302.25 	exceed 12 months.
302.26 	(b) Upon receipt of a written notice of termination of the direct agreement from a direct 
302.27 	patient or the patient's legal representative, the direct practice must promptly refund the 
302.28 	unearned amount of the direct fees. If the direct practice discontinues care for any reason 
302.29 	described under subdivision 3, the direct practice must promptly refund to the direct patient 
302.30 	the unearned amount of the direct fees at a prorated amount of the direct fee earned for the 
302.31 	current month based on the date the notice for termination was sent to the direct patient or 
302.32 	the direct patient's legal representative.
302.33 	(c) A direct practice shall not increase the monthly fee that has been negotiated with an 
302.34 	existing direct patient more frequently than on an annual basis. A direct practice must 
303.1 	provide advance notice of at least 60 days to existing patients of any change in the direct 
303.2 	fee.
303.3 		Subd. 5.Conduct of business. (a) A direct practice must maintain appropriate accounts 
303.4 	regarding payments made and services received by a direct patient and upon request provide 
303.5 	any data requested to the direct patient or the patient's legal representative.
303.6 	(b) A direct practice must not submit a claim for payment to a health plan company for 
303.7 	a primary care service provided to a direct patient that is covered by a direct agreement.
303.8 	(c) No person shall make, publish, or disseminate any false, deceptive, or misleading 
303.9 	representation or advertising related to the business of a direct practice.
303.10 	(d) No person shall make, issue, or circulate, or cause to be made, issued, or circulated, 
303.11 	a misrepresentation of the terms of a direct agreement or the benefits or advantages promised, 
303.12 	or use the name or title of a direct agreement misrepresenting the nature of the direct 
303.13 	agreement.
303.14 		Subd. 6.Other care not prohibited. A direct primary care practice is not prohibited 
303.15 	from providing services to other patients under a separate contract with a health plan 
303.16 	company.
303.17 		Subd. 7.Enforcement. A violation of this section shall constitute unprofessional conduct 
303.18 	and may be grounds for disciplinary action under chapters 147 and 148.

303.19 	Sec. 4. Minnesota Statutes 2024, section 116.943, subdivision 2, is amended to read:
303.20 		Subd. 2.Information required. (a) On or before January 1, 2026, a manufacturer of a 
303.21 	product manufactured after July 1, 2023; sold, offered for sale, or distributed in the state; 
303.22 	and that contains intentionally added PFAS must submit to the commissioner information 
303.23 	that includes:
303.24 	(1) a brief description of the product, including a universal product code (UPC), stock 
303.25 	keeping unit (SKU), or other numeric code assigned to the product;
303.26 	(2) the purpose for which PFAS are used in the product, including in any product 
303.27 	components;
303.28 	(3) the amount of each PFAS, identified by its chemical abstracts service registry number, 
303.29 	in the product, reported as an exact quantity determined using commercially available 
303.30 	analytical methods or as falling within a range approved for reporting purposes by the 
303.31 	commissioner;
304.1 	(4) the name and address of the manufacturer and the name, address, and phone number 
304.2 	of a contact person for the manufacturer; and
304.3 	(5) any additional information requested by the commissioner as necessary to implement 
304.4 	the requirements of this section.
304.5 	(b) With the approval of the commissioner, a manufacturer may supply the information 
304.6 	required in paragraph (a) for a category or type of product rather than for each individual 
304.7 	product.
304.8 	(c) A manufacturer must submit the information required under this subdivision whenever 
304.9 	a new product that contains intentionally added PFAS is sold, offered for sale, or distributed 
304.10 	in the state and update and revise the information whenever there is significant change in 
304.11 	the information or when requested to do so by the commissioner.
304.12 	(d) A person may not sell, offer for sale, or distribute for sale in the state a product 
304.13 	containing intentionally added PFAS if the manufacturer has failed to provide the information 
304.14 	required under this subdivision and the person has received notification under subdivision 
304.15 	4.

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

304.17 	Sec. 5. Minnesota Statutes 2025 Supplement, section 145C.18, subdivision 3, is amended 
304.18 	to read:
304.19 		Subd. 3.Compliance with nonopioid directive; exception. (a) Except as specified in 
304.20 	paragraph paragraphs (b) and (c), prescribers and health professionals must comply with a 
304.21 	nonopioid directive executed under this section.
304.22 	(b) A prescriber or a health professional acting on the order of a prescriber may administer 
304.23 	an opioid to a patient with a nonopioid directive if:
304.24 	(1) the patient is being treated, in emergency circumstances, in a hospital setting or in 
304.25 	a setting outside a hospital;
304.26 	(2) in the prescriber's professional opinion, it is medically necessary to administer an 
304.27 	opioid to the patient in order to treat the patient, including but not limited to during a surgical 
304.28 	procedure when one or more complications arise; and
304.29 	(3) it is not practical or feasible for the prescriber or health professional to access the 
304.30 	patient's health care record.
305.1 	If an opioid is administered according to this paragraph to a patient with a nonopioid 
305.2 	directive, the prescriber must ensure that the patient is provided with information on substance 
305.3 	use disorder services.
305.4 	(c) A prescriber or a health professional acting on the order of a prescriber may prescribe 
305.5 	or administer an opioid to a patient with a nonopioid directive if the opioid is prescribed or 
305.6 	administered to treat the patient for a substance use disorder.

305.7 	Sec. 6. Minnesota Statutes 2025 Supplement, section 145C.18, subdivision 4, is amended 
305.8 	to read:
305.9 		Subd. 4.Immunities. Except as otherwise provided by law, the following persons or 
305.10 	entities are not subject to criminal prosecution, civil liability, or professional disciplinary 
305.11 	action for failing to prescribe, administer, or dispense an opioid to a patient with a nonopioid 
305.12 	directive; for the administration of an opioid in the circumstances in subdivision 3, paragraph 
305.13 	(b), to a patient with a nonopioid directive; for the prescribing or administration of an opioid 
305.14 	in the circumstances in subdivision 3, paragraph (c), to a patient with a nonopioid directive; 
305.15 	or for the inadvertent administration of an opioid to a patient with a nonopioid directive, if 
305.16 	the act or failure to act was performed in good faith and in accordance with the applicable 
305.17 	standard of care:
305.18 	(1) a health professional whose scope of practice includes prescribing, administering, 
305.19 	or dispensing a controlled substance;
305.20 	(2) an employee of a health professional described in clause (1);
305.21 	(3) a health care facility or an employee of a health care facility; or
305.22 	(4) an emergency medical services provider.

305.23 	Sec. 7. Minnesota Statutes 2024, section 471.6161, is amended by adding a subdivision 
305.24 	to read:
305.25 		Subd. 9.School districts and charter schools; reports. (a) For purposes of this 
305.26 	subdivision, an entity offering or providing group health insurance includes both health 
305.27 	plan companies and third-party administrators of health plans.
305.28 	(b) By July 15, 2026, and July 1 each year thereafter, the Legislative Budget Office must 
305.29 	send an annual survey regarding health insurance costs to all school districts and charter 
305.30 	schools in the state.
306.1 	(c) The annual survey must be completed by the school district or charter school using 
306.2 	data from its most recent plan year, be returned to the Legislative Budget Office by September 
306.3 	1 each year, and provide the following information about school employees who meet the 
306.4 	definition of public employee under section 179A.03, subdivision 14:
306.5 	(1) the total number of salaried employees;
306.6 	(2) the total number of nonsalaried or hourly employees;
306.7 	(3) for employees participating in the group health insurance offered by the school district 
306.8 	or charter school, the total number of people, as of May 1, in each of the following categories:
306.9 	(i) salaried employees;
306.10 	(ii) nonsalaried or hourly employees; and
306.11 	(iii) retirees and any other persons who continue to receive coverage through the school 
306.12 	district's or charter school's health plan after separation from employment;
306.13 	(4) the total number of employees not participating in the health plan;
306.14 	(5) the total number of insured persons covered by the health plan;
306.15 	(6) the total dollar amount the school district or charter school paid in health insurance 
306.16 	premiums on behalf of all employees, not including employee contributions transmitted to 
306.17 	an entity providing group health insurance coverage or payments made on behalf of former 
306.18 	employees;
306.19 	(7) if a school district or charter school funds an individual coverage health reimbursement 
306.20 	arrangement, the total amount contributed by the school district or charter school;
306.21 	(8) the total amount employees paid in health insurance premiums;
306.22 	(9) an accounting of all forms of compensation, either direct or indirect, including but 
306.23 	not limited to fees, commissions, incentives, or rewards of any kind paid to a broker or 
306.24 	agent, regardless of whether it was billed as a flat fee or percentage of premium and whether 
306.25 	paid directly by the school district or charter school or through the entity offering group 
306.26 	health insurance;
306.27 	(10) the name of any entity providing group health insurance the school district or charter 
306.28 	school has contracted with and the expiration date of the contract;
306.29 	(11) the date range of the most recent plan year;
306.30 	(12) for each type of health plan offered to employees of a school district or charter 
306.31 	school:
307.1 	(i) the name of the plan and its actuarial value, using the minimum value calculator 
307.2 	information required in bid proposals under section 471.6161, subdivision 8, paragraph (d), 
307.3 	clause (2), and described in Code of Federal Regulations, title 45, section 156.145. The plan 
307.4 	data must also delineate amounts for single, family, and two-party plans, if offered;
307.5 	(ii) the monthly contribution by the school district or charter school for each employee 
307.6 	group per plan, including contributions to individual coverage health reimbursement 
307.7 	arrangements;
307.8 	(iii) the amount per month an employee must pay in health insurance premiums for the 
307.9 	plan; and
307.10 	(iv) the plan design for each type of plan, including:
307.11 	(A) in-network deductibles;
307.12 	(B) in-network out-of-pocket limits;
307.13 	(C) out-of-network limits;
307.14 	(D) co-payments;
307.15 	(E) the employee's share of coinsurance; and
307.16 	(F) the prescription annual out-of-pocket maximum, if separate from subitem (B);
307.17 	(13) the dollar or percentage cost for all prescription levels, commonly generic or tier 
307.18 	1, formulary or tier 2, and nonformulary or tier 3;
307.19 	(14) the total amount of annual contributions, per employee, paid by the school district 
307.20 	or charter school to an individual coverage health reimbursement arrangement or health 
307.21 	savings account, excluding amounts contributed solely to a health care retirement account;
307.22 	(15) the total amount assessed by the entity providing group health insurance as an 
307.23 	administrative fee and the rate of the fee assessed;
307.24 	(16) if a school district is self-insured, the total amount that is in a district set-aside health 
307.25 	insurance reserve account; and
307.26 	(17) any additional items as determined by the Legislative Budget Office.
307.27 	(d) The Legislative Budget Office must compile information from the surveys described 
307.28 	above and provide a report by December 1 each year to the chairs and ranking minority 
307.29 	members of the legislative committees with jurisdiction over education and health insurance. 
307.30 	The Legislative Budget Office must post the report, including the executive summary and 
308.1 	all underlying data received from school districts and charter schools, on its public website. 
308.2 	Data posted on the Legislative Budget Office's website must be in a standardized format.

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

308.4 	Sec. 8. REPEALER.
 308.5 	Minnesota Statutes 2024, sections 62U.10, subdivision 4; and 256B.69, subdivision 31a,
308.6 	are repealed.

308.7 	ARTICLE 15
308.8 	DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENTS

308.9	Section 1. HUMAN SERVICES FORECAST ADJUSTMENTS.
 	
308.10 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
308.11 	parentheses, subtracted from the appropriations in Laws 2025, First Special Session chapter 
308.12 	3, article 20, and Laws 2025, First Special Session chapter 9, article 12, to the commissioner 
308.13 	of human services from the general fund or other named fund for the purposes specified in 
308.14 	section 2 and are available for the fiscal years indicated for each purpose. The figures "2026" 
308.15 	and "2027" used in this article mean that the addition to or subtraction from the appropriation 
308.16 	listed under them is available for the fiscal year ending June 30, 2026, or June 30, 2027, 
308.17 	respectively.

308.18				APPROPRIATIONS
	
308.19				Available for the Year
	
308.20				Ending June 30
	
308.21					2026
		2027

308.22
308.23	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES.

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

308.25	Appropriations by Fund
	
308.26	General Fund
	652,953,000
	615,407,000
	
308.27
308.28	Health Care Access 
Fund
	86,681,000
	159,628,000

308.29	Subd. 2.Forecasted Programs

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

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

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

308.33	(d) MinnesotaCare
		86,681,000
		159,628,000
	
309.1 	These appropriations are from the health care 
309.2 	access fund.

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

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

309.5 	Sec. 3. EFFECTIVE DATE.
 309.6 	This article is effective the day following final enactment.

309.7 	ARTICLE 16
309.8 	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES FORECAST 
309.9 	ADJUSTMENTS

309.10	Section 1. CHILDREN, YOUTH, AND FAMILIES FORECAST ADJUSTMENTS.
 	
309.11 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
309.12 	parentheses, subtracted from the appropriations in Laws 2025, First Special Session chapter 
309.13 	3, article 22, to the commissioner of children, youth, and families from the general fund or 
309.14 	other named fund for the purposes specified in section 2 and are available for the fiscal 
309.15 	years indicated for each purpose. The figures "2026" and "2027" used in this article mean 
309.16 	that the addition to or subtraction from the appropriation listed under them is available for 
309.17 	the fiscal year ending June 30, 2026, or June 30, 2027, respectively.

309.18				APPROPRIATIONS
	
309.19				Available for the Year
	
309.20				Ending June 30
	
309.21					2026
		2027

309.22
309.23	Sec. 2. COMMISSIONER OF CHILDREN, 
YOUTH, AND FAMILIES.

309.24	Subdivision 1.Total Appropriation
 	$
	(45,161,000)
	$
	(36,451,000)

309.25	Appropriations by Fund
	
309.26	General Fund
	(22,395,000)
	(10,320,000)
	
309.27	Federal TANF
	(22,766,000)
	(26,131,000)

309.28	Subd. 2.Forecasted Programs

309.29	(a) MFIP/DWP

309.30	Appropriations by Fund
	
309.31	General Fund
	(7,245,000)
	(3,125,000)
	
309.32	Federal TANF
	(22,766,000)
	(26,131,000)

309.33	(b) MFIP Child Care Assistance
		(26,220,000)
		(18,822,000)

310.1	(c) Northstar Care for Children
		11,070,000
		11,627,000

310.2 	Sec. 3. EFFECTIVE DATE.
 310.3 	This article is effective the day following final enactment.

310.4 	ARTICLE 17
310.5 	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS

310.6	Section 1. DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS.
 	
310.7 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
310.8 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
310.9 	Session chapter 3, article 20, from the general fund or any fund named for the purposes 
310.10 	specified in this article, to be available for the fiscal year indicated for each purpose. The 
310.11 	figures "2026" and "2027" used in this article mean that the appropriations listed under them 
310.12 	are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The 
310.13 	first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is 
310.14 	fiscal years 2026 and 2027.

310.15				APPROPRIATIONS
	
310.16				Available for the Year
	
310.17				Ending June 30
	
310.18					2026
		2027

310.19
310.20	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES
 	$
	-0-
	$
	132,522,000
	
310.21 	The amounts that may be spent for each 
310.22 	purpose are specified in this article.

310.23	Sec. 3. CENTRAL OFFICE; OPERATIONS
 	$
	-0-
	$
	2,154,000
	
310.24 	The general fund base is increased by 
310.25 	$6,741,000 in fiscal year 2028 and increased 
310.26 	by $7,577,000 in fiscal year 2029.

310.27	Sec. 4. CENTRAL OFFICE; HEALTH CARE
 	$
	-0-
	$
	19,403,000
	
310.28 	The general fund base is increased by 
310.29 	$59,838,000 in fiscal year 2028 and increased 
310.30 	by $60,350,000 in fiscal year 2029.

310.31
310.32	Sec. 5. CENTRAL OFFICE; BEHAVIORAL 
HEALTH
 	$
	-0-
	$
	896,000
	
311.1 	This is a onetime appropriation.

311.2
311.3	Sec. 6. CENTRAL OFFICE; OFFICE OF 
INSPECTOR GENERAL
 	$
	-0-
	$
	330,000

311.4
311.5	Subdivision 1.Crisis Nursery Licensing 
Framework
 					
311.6 	$304,000 in fiscal year 2027 is to develop a 
311.7 	licensing framework for crisis nurseries. The 
311.8 	base for this appropriation is $358,000 in fiscal 
311.9 	year 2028 and $0 in fiscal year 2029.

311.10	Subd. 2.Base Level Adjustments
 					
311.11 	The general fund base is increased by 
311.12 	$384,000 in fiscal year 2028 and increased by 
311.13 	$26,000 in fiscal year 2029.

311.14
311.15	Sec. 7. FORECASTED PROGRAMS; 
MEDICAL ASSISTANCE
 	$
	-0-
	$
	94,505,000
	
311.16 	$100,000,000 in fiscal year 2027 is for the 
311.17 	nonfederal share of the directed payment 
311.18 	arrangement under Minnesota Statutes, section 
311.19 	256B.1973. This is a onetime appropriation 
311.20 	and is available until June 30, 2028. This 
311.21 	appropriation is not effective until the day 
311.22 	following final enactment of H.F. 2438 in the 
311.23 	2026 regular legislative session.

311.24
311.25	Sec. 8. GRANT PROGRAMS; CHILD AND 
ECONOMIC SUPPORT GRANTS
 	$
	-0-
	$
	(407,000)
	
311.26 	Any unexpended amount in fiscal year 2027 
311.27 	and any amounts in the planning estimate for 
311.28 	fiscal year 2028 and fiscal year 2029 for the 
311.29 	emergency shelter facility grant and 
311.30 	emergency services grants must be transferred 
311.31 	from child and economic support grants to 
311.32 	housing support grants.

311.33
311.34	Sec. 9. GRANT PROGRAMS; FRAUD 
PREVENTION GRANTS
 	$
	-0-
	$
	(425,000)

312.1
312.2	Sec. 10. GRANT PROGRAMS; HEALTH 
CARE GRANTS
 	$
	-0-
	$
	1,500,000

312.3
312.4	Subdivision 1.Health Care Navigator Incentive 
Payment Grants
 					
312.5 	$250,000 in fiscal year 2027 is for application 
312.6 	assistance bonuses to organizations and 
312.7 	licensed insurance producers for applicants 
312.8 	successfully enrolled in medical assistance 
312.9 	under Minnesota Statutes, section 256.962, 
312.10 	subdivision 5. The base for this appropriation 
312.11 	is $500,000 in fiscal year 2028 and $500,000 
312.12 	in fiscal year 2029.

312.13	Subd. 2.Community Minigrant Program
 					
312.14 	$1,250,000 in fiscal year 2027 is for the 
312.15 	community minigrant program under 
312.16 	Minnesota Statutes, section 256.01, 
312.17 	subdivision 2, paragraph (a), clause (6). Grants 
312.18 	under this subdivision are subject to the grant 
312.19 	requirements under Minnesota Statutes, 
312.20 	chapter 16B. The base for this appropriation 
312.21 	is $1,250,000 in fiscal year 2028 and $625,000 
312.22 	in fiscal year 2029.

312.23	Subd. 3.Base Level Adjustments
 					
312.24 	The general fund base is increased by 
312.25 	$1,750,000 in fiscal year 2028 and $1,125,000 
312.26 	in fiscal year 2029.

312.27
312.28	Sec. 11. GRANT PROGRAMS; HOUSING AND 
SUPPORT SERVICES GRANTS
 	$
	-0-
	$
	192,000

312.29
312.30	Sec. 12. GRANT PROGRAMS; ADULT 
MENTAL HEALTH GRANTS
 	$
	-0-
	$
	2,483,000

312.31	Subdivision 1.Mobile Crisis Grants
 					
312.32 	$3,800,000 in fiscal year 2027 is for the 
312.33 	mobile crisis grants under Minnesota Statutes, 
312.34 	sections 245.4661, subdivision 9, paragraph 
312.35 	(b), clause (15), and 245.4889, subdivision 1, 
313.1 	paragraph (b), clause (4). This is a onetime 
313.2 	appropriation and is available until June 30, 
313.3 	2029.

313.4	Subd. 2.Base Level Adjustments
 					
313.5 	The general fund base is reduced by 
313.6 	$1,317,000 in fiscal year 2028 and reduced 
313.7 	by $1,317,000 in fiscal year 2029.

313.8
313.9	Sec. 13. GRANT PROGRAMS; CHILD 
MENTAL HEALTH GRANTS
 	$
	-0-
	$
	12,252,000

313.10
313.11	Subdivision 1.School-Linked Behavioral Health 
Grants
 					
313.12 	$11,891,000 in fiscal year 2027 is for 
313.13 	school-linked behavioral health grants under 
313.14 	Minnesota Statutes, section 245.4901. Grant 
313.15 	awards under this subdivision must allow a 
313.16 	grantee to use grant funds for a partnership 
313.17 	with a nonpublic school or a Tribal contract 
313.18 	school to provide services to students 
313.19 	attending a nonpublic or Tribal contract school 
313.20 	and to provide staff professional development 
313.21 	activities for school's licensed and unlicensed 
313.22 	staff. This is a onetime appropriation and is 
313.23 	available until June 30, 2029.

313.24	Subd. 2.Base Level Adjustments
 					
313.25 	The general fund base is increased by 
313.26 	$361,000 in fiscal year 2028 and increased by 
313.27 	$361,000 in fiscal year 2029.

313.28
313.29
313.30	Sec. 14. GRANT PROGRAMS; CHEMICAL 
DEPENDENCY TREATMENT SUPPORT 
GRANTS
 	$
	-0-
	$
	(361,000)

313.31 	Sec. 15. GRANT ADMINISTRATION COSTS.
 313.32 	This article appropriates necessary administrative costs. The administrative costs retention 
313.33 	requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to 
313.34 	any appropriation in this article for a grant.

314.1 	Sec. 16. EXPIRATION OF UNCODIFIED LANGUAGE.
 314.2 	All uncodified language contained in this article expires on June 30, 2027, unless a 
314.3 	different expiration date is explicit or an appropriation is made available beyond June 30, 
314.4 	2027.

314.5 	Sec. 17. APPROPRIATIONS GIVEN EFFECT ONCE.
 314.6 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
314.7 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
314.8 	effect once.

314.9 	ARTICLE 18
314.10 	DEPARTMENT OF HEALTH APPROPRIATIONS

314.11	Section 1. HEALTH APPROPRIATIONS.
 	
314.12 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
314.13 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
314.14 	Session chapter 3, article 21, from the general fund or any named fund and are available 
314.15 	for the fiscal years indicated for each purpose. The figures "2026" and "2027" used in this 
314.16 	article mean that the addition to or subtraction from the appropriations listed under them 
314.17 	are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The 
314.18 	first year" is fiscal year 2026. "The second year" is fiscal year 2027.

314.19				APPROPRIATIONS
	
314.20				Available for the Year
	
314.21				Ending June 30
	
314.22					2026
		2027

314.23	Sec. 2. COMMISSIONER OF HEALTH
 	$
	50,440,000
	$
	89,010,000

314.24	Appropriations by Fund
	
314.25		2026
	2027
	
314.26	General
	50,000,000
	88,383,000
	
314.27
314.28	State Government 
Special Revenue
	440,000
	627,000
	
314.29 	The amounts that may be spent for each 
314.30 	purpose are specified in the following sections.

314.31	Sec. 3. HEALTH IMPROVEMENT

314.32	Subdivision 1.Total Appropriation

315.1	Appropriations by Fund
	
315.2	General
	50,000,000
	86,330,000
	
315.3
315.4	State Government 
Special Revenue
	440,000
	627,000

315.5	Subd. 2.Helping Paws
 					
315.6 	(a) Helping Paws Grant. $200,000 in fiscal 
315.7 	year 2027 is from the general fund for a grant 
315.8 	to Helping Paws, Inc., to breed, train, and 
315.9 	place service or facility dogs with individuals 
315.10 	who have physical disabilities; veterans and 
315.11 	first responders living with service-related 
315.12 	post-traumatic stress disorder; and 
315.13 	professionals in courthouse, educational, and 
315.14 	mental health settings. This is a onetime 
315.15 	appropriation in memory of Speaker Emerita 
315.16 	Melissa Hortman. Up to $10,000 in fiscal year 
315.17 	2027 may be used for administration.
315.18 	(b) Helping Paws; Private Donations. The 
315.19 	commissioner of health may accept private 
315.20 	donations to supplement the state money 
315.21 	appropriated under paragraph (a). All 
315.22 	donations accepted by the commissioner under 
315.23 	this paragraph must be deposited in the gift 
315.24 	fund and are appropriated to the commissioner 
315.25 	for the purposes of paragraph (a).

315.26	Subd. 3.Crisis Telephone Services
 					
315.27 	$1,125,000 in fiscal year 2027 is from the 
315.28 	general fund for regional coordination and 
315.29 	24-hour-a-day, seven-day-a-week statewide 
315.30 	crisis telephone services. Up to $112,500 in 
315.31 	fiscal year 2027 is for administration.

315.32	Subd. 4.Hospital Stabilization Program
 					
315.33 	$30,000,000 in fiscal year 2027 is from the 
315.34 	general fund for the hospital stabilization 
316.1 	program. This is a onetime appropriation. Of 
316.2 	this appropriation, $600,000 in fiscal year 
316.3 	2027 is for the commissioner to administer 
316.4 	the program.

316.5
316.6	Subd. 5.Hennepin Healthcare Stabilization 
Payments
 					
316.7 	$50,000,000 in fiscal year 2026 and 
316.8 	$54,950,000 in fiscal year 2027 are for direct 
316.9 	payments to Hennepin Healthcare System, 
316.10 	Inc., to avoid closure of the Hennepin County 
316.11 	Medical Center. The commissioner must make 
316.12 	a payment of the amount appropriated in fiscal 
316.13 	year 2026 by June 30, 2026. For the purposes 
316.14 	of these payments, the statewide grant-making 
316.15 	requirements, including but not limited to 
316.16 	those under Minnesota Statutes, sections 
316.17 	16A.15; 16B.97; 16C.05, subdivisions 1 to 4 
316.18 	and 6 to 8; and 16C.06, do not apply. The 
316.19 	commissioner may use up to $350,000 in fiscal 
316.20 	year 2027 for administration. This is a onetime 
316.21 	appropriation. Notwithstanding section 8, this 
316.22 	appropriation is not effective until the day 
316.23 	following final enactment of House File No. 
316.24 	2438 from the 2026 regular session.

316.25
316.26	Subd. 6.Licensing and Regulation of Health 
Maintenance Organizations
 					
316.27 	$440,000 in fiscal year 2026 and $440,000 in 
316.28 	fiscal year 2027 are from the state government 
316.29 	special revenue fund for licensing and 
316.30 	regulation of health maintenance organizations 
316.31 	under Minnesota Statutes, chapter 62D.

316.32
316.33	Subd. 7.All-Payer Claims Database; 
Administration
 					
316.34 	$187,000 in fiscal year 2027 is from the state 
316.35 	government special revenue fund for 
317.1 	administering the all-payer claims database 
317.2 	under Minnesota Statutes, section 62U.04. The 
317.3 	state government special revenue fund base 
317.4 	for this subdivision is increased by $233,000 
317.5 	in fiscal year 2028 and increased by $291,000 
317.6 	in fiscal year 2029.

317.7
317.8	Subd. 8.All-Payer Claims Database; Data on 
Fully Denied Claims
 					
317.9 	$55,000 in fiscal year 2027 is from the general 
317.10 	fund for the collection of data on fully denied 
317.11 	claims according to Minnesota Statutes, 
317.12 	section 62U.04, subdivision 4. This is a 
317.13 	onetime appropriation.

317.14	Subd. 9.Base Adjustment
 					
317.15 	The general fund base is increased by 
317.16 	$1,125,000 in fiscal year 2028 and increased 
317.17 	by $1,125,000 in fiscal year 2029. The state 
317.18 	government special revenue fund base is 
317.19 	increased by $673,000 in fiscal year 2028 and 
317.20 	increased by $731,000 in fiscal year 2029.

317.21	Sec. 4. HEALTH PROTECTION
 	$
	-0-
	$
	2,053,000
	
317.22 	$2,053,000 in fiscal year 2027 is for 
317.23 	rulemaking and administrative activities under 
317.24 	Minnesota Statutes, section 103I.706. This is 
317.25 	a onetime appropriation and is available until 
317.26 	December 31, 2029.

317.27 	Sec. 5. GRANT ADMINISTRATION COSTS.
 317.28 	This article appropriates necessary administrative costs. The administrative costs retention 
317.29 	requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to 
317.30 	any appropriation in this article for a grant.

318.1 	Sec. 6. EXPIRATION OF UNCODIFIED LANGUAGE.
 318.2 	All uncodified language contained in this article expires on June 30, 2027, unless a 
318.3 	different expiration date is explicit or an appropriation is made available beyond June 30, 
318.4 	2027.

318.5 	Sec. 7. APPROPRIATIONS GIVEN EFFECT ONCE.
 318.6 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
318.7 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
318.8 	effect once.

318.9 	Sec. 8. EFFECTIVE DATE.
 318.10 	This article is effective the day following final enactment.

318.11 	ARTICLE 19
318.12 	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS

318.13	Section 1. CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS.
 	
318.14 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
318.15 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
318.16 	Session chapter 3, article 22, from the general fund or any fund named for the purposes 
318.17 	specified in this article, to be available for the fiscal year indicated for each purpose. The 
318.18 	figures "2026" and "2027" used in this article mean that the appropriations listed under them 
318.19 	are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The 
318.20 	first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is 
318.21 	fiscal years 2026 and 2027.

318.22				APPROPRIATIONS
	
318.23				Available for the Year
	
318.24				Ending June 30
	
318.25					2026
		2027

318.26
318.27	Sec. 2. COMMISSIONER OF CHILDREN, 
YOUTH, AND FAMILIES
 	$
	-0-
	$
	46,952,000
	
318.28 	The amounts that may be spent for each 
318.29 	purpose are specified in the following sections.

318.30
318.31
318.32	Sec. 3. OPERATIONS AND 
ADMINISTRATION; AGENCY-WIDE 
SUPPORTS
 	$
	-0-
	$
	6,546,000

319.1
319.2	Subdivision 1.Crisis Nursery Licensing 
Framework
 					
319.3 	$212,000 in fiscal year 2027 is to develop a 
319.4 	licensing framework for crisis nurseries. The 
319.5 	base for this appropriation is $441,000 in fiscal 
319.6 	year 2028 and $0 in fiscal year 2029.

319.7	Subd. 2.Base Adjustments
 					
319.8 	The base is increased by $6,260,000 in fiscal 
319.9 	year 2028 and increased by $5,819,000 in 
319.10 	fiscal year 2029.

319.11
319.12	Sec. 4. OPERATIONS AND 
ADMINISTRATION; EARLY CHILDHOOD
 	$
	-0-
	$
	281,000

319.13
319.14
319.15	Sec. 5. OPERATIONS AND 
ADMINISTRATION; ECONOMIC 
OPPORTUNITY AND YOUTH SERVICES
 	$
	-0-
	$
	147,000
	
319.16 	This is a onetime appropriation.

319.17
319.18	Sec. 6. OPERATIONS AND 
ADMINISTRATION; FAMILY WELL-BEING
 	$
	-0-
	$
	2,818,000
	
319.19 	The general fund base is increased by 
319.20 	$3,308,000 in fiscal year 2028 and increased 
319.21 	by $3,308,000 in fiscal year 2029.

319.22
319.23	Sec. 7. GRANT PROGRAMS; SUPPORT 
SERVICES GRANTS
 	$
	-0-
	$
	10,728,000
	
319.24 	County allocation for SNAP administrative 
319.25 	costs. $10,728,000 in fiscal year 2027 is for 
319.26 	an allocation to counties for SNAP 
319.27 	administrative costs. The commissioner must 
319.28 	allocate money under this section to counties 
319.29 	based on each county's proportional share of 
319.30 	SNAP administrative costs in the most recent 
319.31 	year for which data are available. This is a 
319.32 	onetime appropriation.

319.33
319.34	Sec. 8. GRANT PROGRAMS; CHILD CARE 
DEVELOPMENT GRANTS
 	$
	-0-
	$
	450,000

320.1
320.2	Subdivision 1.Child Care Licensing Basics 
Training Contract
 					
320.3 	$450,000 in fiscal year 2027 is for a contract 
320.4 	with a vendor to provide child care licensing 
320.5 	basics training, including course content 
320.6 	creation, translation, marketing, promotion, 
320.7 	and underwriting. The base for this 
320.8 	appropriation is $338,000 in fiscal year 2028 
320.9 	and $338,000 in fiscal year 2029.

320.10	Subd. 2.Base Adjustment
 					
320.11 	The general fund base is increased by 
320.12 	$338,000 in fiscal year 2028 and increased by 
320.13 	$338,000 in fiscal year 2029.

320.14
320.15	Sec. 9. GRANT PROGRAMS; CHILDREN'S 
SERVICES GRANTS
 	$
	-0-
	$
	250,000
	
320.16 	Forensic Interview Training Scholarships.
320.17 	$250,000 in fiscal year 2027 is for grants to 
320.18 	provide training scholarships for recipients to 
320.19 	attend nationally recognized forensic interview 
320.20 	protocol training. Eligible grantees must award 
320.21 	scholarships for recipients to attend basic 
320.22 	forensic interview training, advanced forensic 
320.23 	interview training, and specialized interview 
320.24 	topics training. Scholarship recipients may 
320.25 	include individuals in law enforcement, child 
320.26 	protection, and prosecution; health 
320.27 	professionals investigating, treating, and 
320.28 	managing child maltreatment cases in 
320.29 	Minnesota; advocates working with a 
320.30 	multidisciplinary team; and forensic 
320.31 	interviewers at children's advocacy centers. 
320.32 	This is a onetime appropriation.

320.33
320.34	Sec. 10. GRANT PROGRAMS; CHILD AND 
COMMUNITY SERVICES GRANTS
 	$
	-0-
	$
	15,000,000
	
321.1 	County Implementation of Minnesota 
321.2 	African American Family Preservation and 
321.3 	Child Welfare Disproportionality Act.
321.4 	$15,000,000 in fiscal year 2027 is for initial 
321.5 	county implementation of the Minnesota 
321.6 	African American Family Preservation and 
321.7 	Child Welfare Disproportionality Act under 
321.8 	Minnesota Statutes, chapter 260. The 
321.9 	commissioner must distribute this 
321.10 	appropriation to counties under Minnesota 
321.11 	Statutes, section 260.694. This is a onetime 
321.12 	appropriation.

321.13
321.14	Sec. 11. GRANT PROGRAMS; CHILD AND 
ECONOMIC SUPPORT GRANTS
 	$
	-0-
	$
	10,732,000

321.15	Subdivision 1.Regional Food Bank Grants
 					
321.16 	$4,900,000 in fiscal year 2027 is for regional 
321.17 	food bank grants. This is a onetime 
321.18 	appropriation.

321.19	Subd. 2.Minnesota Food Shelf Program
 					
321.20 	$5,000,000 in fiscal year 2027 is for food shelf 
321.21 	programs under Minnesota Statutes, section 
321.22 	142F.14. This is a onetime appropriation.

321.23	Subd. 3.Base Adjustment
 					
321.24 	The general fund base is increased by 
321.25 	$832,000 in fiscal year 2028 and increased by 
321.26 	$832,000 in fiscal year 2029.

321.27 	Sec. 12. Minnesota Statutes 2025 Supplement, section 256.043, subdivision 3, is amended 
321.28 	to read:
321.29 		Subd. 3.Appropriations from registration and license fee account. (a) The 
321.30 	appropriations in paragraphs (b) to (n) shall be made from the registration and license fee 
321.31 	account on a fiscal year basis in the order specified.
322.1 	(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs 
322.2 	(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be 
322.3 	made accordingly.
322.4 	(c) $100,000 is appropriated to the commissioner of human services for grants for opiate 
322.5 	antagonist distribution. Grantees may utilize funds for opioid overdose prevention, 
322.6 	community asset mapping, education, and opiate antagonist distribution.
322.7 	(d) $2,000,000 is appropriated to the commissioner of human services for direct payments 
322.8 	to Tribal nations and five urban Indian communities for traditional healing practices for 
322.9 	American Indians and to increase the capacity of culturally specific providers in the 
322.10 	behavioral health workforce. Any evaluations of practices under this paragraph must be 
322.11 	designed cooperatively by the commissioner and Tribal nations or urban Indian communities. 
322.12 	The commissioner must not require recipients to provide the details of specific ceremonies 
322.13 	or identities of healers.
322.14 	(e) $400,000 is appropriated to the commissioner of human services for competitive 
322.15 	grants for opioid-focused Project ECHO programs.
322.16 	(f) $277,000 $321,000 in fiscal year 2024 2027 and $321,000 each year thereafter is 
322.17 	appropriated to the commissioner of human services children, youth, and families to 
322.18 	administer the funding distribution and reporting requirements in paragraph (o) (m).
322.19 	(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated 
322.20 	to the commissioner of human services for safe recovery sites start-up and capacity building 
322.21 	grants under section 254B.18.
322.22 	(h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to 
322.23 	the commissioner of human services for the opioid overdose surge alert system under section 
322.24 	245.891.
322.25 	(i) $300,000 is appropriated to the commissioner of management and budget for 
322.26 	evaluation activities under section 256.042, subdivision 1, paragraph (c).
322.27 	(j) $261,000 is appropriated to the commissioner of human services for the provision of 
322.28 	administrative services to the Opiate Epidemic Response Advisory Council and for the 
322.29 	administration of the grants awarded under paragraph (n).
322.30 	(k) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration 
322.31 	fees under section 151.066.
323.1 	(l) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
323.2 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
323.3 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
323.4 	(m) After the appropriations in paragraphs (b) to (l) are made, 50 percent of the remaining 
323.5 	amount is appropriated to the commissioner of children, youth, and families for distribution 
323.6 	to county social service agencies and Tribal social service agency initiative projects 
323.7 	authorized under section 256.01, subdivision 14b, to provide prevention and child protection 
323.8 	services to children and families who are affected by addiction. The commissioner shall 
323.9 	distribute this money proportionally to county social service agencies and Tribal social 
323.10 	service agency initiative projects through a formula based on intake data from the previous 
323.11 	three calendar years related to substance use and out-of-home placement episodes where 
323.12 	parental drug abuse is a reason for the out-of-home placement. County social service agencies 
323.13 	and Tribal social service agency initiative projects receiving funds from the opiate epidemic 
323.14 	response fund must annually report to the commissioner on how the funds were used to 
323.15 	provide prevention and child protection services, including measurable outcomes, as 
323.16 	determined by the commissioner. County social service agencies and Tribal social service 
323.17 	agency initiative projects must not use funds received under this paragraph to supplant 
323.18 	current state or local funding received for child protection services for children and families 
323.19 	who are affected by addiction.
323.20 	(n) After the appropriations in paragraphs (b) to (m) are made, the remaining amount in 
323.21 	the account is appropriated to the commissioner of human services to award grants as 
323.22 	specified by the Opiate Epidemic Response Advisory Council in accordance with section 
323.23 	256.042, unless otherwise appropriated by the legislature.
323.24 	(o) Beginning in fiscal year 2022 and each year thereafter, funds for county social service 
323.25 	agencies and Tribal social service agency initiative projects under paragraph (m) and grant 
323.26 	funds specified by the Opiate Epidemic Response Advisory Council under paragraph (n) 
323.27 	may be distributed on a calendar year basis.
323.28 	(p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
323.29 	(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.

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

324.1 	Sec. 13. Laws 2024, chapter 117, section 22, is amended to read:
324.2 	Sec. 22. APPROPRIATIONS; MINNESOTA AFRICAN AMERICAN FAMILY 
324.3 	PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT.
 324.4 	(a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the 
324.5 	commissioner of human services for grants to Hennepin and Ramsey Counties to implement 
324.6 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
324.7 	Act phase-in program. Of this amount, $2,500,000 must be provided to Hennepin County 
324.8 	and $2,500,000 must be provided to Ramsey County. This is a onetime appropriation and 
324.9 	is available until June 30 December 31, 2026.
324.10 	(b) $1,000,000 in fiscal year 2025 is appropriated from the general fund to the 
324.11 	commissioner of human services for the African American and disproportionately represented 
324.12 	family preservation grant program under Minnesota Statutes, section 260.693. 
324.13 	Notwithstanding Minnesota Statutes, section 16B.98, subdivision 14, the amount for 
324.14 	administrative costs under this paragraph is $0.
324.15 	(c) $2,367,000 in fiscal year 2025 is appropriated from the general fund to the 
324.16 	commissioner of human services to implement the African American Family Preservation 
324.17 	and Child Welfare Disproportionality Act. The base for this appropriation is $3,251,000 in 
324.18 	fiscal year 2026 and $3,110,000 in fiscal year 2027.

324.19 	Sec. 14. GRANT ADMINISTRATION COSTS.
 324.20 	This article appropriates necessary administrative costs. The administrative costs retention 
324.21 	requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to 
324.22 	any appropriation in this article for a grant.

324.23 	Sec. 15. EXPIRATION OF UNCODIFIED LANGUAGE.
 324.24 	All uncodified language contained in this article expires on June 30, 2027, unless a 
324.25 	different expiration date is explicit or an appropriation is made available beyond June 30, 
324.26 	2027.

324.27 	Sec. 16. APPROPRIATIONS GIVEN EFFECT ONCE.
 324.28 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
324.29 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
324.30 	effect once.

325.1 	Sec. 17. EFFECTIVE DATE.
 325.2 	This article is effective the day following final enactment unless otherwise indicated.

325.3 	ARTICLE 20
325.4 	OTHER AGENCY APPROPRIATIONS

325.5	Section 1. OTHER AGENCY APPROPRIATIONS.
 	
325.6 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
325.7 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
325.8 	Session chapter 3, articles 23 and 24, from the general fund or any fund named for the 
325.9 	purposes specified in this article, to be available for the fiscal year indicated for each purpose. 
325.10 	The figures "2026" and "2027" used in this article mean that the appropriations listed under 
325.11 	them are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. 
325.12 	"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" 
325.13 	is fiscal years 2026 and 2027.

325.14				APPROPRIATIONS
	
325.15				Available for the Year
	
325.16				Ending June 30
	
325.17					2026
		2027

325.18
325.19	Sec. 2. LEGISLATIVE COORDINATING 
COMMISSION
 	$
	17,000
	$
	74,000

325.20
325.21	Subdivision 1.Education Group Insurance 
Program Report
 					
325.22 	$17,000 in fiscal year 2026 and $74,000 in 
325.23 	fiscal year 2027 are for the Legislative Budget 
325.24 	Office to complete the annual report under 
325.25 	Minnesota Statutes, section 471.6161, 
325.26 	subdivision 9. The base for this appropriation 
325.27 	is $36,000 in fiscal year 2028 and $36,000 in 
325.28 	fiscal year 2029.

325.29	Subd. 2.Base Adjustment
 					
325.30 	The general fund base is increased by $36,000 
325.31 	in fiscal year 2028 and increased by $36,000 
325.32 	in fiscal year 2029.

325.33
325.34	Sec. 3. COMMISSIONER OF PUBLIC 
SAFETY
 	$
	-0-
	$
	-0-

326.1
326.2	Subdivision 1.Child Care Licensing 
Modernization
 					
326.3 	The base in fiscal year 2029 must include 
326.4 	$544,000 for child care licensing 
326.5 	modernization under Minnesota Statutes, 
326.6 	chapters 142H and 142I.

326.7	Subd. 2.Base Adjustment
 					
326.8 	The general fund base is increased by 
326.9 	$544,000 in fiscal year 2029.

326.10	Sec. 4. COMMISSIONER OF EDUCATION
 	$
	-0-
	$
	(281,000)
	
326.11 	This reduction is for preschool assessment 
326.12 	funding.

326.13
326.14	Sec. 5. COMMISSIONER OF MANAGEMENT 
AND BUDGET
 	$
	-0-
	$
	193,000
	
326.15 	$193,000 in fiscal year 2027 is for 
326.16 	administration of the advisory task force on 
326.17 	governance and financing of Hennepin 
326.18 	Healthcare System, Inc. This is a onetime 
326.19 	appropriation.

326.20	Sec. 6. ATTORNEY GENERAL
 	$
	-0-
	$
	1,230,000

326.21	Subdivision 1.Medicaid Fraud Control Unit
 					
326.22 	$1,230,000 in fiscal year 2027 is for the 
326.23 	Medicaid fraud control unit. The base for this 
326.24 	appropriation is $1,230,000 in fiscal year 2028 
326.25 	and $1,230,000 in fiscal year 2029.

326.26	Subd. 2.Base Adjustment
 					
326.27 	The general fund base is increased by 
326.28 	$1,230,000 in fiscal year 2028 and increased 
326.29 	by $1,230,000 in fiscal year 2029.

326.30 	Sec. 7. Laws 2024, chapter 127, article 67, section 7, is amended to read:

326.31	Sec. 7. BOARD OF DIRECTORS OF MNSURE
 	$
	-0-
	$
	2,330,000
	
327.1 	(a) Information Technology to Implement 
327.2 	Federal Deferred Action for Childhood 
327.3 	Arrivals Regulatory Requirements.
327.4 	$2,330,000 in fiscal year 2025 is for 
327.5 	information technology to implement federal 
327.6 	Deferred Action for Childhood Arrivals 
327.7 	regulatory requirements for technology and 
327.8 	operational needs. This appropriation is for 
327.9 	information technology enhancements, system 
327.10 	readiness, consumer communications, and 
327.11 	operational changes to maintain service 
327.12 	continuity and improve the consumer 
327.13 	experience. This is a onetime appropriation 
327.14 	and is available until June 30, 2027.
327.15 	(b) Transfer to Enterprise Account. The 
327.16 	Board of Directors of MNsure must transfer 
327.17 	$2,330,000 in fiscal year 2025 from the 
327.18 	general fund to the enterprise account under 
327.19 	Minnesota Statutes, section 62V.07. This is a 
327.20 	onetime transfer.

327.21 	Sec. 8. GRANT ADMINISTRATION COSTS.
 327.22 	This article appropriates necessary administrative costs. The administrative costs retention 
327.23 	requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to 
327.24 	any appropriation in this article for a grant.

327.25 	Sec. 9. EXPIRATION OF UNCODIFIED LANGUAGE.
 327.26 	All uncodified language contained in this article expires on June 30, 2027, unless a 
327.27 	different expiration date is explicit or an appropriation is made available beyond June 30, 
327.28 	2027.

327.29 	Sec. 10. APPROPRIATIONS GIVEN EFFECT ONCE.
 327.30 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
327.31 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
327.32 	effect once.

	ARTICLE 1	DEPARTMENT OF HEALTH........	Page.Ln 2.39	
	ARTICLE 2	GAS RESOURCE DEVELOPMENT........	Page.Ln 35.10	
	ARTICLE 3	HOSPITAL STABILIZATION........	Page.Ln 44.1	
	ARTICLE 4	HEALTH LICENSING BOARDS........	Page.Ln 64.12	
	ARTICLE 5	HEALTH CARE........	Page.Ln 84.19	
	ARTICLE 6	FEDERAL CONFORMITY........	Page.Ln 104.25	
	ARTICLE 7	MEDICAL ASSISTANCE FRAUD PREVENTION........	Page.Ln 123.20	
	ARTICLE 8	MEDICAL ASSISTANCE FRAUD PREVENTION CONFORMING CHANGES........	Page.Ln 133.18	
	ARTICLE 9	CHILDREN, YOUTH, AND FAMILIES POLICY........	Page.Ln 141.23	
	ARTICLE 10	CHILDREN, YOUTH, AND FAMILIES BUDGET........	Page.Ln 165.4	
	ARTICLE 11	MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT CHANGES........	Page.Ln 166.17	
	ARTICLE 12	CHILD CARE CENTER LICENSING MODERNIZATION........	Page.Ln 178.19	
	ARTICLE 13	FAMILY CHILD CARE LICENSING MODERNIZATION........	Page.Ln 245.8	
	ARTICLE 14	MISCELLANEOUS........	Page.Ln 298.17	
	ARTICLE 15	DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENTS........	Page.Ln 308.7	
	ARTICLE 16	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES FORECAST ADJUSTMENTS........	Page.Ln 309.7	
	ARTICLE 17	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS........	Page.Ln 310.4	
	ARTICLE 18	DEPARTMENT OF HEALTH APPROPRIATIONS........	Page.Ln 314.9	
	ARTICLE 19	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS........	Page.Ln 318.11	
	ARTICLE 20	OTHER AGENCY APPROPRIATIONS........	Page.Ln 325.3	

APPENDIX 

Repealed Minnesota Statutes: S4612-4 

13D.08 OPEN MEETING LAW CODED ELSEWHERE.Subd. 4.Health Technology Advisory Committee. 
Certain meetings of the Health Technology Advisory Committee are governed by section 62J.156. 

62J.06 IMMUNITY FROM LIABILITY.
No member of the Health Technology Advisory Committee shall be held civilly or criminally liable for an act or omission by that person if the act or omission was in good faith and within the scope of the member's responsibilities under this chapter. 

62J.156 CLOSED COMMITTEE HEARINGS.
Notwithstanding chapter 13D, the Health Technology Advisory Committee may meet in closed session to discuss a specific technology or procedure that involves data received that have been classified as nonpublic data, where disclosure of the data would cause harm to the competitive or economic position of the source of the data. 

62J.2930 INFORMATION CLEARINGHOUSE.Subd. 4.Coordination. 
To the extent possible, the commissioner shall coordinate the activities of the clearinghouse with the activities of the Minnesota Health Data Institute. 

62J.57 MINNESOTA CENTER FOR HEALTH CARE ELECTRONIC DATA INTERCHANGE.
(a) It is the intention of the legislature to support, to the extent of funds appropriated for that purpose, the creation of the Minnesota Center for Health Care Electronic Data Interchange as a broad-based effort of public and private organizations representing group purchasers, health care providers, and government programs to advance the use of health care electronic data interchange in the state. The center shall attempt to obtain private sector funding to supplement legislative appropriations, and shall become self-supporting by the end of the second year. 

(b) The Minnesota Center for Health Care Electronic Data Interchange shall facilitate the statewide implementation of electronic data interchange standards in the health care industry by: 

(1) coordinating and ensuring the availability of quality electronic data interchange education and training in the state; 

(2) developing an extensive, cohesive health care electronic data interchange education curriculum; 

(3) developing a communications and marketing plan to publicize electronic data interchange education activities, and the products and services available to support the implementation of electronic data interchange in the state; 

(4) administering a resource center that will serve as a clearinghouse for information relative to electronic data interchange, including the development and maintenance of a health care constituents database, health care directory and resource library, and a health care communications network through the use of electronic bulletin board services and other network communications applications; and 

(5) providing technical assistance in the development of implementation guides, and in other issues including legislative, legal, and confidentiality requirements. 

62U.10 HEALTH CARE TRANSFER, SAVINGS, AND REPAYMENT.Subd. 4.Repayment of transfer. 
When accumulated savings accruing to state-administered health care programs, as calculated under subdivision 3, meet or exceed $50,000,000, the commissioner of health shall certify that event to the commissioner of management and budget. In the next fiscal year following the certification, the commissioner of management and budget shall transfer $50,000,000 from the general fund to the health care access fund. The amount necessary to make the transfer is appropriated from the general fund to the commissioner of management and budget. 

142B.01 DEFINITIONS.Subd. 11.Drop-in child care program. 
"Drop-in child care program" means a nonresidential program of child care in which children participate on a onetime only or occasional basis up to a maximum of 90 hours per child, per month. A drop-in child care program must be licensed under Minnesota Rules governing child care centers. A drop-in child care program must meet one of the following requirements to qualify for the rule exemptions specified in section 142B.41, subdivision 6: 

(1) the drop-in child care program operates in a child care center which houses no child care program except the drop-in child care program; 

(2) the drop-in child care program operates in the same child care center but not during the same hours as a regularly scheduled ongoing child care program with a stable enrollment; or 

(3) the drop-in child care program operates in a child care center at the same time as a regularly scheduled ongoing child care program with a stable enrollment but the program's activities, except for bathroom use and outdoor play, are conducted separately from each other. 

Subd. 12.Experience. 
For purposes of child care centers, "experience" means paid or unpaid employment: 

(1) caring for children as a teacher, assistant teacher, aide, or student intern: 

(i) in a licensed child care center, a licensed family day care or group family day care, or a Tribally licensed child care program in any United States state or territory; or 

(ii) in a public or nonpublic school; 

(2) caring for children as a staff person or unsupervised volunteer in a certified, license-exempt child care center under chapter 142C; or 

(3) providing direct contact services in a home or residential facility serving children with disabilities that requires a background study under section 245C.03. 

Subd. 13.Family day care and group family day care child age classifications. 
(a) For the purposes of family day care and group family day care licensing under this chapter, the following terms have the meanings given them in this subdivision. 

(b) "Newborn" means a child between birth and six weeks old. 

(c) "Infant" means a child who is at least six weeks old but less than 12 months old. 

(d) "Toddler" means a child who is at least 12 months old but less than 24 months old, except that for purposes of specialized infant and toddler family and group family day care, "toddler" means a child who is at least 12 months old but less than 30 months old. 

(e) "Preschooler" means a child who is at least 24 months old up to school age. 

(f) "School age" means a child who is at least five years of age, but is younger than 11 years of age. 

Subd. 25.School-age child. 
"School-age child," for programs licensed or required to be licensed as a child care center, means a child who is at least of sufficient age to have attended the first day of kindergarten, or is eligible to enter kindergarten within the next four months, but is younger than 13 years of age. 

Subd. 26.School-age child care program. 
"School-age child care program" means a program licensed or required to be licensed as a child care center, serving more than ten children with the primary purpose of providing child care for school age children. 

Subd. 27.Supervision. 
(a) For purposes of licensed child care centers, "supervision" means when a program staff person: 

(1) is accountable for the child's care; 

(2) can intervene to protect the health and safety of the child; and 

(3) is within sight and hearing of the child at all times except as described in paragraphs (b) to (e). 

(b) When an infant is placed in a crib room to sleep, supervision occurs when a program staff person is within sight or hearing of the infant. When supervision of a crib room is provided by sight or hearing, the center must have a plan to address the other supervision components. 

(c) When a single school-age child uses the restroom within the licensed space, supervision occurs when a program staff person has knowledge of the child's activity and location and checks on the child at least every five minutes. When a school-age child uses the restroom outside the licensed space, including but not limited to field trips, supervision occurs when staff accompany children to the restroom. 

(d) When a school-age child leaves the classroom but remains within the licensed space to deliver or retrieve items from the child's personal storage space, supervision occurs when a program staff person has knowledge of the child's activity and location and checks on the child at least every five minutes. 

(e) When a single preschooler uses an individual, private restroom within the classroom with the door closed, supervision occurs when a program staff person has knowledge of the child's activity and location, can hear the child, and checks on the child at least every five minutes. 

142B.41 SPECIAL CONDITIONS FOR NONRESIDENTIAL PROGRAMS.Subd. 4.Special family child care homes. 
(a) Nonresidential child care programs serving 14 or fewer children that are conducted at a location other than the license holder's own residence shall be licensed under this section and the rules governing family child care or group family child care if: 

(1) the license holder is the primary provider of care and the nonresidential child care program is conducted in a dwelling that is located on a residential lot; 

(2) the license holder is an employer who may or may not be the primary provider of care, and the purpose for the child care program is to provide child care services to children of the license holder's employees; 

(3) the license holder is a church or religious organization; 

(4) the license holder is a community collaborative child care provider. For purposes of this subdivision, a community collaborative child care provider is a provider participating in a cooperative agreement with a community action agency as defined in section 142F.301; 

(5) the license holder is a not-for-profit agency that provides child care in a dwelling located on a residential lot and the license holder maintains two or more contracts with community employers or other community organizations to provide child care services. The county licensing agency may grant a capacity variance to a license holder licensed under this clause to exceed the licensed capacity of 14 children by no more than five children during transition periods related to the work schedules of parents, if the license holder meets the following requirements: 

(i) the program does not exceed a capacity of 14 children more than a cumulative total of four hours per day; 

(ii) the program meets a one to seven staff-to-child ratio during the variance period; 

(iii) all employees receive at least an extra four hours of training per year than required in the rules governing family child care each year; 

(iv) the facility has square footage required per child under Minnesota Rules, part 9502.0425; 

(v) the program is in compliance with local zoning regulations; 

(vi) the program is in compliance with the applicable fire code as follows: 

(A) if the program serves more than five children older than 2-1/2 years of age, but no more than five children 2-1/2 years of age or less, the applicable fire code is educational occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2020, Section 202; or 

(B) if the program serves more than five children 2-1/2 years of age or less, the applicable fire code is Group I-4 Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202, unless the rooms in which the children 2-1/2 years of age or younger are cared for are located on a level of exit discharge and each of these child care rooms has an exit door directly to the exterior, then the applicable fire code is Group E Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202; and 

(vii) any age and capacity limitations required by the fire code inspection and square footage determinations shall be printed on the license; or 

(6) the license holder is the primary provider of care and has located the licensed child care program in a commercial space, if the license holder meets the following requirements: 

(i) the program is in compliance with local zoning regulations; 

(ii) the program is in compliance with the applicable fire code as follows: 

(A) if the program serves more than five children older than 2-1/2 years of age, but no more than five children 2-1/2 years of age or less, the applicable fire code is educational occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2020, Section 202; or 

(B) if the program serves more than five children 2-1/2 years of age or less, the applicable fire code is Group I-4 Occupancy, as provided under the Minnesota State Fire Code 2020, Section 202, unless the rooms in which the children 2-1/2 years of age or younger are cared for are located on a level of exit discharge and each of these child care rooms has an exit door directly to the exterior, then the applicable fire code is Group E Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202; 

(iii) any age and capacity limitations required by the fire code inspection and square footage determinations are printed on the license; and 

(iv) the license holder prominently displays the license issued by the commissioner which contains the statement "This special family child care provider is not licensed as a child care center." 

(b) Notwithstanding Minnesota Rules, part 9502.0335, subpart 12, the commissioner may issue up to four licenses to an organization licensed under paragraph (a), clause (2), (3), or (5). Each license must have its own primary provider of care as required under paragraph (d). Each license must operate as a distinct and separate program in compliance with all applicable laws and regulations. 

(c) For licenses issued under paragraph (a), clause (2), (3), (4), (5), or (6), the commissioner may approve up to four licenses at the same location or under one contiguous roof if each license holder is able to demonstrate compliance with all applicable rules and laws. Each licensed program must operate as a distinct program and within the capacity, age, and ratio distributions of each license. 

(d) For a license issued under paragraph (a), clause (2), (3), or (5), the license holder must designate a person to be the primary provider of care at the licensed location on a form and in a manner prescribed by the commissioner. The license holder shall notify the commissioner in writing before there is a change of the person designated to be the primary provider of care. The primary provider of care: 

(1) must be the person who will be the provider of care at the program and present during the hours of operation; 

(2) must operate the program in compliance with applicable laws and regulations under this chapter and Minnesota Rules, chapter 9502; 

(3) is considered a child care background study subject as defined in section 245C.02, subdivision 6a, and must comply with background study requirements in chapter 245C; 

(4) must complete the training that is required of license holders in section 142B.70; and 

(5) is authorized to communicate with the county licensing agency and the department on matters related to licensing. 

(e) For any license issued under this subdivision, the license holder must ensure that any other caregiver, substitute, or helper who assists in the care of children meets the training requirements in section 142B.70 and background study requirements under chapter 245C. 

Subd. 6.Drop-in and school age child care programs. 
(a) Except as expressly set forth in this subdivision, drop-in and school age child care programs must be licensed as a drop-in or school age program under the rules governing child care programs operated in a center. 

(b) Drop-in and school age child care programs are exempt from the following Minnesota Rules: 

(1) part 9503.0040; 

(2) part 9503.0045, subpart 1, items F and G; 

(3) part 9503.0050, subpart 6, except for children less than 2-1/2 years old; 

(4) one-half the requirements of part 9503.0060, subpart 4, item A, subitems (2), (5), and (8), subpart 5, item A, subitems (2), (3), and (7), and subpart 6, item A, subitems (3) and (6); 

(5) part 9503.0070; and 

(6) part 9503.0090, subpart 2. 

(c) A drop-in and school age child care program must be operated under the supervision of a person qualified as a director and a teacher. 

(d) A drop-in and school age child care program must have at least two persons on staff whenever the program is operating, except that the commissioner may permit variances from this requirement under specified circumstances for parent cooperative programs, as long as all other staff-to-child ratios are met. 

(e) Whenever the total number of children present to be cared for at a drop-in child care center is more than 20, children that are younger than age 2-1/2 must be in a separate group. This group may contain children up to 60 months old. This group must be cared for in an area that is physically separated from older children. 

(f) A drop-in child care program must maintain a minimum staff ratio for children age 2-1/2 or greater of one staff person for each ten children. A school age child care program must maintain a minimum staff ratio of one staff person for every 15 children. 

(g) If the drop-in child care program has additional staff who are on call as a mandatory condition of their employment, the minimum child-to-staff ratio may be exceeded only for children age 2-1/2 or greater, by a maximum of four children, for no more than 20 minutes while additional staff are in transit. 

(h) In a drop-in child care program, the minimum staff-to-child ratio for infants up to 16 months of age is one staff person for every four infants. The minimum staff-to-child ratio for children age 17 months to 30 months is one staff for every seven children. 

(i) In drop-in care programs that serve both infants and older children, children up to age 2-1/2 may be supervised by assistant teachers, as long as other staff are present in appropriate ratios. 

(j) The minimum staff distribution pattern for a drop-in child care program serving children age 2-1/2 or greater and a school age child care program serving school age children is: the first staff member must be a teacher; the second, third, and fourth staff members must have at least the qualifications of a child care aide; the fifth staff member must have at least the qualifications of an assistant teacher; the sixth, seventh, and eighth staff members must have at least the qualifications of a child care aide; and the ninth staff person must have at least the qualifications of an assistant teacher. 

(k) A drop-in child care program may care for siblings 16 months or older together in any group. For purposes of this subdivision, sibling is defined as sister or brother, half sister or half brother, or stepsister or stepbrother. 

(l) The commissioner may grant a variance to any of the requirements in paragraphs (a) to (k), as long as the health and safety of the persons served by the program are not affected. The request for a variance shall comply with the provisions in section 142B.10, subdivision 16. 

Subd. 7.Experienced aides; child care centers. 
(a) An individual employed as an aide at a child care center may work with children without being directly supervised for an amount of time that does not exceed 25 percent of the child care center's daily hours if: 

(1) a teacher is in the facility; 

(2) the individual is at least 20 years old; and 

(3) the individual has at least 4,160 hours of child care experience as a staff member in a licensed child care center or as the license holder of a family day care home, 120 days of which must be in the employment of the current company. 

(b) A child care center that uses experienced aides under this subdivision must notify parents or guardians by posting the notification in each classroom that uses experienced aides, identifying which staff member is the experienced aide. Records of experienced aide usage must be kept on site and given to the commissioner upon request. 

(c) A child care center may not use the experienced aide provision for one year following two determined experienced aide violations within a one-year period. 

(d) A child care center may use one experienced aide per every four full-time child care classroom staff. 

Subd. 8.Portable wading pools; family day care and group family day care providers. 
A portable wading pool as defined in section 144.1222 may not be used by a child at a family day care or group family day care home or at a home at which child care services are provided under section 142B.05, subdivision 2, paragraph (a), clause (2), unless the parent or legal guardian of the child has provided written consent. The written consent shall include a statement that the parent or legal guardian has received and read material provided by the Department of Health to the Department of Children, Youth, and Families for distribution to all family day care or group family day care homes and the general public on the human services Internet website related to the risk of disease transmission as well as other health risks associated with the use of portable wading pools. 

Subd. 9.Swimming pools; family day care and group family day care providers. 
(a) This subdivision governs swimming pools located at family day care or group family day care homes licensed under Minnesota Rules, chapter 9502. This subdivision does not apply to portable wading pools or whirlpools located at family day care or group family day care homes licensed under Minnesota Rules, chapter 9502. For a provider to be eligible to allow a child cared for at the family day care or group family day care home to use the swimming pool located at the home, the provider must not have had a licensing sanction under section 142B.18 or 245A.07 or a correction order or conditional license under section 142B.16 or 245A.06 relating to the supervision or health and safety of children during the prior 24 months, and must satisfy the following requirements: 

(1) notify the county agency before initial use of the swimming pool and annually, thereafter; 

(2) obtain written consent from a child's parent or legal guardian allowing the child to use the swimming pool and renew the parent or legal guardian's written consent at least annually. The written consent must include a statement that the parent or legal guardian has received and read materials provided by the Department of Health to the Department of Children, Youth, and Families for distribution to all family day care or group family day care homes and the general public on the human services Internet website related to the risk of disease transmission as well as other health risks associated with swimming pools. The written consent must also include a statement that the Department of Health, Department of Children, Youth, and Families, and county agency will not monitor or inspect the provider's swimming pool to ensure compliance with the requirements in this subdivision; 

(3) enter into a written contract with a child's parent or legal guardian and renew the written contract annually. The terms of the written contract must specify that the provider agrees to perform all of the requirements in this subdivision; 

(4) attend and successfully complete a swimming pool operator training course once every five years. Acceptable training courses are: 

(i) the National Swimming Pool Foundation Certified Pool Operator course; 

(ii) the National Spa and Pool Institute Tech I and Tech II courses (both required); or 

(iii) the National Recreation and Park Association Aquatic Facility Operator course; 

(5) require a caregiver trained in first aid and adult and child cardiopulmonary resuscitation to supervise and be present at the swimming pool with any children in the pool; 

(6) toilet all potty-trained children before they enter the swimming pool; 

(7) require all children who are not potty-trained to wear swim diapers while in the swimming pool; 

(8) if fecal material enters the swimming pool water, add three times the normal shock treatment to the pool water to raise the chlorine level to at least 20 parts per million, and close the pool to swimming for the 24 hours following the entrance of fecal material into the water or until the water pH and disinfectant concentration levels have returned to the standards specified in clause (10), whichever is later; 

(9) prevent any person from entering the swimming pool who has an open wound or any person who has or is suspected of having a communicable disease; 

(10) maintain the swimming pool water at a pH of not less than 7.2 and not more than 8.0, maintain the disinfectant concentration between two and five parts per million for chlorine or between 2.3 and 4.5 parts per million for bromine, and maintain a daily record of the swimming pool's operation with pH and disinfectant concentration readings on days when children cared for at the family day care or group family day care home are present; 

(11) have a disinfectant feeder or feeders; 

(12) have a recirculation system that will clarify and disinfect the swimming pool volume of water in ten hours or less; 

(13) maintain the swimming pool's water clarity so that an object on the pool floor at the pool's deepest point is easily visible; 

(14) comply with the provisions of the Abigail Taylor Pool Safety Act in section 144.1222, subdivisions 1c and 1d; 

(15) have in place and enforce written safety rules and swimming pool policies; 

(16) have in place at all times a safety rope that divides the shallow and deep portions of the swimming pool; 

(17) satisfy any existing local ordinances regarding swimming pool installation, decks, and fencing; 

(18) maintain a water temperature of not more than 104 degrees Fahrenheit and not less than 70 degrees Fahrenheit; and 

(19) for lifesaving equipment, have a United States Coast Guard-approved life ring attached to a rope, an exit ladder, and a shepherd's hook available at all times to the caregiver supervising the swimming pool. 

The requirements of clauses (5), (16), and (18) only apply at times when children cared for at the family day care or group family day care home are present. 

(b) A violation of paragraph (a), clauses (1) to (3), is grounds for a sanction under section 142B.18 or a correction order or conditional license under section 142B.16. 

(c) If a provider under this subdivision receives a licensing sanction under section 142B.18 or 245A.07 or a correction order or a conditional license under section 142B.16 or 245A.06 relating to the supervision or health and safety of children, the provider is prohibited from allowing a child cared for at the family day care or group family day care home to continue to use the swimming pool located at the home. 

Subd. 10.Attendance records for publicly funded services. 
(a) A child care center licensed under this chapter and according to Minnesota Rules, chapter 9503, must maintain documentation of actual attendance for each child receiving care for which the license holder is reimbursed by a governmental program. The records must be accessible to the commissioner during the program's hours of operation, they must be completed on the actual day of attendance, and they must include: 

(1) the first and last name of the child; 

(2) the time of day that the child was dropped off; and 

(3) the time of day that the child was picked up. 

(b) A family child care provider licensed under this chapter and according to Minnesota Rules, chapter 9502, must maintain documentation of actual attendance for each child receiving care for which the license holder is reimbursed for the care of that child by a governmental program. The records must be accessible to the commissioner during the program's hours of operation, they must be completed on the actual day of attendance, and they must include: 

(1) the first and last name of the child; 

(2) the time of day that the child was dropped off; and 

(3) the time of day that the child was picked up. 

Subd. 11.Parental access in child care programs. 
An enrolled child's parent or legal guardian must be allowed access to the parent's or legal guardian's child at any time while the child is in care. 

Subd. 12.Valid driver's license. 
Notwithstanding any law to the contrary, when a licensed child care center provides transportation for children or contracts to provide transportation for children, a person who has a current, valid driver's license appropriate to the vehicle driven may transport the child. 

Subd. 13.Reusable water bottles or cups. 
Notwithstanding any law to the contrary, a licensed child care center may provide drinking water to a child in a reusable water bottle or reusable cup if the center develops and ensures implementation of a written policy that at a minimum includes the following procedures: 

(1) each day the water bottle or cup is used, the child care center cleans and sanitizes the water bottle or cup using procedures that comply with the Food Code under Minnesota Rules, chapter 4626, or allows the child's parent or legal guardian to bring the water bottle or cup home to be cleaned and sanitized each day the water bottle or cup is used; 

(2) a water bottle or cup is assigned to a specific child and labeled with the child's first and last name; 

(3) water bottles and cups are stored in a manner that reduces the risk of a child using the wrong water bottle or cup; and 

(4) a water bottle or cup is used only for water. 

142B.54 REQUIREMENTS; MALTREATMENT OF MINORS OR VULNERABLE ADULTS.Subdivision 1.Maltreatment of minors internal review. 
Except for family child care settings and foster care for children in the license holder's residence, license holders serving children shall: 

(1) establish and maintain policies and procedures to ensure that an internal review is completed within 30 calendar days and that corrective action is taken if necessary to protect the health and safety of children in care when the facility has reason to know that an internal or external report of alleged or suspected maltreatment has been made. The review must include an evaluation of whether: 

(i) related policies and procedures were followed; 

(ii) the policies and procedures were adequate; 

(iii) there is a need for additional staff training; 

(iv) the reported event is similar to past events with the children or the services involved; and 

(v) there is a need for corrective action by the license holder to protect the health and safety of children in care. 

Based on the results of this review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by individuals or the license holder, if any; 

(2) identify the primary and secondary person or position who will ensure that, when required, internal reviews are completed. The secondary person shall be involved when there is reason to believe that the primary person was involved in the alleged or suspected maltreatment; and 

(3) document and make internal reviews accessible to the commissioner immediately upon the commissioner's request. For the purposes of this section, the documentation provided to the commissioner by the license holder may consist of a completed checklist that verifies completion of each of the requirements of the review. 

Subd. 2.Child care centers; risk reduction plan. 
(a) Child care centers licensed under this chapter and Minnesota Rules, chapter 9503, must develop a risk reduction plan that identifies the general risks to children served by the child care center. The license holder must establish procedures to minimize identified risks, train staff on the procedures, and annually review the procedures. 

(b) The risk reduction plan must include an assessment of risk to children the center serves or intends to serve and identify specific risks based on the outcome of the assessment. The assessment of risk must be based on the following: 

(1) an assessment of the risks presented by the physical plant where the licensed services are provided, including an evaluation of the following factors: the condition and design of the facility and its outdoor space, bathrooms, storage areas, and accessibility of medications and cleaning products that are harmful to children when children are not supervised and the existence of areas that are difficult to supervise; and 

(2) an assessment of the risks presented by the environment for each facility and for each site, including an evaluation of the following factors: the type of grounds and terrain surrounding the building and the proximity to hazards, busy roads, and publicly accessed businesses. 

(c) The risk reduction plan must include a statement of measures that will be taken to minimize the risk of harm presented to children for each risk identified in the assessment required under paragraph (b) related to the physical plant and environment. At a minimum, the stated measures must include the development and implementation of specific policies and procedures or reference to existing policies and procedures that minimize the risks identified. 

(d) In addition to any program-specific risks identified in paragraph (b), the plan must include development and implementation of specific policies and procedures or refer to existing policies and procedures that minimize the risk of harm or injury to children, including: 

(1) closing children's fingers in doors, including cabinet doors; 

(2) leaving children in the community without supervision; 

(3) children leaving the facility without supervision; 

(4) caregiver dislocation of children's elbows; 

(5) burns from hot food or beverages, whether served to children or being consumed by caregivers, and the devices used to warm food and beverages; 

(6) injuries from equipment, such as scissors and glue guns; 

(7) sunburn; 

(8) feeding children foods to which they are allergic; 

(9) children falling from changing tables; and 

(10) children accessing dangerous items or chemicals or coming into contact with residue from harmful cleaning products. 

(e) The plan shall prohibit the accessibility of hazardous items to children. 

(f) The plan must include specific policies and procedures to ensure adequate supervision of children at all times as defined under section 142B.01, subdivision 27, with particular emphasis on: 

(1) times when children are transitioned from one area within the facility to another; 

(2) nap-time supervision, including infant crib rooms as specified under section 142B.01, subdivision 27, which requires that when an infant is placed in a crib to sleep, supervision occurs when a staff person is within sight or hearing of the infant. When supervision of a crib room is provided by sight or hearing, the center must have a plan to address the other supervision components; 

(3) child drop-off and pick-up times; 

(4) supervision during outdoor play and on community activities, including but not limited to field trips and neighborhood walks; 

(5) supervision of children in hallways; 

(6) supervision of school-age children when using the restroom and visiting the child's personal storage space; and 

(7) supervision of preschool children when using an individual, private restroom within the classroom. 

Subd. 3.Yearly review of risk reduction plan. 
 The license holder must review the risk reduction plan each calendar year and document the review. When conducting the review, the license holder must consider incidents that have occurred in the center since the last review, including: 

(1) the assessment factors in the plan; 

(2) the internal reviews conducted under this section, if any; 

(3) substantiated maltreatment findings, if any; and 

(4) incidents that caused injury or harm to a child, if any, that occurred since the last review. 

Following any change to the risk reduction plan, the license holder must inform staff persons, under the control of the license holder, of the changes in the risk reduction plan, and document that the staff were informed of the changes. 

142B.62 CHILD CARE LICENSE HOLDER INSURANCE.
(a) A license holder must provide a written notice to all parents or guardians of all children to be accepted for care prior to admission stating whether the license holder has liability insurance. This notice may be incorporated into and provided on the admission form used by the license holder. 

(b) If the license holder has liability insurance: 

(1) the license holder shall inform parents in writing that a current certificate of coverage for insurance is available for inspection to all parents or guardians of children receiving services and to all parents seeking services from the family child care program; 

(2) the notice must provide the parent or guardian with the date of expiration or next renewal of the policy; and 

(3) upon the expiration of the policy or a change in coverage, the license holder must provide a new written notice informing all parents or guardians of children receiving services of the change and indicating whether the insurance policy has lapsed. 

If a license holder has a continuous insurance policy that renews each year, the license holder may indicate the policy's renewal date in the initial written notice to parents and guardians. This initial written notice shall remain valid and no further notices are required until the insurance coverage changes or the policy lapses. 

(c) If the license holder does not have liability insurance, the license holder must provide an annual notice, on a form developed and made available by the commissioner, to the parents or guardians of children in care indicating that the license holder does not carry liability insurance. 

(d) The license holder must notify all parents and guardians in writing immediately of any change in insurance status. 

(e) The license holder must make available upon request the certificate of liability insurance to the parents of children in care, to the commissioner, and to county licensing agents. 

(f) The license holder must document, with the signature of the parent or guardian, that the parent or guardian received the notices required by this section. 

142B.65 CHILD CARE CENTER TRAINING REQUIREMENTS.Subdivision 1.Orientation. 
(a) The child care center license holder must ensure that the director, staff persons, substitutes, and unsupervised volunteers are given orientation training and successfully complete the training before starting assigned duties. The orientation training must include information about: 

(1) the center's philosophy, child care program, and procedures for maintaining health and safety according to section 142B.66 and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according to Minnesota Rules, part 9503.0110; 

(2) specific job responsibilities; 

(3) the behavior guidance standards in Minnesota Rules, part 9503.0055; 

(4) the reporting responsibilities in chapter 260E and Minnesota Rules, part 9503.0130; 

(5) the center's drug and alcohol policy under section 142B.10, subdivision 1, paragraph (c); 

(6) the center's risk reduction plan as required under section 142B.54, subdivision 2; 

(7) at least one-half hour of training on the standards under section 142B.46 and on reducing the risk of sudden unexpected infant death as required in subdivision 6, if applicable; 

(8) at least one-half hour of training on the risk of abusive head trauma as required for the director and staff under subdivision 7, if applicable; and 

(9) training required by a child's individual child care program plan as required under Minnesota Rules, part 9503.0065, subpart 3, if applicable. 

(b) In addition to paragraph (a), before having unsupervised direct contact with a child, the director and staff persons within the first 90 days of employment, and substitutes and unsupervised volunteers within 90 days after the first date of direct contact with a child, must complete: 

(1) pediatric first aid, in accordance with subdivision 4; and 

(2) pediatric cardiopulmonary resuscitation, in accordance with subdivision 5. 

(c) In addition to paragraph (b), the director and staff persons within the first 90 days of employment, and substitutes and unsupervised volunteers within 90 days from the first date of direct contact with a child, must complete training in child development, in accordance with subdivision 3. 

(d) The license holder must ensure that documentation, as required in subdivision 10, identifies the number of hours completed for each topic with a minimum training time identified, if applicable, and that all required content is included. 

(e) Training in this subdivision must not be used to meet in-service training requirements in subdivision 9. 

(f) Training completed within the previous 12 months under paragraphs (a), clauses (7) and (8), and (c) are transferable to another child care center. 

Subd. 2.Definitions. 
(a) For the purposes of this section, the following terms have the meanings given. 

(b) "Substitute" means an adult who is temporarily filling a position as a director, teacher, assistant teacher, or aide in a licensed child care center for less than 240 hours total in a calendar year due to the absence of a regularly employed staff person. 

(c) "Staff person" means an employee of a child care center who provides direct contact services to children. 

(d) "Unsupervised volunteer" means an individual who: 

(1) assists in the care of a child in care; 

(2) is not under the continuous direct supervision of a staff person; and 

(3) is not employed by the child care center. 

Subd. 3.Child development and learning training. 
(a) The director and all staff persons, substitutes, and unsupervised volunteers shall complete child development and learning training within the first 90 days of employment. The director and staff persons, not including substitutes, must complete at least two hours of training on child development and learning. The training for substitutes and unsupervised volunteers is not required to be of a minimum length. For purposes of this subdivision, "child development and learning training" means any training in Knowledge and Competency Area I: Child Development and Learning, which is training in understanding how children develop physically, cognitively, emotionally, and socially and learn as part of the children's family, culture, and community. 

(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they: 

(1) have taken a three-credit college course on early childhood development within the past five years; 

(2) have received a baccalaureate or master's degree in early childhood education or school-age child care within the past five years; 

(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood special education teacher, or an elementary teacher with a kindergarten endorsement; or 

(4) have received a baccalaureate degree with a Montessori certificate within the past five years. 

(c) The director and staff persons, not including substitutes, must complete at least two hours of child development and learning training every second calendar year. 

(d) Substitutes and unsupervised volunteers must complete child development and learning training every second calendar year. There is no minimum number of training hours required. 

(e) Except for training required under paragraph (a), training completed under this subdivision may be used to meet the in-service training requirements under subdivision 9. 

Subd. 4.First aid. 
(a) Unless training has been completed within the previous two years, the director, staff persons, substitutes, and unsupervised volunteers must satisfactorily complete pediatric first aid training prior to having unsupervised direct contact with a child, but not to exceed the first 90 days of employment. 

(b) Pediatric first aid training must be repeated at least every second calendar year. First aid training under this subdivision must be provided by an individual approved as a first aid instructor and must not be used to meet in-service training requirements under subdivision 9. 

Subd. 5.Cardiopulmonary resuscitation. 
(a) Unless training has been completed within the previous two years, the director, staff persons, substitutes, and unsupervised volunteers must satisfactorily complete pediatric cardiopulmonary resuscitation (CPR) training that meets the requirements of this subdivision. Pediatric CPR training must be completed prior to having unsupervised direct contact with a child, but not to exceed the first 90 days of employment. 

(b) Pediatric CPR training must be provided by an individual approved to provide pediatric CPR instruction. 

(c) The pediatric CPR training must: 

(1) cover CPR techniques for infants and children and the treatment of obstructed airways; 

(2) include instruction, hands-on practice, and an in-person, observed skills assessment under the direct supervision of a CPR instructor; and 

(3) be developed by the American Heart Association, the American Red Cross, or another organization that uses nationally recognized, evidence-based guidelines for CPR. 

(d) Pediatric CPR training must be repeated at least once every second calendar year. 

(e) Pediatric CPR training in this subdivision must not be used to meet in-service training requirements under subdivision 9. 

Subd. 6.Sudden unexpected infant death training. 
(a) Before caring for infants, the director, staff persons, substitutes, unsupervised volunteers, and any other volunteers must receive training on the standards under section 142B.46 and on reducing the risk of sudden unexpected infant death during orientation and each calendar year thereafter. 

(b) Sudden unexpected infant death reduction training required under this subdivision must be at least one-half hour in length. At a minimum, the training must address the risk factors related to sudden unexpected infant death, means of reducing the risk of sudden unexpected infant death in child care, and license holder communication with parents regarding reducing the risk of sudden unexpected infant death. 

(c) Except if completed during orientation, training taken under this subdivision may be used to meet the in-service training requirements under subdivision 9. 

Subd. 7.Abusive head trauma training. 
(a) Before caring for children under school age, the director, staff persons, substitutes, and unsupervised volunteers must receive training on the risk of abusive head trauma during orientation and each calendar year thereafter. 

(b) Abusive head trauma training under this subdivision must be at least one-half hour in length. At a minimum, the training must address the risk factors related to shaking infants and young children, means to reduce the risk of abusive head trauma in child care, and license holder communication with parents regarding reducing the risk of abusive head trauma. 

(c) Except if completed during orientation, training taken under this subdivision may be used to meet the in-service training requirements under subdivision 9. 

(d) The commissioner shall make available for viewing a video presentation on the dangers associated with shaking infants and young children, which may be used in conjunction with the annual training required under paragraph (b). 

Subd. 8.Child passenger restraint systems; training requirement. 
 (a) Before a license holder transports a child or children under age nine in a motor vehicle, the person placing the child or children in a passenger restraint must satisfactorily complete training on the proper use and installation of child restraint systems in motor vehicles. 

(b) Training required under this subdivision must be repeated at least once every five years. At a minimum, the training must address the proper use of child restraint systems based on the child's size, weight, and age, and the proper installation of a car seat or booster seat in the motor vehicle used by the license holder to transport the child or children. 

(c) Training required under this subdivision must be provided by individuals who are certified and approved by the Department of Public Safety, Office of Traffic Safety. License holders may obtain a list of certified and approved trainers through the Department of Public Safety website or by contacting the agency. 

(d) Child care providers that only transport school-age children as defined in section 142B.01, subdivision 25, in child care buses as defined in section 169.448, subdivision 1, paragraph (e), are exempt from this subdivision. 

(e) Training completed under this subdivision may be used to meet in-service training requirements under subdivision 9. Training completed within the previous five years is transferable upon a staff person's change in employment to another child care center. 

Subd. 9.In-service training. 
(a) A license holder must ensure that the center director, staff persons, substitutes, and unsupervised volunteers complete in-service training each calendar year. 

(b) The center director and staff persons who work more than 20 hours per week must complete 24 hours of in-service training each calendar year. Staff persons who work 20 hours or less per week must complete 12 hours of in-service training each calendar year. Substitutes and unsupervised volunteers must complete at least two hours of training each year, and the training must include the requirements of paragraphs (d) to (g). 

(c) The number of in-service training hours may be prorated for center directors and staff persons not employed for an entire year. 

(d) Each year, in-service training must include: 

(1) the center's procedures for maintaining health and safety according to section 142B.66 and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according to Minnesota Rules, part 9503.0110; 

(2) the reporting responsibilities under chapter 260E and Minnesota Rules, part 9503.0130; 

(3) at least one-half hour of training on the standards under section 142B.46 and on reducing the risk of sudden unexpected infant death as required under subdivision 6, if applicable; and 

(4) at least one-half hour of training on the risk of abusive head trauma from shaking infants and young children as required under subdivision 7, if applicable. 

(e) Each year, or when a change is made, whichever is more frequent, in-service training must be provided on: (1) the center's risk reduction plan under section 142B.54, subdivision 2; and (2) a child's individual child care program plan as required under Minnesota Rules, part 9503.0065, subpart 3. 

(f) At least once every two calendar years, the in-service training must include: 

(1) child development and learning training under subdivision 3; 

(2) pediatric first aid that meets the requirements of subdivision 4; 

(3) pediatric cardiopulmonary resuscitation training that meets the requirements of subdivision 5; 

(4) cultural dynamics training to increase awareness of cultural differences; and 

(5) disabilities training to increase awareness of differing abilities of children. 

(g) At least once every five years, in-service training must include child passenger restraint training that meets the requirements of subdivision 8, if applicable. 

(h) The remaining hours of the in-service training requirement must be met by completing training in the following content areas of the Minnesota Knowledge and Competency Framework: 

(1) Content area I: child development and learning; 

(2) Content area II: developmentally appropriate learning experiences; 

(3) Content area III: relationships with families; 

(4) Content area IV: assessment, evaluation, and individualization; 

(5) Content area V: historical and contemporary development of early childhood education; 

(6) Content area VI: professionalism; 

(7) Content area VII: health, safety, and nutrition; and 

(8) Content area VIII: application through clinical experiences. 

(i) For purposes of this subdivision, the following terms have the meanings given them. 

(1) "Child development and learning training" means training in understanding how children develop physically, cognitively, emotionally, and socially and learn as part of the children's family, culture, and community. 

(2) "Developmentally appropriate learning experiences" means creating positive learning experiences, promoting cognitive development, promoting social and emotional development, promoting physical development, and promoting creative development. 

(3) "Relationships with families" means training on building a positive, respectful relationship with the child's family. 

(4) "Assessment, evaluation, and individualization" means training in observing, recording, and assessing development; assessing and using information to plan; and assessing and using information to enhance and maintain program quality. 

(5) "Historical and contemporary development of early childhood education" means training in past and current practices in early childhood education and how current events and issues affect children, families, and programs. 

(6) "Professionalism" means training in knowledge, skills, and abilities that promote ongoing professional development. 

(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring safety, and providing healthy nutrition. 

(8) "Application through clinical experiences" means clinical experiences in which a person applies effective teaching practices using a range of educational programming models. 

(j) The license holder must ensure that documentation, as required in subdivision 10, includes the number of total training hours required to be completed, name of the training, the Minnesota Knowledge and Competency Framework content area, number of hours completed, and the director's approval of the training. 

(k) In-service training completed by a staff person that is not specific to that child care center is transferable upon a staff person's change in employment to another child care program. 

Subd. 10.Documentation. 
All training must be documented and maintained on site in each personnel record. In addition to any requirements for each training provided in this section, documentation for each staff person must include the staff person's first date of direct contact and first date of unsupervised contact with a child in care. 

142B.66 CHILD CARE CENTER HEALTH AND SAFETY REQUIREMENTS.Subdivision 1.Allergy prevention and response. 
(a) Before admitting a child for care, the license holder must obtain documentation of any known allergy from the child's parent or legal guardian or the child's source of medical care. If a child has a known allergy, the license holder must maintain current information about the allergy in the child's record and develop an individual child care program plan as specified in Minnesota Rules, part 9503.0065, subpart 3. The individual child care program plan must include but not be limited to a description of the allergy, specific triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for responding to an allergic reaction, including medication, dosages, and a doctor's contact information. 

(b) The license holder must ensure that each staff person who is responsible for carrying out the individual child care program plan review and follow the plan. Documentation of a staff person's review must be kept on site. 

(c) At least once each calendar year or following any changes made to allergy-related information in the child's record, the license holder must update the child's individual child care program plan and inform each staff person who is responsible for carrying out the individual child care program plan of the change. The license holder must keep on site documentation that a staff person was informed of a change. 

(d) A child's allergy information must be available at all times including on site, when on field trips, or during transportation. A child's food allergy information must be readily available to a staff person in the area where food is prepared and served to the child. 

(e) The license holder must contact the child's parent or legal guardian as soon as possible in any instance of exposure or allergic reaction that requires medication or medical intervention. The license holder must call emergency medical services when epinephrine is administered to a child in the license holder's care. 

Subd. 2.Handling and disposal of bodily fluids. 
The licensed child care center must comply with the following procedures for safely handling and disposing of bodily fluids: 

(1) surfaces that come in contact with potentially infectious bodily fluids, including blood and vomit, must be cleaned and disinfected according to Minnesota Rules, part 9503.0005, subpart 11; 

(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie; 

(3) sharp items used for a child with special care needs must be disposed of in a "sharps container." The sharps container must be stored out of reach of a child; 

(4) the license holder must have the following bodily fluid disposal supplies in the center: disposable gloves, disposal bags, and eye protection; and 

(5) the license holder must ensure that each staff person follows universal precautions to reduce the risk of spreading infectious disease. 

Subd. 3.Emergency preparedness. 
(a) A licensed child care center must have a written emergency plan for emergencies that require evacuation, sheltering, or other protection of a child, such as fire, natural disaster, intruder, or other threatening situation that may pose a health or safety hazard to a child. The plan must be written on a form developed by the commissioner and must include: 

(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown; 

(2) a designated relocation site and evacuation route; 

(3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation, shelter-in-place, or lockdown, including procedures for reunification with families; 

(4) accommodations for a child with a disability or a chronic medical condition; 

(5) procedures for storing a child's medically necessary medicine that facilitates easy removal during an evacuation or relocation; 

(6) procedures for continuing operations in the period during and after a crisis; 

(7) procedures for communicating with local emergency management officials, law enforcement officials, or other appropriate state or local authorities; and 

(8) accommodations for infants and toddlers. 

(b) The license holder must train staff persons on the emergency plan at orientation, when changes are made to the plan, and at least once each calendar year. Training must be documented in each staff person's personnel file. 

(c) The license holder must conduct drills according to the requirements in Minnesota Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented. 

(d) The license holder must review and update the emergency plan each calendar year. Documentation of the yearly emergency plan review shall be maintained in the program's administrative records. 

(e) The license holder must include the emergency plan in the program's policies and procedures as specified under section 142B.10, subdivision 21. The license holder must provide a physical or electronic copy of the emergency plan to the child's parent or legal guardian upon enrollment. 

(f) The relocation site and evacuation route must be posted in a visible place as part of the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140, subpart 21. 

Subd. 4.Child passenger restraint requirements. 
A license holder must comply with all seat belt and child passenger restraint system requirements under section 169.685. 

Subd. 5.Telephone requirement in licensed child care centers. 
(a) A working telephone which is capable of making outgoing calls and receiving incoming calls must be located within the licensed child care center at all times. Staff must have access to a working telephone while providing care and supervision to children in care, even if the care occurs outside of the child care facility. A license holder may use a cellular telephone to meet the requirements of this subdivision. 

(b) If a cellular telephone is used to satisfy the requirements of this subdivision, the cellular telephone must be accessible to staff, be stored in a centrally located area when not in use, and be sufficiently charged for use at all times. 

142B.70 FAMILY CHILD CARE TRAINING REQUIREMENTS.Subdivision 1.Initial training. 
(a) License holders, second adult caregivers, and substitutes must comply with the training requirements in this section. 

(b) Helpers who assist with care on a regular basis must complete six hours of training within one year after the date of initial employment. 

(c) Training requirements established under this section that must be completed prior to initial licensure must be satisfied only by a newly licensed child care provider or by a child care provider who has not held an active child care license in Minnesota in the previous 12 months. A child care provider who voluntarily cancels a license or allows the license to lapse for a period of less than 12 months and who seeks reinstatement of the lapsed or canceled license within 12 months of the lapse or cancellation must satisfy the annual, ongoing training requirements, and is not required to satisfy the training requirements that must be completed prior to initial licensure. A child care provider who relocates within the state must (1) satisfy the annual, ongoing training requirements according to the schedules established in this section and (2) not be required to satisfy the training requirements under this section that the child care provider completed prior to initial licensure. If a licensed provider moves to a new county, the new county is prohibited from requiring the provider to complete any orientation class or training for new providers. 

(d) Before a second adult caregiver or substitute cares for a child or assists in the care of a child, the license holder must train the second adult caregiver or substitute on: 

(1) the emergency preparedness plan required under section 142B.71, subdivision 3; and 

(2) allergy prevention and response required under section 142B.71, subdivision 1. 

Subd. 2.Definitions and general provisions. 
For the purposes of this section, the following terms have the meanings given: 

(1) "second adult caregiver" means an adult who cares for children in the licensed program along with the license holder for a cumulative total of more than 500 hours annually; 

(2) "helper" means a minor, ages 13 to 17, who assists in caring for children; and 

(3) "substitute" means an adult who assumes responsibility for a license holder for a cumulative total of not more than 500 hours annually. 

An adult who cares for children in the licensed program along with the license holder for a cumulative total of not more than 500 hours annually has the same training requirements as a substitute. 

Subd. 3.Child development and learning and behavior guidance training. 
(a) For purposes of family and group family child care, the license holder and each second adult caregiver shall complete and document at least four hours of child development and learning and behavior guidance training prior to initial licensure, and before caring for children. For purposes of this subdivision, "child development and learning training" means training in understanding how children develop physically, cognitively, emotionally, and socially and learn as part of the children's family, culture, and community. "Behavior guidance training" means training in the understanding of the functions of child behavior and strategies for managing challenging situations. The training shall be developed or approved by the commissioner of children, youth, and families. 

(b) Notwithstanding initial child development and learning and behavior guidance training requirements in paragraph (a), individuals are exempt from this requirement if they: 

(1) have taken a three-credit course on early childhood development within the past five years; 

(2) have received a baccalaureate or master's degree in early childhood education or school-age child care within the past five years; 

(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early childhood special education teacher, or an elementary teacher with a kindergarten endorsement; or 

(4) have received a baccalaureate degree with a Montessori certificate within the past five years. 

(c) The license holder and each second adult caregiver must annually take at least two hours of child development and learning or behavior guidance training. A three-credit course about early childhood development meets the requirements of this paragraph. 

Subd. 4.First aid. 
(a) Before initial licensure and before caring for a child, license holders, second adult caregivers, and substitutes must be trained in pediatric first aid. The first aid training must have been provided by an individual approved to provide first aid instruction. First aid training may be less than eight hours and persons qualified to provide first aid training include individuals approved as first aid instructors. License holders, second adult caregivers, and substitutes must repeat pediatric first aid training every two years within 90 days of the date the training was previously taken. 

(b) Video training reviewed and approved by the county licensing agency satisfies the training requirement of this subdivision. 

Subd. 5.Cardiopulmonary resuscitation. 
(a) Before initial licensure and before caring for a child, license holders, second adult caregivers, and substitutes must be trained in pediatric cardiopulmonary resuscitation (CPR), including CPR techniques for infants and children, and in the treatment of obstructed airways. The CPR training must have been provided by an individual approved to provide CPR instruction. License holders, second adult caregivers, and substitutes must repeat pediatric CPR training at least once every two years within 90 days of the date the training was previously taken, and the training must be documented in the license holder's records. 

(b) Persons providing CPR training must use CPR training that has been developed: 

(1) by the American Heart Association or the American Red Cross and incorporates psychomotor skills to support the instruction; or 

(2) using nationally recognized, evidence-based guidelines for CPR training and incorporates psychomotor skills to support the instruction. 

Subd. 6.Sudden unexpected infant death and abusive head trauma training. 
(a) License holders must ensure and document that before the license holder, second adult caregivers, substitutes, and helpers assist in the care of infants, they are instructed on the standards in section 142B.46 and receive training on reducing the risk of sudden unexpected infant death. In addition, license holders must ensure and document that before the license holder, second adult caregivers, substitutes, and helpers assist in the care of infants and children under school age, they receive training on reducing the risk of abusive head trauma from shaking infants and young children. The training in this subdivision may be provided as initial training under subdivision 1 or ongoing annual training under subdivision 8. 

(b) Sudden unexpected infant death reduction training required under this subdivision must, at a minimum, address the risk factors related to sudden unexpected infant death, means of reducing the risk of sudden unexpected infant death in child care, and license holder communication with parents regarding reducing the risk of sudden unexpected infant death. 

(c) Abusive head trauma training required under this subdivision must, at a minimum, address the risk factors related to shaking infants and young children, means of reducing the risk of abusive head trauma in child care, and license holder communication with parents regarding reducing the risk of abusive head trauma. 

(d) Training for family and group family child care providers must be developed by the commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved by the Minnesota Center for Professional Development. Sudden unexpected infant death reduction training and abusive head trauma training may be provided in a single course of no more than two hours in length. 

(e) Sudden unexpected infant death reduction training and abusive head trauma training required under this subdivision must be completed in person or as allowed under subdivision 11, clause (1) or (2), at least once every two years. On the years when the individual receiving training is not receiving training in person or as allowed under subdivision 11, clause (1) or (2), the individual receiving training in accordance with this subdivision must receive sudden unexpected infant death reduction training and abusive head trauma training through a video of no more than one hour in length. The video must be developed or approved by the commissioner. 

(f) An individual who is related to the license holder as defined in section 142B.01, subdivision 15, and who is involved only in the care of the license holder's own infant or child under school age and who is not designated to be a second adult caregiver, helper, or substitute for the licensed program, is exempt from the sudden unexpected infant death and abusive head trauma training. 

Subd. 7.Child passenger restraint systems; training requirement. 
(a) A license holder must comply with all seat belt and child passenger restraint system requirements under section 169.685. 

(b) Family and group family child care programs licensed by the Department of Children, Youth, and Families that serve a child or children under nine years of age must document training that fulfills the requirements in this subdivision. 

(1) Before a license holder, second adult caregiver, substitute, or helper transports a child or children under age nine in a motor vehicle, the person placing the child or children in a passenger restraint must satisfactorily complete training on the proper use and installation of child restraint systems in motor vehicles. Training completed under this subdivision may be used to meet initial training under subdivision 1 or ongoing training under subdivision 8. 

(2) Training required under this subdivision must be at least one hour in length, completed at initial training, and repeated at least once every five years. At a minimum, the training must address the proper use of child restraint systems based on the child's size, weight, and age, and the proper installation of a car seat or booster seat in the motor vehicle used by the license holder to transport the child or children. 

(3) Training under this subdivision must be provided by individuals who are certified and approved by the Department of Public Safety, Office of Traffic Safety. License holders may obtain a list of certified and approved trainers through the Department of Public Safety website or by contacting the agency. 

(c) Child care providers that only transport school-age children as defined in section 142B.01, subdivision 13, paragraph (f), in child care buses as defined in section 169.448, subdivision 1, paragraph (e), are exempt from this subdivision. 

Subd. 8.Training requirements for family and group family child care. 
(a) For purposes of family and group family child care, the license holder and each second adult caregiver must complete 16 hours of ongoing training each year. Repeat of topical training requirements in subdivisions 3 to 9 shall count toward the annual 16-hour training requirement. Additional ongoing training subjects to meet the annual 16-hour training requirement must be selected from the following areas: 

(1) child development and learning training in understanding how a child develops physically, cognitively, emotionally, and socially, and how a child learns as part of the child's family, culture, and community; 

(2) developmentally appropriate learning experiences, including training in creating positive learning experiences, promoting cognitive development, promoting social and emotional development, promoting physical development, promoting creative development; and behavior guidance; 

(3) relationships with families, including training in building a positive, respectful relationship with the child's family; 

(4) assessment, evaluation, and individualization, including training in observing, recording, and assessing development; assessing and using information to plan; and assessing and using information to enhance and maintain program quality; 

(5) historical and contemporary development of early childhood education, including training in past and current practices in early childhood education and how current events and issues affect children, families, and programs; 

(6) professionalism, including training in knowledge, skills, and abilities that promote ongoing professional development; and 

(7) health, safety, and nutrition, including training in establishing healthy practices; ensuring safety; and providing healthy nutrition. 

(b) A provider who is approved as a trainer through the Develop data system may count up to two hours of training instruction toward the annual 16-hour training requirement in paragraph (a). The provider may only count training instruction hours for the first instance in which they deliver a particular content-specific training during each licensing year. Hours counted as training instruction must be approved through the Develop data system with attendance verified on the trainer's individual learning record and must be in Knowledge and Competency Framework content area VII A (Establishing Healthy Practices) or B (Ensuring Safety). 

(c) Substitutes and adult caregivers who provide care for 500 or fewer hours per year must complete a minimum of one hour of training each calendar year, and the training must include the requirements in subdivisions 3, 4, 5, 6, and 9. 

Subd. 9.Other required training requirements. 
(a) The training required of family and group family child care providers and staff must include training in the cultural dynamics of early childhood development and child care. The cultural dynamics and disabilities training and skills development of child care providers must be designed to achieve outcomes for providers of child care that include, but are not limited to: 

(1) an understanding and support of the importance of culture and differences in ability in children's identity development; 

(2) understanding the importance of awareness of cultural differences and similarities in working with children and their families; 

(3) understanding and support of the needs of families and children with differences in ability; 

(4) developing skills to help children develop unbiased attitudes about cultural differences and differences in ability; 

(5) developing skills in culturally appropriate caregiving; and 

(6) developing skills in appropriate caregiving for children of different abilities. 

The commissioner shall approve the curriculum for cultural dynamics and disability training. 

(b) The provider must meet the training requirement in section 142B.41, subdivision 9, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child care or group family child care home to use the swimming pool located at the home. 

Subd. 10.Supervising for safety; training requirement. 
(a) Courses required by this subdivision must include the following health and safety topics: 

(1) preventing and controlling infectious diseases; 

(2) administering medication; 

(3) preventing and responding to allergies; 

(4) ensuring building and physical premises safety; 

(5) handling and storing biological contaminants; 

(6) preventing and reporting child abuse and maltreatment; and 

(7) emergency preparedness. 

(b) Before initial licensure and before caring for a child, all family child care license holders and each second adult caregiver shall complete and document the completion of the six-hour Supervising for Safety for Family Child Care course developed by the commissioner. 

(c) The license holder must ensure and document that, before caring for a child, all substitutes have completed the four-hour Basics of Licensed Family Child Care for Substitutes course developed by the commissioner, which must include health and safety topics as well as child development and learning. 

(d) The family child care license holder and each second adult caregiver shall complete and document: 

(1) the annual completion of either: 

(i) a two-hour active supervision course developed by the commissioner; or 

(ii) any courses in the ensuring safety competency area under the health, safety, and nutrition standard of the Knowledge and Competency Framework that the commissioner has identified as an active supervision training course; and 

(2) the completion at least once every five years of the two-hour courses Health and Safety I and Health and Safety II. A license holder's or second adult caregiver's completion of either training in a given year meets the annual active supervision training requirement in clause (1). 

(e) At least once every three years, license holders must ensure and document that substitutes have completed the four-hour Basics of Licensed Family Child Care for Substitutes course. 

Subd. 11.Approved training. 
(a) The commissioner of children, youth, and families must post information on the department's website indicating the specific category within the Knowledge and Competency Framework that will satisfy training requirements for child development and learning, behavior guidance, and active supervision. County licensing staff must accept trainings designated as satisfying training requirements by the commissioner under this paragraph. 

(b) Unless specifically authorized in this section, one training does not fulfill two different training requirements. Courses within the identified knowledge and competency areas that are specific to child care centers or legal nonlicensed providers do not fulfill the requirements of this section. 

(c) County licensing staff must accept training approved by the Minnesota Center for Professional Development, including: 

(1) face-to-face or classroom training; 

(2) online training; and 

(3) relationship-based professional development, such as mentoring, coaching, and consulting. 

Subd. 12.Provider training. 
New and increased training requirements under this section must not be imposed on providers until the commissioner establishes statewide accessibility to the required provider training. 

142B.71 FAMILY CHILD CARE HEALTH AND SAFETY REQUIREMENTS.Subdivision 1.Allergy prevention and response. 
(a) Before admitting a child for care, the license holder must obtain information about any known allergy from the child's parent or legal guardian. The license holder must maintain current allergy information in each child's record. The allergy information must include a description of the allergy, specific triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for responding to an allergic reaction, including medication, dosages, and a doctor's contact information. 

(b) The child's allergy information must be documented on a form approved by the commissioner, readily available to all caregivers, and reviewed annually by the license holder and each caregiver. 

Subd. 2.Handling and disposal of bodily fluids. 
The licensed family child care provider must comply with the following procedures for safely handling and disposing of bodily fluids: 

(1) surfaces that come in contact with potentially infectious bodily fluids, including blood and vomit, must be cleaned and disinfected as described in section 142B.76; 

(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie; 

(3) sharp items used for a child with special care needs must be disposed of in a "sharps container." The sharps container must be stored out of reach of a child; and 

(4) the license holder must have the following bodily fluid disposal supplies available: disposable gloves, disposal bags, and eye protection. 

Subd. 3.Emergency preparedness plan. 
(a) A licensed family child care provider must have a written emergency preparedness plan for emergencies that require evacuation, sheltering, or other protection of children, such as fire, natural disaster, intruder, or other threatening situation that may pose a health or safety hazard to children. The plan must be written on a form developed by the commissioner and updated at least annually. The plan must include: 

(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown; 

(2) a designated relocation site and evacuation route; 

(3) procedures for notifying a child's parent or legal guardian of the evacuation, shelter-in-place, or lockdown, including procedures for reunification with families; 

(4) accommodations for a child with a disability or a chronic medical condition; 

(5) procedures for storing a child's medically necessary medicine that facilitate easy removal during an evacuation or relocation; 

(6) procedures for continuing operations in the period during and after a crisis; 

(7) procedures for communicating with local emergency management officials, law enforcement officials, or other appropriate state or local authorities; and 

(8) accommodations for infants and toddlers. 

(b) The license holder must train caregivers before the caregiver provides care and at least annually on the emergency preparedness plan and document completion of this training. 

(c) The license holder must conduct drills according to the requirements in Minnesota Rules, part 9502.0435, subpart 8. The date and time of the drills must be documented. 

(d) The license holder must have the emergency preparedness plan available for review. 

Subd. 4.Transporting children. 
A license holder must ensure compliance with all seat belt and child passenger restraint system requirements under section 169.685. 

Subd. 5.Telephone requirement. 
Notwithstanding Minnesota Rules, part 9502.0435, subpart 8, item B, a license holder is not required to post a list of emergency numbers. A license holder may use a cellular telephone to meet the requirements of Minnesota Rules, part 9502.0435, subpart 8, if the cellular telephone is sufficiently charged for use at all times. 

142B.72 FAMILY CHILD CARE PHYSICAL SPACE REQUIREMENTS.Subdivision 1.Means of escape. 
(a) At least one emergency escape route separate from the main exit from the space must be available in: (1) each room used for sleeping by anyone receiving licensed care; and (2) a basement used for child care. One means of escape must be a stairway or door leading to the floor of exit discharge. The other must be a door or window leading directly outside. A window used as an emergency escape route must be openable without special knowledge. 

(b) In homes with construction that began before March 31, 2020, the interior of the window leading directly outside must have a net clear opening area of not less than 4.5 square feet or 648 square inches and have minimum clear opening dimensions of 20 inches wide and 20 inches high. The net clear opening dimensions shall be the result of normal operation of the opening. The opening must be no higher than 48 inches from the floor. The height to the window may be measured from a platform if a platform is located below the window. 

(c) In homes with construction that began on or after March 31, 2020, the interior of the window leading directly outside must have minimum clear opening dimensions of 20 inches wide and 24 inches high. The net clear opening dimensions shall be the result of normal operation of the opening. The opening must be no higher than 44 inches from the floor. 

 Additional requirements are dependent on the distance of the openings from the ground outside the window: (1) windows or other openings with a sill height not more than 44 inches above or below the finished ground level adjacent to the opening (grade-floor emergency escape and rescue openings) must have a minimum opening of five square feet; and (2) non-grade-floor emergency escape and rescue openings must have a minimum opening of 5.7 square feet. 

Subd. 2.Door to attached garage. 
(a) If there is an opening between an attached garage and a day care residence, there must be a door that is: 

(1) a solid wood bonded-core door at least 1-3/8 inches thick; 

(2) a steel insulated door at least 1-3/8 inches thick; or 

(3) a door with a fire protection rating of 20 minutes. 

(b) The separation wall on the garage side between the residence and garage must consist of 1/2-inch-thick gypsum wallboard or its equivalent. 

Subd. 3.Heating and venting systems. 
(a) Notwithstanding Minnesota Rules, part 9502.0425, subpart 7, item C, items that can be ignited and support combustion, including but not limited to plastic, fabric, and wood products must not be located within: 

(1) 18 inches of a gas or fuel-oil heater or furnace; or 

(2) 36 inches of a solid-fuel-burning appliance. 

(b) If a license holder produces manufacturer instructions listing a smaller distance, then the manufacturer instructions control the distance combustible items must be from gas, fuel-oil, or solid-fuel burning heaters or furnaces. 

Subd. 4.Fire extinguisher. 
A portable, operational, multipurpose, dry chemical fire extinguisher with a minimum 2 A 10 BC rating must be located in or near the kitchen and cooking areas of the residence at all times. The fire extinguisher must be serviced annually by a qualified inspector. All caregivers must know how to properly use the fire extinguisher. 

Subd. 5.Carbon monoxide and smoke alarms. 
(a) All homes must have an approved and operational carbon monoxide alarm installed within ten feet of each room used for sleeping children in care. 

(b) Smoke alarms that have been listed by the Underwriter Laboratory must be properly installed and maintained in hallways outside of rooms used for sleeping children and on all levels, including basements but not including crawl spaces and uninhabitable attics. 

(c) In homes with construction that began on or after March 31, 2020, smoke alarms must be installed and maintained in each room used for sleeping children in care. 

Subd. 6.Updates. 
After readoption of the Minnesota State Fire Code, the fire marshal must notify the commissioner of any changes that conflict with this section and Minnesota Rules, chapter 9502. The state fire marshal must identify necessary statutory changes to align statutes with the revised code. The commissioner must recommend updates to sections of this chapter that are derived from the Minnesota State Fire Code in the legislative session following readoption of the code. 

Subd. 7.Fire code variances. 
When a variance is requested of the standards contained in subdivision 1, 2, 3, 4, or 5, an applicant or provider must submit written approval from the state fire marshal of the variance requested and the alternative measures identified to ensure the safety of children in care. 

Subd. 8.Stairways. 
(a) All stairways must meet the requirements in this subdivision. 

(b) Stairways of four or more steps must have handrails on at least one side. 

(c) Any open area between the handrail and stair tread must be enclosed with a protective guardrail as specified in the State Building Code. At open risers, openings located more than 30 inches or 762 millimeters as measured vertically to the floor or grade below must not permit the passage of a sphere four inches or 102 millimeters in diameter. 

(d) Gates or barriers must be used when children aged six to 18 months are in care. 

(e) Stairways must be well lit, in good repair, and free of clutter and obstructions. 

142B.74 SUBSTITUTE CAREGIVERS AND REPLACEMENTS IN FAMILY CHILD CARE.Subdivision 1.Total hours allowed. 
Notwithstanding Minnesota Rules, part 9502.0365, subpart 5, the use of a substitute caregiver in a licensed family child care program must be limited to a cumulative total of not more than 500 hours annually. The license holder must document the name, dates, and number of hours of the substitute who provided care. 

Subd. 2.Emergency replacement supervision. 
(a) A license holder may allow an adult who has not completed the training requirements under this chapter or the background study requirements under chapter 245C to supervise children in a family child care program in an emergency. For purposes of this subdivision, an emergency is a situation in which: 

(1) the license holder has begun operating the family child care program for the day and for reasons beyond the license holder's control, including, but not limited to a serious illness or injury, accident, or situation requiring the license holder's immediate attention, the license holder needs to leave the licensed space and close the program for the day; and 

(2) the parents or guardians of the children attending the program are contacted to pick up their children as soon as is practicable. 

(b) The license holder must make reasonable efforts to minimize the time the emergency replacement has unsupervised contact with the children in care, not to exceed 24 hours per emergency incident. 

(c) The license holder shall not knowingly use a person as an emergency replacement who has committed an action or has been convicted of a crime that would cause the person to be disqualified from providing care to children, if a background study was conducted under chapter 245C. 

(d) To the extent practicable, the license holder must attempt to arrange for emergency care by a substitute caregiver before using an emergency replacement. 

(e) To the extent practicable, the license holder must notify the county licensing agency within seven days that an emergency replacement was used, and specify the circumstances that led to the use of the emergency replacement. The county licensing agency must notify the commissioner within three business days after receiving the license holder's notice that an emergency replacement was used, and specify the circumstances that led to the use of the emergency replacement. 

(f) Notwithstanding the requirements in Minnesota Rules, part 9502.0405, a license holder is not required to provide the names of persons who may be used as replacements in emergencies to parents or the county licensing agency. 

142B.75 FAMILY CHILD CARE INFANT SLEEP SUPERVISION REQUIREMENTS.Subdivision 1.In-person checks on infants. 
(a) License holders of family child care programs that serve infants are encouraged to monitor sleeping infants by conducting in-person checks on each infant in their care every 30 minutes. 

(b) Upon enrollment of an infant in a family child care program, the license holder is encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during the first four months of care. 

(c) When an infant has an upper respiratory infection, the license holder is encouraged to conduct in-person checks on the sleeping infant every 15 minutes throughout the hours of sleep. 

Subd. 2.Use of audio or visual monitoring devices. 
In addition to conducting the in-person checks encouraged under subdivision 1, license holders serving infants are encouraged to use and maintain an audio or visual monitoring device to monitor each sleeping infant in care during all hours of sleep. 

142B.76 FAMILY CHILD CARE DIAPERING AREA DISINFECTION.
Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may disinfect the diaper changing surface with chlorine bleach in a manner consistent with label directions for disinfection or with a surface disinfectant that meets the following criteria: 

(1) the manufacturer's label or instructions state that the product is registered with the United States Environmental Protection Agency; 

(2) the manufacturer's label or instructions state that the disinfectant is effective against Staphylococcus aureus, Salmonella enterica, and Pseudomonas aeruginosa; 

(3) the manufacturer's label or instructions state that the disinfectant is effective with a ten minute or less contact time; 

(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing and use; 

(5) the disinfectant is used only in accordance with the manufacturer's directions; and 

(6) the product does not include triclosan or derivatives of triclosan. 

142B.77 SUPERVISION OF FAMILY CHILD CARE LICENSE HOLDER'S OWN CHILD.
(a) Notwithstanding Minnesota Rules, part 9502.0365, subpart 5, and with the license holder's consent, an individual may be present in the licensed space, may supervise the family child care license holder's own child both inside and outside of the licensed space, and is exempt from the training and supervision requirements of this chapter and Minnesota Rules, chapter 9502, if the individual: 

(1) is related to the license holder or to the license holder's child, as defined in section 142B.01, subdivision 15, or is a household member who the license holder has reported to the county agency; 

(2) is not a designated caregiver, helper, or substitute for the licensed program; 

(3) is involved only in the care of the license holder's own child; and 

(4) does not have direct, unsupervised contact with any nonrelative children receiving services. 

(b) If the individual in paragraph (a) is not a household member, the individual is also exempt from background study requirements under chapter 245C. 

144.9821 ADVANCING HEALTH EQUITY THROUGH CAPACITY BUILDING AND RESOURCE ALLOCATION.Subdivision 1.Establishment of grant program. 
(a) The commissioner of health shall establish an annual grant program to award infrastructure capacity building grants to help metro and rural community and faith-based organizations serving people of color, American Indians, LGBTQIA+ communities, and people living with disabilities in Minnesota who have been disproportionately impacted by health and other inequities to be better equipped and prepared for success in procuring grants and contracts at the department and addressing inequities. 

(b) The commissioner of health shall create a framework at the department to maintain equitable practices in grantmaking to ensure that internal grantmaking and procurement policies and practices prioritize equity, transparency, and accessibility to include: 

(1) a tracking system for the department to better monitor and evaluate equitable procurement and grantmaking processes and their impacts; and 

(2) technical assistance and coaching to department leadership in grantmaking and procurement processes and programs and providing tools and guidance to ensure equitable and transparent competitive grantmaking processes and award distribution across communities most impacted by inequities and develop measures to track progress over time. 

Subd. 2.Commissioner's duties. 
The commissioner of health shall: 

(1) in consultation with community stakeholders, community health boards and Tribal nations, develop a request for proposals for an infrastructure capacity building grant program to help community-based organizations, including faith-based organizations, to be better equipped and prepared for success in procuring grants and contracts at the department and beyond; 

(2) provide outreach, technical assistance, and program development support to increase capacity for new and existing community-based organizations and other service providers in order to better meet statewide needs particularly in greater Minnesota and areas where services to reduce health disparities have not been established; 

(3) in consultation with community stakeholders, review responses to requests for proposals and award grants under this section; 

(4) ensure communication with the ethnic councils, Minnesota Indian Affairs Council, Minnesota Council on Disability, Minnesota Commission of the Deaf, DeafBlind, and Hard of Hearing, and the governor's office on the request for proposal process; 

(5) in consultation with community stakeholders, establish a transparent and objective accountability process focused on outcomes that grantees agree to achieve; 

(6) maintain data on outcomes reported by grantees; and 

(7) establish a process or mechanism to evaluate the success of the capacity building grant program and to build the evidence base for effective community-based organizational capacity building in reducing disparities. 

Subd. 3.Eligible grantees. 
Organizations eligible to receive grant funding under this section include: organizations or entities that work with diverse communities such as people of color, American Indians, LGBTQIA+ communities, and people with disabilities in metro and rural communities. 

Subd. 4.Strategic consideration and priority of proposals; eligible populations; grant awards. 
(a) The commissioner, in consultation with community stakeholders, shall develop a request for proposals for equity in procurement and grantmaking capacity building grant program to help community-based organizations, including faith-based organizations to be better equipped and prepared for success in procuring grants and contracts at the department and addressing inequities. 

(b) In awarding the grants, the commissioner shall provide strategic consideration and give priority to proposals from organizations or entities led by populations of color or American Indians, and those serving communities of color, American Indians, LGBTQIA+ communities, and disability communities. 

Subd. 5.Geographic distribution of grants. 
The commissioner shall ensure that grant funds are prioritized and awarded to organizations and entities that are within counties that have a higher proportion of Black or African American, nonwhite Latino(a), LGBTQIA+, and disability communities to the extent possible. 

Subd. 6.Report. 
Grantees must report grant program outcomes to the commissioner on the forms and according to the timelines established by the commissioner. 

151.741 INSULIN MANUFACTURER REGISTRATION FEE.Subd. 2.Assessment of registration fee. 
(a) The board shall assess each manufacturer an annual registration fee of $100,000, except as provided in paragraph (b). The board shall notify each manufacturer of this requirement beginning November 1, 2024, and each November 1 thereafter. 

(b) A manufacturer may request an exemption from the annual registration fee. The board shall exempt a manufacturer from the annual registration fee if the manufacturer can demonstrate to the board, in the form and manner specified by the board, that gross revenue from sales of prescription insulin produced by that manufacturer and sold or delivered within or into Minnesota was less than five percent of the total gross revenue from sales of prescription insulin produced by all manufacturers and sold or delivered within or into Minnesota in the previous calendar year. 

Subd. 3.Payment of the registration fee; deposit of fee. 
(a) Each manufacturer must pay the registration fee by March 1, 2025, and by each March 1 thereafter. In the event of a change in ownership of the manufacturer, the new owner must pay the registration fee that the original owner would have been assessed had the original owner retained ownership. The board may assess a late fee of ten percent per month or any portion of a month that the registration fee is paid after the due date. 

(b) The registration fee, including any late fees, must be deposited in the insulin safety net program account. 

Subd. 6.Contingent transfer by commissioner. 
If subdivisions 2 and 3, or the application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any reason in a court of competent jurisdiction, the invalidity of subdivisions 2 and 3 does not affect other provisions of this act, and the commissioner of management and budget shall annually transfer from the health care access fund to the insulin safety net program account an amount sufficient to implement subdivision 4. 

256B.198 PAYMENTS FOR NON-HOSPITAL-BASED GOVERNMENTAL HEALTH CENTERS.
(a) The commissioner may make payments to non-hospital-based health centers operated by a governmental entity for the difference between the expenditures incurred by the health center for patients eligible for medical assistance, and the payments to the health center for medical assistance permitted elsewhere under this chapter. 

(b) The nonfederal share of payments authorized under paragraph (a) shall be provided through certified public expenditures authorized under section 256B.199, paragraph (b). 

(c) Effective July 1, 2013, or no earlier than 12 months after implementation of a total cost of care demonstration project, Hennepin County may receive federal matching funds for certified public expenditures under paragraph (a), if the county participates in a total cost of care demonstration project under sections 256B.0755 and 256B.0756, or another total cost of care demonstration project approved by the commissioner, and the county exceeds the minimum performance threshold established by the commissioner for the demonstration project. The value of the federal matching funds for the certified public expenditures allocated to Hennepin County shall be equal to the value of savings achieved above the minimum performance threshold. The same proportion of federal matching funds for certified public expenditure allocated to Hennepin County based on savings achieved under the demonstration project shall continue after the demonstration project and must continue to be paid to Hennepin County each year thereafter. 

(d) Beginning July 1, 2014, or no earlier than 12 months after the initial allocation under paragraph (c) if a portion of the federal matching funds for certified public expenditure remains with the state, the commissioner shall annually determine if the savings from county's total cost of care demonstration project exceeded the savings from the previous year and allocate federal matching funds for certified public expenditures to Hennepin County equal to the amount of savings achieved above the amount achieved in the previous year. The proportion of federal matching funds for certified public expenditure allocated to Hennepin County shall be paid to Hennepin County each year thereafter, until no federal matching funds for certified public expenditures under paragraph (a) remain with the state. 

(e) Nothing under this section precludes Hennepin County from receiving an additional gain-sharing payment or relieves the county from paying a downside risk-sharing payment to the state under the demonstration project under section 256B.0755. 

256B.69 PREPAID HEALTH PLANS.Subd. 31a.Trend limit; calculation. 
(a) Beginning January 1, 2020, and ending June 30, 2024, the commissioner of human services may, to the extent practicable, limit the year over year increase in rates paid to managed care plans and county-based purchasing plans under this section and section 256B.692 by an amount equal to the value of a 0.8 percent reduction in rates in medical assistance across all products. Managed care rates must meet actuarial soundness and rate development requirements under Code of Federal Regulations, title 42, part 438, subpart A. Forecast expenditure growth assumptions cannot be part of the rate-setting process. 

(b) In the November 2019 forecast, the commissioner of human services, in consultation with the commissioner of management and budget, shall determine the extent to which the year over year change in managed care and county-based purchasing plan rates are forecasted to reduce medical assistance expenditures in fiscal years 2020 through 2024, relative to projected expenditures from the end of the 2019 legislative session that establish a budget for the Department of Human Services. To the extent the total value of the reduction is less than $145,150,000, the commissioner of management and budget shall transfer the difference from the premium security account established in section 62E.25, subdivision 1, to the general fund. 

260.63 DEFINITIONS.Subd. 9.Disproportionality. 
"Disproportionality" means the overrepresentation of African American children and other disproportionately represented children in Minnesota's child welfare system population as compared to the representation of those children in Minnesota's total child population. 

609.466 MEDICAL ASSISTANCE FRAUD.
Any person who, with the intent to defraud, presents a claim for reimbursement, a cost report or a rate application, relating to the payment of medical assistance funds pursuant to chapter 256B, to the state agency, which is false in whole or in part, is guilty of an attempt to commit theft of public funds and may be sentenced accordingly. 

2500.0100DEFINITIONS. Subp. 5b.Good standing.  
"Good standing" means any license which is not the subject of current disciplinary action as identified in Minnesota Statutes, section 148.10, subdivisions 1, 3, and 4. The pendency of a complaint shall not cause a license to lose good standing unless and until the complaint results in disciplinary action under Minnesota Statutes, section 148.10 or pursuant to a stipulation and order. A license shall be restored to good standing upon the satisfactory completion, expiration, or other agreed upon termination of all terms of a stipulation and order. An agreement for corrective action as described under Minnesota Statutes, section 214.103, subdivision 6, shall not cause a license to lose good standing. 

Subp. 6.Inactive license.  
"Inactive license" means a restricted license that allows the licensee to maintain a license but does not allow the licensee to actively practice in Minnesota. 

Subp. 12.Voluntarily retired license.  
"Voluntarily retired license" means a license which has been voluntarily surrendered by a chiropractor. It relinquishes all rights to practice chiropractic in Minnesota. 

2500.1900 LICENSE REINSTATEMENT.  
A license terminated by reason of the licensee's failure to comply with the continuing education requirements of parts 2500.1200 to 2500.2000, or failure to submit a completed application for license renewal as prescribed by the board, may be reinstated or restored to full status by following one of the applicable procedures in items A to E. 

A.
 An applicant whose license has been terminated for a period of less than five years, and who can verify continual practice elsewhere during that time, shall be reinstated by completing all interim continuing education and paying all interim licensure fees that would have been required for continual licensure, paying any accrued penalty fees established in part 2500.1100, subpart 3, and repairing any other deficiencies that led to the termination. 

B.
 An applicant whose license has been terminated for a period of greater than five years and who can verify continual practice elsewhere during that time must, in addition to following the procedures in item A, complete the board's jurisprudence examination. 

C.
 An applicant whose license has been terminated for a period of less than five years, and who cannot verify continual practice during that time, shall be reinstated by completing all interim continuing education that would have been required for continual licensure, completing an additional ten units of approved continuing education for each intervening renewal year, paying all accrued penalty fees and interim licensure fees required for continual licensure, and repairing any other deficiencies that led to the termination. 

D.
 An applicant whose license has been terminated for a period of greater than five years, and who cannot verify continual practice during that time, shall be reinstated by paying all accrued penalty fees and interim licensure fees that would have been required for continual licensure, repairing any other deficiencies that led to the termination, taking the board's jurisprudence examination, and completing the Special Purposes Examination in Chiropractic administered by the National Board of Chiropractic Examiners, or other examination approved by the board. 

E.
 At the election of the applicant, the board shall waive any of the continuing education requirements in items A to C upon successful completion of the Special Purposes Examination in Chiropractic administered by the National Board of Chiropractic Examiners, or any other examination approved by the board, within 12 months preceding the application. 

Any continuing education units acquired in another jurisdiction for the purposes of license renewal may be applied to item A, B, or C. None of the continuing education units obtained for the purpose of reinstating a terminated license apply to the current annual requirement. Applicants must complete a board-approved application for reinstatement. 

2500.2020INACTIVE LICENSE. 
A Minnesota licensed chiropractor may apply to the board for an inactive license according to items A to C. An inactive license is intended for those chiropractors who will be in active practice elsewhere. 

A.
 Applicants must complete a board-approved application which must include a signed affidavit stating that the applicant will no longer be actively practicing chiropractic in the state of Minnesota. 

B.
 Upon approval of an application, the board will modify the annual license certificate to indicate inactive licensure. 

C.
 The board may refuse to approve an application if: 

(1)
 a pending or final disciplinary action exists against an applicant's Minnesota license; 

(2)
 a pending or final disciplinary action exists against an applicant's license in another state where the applicant has been licensed to practice chiropractic; or 

(3)
 the applicant's Minnesota license is not current in fees and penalties paid, or in continuing education units obtained for annual license renewal. 

2500.2040 REINSTATEMENT OF INACTIVE LICENSE.  
An inactive license may be reinstated to an active license according to items A to E: 

A.
 completion of a board-approved application of reinstatement; 

B.
 payment of a reinstatement fee in the amount of $100; 

C.
 submission of a certification of good standing from each state the doctor was granted a license; 

D.
 submission of a notarized statement from the doctor stating: 

(1)
 that the doctor has remained in active practice in another state or country during the period of inactive license status in Minnesota; 

(2)
 that the doctor has met the continuing education requirements as approved by Minnesota or the states or countries in which the doctor practiced chiropractic, or has taken at least 12 units of continuing education each year of inactive license status, whichever is greater; and 

(3)
 the specific addresses of where the doctor has been in active practice; and 

E.
 completion of 20 units of continuing education as approved by the board the year prior to application for reinstatement. 

If any of the requirements of items A to E are not met by the doctor, the board will deny approval of the application for reinstatement. 

2500.2100VOLUNTARILY RETIRED LICENSE. 
Upon request of a Minnesota licensed chiropractor, the board may place a license in voluntary retirement unless: 

A.
 a pending or final disciplinary action exists against an applicant's Minnesota license; 

B.
 a pending or final disciplinary action exists against an applicant's license in another state where the applicant has been licensed to practice chiropractic; or 

C.
 the applicant's Minnesota license is not current in fees and penalties paid or in continuing education units obtained for annual license renewal. 

2500.2110 REINSTATEMENT OF VOLUNTARILY RETIRED LICENSE.  A.
 An applicant who has voluntarily retired a license may be reinstated or restored to full status by: 

(1)
 completing a board-approved application of reinstatement; 

(2)
 paying a reinstatement fee in the amount of $100; 

(3)
 submitting a certification of good standing from each state the doctor was granted a license; and 

(4)
 following one of the applicable procedures in items B to F. 

B.
 An applicant who has been voluntarily retired for a period of less than five years, and who can verify continual practice elsewhere during that time, shall be reinstated by completing all interim continuing education and paying all accrued penalty fees and interim licensure fees which would have been required for continual licensure, and repairing any deficiencies that occurred prior to retirement. 

C.
 An applicant who has been voluntarily retired for a period of greater than five years who can verify continual practice elsewhere during that time must, in addition to following the procedures in items A and B, complete the board's jurisprudence examination. 

D.
 An applicant who has been voluntarily retired for a period of less than five years, and who cannot verify continual practice during that time, shall be reinstated by completing all interim continuing education that would have been required for continual licensure, completing an additional ten units of approved continuing education for each intervening renewal year, paying all accrued penalty fees and interim licensure fees that would have been required for continual licensure, and repairing any deficiencies that occurred prior to retirement. 

E.
 An applicant who has been voluntarily retired for a period of greater than five years, and who cannot verify continual practice during that time, shall be reinstated by paying all accrued penalty fees and interim licensure fees that would have been required for continual licensure, repairing any other deficiencies that may have occurred prior to retirement, taking the board's jurisprudence examination, and completing the Special Purposes Examination in Chiropractic administered by the National Board of Chiropractic Examiners, or any other examination the board may deem appropriate. 

F.
 At the election of the applicant, the board shall waive any of the continuing education requirements in items B to D, upon successful completion of the Special Purposes Examination in Chiropractic administered by the National Board of Chiropractic Examiners, or other examination the board may deem appropriate, within the 12 months preceding the application. 

Any continuing education units acquired in another jurisdiction, for the purposes of license renewal, may be applied to items B, C, and D. None of the continuing education units obtained for the purpose of reinstating a voluntarily retired license apply to the current annual requirement. Applicants must complete a board-approved application of reinstatement. 

6800.0400ANNUAL LICENSE RENEWAL DATE AND FEES. 
Each pharmacy license shall expire on June 30 of each year and shall be renewed annually by filing an application for license renewal, on or before June 1 of each year, together with a fee established in Minnesota Statutes, chapter 151. Renewal applications received on or after July 1 are subject to a late filing fee of an amount equal to 50 percent of the renewal fee in addition to the renewal fee. 

6800.1150ANNUAL RENEWAL, FEES, AND POSTING. 
A pharmacist license expires on March 1 of each year and shall be renewed annually by filing an application for license renewal on or before February 1 of each year, together with a fee of $105. A pharmacist license renewal application received after March 1 is subject to a late filing fee of an amount equal to 50 percent of the renewal fee in addition to the renewal fee. 

A pharmacist shall post the license or renewal most recently issued by the board or a copy of it in a conspicuous place within the pharmacy in which the pharmacist is practicing. For community pharmacies, this place shall be a place which is readily visible to the public. 

9502.0300REPEALER AND EFFECTIVE DATE. Subpart 1.Repealer.  
Minnesota Rules, parts 9545.0310, 9545.0320, 9545.0330, 9545.0340, 9545.0350, 9545.0360, 9545.0370, 9545.0380, 9545.0390, 9545.0400, 9545.0410, 9545.0420, 9545.0430, 9545.0440, and 9545.0450, are repealed, except for providers who are licensed under those parts. As to those providers, parts 9545.0310, 9545.0320, 9545.0330, 9545.0340, 9545.0350, 9545.0360, 9545.0370, 9545.0380, 9545.0390, 9545.0400, 9545.0410, 9545.0420, 9545.0430, 9545.0440, and 9545.0450 are repealed March 25, 1986. 

Subp. 2.Effective date.  
Parts 9502.0315 to 9502.0445 take effect April 1, 1985, except for providers who are licensed on April 1, 1985 under parts 9545.0310 to 9545.0440. As to those providers, parts 9502.0315 to 9502.0445 take effect October 1, 1985, or on the first date the provider's license is renewed after March 25, 1985, whichever is later, except that parts 9502.0365 and 9502.0367 shall be construed not to require the exclusion from the day care facility of any child who is receiving care on March 25, 1985. 

Any provider who is licensed under parts 9545.0310 to 9545.0440 April 1, 1985, and who is not providing care in a residence as defined by part 9502.0315, subpart 27, may be licensed under parts 9502.0315 to 9502.0445 until the provider ceases to give care in that facility or obtains a license to operate a day care center. 

9502.0315DEFINITIONS. Subpart 1.Applicability.  
As used in parts 9502.0315 to 9502.0445, the following terms have the meanings given them. 

Subp. 2.Adult.  
"Adult" means a person at least 18 years of age. 

Subp. 3.Agency.  
"Agency" means the county or multicounty social or human service agency governed by the county board or multicounty human services board. 

Subp. 4.Applicant.  
"Applicant" means the person seeking a license to be the primary provider of day care in the residence. 

Subp. 5.Building official.  
"Building official" means the person appointed in accordance with Minnesota Statutes, section 326B.133, to administer the State Building Code, or the building official's authorized representative. 

Subp. 6.Caregiver.  
"Caregiver" means the provider, substitute, helper, or another adult giving care in the residence. 

Subp. 7.Child.  
"Child" means a person ten years of age or younger. 

Subp. 8.Commissioner.  
"Commissioner" means the Minnesota commissioner of the Department of Human Services or the commissioner's authorized representative. 

Subp. 9.Day care.  
"Day care" means the care of a child in a residence outside the child's own home for gain or otherwise, on a regular basis, for any part of a 24 hour day. 

Subp. 10.Department.  
"Department" means the Minnesota Department of Human Services. 

Subp. 11.Family day care.  
"Family day care" means day care for no more than ten children at one time of which no more than six are under school age. The licensed capacity must include all children of any caregiver when the children are present in the residence. 

Subp. 12.Fire marshal.  
"Fire marshal" means the person designated by Minnesota Statutes, section 299F.011 to administer and enforce the State Fire Code, or the fire marshal's authorized representative. 

Subp. 13.Group family day care.  
"Group family day care" means day care for no more than 14 children at any one time. The total number of children includes all children of any caregiver when the children are present in the residence. 

Subp. 14.Helper.  
"Helper" means a person at least 13 years of age and less than 18 years of age who assists the provider with the care of children. 

Subp. 15.Agent of a community health board.  
"Agent of a community health board" as authorized under Minnesota Statutes, section 145A.04, means the designated representative of the state or community health board authorized to enforce state and local health codes. 

Subp. 16.Infant.  
"Infant" means a child who is at least six weeks of age but less than 12 months of age. 

Subp. 17.License.  
"License" means a certificate issued by the commissioner authorizing the provider to give specified services for a specified period of time in accordance with the terms in parts 9502.0315 to 9502.0445; Minnesota Statutes, chapter 245A; and the rules of the department. 

Subp. 18.Licensed capacity.  
"Licensed capacity" means the total number of children ten years of age or younger permitted at any one time in the residence. The licensed capacity includes all children of any caregiver when the children are present in the residence. 

Subp. 19.Medicine.  
"Medicine" means a prescription or nonprescription substance taken internally or applied externally to prevent or cure disease, heal, or relieve pain. 

Subp. 19a.Mental illness.  
"Mental illness" means the inability to interpret reality realistically and the impaired functioning in primary aspects of daily living, such as personal relations, living arrangements, work, and recreation; which is listed in the International Classification of Diseases (ICD-9-CM) Ninth Revision (1980), code range 290.0-299.9, or the corresponding code in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) Third Edition (1980), Axes I, II, or III. These publications are incorporated by reference and are not subject to frequent change. They are available in the State Law Library. 

Subp. 19b.State Fire Code.  
"State Fire Code" means those codes and regulations adopted by the state fire marshal in accordance with Minnesota Statutes, section 299F.011 and contained in chapter 7511. 

Subp. 20.Newborn.  
"Newborn" means a child between birth and six weeks of age. 

Subp. 21.Parent.  
"Parent" means a person who has the legal responsibility for a child such as the child's mother, father, or legally appointed guardian. 

Subp. 22.Preschooler.  
"Preschooler" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 19, paragraph (e). 

Subp. 23.
[Repealed, 10 SR 2617] 

Subp. 24.Provider.  
"Provider" means the license holder and primary caregiver. 

Subp. 25.Related.  
"Related" means any of the following relationships by marriage, blood, or adoption: parent, grandparent, brother, sister, stepparent, stepsister, stepbrother, uncle, aunt, child, niece, nephew. Related also includes a legally appointed guardian. 

Subp. 26.Regularly or regular basis.  
"Regularly" or "regular basis" means a cumulative total of more than 30 days within any 12 month period. 

Subp. 27.Residence.  
"Residence" means the dwelling unit, as defined by section 405 of the State Building Code, in which day care is provided and which is occupied as a home. 

Subp. 28.School age.  
"School age" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 19, paragraph (f). 

Subp. 28a.State Building Code.  
"State Building Code" means those codes and regulations adopted by the commissioner of administration in accordance with Minnesota Statutes, section 326B.101 and contained in chapter 1300. 

Subp. 29.Substitute.  
"Substitute" means an adult at least 18 years of age who assumes the responsibility of the provider as specified in part 9502.0365, subpart 5. 

Subp. 29a.Supervision.  
"Supervision" means a caregiver being within sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver is capable of intervening to protect the health and safety of the child. For the school age child, it means a caregiver being available for assistance and care so that the child's health and safety is protected. 

Subp. 30.Toddler.  
"Toddler" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 19, paragraph (d). 

Subp. 31.Variance.  
"Variance" means written permission by the commissioner for a provider or applicant to depart from the provisions of parts 9502.0315 to 9502.0445. 

9502.0325LICENSING OF FACILITIES FOR CHILDREN FAMILY DAY CARE AND GROUP FAMILY DAY CARE HOMES. Subpart 1.Purpose.  
The purpose of parts 9502.0315 to 9502.0445 is to establish procedures and standards for licensing family day care and group family day care homes to ensure that minimum levels of care and service are given and the protection, proper care, health, safety, and development of the children are assured. 

Subp. 2.Applicability.  
Parts 9502.0315 to 9502.0445 as authorized by Minnesota Statutes, chapter 245A, govern the licensing of family day care homes and group family day care homes. 

Subp. 3.Exclusion from licensure.  
Under Minnesota Statutes, section 245A.03, the following day care situations are excluded from licensure under parts 9502.0315 to 9502.0445: 

A.
 day care provided by a relative to only related children; or 

B.
 day care provided to children from a single, unrelated family, for any length of time; or 

C.
 day care provided for a cumulative total of less than 30 days in any 12-month period; or 

D.
 the exclusions contained in items A and B are mutually exclusive. 

9502.0335LICENSING PROCESS. Subpart 1.License application.  
A license to operate a family or group family day care residence must be obtained from the department. 

A.
 Application for a license must be made on the application form issued by the department. The application must be made in the county where the applicant resides. 

B.
 The applicant shall be the person who will be the provider of care in the residence, present during the hours of operation, and who shall be legally responsible for the operation of the residence. 

C.
 An application for licensure is complete when the applicant completes, signs, and submits all department forms and documentation needed for licensure to the agency and the agency receives all inspection, zoning, evaluation, and investigative reports, documentation, and information required to verify compliance with parts 9502.0315 to 9502.0445 and Minnesota Statutes. 

Subp. 2.Licensing study.  
The applicant shall give the agency access to the residence for a licensing study to determine compliance with parts 9502.0315 to 9502.0445. 

A.
 If, in the judgment of the agency representative, a potentially hazardous condition may be present, due to a violation of parts 9502.0315 to 9502.0445, the applicant shall obtain an inspection from a fire marshal, building official, or agent of a community health board as authorized under Minnesota Statutes, section 145A.04 to verify the absence of hazard and report to the agency. 

B.
 The residence must comply with any applicable local ordinances. If the commissioner or the agency has reasonable cause to believe a hazardous condition may be present and requests an inspection by a fire marshal, building official, or authorized agent, then any condition cited by a fire marshal, building official, or authorized agent as hazardous and creating an immediate danger of fire, or threat to human life and safety, must be corrected or a variance approved in accordance with subparts 8, 8a, and 8b prior to issuance of a license. 

C.
 An initial inspection of the residence by a fire marshal to determine compliance with the State Fire Code and compliance with orders issued are conditions of licensure for all residences with freestanding solid fuel heating appliances; manufactured (mobile) homes; new applicants for licensure with a licensed capacity of more than ten; day care residences which use the basement for child care; and residences in mixed or multiple occupancy buildings. "Multiple occupancy building" means a structure with two or more residential dwelling units such as a duplex, apartment building, or townhome. "Mixed occupancy building" means a residence in a structure that contains nonresidential occupancies or an attached garage. 

D.
 The commissioner or agency may require, prior to licensure, or anytime during the licensed term of day care, a physical, mental illness, or chemical dependency or abuse evaluation of any caregiver or person living in the residence or present during the hours children are in care if the agency has reasonable cause to believe that any of the disqualification factors in subpart 6, item A, exist, or that the provider is not physically able to care for the children. These evaluations, conducted by a licensed physician, psychiatrist, psychologist, consulting psychologist, or certified chemical dependency practitioner or counselor may be used to verify physical or mental illness, chemical dependency or chemical abuse, or behavior that would reflect on the ability of the provider to give day care. 

Subp. 3.
[Repealed, 15 SR 2105] 

Subp. 4.Period of licensure; nontransfer.  
A license must be issued by the department when the provider fully complies with parts 9502.0315 to 9502.0445. The period of licensure may be up to two years. The license must not be transferred to another provider. 

Subp. 5.Initial license.  
An applicant for initial licensure may be granted a license by the department for up to two years if all laws and rules cannot be met immediately, the deviations from parts 9502.0315 to 9502.0445 do not threaten the health, rights, or safety of the children, and which will be corrected within the time specified by the commissioner but not to exceed two years. Failure to correct deviations within the stated time shall be cause for revocation, suspension, or nonrenewal. 

Subp. 6.Disqualification factors.  
An applicant or provider shall not be issued a license or the license shall be revoked, not renewed, or suspended if the applicant, provider, or any other person living in the day care residence or present during the hours children are in care, or working with children: 

A.
 Abuses prescription drugs or uses controlled substances as specified in Minnesota Statutes, chapter 152, or alcohol, to the extent that the use or abuse has or may have a negative effect on the ability of the provider to give care or is apparent during the hours children are in care. Caregivers who have abused prescription drugs or have been dependent on controlled substances as specified in Minnesota Statutes, chapter 152, or alcohol, such that the use, abuse, or dependency has had a negative effect on the ability to give care, was apparent during the hours children are in care, or required treatment or therapy, must have 12 months of verified abstinence before licensure. 

B.
 [Repealed, L 1991 c 38 s 2] 

C.
 Refuses to give written consent for the disclosure of criminal history records as specified in Minnesota Statutes, section 245C.09. 

D.
 Has a disqualification under Minnesota Statutes, section 245C.15, that is not set aside under Minnesota Statutes, section 245C.22, or for which a variance has not been granted under Minnesota Statutes, section 245C.30. 

E.
 Has had a child placed in foster care within the past 12 months and the agency determines the reasons for placement reflect on the ability of the provider to give care. A license may not be denied if the primary reason for the placement was due to a physical illness of the parent, developmental disability of the child, a disability of the child, or for the temporary care of an infant being relinquished for adoption. 

F.
 Has had a child placed in residential treatment within the past 12 months for emotional disturbance or antisocial behavior and the agency determines that the reasons for the placement reflect on the ability of the provider to give care. 

Subp. 7.
[Repealed, 15 SR 2043] 

Subp. 8.Variance standard.  
An applicant or provider may request a variance from compliance with parts 9502.0315 to 9502.0445. When reviewing a variance request of parts 9502.0315 and 9502.0445, the department shall assess whether alternative methods are identified by the applicant or provider to ensure the health, safety, and protection of children in care. A variance may be granted only if: 

A.
 the applicant complies with all applicable laws, ordinances, and regulations; 

B.
 specific equivalent measures are identified by the applicant or provider to ensure the health, safety, and protection of the children in care; 

C.
 any variance to the safety provisions in part 9502.0425, subparts 4, 5, 6, 7, 12, 15, 16, 17, and 18 which relate to the State Fire Code is approved by a fire marshal and alternative measures are identified to ensure the safety of children in care; 

D.
 any variance of the provisions in part 9502.0435 relating to sanitation and health and part 9502.0445 on water, food, and nutrition are approved by an authorized agent and alternative measures are identified to ensure the health of children in care; 

E.
 any variance of the provisions in part 9502.0425 relating to subparts 10, stairways; 11, decks; and 13, sewage disposal which relate to the State Building Code, are approved by a building official and alternative measures are identified to ensure the health and safety of children in care; and 

F.
 any variance to subpart 6, item F must have clear and convincing evidence presented by the applicant or provider that no threat or harm whatsoever will result to the children in care due to the granting of the variance. The department shall consider the nature of the crime committed and the amount of time which has elapsed without a repeat of the crime. 

Subp. 8a.Variance procedure.  
Request for a variance must comply with and be handled according to the following procedures. 

A.
 An applicant or provider must submit to the agency a written request for a variance. The request must include the following information: 

(1)
 the sections of parts 9502.0315 to 9502.0445 with which the applicant or provider cannot comply; 

(2)
 the reasons why the applicant or provider needs to depart from the specified sections; 

(3)
 the period of time for which the applicant or provider requests a variance; and 

(4)
 the specific equivalent alternative measures which the applicant or provider will provide so the health, safety, and protection of children in care are ensured if the variance is granted. 

B.
 An applicant or provider must submit to the agency written approval from a fire marshal of a variance request and the alternative measures identified to ensure the safety of children in care when a variance of the fire safety provisions in part 9502.0425 on physical environment is requested. These are part 9502.0425, subpart 4, means of escape; subpart 5, occupancy separations; subpart 6, vertical separations; subpart 7, heating and venting systems; subpart 12, locks and latches; subpart 15, interior walls and ceilings; subpart 16, extinguishers; subpart 17, smoke detection systems; and subpart 18, electrical services. 

C.
 An applicant or provider must submit to the agency written approval from an authorized agent of a variance request and the alternative measures identified to ensure the safety of children in care when a variance of the health provisions in parts 9502.0435 on sanitation and health, and 9502.0445 on water, food, and nutrition is requested. 

D.
 An applicant or provider must submit to the agency written approval from a building official of a variance request and alternative measures identified to ensure the health and safety of children in care when a variance is requested of the standards contained in part 9502.0425 relating to subparts 10, stairways; 11, decks; and 13, sewage disposal. 

Subp. 8b.
[Repealed, 30 SR 585] 

Subp. 9.License terms.  
The license must indicate: 

A.
 the number and age groupings of children who may receive care at any one time; 

B.
 the expiration date of the license and location of the residence; 

C.
 the name and address of the provider; and 

D.
 that the provider is licensed under parts 9502.0315 to 9502.0445 of Minnesota Rules. 

Subp. 10.Posting license.  
The provider shall post the license in the residence in a prominent place. 

Subp. 11.Change in license terms.  
The following shall apply to changes in the terms of a license. 

A.
 A new department application form must be submitted by the provider and a full licensing study as specified in part 9502.0335, subpart 2, must be completed when the provider wants to move the day care operation to a new residence or the provider wants to change to group family day care from family day care. 

B.
 A new department application form indicating the changes in the ages and numbers of children in care must be completed when the provider wants to change to family day care from group family day care. 

C.
 A background study must be initiated and completed as required under Minnesota Statutes, chapter 245C. 

Subp. 12.Number of licenses.  
No provider shall be issued a license to operate more than one day care residence. 

Subp. 13.Access to residence.  
The provider shall give authorized representatives of the commissioner or agency access to the residence during the hours of operation to determine whether the residence complies with the standards of parts 9502.0315 to 9502.0445. Access shall include: 

A.
 the residence to be occupied by children in care; 

B.
 any adjoining land or buildings owned or operated by the applicant or provider in conjunction with the provision of day care and designed for use by the children in care; 

C.
 noninterference in interviewing all caregivers and household members present in the residence on a regular basis and present during the hours of operation; and 

D.
 the right to view and photocopy the records and documents specified in part 9502.0405. 

Subp. 14.
[Repealed, 15 SR 2105] 

Subp. 15.Return of license to commissioner.  
When a provider stops giving care, or if a license is revoked, suspended, or not renewed, the provider shall return the license to the commissioner, stop all advertising and refrain from providing care to children in excess of the exclusions specified in part 9502.0325, subpart 3. 

Subp. 16.
[Repealed, 15 SR 2105] 

9502.0341NEGATIVE LICENSING ACTIONS. Subpart 1.
[Repealed, 15 SR 2105] 

Subp. 2.Definitions.  
For the purposes of this subpart, negative licensing actions shall mean denial of application for licensure, issuance of a fine, revocation, suspension, or temporary immediate suspension of an existing license. 

Subp. 3.Procedures.  
In accordance with Minnesota Statutes, section 245A.06 or 245A.07, failure to comply with parts 9502.0315 to 9502.0445 or the terms of licensure is grounds for a negative licensing action. If the agency recommends a negative licensing action, the agency shall notify the department and the department shall determine if the standards in parts 9502.0315 to 9502.0445 or the terms of licensure have been violated. If the grounds are sufficient, the commissioner shall notify the applicant or provider by certified mail unless personal service is required by subpart 9. The notice must be addressed to the name and location shown on the application or license and contain a statement of, and the reasons for, the proposed action. The notice must inform the applicant or provider of the right to appeal the decision within the specified time period. The applicant or provider shall be notified of the specific appeal rights provided under chapter 245A. 

Subp. 3a.Fine.  
If the commissioner issues a fine, the provider must be informed of the reason for the fine and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivision 3. 

Subp. 4.Denial.  
If the commissioner denies an application for licensure, the applicant must be informed of the reason the application was denied and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.05. 

Subp. 5.Revocation.  
If the commissioner revokes a license, the provider must be informed of the reason for the revocation and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivision 3. 

Subp. 6.
[Repealed, 30 SR 585] 

Subp. 7.
[Repealed, 30 SR 585] 

Subp. 8.Suspension.  
If the commissioner suspends a license, the provider must be informed of the reason for the suspension and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivision 3. 

Subp. 9.Temporary immediate suspension.  
If the provider's actions or failure to comply with applicable law or rule poses an imminent risk of harm to the health, safety, or rights of the children in care, the commissioner shall act immediately to temporarily suspend the license. The provider shall be informed by personal service and informed of the right to an expedited hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivisions 2 and 2a. 

Subp. 9a.
[Repealed, 15 SR 2105] 

Subp. 10.Notice to parents of recommended action.  
As soon as the county recommends revocation, suspension, a conditional license, or temporary immediate suspension action, a notice of the circumstances for the action, but not the identity of a child, other than the parent's own, shall be sent by the agency to the parents of children in care. If the provider remains in operation and exercises a right to a hearing, the provider must give a copy of the Notice of and Order for Hearing on the appeal to the parents of any child currently enrolled or seeking admission to the residence. 

Subp. 11.Reapplication after revocation or denial.  
A provider whose license has been revoked because of noncompliance with applicable laws or rules, shall not be granted a new license for five years following revocation. When the commissioner initiates an action to revoke a license, the provider may not voluntarily withdraw his or her license without written assurance from the provider that he or she is voluntarily accepting revocation and will not reapply for five years. An applicant whose application was denied shall not be granted a new license for two years following a denial, unless the applicant's subsequent application contains new information which constitutes a substantial change in the condition that caused the previous denial. 

9502.0345AGENCY RECORDS. Subpart 1.Agency records.  
The agency shall maintain the following records for each provider: 

A.
 A copy of the completed licensing application form signed by the applicant and the agency. 

B.
 The physical health reports on any adult giving care in the residence on a regular basis. 

C.
 Any written reports from the fire marshal, agent of a community health board as authorized under Minnesota Statutes, section 145A.04, or building official. 

D.
 The agency's initial and any renewal licensing studies. 

E.
 If the applicant has been licensed through another jurisdiction, the agency shall request and keep a reference from the licensing authority in that jurisdiction. 

F.
 The annual relicensing evaluation by the agency of the provider. Any comments of the provider about the evaluation by the agency shall also be noted in the agency record. 

G.
 Documentation of any variances of parts 9502.0315 to 9502.0445. 

H.
 Arrest, conviction, or criminal history information and substantiated maltreatment information used to disqualify an individual required to have a background study under Minnesota Statutes, chapter 245C. 

Subp. 2.Data privacy.  
The agency, department, and the authorized agent shall have access to provider records on children in care to determine compliance with parts 9502.0315 to 9502.0445. The provider shall not disclose any records on children in care to any persons other than the parents of the child, the agency, the department, the persons required by part 9502.0375, subpart 1, and medical or public safety persons if information is necessary to protect the health and safety of the child. 

9502.0355CAREGIVER QUALIFICATIONS. Subpart 1.Age.  
An applicant for family day care or group family day care shall be an adult at the time of licensure. 

Subp. 2.Health.  
An adult caregiver shall be physically able to care for children. 

A.
 The applicant shall supply documentation to the agency with the license application that the applicant has had a physical examination from a licensed physician within 12 months prior to initial licensure and is physically able to care for children. 

B.
 The applicant shall supply documentation to the agency with the license application that all adult caregivers who are assisting with care on a regular basis have had a physical examination from a licensed physician within 12 months prior to employment within the residence and are physically able to care for children. 

Subp. 3.Group family day care.  
A group family day care applicant shall meet all the requirements listed in subparts 1 and 2 for family day care. A group family day care applicant shall also meet the qualifications in item A, B, or C. 

A.
 A minimum of one years' substantial compliance with parts 9502.0315 to 9502.0445 as a licensed family day care provider; or 

B.
 A minimum of six months' substantial compliance with parts 9502.0315 to 9502.0445 as a licensed family day care provider; and 

(1)
 completion of an accredited competency based family day care training and assessment program offered by an accredited institute; or 

(2)
 thirty hours of child care, health, and nutrition training as specified in part 9502.0385, and a minimum of 520 hours of experience as an assistant teacher, student teacher, or intern in an elementary school or licensed child care center, or as an assistant adult caregiver in a licensed group family day care home; or 

(3)
 thirty hours of child development or early childhood education training, as specified in part 9502.0385, and a minimum of 520 hours of experience as a licensed practical or registered nurse; or 

C.
 Certification or licensure indicating: 

(1)
 completion of a two year child development or early childhood education associate or certificate program at an accredited college or university; 

(2)
 completion of a nine month child development assistant program at an accredited technical college; 

(3)
 a current Level I or Level II prekindergarten license from the Department of Education; 

(4)
 a kindergarten through sixth grade teaching degree from an accredited university or college that includes a minimum of 30 hours of child development training; or 

(5)
 documentation of a minimum of six months satisfactory experience as a full-time teacher at a state licensed group day care center. 

Subp. 3a.Accredited.  
For the purposes of this part, "accredited" means a postsecondary institution or technical college recognized and listed by a regional, state, or national group approved by the department. To be approved, a group must meet the following criteria: 

A.
 it must be capable of conducting site visits to evaluate the facilities used by the program; 

B.
 it must be capable of evaluating the quality of the program and its faculty; 

C.
 it must have standards which ensure that persons who complete the program have the knowledge and training to work as group family day care providers; and 

D.
 it must not be affiliated with any individual program, postsecondary institution, or technical college. 

Subp. 4.Day care insurance coverage.  
A provider shall have: 

A.
 a certificate of insurance for the residence for general liability coverage for bodily injury in the amount of at least $100,000 per person and $250,000 per occurrence; or 

B.
 if the provider has liability coverage of lesser limits or no liability coverage, the provider shall give a written notice of the level of liability coverage to parents of all children in care prior to admission or when there is a change in the amount of insurance coverage; and 

C.
 the provider shall maintain copies of the notice, signed by the parents to indicate they have read and understood it, in the provider's records on the residence as specified in part 9502.0405. 

9502.0365LICENSED CAPACITY, CHILD/ADULT RATIOS, AGE DISTRIBUTION RESTRICTIONS. Subpart 1.Capacity limits.  
Family day care and group family day care providers shall comply with part 9502.0367, which limits the total number of children and the number of preschoolers, toddlers, and infants who may be in care at any one time, and provides for the number of adults who are required to be present. 

A.
 Providers shall be licensed for the total number of children, ten years of age or younger, who are present in the residence at any one time. The licensed capacity must include all children of any caregiver when the children are present in the residence. 

B.
 Within the licensed capacity, the age distribution restrictions specify the maximum number of children under school age, infants, and toddlers who are in care at any one time. 

Subp. 2.Specialized infant and toddler group family day care.  
In specialized infant and toddler group family day care, the caregivers must be adults. 

Subp. 3.Newborn care.  
When a newborn is in care and only one adult caregiver is present, the newborn shall be the only child under 12 months of age and the provider shall not care for more than two other children at the same time unless another adult caregiver is also present or the newborn is the provider's own. 

Subp. 4.Helpers.  
A helper may be used in place of a second adult caregiver when there is no more than one infant or toddler present. 

Subp. 5.Supervision and use of substitutes.  
A licensed provider must be the primary provider of care in the residence. Children in care must be supervised by a caregiver. The use of a substitute caregiver must be limited to a cumulative total of not more than 30 days in any 12-month period. 

9502.0367CHILD/ADULT RATIOS; AGE DISTRIBUTION RESTRICTIONS. A.
 Family Day Care: 

	Child/Adult Ratio	Age Restrictions	
	Licensed Capacity	Adults	Total children under school age	Total infants and toddlers	
					
	10	1	6	Of the total children under school age, a combined total of no more than 3 shall be infants and toddlers. Of this total, no more than 2 shall be infants.	
B.
 Specialized Infant and Toddler Family Day Care: 

	(1) 5	1	3	No more than 3 shall be infants.	
					
	(2) 6	1	4	No more than 2 shall be infants.	
C.
 Group Family Day Care: 

	(1) 10	1	8	Of the total children under school age, a combined total of no more than 3 shall be infants and toddlers. Of this total, no more than 2 shall be infants.	
					
	(2) 12	1	10	Of the total children under school age, a combined total of no more than 2 shall be infants and toddlers. Of this total, no more than 1 shall be an infant.	
					
	(3) 14	2	10	Of the total children under school age, a combined total of no more than 4 shall be infants and toddlers. Of this total, no more than 3 shall be infants.	
	A helper may be used in place of a second adult caregiver when there is no more than 1 infant or toddler present.			
D.
 Specialized Infant and Toddler Group Family Day Care: 

	9	2	7	Of the total children, no more than 4 shall be infants.	
	Both caregivers shall be adults.			
9502.0375REPORTING TO AGENCY. Subpart 1.Abuse, neglect reporting.  
All caregivers shall report any suspected physical abuse, sexual abuse, or neglect of a child to the agency or police as required by Minnesota Statutes, chapter 260E. If a caregiver has reasonable cause to believe a child has died as a result of physical or sexual abuse or neglect, the caregiver shall report this information to the county medical examiner or coroner. 

Subp. 2.Other reporting.  
The provider shall inform the agency: 

A.
 within 30 days of any change in the regular membership of the household within the day care residence or the addition of an employee who will regularly be providing care; 

B.
 immediately of any suspected case of physical or sexual abuse or neglect; 

C.
 within 48 hours after the occurrence of a fire that requires the service of a fire department so the agency may determine continued substantial compliance with parts 9502.0315 to 9502.0445; and 

D.
 immediately after the occurrence of any serious injury or death of a child within the day care residence. A serious injury is one that is treated by a physician. 

9502.0395BEHAVIOR GUIDANCE. Subpart 1.Methods.  
Caregivers shall give each child guidance which helps the child acquire a positive self-concept, self-control, and teaches acceptable behavior. 

A.
 The provider shall discuss methods of behavior guidance with parents at the time of admission and the parent's standards shall be considered by the provider within the context of this part when guiding the behavior of a child. 

B.
 Behavior guidance used by caregivers must be constructive, positive, and suited to the age of the child. Methods of intervention, guidance, and redirection must be used. 

Subp. 2.Standards.  
The following shall apply to all caregivers when guiding behavior in children. 

A.
 No child shall be subject to corporal punishment or emotional abuse. "Corporal punishment" means the nonaccidental infliction of physical pain on a child by a caregiver. Corporal punishment includes, but is not limited to, rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking. "Emotional abuse" means the infliction of verbal or psychological abuse on a child by a caregiver. Emotional abuse includes, but is not limited to, name calling, ostracism, shaming, derogatory remarks about the child or child's family, and threats which threaten, humiliate, or frighten the child. 

B.
 Food, light, warmth, clothing, and medical care shall not be withheld from the child. 

C.
 Discipline and punishment shall not be delegated to another child. 

D.
 The separation of a child from a group to guide behavior must be appropriate to the age of the child and circumstances requiring the separation. 

E.
 An infant shall not be separated from the group for disciplinary reasons. 

F.
 A child shall not be separated from the group for a period longer than ten minutes. 

G.
 A child separated from the group must be placed in an area or separate room that is well-lighted, free from hazards, ventilated, and open to the view of caregivers. 

H.
 No child shall be placed in a locked room to separate the child from the group. 

Subp. 3.Toilet training.  
If toilet training is undertaken, the provider and parent shall cooperatively develop a plan for the timing and method of training. 

A.
 No child shall be punished for toileting accidents. 

B.
 A child shall be offered opportunity for toileting. 

9502.0405ADMISSIONS; PROVIDER RECORDS; REPORTING. Subpart 1.Cooperating with parents.  
When admitting a child to day care, the provider and parents shall discuss child rearing, sleeping, feeding, and behavior guidance practices essential for the care of the child. 

Subp. 2.Rule summary for parents.  
A descriptive summary of parts 9502.0315 to 9502.0445 shall be distributed to the parent by the provider at the time a child is admitted to care. The summary shall be provided by the department to the agency for distribution to the provider. The summary shall be written in language that is understandable to the general public and: 

A.
 state that parts 9502.0315 to 9502.0445 govern the licensing of day care residences; 

B.
 specify the rule part headings contained in parts 9502.0315 to 9502.0445; and 

C.
 state that a complete copy of parts 9502.0315 to 9502.0445 may be seen at the day care residence, the agency, department, or State Law Library, or purchased from the Print Communications Division, Department of Administration, State of Minnesota, 117 University Avenue, Saint Paul, Minnesota 55155. 

Subp. 3.Provider policies.  
The provider shall have the following written information available for discussion with parents or the agency: 

A.
 the ages and numbers of children in care in the residence; 

B.
 the hours and days of operation; 

C.
 meals and snacks to be served; 

D.
 labeling requirements for food brought from the child's home; 

E.
 sleeping and rest arrangements; 

F.
 nondiscrimination practices to comply with subpart 6; 

G.
 policies for the care of ill children, disease notification procedures, immunizations, and medicine permission policies; 

H.
 emergency, fire, and storm plans and the monthly fire drill log; 

I.
 seat belt and transportation plans and field trip and transportation permission requirements; 

J.
 fees; 

K.
 termination and notice procedures; 

L.
 plans for a helper and substitute for emergencies, vacations, or holidays; 

M.
 the presence of pets in the residence; 

N.
 a complete copy of parts 9502.0315 to 9502.0445; 

O.
 insurance coverage; and 

P.
 whether or not smoking is permitted in the residence during the hours children are in care. 

Subp. 4.Records for each child.  
The provider shall obtain the information required by items A to C from parents prior to admission of a child. The provider shall keep this information up-to-date and on file for each child. 

A.
 The signed and completed admission and arrangements form of the department must be on file in the provider's home and contain the following information: 

(1)
 Name and birthdate of the child. 

(2)
 Full name of parents. 

(3)
 Home address, work address, and telephone numbers where parents may be reached. 

(4)
 Name, address, and telephone number of physician, dentist, and hospital to be used for emergencies when parents cannot be reached. 

(5)
 Name, address, and telephone number of persons to be notified in case of emergency, when parents cannot be reached. 

(6)
 Names of all persons authorized to remove the child from the residence. 

(7)
 Enrollment dates. 

(8)
 Financial arrangements. 

(9)
 Insurance notification specified in part 9502.0355, subpart 4. 

B.
 Special instructions from the parent shall be obtained in writing and followed about toilet training, eating, sleeping or napping, allergies, and any health problems. 

C.
 Immunization records must be kept in accordance with Minnesota Statutes, section 121A.15. The provider shall request, update, and keep on file the dates of immunizations received by a child in regular attendance at the residence as follows: 

(1)
 for an infant, every six months; 

(2)
 for a toddler, annually; 

(3)
 for a preschool child, every 18 months; and 

(4)
 for a school-age child, every three years. 

D.
 Signed written consent must be obtained in advance from the parent so the provider can obtain emergency medical care or treatment. The consent may be used if the parent cannot be reached or is delayed in arriving. 

E.
 Written permission to transport children must be obtained from parents if the provider will be transporting a child. 

F.
 A provider shall release a child from care only to a parent or a person authorized by the parent. 

Subp. 5.Children with disabilities.  
For children with disabilities requiring special therapy, program, or behavior guidance, the parents, physician, or therapist shall provide and the provider shall follow written instructions for any special needs. "Child with a disability" means a child who has been determined by a physician, a school district multidisciplinary team, or other person licensed to identify disabling conditions, to have a hearing, mental, neurological, developmental, serious emotional, social, learning, speech or language, physical, or visual impairment. 

Subp. 6.Nondiscrimination.  
No caregiver shall discriminate in relation to admissions on the basis of race, creed, color, national origin, religion, or sex. 

9502.0415ACTIVITIES AND EQUIPMENT. Subpart 1.General activities.  
Day care activities must provide for the physical, intellectual, emotional, and social development of the child. The environment must facilitate the implementation of the activities. Activities must: 

A.
 be scheduled indoors and outdoors, weather permitting; 

B.
 be appropriate to the developmental stage and age of the child; 

C.
 include active and quiet activity; and 

D.
 contain provider-directed and child-initiated activity. 

Subp. 2.
[Repealed, 10 SR 2617] 

Subp. 3.Equipment.  
The provider must have the equipment specified in this part in adequate quantities for the number and ages of children in care and to carry out the activities specified in this part. Equipment may be new, used, commercial, or homemade, as long as it is appropriate for the ages of the children and activities for which it will be used, safe, and in good repair. 

Subp. 4.Newborn or infant activities.  
The provider shall: 

A.
 Hold the infant or newborn during bottle feedings until the child can hold its own bottle. Bottles must not be propped. 

B.
 Respond to the infant or newborn's attempts to communicate. 

C.
 Provide freedom of movement to the infant or newborn during a large part of the waking day to the extent that safety and weather permits. The noncreeping child shall spend part of each day out of a crib or infant seat. The creeping infant or newborn shall have freedom to explore outside of the crib or infant seat. 

D.
 Give the infant or newborn opportunity to stimulate the senses by providing a variety of activities and objects to see, touch, feel, smell, hear, and taste. 

E.
 Provide activities for the infant or newborn that develop the child's manipulative and fine motor skills, self-awareness, and social responsiveness. 

Subp. 5.Newborn or infant equipment.  
The following minimum equipment is required for each infant or newborn: 

A.
 an infant seat or high chair; and 

B.
 a crib, portable crib, or playpen with waterproof mattress or pad which meets the requirements in part 9502.0425, subpart 9. 

Subp. 6.Toddler activities.  
The provider shall: 

A.
 Provide the toddler with freedom of movement and freedom to explore outside the crib or playpen. 

B.
 Talk to, listen to, and interact with the toddler to encourage language development. 

C.
 Provide the toddler with large muscle activities and activities which develop the child's small muscles and manipulative skills. 

D.
 Develop and stimulate learning by reading stories to the child or looking at picture books together. 

E.
 Give the toddler opportunities to stimulate the senses by providing a variety of age-appropriate activities and objects to see, touch, feel, smell, hear, and taste. 

Subp. 7.Toddler equipment.  
Each toddler shall be provided with a mat, crib, cot, bed, sofa, or sleeping bag. 

Subp. 8.Preschooler activities.  
The provider shall: 

A.
 Encourage conversation between the child and other children and adults. 

B.
 Provide opportunity to play near and with other children; provide time and space for individual and group play; allow for quiet times to talk or rest; allow for unplanned time and individual play time. 

C.
 Foster understanding of personal and peer feelings and actions and allow for the constructive release of feelings and anger through discussion or play. 

D.
 Give assistance in toileting and provide time to carry out self-help skills and provide opportunity to be responsible for activities like putting away play equipment and helping around the house. 

E.
 Provide opportunity for each child to make decisions about daily activities and to take credit for the consequences of decisions. 

F.
 Provide time and areas for age appropriate large muscle play. 

G.
 Provide learning, small muscle, manipulative, creative or sensory activities. 

H.
 Read stories, look at books together, and talk about new words and ideas with the child. 

Subp. 9.Preschooler equipment.  
Each preschooler shall be provided with a mat, bed, cot, sofa, or sleeping bag. 

Subp. 10.School-age activities.  
The provider shall: 

A.
 provide opportunities for individual discussion about the happenings of the day and planning for activities; 

B.
 provide space and opportunity for games, activities, or sports using the whole body, outdoors, weather permitting; 

C.
 provide space and opportunity for individual rest and quiet time; 

D.
 allow increased freedom as the child demonstrates increased responsibility; 

E.
 provide opportunities for group experiences with other children; 

F.
 provide opportunities to develop or expand self-help skills or real-life experiences; and 

G.
 provide opportunities for creative and dramatic activity, arts and crafts, or field trips. 

Subp. 11.
[Repealed, 10 SR 2617] 

Subp. 12.Written permission.  
Written permission must be obtained from the parent to allow a school-age child in care to participate in activities away from the residence. 

9502.0425PHYSICAL ENVIRONMENT. Subpart 1.Indoor space.  
The licensed capacity of the day care residence must be limited by the amount of usable indoor space available to children. A minimum of 35 square feet of usable indoor space is required per child. 

A.
 Bathrooms, closets, space occupied by major appliances, and other space not used by children may not be counted as usable space. Space occupied by adult furniture, if it is used by children, may be counted as usable indoor space. 

B.
 Usable indoor space may include a basement if it has been inspected by a fire marshal, is free of hazard, and meets the minimum exiting standards specified in subpart 4. 

Subp. 2.Outdoor play space.  
There must be an outdoor play space of at least 50 square feet per child in attendance, adjacent to the residence, for regular use, or a park, playground, or play space within 1,500 feet of the residence. On-site supervision must be provided by a caregiver for children of less than school age when play space is not adjacent to the residence. Enclosure may be required by the agency to provide protection from rail, traffic, water, or machinery hazard. The area must be free of litter, rubbish, toxic materials, water hazards, machinery, unlocked vehicles, human or animal wastes, and sewage contaminants. 

Subp. 3.Water hazards.  
Swimming and wading pools, beaches, or other bodies of water on or adjacent to the site of the residence must be inaccessible to children except during periods of supervised use. Wading pools, as defined in chapter 4717, must be kept clean. When children use a swimming pool, as defined in chapter 4717, or beach, an attendant trained in first aid and resuscitation shall be present. Any public swimming pool, as defined in chapter 4717, used by children must meet the requirements of chapter 4717. 

Subp. 4.
[Repealed, L 2019 1Sp9 art 2 s 134] 

Subp. 5.
[Repealed, L 2024 c 115 art 19 s 30] 

Subp. 6.Vertical separations.  
For group family day care homes with a licensed capacity of more than ten children, a 1-3/4 inch solid wood core door or a door and frame with at least a 20-minute fire protection rating, must be provided whenever more than two floors of the residence are connected. These doors must be equipped with self-closing devices. 

Subp. 7.Heating and venting systems.  
The following heating and venting guidelines must be met: 

A.
 Stove and heater locations must not block escape in case of a fire. 

B.
 Gas, coal, wood, kerosene, or oil heaters must be vented to the outside in accordance with the State Building Code. 

C.
 Combustible items must not be located within 36 inches of the furnace or other heating sources. 

D.
 Whenever in use, fireplaces, wood-burning stoves, solid fuel appliances, space heaters, steam radiators, and other potentially hot surfaces, such as steam pipes, must be protected by guards to prevent burns. All fireplaces, wood-burning stoves, space heaters, steam radiators, and furnaces must be installed according to the State Building Code. 

E.
 The furnace, hot water heater, and workshop area must be inaccessible to children. Separation may be by a door, partition, or gate. There must be allowance for air circulation to the furnace. 

F.
 Ventilation of usable space must meet the requirements of the State Building Code. Outside doors and windows used for ventilation in summer months must be screened when biting insects are prevalent. 

Subp. 8.Temperature.  
A minimum temperature of 62 degrees Fahrenheit must be maintained in indoor areas used by children. 

Subp. 9.Infant and newborn sleeping space.  
There must be a safe, comfortable sleeping space for each infant and newborn. A crib, portable crib, or playpen with waterproof mattress or pad must be provided for each infant or newborn in care. The equipment must be of safe and sturdy construction that conforms to volume 16, parts 1508 to 1508.7 and parts 1509 to 1509.9 of the Code of Federal Regulations, its successor, or have a bar or rail pattern such that a 2-3/8 inch diameter sphere cannot pass through. Playpens with mesh sidings must not be used for the care or sleeping of infants or newborns. 

Subp. 10.
[Repealed, L 2024 c 115 art 19 s 30] 

Subp. 11.Decks.  
Decks, balconies, or lofts used by children more than 30 inches above the ground or floor must be surrounded by a protective guardrail and be constructed in accordance with the State Building Code. Wooden decks must be free of splinters and coated with wood preservative, paint, or constructed with treated wood. 

Subp. 12.Locks and latches.  
Door locks and latches must meet the following guidelines: 

A.
 a closet door latch must be made so that children can open the door from inside the closet; 

B.
 every bathroom door lock must permit opening of the locked door from the outside and the opening device must be readily accessible to all caregivers; and 

C.
 double cylinder (key required both sides) locks on exit doors are prohibited. 

Subp. 13.Sewage disposal.  
Day care residences must have toilet facilities and sewage disposal systems that conform to the State Building Code or local septic system ordinances. The toilets must flush thoroughly. Outdoor toilets are permissible when local ordinances allow. 

Subp. 14.Construction, remodeling.  
During construction or remodeling, children shall not have access to dangerous construction or remodeling areas within or around the residence. 

Subp. 15.Interior walls and ceilings.  
The interior walls and ceilings within the residence, as well as corridors, stairways, and lobbies must have a flame spread rating of 200 or less. 

Subp. 16.
[Repealed, L 2019 1Sp9 art 2 s 134] 

Subp. 17.
[Repealed, L 2019 1Sp9 art 2 s 134] 

Subp. 18.Electrical services.  
The following electrical guidelines must be met: 

A.
 all electric receptacles accessible to children under first grade must be tamper-proof or shielded when not in use; 

B.
 all major electrical appliances must be properly installed, grounded in accordance with the state electric code, and in good working order; 

C.
 extension cords shall not be used as a substitute for permanent wiring; extension cords and flexible cords shall not be affixed to structures, extended through walls, ceilings, floors, under doors or floor coverings, nor be subject to environmental damage or physical impact; and 

D.
 electrical wiring must be sized to provide for the load and be in good repair. 

Subp. 19.Smoking prohibited in group family child care home.  
Pursuant to Minnesota Statutes, section 144.414, subdivision 2, smoking is prohibited in a group family child care provider's home during hours of operation. 

9502.0435SANITATION AND HEALTH. Subpart 1.Sanitation and cleanliness.  
The residence must be free from accumulations of dirt, rubbish, or peeling paint. 

Subp. 2.Pest control.  
Effective measures must be taken to protect the home against vermin and insects. Chemicals for insect and rodent control must not be applied in areas accessible to children when children are present. 

Subp. 3.Rubbish.  
Indoor and outdoor garbage and rubbish containers must not be accessible to infants and toddlers. 

Subp. 4.Toxic substances.  
All medicines, chemicals, detergents, poisonous plants, alcoholic beverages, and other toxic substances must be inaccessible to children. They must be stored away from food products. Equipment or toys which are mouthed or may be chewed must be free of lead-based paint. Toys and equipment with chipped, cracked, or peeling paint must be tested to verify the absence of lead or be replaced. 

Subp. 5.Firearms.  
All firearms must be unloaded and inaccessible to children. Ammunition and firearms must be stored in separate locked areas. 

Subp. 6.Hazardous activity materials.  
Knives, matches, plastic bags, and other potential hazards must be kept out of the reach of infants, toddlers, and preschoolers. The use of potentially hazardous materials and tools must be supervised. 

Subp. 7.First aid kit.  
The provider shall have a first aid kit that contains bandages, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, and adhesive tape. A first aid manual must be included. The kit and manual must be accessible and taken on field trips. 

Subp. 8.Emergencies.  
The provider shall be prepared for emergencies. 

A.
 An operable telephone must be located within the residence. 

B.
 Emergency phone numbers must be posted by the telephone. The numbers must be those of the local fire department, police department, emergency transportation, and poison control center. 

C.
 The emergency phone numbers of the parents and child's physician and dentist must be readily available within the residence and taken on field trips. 

D.
 Prior arrangements must be made for a substitute to provide care during emergencies. 

E.
 For severe storms and tornadoes, the provider shall have a designated area within the residence that children shall go to for cover, and an operable battery flashlight, and portable radio or TV available. 

F.
 The provider shall have a written fire escape plan and a log of monthly fire and storm drills on file in the residence. The plan must be approved by the agency and specify: 

(1)
 emergency phone numbers; 

(2)
 a place to meet outdoors for roll call; 

(3)
 smoke detector and fire extinguisher locations; 

(4)
 plans for monthly fire and tornado drill sessions; and 

(5)
 escape routes to the outside from all levels used by children. In buildings with three or more dwelling units, enclosed exit stairs must be indicated. 

Subp. 9.Transportation of children.  
When transportation is given to children in a motor vehicle other than a bus or school bus operated by a common carrier, the following provisions for their safety must be made. 

A.
 A child may be transported only if the child is fastened in a safety seat, seat belt, or harness appropriate to the child's weight and the restraint is installed and used in accordance with the manufacturer's instructions. 

B.
 A child under the age of four may be transported only if the child is securely fastened in a child passenger restraint system which meets the federal motor vehicle safety standards contained in Code of Federal Regulations, title 49, section 571.213 or its successor. 

C.
 Any vehicle operated by the provider for the transportation of children must be licensed in accordance with the laws of the state and the driver shall hold a current, valid driver's license. 

D.
 Written permission to transport children must be obtained from parents. 

E.
 No child is permitted to remain unattended in any vehicle. 

Subp. 10. Separation of personal articles.  
Separate towels, wash cloths, drinking cups, combs, and other personal articles must be used for each child. 

Subp. 11.Bedding.  
Clean, separate bedding must be provided for each child in care. 

Subp. 12.Pets.  
All pets housed within the residence shall be maintained in good health and limited to dogs, cats, fish, guinea pigs, gerbils, rabbits, hamsters, rats, mice, and birds if the birds are clear of chlamydia psittaci. The provider shall ensure that: 

A.
 parents are notified prior to admission of the presence of pets in the residence; 

B.
 children handle animals only with supervision; 

C.
 rabies shots and tags are current for all dogs and cats; 

D.
 pet cages are located and cleaned away from any food preparation, storage, or serving areas; 

E.
 play areas are free of animal excrement not confined to pet cages; 

F.
 parents of a child whose skin is broken by an animal bite or scratch, are notified of the injury on the day the injury occurs; and 

G.
 the agent of a community health board as authorized under Minnesota Statutes, section 145A.04 is immediately notified whenever a child in care is bitten by an animal, the notification shall be given before any steps are taken to destroy the animal, and the provider shall take reasonable steps to confine the animal. 

Subp. 13.Diapers.  
Children in diapers shall be kept clean and dry. The following sanitary procedures must be used to reduce the spread of communicable disease. 

A.
 An adequate supply of clean diapers must be available for each child and stored in a clean place inaccessible to children. If cloth diapers are used, parents must provide a change of the outer plastic pants for each fecally soiled diaper change. Cloth diapers, except those supplied by a commercial diaper service, and plastic pants, if supplied by parents, must be labeled with the child's name. 

B.
 Diapers and clothing must be changed when wet or soiled. 

C.
 For disposable diapers, a covered diaper disposal container must be located in the diaper changing area and lined with a disposable plastic bag. The container must be emptied when full, and at least daily. 

D.
 Diapering must not take place in a food preparation area. The diaper changing area must be covered with a smooth, nonabsorbent surface. If the surface is not disposable and is wet or soiled, it must be washed with soap and water to remove debris and then disinfected with a solution of at least two teaspoons of chlorine bleach to one quart of water. If the surface is not soiled with feces or urine, then it must be disinfected with the solution of chlorine bleach and water after each diapering. 

E.
 Single service disposable wipes or freshly laundered cloths must be used for washing a soiled child. A child who has soiled or wet must be washed with a disposable wipe or a freshly laundered cloth before rediapering. 

F.
 Cloth diapers, except those supplied by a commercial diaper service, plastic pants, and soiled clothing must be placed in the plastic bag after removal and sent home with the parent daily. 

Subp. 14.Toilet training chairs.  
Toilet training chairs, chairs, stools, and seats must be washed with soap and water when soiled, and at least daily. 

Subp. 15.Hand washing.  
A child's hands must be washed with soap and water when soiled, after the use of a toilet or toilet training chair, and before eating a meal or snack. The provider shall monitor and assist the child who needs help. 

A.
 In sinks and tubs accessible to children, the water temperature must not exceed 120 degrees Fahrenheit to prevent children from scalding themselves while washing. 

B.
 Caregivers shall wash their hands with soap and water after each diaper change, after assisting a child on the toilet, after washing the diapering surface, and before food preparation. Hands must be dried on a single use towel. 

Subp. 16.Care of ill children, medicine administration.  
The following provisions must be followed for the care of ill children and the administration of medicine. 

A.
 The provider shall notify the parent immediately when a child in care develops any of the following symptoms: 

(1)
 underarm temperature of 100 degrees Fahrenheit or over, or an oral temperature of 101 degrees Fahrenheit or over; 

(2)
 vomiting; 

(3)
 diarrhea; or 

(4)
 rash, other than mild diaper or heat-related rash. 

B.
 The provider shall follow written instructions from an authorized agent or the physician of an ill child placed in the provider's care if the child has any of the illnesses specified in item E. 

C.
 The provider shall require that a child's parent notify the provider within 24 hours of the diagnosis of a serious contagious illness or parasitic infestation listed in item E so the provider may notify the parents of other children in care. 

D.
 The provider shall inform a parent of each exposed child the same day the provider is notified a positive diagnosis has been made for any of the illnesses or parasitic infestations in item E. 

E.
 The provider shall notify the authorized agent or Minnesota Department of Health of any suspected case of reportable disease as specified in part 4605.7040. The agency shall provide the provider with a copy of part 4605.7040 at the time of initial licensure. 

F.
 The following govern the administration of medicine by the provider to children in care: 

(1)
 The provider shall obtain written permission from the child's parent prior to administering medicine, diapering products, sunscreen lotions, and insect repellents. Nonprescription medicines, diapering products, sunscreen lotions, and insect repellents must be administered according to the manufacturer's instructions unless there are written instructions for their use provided by a licensed physician or dentist. 

(2)
 The provider shall obtain and follow written instructions from a licensed physician or dentist prior to administering each prescription medicine. Medicine with the child's name and current prescription information on the label constitutes instructions. 

9502.0445WATER, FOOD, AND NUTRITION. Subpart 1.Water.  
There must be a safe water supply in the residence. 

A.
 Water from privately owned wells, must be tested annually by a Minnesota Health Department certified laboratory for coliform bacteria and nitrate nitrogens to verify safety. The provider shall file a record of the test results with the agency. Retesting and corrective measures may be required by the agency if results exceed state drinking water standards or where the supply may be subject to off-site contamination. 

B.
 Drinking water must be available to the children and offered at frequent intervals in separate or single service drinking cups or bottles. 

Subp. 2.Milk.  
Milk served to children in care must be pasteurized. 

Subp. 3.Meals and snacks.  
Well-balanced meals and snacks must be offered daily. 

A.
 Food served during the day must include servings from each of the basic food groups as defined by the United States Department of Agriculture's Code of Federal Regulations, title 7, section 226.20. 

B.
 The provider shall follow written instructions obtained from the parents, at the time of enrollment, on each child's special diet or food needs. Parents shall be consulted about special food preferences. 

C.
 Flexible feeding schedules must be provided for infants and toddlers, and the infant or toddler's usual diet and feeding schedule must be followed. 

D.
 Food, lunches, and bottles brought from home must be labeled with the child's name and refrigerated when necessary. Bottles must be washed after use. 

Subp. 4.Food safety.  
Food must be handled and stored properly to prevent contamination and spoilage. 

A.
 All food and cooking utensils must be stored to protect them from dust, vermin, pipe leakage, or other contamination. 

B.
 Food requiring refrigeration must be maintained at no more than 40 degrees Fahrenheit. Food requiring heating must be maintained at no less than 150 degrees Fahrenheit until ready to serve. Frozen food must be maintained in a solid state until used. 

C.
 Appliances used in food storage and preparation must be safe and clean. 

D.
 No hermetically sealed (canned), nonacid or low-acid food which has been processed in a place other than a commercial food-processing establishment shall be served to children in care. Low-acid food includes meats, fish, and poultry and most vegetables and is required to be steam-pressure canned by the United States Department of Agriculture in Bulletin number 8, "Home Canning of Fruits and Vegetables," 1983 Edition. Fresh and frozen foods, properly canned tomatoes, pickled foods, and canned fruits such as apples, berries, peaches, apricots, jams, and jellies may be served to children in care. The USDA "Home Canning of Fruits and Vegetables," Home and Garden Bulletin number 8, 1983 Edition, is incorporated by reference. It is not subject to frequent change and is available through Minitex interlibrary loan system, or by writing the Superintendent of Documents, U.S. Government Printing Office, Washington D.C., 20402. 

9503.0005DEFINITIONS. Subpart 1.Scope.  
The definitions in this part apply to parts 9503.0005 to 9503.0170. 

Subp. 2.Age category.  
"Age category" means the designation given a child according to the child's age. The age categories are as follows: 

A.
 "Infant" means a child who is at least six weeks old but less than 16 months old. 

B.
 "Toddler" means a child at least 16 months old but less than 33 months old. 

C.
 "Preschooler" means a child who is at least 33 months old but who has not yet attended the first day of kindergarten. 

D.
 "School-age child" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 16. 

The age designation given a child may be further modified in accordance with part 9503.0040, subpart 4. 

Subp. 3.Applicant.  
"Applicant" means a person, corporation, partnership, voluntary association, or other organization that has applied for licensure under Minnesota Statutes, chapter 245A, and parts 9503.0005 to 9503.0170. The term includes license holders that have applied for a new license to continue operating a child care program after the expiration date of their current license. 

Subp. 4.Building official.  
"Building official" means a person appointed according to Minnesota Statutes, section 326B.133, to administer the State Building Code. The term includes the appointee's authorized representative. 

Subp. 5.Center.  
"Center" means a facility in which a child care program is operated when the facility is not excluded by Minnesota Statutes, section 245A.03, subdivision 2, and is not required to be licensed under parts 9502.0315 to 9502.0445 as a family or group family day care home. 

Subp. 6.Child.  
"Child" means a person 12 years old or younger. 

Subp. 7.Child care program.  
"Child care program" means the systematic organization or arrangement of activities, personnel, materials, and equipment in a facility to promote the physical, intellectual, social, and emotional development of a child in the absence of the parent for a period of less than 24 hours a day. 

Subp. 8.Child care program plan.  
"Child care program plan" means the written document that states the specific activities that will be provided by the license holder to promote the physical, intellectual, social, and emotional development of the children enrolled in the center. 

Subp. 9.Clean.  
"Clean" means free from dirt or other contaminants that can be detected by sight, smell, or touch. 

Subp. 10.Commissioner.  
"Commissioner" means the commissioner of the Department of Human Services or the commissioner's designated representative. 

Subp. 11.Disinfected.  
"Disinfected" means treated to reduce microorganism contamination after an object has been cleaned. Disinfection must be done by rinsing or wiping with a solution of one-fourth cup chlorine bleach plus water to equal one gallon, or an equivalent product or process approved by the community health board as defined in Minnesota Statutes, section 145A.02, or its designee. 

Subp. 12.Facility.  
"Facility" means the indoor and outdoor space in which the child care program is provided. 

Subp. 13.Fire marshal.  
"Fire marshal" means the person designated by Minnesota Statutes, section 299F.011, to administer and enforce the Minnesota Uniform Fire Code. The term includes the fire marshal's authorized representative. 

Subp. 14.Health consultant.  
"Health consultant" means a physician licensed to practice medicine under Minnesota Statutes, chapter 147; a public health nurse or registered nurse licensed under Minnesota Statutes, section 148.171; or the community health board as defined in Minnesota Statutes, section 145A.02, or its designee. 

Subp. 15.License.  
"License" means a certificate issued by the commissioner authorizing the license holder to operate a child care program in a center for a specified period of time in accordance with the terms of the license, rules of the commissioner, and provisions of Minnesota Statutes, chapter 245A. 

Subp. 16.License holder.  
"License holder" means the individual, corporation, partnership, voluntary association, or other organization legally responsible for the operation of the child care program in a center that has been granted a license by the commissioner under Minnesota Statutes, chapter 245A, and parts 9503.0005 to 9503.0170. 

Subp. 17.Licensed capacity.  
"Licensed capacity" means the maximum number of children for which the license holder is licensed to operate a child care program in a center at any one time. 

Subp. 18.Medicine.  
"Medicine" means a substance used to treat disease or injuries, maintain health, heal, or relieve pain. The term applies to prescription and nonprescription substances taken internally or applied externally. 

Subp. 19.Minnesota Uniform Fire Code.  
"Minnesota Uniform Fire Code" means those codes and regulations adopted by the state fire marshal according to Minnesota Statutes, section 299F.011. 

Subp. 20.Parent.  
"Parent" means the person or persons with legal custody of the child. 

Subp. 21.Program staff person.  
"Program staff person" means a teacher, assistant teacher, or aide, whether paid or unpaid, who carries out the child care program plan in the center and has direct contact with children. 

Subp. 21a.School-age child care program.  
"School-age child care program" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 17. 

Subp. 22.Sick child.  
"Sick child" means a child with a condition or illness as specified in part 9503.0080. 

Subp. 23.Staff person.  
"Staff person" means a person, whether paid or unpaid, who works in the center. 

Subp. 24.State Building Code.  
"State Building Code" means those codes and regulations adopted by the commissioner of the Department of Administration according to Minnesota Statutes, section 326B.101, and contained in chapter 1300. 

Subp. 25.Supervision.  
"Supervision" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 18. 

Subp. 26.Variance.  
"Variance" means time limited written permission by the commissioner for an applicant or license holder to depart from the provisions of parts 9503.0005 to 9503.0170 if equivalent alternative measures are taken to ensure the health, safety, and rights of the children in care. 

9503.0010APPLICABILITY. 
Parts 9503.0005 to 9503.0170 govern the licensure of the applicants for and license holders operating a child care program in a center. 

9503.0015OPTIONS FOR CHILD CARE PROGRAMS. 
A license holder must provide one or more of the following child care programs: 

A.
 A "day program" means a child care program operated during normal waking hours (approximately 6 a.m. to 6 p.m.). The program: 

(1)
 operates for more than 30 days in any 12 month period and is not excluded by Minnesota Statutes, section 245A.03, subdivision 2; and 

(2)
 provides care to any child for more than 30 days in any 12 month period and 45 hours in any calendar month. 

B.
 A "drop-in child care program" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 6a. 

C.
 A "night care program" means a child care program operated during normal sleeping hours (approximately 6 p.m. to 6 a.m.). 

D.
 A "sick care program" means a child care program that provides care to a sick child. 

E.
 A "school-age child care program" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 17. 

9503.0030QUALIFICATIONS OF APPLICANT AND STAFF. Subpart 1.Definitions.  
In parts 9503.0030 to 9503.0034: 

A.
 "Accredited course" means a course that is offered for credit by or through an accredited postsecondary institution. 

B.
[Repealed, L 2025 1Sp3 art 14 s 22] 

C.
 "Experience" means paid or unpaid employment serving children as a teacher, assistant teacher, or aide, in a licensed child care center, or work as a student intern in a licensed center, a school operated by the commissioner of education or by a legally constituted local school board, or a private school approved under rules administered by the commissioner of education. 

D.
 "Student intern" means a student of a postsecondary institution assigned by that institution for a supervised experience with children. The experience must be in a licensed center, an elementary school operated by the commissioner of education or a legally constituted local school board, or a private school approved under rules administered by the commissioner of education. The term includes a person who is practice teaching, student teaching, or carrying out a practicum or internship. 

E.
 "Staff supervision" means responsibility to hire, train, assign duties, and direct staff in day to day activities and evaluate staff performance. A "supervisor" is a person with staff supervision responsibility. 

Subp. 2.
[Repealed, 18 SR 2748] 

Subp. 3.
[Repealed, 18 SR 2748] 

Subp. 4.
[Repealed, 18 SR 2748] 

9503.0031DIRECTORS. Subpart 1.General requirements for a director.  
A director must: 

A.
 be at least 18 years old; 

B.
 be a graduate of a high school or hold an equivalent diploma attained through successful completion of the commissioner of education-selected high school equivalency test; 

C.
 have at least 1,040 hours of paid or unpaid staff supervision experience; and 

D.
 have at least nine quarter credits or 90 hours earned in any combination of accredited courses in staff supervision, human relations, and child development. 

Subp. 2.Additional requirements.  
If a director functions as a teacher or develops or revises the child care program plan, the director must meet the qualifications of a teacher specified in part 9503.0032. 

9503.0032TEACHERS. Subpart 1.Teacher qualifications, general.  
A teacher must be at least 18 years old and meet the qualifications in subpart 2 with the following exceptions: 

A.
 A registered nurse or licensed practical nurse is qualified as a teacher for infants only. 

B.
 A registered nurse may be used to meet the staff-to-child ratios for a teacher for sick care in a center licensed to operate a sick care program. 

Subp. 2.Teacher education and experience requirements.  
A teacher with the credential listed in column A must have the education and experience listed in column B. 

	Column A	Column B	
			
	(1) A high school diploma or commissioner of education-selected high school equivalency certification	Experience: 4,160 hours as assistant teacherEducation: 24 quarter credits	
	........	
	(2) Diploma from Association Montessori Internationale; preprimary credential, primary diploma, or provisional certificate from the American Montessori Society, without a baccalaureate degree	Experience: 2,080 hours as assistant teacher, aide, or student internEducation: 12 quarter credits	
	........	
	(3) Preprimary credential, primary diploma, or provisional certificate from the American Montessori Society; or diploma from the Association Montessori Internationale with a baccalaureate degree	Experience: 1,040 hours as assistant teacher, aide, or student internEducation: no additional required	
	........	
	(4) Minnesota technical institute certificate as a Child Development Assistant	Experience: 2,080 hours as an assistant teacherEducation: six quarter credits	
	........	
	(5) Child Development Associate credential (center based or family day care) for preschool or for infants and toddlers from the Council for Early Childhood Professional Recognition	Experience: 1,560 hours as assistant teacher, aide, or student internEducation: no additional required	
	........	
	(6) License from the Minnesota Department of Education for Prekindergarten Associate; or a certificate or credential for a two-year program from an accredited community college or technical college in child development or early childhood education	Experience: 1,040 hours as assistant teacher, aide, or student internEducation: six quarter credits	
	........	
	(7) Baccalaureate degree from an accredited college or university in any field	Experience: 1,040 hours as assistant teacher, aide, or student internEducation: 18 quarter credits	
	........	
	(8) License from the Minnesota Department of Education for elementary education without kindergarten endorsement	Experience: 520 hours as assistant teacher, aide, or student intern if teaching children under school ageEducation: six quarter credits within one year of initial employment if teaching children under school age	
	........	
	(9) License from the Minnesota Department of Education for prekindergarten/nursery, or a license from the Minnesota Department of Education for elementary education with a kindergarten endorsement	Experience: no additional requiredEducation: no additional required	
9503.0033ASSISTANT TEACHERS. Subpart 1.Assistant teacher qualifications, general.  
An assistant teacher must work under the supervision of a teacher. An assistant teacher must be at least 18 years old and meet the qualifications in subpart 2 with the following exceptions: 

A.
 A registered nurse or licensed practical nurse is qualified as an assistant teacher for infants only. 

B.
 A registered nurse may be used to meet the staff-to-child ratios for an assistant teacher for sick care in a center licensed to operate a sick care program. 

Subp. 2.Assistant teacher education and experience requirements.  
An assistant teacher with the credential listed in column A must have the education and experience listed in column B. 

	Column A	Column B	
			
	(1) High school diploma or commissioner of education-selected high school equivalency certification	Experience: 2,080 hours as an aide or student internEducation: 12 quarter credits	
	........	
	(2) Minnesota license as a family day care or group family day care provider	Experience: 2,080 hours as a licensed family day care or group family day care providerEducation: 12 quarter credits	
	........	
	(3) Diploma from Association Montessori Internationale or preprimary credential, primary diploma, or provisional certificate from the American Montessori Society	Experience: 520 hours as an aide or student internEducation: three quarter credits	
	........	
	(4) Minnesota technical institute certificate as a Child Development Assistant	Experience: 520 hours as an aide or student internEducation: no additional required	
	........	
	(5) Two years full-time postsecondary education from a college or university	Experience: 1,040 hours as an aide or student internEducation: nine quarter credits	
	........	
	(6) Child Development Associate credential, center based or for family day care, from the Council for Early Childhood Professional Recognition	Experience: no additional requiredEducation: no additional required	
	........	
	(7) Baccalaureate degree in any field from an accredited college or university	Experience: no additional requiredEducation: nine quarter credits	
	........	
	(8) Certificate or credential for a two year program in child development or early childhood education at a Minnesota community college or technical college	Experience: no additional requiredEducation: no additional required	
	........	
	(9) License from the Minnesota Department of Children, Families, and Learning for Prekindergarten Associate	Experience: no additional requiredEducation: no additional required	
9503.0034AIDES, VOLUNTEERS, SUBSTITUTES. Subpart 1.Aide qualifications.  
In this part, "aide" means a staff person who carries out child care program activities under the supervision of a teacher or assistant teacher. An aide who is under 18 years old must be directly supervised by a teacher or assistant teacher at all times except when the aide is assisting with the supervision of sleeping children or assisting children with washing, toileting, and diapering. An aide must be at least 16 years old. 

Subp. 2.Volunteers used as staff.  
A volunteer who is included in the staff-to-child ratio must meet the requirements for the assigned staff position as specified in parts 9503.0030 to 9503.0034. Volunteers who have direct contact with or access to children must be supervised by a staff person who meets the qualifications for director, teacher, or assistant teacher. 

Subp. 3.Substitute staff.  
A person designated as a substitute must meet the qualifications for the assigned staff position as specified in parts 9503.0030 to 9503.0034, except that the license holder may use substitutes who do not meet the qualifications for teacher in part 9503.0032, subpart 2, or assistant teacher in part 9503.0033, subpart 2, only if: 

A.
 the amount of unqualified substitute hours per center per calendar year does not exceed 40 hours multiplied by the number of the center's full-time teacher and assistant teacher positions; 

B.
 unqualified substitutes are not used as teachers or assistant teachers for more than ten consecutive working days for the same group of children per calendar year; and 

C.
 there is always a person qualified as a teacher present within the center except as qualified in part 9503.0040, subpart 2, item B. 

9503.0040STAFF RATIOS AND GROUP SIZE. Subpart 1.Staff-to-child ratios and maximum group size.  
Except as provided in subpart 2, the minimally acceptable staff-to-child ratios and the maximum group size within each age category are: 

	Age Category	Minimum Staff:Child Ratio	Maximum Group Size	
				
	Infant	1:4	8	
	Toddler	1:7	14	
	Preschooler	1:10	20	
	School-age child	1:15	30	
Subp. 2.Staff distribution. 
The license holder must ensure that the following requirements for staff distribution are met and a written staff distribution record is kept in the administrative record. 

A.
 Only a staff person who is qualified as a teacher, assistant teacher, or aide and who works directly with children can be counted in meeting the staff-to-child ratios. 

B.
 An assistant teacher may be substituted for a teacher during morning arrival and afternoon departure times if the total arrival and departure time does not exceed 25 percent of the center's daily hours of operation. 

C.
 The maximum group size applies at all times except during meals, outdoor activities, field trips, naps and rest, and special activities such as films, guest speakers, and holiday programs. 

D.
 Except as provided in item B, staff distribution within each age category must follow the pattern in subitems (1) to (4). 

(1)
 The first staff member needed to meet the required staff-to-child ratio must be a teacher. 

(2)
 The second staff member must have at least the qualifications of a child care aide. 

(3)
 The third staff member must have at least the qualifications of an assistant teacher. 

(4)
 The fourth staff member must have at least the qualifications of a child care aide. 

The pattern in subitems (1) to (4) must be repeated until the number of staff needed to meet the staff-to-child ratio for each age category has been achieved. 

Subp. 3.Age category grouping.  
Children in different age categories may be grouped as follows: 

A.
 During morning arrival and afternoon departure times, children in different age categories may be grouped together if: 

(1)
 the total arrival and departure time does not exceed 25 percent of the daily hours of operation; 

(2)
 the staff-to-child ratio, group size, and staff distribution applied are for the age category of the youngest child present; and 

(3)
 the group is divided when the number of children present reaches the maximum group size of the youngest child present. 

B.
 During the center's regular hours of operation, children in different age categories may be mixed within a group if: 

(1)
 infants are not grouped with children of other age categories; 

(2)
 there is no more than a 36-month range in age among children in a group; 

(3)
 the staff-to-child ratios, group size, and staff distribution applied are for the youngest child present; and 

(4)
 program staff are qualified to teach the ages of all children present within the group. 

The restriction in subitem (2) may be waived if all children in the group are school age. 

Subp. 4.Age designation.  
A child must be designated as a member of the age category that is consistent with the child's date of birth with the following exceptions: 

A.
 A child may be designated as an "infant" up to the age of 18 months for purposes of staff ratios, group size, and child care programming, if the parent, teacher, and center director determine that such a designation is in the best interests of the child. A child may be designated as a "toddler" up to the age of 35 months, or as a "preschooler" at the age of 31 months for purposes of staff ratios, group size, and child care programming, if the parent, teacher, and center director determine that the designation is in the best interests of the child. 

B.
 A child attending kindergarten must be designated a school-age child. 

9503.0045CHILD CARE PROGRAM PLAN. Subpart 1.General requirement.  
The applicant must develop a written child care program plan, and the license holder must see that it is carried out. The child care program plan must: 

A.
 mandate that children have supervision at all times; 

B.
 describe the age categories and number of children to be served by the program; 

C.
 describe the days and hours of operation of the program; 

D.
 describe the general educational methods to be used by the program and the religious, political, or philosophical basis, if any; 

E.
 be developed and evaluated in writing annually by a staff person qualified as a teacher under part 9503.0032; 

F.
 have stated goals and objectives to promote the physical, intellectual, social, and emotional development of the children in each age category in part 9503.0005, subpart 2, for which care is provided; 

G.
 specify activities designed to promote the intellectual, physical, social, and emotional development of a child in a manner consistent with the child's cultural background; 

H.
 specify that the intellectual, physical, social, and emotional progress of each child be documented in the child's record and conveyed to the parent during the conferences specified in part 9503.0090, subpart 2; 

I.
 provide a daily schedule for both indoor and outdoor activities; 

J.
 provide for activities that are both quiet and active, teacher directed and child initiated; 

K.
 provide for a variety of activities that require the use of varied equipment and materials; and 

L.
 be available to parents for review on request. 

Subp. 2.Interest areas.  
A child care program that operates for more than three hours a day must provide daily access to interest areas of the center that are supplied with the equipment and materials needed to carry out the activities specified in items A to H, except that a child care program serving only school-age children and operating for less than 90 consecutive calendar days or any program operating for less than three hours a day must provide each child with daily access to indoor or outdoor large muscle activities specified in item G and at least five of the following interest areas: 

A.
 creative arts and crafts; 

B.
 construction; 

C.
 dramatic or practical life activities; 

D.
 science; 

E.
 music; 

F.
 fine motor activities; 

G.
 large muscle activities; or 

H.
 sensory stimulation activities. 

9503.0050NAPS AND REST. Subpart 1.Naps and rest policy.  
The applicant must develop a policy for naps and rest that is consistent with the developmental level of the children enrolled in the center. 

Subp. 2.Parent consultation.  
The parent of each child must be informed at the time the child is enrolled of the center's policy on naps and rest. 

Subp. 3.Confinement limitation.  
A child who has completed a nap or rested quietly for 30 minutes must not be required to remain on a cot or mat or in a crib or bed. 

Subp. 4.Placement of equipment.  
Naps and rest must be provided in a quiet area that is physically separated from children who are engaged in activity that will disrupt a napping or resting child. Cribs, cots, beds, and mats must be placed so there are clear aisles and unimpeded access for both adults and children on at least one side of each piece of napping and resting equipment. Cribs, cots, beds, and mats must be placed directly on the floor and must not be stacked when in use. 

Subp. 5.Crib standard.  
A crib or portable crib must be provided for each infant for which the center is licensed to provide care. The equipment must be of safe and sturdy construction that conforms to Code of Federal Regulations, title 16, sections 1508 to 1508.7 and 1509 to 1509.9, as amended through October 27, 1982, or have a bar, mesh, or rail pattern such that a 2-3/8 inch diameter sphere cannot pass through. 

Subp. 6.Bedding.  
Separate bedding must be provided for each child in care. Bedding must be washed weekly and when soiled or wet. Blankets must be washed or dry cleaned weekly and when soiled or wet. 

9503.0055BEHAVIOR GUIDANCE. Subpart 1.General requirements.  
The applicant must develop written behavior guidance policies and procedures, and the license holder must see that the policies and procedures are carried out. The policies and procedures must: 

A.
 ensure that each child is provided with a positive model of acceptable behavior; 

B.
 be tailored to the developmental level of the children the center is licensed to serve; 

C.
 redirect children and groups away from problems toward constructive activity in order to reduce conflict; 

D.
 teach children how to use acceptable alternatives to problem behavior in order to reduce conflict; 

E.
 protect the safety of children and staff persons; and 

F.
 provide immediate and directly related consequences for a child's unacceptable behavior. 

Subp. 2.Persistent unacceptable behavior.  
The license holder must have written procedures for dealing with persistent unacceptable behavior that requires an increased amount of staff guidance and time. The procedures must specify that staff: 

A.
 observe and record the behavior of the child and staff response to the behavior; and 

B.
 develop a plan to address the behavior documented in item A in consultation with the child's parent and with other staff persons and professionals when appropriate. 

Subp. 3.Prohibited actions.  
The license holder must have and enforce a policy that prohibits the following actions by or at the direction of a staff person: 

A.
 Subjection of a child to corporal punishment. Corporal punishment includes, but is not limited to, rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking. 

B.
 Subjection of a child to emotional abuse. Emotional abuse includes, but is not limited to, name calling, ostracism, shaming, making derogatory remarks about the child or the child's family, and using language that threatens, humiliates, or frightens the child. 

C.
 Separation of a child from the group except as provided in subpart 4. 

D.
 Punishment for lapses in toilet habits. 

E.
 Withholding food, light, warmth, clothing, or medical care as a punishment for unacceptable behavior. 

F.
 The use of physical restraint other than to physically hold a child when containment is necessary to protect a child or others from harm. 

G.
 The use of mechanical restraints, such as tying. 

For children with developmental disabilities or children under the age of five, as specified in parts 9525.0004 to 9525.0036, physical and mechanical restraints may be permitted if they are implemented in accordance with the aversive and deprivation procedures governed by parts 9525.2700 to 9525.2810. 

Subp. 4.Separation from the group.  
No child may be separated from the group unless the license holder has tried less intrusive methods of guiding the child's behavior which have been ineffective and the child's behavior threatens the well being of the child or other children in the center. A child who requires separation from the group must remain within an unenclosed part of the classroom where the child can be continuously seen and heard by a program staff person. When separation from the group is used as a behavior guidance technique, the child's return to the group must be contingent on the child's stopping or bringing under control the behavior that precipitated the separation, and the child must be returned to the group as soon as the behavior that precipitated the separation abates or stops. A child between the ages of six weeks and 16 months must not be separated from the group as a means of behavior guidance. 

Subp. 5.Separation report.  
All separations from the group must be noted on a daily log. The license holder must ensure that notation in the log includes the child's name, staff person's name, time, date, and information indicating what less intrusive methods were used to guide the child's behavior and how the child's behavior continued to threaten the well being of the child or other children in care. If a child is separated from the group three times or more in one day, the child's parent shall be notified and notation of the parent notification shall be indicated on the daily log. If a child is separated five times or more in one week or eight times or more in two weeks, the procedure in subpart 2 must be followed. 

Subp. 6.Children with developmental disabilities.  
For children with developmental disabilities or children under the age of five, as specified in parts 9525.0004 to 9525.0036, the standards governing the use of aversive and deprivation procedures in parts 9525.2700 to 9525.2810 apply. 

9503.0060FURNISHINGS, EQUIPMENT, MATERIALS, AND SUPPLIES. Subpart 1.General requirements.  
Each child care program must have the quantity and type of equipment specified in subparts 3 to 6 for the age categories of children served. Equipment must be appropriate to the age categories and any special needs of the children served. A center must have enough equipment for the number of children for which the center is licensed unless the use of equipment is rotated among groups of children. If the equipment is rotated among groups of children, the center must have enough for the maximum group size of the age category scheduled to use the equipment at times shown on the child care program plan. When the term "group" is used in this part it means the maximum group size for the age category specified in part 9503.0040, subpart 1. The minimum equipment specified for an age category in subparts 3 to 6 must be accessible every day to the children of that age category and arranged as specified in the child care program plan. Centers operating for less than three hours a day do not have to provide the outdoor equipment required in subpart 4, item B, subitem (9); subpart 5, item B, subitem (9); and subpart 6, item B, subitem (7). 

Subp. 2.Definitions.  
For the purpose of this part, the following terms have the meanings given them. 

A.
 "Cognitive development equipment and materials" means equipment and materials designed to enhance components of intellectual development, such as problem solving abilities, observation skills, group skills, and symbol recognition. 

B.
 "Dramatic play equipment" or "practical life activity equipment" means equipment, such as dress up clothes, large or miniature play sets, figures, and small and large building blocks that can be used to design a setting or space that stimulates the child's imagination and encourages role playing and the learning of practical life skills. 

C.
 "Large muscle equipment" means equipment that is designed to enhance large muscle development and coordination, such as playground equipment, large boxes and pillows, large wheel toys, pull toys, balls, jump ropes, climbers, and rocking boats. 

D.
 "Manipulative equipment" means equipment that is designed to enhance fine motor development and coordination, such as pegs and peg boards, puzzles, beads and strings, interlocking plastic forms, and carpentry materials. 

E.
 "Sensory stimulation materials" means equipment, other than pictures, that has different shapes, colors, and textures that stimulate the child's visual and tactile senses. Examples of sensory stimulation materials include mobiles, crib attached activity boxes, sand and water activity materials, swatches of different textures of cloth, and wooden or plastic items of different shapes and colors. 

Subp. 3.Equipment and materials for infants.  
The minimum equipment and materials required for a center serving infants are as follows: 

A.
 Furnishings: 

(1)
 one area rug or carpet per group; 

(2)
 a variety of nonfolding child size chairs including infant seats and high chairs, one per child, or a minimum of four per group; 

(3)
 one changing table for every group of 12 infants and succeeding group of 12 or fewer infants; 

(4)
 one foot operated, covered diaper container per changing table; 

(5)
 one crib or portacrib and waterproof mattress per child; and 

(6)
 one linear foot of low, open shelving per child. 

B.
 Program equipment and materials: 

(1)
 one book per child; 

(2)
 two large, soft building blocks per child; 

(3)
 two pieces of infant mobility equipment, such as strollers and wagons per group; 

(4)
 two pieces of manipulative equipment per child such as shape toys and clutch balls; 

(5)
 one mirror at least 12 inches by 36 inches in size made of Plexiglas or a similar plastic or of safety glass per group; 

(6)
 one music source such as a tape player or record player per group and music selections appropriate for the music source; 

(7)
 one noise or music making toy per child; 

(8)
 visual and tactile sensory stimulation materials as needed to provide visual and tactile stimulation; and 

(9)
 one soft washable toy per child. 

C.
 Supplies: 

(1)
 two sets of blankets and sheets for each crib; 

(2)
 an adequate amount of disposable paper for the changing table; 

(3)
 an adequate amount of diapers; 

(4)
 an adequate amount of facial tissue; 

(5)
 an adequate amount of single service towels; and 

(6)
 an adequate amount of liquid hand soap. 

Subp. 4.Equipment and materials for toddlers.  
The minimum equipment required for a center serving toddlers is as follows: 

A.
 Furnishings: 

(1)
 one area rug or carpet per group; 

(2)
 one nonfolding child size chair, including high chairs, per child; 

(3)
 one changing table for every group of 14 toddlers and succeeding group of 14 or fewer toddlers; 

(4)
 one foot operated, covered diaper container per changing table; 

(5)
 one cot per child (mats are acceptable for programs operating during the day for less than five hours); 

(6)
 one partially enclosed space equipped for quiet activity per group; 

(7)
 one linear foot of low open shelving per child; and 

(8)
 20 linear inches of child size table edge per child. 

B.
 Program equipment and materials: 

(1)
 arts and crafts supplies, such as clay or playdough, tempera or finger paints, colored and white paper, paste, collage materials, paint brushes, washable felt type markers, crayons, blunt scissors, and smocks; 

(2)
 one book per child; 

(3)
 24 large building blocks per group; 

(4)
 100 small building blocks per group; 

(5)
 three pieces of dramatic play equipment or sets of Montessori Practical Life equipment per group; 

(6)
 materials and accessories required for subitem (5) as needed to carry out the theme of the activity, or six Montessori Practical Life exercises; 

(7)
 one double easel per group; 

(8)
 three pieces of durable, indoor, large muscle equipment per group; 

(9)
 three pieces of durable, outdoor, large muscle equipment per group; 

(10)
 one mirror, at least 12 inches by 36 inches, made of Plexiglas or a similar plastic or safety glass, per group; 

(11)
 one music source such as a tape recorder or record player per group and music selections appropriate for the source; 

(12)
 one set of cognitive developmental equipment and materials, such as puzzles and matching games, per child; 

(13)
 two sets of manipulative equipment, such as interlocking plastic forms or beads and string, per child; 

(14)
 one music making toy per child; 

(15)
 one soft washable toy per child; and 

(16)
 sensory stimulation materials as needed to provide visual and tactile stimulation. 

C.
 Supplies: 

(1)
 an adequate amount of disposable paper for the changing table; 

(2)
 an adequate amount of diapers; 

(3)
 an adequate amount of facial tissue; 

(4)
 an adequate amount of single service towels; and 

(5)
 an adequate amount of liquid hand soap. 

Subp. 5.Equipment and materials for preschoolers.  
The minimum equipment required for a center serving preschoolers is as follows: 

A.
 Furnishings: 

(1)
 one area rug or carpet per group; 

(2)
 one nonfolding child size chair per child; 

(3)
 one cot or bed and waterproof mattress per child (mats are acceptable for programs operating during the day for less than five hours). This subitem is not required for preschoolers in programs operating for less than five hours per day if rest is not indicated as part of the center's child care program; 

(4)
 two square feet of wall or bulletin board display space per child, one-half at child's eye level; 

(5)
 one partially enclosed space equipped for quiet activity per group; 

(6)
 one linear foot of open shelving per child; and 

(7)
 20 linear inches of child size table edge per child. 

B.
 Program equipment and materials: 

(1)
 arts and crafts supplies, such as clay or playdough, tempera or fingerpaints, white or colored paper, paste, collage materials, paint brushes, washable felt type markers, crayons, scissors, and smocks; 

(2)
 two books per child; 

(3)
 48 large building blocks per group; 

(4)
 200 small building blocks per group; 

(5)
 five pieces of dramatic play equipment or sets of Montessori Practical Life equipment per group; 

(6)
 materials and accessories required for subitem (5) to carry out the theme of the activity; 

(7)
 one double easel per group; 

(8)
 three pieces of durable, indoor, large muscle equipment per group; 

(9)
 three pieces of durable, outdoor, large muscle equipment per group; 

(10)
 one mirror, at least 12 inches by 36 inches, made of Plexiglas or a similar plastic or safety glass, per group; 

(11)
 one music source such as a tape recorder or record player per group and music selections appropriate for the source; 

(12)
 one set of cognitive developmental equipment and materials, such as puzzles and number and letter games, per child; 

(13)
 two sets of manipulative equipment, such as interlocking plastic forms, per child; 

(14)
 pictures at child's eye level, mobiles, and other items as needed to create a pleasant environment and provide sensory stimulation; and 

(15)
 one rhythm instrument per child. 

C.
 Supplies: 

(1)
 an adequate amount of facial tissue; 

(2)
 an adequate amount of single service towels; and 

(3)
 an adequate amount of liquid hand soap. 

Subp. 6.Equipment and materials for school-age children.  
The minimum equipment and materials required for a program serving school-age children are as follows: 

A.
 Furnishings: 

(1)
 one area rug or carpet per group; 

(2)
 two square feet of wall or bulletin board display space per child; 

(3)
 one nonfolding child size chair per child; 

(4)
 one partially enclosed space equipped for quiet activity per group; 

(5)
 one linear foot of open shelving per child; and 

(6)
 20 linear inches of table edge space per child. 

B.
 Program equipment and materials: 

(1)
 arts and crafts supplies, such as clay or playdough, tempera or fingerpaints, white or colored paper, paste, collage materials, paint brushes, felt type markers, crayons, and scissors; 

(2)
 two books per child; 

(3)
 three sets of dramatic play equipment or Montessori Practical Life area equipment per group; 

(4)
 materials and accessories for subitem (3) as required to carry out the theme of the activity; 

(5)
 one music source such as a tape recorder or record player per group and music selections appropriate for the source; 

(6)
 five musical or rhythm instruments per group; 

(7)
 three pieces of durable, outdoor, large muscle equipment per group; 

(8)
 pictures at child's level, mobiles, and other items as needed to create a pleasant environment and provide sensory stimulation; 

(9)
 one set of cognitive developmental equipment and materials, such as puzzles and games, per child; 

(10)
 five sets of manipulative equipment, such as interlocking plastic forms, per group; and 

(11)
 ten pieces of sports or recreational equipment, such as bats, balls, hoops, and jump ropes, per group. 

C.
 Supplies: 

(1)
 an adequate amount of facial tissue; 

(2)
 an adequate amount of single service towels; and 

(3)
 an adequate amount of liquid hand soap. 

9503.0065CHILD CARE FOR CHILDREN WITH SPECIAL NEEDS. Subpart 1.Definition.  
"Child with special needs" for purposes of this part means a child at least six weeks old but younger than 13 years old who: 

A.
 has developmental disabilities or is otherwise eligible for case management as specified in parts 9525.0004 to 9525.0036 and has an individual service plan specifying child care to be provided by the center; 

B.
 has been identified by the local school district as a child with a disability as specified in Minnesota Statutes, section 125A.02, subdivision 1, and has an individualized education program specifying child care to be provided by the center according to Minnesota Statutes, section 125A.05; or 

C.
 has been determined by a licensed physician, psychiatrist, licensed psychologist, or licensed consulting psychologist as having a special need relating to physical, social, or emotional development. 

Subp. 2.Report to parent.  
The license holder must inform the parent of any diagnosed or identified special need of a child that was not reported by the parent at the time of admission. 

Subp. 3.Individual child care program plan.  
When a license holder admits a child with special needs, the license holder must ensure that an individual child care program plan is developed to meet the child's individual needs. The individual child care program plan must be in writing and specify methods of implementation and be reviewed and followed by all staff who interact with the child. 

If the child has developmental disabilities or is otherwise eligible for case management as specified in subpart 1, item A, then the individual child care plan must be coordinated with the child's individual service plan developed under parts 9525.0004 to 9525.0036. 

If the child has a disability as specified in subpart 1, item B, then the individual child care plan must be coordinated with the child's individualized education program developed under Minnesota Statutes, chapter 125A. 

If the child has a special need determined under subpart 1, item C, the individual child care plan must be coordinated with reports from the licensed physician, licensed psychiatrist, licensed psychologist, or licensed consulting psychologist. The individual child care plan must be evaluated at least annually by the licensed physician, licensed psychiatrist, licensed psychologist, or licensed consulting psychologist and with the child's parent to determine if the needs of the child are being met. 

Subp. 4.Service contracts.  
The license holder must have copies of all service contracts with the center for care or services provided under parts 9525.0004 to 9525.0036 and Minnesota Statutes, chapter 125A, when the care or service is provided to a child while at the center. 

Subp. 5.Additional staff, staff qualifications, or training.  
The license holder must ensure that any additional staff, staff qualifications, or training required by the child's individual child care plan in subpart 3 are provided. 

9503.0070NIGHT CARE PROGRAM. Subpart 1.Applicability.  
A license holder operating a night care program must comply with this part as well as with all other requirements of parts 9503.0005 to 9503.0170. 

Subp. 2.Furnishings.  
Each child enrolled in a night care program must be provided with a crib, a bed, or a cot with a mattress. A crib and two sets of clean linens must be provided for each infant and meet the standards specified in part 9503.0050. A bed or a cot with a mattress, two sets of sheets, a blanket or quilt, and personal towels and washcloths must be provided for each child in all other age categories. 

Subp. 3.Garments for sleeping.  
The license holder must ensure that all children are put to bed in garments for sleeping as designated by the child's parent. 

Subp. 4.Personal effects.  
The license holder must ensure that all children have the personal effects needed to clean up and prepare for sleep. The effects must include an individual wash cloth, towel, toothbrush, toothpaste, and liquid hand soap. 

Subp. 5.Meals and snacks.  
The license holder must ensure that a child who will be present in the center between 6:00 p.m. and 7:00 p.m. has had or will be provided with an evening meal. A bedtime snack must be available for all children in attendance. Eating times and schedules for the individual child must be consistent with patterns established in consultation with the child's parents. 

Subp. 6.Staffing.  
At least two staff persons, one of whom must qualify as a teacher under part 9503.0032, must be present in the center at all times during the hours the night program is in operation. When more than 80 percent of the children present are asleep, the remaining staff persons needed to meet the required staff-to-child ratio must have at least the qualifications of a child care aide. Program staff must be awake and dressed and provide supervision to children who are sleeping. 

Subp. 7.Wash-up assistance.  
The license holder must ensure that children have the opportunity to wash up and cleanse their teeth before bedtime and be assisted by program staff when necessary. 

Subp. 8.Privacy.  
To ensure privacy, school-age boys and girls must be separated during bedtime washing and changing activities. 

Subp. 9.Infants.  
Infants must have a sleep area separate from the center's play and activity areas. 

Subp. 10.Bedtime.  
A child's bedtime must be scheduled in consultation with the child's parent. 

Subp. 11.Light.  
In rooms used for sleep during children's bedtime, light must be reduced to no less than one footcandle. 

Subp. 12.Program emphasis.  
A license holder operating a night care program must comply with the child care program standards in part 9503.0045. However, the child care program plan must emphasize quiet activities. 

Subp. 13.Exceptions.  
The outdoor activity area, outdoor activities, and outdoor equipment required by part 9503.0060 for children enrolled in a night care program need not be provided. 

9503.0075DROP-IN AND SCHOOL-AGE CHILD CARE PROGRAMS. Subpart 1.Exemptions for drop-in and school-age child care programs.  
A license holder operating a drop-in or school-age child care program as defined in part 9503.0015 must comply with parts 9503.0005 to 9503.0170 with the following exceptions: 

A.
 The staff ratios and group size restrictions in part 9503.0040 do not apply and are replaced by the requirements in subparts 2 to 6. 

B.
 Part 9503.0045, subpart 1, items F and G, of the child care program plan do not apply. 

C.
 The requirement in part 9503.0050, subpart 6, that separate bedding be provided for each child in care applies only to those children in care who are less than 30 months old. The provisions in part 9503.0050, subpart 6, requiring washing and cleaning of bedding and blankets remain in effect and apply to all bedding or blankets used by the drop-in child care program. 

D.
 Half the furnishings, equipment, materials, or supplies specified by the following subparts of part 9503.0060 are required: 

(1)
 subpart 4, item A, subitems (2), (5), and (8); 

(2)
 subpart 5, item A, subitems (2), (3), and (7); and 

(3)
 subpart 6, item A, subitems (3) and (6). 

E.
 Part 9503.0070, regarding night care programs, does not apply. 

F.
 Part 9503.0090, subpart 2, regarding parent conferences and daily reports, does not apply. 

Subp. 2.Supervision.  
A drop-in and school-age child care program must: 

A.
 be operated under the supervision of a person who qualifies both as a director under part 9503.0031 and as a teacher under part 9503.0032; and 

B.
 have at least two staff persons present at the center whenever the program is operating even when the ages and numbers of children present are such that the staff-to-child ratio requirements established in subpart 3 could be met by having only one staff person. 

Subp. 3.Staff ratios; drop-in programs.  
The minimum ratio of staff persons to children that a license holder may maintain in a drop-in program is: 

A.
 for infants ages six weeks through 16 months, one staff person for every four infants; 

B.
 for children ages 17 months through 29 months, one staff person for every seven children; and 

C.
 for children ages 30 months through 12 years, one staff person for every ten children. 

Subp. 3a.Staff ratios; school-age programs.  
A school age program must maintain a minimum staff ratio as provided in Minnesota Statutes, section 245A.14, subdivision 6, paragraph (f). 

Subp. 4. Exception to staff ratio for ages 30 months through 12 years in a drop-in program.  
The number of children per staff person specified in subpart 3 for a drop-in program may be increased only with children ages 30 months through 12 years, only by a maximum of four children, and only for a time period, not to exceed 20 minutes, required for additional staff to arrive at the center. A center that exceeds the ratio in subpart 3, item C, must be able to document having staff persons who, as a condition of their employment, are on call to come to the center as needed and arrive at the center within 20 minutes after receiving notification to report. 

Subp. 5.Age category grouping; drop-in programs.  
Whenever the total number of children present to be cared for at a drop-in child care center is more than 20, the center shall comply with Minnesota Statutes, section 245A.14, subdivision 6, paragraph (e). 

Subp. 5a.Care provided to siblings.  
A drop-in child care program may group siblings together as provided in Minnesota Statutes, section 245A.14, subdivision 6, paragraph (k). 

Subp. 6.Staff distribution.  
Staff distributions for drop-in child care programs must meet the requirements in items A and B. 

A.
 If a drop-in child care program serves both infants and older children, the following minimum staff distribution pattern applies for the supervision of infants ages six weeks through 16 months and children ages 17 months through 29 months: 

(1)
 The first staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an assistant teacher as specified in part 9503.0033. 

(2)
 The second staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1. 

(3)
 The third staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an assistant teacher as specified in part 9503.0033. 

(4)
 The fourth staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1. 

(5)
 The fifth staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an assistant teacher as specified in part 9503.0033. 

(6)
 The sixth staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1. 

B.
 The following minimum staff distribution pattern applies for the supervision of children 30 months and older. 

(1)
 The first staff person needed to meet the required staff-to-child ratio specified in subpart 3, item C, must meet the qualifications for teachers specified in part 9503.0032. 

(2)
 The second, third, and fourth staff persons needed to meet the required staff-to-child ratio specified in subpart 3, item C, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1. 

(3)
 The fifth staff person needed to meet the staff-to-child ratio required in subpart 3, item C, must have at least the qualifications of an assistant teacher as specified in part 9503.0033. 

(4)
 The sixth, seventh, and eighth staff persons needed to meet the staff-to-child ratio required in subpart 3, item C, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1. 

(5)
 For any additional staff persons needed after the eighth staff person to meet ratio requirements, the pattern of required staff qualifications established in subitems (3) and (4) applies. 

9503.0080EXCLUSION OF SICK CHILDREN. 
A child with any of the following conditions or behaviors is a sick child and must be excluded from a center not licensed to operate a sick care program. If the child becomes sick while at the center, the child must be isolated from other children in care and the parent called immediately. A sick child must be supervised at all times. The license holder must exclude a child: 

A.
 with a reportable illness or condition as specified in part 4605.7040 that the commissioner of health determines to be contagious and a physician determines has not had sufficient treatment to reduce the health risk to others; 

B.
 with chicken pox until the child is no longer infectious or until the lesions are crusted over; 

C.
 who has vomited two or more times since admission that day; 

D.
 who has had three or more abnormally loose stools since admission that day; 

E.
 who has contagious conjunctivitis or pus draining from the eye; 

F.
 who has a bacterial infection such as streptococcal pharyngitis or impetigo and has not completed 24 hours of antimicrobial therapy; 

G.
 who has unexplained lethargy; 

H.
 who has lice, ringworm, or scabies that is untreated and contagious to others; 

I.
 who has a 100 degree Fahrenheit axillary or higher temperature of undiagnosed origin before fever reducing medication is given; 

J.
 who has an undiagnosed rash or a rash attributable to a contagious illness or condition; 

K.
 who has significant respiratory distress; 

L.
 who is not able to participate in child care program activities with reasonable comfort; or 

M.
 who requires more care than the program staff can provide without compromising the health and safety of other children in care. 

9503.0085SICK CARE PROGRAM. Subpart 1.Licensure of sick care programs.  
If a license holder chooses to care for a sick child, then the license holder must operate a sick care program that complies with the standards specified by this part and with all other applicable provisions of parts 9503.0005 to 9503.0170, and any standards of the commissioner of health governing the group care of children. 

Subp. 2.Review of admission and health policies and practices.  
At the time of initial license application, after the first six months of initial operation, and annually after that time, a sick care program's admission policies must be reviewed and approved by a licensed physician with a specialization in pediatric care. The physician's review must include consultation with the licensed registered nurse or physician responsible for admissions. A report of the physician's findings must be sent to the commissioner with the initial application for licensure, and subsequent reports must be placed in the center's administrative record. 

The license holder operating a sick care program must ensure that the program's health policies and practices are reviewed quarterly by a health consultant. 

Subp. 3.Evaluation of a sick child.  
A license holder who operates a sick care program must provide for the evaluation of the condition of a sick child before admitting the child to the center. The evaluation must be based on the physical symptoms of the child each day of admission, the probable contagion and risk to the health of others present, and the ability of the program to provide the care the child requires. A physician or registered nurse affiliated with the center must perform the evaluations specified in items A to C. 

A.
 A preliminary evaluation must be made before the parent brings the child to the center. The preliminary evaluation must consist of the parent's reporting the child's symptoms to the center's physician or registered nurse by phone. The physician or registered nurse must tell the parent whether the parent may bring the child to the center for further evaluation. Children with a communicable reportable illness or condition as specified in part 4605.7040 must be evaluated by a physician prior to admission to the center. 

B.
 The physician or registered nurse must do a physical assessment of the child and obtain a health history from the parent when the child is brought to the center. 

C.
 The decision of the physician or registered nurse not to admit the child for care is final. 

Subp. 3a.Illness separation.  
Children recovering from a noncontagious condition must be cared for in a room separate from children with contagious conditions. 

Subp. 4.Chicken pox.  
Children with chicken pox must be excluded from any child care program, including a sick care program, unless care is provided in a room that is separate from other parts of the facility and has its own air circulation system and street entrance. 

Subp. 5.Gastrointestinal illness.  
Children with gastrointestinal illness must be at least two years old to be in a sick care program and must be cared for in a separate room used exclusively for the care of gastrointestinal illness. 

Subp. 6.Information to parents.  
A summary of the sick care program's health care policies and practices and the center's procedures for notification of parents in the event of an emergency must be given to the parent at the time a child is admitted. 

Subp. 7.Parent conference exception.  
Centers licensed to provide child care exclusively to sick children need not provide parent conferences as specified in part 9503.0090, subpart 2, item B. 

Subp. 8.Child care program emphasis.  
A sick care program must meet the child care program plan standards in part 9503.0045. However, the child care program plan for the care of sick children must emphasize quiet activities. 

Subp. 9.Group size and age category grouping exceptions.  
The maximum group sizes specified in part 9503.0040, subpart 1, and the age category grouping restrictions in part 9503.0040, subpart 3, are not required except that there must be no more than 16 children in care in a room at the same time and the provisions in subparts 5 and 14 apply. 

Subp. 10.Additional staff-to-child ratios and staff distribution requirements.  
A one to four staff to child ratio must be maintained at all times in a room used to care for sick children. At least two staff persons must be present in a center operating a sick care program whenever sick children are in care. The first staff person must be a nurse registered by the Board of Nursing to practice professional nursing. The second staff person must meet the qualifications for a teacher in part 9503.0032. The remaining staff persons must at least meet the qualifications and follow the staff distribution pattern specified in part 9503.0040. 

Subp. 11.Limitation on staff assignment.  
Staff must not care for well children or prepare food for well children on the same day they care for sick children. Staff caring for sick children must not enter the kitchen used to prepare food for well children. 

Subp. 12.Food preparation.  
Food provided by the license holder and prepared at the center must be prepared in a room separate from rooms where sick care is provided and must be delivered to each sick care room in individual servings and in covered containers. Procedures for preparing, handling, and serving food and washing food, utensils, and equipment must comply with the requirements in chapter 4626. 

Subp. 13.Menus.  
Menus for sick children must be modified to meet the individual needs of the child. 

Subp. 14.Additional facility requirements.  
A license holder operating a sick care program must provide: 

A.
 a room or rooms that are exclusively used to care for sick children and that are not used at any time for any other child care purpose; and 

B.
 toilets and hand sinks that are within or immediately adjacent to the room or rooms used for sick care and are not used by well children in care. 

Subp. 15.Outdoor activity area, activities and equipment exception.  
A license holder operating a sick care program that provides care exclusively to sick children need not provide the outdoor activity area required in part 9503.0155, subpart 7; outdoor activities as specified in part 9503.0045, subpart 1, item I; and the outdoor equipment required in part 9503.0060, subpart 4, item B, subitem (9); subpart 5, item B, subitem (9); and subpart 6, item B, subitems (7) and (11). 

Subp. 16.Disinfection.  
Walls and floors in rooms where sick care is provided and all linens, furnishings, objects, and equipment used by sick children must be cleaned and disinfected at least daily and as needed. 

Subp. 17.Linens and changes of clothing.  
All linens used by a sick child must be washed after each use, and each child must be in clean clothing at all times. 

Subp. 18.Additional equipment.  
Each sick child must be provided with a crib, bed, or cot, two sheets, a pillow, a pillowcase, and a blanket or quilt. 

9503.0090INFORMATION FOR PARENTS. Subpart 1.Policies given to parents.  
At the time of a child's enrollment, the parent must be provided with written notification of the: 

A.
 ages and numbers of children the center is licensed to serve; 

B.
 hours and days of operation; 

C.
 child care program options the center is licensed to operate, including a description of the program's educational methods and religious, political, or philosophical basis, if any, and how parents may review the center's child care program plan; 

D.
 center's policy on parent conferences and notification to a parent of a child's intellectual, physical, social, and emotional development; 

E.
 center's policy requiring a health care summary and immunization record of a child; 

F.
 policies and procedures for the care of children who become sick at the center and parent notification practices for the onset of or exposure to a contagious illness or condition or when there is an emergency or injury requiring medical attention; 

G.
 center's policies and procedures for administering first aid and sources of care to be used in case of emergencies; 

H.
 center's policies on the administration of medicine; 

I.
 procedures for obtaining written parental permission for field trips; 

J.
 procedures for obtaining written parental permission before each occasion of research, experimental procedure, or public relations activity involving a child; 

K.
 center's policies on the provision of meals and snacks; 

L.
 center's behavior guidance policies and procedures; 

M.
 presence of pets; 

N.
 center's policy that parents of enrolled children may visit the center any time during the hours of operation; and 

O.
 telephone number of the Department of Human Services, Division of Licensing. 

Subp. 2.Parent conferences and daily reports.  
The license holder must ensure that the parent of a child is informed of the child's progress. The license holder must ensure that: 

A.
 individual parent conferences are planned and offered by program staff at least twice a year; 

B.
 documentation is made in the child's record that individual parent conferences were planned and offered; 

C.
 the status of the child's intellectual, physical, social, and emotional development is reported to the parent during the conference; and 

D.
 daily written reports are made to the parent of an infant or toddler about the child's food intake, elimination, sleeping patterns, and general behavior. 

9503.0095PARENT VISITATION. 
Parents of enrolled children may visit the center any time during the hours of operation. 

9503.0100PARTICIPATION IN FIELD TRIPS. 
The license holder must ensure that written permission is obtained from each child's parent before taking a child on a field trip. A written permission form must be obtained before each field trip or on a form that annually summarizes all field trips that will be taken. The parent's written permission must state that the parent has been informed of the purpose and destination of the field trip. 

On field trips, staff must take emergency phone numbers for the child's parent and the persons to be called if a parent cannot be reached, the phone number of the child's physician, and a first aid kit. 

9503.0105RESEARCH AND PUBLIC RELATIONS PERMISSION. 
The license holder must ensure that written permission is obtained from a parent before a child is involved in experimental research or public relations activity involving a child while at the center. A separate written permission form must be obtained before each occasion of experimental research or public relations activity or on a form that annually summarizes all research and public relations activities that will be undertaken. The permission form must be maintained in the child's record. 

9503.0110EMERGENCY AND ACCIDENT POLICIES AND RECORDS. Subpart 1.Policies and records.  
The applicant must develop written policies governing emergencies, accidents, and injuries. The license holder must ensure that written records are kept about incidents, emergencies, accidents, and injuries that have occurred. 

Subp. 2.Instruction record.  
The license holder must keep a record of instruction to all staff persons and, when appropriate, to children and parents, about how to carry out the policies. 

Subp. 3.Policy content.  
The policies must contain: 

A.
 Procedures for administering first aid. 

B.
 Safety rules to follow in avoiding injuries, burns, poisoning, choking, suffocation, and traffic and pedestrian accidents. 

C.
 Procedures for the daily inspection of potential hazards. 

D.
 Procedures for fire prevention and procedures to follow in the event of a fire. Fire procedures must: 

(1)
 mandate monthly fire drills and a log of drill times and dates; 

(2)
 identify primary and secondary exits, building evacuation routes, the phone number of the fire department, persons responsible for the evacuation of children, and areas for which they are responsible; 

(3)
 contain instruction on how to use a fire extinguisher and how to close off the fire area; and 

(4)
 provide for the training of staff persons to carry out the fire procedures. 

E.
 Procedures to follow in the event of a blizzard, tornado, or other natural disaster that include the location of emergency shelter, procedures for monthly tornado drills from April to September, and a log of times and dates showing that the drills were held. 

F.
 Procedures to follow when a child is missing. 

G.
 Procedures to follow if an unauthorized person or a person who is incapacitated or suspected of abuse attempts to pick up a child or if no one comes to pick up a child. 

H.
 Sources of emergency medical care. 

I.
 Procedures for recording accidents, injuries, and incidents involving a child enrolled in the center. The written record must contain the name and age of the persons involved; date and place of the accident, injury, or incident; type of injury; action taken by staff; and to whom the accident, injury, or incident was reported. 

J.
 Procedures mandating an annual analysis of the record in item I and any modification of the center's policies based on the analysis. 

Subp. 4.Records.  
The following records must be maintained in the center's administrative record: 

A.
 the procedures specified in subpart 3; 

B.
 a log of fire and tornado drills; and 

C.
 a written record of accidents, injuries, emergencies, and incidents. 

9503.0115CENTER ADMINISTRATIVE RECORDS. 
The records required by this part must be maintained within the center and be available for inspection at the request of the commissioner. The license holder must ensure that the following are maintained: 

A.
 a record of the information given to parents specified in part 9503.0090; 

B.
 the personnel records specified in part 9503.0120; 

C.
 the children's records specified in part 9503.0125; 

D.
 the child care program plan specified in part 9503.0045; 

E.
 the accident, injury, emergency, and incident records specified in part 9503.0110; 

F.
 the staff distribution schedule specified in part 9503.0040; 

G.
 the separation reports mandated in part 9503.0055; and 

H.
 the report by the health consultant mandated in part 9503.0140. 

9503.0120PERSONNEL RECORDS. 
The license holder must ensure that a personnel record for each staff person is maintained at the center. The personnel record for each staff person must contain: 

A.
 the staff person's name, home address, home telephone number, and date of birth; 

B.
 the staff person's documentation indicating that the staff person meets the requirements of the staff person's job position and the education and experience requirements specified in parts 9503.0031 to 9503.0034; 

C.
 documentation that the staff person has completed the orientation to the center required in part 9503.0035, subpart 1; 

D.
 documentation, when applicable, that the staff person has completed the first aid and CPR training required in part 9503.0035, subparts 2 and 3; and 

E.
 documentation of completion of the in-service training required by part 9503.0035, subpart 4, showing the training topic, source of training, number of hours completed, and method used to document mastery of the subject. 

9503.0125CHILDREN'S RECORDS. 
At the time of enrollment in the center, the license holder must ensure that a record is maintained on each child. The record must contain: 

A.
 the child's full name, birthdate, and current home address; 

B.
 the name, address, and telephone number of the child's parent; 

C.
 instructions on how the parent can be reached when the child is attending the center; 

D.
 the names and telephone numbers of any persons authorized to take the child from the center; 

E.
 the names, addresses, and telephone numbers of the child's source of regular medical and dental care and the source of medical and dental care to be used in case of an emergency; 

F.
 the names, addresses, and telephone numbers of two persons to be contacted if a parent cannot be reached in an emergency or when there is an injury requiring medical attention; 

G.
 the health form and immunization information required by part 9503.0140; 

H.
 written authorization for the license holder to act in an emergency, or when a parent cannot be reached or is delayed; 

I.
 the hours and days of the week the child will attend the center; 

J.
 for children age six weeks to 36 months, a description of the child's eating, sleeping, toileting, and communication habits, and effective methods for comforting the child; 

K.
 documentation of any dietary or medical needs of the child; 

L.
 documentation of any individual child care program needs for the child; and 

M.
 the date of parent conferences and a summary of the information provided to the parent at the conference. 

The license holder shall not disclose a child's record to any person other than the child, the child's parent or guardian, the child's legal representative, employees of the license holder, and the commissioner unless the child's parent or guardian has given written consent or as otherwise required by law. 

9503.0130REPORTING. Subpart 1.Abuse; neglect.  
The license holder must comply with the reporting requirements for abuse and neglect specified in Minnesota Statutes, chapter 260E. 

Subp. 2.Other reporting.  
The license holder must inform the commissioner within: 

A.
 24 hours of the death of a child in care in the center; 

B.
 24 hours of any injury to a child in care in the center that required treatment by a physician; 

C.
 48 hours of the occurrence of a fire during the hours of operation that requires the service of a fire department; and 

D.
 24 hours of the use of any emergency medical service by a child while in care. 

Subp. 3.
[Repealed, 18 SR 2748] 

Subp. 4.
[Repealed, 18 SR 2748] 

9503.0140HEALTH. Subpart 1.Health policies.  
The license holder must develop written health policies approved by the commissioner and must ensure that they are carried out. 

Subp. 2.Health consultation.  
The center must have a health consultant who must review the center's health policies and practices specified in items A to C and certify that they are adequate to protect the health of children in care. 

The review must be done before initial licensure, submitted with the application for initial licensure and repeated every year after the date of initial licensure. For programs serving infants, this review must be done initially and monthly thereafter. Additionally, the license holder must request a review by the health consultant of the center's health policies and practices if there is a proposed change in the center's health policies or practices or an outbreak of contagious reportable illness as specified in part 4605.7040. A copy of the consultant's findings must be placed in the center's administrative record. 

The consultant must review: 

A.
 The first aid and safety policies and procedures required by part 9503.0110, subpart 3, items A, B, and C. 

B.
 The diapering procedures and practices specified in subpart 12. 

C.
 The sanitation procedures and practices for food not prepared by or provided by the license holder as specified in part 9503.0145, subpart 3, and for infants as specified in part 9503.0145, subpart 7. 

Subp. 3.Health information at admission.  
Before a child is admitted to a center or within 30 days of admission, the license holder must obtain a report on a current physical examination of the child signed by the child's source of medical care. 

Subp. 4.Reexamination.  
For children already admitted to the center, the license holder shall obtain an updated report of physical examination signed by the child's source of medical care at least annually for children under 24 months of age, and whenever a child 24 months or older advances to an older age category. 

Subp. 5.Immunizations.  
When a child is enrolled in the center, the license holder must obtain documentation of current immunization according to Minnesota Statutes, section 121A.15, a signed notarized statement of parental objection to the immunization, or a medical exemption. 

Subp. 6.Notice about a sick child.  
Notices about the illness or condition of a child must be given as required in items A to D: 

A.
 The license holder must ensure that a parent is notified immediately when the parent's child becomes sick at the center. 

B.
 The license holder must require a parent to inform the center within 24 hours, exclusive of weekends and holidays, when a child is diagnosed by a child's source of medical or dental care as having a contagious reportable disease specified in part 4605.7040, or lice, scabies, impetigo, ringworm, or chicken pox. 

C.
 The license holder must post or give a notice to the parents of exposed children the same day a parent notifies the center of a child's illness or condition listed in item B. 

D.
 The license holder must ensure that the health authority is notified of any suspected case of reportable disease as specified in part 4605.7040 within 24 hours of receiving the parent's report. 

Subp. 7.Administration of medicine.  
A license holder who chooses to administer medicine must ensure that the procedures in items A to E are followed. 

A.
 The license holder must get written permission from the child's parent before administering medicine, diapering products, sunscreen lotions, and insect repellents. Nonprescription medicines, diapering products, sunscreen lotions, and insect repellents must be administered according to the manufacturer's instructions unless there are written instructions for their use provided by a licensed physician or dentist. 

B.
 The license holder must get and follow written instructions from a licensed physician or dentist before administering each prescription medicine. Medicine with the child's name and current prescription information on the label constitutes instructions. 

C.
 All medicine must be kept in its original container and have a legible label stating the child's name. The medicine must be given only to the child whose name is on the label. The medicine must not be given after an expiration date on the label, and any unused portion must be returned to the child's parent or destroyed. The license holder must ensure that the administration of medicine is recorded and give the name of the child, name of the medication or prescription number, date, time, dosage, and the name and signature of the person who dispensed the medicine. The record must be available to the parent and maintained in the child's record. 

D.
 Sunscreen lotions and insect repellents supplied by the license holder may be used on more than one child. A product to control or prevent diaper rash, including premoistened commercial wipes that cannot be dispensed in a manner that prevents cross contamination of the product and container as determined by the health consultant, must be labeled with the child's name and used only for the individual child whose name is written on the label. 

E.
 Medicines, insect repellents, sunscreen lotions, and diaper rash control products must be stored according to directions on the original container and so that they are inaccessible to children. 

Subp. 8.
[Repealed, 18 SR 2748] 

Subp. 9.Cleanliness.  
The indoor and outdoor space and equipment of the center must be clean. 

Subp. 10.Toilet facilities.  
The toilet rooms of the center must be cleaned daily. Toilet training chairs must be emptied, washed with soap and water, and disinfected after each use. Toilets and seats must be washed with soap and water and disinfected when soiled or at least daily. 

Subp. 11.Diaper changing area.  
A diaper must be changed only in the diaper changing area. The diaper changing area must be separate from areas used for food storage, food preparation, and eating. The area must have a hand sink equipped with hot and cold running water within three feet of the diaper changing surface, a smooth nonabsorbent diaper changing surface and floor covering, and a sanitary container for soiled and wet diapers. 

Subp. 12.Diaper changing procedures.  
The center must have and follow diaper changing procedures that have been developed in consultation with a health consultant. The license holder must post the diaper changing procedures in the diaper changing area. 

Subp. 13.Hand washing: child.  
A child's hands must be washed with soap and water after a diaper change, after use of a toilet or toilet training chair, and before eating a meal or snack. Staff must monitor hand washing and assist a child who needs help. The use of a common basin or a hand sink filled with standing water is prohibited. 

Subp. 14.Hand washing: staff person.  
A staff person must wash his or her hands with soap and water after changing a child's diaper, after using toilet facilities, and before handling food or eating. 

Subp. 15.Toilet articles.  
The license holder shall provide the following supplies and make them accessible to children: toilet paper, liquid hand soap, facial tissues, and single use paper towels or warm air hand dryers. 

Subp. 16.First aid kit.  
The license holder must ensure that a first aid kit is available within the center. The kit must contain sterile bandages and band-aids, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer, and adhesive tape. A current first aid manual must be included. The first aid kit and manual must be accessible to the staff in the center and taken on field trips. 

Subp. 17.Hazardous objects.  
Sharp objects, medicines, plastic bags, and poisonous plants and chemicals, including household supplies, must be stored out of reach of children. 

Subp. 18.Emergency equipment.  
The center must have a battery operated flashlight and battery operated portable radio. 

Subp. 19.Condition of equipment and furniture.  
Equipment and furniture must be durable, in good repair, structurally sound and stable following assembly and installation. Equipment must be free of sharp edges, dangerous protrusions, points where a child's extremities could be pinched or crushed, and openings or angles that could trap part of a child's body. Tables, chairs, and other furniture must be appropriate to the age and size of children who use them. Toys and equipment that are likely to be mouthed by infants and toddlers must be made of a material that can be disinfected. These must be cleaned and disinfected when mouthed or soiled and at least daily. 

Infant rattles must meet the United States consumer product safety standards contained in the Code of Federal Regulations, title 16, sections 1510.1 to 1510.4, as adopted on May 23, 1978. All toys and other articles intended for use by children under three years of age that present choking, aspiration, or ingestion hazards because of small parts must meet the size standards in Code of Federal Regulations, title 16, sections 1501.1 to 1501.5, as adopted on June 15, 1979. 

Subp. 20.Maintenance of areas used by children.  
The areas used by children must be free from debris, loose flaking, peeling, or chipped paint, loose wallpaper, or crumbling plaster, litter, and holes in the walls, floors, and ceilings. Rugs must have a nonskid backing or be firmly fastened to the floor and be free from tears, curled or frayed edges, and hazardous wrinkles. 

Subp. 21.Emergencies.  
The license holder must ensure that written procedures for emergencies and accidents are posted in a visible place. The procedures must: 

A.
 identify persons responsible for each area; 

B.
 identify primary and secondary exits; 

C.
 identify a tornado shelter area; 

D.
 identify building evacuation routes; 

E.
 describe how to use a fire extinguisher and close off the fire area; and 

F.
 list the phone numbers and sources of emergency medical and dental care, poison control center, fire department, health authority, and licensing division of the Department of Human Services. 

Subp. 22.Pets.  
If pets are permitted at the center, parents must be informed at the time of admission that a pet is present. 

9503.0145FOOD AND WATER. Subpart 1.Food.  
The license holder must see that meals and supplemental snacks are available. Bag lunches provided by the parent are acceptable as specified in subpart 4. 

Subp. 2.Menus.  
When food is provided by the license holder, menus must comply with the nutritional requirements of the United States Department of Agriculture, Food and Nutrition Service, Code of Federal Regulations, title 7, section 226.20. 

Subp. 3.Sanitation.  
Procedures for preparing, handling, and serving food, and washing food, utensils, and equipment must comply with the requirements for food and beverage establishments in chapter 4626. If the food is prepared off site by another facility or if food service is provided according to a contract with a food service provider, the facility or license holder must ensure that food is prepared in compliance with chapter 4626. The license holder must provide refrigeration for dairy products and other perishable foods, whether supplied by the license holder or supplied by the parent. The refrigeration must have a temperature of 40 degrees Fahrenheit or less. Tables and highchair trays used for meals must be washed with soap and water before and after each use. 

Subp. 4.Meals and snacks.  
Each meal must provide one-third of the child's daily nutritional needs as specified by the United States Department of Agriculture, Food and Nutrition Service, in Code of Federal Regulations, title 7, section 226.20. The license holder must provide or ensure the availability of: 

A.
 a snack for a child in attendance for more than two hours, but fewer than five hours; 

B.
 one meal and two snacks or two meals and one snack for a child in attendance five to ten hours unless four or more of these hours are spent in sleep; 

C.
 a minimum of two meals and two snacks for a child in attendance more than ten hours unless four or more of these hours are spent in sleep; and 

D.
 program staff who are seated with the children during meal and snack times. 

Subp. 5.Prescribed diet needs.  
The license holder must provide for a child's dietary needs prescribed by the child's source of medical care or require the parent to provide the prescribed diet items that are not part of the menu plan approved in subpart 2. A license holder serving a child who has a prescribed diet must keep the diet order and its duration specified in the child's record. All staff designated to provide care to the child must be informed of the diet order. 

Subp. 6.Food allergy information.  
Information about food allergies of the children in the center must be available in the area where food is prepared or served to children with allergies. All staff providing care to the child must be informed of the allergy. 

Subp. 7.Infant diets.  
The diet of an infant must be determined by the infant's parent. The license holder must ensure that sanitary procedures and practices are used to prepare, handle, and store formula, milk, breast milk, solid foods, and supplements. Procedures must be reviewed and certified by a health consultant. A center serving infants must: 

A.
 obtain written dietary instructions from the parent of the child; 

B.
 have the infant's feeding schedule available in the food preparation area; 

C.
 offer the child formula or milk and nutritionally adequate solid foods in prescribed quantities at specified time intervals; and 

D.
 label each child's bottle. 

Subp. 8.Water.  
The center must have a safe water supply. A center that uses water from a privately owned well that is not governed by chapter 4720 must be tested annually by a Minnesota Health Department certified laboratory for coliform bacteria and nitrate nitrogens to verify safety. The license holder must ensure that a record of the test results is in the center's administrative record. The commissioner of health may issue an advisory order for retesting and corrective measures. 

Drinking water must be available to children throughout the hours of operation and offered at frequent intervals. Drinking water for children must be provided in single service drinking cups or from drinking fountains accessible to children. 

9503.0150TRANSPORTATION. 
A license holder who provides transportation for children or contracts to provide transportation must comply with the following transportation policies: 

A.
 The vehicle must be driven by a person who holds a current Minnesota driver's license appropriate to the vehicle driven. 

B.
 Staff ratios must be maintained on all transportation provided on all field trips. 

C.
 When children are driven in a private car or van, a second adult must be present when more than four children under the age of five are being transported. 

D.
 When the license holder provides transportation to and from the center, a second adult must be present in the vehicle and children must not be transported more than one hour per one-way trip. A two-way communication system can be used in lieu of a second adult when ten or fewer children are being transported. 

E.
 When children are transported, they must be restrained in accordance with Minnesota Statutes, section 169.686, and a child under the age of four may be transported only if the child is properly fastened in a child passenger restraint system that meets the federal motor vehicle safety standards contained in Code of Federal Regulations, title 49, section 571.213. 

9503.0155FACILITY. Subpart 1.Occupancy designation.  
In areas of the state that have adopted the Minnesota State Building Code, the applicant must comply with the standards specified by the code if the application is an initial one. In those areas of the state that have not adopted the Minnesota State Building Code, an applicant for licensure must comply with any applicable local building ordinances if the application is an initial one. The commissioner must not grant an initial license until written verification of compliance with the State Building Code or local building ordinance, when applicable, has been received by the commissioner from the building official with jurisdiction. 

Subp. 2.Fire inspection.  
The center must be inspected by a fire marshal within 12 months before initial licensure. The commissioner must not grant an initial license until the commissioner has received written approval of compliance with the Minnesota Uniform Fire Code from the fire marshal with jurisdiction. 

Subp. 3.Reinspection for cause.  
If the commissioner has reasonable cause to believe that a potential hazard exists, the commissioner may request another inspection and written report by a fire marshal, building official, or health authority to verify the absence of hazard. 

Subp. 4.Facility floor plan and designated areas.  
Indoor and outdoor space to be used for child care must be designated on a facility floor plan. This space must be exclusively used for child care by the center during the hours of operation. The initial application for licensure and the center's administrative record must contain a floor plan of the center. Precise scale drawings are not required. The plan must indicate the: 

A.
 dimensions and location of all areas of the center designated for the provision of child care; 

B.
 planned use of each area; and 

C.
 size and location of areas used for outdoor activity. 

Subp. 5.Child's personal storage space.  
A center must have storage space for each child's clothing and personal belongings. The space must be at a height appropriate to the age of the child. 

Subp. 6.Space for children who become sick.  
Space must be provided in the center for a child who becomes sick at a center not licensed to operate a sick care program under part 9503.0085. The space must be separate from activity areas used by other children. A cot and blanket must be provided. The space must be within sight and hearing of a staff person and supervised by a staff person when occupied by a sick child. 

Subp. 7.Outdoor activity area.  
An outdoor activity area that complies with the following items must be provided or available for all child care programs except those licensed to exclusively provide sick care as specified in part 9503.0085, drop in care as specified in part 9503.0075, and those operating for less than three hours a day. 

A.
 A center must have an outdoor activity area of at least 1,500 square feet, and there must be at least 75 square feet of space per child within the area at any given time during use. 

B.
 An outdoor activity area used daily by children under school age must be within 2,000 feet of the center or transportation must be provided by the license holder. In no case, however, shall the outdoor activity area be farther than one-half mile from the center. 

C.
 The area must be enclosed if it is located adjacent to a traffic, rail, water, machinery, or other environmental hazard, unless the area is a public park or playground. 

D.
 The area must be free of litter, rubbish, toxic materials, water hazard, machinery, animal waste, and sewage contaminants. 

E.
 The area must contain the outdoor large muscle equipment required by part 9503.0060. 

Subp. 8.
[Repealed, L 2019 1Sp9 art 2 s 134] 

Subp. 9.Indoor space.  
The licensed capacity of the center must be limited by the amount of indoor space. A minimum of 35 square feet of indoor space must be available for each child in attendance. Hallways, stairways, closets, utility rooms, lavatories, water closets, kitchens, and space occupied by cribs may not be counted as indoor space. Twenty-five percent of the space occupied by furniture or equipment used by staff or children may be counted as indoor space. 

Subp. 10.Shielding of hot surfaces.  
Radiators, fireplaces, hot pipes, and other hot surfaces in areas used by children must be shielded or insulated to prevent burns. 

Subp. 11.Electrical outlets.  
Except in a center that serves only school-age children, electrical outlets must be tamper proof or shielded when not in use. 

Subp. 12.Water hazards.  
Bodies of water within or adjacent to the center must be inaccessible to children. When using a pool or beach, children must be supervised at all times. 

Subp. 13.Room temperature.  
A minimum temperature of 68 degrees Fahrenheit must be maintained in indoor areas used by children. 

Subp. 14.
[Repealed, 18 SR 2748] 

Subp. 15.Hazardous areas.  
Kitchens, stairs, and other hazardous areas must be inaccessible to children except during periods of supervised use. 

Subp. 16.Fire extinguisher inspection.  
Fire extinguishers must be serviced annually by a qualified inspector. The name of the inspector and date of the inspection must be written on a tag attached to the extinguisher. 

Subp. 17.Screens.  
Outside doors and windows used for ventilation must be screened to provide protection from insects. 

Subp. 18.Toilets and hand sinks.  
Toilets and hand sinks must be provided as specified in items A to G: 

A.
 The center must have at least one hand sink and one toilet for each 15 children or portion of 15 children specified in the licensed capacity. One toilet training seat or training chair must be provided for every 15 toddlers specified in the licensed capacity. Any hand sink required for children, other than infants, must be in the toilet area. 

B.
 In newly constructed centers or those undergoing major remodeling to the plumbing system, foot or wrist operated sinks must be provided in the diaper changing area. 

C.
 Hand sinks for children must not be used for custodial work or food preparation. 

D.
 The temperature of hot water in the hand sinks used by children must not exceed 120 degrees Fahrenheit. 

E.
 Single service towels or air dryers must be available to dry hands and designed for easy use by the children. 

F.
 Toilets, sinks, faucets, and hand drying devices in the toilet area used by children under school age other than infants must be placed at a height appropriate to the ages of the children. 

G.
 Portable steps may be used to meet the requirement in item F for toddlers and preschoolers, if the steps are sturdy and washable. 

9503.0170LICENSING PROCESS. Subpart 1.License required.  
A person, corporation, partnership, voluntary association, or other organization may not operate a child care program in a center unless licensed by the commissioner under parts 9503.0005 to 9503.0170 and Minnesota Statutes, chapter 245A. 

Subp. 2.
[Repealed, 18 SR 2748] 

Subp. 3.Posting license.  
A license holder must post the license in a conspicuous place within the child care center. 

Subp. 4.
[Repealed, 18 SR 2748] 

Subp. 5.
[Repealed, 18 SR 2748] 

Subp. 6.
[Repealed, 18 SR 2748] 

Subp. 7.
[Repealed, L 1997 c 248 s 51 subd 3]