1.1 	CONFERENCE COMMITTEE REPORT ON S.F. No. 4612
1.2 	A bill for an act
1.3 	relating to state government; modifying provisions relating to the Departments of 
1.4 	Health, Human Services, and Children, Youth, and Families; making changes for 
1.5 	federal compliance; establishing work or community engagement requirements; 
1.6 	providing for pharmacy dispensing reimbursements; modifying reimbursement 
1.7 	rates for mental health services; modifying mental health provider credentialing 
1.8 	requirements; modifying the county share for Supplemental Nutrition Assistance 
1.9 	Program costs; modernizing child care and family child care licensing; modifying 
1.10 	the Minnesota African American Family Preservation and Child Welfare 
1.11 	Disproportionality Act; establishing a committee, legislative commission, and 
1.12 	advisory task force; establishing a hospital stabilization program; transferring 
1.13 	regulatory oversight of health maintenance organizations to the commissioner of 
1.14 	commerce; requiring coverage of infertility treatment; regulating gas resource 
1.15 	development; providing for health care worker retention and protection; requiring 
1.16 	reports; authorizing rulemaking; requiring transfer; appropriating money;amending 
1.17 	Minnesota Statutes 2024, sections 16A.103, by adding a subdivision; 60A.50, 
1.18 	subdivision 3; 60A.951, subdivision 3; 60A.985, subdivision 8; 60A.9853, 
1.19 	subdivision 1; 60A.9854; 60B.03, subdivision 2; 60G.01, subdivisions 2, 4; 62A.02, 
1.20 	subdivision 8; 62A.021, subdivision 1; 62A.61; 62A.65, subdivisions 7, 8; 62D.08, 
1.21 	subdivisions 1, 2, 3, 7; 62D.12, subdivision 1; 62D.124, subdivision 5; 62D.221, 
1.22 	subdivisions 1, 2; 62E.11, subdivisions 9, 13; 62J.60, subdivision 5; 62L.02, 
1.23 	subdivision 8; 62L.08, subdivision 11; 62L.09, subdivision 3; 62L.10, subdivision 
1.24 	4; 62L.11, subdivision 2; 62M.11; 62Q.01, subdivision 2; 62Q.096; 62Q.106; 
1.25 	62Q.188, subdivision 2; 62Q.37, subdivision 2; 62Q.47; 62Q.51, subdivision 3; 
1.26 	62Q.556, subdivisions 3, 4; 62Q.679; 62Q.69, subdivisions 2, 3; 62Q.71; 62Q.73, 
1.27 	subdivisions 3, 10; 62Q.81, subdivision 7; 62U.04, subdivision 13, by adding a 
1.28 	subdivision; 103I.001; 103I.005, subdivisions 9, 21, by adding subdivisions; 
1.29 	103I.601, subdivision 1, by adding subdivisions; 142D.21, subdivision 3; 142F.05, 
1.30 	by adding subdivisions; 144.1222, subdivision 4, by adding a subdivision; 144.1501, 
1.31 	subdivision 2; 144.1503, subdivision 7; 144.1505, subdivisions 1, 2, 3; 144.1507, 
1.32 	subdivisions 1, 2, 4, by adding a subdivision; 144.1911, subdivisions 1, 5, 6; 
1.33 	144.555, by adding subdivisions; 145A.14, subdivision 2a; 151.741, subdivision 
1.34 	4; 245.462, by adding a subdivision; 245.4711, subdivision 5; 245.4881, subdivision 
1.35 	5; 245A.211, subdivision 1; 256.01, by adding a subdivision; 256.017, subdivision 
1.36 	2; 256B.01; 256B.04, subdivision 27; 256B.056, subdivisions 1, 2a, 7, 7a; 
1.37 	256B.0561, subdivision 2; 256B.06, subdivision 4; 256B.0625, by adding a 
1.38 	subdivision; 256B.076, subdivision 1, by adding subdivisions; 256B.094, 
1.39 	subdivisions 2, 3, 6; 256B.75; 260.63, subdivision 10; 260.64, subdivision 2; 
1.40 	260.67, subdivision 2; 260.68, subdivision 2; 260.69, subdivision 1; 260.693, 
1.41 	subdivision 2; 260C.451, by adding a subdivision; 295.52, subdivision 8; Minnesota 
1.42 	Statutes 2025 Supplement, sections 62D.21; 62D.211; 142A.03, subdivision 2; 
1.43 	144.125, subdivision 1; 151.741, subdivision 5; 245A.07, subdivision 3; 245C.02, 
2.1 	subdivision 15a; 245C.05, subdivision 5; 256.043, subdivision 3; 256.9657, 
2.2 	subdivision 2b; 256.969, subdivision 2f; 256B.0625, subdivisions 8, 20; 256B.0924, 
2.3 	subdivision 6; 256B.1973, subdivision 9; 256B.69, subdivision 6d; 256B.761, by 
2.4 	adding a subdivision; 260.691, subdivision 1; 260.692, subdivisions 1, 2, 3; Laws 
2.5 	2024, chapter 117, sections 21; 22; Laws 2024, chapter 127, article 67, section 7; 
2.6 	proposing coding for new law in Minnesota Statutes, chapters 62D; 62Q; 103I; 
2.7 	142D; 144; 245A; 256; 256B; 260; proposing coding for new law as Minnesota 
2.8 	Statutes, chapters 142H; 142I; repealing Minnesota Statutes 2024, sections 142B.01, 
2.9 	subdivisions 11, 12, 13, 25, 26, 27; 142B.41, subdivisions 4, 6, 7, 8, 10, 11, 12, 
2.10 	13; 142B.54, subdivisions 1, 2, 3; 142B.62; 142B.65, subdivisions 1, 2, 3, 4, 5, 6, 
2.11 	7, 10; 142B.66, subdivisions 1, 2, 4, 5; 142B.70, subdivisions 1, 2, 3, 4, 5, 6, 9, 
2.12 	10, 11, 12; 142B.71; 142B.72; 142B.74; 142B.75; 142B.76; 142B.77; 151.741, 
2.13 	subdivisions 2, 3, 6; 256B.0625, subdivision 38; 256B.198; 260.63, subdivision 
2.14 	9; Minnesota Statutes 2025 Supplement, sections 142B.41, subdivision 9; 142B.65, 
2.15 	subdivisions 8, 9; 142B.66, subdivision 3; 142B.70, subdivisions 7, 8; 256B.69, 
2.16 	subdivision 6i; Minnesota Rules, parts 9502.0300; 9502.0315; 9502.0325; 
2.17 	9502.0335; 9502.0341; 9502.0345; 9502.0355; 9502.0365; 9502.0367; 9502.0375; 
2.18 	9502.0395; 9502.0405; 9502.0415; 9502.0425; 9502.0435, subparts 1, 2, 3, 4, 6, 
2.19 	7, 8, 9, 10, 11, 12, 13, 14, 15, 16; 9502.0445; 9503.0005; 9503.0010; 9503.0015; 
2.20 	9503.0030; 9503.0031; 9503.0032; 9503.0033; 9503.0034; 9503.0040; 9503.0045; 
2.21 	9503.0050; 9503.0055; 9503.0060; 9503.0065; 9503.0070; 9503.0075; 9503.0080; 
2.22 	9503.0085; 9503.0090; 9503.0095; 9503.0100; 9503.0105; 9503.0110; 9503.0115; 
2.23 	9503.0120; 9503.0125; 9503.0130; 9503.0140; 9503.0145; 9503.0150; 9503.0155; 
2.24 	9503.0170.
2.25 	May 17, 2026
2.26 	The Honorable Bobby Joe Champion
2.27 	President of the Senate
2.28 	The Honorable Lisa M. Demuth
2.29 	Speaker of the House of Representatives
2.30 	We, the undersigned conferees for S.F. No. 4612 report that we have agreed upon the 
2.31 	items in dispute and recommend as follows:
2.32 	That the House recede from its amendments and that S.F. No. 4612 be further amended 
2.33 	as follows:
2.34 	Delete everything after the enacting clause and insert:

2.35 	ARTICLE 1
2.36 	DEPARTMENT OF HEALTH

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

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

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

5.1 	Sec. 4. Minnesota Statutes 2024, section 62K.02, subdivision 2, is amended to read:
5.2 		Subd. 2.Scope. (a) This chapter applies only to health plans offered in the individual 
5.3 	market or the small group market, including stand-alone dental plans sold on MNsure.
5.4 	(b) This chapter applies to health carriers with respect to individual health plans and 
5.5 	small group health plans, unless otherwise specified.
5.6 	(c) If a health carrier issues or renews individual or small group health plans in other 
5.7 	states, this chapter applies only to health plans issued or renewed in this state to a Minnesota 
5.8 	resident, or to cover a resident of the state, or issued or renewed to a small employer that 
5.9 	is actively engaged in business in this state, unless otherwise specified.
5.10 	(d) This chapter does not apply to short-term coverage as defined in section 62A.65, 
5.11 	subdivision 7, or grandfathered plan coverage as defined in section 62A.011, subdivision 
5.12 	1b.

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

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

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

6.8 	Sec. 8. Minnesota Statutes 2024, section 62K.105, is amended to read:
6.9 	62K.105 NETWORK ADEQUACY COMPLAINTS.
6.10 	The commissioner of health shall establish a clear, easily accessible process for accepting 
6.11 	complaints from enrollees regarding health carrier compliance with section 62K.10, 
6.12 	subdivision 2, 3, or 4. Using this process, an enrollee may file a complaint with the 
6.13 	commissioner that a health carrier is not in compliance with the requirements of section 
6.14 	62K.10, subdivision 2, 3, or 4. The commissioner of health shall investigate all complaints 
6.15 	received under this section.

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

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

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

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

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

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

12.18 	Sec. 15. Minnesota Statutes 2024, section 144.1222, subdivision 4, is amended to read:
12.19 		Subd. 4.Definitions. (a) For purposes of this section, the following terms have the 
12.20 	meanings given them.
12.21 	(b) "ASME/ANSI standard" means a safety standard accredited by the American National 
12.22 	Standards Institute and published by the American Society of Mechanical Engineers.
12.23 	(c) "ASTM standard" means a safety standard issued by ASTM International, formerly 
12.24 	known as the American Society for Testing and Materials.
12.25 	(d) "Public pool" means any pool other than a private residential pool, that is: (1) open 
12.26 	to the public generally, whether for a fee or free of charge; (2) open exclusively to members 
12.27 	of an organization and their guests; (3) open to residents of a multiunit apartment building, 
12.28 	apartment complex, residential real estate development, or other multifamily residential 
12.29 	area; (4) open to patrons of a hotel or lodging or other public accommodation facility; or 
12.30 	(5) operated by a person in a park, school, licensed child care facility, group home, motel, 
12.31 	camp, resort, club, condominium, manufactured home park, or political subdivision with 
13.1 	the exception of swimming pools at family day care homes licensed under section 142B.41, 
13.2 	subdivision 9, paragraph (a).
13.3 	(e) "Unblockable suction outlet or drain" means a drain of any size and shape that a 
13.4 	human body cannot sufficiently block to create a suction entrapment hazard and meets 
13.5 	ASME/ANSI standards.
13.6 	(f) "Certified swimming class" means an infant swimming resource (ISR) class; an 
13.7 	American Red Cross swimming class, swimming lesson, or learn-to-swim class; or any 
13.8 	other swimming class certified by a nationally accredited organization that operates in all 
13.9 	50 states.
13.10 	(g) "Certified swimming instructor" means a certified ISR instructor; a certified American 
13.11 	Red Cross swimming instructor or swim coach; or any other swimming instructor certified 
13.12 	by a nationally accredited organization that operates in all 50 states.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

23.26 	Sec. 30. Minnesota Statutes 2024, section 144.551, subdivision 1, as amended by Laws 
23.27 	2026, chapter 91, section 1, is amended to read:
23.28 		Subdivision 1.Restricted construction or modification. (a) The following construction 
23.29 	or modification may not be commenced:
23.30 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
23.31 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
23.32 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
24.1 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
24.2 	state; and
24.3 	(2) the establishment of a new hospital.
24.4 	(b) This section does not apply to:
24.5 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
24.6 	facility that is a national referral center engaged in substantial programs of patient care, 
24.7 	medical research, and medical education meeting state and national needs that receives more 
24.8 	than 40 percent of its patients from outside the state of Minnesota;
24.9 	(2) a project for construction or modification for which a health care facility held an 
24.10 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
24.11 	certificate;
24.12 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
24.13 	appeal results in an order reversing the denial;
24.14 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
24.15 	section 2;
24.16 	(5) a project involving consolidation of pediatric specialty hospital services within the 
24.17 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
24.18 	of pediatric specialty hospital beds among the hospitals being consolidated;
24.19 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
24.20 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
24.21 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
24.22 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
24.23 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
24.24 	(7) the relocation or redistribution of hospital beds within a hospital building or 
24.25 	identifiable complex of buildings provided the relocation or redistribution does not result 
24.26 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
24.27 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
24.28 	state or a region of the state;
24.29 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
24.30 	involves the transfer of beds from a closed facility site or complex to an existing site or 
24.31 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
24.32 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
24.33 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
25.1 	health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution 
25.2 	does not involve the construction of a new hospital building; and (v) the transferred beds 
25.3 	are used first to replace within the hospital corporate system the total number of beds 
25.4 	previously used in the closed facility site or complex for mental health services and substance 
25.5 	use disorder services. Only after the hospital corporate system has fulfilled the requirements 
25.6 	of this item may the remainder of the available capacity of the closed facility site or complex 
25.7 	be transferred for any other purpose;
25.8 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
25.9 	County that primarily serves adolescents and that receives more than 70 percent of its 
25.10 	patients from outside the state of Minnesota;
25.11 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
25.12 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
25.13 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
25.14 	construction of the initial building or as the result of future expansion, will not exceed 100 
25.15 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
25.16 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
25.17 	the Direct Care and Treatment executive board to a new or existing facility, building, or 
25.18 	complex operated by the Direct Care and Treatment executive board; from one regional 
25.19 	treatment center site to another; or from one building or site to a new or existing building 
25.20 	or site on the same campus;
25.21 	(12) the construction or relocation of hospital beds operated by a hospital having a 
25.22 	statutory obligation to provide hospital and medical services for the indigent that does not 
25.23 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
25.24 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
25.25 	Medical Center to Regions Hospital under this clause;
25.26 	(13) a construction project involving the addition of up to 31 new beds in an existing 
25.27 	nonfederal hospital in Beltrami County;
25.28 	(14) a construction project involving the addition of up to eight new beds in an existing 
25.29 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
25.30 	(15) a construction project involving the addition of 20 new hospital beds in an existing 
25.31 	hospital in Carver County serving the southwest suburban metropolitan area;
26.1 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
26.2 	of up to two psychiatric facilities or units for children provided that the operation of the 
26.3 	facilities or units have received the approval of the commissioner of human services;
26.4 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
26.5 	services in an existing hospital in Itasca County;
26.6 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
26.7 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
26.8 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
26.9 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
26.10 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
26.11 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
26.12 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
26.13 	to the extent that the critical access hospital does not seek to exceed the maximum number 
26.14 	of beds permitted such hospital under federal law;
26.15 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
26.16 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
26.17 	(i) the project, including each hospital or health system that will own or control the entity 
26.18 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
26.19 	Council as of March 1, 2006;
26.20 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
26.21 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
26.22 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
26.23 	have been found to be in the public interest by the commissioner of health as of April 1, 
26.24 	2005;
26.25 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
26.26 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
26.27 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
26.28 	services, and emergency room services;
26.29 	(iv) the new hospital:
26.30 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
26.31 	needs of the Maple Grove service area and the surrounding communities currently being 
26.32 	served by the hospital or health system that will own or control the entity that will hold the 
26.33 	new hospital license;
27.1 	(B) will provide uncompensated care;
27.2 	(C) will provide mental health services, including inpatient beds;
27.3 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
27.4 	occupations and have a commitment to providing clinical training programs for physicians 
27.5 	and other health care providers;
27.6 	(E) will demonstrate a commitment to quality care and patient safety;
27.7 	(F) will have an electronic medical records system, including physician order entry;
27.8 	(G) will provide a broad range of senior services; and
27.9 	(H) will provide emergency medical services that will coordinate care with regional 
27.10 	providers of trauma services and licensed emergency ambulance services in order to enhance 
27.11 	the continuity of care for emergency medical patients; and
27.12 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
27.13 	the control of the entity holding the new hospital license; and
27.14 	(v) as of 30 days following submission of a written plan, the commissioner of health 
27.15 	has not determined that the hospitals or health systems that will own or control the entity 
27.16 	that will hold the new hospital license are unable to meet the criteria of this clause;
27.17 	(21) a project approved under section 144.553;
27.18 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
27.19 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
27.20 	is approved by the Cass County Board;
27.21 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
27.22 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
27.23 	a separately licensed 13-bed skilled nursing facility;
27.24 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
27.25 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
27.26 	who are under 21 years of age on the date of admission. The commissioner conducted a 
27.27 	public interest review of the mental health needs of Minnesota and the Twin Cities 
27.28 	metropolitan area in 2008. No further public interest review shall be conducted for the 
27.29 	construction or expansion project under this clause;
27.30 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
27.31 	commissioner finds the project is in the public interest after the public interest review 
27.32 	conducted under section 144.552 is complete;
28.1 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
28.2 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
28.3 	admission, if the commissioner finds the project is in the public interest after the public 
28.4 	interest review conducted under section 144.552 is complete;
28.5 	(ii) this project shall serve patients in the continuing care benefit program under section 
28.6 	256.9693. The project may also serve patients not in the continuing care benefit program; 
28.7 	and
28.8 	(iii) if the project ceases to participate in the continuing care benefit program, the 
28.9 	commissioner must complete a subsequent public interest review under section 144.552. If 
28.10 	the project is found not to be in the public interest, the license must be terminated six months 
28.11 	from the date of that finding. If the commissioner of human services terminates the contract 
28.12 	without cause or reduces per diem payment rates for patients under the continuing care 
28.13 	benefit program below the rates in effect for services provided on December 31, 2015, the 
28.14 	project may cease to participate in the continuing care benefit program and continue to 
28.15 	operate without a subsequent public interest review;
28.16 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
28.17 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
28.18 	date of admission;
28.19 	(28) a project to add 55 licensed beds in an existing safety net, level I trauma center 
28.20 	hospital in Ramsey County as regulated under section 383A.91, subdivision 5, of which 15 
28.21 	beds are to be used for inpatient mental health and 40 are to be used for other services. In 
28.22 	addition, five unlicensed observation mental health beds shall be added;
28.23 	(29) upon submission of a plan to the commissioner for public interest review under 
28.24 	section 144.552 and the addition of the 15 inpatient mental health beds specified in clause 
28.25 	(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I 
28.26 	trauma center hospital in Ramsey County as regulated under section 383A.91, subdivision 
28.27 	5. Five of the 45 additional beds authorized under this clause must be designated for use 
28.28 	for inpatient mental health and must be added to the hospital's bed capacity before the 
28.29 	remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed 
28.30 	beds under this clause prior to completion of the public interest review, provided the hospital 
28.31 	submits its plan by the 2021 deadline and adheres to the timelines for the public interest 
28.32 	review described in section 144.552;
28.33 	(30) upon submission of a plan to the commissioner for public interest review under 
28.34 	section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital 
29.1 	in Hennepin County that exclusively provides care to patients who are under 21 years of 
29.2 	age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital 
29.3 	may add licensed beds under this clause prior to completion of the public interest review, 
29.4 	provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for 
29.5 	the public interest review described in section 144.552;
29.6 	(31) any project to add licensed beds in a hospital located in Cook County or Mahnomen 
29.7 	County that: (i) is designated as a critical access hospital under section 144.1483, clause 
29.8 	(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of 
29.9 	fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of 
29.10 	licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding 
29.11 	section 144.552, a public interest review is not required for a project authorized under this 
29.12 	clause;
29.13 	(32) upon submission of a plan to the commissioner for public interest review under 
29.14 	section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's 
29.15 	hospital in St. Paul that is part of an independent pediatric health system with freestanding 
29.16 	inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric 
29.17 	inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add 
29.18 	licensed beds under this clause prior to completion of the public interest review, provided 
29.19 	the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public 
29.20 	interest review described in section 144.552;
29.21 	(33) a project for a 144-bed psychiatric hospital on the site of the former Bethesda 
29.22 	hospital in the city of Saint Paul, Ramsey County, if the commissioner finds the project is 
29.23 	in the public interest after the public interest review conducted under section 144.552 is 
29.24 	complete. Following the completion of the construction project, the commissioner of health 
29.25 	shall monitor the hospital, including by assessing the hospital's case mix and payer mix, 
29.26 	patient transfers, and patient diversions. The hospital must have an intake and assessment 
29.27 	area. The hospital must accommodate patients with acute mental health needs, whether they 
29.28 	walk up to the facility, are delivered by ambulances or law enforcement, or are transferred 
29.29 	from other facilities. The hospital must comply with subdivision 1a, paragraph (b). The 
29.30 	hospital must annually submit de-identified data to the department in the format and manner 
29.31 	defined by the commissioner;
29.32 	(34) a project involving the relocation of up to 26 licensed long-term acute care hospital 
29.33 	beds from an existing long-term care hospital located in Hennepin County with a licensed 
29.34 	capacity prior to the relocation of 92 beds to dedicated space on the campus of an existing 
29.35 	safety net, level I trauma center hospital in Ramsey County as regulated under section 
30.1 	383A.91, subdivision 5, provided both the commissioner finds the project is in the public 
30.2 	interest after the public interest review conducted under section 144.552 is complete and 
30.3 	the relocated beds continue to be used as long-term acute care hospital beds after the 
30.4 	relocation; or
30.5 	(35) a project to add 85 licensed beds in an existing safety net, level I trauma center 
30.6 	hospital in Ramsey County as regulated under section 383A.91, subdivision 5.

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

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

30.16 	Sec. 32. Minnesota Statutes 2024, section 145.561, subdivision 2, is amended to read:
30.17 		Subd. 2.988 Lifeline. (a) The commissioner shall administer the designation of and 
30.18 	oversight for a 988 Lifeline center or a network of 988 Lifeline centers to answer contacts 
30.19 	from individuals accessing the Suicide and Crisis Lifeline from any jurisdiction within the 
30.20 	state 24 hours per day, seven days per week.
30.21 	(b) The designated 988 Lifeline Center must:
30.22 	(1) have an active agreement with the 988 Suicide and Crisis Lifeline program for 
30.23 	participation in the network and the department;
30.24 	(2) meet the 988 Lifeline program requirements and best practice guidelines for 
30.25 	operational and clinical standards;
30.26 	(3) provide data and reports, and participate in evaluations and related quality 
30.27 	improvement activities as required by the 988 Lifeline program and the department;
30.28 	(4) identify or adapt technology that is demonstrated to be interoperable across mobile 
30.29 	crisis and public safety answering points used in the state for the purpose of crisis care 
30.30 	coordination;
31.1 	(5) facilitate crisis and outgoing services, including mobile crisis teams in accordance 
31.2 	with guidelines established by the 988 Lifeline program and the department;
31.3 	(6) actively collaborate and coordinate service linkages with mental health and substance 
31.4 	use disorder treatment providers, local community mental health centers including certified 
31.5 	community behavioral health clinics and community behavioral health centers, mobile crisis 
31.6 	teams, and community based and hospital emergency departments;
31.7 	(7) offer follow-up services to individuals accessing the 988 Lifeline Center that are 
31.8 	consistent with guidance established by the 988 Lifeline program and the department; and
31.9 	(8) meet the requirements set by the 988 Lifeline program and the department for serving 
31.10 	at-risk and specialized populations.
31.11 	(c) The commissioner shall adopt rules to allow appropriate information sharing and 
31.12 	communication between and across crisis and emergency response systems.
31.13 	(d) The commissioner, having primary oversight of suicide prevention, shall work with 
31.14 	the 988 Lifeline program, veterans crisis line, and other SAMHSA-approved networks for 
31.15 	the purpose of ensuring consistency of public messaging about 988 services.
31.16 	(e) The commissioner shall work with representatives from 988 Lifeline Centers and 
31.17 	public safety answering points, other public safety agencies, and the commissioner of public 
31.18 	safety to facilitate the development of protocols and procedures for interactions between 
31.19 	988 and 911 services across Minnesota. Protocols and procedures shall be developed 
31.20 	following available national standards and guidelines.
31.21 	(f) The commissioner shall provide an annual a biennial public report on 988 Lifeline 
31.22 	usage by July 1 of each even-numbered year, including data on answer rates, abandoned 
31.23 	calls, and referrals to 911 emergency response. The biennial report may be included as a 
31.24 	section within the state suicide prevention report required under section 145.56.

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

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

32.9 	Sec. 35. Minnesota Statutes 2024, section 145A.04, subdivision 15, is amended to read:
32.10 		Subd. 15.State and local advisory committees. (a) A state community health services 
32.11 	advisory committee is established to advise, consult with, and make recommendations to 
32.12 	the commissioner on the development, maintenance, funding, and evaluation of local and 
32.13 	Tribal public health services. Each community health board may appoint a member to serve 
32.14 	on the committee. Each of Minnesota's federally recognized Tribal Nations may appoint a 
32.15 	member to serve on the committee. The committee must meet at least quarterly, and special 
32.16 	meetings may be called by the committee chair or a majority of the members. A Tribal 
32.17 	Nation may elect to participate at any time. Members or their alternates may be reimbursed 
32.18 	for travel and other necessary expenses while engaged in their official duties.
32.19 	(b) Notwithstanding section 15.059, the State Community Health Services Advisory 
32.20 	Committee does not expire.
32.21 	(c) The city boards or county boards that have established or are members of a community 
32.22 	health board may appoint a community health advisory committee to advise, consult with, 
32.23 	and make recommendations to the community health board on the duties under subdivision 
32.24 	1a.

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

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

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

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

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

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

35.1 	Sec. 42. Minnesota Statutes 2024, section 149A.955, subdivision 14, is amended to read:
35.2 		Subd. 14.Bodies awaiting natural organic reduction. A dead human body must be 
35.3 	placed in the natural organic reduction vessel to initiate the natural reduction process within 
35.4 	24 hours 14 calendar days after the natural organic reduction facility accepts legal and 
35.5 	physical custody of the body. A natural organic reduction facility must keep the body in 
35.6 	refrigeration while awaiting natural reduction. If a natural organic reduction facility does 
35.7 	not initiate natural reduction within 14 calendar days after accepting legal and physical 
35.8 	custody of the body, the facility must arrange final disposition of the body by burial or 
35.9 	cremation. The person or persons with the right to control and duty of disposition of the 
35.10 	body must determine whether the body is buried or cremated, and the body must be buried 
35.11 	or cremated within five calendar days after the end of the 14-day period.

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

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

35.19 	ARTICLE 2
35.20 	GAS RESOURCE DEVELOPMENT

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

36.20 	Sec. 2. Minnesota Statutes 2024, section 103I.001, is amended to read:
36.21 	103I.001 LEGISLATIVE INTENT.
36.22 	This chapter is intended to protect the health and general welfare by providing a means 
36.23 	for the development and protection of the natural resource of groundwater in an orderly, 
36.24 	healthful, and reasonable manner.

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

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

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

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

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

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

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

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

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

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

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

43.1 	Sec. 14. [103I.707] MORATORIUM ON GAS WELL CONVERSION AND 
43.2 	CONSTRUCTION.
43.3 	A person shall not drill, convert under section 103I.601, subdivision 12, or construct a 
43.4 	gas well for the primary purpose of extracting or producing gas until:
43.5 	(1) rules are adopted under section 103I.706;
43.6 	(2) the legislature enacts a statute specifically authorizing the issuance of gas resource 
43.7 	development permits; and
43.8 	(3) the legislature enacts fees for gas resource development permits.

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

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

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

44.8 	Sec. 18. EFFECTIVE DATE.
 44.9 	This article is effective the day following final enactment.

44.10 	ARTICLE 3
44.11 	HOSPITAL STABILIZATION

44.12 	Section 1. Minnesota Statutes 2024, section 16A.152, is amended by adding a subdivision 
44.13 	to read:
44.14 		Subd. 1c.Hospital stabilization reserve. A hospital stabilization reserve account is 
44.15 	created in the general fund in the state treasury. Amounts in the hospital stabilization reserve 
44.16 	are appropriated to the commissioner of management and budget for the uses authorized in 
44.17 	subdivision 1d. Any balance remaining in the account on June 30, 2031, is canceled to the 
44.18 	general fund.

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

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

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

45.1 	Sec. 3. Minnesota Statutes 2024, section 16A.152, is amended by adding a subdivision to 
45.2 	read:
45.3 		Subd. 1e.Hospital stabilization reserve Legislative Advisory Commission review. (a) 
45.4 	The Legislative Advisory Commission established under section 3.30 must review proposed 
45.5 	allocations from the hospital stabilization reserve account.
45.6 	(b) The commissioner of management and budget must submit proposed expenditures 
45.7 	from the hospital stabilization reserve account to the Legislative Advisory Commission for 
45.8 	its review and recommendation. Upon receiving a submission, the commission has seven 
45.9 	days after the request is submitted to review the proposed expenditures submitted under 
45.10 	this subdivision.
45.11 	(c) Commission members may make a positive recommendation, a negative 
45.12 	recommendation, or no recommendation on a proposed expenditure. If a majority of the 
45.13 	commission members from the senate and a majority of the commission members from the 
45.14 	house of representatives make a negative recommendation on a proposed expenditure, the 
45.15 	commissioner is prohibited from expending the money. If a majority of the commission 
45.16 	members from the senate and a majority of the commission members from the house of 
45.17 	representatives do not make a negative recommendation, or if the commission makes no 
45.18 	recommendation, the commissioner may expend the money.
45.19 	(d) The commission may hold a public meeting to approve or disapprove a proposed 
45.20 	expenditure from the hospital stabilization reserve account. Notwithstanding section 3.055, 
45.21 	the commission may conduct a public meeting remotely. The commission may approve or 
45.22 	disapprove proposed expenditures without a public meeting. The commission members 
45.23 	may approve or disapprove proposed expenditures via written communication sent to the 
45.24 	commissioner of management and budget.

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

45.26 	Sec. 4. Minnesota Statutes 2024, section 16A.152, subdivision 2, is amended to read:
45.27 		Subd. 2.Additional revenues; priority. (a) If on the basis of a forecast of general fund 
45.28 	revenues and expenditures, the commissioner of management and budget determines that 
45.29 	there will be a positive unrestricted budgetary general fund balance at the close of the 
45.30 	biennium, the commissioner of management and budget must allocate money to the following 
45.31 	accounts and purposes in priority order:
45.32 	(1) the cash flow account established in subdivision 1 until that account reaches 
45.33 	$350,000,000;
46.1 	(2) the budget reserve account established in subdivision 1a until that account reaches 
46.2 	$2,852,098,000 $3,421,764,000;
46.3 	(3) the amount necessary to increase the aid payment schedule for school district aids 
46.4 	and credits payments in section 127A.45 to not more than 90 percent rounded to the nearest 
46.5 	tenth of a percent without exceeding the amount available and with any remaining funds 
46.6 	deposited in the budget reserve; and
46.7 	(4) the amount necessary to restore all or a portion of the net aid reductions under section 
46.8 	127A.441 and to reduce the property tax revenue recognition shift under section 123B.75, 
46.9 	subdivision 5, by the same amount.
46.10 	(b) The amounts necessary to meet the requirements of this section are appropriated 
46.11 	from the general fund within two weeks after the forecast is released or, in the case of 
46.12 	transfers under paragraph (a), clauses (3) and (4), as necessary to meet the appropriations 
46.13 	schedules otherwise established in statute.
46.14 	(c) The commissioner of management and budget shall certify the total dollar amount 
46.15 	of the reductions under paragraph (a), clauses (3) and (4), to the commissioner of education. 
46.16 	The commissioner of education shall increase the aid payment percentage and reduce the 
46.17 	property tax shift percentage by these amounts and apply those reductions to the current 
46.18 	fiscal year and thereafter.

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

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

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

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

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

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

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

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

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

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

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

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

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

50.26 	Sec. 12. Laws 2023, chapter 68, article 1, section 2, subdivision 2, as amended by Laws 
50.27 	2025, First Special Session chapter 8, article 1, section 13, is amended to read:

50.28	Subd. 2.Multimodal Systems
 					
50.29 	(a) Aeronautics

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

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

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

52.13	Appropriations by Fund
	
52.14		2024
	2025
	
52.15	General
	8,707,000
	1,741,000
	
52.16	Airports
	6,690,000
	6,690,000
	
52.17 	$7,000,000 in fiscal year 2024 is from the 
52.18 	general fund to purchase two utility aircraft 
52.19 	for the Department of Transportation.

52.20	(3) Civil Air Patrol
		80,000
		80,000
	
52.21 	This appropriation is from the state airports 
52.22 	fund for the Civil Air Patrol.

52.23	(b) Transit and Active Transportation
		58,478,000
		18,374,000
	
52.24 	This appropriation is from the general fund.
52.25 	$200,000 in fiscal year 2024 and $50,000 in 
52.26 	fiscal year 2025 are for a grant to the city of 
52.27 	Rochester to implement demand response 
52.28 	transit service using electric transit vehicles. 
52.29 	The money is available for mobile software 
52.30 	application development; vehicles and 
52.31 	equipment, including accessible vehicles; 
52.32 	associated charging infrastructure; and capital 
52.33 	and operating costs.
53.1 	$40,000,000 in fiscal year 2024 is for matches 
53.2 	to federal aid and state investments related to 
53.3 	transit and active transportation projects. This 
53.4 	is a onetime appropriation and is available 
53.5 	until June 30, 2027.

53.6	(c) Safe Routes to School
		15,297,000
		10,500,000
	
53.7 	This appropriation is from the general fund 
53.8 	for the safe routes to school program under 
53.9 	Minnesota Statutes, section 174.40.
53.10 	If the appropriation for either year is 
53.11 	insufficient, the appropriation for the other 
53.12 	year is available for it. The appropriations in 
53.13 	each year are available until June 30, 2027.
53.14 	The base for this appropriation is $1,500,000 
53.15 	in each of fiscal years 2026 and 2027.

53.16	(d) Passenger Rail
		197,521,000
		4,226,000
	
53.17 	This appropriation is from the general fund 
53.18 	for passenger rail activities under Minnesota 
53.19 	Statutes, sections 174.632 to 174.636.
53.20 	$194,700,000 in fiscal year 2024 is for capital 
53.21 	improvements and betterments for the 
53.22 	Minneapolis-Duluth Northern Lights Express 
53.23 	intercity passenger rail project, including 
53.24 	preliminary engineering, design, engineering, 
53.25 	environmental analysis and mitigation, 
53.26 	acquisition of land and right-of-way, 
53.27 	equipment and rolling stock, and construction. 
53.28 	From this appropriation, the amount necessary 
53.29 	is for: (1) Coon Rapids station improvements 
53.30 	to establish a joint station that provides for 
53.31 	Amtrak train service on the Empire Builder 
53.32 	line between Chicago and Seattle; and (2) 
53.33 	acquisition of equipment and rolling stock for 
53.34 	purposes of participation in the Midwest fleet 
54.1 	pool to provide for service on Northern Lights 
54.2 	Express and expanded Amtrak train service 
54.3 	between Minneapolis and St. Paul and 
54.4 	Chicago. The commissioner of transportation 
54.5 	must not approve additional stops or stations 
54.6 	beyond those included in the Federal Railroad 
54.7 	Administration's January 2018 Finding of No 
54.8 	Significant Impact and Section 4(f) 
54.9 	Determination if the commissioner determines 
54.10 	that the resulting speed reduction would 
54.11 	negatively impact total ridership. This 
54.12 	appropriation is onetime and is available until 
54.13 	June 30, 2028. Any remaining balance must 
54.14 	cancel to the hospital stabilization reserve 
54.15 	account under Minnesota Statutes, section 
54.16 	16A.152, subdivision 1c.
54.17 	$1,833,000 in fiscal year 2024 and $3,238,000 
54.18 	in fiscal year 2025 are for a match to federal 
54.19 	aid for capital and operating costs for 
54.20 	expanded Amtrak train service between 
54.21 	Minneapolis and St. Paul and Chicago. These 
54.22 	amounts are available until June 30, 2028.
54.23 	The base from the general fund is $5,742,000 
54.24 	in each of fiscal years 2026 and 2027.

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

54.26	Appropriations by Fund
	
54.27		2024
	2025
	
54.28	General
	8,283,000
	2,400,000
	
54.29	Trunk Highway
	6,367,000
	6,666,000
	
54.30 	$5,000,000 in fiscal year 2024 is from the 
54.31 	general fund for matching federal aid grants 
54.32 	for improvements, engineering, and 
54.33 	administrative costs for the Stone Arch Bridge 
54.34 	in Minneapolis. This is a onetime 
55.1 	appropriation and is available until June 30, 
55.2 	2027.
55.3 	$1,000,000 in each year is from the general 
55.4 	fund for staff, operating costs, and 
55.5 	maintenance related to weight and safety 
55.6 	enforcement systems.
55.7 	$974,000 in fiscal year 2024 is from the 
55.8 	general fund for procurement costs of a 
55.9 	statewide freight network optimization tool 
55.10 	under Laws 2021, First Special Session 
55.11 	chapter 5, article 4, section 133. This is a 
55.12 	onetime appropriation and is available until 
55.13 	June 30, 2025.

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

55.15 	Sec. 13. Laws 2023, chapter 68, article 1, section 3, subdivision 2, as amended by Laws 
55.16 	2024, chapter 127, article 1, section 11, is amended to read:

55.17	Subd. 2.Transit System Operations
 		75,654,000
		32,654,000
	
55.18 	This appropriation is for transit system 
55.19 	operations under Minnesota Statutes, sections 
55.20 	473.371 to 473.449.
55.21 	$40,000,000 in fiscal year 2024 is for a grant 
55.22 	to Hennepin County for the Blue Line light 
55.23 	rail transit extension project, including but not 
55.24 	limited to predesign, design, engineering, 
55.25 	environmental analysis and mitigation, 
55.26 	right-of-way acquisition, construction, and 
55.27 	acquisition of rolling stock. Of this amount, 
55.28 	$30,000,000 is available only upon entering 
55.29 	a full funding grant agreement with the Federal 
55.30 	Transit Administration by June 30, 2027. This 
55.31 	is a onetime appropriation and is available 
55.32 	until June 30, 2030. If a full funding grant 
55.33 	agreement with the Federal Transit 
56.1 	Administration is not reached by June 30, 
56.2 	2027, this appropriation cancels to the hospital 
56.3 	stabilization reserve under Minnesota Statutes, 
56.4 	section 16A.152, subdivision 1c.
56.5 	$3,000,000 in fiscal year 2024 is for highway 
56.6 	bus rapid transit project development in the 
56.7 	marked U.S. Highway 169 and marked Trunk 
56.8 	Highway 55 corridors, including but not 
56.9 	limited to feasibility study, predesign, design, 
56.10 	engineering, environmental analysis and 
56.11 	remediation, and right-of-way acquisition.

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

56.13 	Sec. 14. HOSPITAL STABILIZATION RESERVE; TRANSFER.
 56.14 	(a) By July 15, 2027, the commissioner of management and budget must transfer 
56.15 	$354,000,000 from the general fund budget reserve account to the hospital stabilization 
56.16 	reserve account. This is a onetime transfer.
56.17 	(b) By July 15, 2028, the commissioner of management and budget must transfer up to 
56.18 	$146,000,000 from the general fund budget reserve account to the hospital stabilization 
56.19 	reserve account. This is a onetime transfer.
56.20 	(c) The total transfers and cancellations credited to the hospital stabilization reserve 
56.21 	account must not exceed $500,000,000.

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

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

59.25 	Sec. 16. CORPORATE BOARD OF HENNEPIN HEALTHCARE SYSTEM, INC.; 
59.26 	RECONSTITUTED AND OPERATIONAL.
 59.27 	(a) For purposes of this section, "Hennepin Healthcare System, Inc.," means the public 
59.28 	corporation created under Minnesota Statutes, section 383B.901.
59.29 	(b) By January 15, 2027, the Hennepin County Board of Commissioners must:
59.30 	(1) reconstitute the corporate board of Hennepin Healthcare System, Inc., with members 
59.31 	who meet the requirements in Minnesota Statutes, section 383B.903, subdivision 4; and
60.1 	(2) complete the transition of governance of Hennepin Healthcare System, Inc., to the 
60.2 	reconstituted corporate board.

60.3 	Sec. 17. HENNEPIN HEALTHCARE SYSTEM, INC.; STABILIZATION 
60.4 	PAYMENTS.
 60.5 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
60.6 	the meanings given.
60.7 	(b) "Commissioner" means the commissioner of health.
60.8 	(c) "HCMC" has the meaning given in Minnesota Statutes, section 383B.902.
60.9 	(d) "Hennepin Healthcare System, Inc.," means the public corporation created under 
60.10 	Minnesota Statutes, section 383B.901.
60.11 		Subd. 2.Annual stabilization payments. The commissioner of health must award 
60.12 	stabilization payments to Hennepin Healthcare System, Inc., in fiscal years 2026 and 2027 
60.13 	to stabilize HCMC operations, avoid the closure of HCMC, ensure that HCMC continues 
60.14 	to provide high-quality care to patients, and preserve access to essential services at HCMC 
60.15 	that support the health care needs of the communities served by HCMC and of the state of 
60.16 	Minnesota.
60.17 		Subd. 3.Accountability requirements. (a) To ensure that Hennepin Healthcare System, 
60.18 	Inc., is meeting the requirements of this section, the commissioner must collect from HCMC 
60.19 	the information necessary to complete the commissioner's reporting requirements under 
60.20 	subdivision 4 and must collect from HCMC the following information in fiscal year 2027:
60.21 	(1) a comprehensive financial analysis that describes the financial stability of HCMC. 
60.22 	The report must consider the core financial metrics of HCMC, including expenses and 
60.23 	staffing data; revenue, including payer mix; utilization data; and necessary data as determined 
60.24 	by the commissioner; and
60.25 	(2) quarterly updates of financial information submitted under the hospital annual report 
60.26 	according to Minnesota Statutes, sections 144.695 to 144.703, on a schedule to be determined 
60.27 	by the commissioner, and long-term capital spending priorities, including mandatory 
60.28 	maintenance and replacement of existing facilities and equipment.
60.29 	(b) Upon receipt of notice by Hennepin Healthcare System, Inc., provided according to 
60.30 	Minnesota Statutes, section 144.555, the commissioner must provide notice of Hennepin 
60.31 	Healthcare System, Inc.'s planned actions to:
61.1 	(1) the chairs and ranking minority members of the legislative committees with 
61.2 	jurisdiction over health and human services finance and policy; and
61.3 	(2) the majority and minority leaders of the senate and house of representatives.
61.4 		Subd. 4.Reporting requirement. (a) By January 15, 2028, the commissioner must 
61.5 	report to the legislative committees with jurisdiction over health and human services finance 
61.6 	and policy on the financial stabilization of Hennepin Healthcare System, Inc.
61.7 	(b) Hennepin Healthcare System, Inc., must provide the commissioner with all 
61.8 	information and documents requested by the commissioner, including nonpublic data from 
61.9 	HCMC, for purposes of this subdivision and subdivision 3. For purposes of this subdivision 
61.10 	and subdivision 3, "nonpublic data" has the meaning given in Minnesota Statutes, section 
61.11 	13.02, subdivision 9.

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

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

64.22 	ARTICLE 4
64.23 	HEALTH LICENSING BOARDS

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

67.4 	Sec. 2. Minnesota Statutes 2024, section 148.01, subdivision 4, is amended to read:
67.5 		Subd. 4.Practice of chiropractic. An individual licensed to practice under section 
67.6 	148.06 is authorized to perform chiropractic services, acupuncture, and therapeutic services, 
67.7 	and to provide diagnosis and to render opinions pertaining to those services for the purpose 
67.8 	of determining a course of action in the best interests of the patient, such as a treatment 
67.9 	plan, appropriate referral, or both.

67.10 	Sec. 3. Minnesota Statutes 2024, section 148.01, is amended by adding a subdivision to 
67.11 	read:
67.12 		Subd. 5.Practice of therapeutic services. Therapeutic services must be performed 
67.13 	within a practice where the primary focus is the provision of chiropractic services, preparing 
67.14 	the patient for chiropractic services, or complementing the provision of chiropractic services. 
67.15 	The administration of therapeutic services is the responsibility of the treating chiropractor 
67.16 	and must be rendered under the direct supervision of qualified staff.

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

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

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

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

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

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

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

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

75.12 	Sec. 12. Minnesota Statutes 2024, section 148.105, subdivision 1, is amended to read:
75.13 		Subdivision 1.Generally. Any person who practices, or attempts to practice, chiropractic 
75.14 	or who uses any of the terms or letters "Doctors of Chiropractic," "Chiropractor," "DC," or 
75.15 	any other title or letters under any circumstances as to lead the public to believe that the 
75.16 	person who so uses the terms is engaged in the practice of chiropractic, without having 
75.17 	complied with the provisions of sections 148.01 to 148.104, is guilty of a gross misdemeanor; 
75.18 	and, upon conviction, fined not less than $1,000 nor more than $10,000 or be imprisoned 
75.19 	in the county jail for not less than 30 days nor more than six months or punished by both 
75.20 	fine and imprisonment, in the discretion of the court. It is the duty of the county attorney 
75.21 	of the county in which the person practices to prosecute. Nothing in sections 148.01 to 
75.22 	148.105 148.108 shall be considered as interfering with any person:
75.23 	(1) licensed by a health-related licensing board, as defined in section 214.01, subdivision 
75.24 	2, including psychological practitioners with respect to the use of hypnosis;
75.25 	(2) registered or licensed by the commissioner of health under section 214.13; or
75.26 	(3) engaged in other methods of healing regulated by law in the state of Minnesota;
75.27 	provided that the person confines activities within the scope of the license or other regulation 
75.28 	and does not practice or attempt to practice chiropractic.

76.1 	Sec. 13. Minnesota Statutes 2025 Supplement, section 148.108, subdivision 5, is amended 
76.2 	to read:
76.3 		Subd. 5.Chiropractic license fees. Fees for chiropractic licensure are the following 
76.4 	amounts but may be adjusted lower by board action:
76.5 	(1) initial application for licensure fee, $300;
76.6 	(2) annual renewal of an active license fee, $250;
76.7 	(3) annual renewal of an inactive license fee, 75 percent of the current active license 
76.8 	renewal fee under clause (2);
76.9 	(4) (3) late renewal penalty fee, $150 per month late; and
76.10 	(5) (4) application for reinstatement of a voluntarily retired or inactive terminated license 
76.11 	fee, $187.50. $100; and
76.12 	(5) penalty for failure to complete CE requirements at the time of license renewal:
76.13 	(i) at the first failure to complete CE requirements at the time of license renewal, the 
76.14 	amount of the fee for annual renewal of an active license under clause (2);
76.15 	(ii) at the second failure to complete CE requirements at the time of license renewal, 
76.16 	two times the amount of the fee for annual renewal of an active license under clause (2); 
76.17 	and
76.18 	(iii) at the third failure to complete CE requirements at the time of license renewal and 
76.19 	every subsequent failure, three times the amount of the fee for annual renewal of an active 
76.20 	license under clause (2).

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

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

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

78.18 	Sec. 17. Minnesota Statutes 2024, section 151.741, subdivision 4, is amended to read:
78.19 		Subd. 4.Insulin safety net program account. (a) The insulin safety net program account 
78.20 	is established in the special revenue fund in the state treasury. Money in the account is 
78.21 	appropriated each fiscal year to:
78.22 	(1) the MNsure board in an amount sufficient to carry out assigned duties under section 
78.23 	151.74, subdivision 7; and
78.24 	(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board 
78.25 	in assessing and collecting the registration fee under this section and in administering the 
78.26 	insulin safety net program under section 151.74.
78.27 	(b) The commissioner of management and budget shall annually transfer from the health 
78.28 	care access fund to the insulin safety net program account an amount sufficient to implement 
78.29 	paragraph (a).

79.1 	Sec. 18. Minnesota Statutes 2025 Supplement, section 151.741, subdivision 5, is amended 
79.2 	to read:
79.3 		Subd. 5.Insulin repayment account; annual transfer from health care access fund. (a) 
79.4 	The insulin repayment account is established in the special revenue fund in the state treasury. 
79.5 	Money in the account is appropriated each fiscal year to the commissioner of administration 
79.6 	to reimburse manufacturers for insulin dispensed under the insulin safety net program in 
79.7 	section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6, 
79.8 	paragraph (h), and to cover costs incurred by the commissioner in providing these 
79.9 	reimbursement payments.
79.10 	(b) By June 30, 2025, and Each June 30 thereafter, the commissioner of administration 
79.11 	shall certify to the commissioner of management and budget the total amount expended in 
79.12 	the prior fiscal year for:
79.13 	(1) reimbursement to manufacturers for insulin dispensed under the insulin safety net 
79.14 	program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph 
79.15 	(h), and 6, paragraph (h); and
79.16 	(2) costs incurred by the commissioner of administration in providing the reimbursement 
79.17 	payments described in clause (1).
79.18 	(c) Each July 1, the commissioner of management and budget shall transfer from the 
79.19 	health care access fund to the insulin repayment account, beginning July 1, 2025, and each 
79.20 	July 1 thereafter, an amount equal to the amount to which the commissioner of administration 
79.21 	certified pursuant to paragraph (b).

79.22 	Sec. 19. Minnesota Statutes 2024, section 214.41, is amended to read:
79.23 	214.41 PHYSICIAN HEALTH CARE PROVIDER WELLNESS PROGRAM.
79.24 		Subdivision 1.Definition Definitions. (a) For the purposes of this section, the following 
79.25 	terms have the meanings given.
79.26 	(b) "Health care provider" or "provider" means an individual who is licensed or registered 
79.27 	by the state to perform health care services within the provider's scope of practice and in 
79.28 	accordance with state law.
79.29 	(c) "physician Health care provider wellness program" means a program for health care 
79.30 	providers of evaluation, counseling, or other modality to address an issue related to career 
79.31 	fatigue or wellness related to work stress for physicians licensed under chapter 147 that is 
79.32 	administered by a statewide association that is exempt from taxation under United States 
80.1 	Code, title 26, section 501(c)(6), and that primarily represents physicians and osteopaths 
80.2 	of multiple specialties. Physician Health care provider wellness program does not include 
80.3 	the provision of services intended to monitor for impairment under the authority of section 
80.4 	214.31.
80.5 		Subd. 2.Confidentiality. Any record of a person's health care provider's participation 
80.6 	in a physician health care provider wellness program is confidential and not subject to 
80.7 	discovery, subpoena, or a reporting requirement to the applicable health-related licensing 
80.8 	board or to the commissioner of health, unless the person provider voluntarily provides for 
80.9 	written release of the information or the disclosure is required to meet the licensee's provider's
80.10 	obligation to report certain information to the applicable health-related licensing board or 
80.11 	the commissioner of health according to section 147.111 law governing the practice of the 
80.12 	provider's profession.
80.13 		Subd. 3.Civil liability. Any person, agency, institution, facility, or organization employed 
80.14 	by, contracting with, or operating a physician health care provider wellness program is 
80.15 	immune from civil liability for any action related to their duties in connection with a 
80.16 	physician health care provider wellness program when acting in good faith.

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

80.19	Subd. 12.Board of Pharmacy

80.20	Appropriations by Fund
	
80.21	General
	937,000
	937,000
	
80.22
80.23	State Government 
Special Revenue
	6,280,000
	6,280,000
	
80.24 	Medication Repository Program. $450,000 
80.25 	in fiscal year 2026 and $450,000 in fiscal year 
80.26 	2027 are from the general fund for the 
80.27 	medication repository program to purchase 
80.28 	prescription drugs under Minnesota Statutes, 
80.29 	section 151.555, subdivision 6, paragraph (g).

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

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

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

81.6 	Sec. 22. INTERIM CHIROPRACTIC ACUPUNCTURE REGISTRATION 
81.7 	REINSTATEMENT PROCEDURES.
 81.8 		Subdivision 1.Scope. This section applies to a chiropractor whose Minnesota chiropractic 
81.9 	acupuncture registration was canceled.
81.10 		Subd. 2.Application requirements. At the time of application for reinstatement of an 
81.11 	acupuncture registration, the applicant must:
81.12 	(1) hold an active Minnesota chiropractic license;
81.13 	(2) submit an application for reinstatement;
81.14 	(3) pay the current renewal fee;
81.15 	(4) submit license verification from each jurisdiction where the applicant holds or has 
81.16 	held a chiropractic license; and
81.17 	(5) complete any additional applicable requirements as established in subdivisions 3, 4, 
81.18 	and 5.
81.19 		Subd. 3.Reinstatement of canceled registration for registrant in good standing in 
81.20 	another jurisdiction. The Board of Chiropractic Examiners must reinstate the chiropractic 
81.21 	acupuncture registration of an applicant in good standing in another jurisdiction if the 
81.22 	applicant:
81.23 	(1) completes all requirements in subdivision 2;
81.24 	(2) provides verification of a chiropractic acupuncture credential in good standing from 
81.25 	each jurisdiction where the applicant is authorized to perform chiropractic acupuncture; and
81.26 	(3) provides verification of completing two continuing education units in acupuncture 
81.27 	or acupuncture-related subjects in the year immediately preceding the application for 
81.28 	reinstatement.
81.29 		Subd. 4.Reinstatement of canceled registration after five years or less. The board 
81.30 	must reinstate the chiropractic acupuncture registration of an applicant who does not meet 
82.1 	the requirements of subdivision 3 and who applies for reinstatement five years or less after 
82.2 	the Minnesota registration cancellation if the applicant:
82.3 	(1) completes all requirements in subdivision 2; and
82.4 	(2) provides verification of:
82.5 	(i) completing two continuing education hours in acupuncture or acupuncture-related 
82.6 	subjects for each year since the applicant last held an active chiropractic acupuncture 
82.7 	registration in Minnesota or credential in another jurisdiction; or
82.8 	(ii) passing the National Board of Chiropractic Examiners Acupuncture Examination or 
82.9 	the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) 
82.10 	Examination, or an alternate examination the board determines is equivalent, within 12 
82.11 	months after application.
82.12 		Subd. 5.Reinstatement of canceled registration license after more than five 
82.13 	years. The board must reinstate the chiropractic acupuncture registration of an applicant 
82.14 	who does not meet the requirements of subdivision 3 and who applies for reinstatement 
82.15 	more than five years after the Minnesota registration cancellation if the applicant:
82.16 	(1) completes all requirements in subdivision 2; and
82.17 	(2) provides verification of passing either the National Board of Chiropractic Examiners 
82.18 	Acupuncture Examination or the NCCAOM Examination, or an alternative examination 
82.19 	the board determines is equivalent, within 12 months after application.
82.20 		Subd. 6.Continuing education in year of reinstatement. A licensee must not use 
82.21 	continuing education units obtained for the purpose of applying for reinstatement of a 
82.22 	canceled registration under this section to meet the annual requirement for the year the 
82.23 	license is reinstated.
82.24 		Subd. 7.Board authority. Applications for reinstatement and registrations reinstated 
82.25 	under this section are subject to the same board authority under Minnesota Statutes, sections 
82.26 	148.10 and 214.103, as other applications and registrations issued by the board to deny, 
82.27 	refuse to issue, revoke, suspend, condition, or limit a license or to take disciplinary or 
82.28 	corrective action against a registrant or applicant for conduct that violates applicable law 
82.29 	or professional standards.
82.30 		Subd. 8.Expiration. This section expires on the date that rules adopted by the board 
82.31 	removing the inactive status for chiropractic acupuncture registration reinstatement and 
82.32 	establishing new chiropractic acupuncture registration reinstatement procedures become 
82.33 	effective.

83.1 	Sec. 23. INTERIM ANIMAL CHIROPRACTIC REGISTRATION 
83.2 	REINSTATEMENT PROCEDURES.
 83.3 		Subdivision 1.Scope. This section applies to a chiropractor whose Minnesota animal 
83.4 	chiropractic registration was canceled.
83.5 		Subd. 2.Application requirements. At the time of application for reinstatement of an 
83.6 	animal chiropractic registration, the applicant must:
83.7 	(1) hold an active Minnesota chiropractic license;
83.8 	(2) submit an application for reinstatement;
83.9 	(3) pay the current renewal fee;
83.10 	(4) submit license verification from each jurisdiction where the applicant holds or has 
83.11 	held a chiropractic license; and
83.12 	(5) complete any additional applicable requirements as established in subdivisions 3 and 
83.13 	4.
83.14 		Subd. 3.Reinstatement of canceled registration for registrant in good standing in 
83.15 	another jurisdiction. The Board of Chiropractic Examiners must reinstate the animal 
83.16 	chiropractic registration of an applicant who holds an animal chiropractic credential that is 
83.17 	equivalent to a Minnesota registration and in good standing in another jurisdiction if the 
83.18 	applicant:
83.19 	(1) completes all requirements in subdivision 2;
83.20 	(2) provides verification of an animal acupuncture credential in good standing from each 
83.21 	jurisdiction where the applicant is authorized to perform animal acupuncture; and
83.22 	(3) provides verification of completing six continuing education units in animal 
83.23 	chiropractic diagnosis and treatment in the year immediately preceding the application for 
83.24 	reinstatement.
83.25 		Subd. 4.Reinstatement of canceled registration for registrant with no animal 
83.26 	chiropractic credential in good standing in another jurisdiction. The board must reinstate 
83.27 	the registration of an applicant who does not meet the requirements of subdivision 3 if the 
83.28 	applicant:
83.29 	(1) completes all requirements in subdivision 2; and
83.30 	(2) provides verification of completing six continuing education units related to animal 
83.31 	chiropractic diagnosis and treatment for each year the applicant cannot verify an active 
84.1 	animal chiropractic credential that is equivalent to a Minnesota registration and in good 
84.2 	standing.
84.3 		Subd. 5.Continuing education in year of reinstatement. A licensee must not use 
84.4 	continuing education hours obtained for the purposes of applying for reinstatement of a 
84.5 	canceled registration under this section to meet the annual hour requirement for the year 
84.6 	the license is reinstated.
84.7 		Subd. 6.Board authority. Applications for reinstatement and registrations reinstated 
84.8 	under this section are subject to the same board authority under Minnesota Statutes, sections 
84.9 	148.10 and 214.103, as other applications and registrations issued by the board to deny, 
84.10 	refuse to issue, revoke, suspend, condition, or limit a license or to take disciplinary or 
84.11 	corrective action against a registrant or applicant for conduct that violates applicable law 
84.12 	or professional standards.
84.13 		Subd. 7.Expiration. This section expires on the date that rules adopted by the board 
84.14 	removing the inactive status for animal chiropractic registration reinstatement and establishing 
84.15 	new animal chiropractic registration reinstatement procedures become effective.

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

84.20	Column A
	Column B
	
84.21	148.01, subdivision 1a
	148.032, subdivision 1
	
84.22	148.01, subdivision 1b
	148.032, subdivision 2
	
84.23	148.01, subdivision 1c
	148.032, subdivision 3
	
84.24	148.01, subdivision 1d
	148.032, subdivision 4
	
84.2684.25
	148.032, paragraphs (a) and (b)
	148.032, subdivision 5, paragraphs (a) and 
(b)
	
84.2884.27
	148.032, paragraphs (c) and (d)
	148.032, subdivision 6, paragraphs (a) and 
(b)
	
84.29	148.032, paragraph (e)
	148.032, subdivision 7

84.30 	Sec. 25. REPEALER.
 84.31 	(a) Minnesota Statutes 2024, section 151.741, subdivisions 2, 3, and 6, are repealed.
84.32 	(b) Minnesota Rules, parts 2500.0100, subparts 5b, 6, and 12; 2500.1900; 2500.2020; 
84.33 	2500.2040; 2500.2100; 2500.2110; 6800.0400; and 6800.1150, are repealed.

85.1 	ARTICLE 5
85.2 	HEALTH CARE

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

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

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

87.14 	Sec. 3. Minnesota Statutes 2025 Supplement, section 256.9657, subdivision 2b, is amended 
87.15 	to read:
87.16 		Subd. 2b.Hospital assessment. (a) For purposes of this subdivision, the following terms 
87.17 	have the meanings given:
87.18 	(1) "eligible hospital" means:
87.19 	(i) PrairieCare psychiatric hospital; or
87.20 	(ii) a hospital licensed under section 144.50, located in Minnesota, and with a Medicare 
87.21 	cost report filed and showing in the Healthcare Cost Report Information System (HCRIS), 
87.22 	except for the following:
87.23 	(A) federal Indian Health Service facilities;
87.24 	(B) state-owned or state-operated regional treatment centers and all state-operated 
87.25 	services;
87.26 	(C) federal Veterans Administration Medical Centers; and
87.27 	(D) long-term acute care hospitals;
87.28 	(2) "net outpatient revenue" means total outpatient revenue less Medicare revenue as 
87.29 	calculated from:
87.30 	(i) values on Worksheet G of the hospital's Medicare cost report; or
88.1 	(ii) for PrairieCare psychiatric hospital, data available to the commissioner; and
88.2 	(3) "total patient days" means total hospital inpatient days as reported on:
88.3 	(i) Worksheet S-3 of the hospital's Medicare cost report; or
88.4 	(ii) for PrairieCare psychiatric hospital, data available to the commissioner.
88.5 	(b) Subject to paragraphs (m) to (o) (p), each eligible hospital must pay assessments to 
88.6 	the hospital directed payment program account in the special revenue fund, with an aggregate 
88.7 	annual assessment amount equal to the sum of the following:
88.8 	(1) $120.22 multiplied by total patient days; and
88.9 	(2) 5.96 percent of the hospital's net outpatient revenue.
88.10 	(c) The assessment amount for calendar years 2026 and 2027 must be based on the total 
88.11 	patient days and net outpatient revenue reflected on an eligible hospital's Medicare cost 
88.12 	report as follows:
88.13 	(1) an eligible hospital with a fiscal year ending on March 31 or June 30 must use data 
88.14 	from a cost report from the hospital's fiscal year 2022; and
88.15 	(2) an eligible hospital with a fiscal year ending on September 30 or December 31 must 
88.16 	use data from a cost report from the hospital's fiscal year 2021.
88.17 	(d) The annual assessment amount for calendar years after 2027 must be set for a two-year 
88.18 	period and must be based on the total patient days and net outpatient revenue reflected on 
88.19 	an eligible hospital's most recent Medicare cost report filed and showing in HCRIS as of 
88.20 	August 1 of the year prior to the subsequent two-year period.
88.21 	(e) The commissioner may, after consultation with the Minnesota Hospital Association, 
88.22 	modify the rates of assessment in paragraph (b) as necessary to comply with federal law, 
88.23 	obtain or maintain a waiver under Code of Federal Regulations, title 42, section 433.72, or 
88.24 	otherwise maximize under this section federal financial participation for medical assistance. 
88.25 	Notwithstanding the foregoing authorization to maximize federal financial participation for 
88.26 	medical assistance, the commissioner must reduce the rates of assessment in paragraph (b) 
88.27 	as necessary to ensure:
88.28 	(1) the state's aggregated health care-related taxes on inpatient hospital services do not 
88.29 	exceed 5.75 percent of the net patient revenue attributable to those services; and
88.30 	(2) the state's aggregated health care-related taxes on outpatient hospital services do not 
88.31 	exceed 5.75 percent of the net patient revenue attributable to those services.
89.1 	(f) Eligible hospitals must pay the annual assessment amount under paragraph (b) to the 
89.2 	commissioner by paying four equal, quarterly assessments. Eligible hospitals must pay the 
89.3 	quarterly assessments by January 1, April 1, July 1, and October 1 each year. Assessments 
89.4 	must be paid in the form and manner specified by the commissioner. An eligible hospital 
89.5 	is prohibited from paying a quarterly assessment until the eligible hospital has received the 
89.6 	applicable invoice under paragraph (g).
89.7 	(g) The commissioner must provide eligible hospitals with an invoice by December 1 
89.8 	for the assessment due January 1, March 1 for the assessment due April 1, June 1 for the 
89.9 	assessment due July 1, and September 1 for the assessment due October 1 each year.
89.10 	(h) The commissioner must notify each eligible hospital of the hospital's estimated annual 
89.11 	assessment amount for the subsequent calendar year by October 15 each year.
89.12 	(i) If any of the dates for assessments or invoices in paragraphs (f) to (h) fall on a holiday, 
89.13 	the applicable date is the next business day.
89.14 	(j) A hospital that has merged with another hospital must have the surviving hospital's 
89.15 	assessment revised at the start of the hospital's first full fiscal year after the merger is 
89.16 	complete. A closed hospital is retroactively responsible for assessments owed for services 
89.17 	provided through the final date of operations.
89.18 	(k) If the commissioner determines that a hospital has underpaid or overpaid an 
89.19 	assessment, the commissioner must notify the hospital of the unpaid assessment or of any 
89.20 	refund due. The commissioner must refund a hospital's overpayment from the hospital 
89.21 	directed payment program account created in section 256B.1975, subdivision 1.
89.22 	(l) Revenue from an assessment under this subdivision must only be used by the 
89.23 	commissioner to pay the nonfederal share of the directed payment program under section 
89.24 	256B.1974.
89.25 	(m) The commissioner is prohibited from collecting any assessment under this subdivision 
89.26 	during any period of time when:
89.27 	(1) federal financial participation is unavailable or disallowed, or if the approved 
89.28 	aggregate federal financial participation for the directed payment under section 256B.1974 
89.29 	is less than 51 percent; or
89.30 	(2) a directed payment under section 256B.1974 is not approved by the Centers for 
89.31 	Medicare and Medicaid Services.
90.1 	(n) The commissioner must make the following discounts from the inpatient portion of 
90.2 	the assessment under paragraph (b), clause (1), in the stated amount or as necessary to 
90.3 	achieve federal approval of the assessment in this section:
90.4 	(1) Hennepin Healthcare, with a discount of 25 percent;
90.5 	(2) Mayo Rochester, with a discount of ten percent;
90.6 	(3) Gillette Children's Hospital, with a discount of 90 percent;
90.7 	(4) each hospital not included in another discount category, and with greater than 
90.8 	$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service 
90.9 	and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service 
90.10 	and managed care claims data, with a discount of five percent; and
90.11 	(5) any hospital responsible for greater than 12 percent of the total assessment annually 
90.12 	collected statewide, with a discount in the amount necessary such that the hospital is 
90.13 	responsible for 12 percent of the total assessment annually collected statewide.
90.14 	(o) The commissioner must make the following discounts from the outpatient portion 
90.15 	of the assessment under paragraph (b), clause (2), in the stated amount or as necessary to 
90.16 	achieve federal approval of the assessment in this section:
90.17 	(1) each critical access hospital or independent hospital located outside a city of the first 
90.18 	class and paid under the Medicare prospective payment system, with a discount of 40 percent;
90.19 	(2) Gillette Children's Hospital, with a discount of 90 percent;
90.20 	(3) Hennepin Healthcare, with a discount of 60 percent;
90.21 	(4) Mayo Rochester, with a discount of 20 percent; and
90.22 	(5) each hospital not included in another discount category, and with greater than 
90.23 	$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service 
90.24 	and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service 
90.25 	and managed care claims data, with a discount of ten percent.
90.26 	(p) The commissioner must not impose any assessment under this subdivision on a 
90.27 	hospital that does not receive payments under section 256B.1974.
90.28 	(p) (q) If the federal share of the hospital directed payment program under section 
90.29 	256B.1974 is increased as the result of an increase to the federal medical assistance 
90.30 	percentage, the commissioner must reduce the assessment on a uniform percentage basis 
90.31 	across eligible hospitals on which the assessment is imposed, such that the aggregate amount 
90.32 	collected from hospitals under this subdivision does not exceed the total amount needed to 
91.1 	maintain the same aggregate state and federal funding level for the directed payments 
91.2 	authorized by section 256B.1974.
91.3 	(q) (r) Eligible hospitals must submit to the commissioner on an annual basis, in the 
91.4 	form and manner specified by the commissioner in consultation with the Minnesota Hospital 
91.5 	Association, all documentation necessary to determine the assessment amounts under this 
91.6 	subdivision.

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

91.9 	Sec. 4. Minnesota Statutes 2024, section 256.969, subdivision 2b, is amended to read:
91.10 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
91.11 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
91.12 	to the following:
91.13 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
91.14 	methodology;
91.15 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
91.16 	under subdivision 25;
91.17 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
91.18 	distinct parts as defined by Medicare shall be paid according to the methodology under 
91.19 	subdivision 12; and
91.20 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
91.21 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
91.22 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
91.23 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
91.24 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
91.25 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
91.26 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
91.27 	period as other hospitals.
91.28 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
91.29 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
91.30 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
91.31 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
91.32 	manner similar to Medicare. The base year or years for the rates effective November 1, 
92.1 	2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, 
92.2 	ensuring that the total aggregate payments under the rebased system are equal to the total 
92.3 	aggregate payments that were made for the same number and types of services in the base 
92.4 	year. Separate budget neutrality calculations shall be determined for payments made to 
92.5 	critical access hospitals and payments made to hospitals paid under the DRG system. Only 
92.6 	the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being 
92.7 	rebased during the entire base period shall be incorporated into the budget neutrality 
92.8 	calculation.
92.9 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
92.10 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
92.11 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
92.12 	a five percent increase or decrease from the base year payments for any hospital. Any 
92.13 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
92.14 	shall maintain budget neutrality as described in paragraph (c).
92.15 	(e) For discharges occurring on or after November 1, 2014, the commissioner may make 
92.16 	additional adjustments to the rebased rates, and when evaluating whether additional 
92.17 	adjustments should be made, the commissioner shall consider the impact of the rates on the 
92.18 	following:
92.19 	(1) pediatric services;
92.20 	(2) behavioral health services;
92.21 	(3) trauma services as defined by the National Uniform Billing Committee;
92.22 	(4) transplant services;
92.23 	(5) obstetric services, newborn services, and behavioral health services provided by 
92.24 	hospitals outside the seven-county metropolitan area;
92.25 	(6) outlier admissions;
92.26 	(7) low-volume providers; and
92.27 	(8) services provided by small rural hospitals that are not critical access hospitals.
92.28 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
92.29 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
92.30 	admission is standardized by the applicable Medicare wage index and adjusted by the 
92.31 	hospital's disproportionate population adjustment;
93.1 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
93.2 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
93.3 	October 31, 2014;
93.4 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
93.5 	inpatient services covered by medical assistance; and
93.6 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
93.7 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
93.8 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
93.9 	program in effect during the base year or years. In determining hospital payment rates for 
93.10 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
93.11 	methods and allowable costs of the Medicare program in effect during the base year or 
93.12 	years.
93.13 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
93.14 	the rates established under paragraph (c), and any adjustments made to the rates under 
93.15 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
93.16 	total aggregate payments for the same number and types of services under the rebased rates 
93.17 	are equal to the total aggregate payments made during calendar year 2013.
93.18 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
93.19 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
93.20 	in hospital costs between the existing base year or years and the next base year or years. In 
93.21 	any year that inpatient claims volume falls below the threshold required to ensure a 
93.22 	statistically valid sample of claims, the commissioner may combine claims data from two 
93.23 	consecutive years to serve as the base year. Years in which inpatient claims volume is 
93.24 	reduced or altered due to a pandemic or other public health emergency shall not be used as 
93.25 	a base year or part of a base year if the base year includes more than one year. Changes in 
93.26 	costs between base years shall be measured using the lower of the hospital cost index defined 
93.27 	in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
93.28 	claim. The commissioner shall establish the base year for each rebasing period considering 
93.29 	the most recent year or years for which filed Medicare cost reports are available, except 
93.30 	that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019. 
93.31 	The estimated change in the average payment per hospital discharge resulting from a 
93.32 	scheduled rebasing must be calculated and made available to the legislature by January 15 
93.33 	of each year in which rebasing is scheduled to occur, and must include by hospital the 
93.34 	differential in payment rates compared to the individual hospital's costs.
94.1 	(i) Effective for discharges occurring on or after July 1, 2015, through December 31, 
94.2 	2026, inpatient payment rates for critical access hospitals located in Minnesota or the local 
94.3 	trade area shall be determined using a new cost-based methodology. The commissioner 
94.4 	shall establish within the methodology tiers of payment designed to promote efficiency and 
94.5 	cost-effectiveness. Payment rates for hospitals under this paragraph shall be set at a level 
94.6 	that does not exceed the total cost for critical access hospitals as reflected in base year cost 
94.7 	reports. Until the next rebasing that occurs, the new methodology shall result in no greater 
94.8 	than a five percent decrease from the base year payments for any hospital, except a hospital 
94.9 	that had payments that were greater than 100 percent of the hospital's costs in the base year 
94.10 	shall have their rate set equal to 100 percent of costs in the base year. The rates paid for 
94.11 	discharges on and after July 1, 2016, covered under this paragraph shall be increased by the 
94.12 	inflation factor in subdivision 1, paragraph (a). The new cost-based rate shall be the final 
94.13 	rate and shall not be settled to actual incurred costs. Hospitals shall be assigned a payment 
94.14 	tier based on the following criteria:
94.15 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
94.16 	shall have a rate set that equals 85 percent of their base year costs;
94.17 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
94.18 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
94.19 	base year costs; and
94.20 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
94.21 	shall have a rate set that equals 100 percent of their base year costs.
94.22 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
94.23 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
94.24 	methodology may include, but are not limited to:
94.25 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
94.26 	hospital's charges to the medical assistance program;
94.27 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
94.28 	hospital's payments received from the medical assistance program for the care of medical 
94.29 	assistance patients;
94.30 	(3) the ratio between the hospital's charges to the medical assistance program and the 
94.31 	hospital's payments received from the medical assistance program for the care of medical 
94.32 	assistance patients;
94.33 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
95.1 	(5) the proportion of that hospital's costs that are administrative and trends in 
95.2 	administrative costs; and
95.3 	(6) geographic location.
95.4 	(j) Effective for discharges occurring on or after January 1, 2027, inpatient payment 
95.5 	rates for critical access hospitals located in Minnesota or the local trade area must be 
95.6 	determined using 100 percent of each hospital's base year costs. The base year costs must 
95.7 	be increased by the percentage change in the Centers for Medicare and Medicaid Services 
95.8 	Inpatient Hospital Market Basket between the base year and the payment year. Effective 
95.9 	January 1, 2027, payments made by managed care plans and county-based purchasing plans 
95.10 	must be at least equivalent to those paid by fee-for-service.
95.11 	(k) Subject to subdivision 2g, effective for discharges occurring on or after January 1, 
95.12 	2024, the rates paid to hospitals described in paragraph (a), clauses (2) to (4), must include 
95.13 	a rate factor specific to each hospital that qualifies for a medical education and research 
95.14 	cost distribution under section 62J.692, subdivision 4, paragraph (a).

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

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

96.3 	Sec. 6. Minnesota Statutes 2024, section 256.969, subdivision 25, is amended to read:
96.4 		Subd. 25.Long-term hospital rates. (a) Long-term hospitals shall be paid on a per diem 
96.5 	basis.
96.6 	(b) For admissions occurring on or after April 1, 1995, a long-term hospital as designated 
96.7 	by Medicare that does not have admissions in the base year shall have inpatient rates 
96.8 	established at the average of other hospitals with the same designation. For subsequent 
96.9 	rate-setting periods in which base years are updated, the hospital's base year shall be the 
96.10 	first Medicare cost report filed with the long-term hospital designation and shall remain in 
96.11 	effect until it falls within the same period as other hospitals.
96.12 	(c) For admissions occurring on or after July 1, 2023, long-term hospitals must be paid 
96.13 	the higher of a per diem amount computed using the methodology described in subdivision 
96.14 	2b, paragraph (i), or the per diem rate as of July 1, 2021., or a per diem amount computed 
96.15 	as follows:
96.16 	(1) hospitals that had payments at or below 80 percent of the hospital's costs in the base 
96.17 	year must have a rate set that equals 85 percent of the hospital's base year costs;
96.18 	(2) hospitals that had payments that were above 80 percent up to and including 90 percent 
96.19 	of the hospital's costs in the base year must have a rate set that equals 95 percent of the 
96.20 	hospital's base year costs; and
96.21 	(3) hospitals that had payments that were above 90 percent of the hospital's costs in the 
96.22 	base year must have a rate set that equals 100 percent of the hospital's base year costs.

96.23 	Sec. 7. Minnesota Statutes 2024, section 256B.056, subdivision 1, is amended to read:
96.24 		Subdivision 1.Residency. (a) To be eligible for medical assistance, a person must reside 
96.25 	in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota, in 
96.26 	accordance with Code of Federal Regulations, title 42, section 435.403. A child who is 
96.27 	placed in a family foster home in Minnesota by another state is a Minnesota resident in 
96.28 	accordance with Minnesota's interstate agreements and Code of Federal Regulations, title 
96.29 	42, section 435.403(k). For the purposes of this paragraph, "family foster home" has the 
96.30 	meaning given in section 260C.007, subdivision 16b.
97.1 	(b) The commissioner shall identify individuals who are enrolled in medical assistance 
97.2 	and who are absent from the state for more than 30 consecutive days, but who continue to 
97.3 	qualify for medical assistance in accordance with paragraph (a).
97.4 	(c) If the individual is absent from the state for more than 30 consecutive days but still 
97.5 	deemed a resident of Minnesota in accordance with paragraph (a), any covered service 
97.6 	provided to the individual must be paid through the fee-for-service system and not through 
97.7 	the managed care capitated rate payment system under section 256B.69 or 256L.12.

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

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

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

98.1 	Sec. 9. Minnesota Statutes 2025 Supplement, section 256B.1973, subdivision 9, is amended 
98.2 	to read:
98.3 		Subd. 9.Interaction with other directed payments. (a) An eligible provider under 
98.4 	subdivision 3 may participate in the hospital directed payment program under section 
98.5 	256B.1974 for inpatient hospital services, outpatient hospital services, or both. A provider 
98.6 	participating in the hospital directed payment program must not receive a directed payment 
98.7 	under this section for any provider classes paid via the hospital directed payment program. 
98.8 	A hospital subject to this section must notify the commissioner in writing no later than 30 
98.9 	days after enactment of this subdivision of the hospital's intention to participate in the 
98.10 	hospital directed payment program under section 256B.1974 for inpatient hospital services, 
98.11 	outpatient hospital services, or both.
98.12 	(b) The election under this subdivision is a onetime election, except that if an eligible 
98.13 	provider elects to participate in the hospital directed payment program, and the hospital 
98.14 	directed payment program expires or is not federally approved, the eligible provider may 
98.15 	subsequently elect to participate in the directed payment under this section.
98.16 	(c) If an eligible provider elects not to participate in the hospital directed payment 
98.17 	program under section 256B.1974 and the federal statutes or regulations related to hospital 
98.18 	directed payment programs are subsequently substantially changed, the eligible provider 
98.19 	may elect to participate in the hospital directed payment program under section 256B.1974.
98.20 	(d) The effective date of the election to participate in the hospital directed payment 
98.21 	program under this section must align with the beginning of the calendar year in which 
98.22 	payment rates under this section are updated. The eligible provider must notify the 
98.23 	commissioner of the eligible provider's intention to make the election ten months before 
98.24 	the effective date of the election.

98.25 	Sec. 10. Minnesota Statutes 2025 Supplement, section 256B.69, subdivision 6d, is amended 
98.26 	to read:
98.27 		Subd. 6d.Prescription drugs. (a) The commissioner may exclude or modify coverage 
98.28 	for prescription drugs from the prepaid managed care contracts entered into under this 
98.29 	section in order to increase savings to the state by collecting additional prescription drug 
98.30 	rebates.
98.31 	(b) The contracts must maintain incentives for the managed care plan to manage drug 
98.32 	costs and utilization and may require that the managed care plans maintain an open drug 
98.33 	formulary. In order to manage drug costs and utilization, the contracts may authorize the 
99.1 	managed care plans to use preferred drug lists and prior authorization. The contracts must 
99.2 	require that the managed care plans enter into contracts with the state's selected pharmacy 
99.3 	benefit manager vendor to administer the pharmacy benefit.
99.4 	(c) This subdivision is contingent on federal approval of the managed care contract 
99.5 	changes and the collection of additional prescription drug rebates.
99.6 	(d) The commissioner must require that the final reimbursement to a pharmacy from 
99.7 	managed care and county-based purchasing plans and any pharmacy benefit managers under 
99.8 	contract with these entities be at least a dispensing fee of $11.55 per claim for prescriptions 
99.9 	filled with drugs meeting the definition of covered outpatient drugs. The commissioner 
99.10 	must require the payment of a dispensing fee of at least $3.65 for drugs not meeting the 
99.11 	definition of covered outpatient drug.
99.12 	(e) In addition to the dispensing fee set forth in paragraph (d), the commissioner must 
99.13 	require that the final reimbursement to a pharmacy from managed care and county-based 
99.14 	purchasing plans and any pharmacy benefit managers under contract with these entities be 
99.15 	equal to the ingredient cost for a drug as either:
99.16 	(1) the lower of the National Average Drug Acquisition Cost (NADAC) or the Minnesota 
99.17 	actual acquisition cost (MNAAC) under section 256B.0625, subdivision 13, paragraph (g);
99.18 	(2) the maximum allowable cost, if a drug ingredient cost is unreported in the NADAC 
99.19 	and the MNAAC; or
99.20 	(3) the wholesale acquisition cost minus two percent, if a drug ingredient cost is 
99.21 	unreported in the NADAC and the MNAAC and a maximum allowable cost is unavailable.
99.22 	(f) The commissioner must monitor the effect of this requirement on access to 
99.23 	pharmaceutical services in rural and underserved areas of the state. If, for any contract year, 
99.24 	federal approval is not received for paragraphs (d) and (e), the commissioner must adjust 
99.25 	the capitation rates paid to managed care plans and county-based purchasing plans for that 
99.26 	contract year to reflect removal of paragraphs (d) and (e). A contract between a managed 
99.27 	care plan or county-based purchasing plan, or any pharmacy benefit manager under contract 
99.28 	with one of those entities, and a provider to whom paragraphs (d) and (e) apply must allow 
99.29 	recovery of payments from those providers if capitation rates are adjusted in accordance 
99.30 	with this paragraph. Payment recoveries must not exceed the amount equal to any increase 
99.31 	in rates that results from paragraphs (d) and (e). This subdivision expires if federal approval 
99.32 	is not received for paragraphs (d) and (e) at any time.
100.1 	(g) Paragraphs (d) to (g) expire upon the effective date of a master contract under section 
100.2 	256B.696. The commissioner shall notify the revisor of statutes of the effective date.

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

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

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

101.9 	Sec. 12. Minnesota Statutes 2024, section 256B.75, is amended to read:
101.10 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
101.11 	(a) For outpatient hospital facility fee payments for services rendered on or after October 
101.12 	1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, 
101.13 	or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for 
101.14 	which there is a federal maximum allowable payment. Effective for services rendered on 
101.15 	or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and 
101.16 	emergency room facility fees shall be increased by eight percent over the rates in effect on 
101.17 	December 31, 1999, except for those services for which there is a federal maximum allowable 
101.18 	payment. Services for which there is a federal maximum allowable payment shall be paid 
101.19 	at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total 
101.20 	aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare 
101.21 	upper limit. If it is determined that a provision of this section conflicts with existing or 
101.22 	future requirements of the United States government with respect to federal financial 
101.23 	participation in medical assistance, the federal requirements prevail. The commissioner 
101.24 	may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial 
101.25 	participation resulting from rates that are in excess of the Medicare upper limitations.
101.26 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory 
101.27 	surgery hospital facility fee services for critical access hospitals designated under section 
101.28 	144.1483, clause (9), shall be paid on a cost-based payment system that is based on the 
101.29 	cost-finding methods and allowable costs of the Medicare program. Effective for services 
101.30 	provided on or after July 1, 2015, rates established for critical access hospitals under this 
101.31 	paragraph for the applicable payment year shall be the final payment and shall not be settled 
101.32 	to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal 
101.33 	year ending in 2017, the rate for outpatient hospital services shall be computed using 
102.1 	information from each hospital's Medicare cost report as filed with Medicare for the year 
102.2 	that is two years before the year that the rate is being computed. Rates shall be computed 
102.3 	using information from Worksheet C series until the department finalizes the medical 
102.4 	assistance cost reporting process for critical access hospitals. After the cost reporting process 
102.5 	is finalized, rates shall be computed using information from Title XIX Worksheet D series. 
102.6 	The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs 
102.7 	related to rural health clinics and federally qualified health clinics, divided by ancillary 
102.8 	charges plus outpatient charges, excluding charges related to rural health clinics and federally 
102.9 	qualified health clinics. Effective for services delivered on or after January 1, 2024, the 
102.10 	rates paid to critical access hospitals under this section must be adjusted to include the 
102.11 	amount of any distributions under section 62J.692, subdivision 4, paragraph (a), that were 
102.12 	not included in the rate adjustment described under section 256.969, subdivision 2b, 
102.13 	paragraph (k).
102.14 	(c) Effective for services provided on or after July 1, 2003, rates that are based on the 
102.15 	Medicare outpatient prospective payment system shall be replaced by a budget neutral 
102.16 	prospective payment system that is derived using medical assistance data. The commissioner 
102.17 	shall provide a proposal to the 2003 legislature to define and implement this provision. 
102.18 	When implementing prospective payment methodologies, the commissioner shall use general 
102.19 	methods and rate calculation parameters similar to the applicable Medicare prospective 
102.20 	payment systems for services delivered in outpatient hospital and ambulatory surgical center 
102.21 	settings unless other payment methodologies for these services are specified in this chapter.
102.22 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
102.23 	before third-party liability and spenddown, made to hospitals for outpatient hospital facility 
102.24 	services is reduced by .5 percent from the current statutory rate.
102.25 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
102.26 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility 
102.27 	services before third-party liability and spenddown, is reduced five percent from the current 
102.28 	statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from 
102.29 	this paragraph.
102.30 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
102.31 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
102.32 	hospital facility services before third-party liability and spenddown, is reduced three percent 
102.33 	from the current statutory rates. Mental health services and facilities defined under section 
102.34 	256.969, subdivision 16, are excluded from this paragraph.
103.1 	(g) Critical access hospitals that convert to rural emergency hospitals in accordance with 
103.2 	section 1861(kkk) of the Social Security Act must be paid the rate described in paragraph 
103.3 	(b). The rate must be classified as either an outpatient hospital rate or a clinic rate as 
103.4 	determined upon federal approval.

103.5 	Sec. 13. Minnesota Statutes 2024, section 256L.05, subdivision 3, is amended to read:
103.6 		Subd. 3.Effective date of coverage. (a) The effective date of coverage is the first day 
103.7 	of the month following the month in which eligibility is approved and the first premium 
103.8 	payment has been received. The effective date of coverage for new members added to the 
103.9 	family is the first day of the month following the month in which the change is reported. 
103.10 	All eligibility criteria must be met by the family at the time the new family member is added. 
103.11 	The income of the new family member is included with the family's modified adjusted gross 
103.12 	income and the adjusted premium begins in the month the new family member is added.
103.13 	(b) The initial premium must be received by the last working day of the month for 
103.14 	coverage to begin the first day of the following month.
103.15 	(c) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to 
103.16 	256L.18 are secondary to a plan of insurance or benefit program under which an eligible 
103.17 	person may have coverage and the commissioner shall use cost avoidance techniques to 
103.18 	ensure coordination of any other health coverage for eligible persons. The commissioner 
103.19 	shall identify eligible persons who may have coverage or benefits under other plans of 
103.20 	insurance or who become eligible for medical assistance.
103.21 	(d) The effective date of coverage for individuals or families who are exempt from 
103.22 	paying premiums under section 256L.15, subdivision subdivisions 1, paragraph (c) and 2, 
103.23 	is the first day of the month following the month in which eligibility is approved.

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

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

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

104.19 	Sec. 15. Minnesota Statutes 2024, section 295.52, subdivision 8, is amended to read:
104.20 		Subd. 8.Contingent reduction in tax rate. (a) By December 1 of each year, beginning 
104.21 	in 2011, the commissioner of management and budget shall determine the projected balance 
104.22 	in the health care access fund for the biennium.
104.23 	(b) If the commissioner of management and budget determines that the projected balance 
104.24 	in the health care access fund for the biennium reflects a ratio of revenues to expenditures 
104.25 	and transfers greater than 125 percent, and if the actual cash balance in the fund is adequate, 
104.26 	as determined by the commissioner of management and budget, the commissioner, in 
104.27 	consultation with the commissioner commissioners of revenue and human services, shall 
104.28 	reduce the tax rates levied under subdivisions 1, 1a, 2, 3, and 4, for the subsequent calendar 
104.29 	year sufficient to reduce the structural balance in the fund. The rate may be reduced to the 
104.30 	extent that the projected revenues for the biennium do not exceed 125 percent of expenditures 
104.31 	and transfers. The new rate shall be rounded to the nearest one-tenth of one percent. The 
104.32 	rate reduction under this paragraph expires at the end of each calendar year and is subject 
104.33 	to an annual redetermination by the commissioner of management and budget.
105.1 	(c) For purposes of the analysis defined in paragraph (b), the commissioner of 
105.2 	management and budget shall include projected revenues.

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

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

105.8 	Sec. 17. REPEALER.
 105.9 	Minnesota Statutes 2024, section 256B.198, is repealed.

105.10 	ARTICLE 6
105.11 	FEDERAL CONFORMITY

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

105.18 	Sec. 2. Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to 
105.19 	read:
105.20 		Subd. 46.Health care eligibility oversight unit. (a) The commissioner shall establish 
105.21 	and maintain a Department of Human Services health care eligibility oversight unit 
105.22 	responsible for collaboration at a regional level to ensure federal and state Medicaid eligibility 
105.23 	requirements are consistently applied by all processing entities.
105.24 	(b) The oversight unit must monitor compliance, identify systemic issues, and provide 
105.25 	guidance and technical assistance to lead agencies.
105.26 	(c) The commissioner shall require lead agencies to work directly with the oversight 
105.27 	unit on corrective action planning and implementation to achieve compliance and strengthen 
105.28 	performance outcomes.

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

106.1 	Sec. 3. Minnesota Statutes 2024, section 256B.04, subdivision 27, is amended to read:
106.2 		Subd. 27.Disenrollment under medical assistance and MinnesotaCare. (a) The 
106.3 	commissioner shall regularly obtain and use information from reliable data sources, including 
106.4 	but not limited to managed care and county-based purchasing plans, state health and human 
106.5 	services programs, mail returned  by the United States Postal Service with a forwarding 
106.6 	address, and the National Change of Address database maintained by the United States 
106.7 	Postal Service, to update mailing addresses and other contact information for medical 
106.8 	assistance and MinnesotaCare enrollees in cases of returned mail and nonresponse using 
106.9 	information available through managed care and county-based purchasing plans, state health 
106.10 	and human services programs, and other sources.
106.11 	(b) The commissioner shall not disenroll an individual from medical assistance or 
106.12 	MinnesotaCare in cases of returned mail until the commissioner makes at least two attempts 
106.13 	by phone, email, or other methods to contact the individual. The commissioner may disenroll 
106.14 	the individual after providing no less than 30 days for the individual to respond to the most 
106.15 	recent contact attempt.

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

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

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

107.1 	Sec. 6. Minnesota Statutes 2024, section 256B.056, subdivision 2a, is amended to read:
107.2 		Subd. 2a.Home equity limit for medical assistance payment of long-term care 
107.3 	services. (a) Effective for requests of medical assistance payment of long-term care services 
107.4 	filed on or after July 1, 2006, and for renewals on or after July 1, 2006, for persons who 
107.5 	received payment of long-term care services under a request filed on or after January 1, 
107.6 	2006, the equity interest in the home of a person whose eligibility for long-term care services 
107.7 	is determined on or after January 1, 2006, shall not exceed $500,000, unless it is the lawful 
107.8 	residence of the person's spouse or child who is under age 21, or a child of any age who is 
107.9 	blind or permanently and totally disabled as defined in the Supplemental Security Income 
107.10 	program. The amount specified in this paragraph shall be increased beginning in year 2011, 
107.11 	from year to year based on the percentage increase in the Consumer Price Index for all urban 
107.12 	consumers (all items; United States city average), rounded to the nearest $1,000.
107.13 	(b) Effective January 1, 2028, the amount specified in paragraph (a) must not exceed 
107.14 	$1,000,000.
107.15 	(b) (c) For purposes of this subdivision, a "home" means any real or personal property 
107.16 	interest, including an interest in an agricultural homestead as defined under section 273.124, 
107.17 	subdivision 1, that, at the time of the request for medical assistance payment of long-term 
107.18 	care services, is the primary dwelling of the person or was the primary dwelling of the 
107.19 	person before receipt of long-term care services began outside of the home.
107.20 	(c) (d) A person denied or terminated from medical assistance payment of long-term 
107.21 	care services because the person's home equity exceeds the home equity limit may seek a 
107.22 	waiver based upon a hardship by filing a written request with the county agency. Hardship 
107.23 	is an imminent threat to the person's health and well-being that is demonstrated by 
107.24 	documentation of no alternatives for payment of long-term care services. The county agency 
107.25 	shall make a decision regarding the written request to waive the home equity limit within 
107.26 	30 days if all necessary information has been provided. The county agency shall send the 
107.27 	person and the person's representative a written notice of decision on the request for a 
107.28 	demonstrated hardship waiver that also advises the person of appeal rights under the fair 
107.29 	hearing process of section 256.045.

107.30 	Sec. 7. Minnesota Statutes 2024, section 256B.056, subdivision 3d, is amended to read:
107.31 		Subd. 3d.Reduction of excess assets. Assets in excess of the limits in subdivisions 3 
107.32 	to 3c may be reduced to allowable limits as follows:
108.1 	(a) Assets may be reduced in any of the three either one or two calendar months before 
108.2 	the month of application in which the applicant seeks coverage, according to the applicant's 
108.3 	retroactive eligibility under section 256B.061 by paying bills for health services that are 
108.4 	incurred in the retroactive period for which the applicant seeks eligibility, starting with the 
108.5 	oldest bill. After assets are reduced to allowable limits, eligibility begins with the next dollar 
108.6 	of MA-covered health services incurred in the retroactive period. Applicants reducing assets 
108.7 	under this subdivision who also have excess income shall first spend excess assets to pay 
108.8 	health service bills and may meet the income spenddown on remaining bills.
108.9 	(b) Assets may be reduced beginning the month of application by paying bills for health 
108.10 	services that are incurred during the period specified in Minnesota Rules, part 9505.0090, 
108.11 	subpart 2, that would otherwise be paid by medical assistance. After assets are reduced to 
108.12 	allowable limits, eligibility begins with the next dollar of medical assistance covered health 
108.13 	services incurred in the period. Applicants reducing assets under this subdivision who also 
108.14 	have excess income shall first spend excess assets to pay health service bills and may meet 
108.15 	the income spenddown on remaining bills.

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

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

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

109.26 	Sec. 9. Minnesota Statutes 2024, section 256B.056, subdivision 7a, is amended to read:
109.27 		Subd. 7a.Periodic renewal of eligibility. (a) Except as provided in paragraphs (d) and 
109.28 	(e), the commissioner shall make an annual redetermination of eligibility based on 
109.29 	information contained in the enrollee's case file and other information available to the 
109.30 	agency, including but not limited to information accessed through an electronic database, 
110.1 	without requiring the enrollee to submit any information when sufficient data is available 
110.2 	for the agency to renew eligibility.
110.3 	(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the 
110.4 	commissioner must provide the enrollee with a prepopulated renewal form containing 
110.5 	eligibility information available to the agency and permit the enrollee to submit the form 
110.6 	with any corrections or additional information to the agency and sign the renewal form via 
110.7 	any of the modes of submission specified in section 256B.04, subdivision 18.
110.8 	(c) An enrollee who is terminated for failure to complete the renewal process may 
110.9 	subsequently submit the renewal form and required information within four months after 
110.10 	the date of termination and have coverage reinstated without a lapse, if otherwise eligible 
110.11 	under this chapter. The local agency may close the enrollee's case file if the required 
110.12 	information is not submitted within four months of termination.
110.13 	(d) Notwithstanding paragraph (a), A person who is eligible under subdivision 5 shall 
110.14 	be is subject to a review of the person's income every six months.
110.15 	(e) A person subject to six-month eligibility redeterminations under Public Law 119-21, 
110.16 	section 71107, is subject to a redetermination of eligibility every six months.

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

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

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

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

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

113.25 	Sec. 12. [256B.0563] REVIEW OF DEATH MASTER FILE.
113.26 		Subdivision 1.Definition. For purposes of this section, "death master file" means 
113.27 	information about deceased individuals maintained by the Social Security Administration 
113.28 	under United States Code, title 42, section 1306c(d), or any successor system.
114.1 		Subd. 2.Review of the death master file. (a) Beginning January 1, 2027, the 
114.2 	commissioner must review the death master file at least quarterly to identify any medical 
114.3 	assistance recipients who are deceased.
114.4 	(b) If review of the death master file or any other source indicates that a recipient is 
114.5 	deceased, the commissioner must:
114.6 	(1) terminate the recipient's eligibility for medical assistance in the manner provided for 
114.7 	by the laws and regulations governing medical assistance;
114.8 	(2) notify the recipient and the recipient's representative no later than the date of the 
114.9 	termination; and
114.10 	(3) discontinue any payments to providers under this chapter made on behalf of the 
114.11 	recipient as of the date of the termination.
114.12 	(c) If the commissioner determines that a recipient was misidentified as deceased and 
114.13 	erroneously disenrolled from medical assistance based on information obtained from the 
114.14 	death master file or any other source, the commissioner must immediately re-enroll the 
114.15 	individual in medical assistance retroactive to the date of termination under paragraph (b).
114.16 		Subd. 3.Review of other sources. Nothing in this section prevents the commissioner 
114.17 	from reviewing other sources to identify recipients of medical assistance who are deceased, 
114.18 	provided the commissioner is in compliance with this section and all other requirements 
114.19 	under this chapter related to medical assistance eligibility determination and redetermination.

114.20 	Sec. 13. Minnesota Statutes 2024, section 256B.06, subdivision 4, is amended to read:
114.21 		Subd. 4.Citizenship requirements. (a) Except as provided in paragraph (c), eligibility 
114.22 	for medical assistance is limited to citizens and nationals of the United States, qualified 
114.23 	noncitizens as defined in this subdivision, and other persons residing lawfully in the United 
114.24 	States and noncitizens who are eligible for coverage with federal financial participation 
114.25 	provided by Medicaid or the Children's Health Insurance Program. Noncitizens who are 
114.26 	eligible for federal financial participation include but are not limited to:
114.27 	(1) children and pregnant women who are lawfully residing in the United States as 
114.28 	provided by section 214 of the federal Children's Health Insurance Program Reauthorization 
114.29 	Act of 2009, Public Law 111-3, and who otherwise meet eligibility requirements of this 
114.30 	chapter; and
114.31 	(2) pregnant noncitizens who are ineligible for federal financial participation because 
114.32 	of immigration status; who are not covered by a group health plan or health insurance 
115.1 	coverage according to Code of Federal Regulations, title 42, section 457.310; and who 
115.2 	otherwise meet the eligibility requirements of this chapter. These individuals are eligible 
115.3 	for medical assistance through the period of pregnancy, including labor and delivery, and 
115.4 	12 months postpartum.
115.5 	(b) Citizens or nationals of the United States must cooperate in obtaining satisfactory 
115.6 	documentary evidence of citizenship or nationality according to the requirements of the 
115.7 	federal Deficit Reduction Act of 2005, Public Law 109-171.
115.8 	(c) Beginning October 1, 2003, persons who are receiving care and rehabilitation services 
115.9 	from a nonprofit center established to serve victims of torture and who are otherwise 
115.10 	ineligible for medical assistance under this chapter are eligible for medical assistance without 
115.11 	federal financial participation. These individuals are eligible only for the period during 
115.12 	which they are receiving services from the center. Individuals eligible under this paragraph 
115.13 	are not required to participate in prepaid medical assistance. The nonprofit center referenced 
115.14 	in this paragraph may establish itself as a provider of mental health targeted case management 
115.15 	services through a county contract under section 256.0112, subdivision 6. If the nonprofit 
115.16 	center is unable to secure a contract with a lead county in its service area, then, 
115.17 	notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner 
115.18 	may negotiate a contract with the nonprofit center for provision of mental health targeted 
115.19 	case management services. When serving clients who are not the financial responsibility 
115.20 	of their contracted lead county, the nonprofit center must gain the concurrence of the county 
115.21 	of financial responsibility prior to providing mental health targeted case management services 
115.22 	for those clients.
115.23 	(b) "Qualified noncitizen" means a person who meets one of the following immigration 
115.24 	criteria:
115.25 	(1) admitted for lawful permanent residence according to United States Code, title 8;
115.26 	(2) admitted to the United States as a refugee according to United States Code, title 8, 
115.27 	section 1157;
115.28 	(3) granted asylum according to United States Code, title 8, section 1158;
115.29 	(4) granted withholding of deportation according to United States Code, title 8, section 
115.30 	1253(h);
115.31 	(5) paroled for a period of at least one year according to United States Code, title 8, 
115.32 	section 1182(d)(5);
116.1 	(6) granted conditional entrant status according to United States Code, title 8, section 
116.2 	1153(a)(7);
116.3 	(7) determined to be a battered noncitizen by the United States Attorney General 
116.4 	according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 
116.5 	title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
116.6 	(8) is a child of a noncitizen determined to be a battered noncitizen by the United States 
116.7 	Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility 
116.8 	Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; 
116.9 	or
116.10 	(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public 
116.11 	Law 96-422, the Refugee Education Assistance Act of 1980.
116.12 	(c) All qualified noncitizens who were residing in the United States before August 22, 
116.13 	1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical 
116.14 	assistance with federal financial participation.
116.15 	(d) Beginning December 1, 1996, qualified noncitizens who entered the United States 
116.16 	on or after August 22, 1996, and who otherwise meet the eligibility requirements of this 
116.17 	chapter are eligible for medical assistance with federal participation for five years if they 
116.18 	meet one of the following criteria:
116.19 	(1) refugees admitted to the United States according to United States Code, title 8, section 
116.20 	1157;
116.21 	(2) persons granted asylum according to United States Code, title 8, section 1158;
116.22 	(3) persons granted withholding of deportation according to United States Code, title 8, 
116.23 	section 1253(h);
116.24 	(4) veterans of the United States armed forces with an honorable discharge for a reason 
116.25 	other than noncitizen status, their spouses and unmarried minor dependent children; or
116.26 	(5) persons on active duty in the United States armed forces, other than for training, 
116.27 	their spouses and unmarried minor dependent children.
116.28 	Beginning July 1, 2010, children and pregnant women who are noncitizens described 
116.29 	in paragraph (b) or who are lawfully present in the United States as defined in Code of 
116.30 	Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements 
116.31 	of this chapter, are eligible for medical assistance with federal financial participation as 
117.1 	provided by the federal Children's Health Insurance Program Reauthorization Act of 2009, 
117.2 	Public Law 111-3.
117.3 	(e) (d) Nonimmigrants who otherwise meet the eligibility requirements of this chapter 
117.4 	are eligible for the benefits as provided in paragraphs (f) (e) to (h) (g). For purposes of this 
117.5 	subdivision, a "nonimmigrant" is a person in one of the classes listed in United States Code, 
117.6 	title 8, section 1101(a)(15).
117.7 	(f) (e) Payment shall also be made for care and services that are furnished to noncitizens, 
117.8 	regardless of immigration status, who otherwise meet the eligibility requirements of this 
117.9 	chapter, if such care and services are necessary for the treatment of an emergency medical 
117.10 	condition.
117.11 	(g) (f) For purposes of this subdivision, the term "emergency medical condition" means 
117.12 	a medical condition that meets the requirements of United States Code, title 42, section 
117.13 	1396b(v).
117.14 	(h) (g)(1) Notwithstanding paragraph (g) (f), services that are necessary for the treatment 
117.15 	of an emergency medical condition are limited to the following:
117.16 	(i) services delivered in an emergency room or by an ambulance service licensed under 
117.17 	chapter 144E that are directly related to the treatment of an emergency medical condition;
117.18 	(ii) services delivered in an inpatient hospital setting following admission from an 
117.19 	emergency room or clinic for an acute emergency condition; and
117.20 	(iii) follow-up services that are directly related to the original service provided to treat 
117.21 	the emergency medical condition and are covered by the global payment made to the 
117.22 	provider.
117.23 	(2) Services for the treatment of emergency medical conditions do not include:
117.24 	(i) services delivered in an emergency room or inpatient setting to treat a nonemergency 
117.25 	condition;
117.26 	(ii) organ transplants, stem cell transplants, and related care;
117.27 	(iii) services for routine prenatal care;
117.28 	(iv) continuing care, including long-term care, nursing facility services, home health 
117.29 	care, adult day care, day training, or supportive living services;
117.30 	(v) elective surgery;
118.1 	(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part 
118.2 	of an emergency room visit;
118.3 	(vii) preventative health care and family planning services;
118.4 	(viii) rehabilitation services;
118.5 	(ix) physical, occupational, or speech therapy;
118.6 	(x) transportation services;
118.7 	(xi) case management;
118.8 	(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
118.9 	(xiii) dental services;
118.10 	(xiv) hospice care;
118.11 	(xv) audiology services and hearing aids;
118.12 	(xvi) podiatry services;
118.13 	(xvii) chiropractic services;
118.14 	(xviii) immunizations;
118.15 	(xix) vision services and eyeglasses;
118.16 	(xx) waiver services;
118.17 	(xxi) individualized education programs; or
118.18 	(xxii) substance use disorder treatment.
118.19 	(i) Pregnant noncitizens who are ineligible for federally funded medical assistance 
118.20 	because of immigration status, are not covered by a group health plan or health insurance 
118.21 	coverage according to Code of Federal Regulations, title 42, section 457.310, and who 
118.22 	otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance 
118.23 	through the period of pregnancy, including labor and delivery, and 12 months postpartum.
118.24 	(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services 
118.25 	from a nonprofit center established to serve victims of torture and are otherwise ineligible 
118.26 	for medical assistance under this chapter are eligible for medical assistance without federal 
118.27 	financial participation. These individuals are eligible only for the period during which they 
118.28 	are receiving services from the center. Individuals eligible under this paragraph shall not 
118.29 	be required to participate in prepaid medical assistance. The nonprofit center referenced 
118.30 	under this paragraph may establish itself as a provider of mental health targeted case 
119.1 	management services through a county contract under section 256.0112, subdivision 6. If 
119.2 	the nonprofit center is unable to secure a contract with a lead county in its service area, then, 
119.3 	notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner 
119.4 	may negotiate a contract with the nonprofit center for provision of mental health targeted 
119.5 	case management services. When serving clients who are not the financial responsibility 
119.6 	of their contracted lead county, the nonprofit center must gain the concurrence of the county 
119.7 	of financial responsibility prior to providing mental health targeted case management services 
119.8 	for those clients.
119.9 	(k) (h) Notwithstanding paragraph (h) (g), clause (2), the following services are covered 
119.10 	as emergency medical conditions under paragraph (f) (e) except where coverage is prohibited 
119.11 	under federal law for services under clauses (1) and (2):
119.12 	(1) dialysis services provided in a hospital or freestanding dialysis facility;
119.13 	(2) surgery and the administration of chemotherapy, radiation, and related services 
119.14 	necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and 
119.15 	requires surgery, chemotherapy, or radiation treatment; and
119.16 	(3) kidney transplant if the person has been diagnosed with end stage renal disease, is 
119.17 	currently receiving dialysis services, and is a potential candidate for a kidney transplant.
119.18 	(l) (i) Effective July 1, 2013, recipients of emergency medical assistance under this 
119.19 	subdivision are eligible for coverage of the elderly waiver services provided under chapter 
119.20 	256S, and coverage of rehabilitative services provided in a nursing facility. The age limit 
119.21 	for elderly waiver services does not apply. In order to qualify for coverage, a recipient of 
119.22 	emergency medical assistance is subject to the assessment and reassessment requirements 
119.23 	of section 256B.0911. Initial and continued enrollment under this paragraph is subject to 
119.24 	the limits of available funding.

119.25 	Sec. 14. Minnesota Statutes 2024, section 256B.061, is amended to read:
119.26 	256B.061 ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.
119.27 	(a) If any individual has been determined to be eligible for medical assistance and is 
119.28 	subject to six-month eligibility redeterminations under Public Law 119-21, section 71107, 
119.29 	it medical assistance will be made available for care and services included under the plan 
119.30 	and furnished in or after the third first month before the month in which the individual made 
119.31 	application for such assistance, if such individual was, or upon application would have been, 
119.32 	eligible for medical assistance at the time the care and services were furnished.
120.1 	(b) If any individual has been determined to be eligible for medical assistance and is not 
120.2 	subject to six-month eligibility redeterminations under Public Law 119-21, section 71107, 
120.3 	medical assistance will be made available for care and services included under the plan and 
120.4 	furnished in or after the second month before the month in which the individual made 
120.5 	application for such assistance if such individual was, or upon application would have been, 
120.6 	eligible for medical assistance at the time the care and services were furnished.
120.7 	(c) The commissioner may limit, restrict, or suspend the eligibility of an individual for 
120.8 	up to one year upon that individual's conviction of a criminal offense related to application 
120.9 	for or receipt of medical assistance benefits.

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

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

120.16 	Sec. 16. Minnesota Statutes 2024, section 256B.0631, is amended by adding a subdivision 
120.17 	to read:
120.18 		Subd. 5.Cost sharing. (a) Effective for services provided on or after October 1, 2028, 
120.19 	except as provided in subdivision 6, the medical assistance benefit plan includes the following 
120.20 	cost sharing for recipients eligible under section 256B.055, subdivision 15, with income 
120.21 	above 100 percent of the federal poverty level:
120.22 	(1) $3 per nonpreventive visit, except as provided in paragraph (c). For purposes of this 
120.23 	subdivision, a visit means an episode of service that is required because of a recipient's 
120.24 	symptoms, diagnosis, or established illness, and that is delivered in an ambulatory setting 
120.25 	by a physician or physician assistant, chiropractor, podiatrist, nurse midwife, advanced 
120.26 	practice nurse, audiologist, optician, or optometrist;
120.27 	(2) $3.50 for nonemergency visits to a hospital-based emergency room; and
120.28 	(3) $3 per brand-name drug prescription, $1 per generic drug prescription, and $1 per 
120.29 	prescription for a brand-name multisource drug listed in preferred status on the preferred 
120.30 	drug list, subject to a $12 maximum per month for prescription drug co-payments. No 
120.31 	co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness.
121.1 	(b) Cost sharing for prescription drugs and related medical supplies to treat chronic 
121.2 	disease must comply with the requirements of section 62Q.481.
121.3 	(c) A person eligible for medical assistance under section 256B.055, subdivision 15, is 
121.4 	responsible for all co-payments and deductibles in this subdivision.

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

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

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

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

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

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

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

124.9 	ARTICLE 7
124.10 	MEDICAL ASSISTANCE FRAUD PREVENTION

124.11 	Section 1. Minnesota Statutes 2024, section 8.16, subdivision 1, is amended to read:
124.12 		Subdivision 1.Authority. (a) The attorney general, or any deputy, assistant, or special 
124.13 	assistant attorney general whom the attorney general authorizes in writing, has the authority 
124.14 	in any county of the state to subpoena and require the production of: (1) any records of: (i)
124.15 	telephone companies, cellular phone companies, and paging companies,; (ii) subscribers of 
124.16 	private computer networks, including Internet service providers or computer bulletin board 
124.17 	systems,; (iii) electric companies, gas companies, and water utilities,; (iv) chemical suppliers,; 
124.18 	(v) hotels and motels,; (vi) pawn shops,; (vii) airlines, buses, taxis, and other entities engaged 
124.19 	in the business of transporting people,; and (viii) freight companies, self-service storage 
124.20 	facilities, warehousing companies, package delivery companies, and other entities engaged 
124.21 	in the businesses of transport, storage, or delivery, and; (2) wage and employment records 
124.22 	relating to an investigation conducted under the attorney general's authority under section 
124.23 	256B.12; (3) records of the existence of safe deposit box account numbers and customer 
124.24 	savings and checking account numbers maintained by financial institutions and safe deposit 
124.25 	companies; (4) insurance records related to claim settlement relating to an investigation 
124.26 	conducted under the attorney general's authority under section 256B.12; and (5) banking, 
124.27 	credit card, and financial records, including but not limited to a safe deposit, loan and account 
124.28 	application and agreement, signature card, statement, check, transfer, account authorization, 
124.29 	safe deposit access record, and documentation of fraud, that belong to the subject of an 
124.30 	investigation conducted pursuant to the attorney general's authority under section 256B.12, 
124.31 	whether the record is held in the investigation subject's name or in another person's name.
124.32 	(b) Subpoenas may only be issued for records that are relevant to an ongoing legitimate 
124.33 	law enforcement investigation.

125.1 	Sec. 2. Minnesota Statutes 2025 Supplement, section 256B.12, is amended to read:
125.2 	256B.12 LEGAL REPRESENTATION.
125.3 	The attorney general or the appropriate county attorney appearing at the direction of the 
125.4 	attorney general shall be the attorney for the state agency, and the county attorney of the 
125.5 	appropriate county shall be the attorney for the county agency in all matters pertaining 
125.6 	hereto. To prosecute under this chapter or sections 609.466 609.467; 609.52, subdivision 
125.7 	2; and 609.542 or to recover payments wrongfully made under this chapter, the attorney 
125.8 	general or the appropriate county attorney, acting independently or at the direction of the 
125.9 	attorney general may institute a criminal or civil action.

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

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

127.25 	Sec. 4. Minnesota Statutes 2024, section 609.52, subdivision 2, is amended to read:
127.26 		Subd. 2.Acts constituting theft. (a) Whoever does any of the following commits theft 
127.27 	and may be sentenced as provided in subdivision 3:
127.28 	(1) intentionally and without claim of right takes, uses, transfers, conceals or retains 
127.29 	possession of movable property of another without the other's consent and with intent to 
127.30 	deprive the owner permanently of possession of the property; or
127.31 	(2) with or without having a legal interest in movable property, intentionally and without 
127.32 	consent, takes the property out of the possession of a pledgee or other person having a 
128.1 	superior right of possession, with intent thereby to deprive the pledgee or other person 
128.2 	permanently of the possession of the property; or
128.3 	(3) obtains for the actor or another the possession, custody, or title to property of or 
128.4 	performance of services by a third person by intentionally deceiving the third person with 
128.5 	a false representation which is known to be false, made with intent to defraud, and which 
128.6 	does defraud the person to whom it is made. "False representation" includes without 
128.7 	limitation:
128.8 	(i) the issuance of a check, draft, or order for the payment of money, except a forged 
128.9 	check as defined in section 609.631, or the delivery of property knowing that the actor is 
128.10 	not entitled to draw upon the drawee therefor or to order the payment or delivery thereof; 
128.11 	or
128.12 	(ii) a promise made with intent not to perform. Failure to perform is not evidence of 
128.13 	intent not to perform unless corroborated by other substantial evidence; or
128.14 	(iii) the preparation or filing of a claim for reimbursement, a rate application, or a cost 
128.15 	report used to establish a rate or claim for payment for medical care provided to a recipient 
128.16 	of medical assistance under chapter 256B, which intentionally and falsely states the costs 
128.17 	of or actual services provided by a vendor of medical care; or
128.18 	(iv) (iii) the preparation or filing of a claim for reimbursement for providing treatment 
128.19 	or supplies required to be furnished to an employee under section 176.135 which intentionally 
128.20 	and falsely states the costs of or actual treatment or supplies provided; or
128.21 	(v) (iv) the preparation or filing of a claim for reimbursement for providing treatment 
128.22 	or supplies required to be furnished to an employee under section 176.135 for treatment or 
128.23 	supplies that the provider knew were medically unnecessary, inappropriate, or excessive; 
128.24 	or
128.25 	(4) by swindling, whether by artifice, trick, device, or any other means, obtains property 
128.26 	or services from another person; or
128.27 	(5) intentionally commits any of the acts listed in this subdivision but with intent to 
128.28 	exercise temporary control only and:
128.29 	(i) the control exercised manifests an indifference to the rights of the owner or the 
128.30 	restoration of the property to the owner; or
128.31 	(ii) the actor pledges or otherwise attempts to subject the property to an adverse claim; 
128.32 	or
129.1 	(iii) the actor intends to restore the property only on condition that the owner pay a 
129.2 	reward or buy back or make other compensation; or
129.3 	(6) finds lost property and, knowing or having reasonable means of ascertaining the true 
129.4 	owner, appropriates it to the finder's own use or to that of another not entitled thereto without 
129.5 	first having made reasonable effort to find the owner and offer and surrender the property 
129.6 	to the owner; or
129.7 	(7) intentionally obtains property or services, offered upon the deposit of a sum of money 
129.8 	or tokens in a coin or token operated machine or other receptacle, without making the 
129.9 	required deposit or otherwise obtaining the consent of the owner; or
129.10 	(8) intentionally and without claim of right converts any article representing a trade 
129.11 	secret, knowing it to be such, to the actor's own use or that of another person or makes a 
129.12 	copy of an article representing a trade secret, knowing it to be such, and intentionally and 
129.13 	without claim of right converts the same to the actor's own use or that of another person. It 
129.14 	shall be a complete defense to any prosecution under this clause for the defendant to show 
129.15 	that information comprising the trade secret was rightfully known or available to the 
129.16 	defendant from a source other than the owner of the trade secret; or
129.17 	(9) leases or rents personal property under a written instrument and who:
129.18 	(i) with intent to place the property beyond the control of the lessor conceals or aids or 
129.19 	abets the concealment of the property or any part thereof; or
129.20 	(ii) sells, conveys, or encumbers the property or any part thereof without the written 
129.21 	consent of the lessor, without informing the person to whom the lessee sells, conveys, or 
129.22 	encumbers that the same is subject to such lease or rental contract with intent to deprive the 
129.23 	lessor of possession thereof; or
129.24 	(iii) does not return the property to the lessor at the end of the lease or rental term, plus 
129.25 	agreed-upon extensions, with intent to wrongfully deprive the lessor of possession of the 
129.26 	property; or
129.27 	(iv) returns the property to the lessor at the end of the lease or rental term, plus 
129.28 	agreed-upon extensions, but does not pay the lease or rental charges agreed upon in the 
129.29 	written instrument, with intent to wrongfully deprive the lessor of the agreed-upon charges.
129.30 	For the purposes of items (iii) and (iv), the value of the property must be at least $100.
129.31 	Evidence that a lessee used a false, fictitious, or not current name, address, or place of 
129.32 	employment in obtaining the property or fails or refuses to return the property or pay the 
129.33 	rental contract charges to lessor within five days after written demand for the return has 
130.1 	been served personally in the manner provided for service of process of a civil action or 
130.2 	sent by certified mail to the last known address of the lessee, whichever shall occur later, 
130.3 	shall be evidence of intent to violate this clause. Service by certified mail shall be deemed 
130.4 	to be complete upon deposit in the United States mail of such demand, postpaid and addressed 
130.5 	to the person at the address for the person set forth in the lease or rental agreement, or, in 
130.6 	the absence of the address, to the person's last known place of residence; or
130.7 	(10) alters, removes, or obliterates numbers or symbols placed on movable property for 
130.8 	purpose of identification by the owner or person who has legal custody or right to possession 
130.9 	thereof with the intent to prevent identification, if the person who alters, removes, or 
130.10 	obliterates the numbers or symbols is not the owner and does not have the permission of 
130.11 	the owner to make the alteration, removal, or obliteration; or
130.12 	(11) with the intent to prevent the identification of property involved, so as to deprive 
130.13 	the rightful owner of possession thereof, alters or removes any permanent serial number, 
130.14 	permanent distinguishing number or manufacturer's identification number on personal 
130.15 	property or possesses, sells or buys any personal property knowing or having reason to 
130.16 	know that the permanent serial number, permanent distinguishing number or manufacturer's 
130.17 	identification number has been removed or altered; or
130.18 	(12) intentionally deprives another of a lawful charge for cable television service by:
130.19 	(i) making or using or attempting to make or use an unauthorized external connection 
130.20 	outside the individual dwelling unit whether physical, electrical, acoustical, inductive, or 
130.21 	other connection; or by
130.22 	(ii) attaching any unauthorized device to any cable, wire, microwave, or other component 
130.23 	of a licensed cable communications system as defined in chapter 238. Nothing herein shall 
130.24 	be construed to prohibit the electronic video rerecording of program material transmitted 
130.25 	on the cable communications system by a subscriber for fair use as defined by Public Law 
130.26 	94-553, section 107; or
130.27 	(13) except as provided in clauses (12) and (14), obtains the services of another with 
130.28 	the intention of receiving those services without making the agreed or reasonably expected 
130.29 	payment of money or other consideration; or
130.30 	(14) intentionally deprives another of a lawful charge for telecommunications service 
130.31 	by:
131.1 	(i) making, using, or attempting to make or use an unauthorized connection whether 
131.2 	physical, electrical, by wire, microwave, radio, or other means to a component of a local 
131.3 	telecommunication system as provided in chapter 237; or
131.4 	(ii) attaching an unauthorized device to a cable, wire, microwave, radio, or other 
131.5 	component of a local telecommunication system as provided in chapter 237.
131.6 	The existence of an unauthorized connection is prima facie evidence that the occupier 
131.7 	of the premises:
131.8 	(A) made or was aware of the connection; and
131.9 	(B) was aware that the connection was unauthorized;
131.10 	(15) with intent to defraud, diverts corporate property other than in accordance with 
131.11 	general business purposes or for purposes other than those specified in the corporation's 
131.12 	articles of incorporation; or
131.13 	(16) with intent to defraud, authorizes or causes a corporation to make a distribution in 
131.14 	violation of section 302A.551, or any other state law in conformity with it; or
131.15 	(17) takes or drives a motor vehicle without the consent of the owner or an authorized 
131.16 	agent of the owner, knowing or having reason to know that the owner or an authorized agent 
131.17 	of the owner did not give consent; or
131.18 	(18) intentionally, and without claim of right, takes motor fuel from a retailer without 
131.19 	the retailer's consent and with intent to deprive the retailer permanently of possession of 
131.20 	the fuel by driving a motor vehicle from the premises of the retailer without having paid 
131.21 	for the fuel dispensed into the vehicle; or
131.22 	(19) commits wage theft under subdivision 1, clause (13).
131.23 	(b) Proof that the driver of a motor vehicle into which motor fuel was dispensed drove 
131.24 	the vehicle from the premises of the retailer without having paid for the fuel permits the 
131.25 	factfinder to infer that the driver acted intentionally and without claim of right, and that the 
131.26 	driver intended to deprive the retailer permanently of possession of the fuel. This paragraph 
131.27 	does not apply if: (1) payment has been made to the retailer within 30 days of the receipt 
131.28 	of notice of nonpayment under section 604.15; or (2) a written notice as described in section 
131.29 	604.15, subdivision 4, disputing the retailer's claim, has been sent. This paragraph does not 
131.30 	apply to the owner of a motor vehicle if the vehicle or the vehicle's license plate has been 
131.31 	reported stolen before the theft of the fuel.

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

132.3 	Sec. 5. Minnesota Statutes 2025 Supplement, section 609.902, subdivision 4, is amended 
132.4 	to read:
132.5 		Subd. 4.Criminal act. "Criminal act" means conduct constituting, or a conspiracy or 
132.6 	attempt to commit, a felony violation of chapter 152, or a felony violation of section 299F.79; 
132.7 	299F.80; 299F.82; 609.185; 609.19; 609.195; 609.20; 609.205; 609.221; 609.222; 609.223; 
132.8 	609.2231; 609.228; 609.235; 609.245; 609.25; 609.27; 609.322; 609.342; 609.343; 609.344; 
132.9 	609.345; 609.42; 609.467;609.48; 609.485; 609.495; 609.496; 609.497; 609.498; 609.52, 
132.10 	subdivision 2, if the offense is punishable under subdivision 3, clause (1), if the property is 
132.11 	a firearm, clause (3)(b), or clause (3)(d)(v); section 609.52, subdivision 2, paragraph (a), 
132.12 	clause (1) or (4); 609.527, if the crime is punishable under subdivision 3, clause (4); 609.528, 
132.13 	if the crime is punishable under subdivision 3, clause (4); 609.53; 609.561; 609.562; 609.582, 
132.14 	subdivision 1 or 2; 609.668, subdivision 6, paragraph (a); 609.67; 609.687; 609.713; 609.86; 
132.15 	609.894, subdivision 3 or 4; 609.895; 624.713; 624.7191; or 626A.02, subdivision 1, if the 
132.16 	offense is punishable under section 626A.02, subdivision 4, paragraph (a). "Criminal act" 
132.17 	also includes conduct constituting, or a conspiracy or attempt to commit, a felony violation 
132.18 	of section 609.52, subdivision 2, clause (3), (4), (15), or (16), if the violation involves an 
132.19 	insurance company as defined in section 60A.02, subdivision 4, a nonprofit health service 
132.20 	plan corporation regulated under chapter 62C, a health maintenance organization regulated 
132.21 	under chapter 62D, or a fraternal benefit society regulated under chapter 64B, or any state 
132.22 	agency.

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

134.6 	Sec. 7. REPEALER.
 134.7 	Minnesota Statutes 2024, section 609.466, is repealed.

134.8 	ARTICLE 8
134.9 	MEDICAL ASSISTANCE FRAUD PREVENTION CONFORMING CHANGES

134.10 	Section 1. Minnesota Statutes 2025 Supplement, section 145A.061, subdivision 3, is 
134.11 	amended to read:
134.12 		Subd. 3.Denial of service. The commissioner may deny an application from any 
134.13 	applicant who has been convicted of any of the following crimes:
134.14 	Section 609.185 (murder in the first degree); section 609.19 (murder in the second 
134.15 	degree); section 609.195 (murder in the third degree); section 609.20 (manslaughter in the 
134.16 	first degree); section 609.205 (manslaughter in the second degree); section 609.25 
134.17 	(kidnapping); section 609.2661 (murder of an unborn child in the first degree); section 
134.18 	609.2662 (murder of an unborn child in the second degree); section 609.2663 (murder of 
134.19 	an unborn child in the third degree); section 609.342 (criminal sexual conduct in the first 
134.20 	degree); section 609.343 (criminal sexual conduct in the second degree); section 609.344 
134.21 	(criminal sexual conduct in the third degree); section 609.345 (criminal sexual conduct in 
134.22 	the fourth degree); section 609.3451 (criminal sexual conduct in the fifth degree); section 
134.23 	609.3453 (criminal sexual predatory conduct); section 609.352 (solicitation of children to 
134.24 	engage in sexual conduct); section 609.352 (communication of sexually explicit materials 
134.25 	to children); section 609.365 (incest); section 609.377 (felony malicious punishment of a 
134.26 	child); section 609.378 (felony neglect or endangerment of a child); section 609.561 (arson 
134.27 	in the first degree); section 609.562 (arson in the second degree); section 609.563 (arson in 
134.28 	the third degree); section 609.749, subdivision 3, 4, or 5 (felony harassment or stalking); 
134.29 	section 152.021 (controlled substance crimes in the first degree); section 152.022 (controlled 
134.30 	substance crimes in the second degree); section 152.023 (controlled substance crimes in the 
134.31 	third degree); section 152.024 (controlled substance crimes in the fourth degree); section 
134.32 	152.025 (controlled substance crimes in the fifth degree); section 243.166 (violation of 
134.33 	predatory offender registration law); section 617.23, subdivision 2, clause (1), or subdivision 
135.1 	3, clause (1) (indecent exposure involving a minor); section 617.246 (use of minors in sexual 
135.2 	performance); section 617.247 (possession of child sexual abuse material); section 609.221
135.3 	(assault in the first degree); section 609.222 (assault in the second degree); section 609.223
135.4 	(assault in the third degree); section 609.2231 (assault in the fourth degree); section 609.224
135.5 	(assault in the fifth degree); section 609.2242 (domestic assault); section 609.2247 (domestic 
135.6 	assault by strangulation); section 609.228 (great bodily harm caused by distribution of 
135.7 	drugs); section 609.23 (mistreatment of persons confined); section 609.231 (mistreatment 
135.8 	of residents or patients); section 609.2325 (criminal abuse); section 609.233 (criminal 
135.9 	neglect); section 609.2335 (financial exploitation of a vulnerable adult); section 609.234 
135.10 	(failure to report); section 609.24 (simple robbery); section 609.245 (aggravated robbery); 
135.11 	section 609.247 (carjacking); section 609.255 (false imprisonment); section 609.322 
135.12 	(solicitation, inducement, and promotion of prostitution and sex trafficking); section 609.324, 
135.13 	subdivision 1 (hiring or engaging minors in prostitution); section 609.465 (presenting false 
135.14 	claims to a public officer or body); Minnesota Statutes 2024, section 609.466or section 
135.15 	609.467 (medical assistance fraud); section 609.52 (felony theft); section 609.82 (felony 
135.16 	fraud in obtaining credit); section 609.527 (felony identity theft); section 609.582 (felony 
135.17 	burglary); section 609.611 (felony insurance fraud); section 609.625 (aggravated forgery); 
135.18 	section 609.63 (forgery); section 609.631 (felony check forgery); section 609.66, subdivision 
135.19 	1e (felony drive-by shooting); section 609.71 (felony riot); section 609.713 (terroristic 
135.20 	threats); section 609.72, subdivision 3 (disorderly conduct by a caregiver against a vulnerable 
135.21 	adult); section 609.821 (felony financial transaction card fraud); section 609.855, subdivision 
135.22 	5 (shooting at or in a public transit vehicle or facility); or aiding and abetting, attempting, 
135.23 	or conspiring to commit any of the offenses in this subdivision.

135.24 	Sec. 2. Minnesota Statutes 2024, section 214.10, subdivision 2a, is amended to read:
135.25 		Subd. 2a.Proceedings. A board shall initiate proceedings to suspend or revoke a license 
135.26 	or shall refuse to renew a license of a person licensed by the board who is convicted in a 
135.27 	court of competent jurisdiction of violating section 609.2231, subdivision 8, 609.23, 609.231, 
135.28 	609.2325, 609.233, 609.2335, 609.234, 609.465, Minnesota Statutes 2024, section609.466,
135.29 	section 609.467,609.52, or 609.72, subdivision 3.

135.30 	Sec. 3. Minnesota Statutes 2024, section 245C.15, subdivision 2, is amended to read:
135.31 		Subd. 2.15-year disqualification. (a) An individual is disqualified under section 245C.14 
135.32 	if: (1) less than 15 years have passed since the discharge of the sentence imposed, if any, 
135.33 	for the offense; and (2) the individual has committed a felony-level violation of any of the 
135.34 	following offenses: sections 152.021, subdivision 1 or 2b, (aggravated controlled substance 
136.1 	crime in the first degree; sale crimes); 152.022, subdivision 1 (controlled substance crime 
136.2 	in the second degree; sale crimes); 152.023, subdivision 1 (controlled substance crime in 
136.3 	the third degree; sale crimes); 152.024, subdivision 1 (controlled substance crime in the 
136.4 	fourth degree; sale crimes); 256.98 (wrongfully obtaining assistance); 268.182 (fraud); 
136.5 	393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 518B.01, subdivision 14 
136.6 	(violation of an order for protection); 609.165 (felon ineligible to possess firearm); 609.2112, 
136.7 	609.2113, or 609.2114 (criminal vehicular homicide or injury); 609.215 (suicide); 609.223 
136.8 	or 609.2231 (assault in the third or fourth degree); repeat offenses under 609.224 (assault 
136.9 	in the fifth degree); 609.229 (crimes committed for benefit of a gang); 609.2325 (criminal 
136.10 	abuse of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 609.235 
136.11 	(use of drugs to injure or facilitate crime); 609.24 (simple robbery); 609.247, subdivision 
136.12 	4 (carjacking in the third degree); 609.255 (false imprisonment); 609.2664 (manslaughter 
136.13 	of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the 
136.14 	second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault 
136.15 	of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the 
136.16 	commission of a crime); 609.27 (coercion); 609.275 (attempt to coerce); Minnesota Statutes 
136.17 	2024, section 609.466or section 609.467 (medical assistance fraud); 609.495 (aiding an 
136.18 	offender); 609.498, subdivision 1 or 1b (aggravated first-degree or first-degree tampering 
136.19 	with a witness); 609.52 (theft); 609.521 (possession of shoplifting gear); 609.522 (organized 
136.20 	retail theft); 609.525 (bringing stolen goods into Minnesota); 609.527 (identity theft); 609.53
136.21 	(receiving stolen property); 609.535 (issuance of dishonored checks); 609.562 (arson in the 
136.22 	second degree); 609.563 (arson in the third degree); 609.582 (burglary); 609.59 (possession 
136.23 	of burglary tools); 609.611 (insurance fraud); 609.625 (aggravated forgery); 609.63 (forgery); 
136.24 	609.631 (check forgery; offering a forged check); 609.635 (obtaining signature by false 
136.25 	pretense); 609.66 (dangerous weapons); 609.67 (machine guns and short-barreled shotguns); 
136.26 	609.687 (adulteration); 609.71 (riot); 609.713 (terroristic threats); 609.746 (interference 
136.27 	with privacy); 609.82 (fraud in obtaining credit); 609.821 (financial transaction card fraud); 
136.28 	617.23 (indecent exposure), not involving a minor; repeat offenses under 617.241 (obscene 
136.29 	materials and performances; distribution and exhibition prohibited; penalty); or 624.713
136.30 	(certain persons not to possess firearms).
136.31 	(b) An individual is disqualified under section 245C.14 if less than 15 years has passed 
136.32 	since the individual's aiding and abetting, attempt, or conspiracy to commit any of the 
136.33 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
137.1 	(c) An individual is disqualified under section 245C.14 if less than 15 years has passed 
137.2 	since the termination of the individual's parental rights under section 260C.301, subdivision 
137.3 	1, paragraph (b), or subdivision 3.
137.4 	(d) An individual is disqualified under section 245C.14 if less than 15 years has passed 
137.5 	since the discharge of the sentence imposed for an offense in any other state or country, the 
137.6 	elements of which are substantially similar to the elements of the offenses listed in paragraph 
137.7 	(a) or since the termination of parental rights in any other state or country, the elements of 
137.8 	which are substantially similar to the elements listed in paragraph (c).
137.9 	(e) If the individual studied commits one of the offenses listed in paragraph (a), but the 
137.10 	sentence or level of offense is a gross misdemeanor or misdemeanor, the individual is 
137.11 	disqualified but the disqualification look-back period for the offense is the period applicable 
137.12 	to the gross misdemeanor or misdemeanor disposition.
137.13 	(f) When a disqualification is based on a judicial determination other than a conviction, 
137.14 	the disqualification period begins from the date of the court order. When a disqualification 
137.15 	is based on an admission, the disqualification period begins from the date of an admission 
137.16 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
137.17 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
137.18 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
137.19 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
137.20 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

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

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

140.19 	Sec. 6. Minnesota Statutes 2025 Supplement, section 609.531, subdivision 1, is amended 
140.20 	to read:
140.21 		Subdivision 1.Definitions. For the purpose of sections 609.531 to 609.5318, the 
140.22 	following terms have the meanings given.
140.23 	(a) "Conveyance device" means a device used for transportation and includes, but is not 
140.24 	limited to, a motor vehicle, trailer, snowmobile, airplane, and vessel and any equipment 
140.25 	attached to it. The term "conveyance device" does not include property which is, in fact, 
140.26 	itself stolen or taken in violation of the law.
140.27 	(b) "Weapon used" means a dangerous weapon as defined under section 609.02, 
140.28 	subdivision 6, that the actor used or had in possession in furtherance of a crime.
140.29 	(c) "Property" means property as defined in section 609.52, subdivision 1, clause (1).
140.30 	(d) "Contraband" means property which is illegal to possess under Minnesota law.
140.31 	(e) "Appropriate agency" means the Bureau of Criminal Apprehension, the Minnesota 
140.32 	Division of Driver and Vehicle Services, the Minnesota State Patrol, a county sheriff's 
141.1 	department, the Three Rivers Park District Department of Public Safety, the Department of 
141.2 	Natural Resources Division of Enforcement, the University of Minnesota Police Department, 
141.3 	the Department of Corrections Fugitive Apprehension Unit, a city, metropolitan transit, or 
141.4 	airport police department; or a multijurisdictional entity established under section 299A.642
141.5 	or 299A.681.
141.6 	(f) "Designated offense" includes:
141.7 	(1) for weapons used: any violation of this chapter, chapter 152 or 624;
141.8 	(2) for driver's license or identification card transactions: any violation of section 171.22; 
141.9 	and
141.10 	(3) for all other purposes: a felony violation of, or a felony-level attempt or conspiracy 
141.11 	to violate, section 325E.17; 325E.18; 609.185; 609.19; 609.195; 609.2112; 609.2113; 
141.12 	609.2114; 609.221; 609.222; 609.223; 609.2231; 609.2335; 609.24; 609.245; 609.247; 
141.13 	609.25; 609.255; 609.282; 609.283; 609.322; 609.342, subdivision 1, or subdivision 1a, 
141.14 	clauses (a) to (f) and (i); 609.343, subdivision 1, or subdivision 1a, clauses (a) to (f) and (i); 
141.15 	609.344, subdivision 1, or subdivision 1a, clauses (a) to (e), (h), or (i); 609.345, subdivision 
141.16 	1, or subdivision 1a, clauses (a) to (e), (h), and (i); 609.352; 609.42; 609.425; Minnesota 
141.17 	Statutes 2024, section609.466; section 609.467;609.485; 609.487; 609.52; 609.525; 609.527; 
141.18 	609.528; 609.53; 609.54; 609.551; 609.561; 609.562; 609.563; 609.582; 609.59; 609.595; 
141.19 	609.611; 609.631; 609.66, subdivision 1e; 609.671, subdivisions 3, 4, 5, 8, and 12; 609.687; 
141.20 	609.821; 609.825; 609.86; 609.88; 609.89; 609.893; 609.895; 617.246; 617.247; or a gross 
141.21 	misdemeanor or felony violation of section 609.891 or 624.7181; or any violation of section 
141.22 	609.324; or a felony violation of, or a felony-level attempt or conspiracy to violate, Minnesota 
141.23 	Statutes 2012, section 609.21.
141.24 	(g) "Controlled substance" has the meaning given in section 152.01, subdivision 4.
141.25 	(h) "Prosecuting authority" means the attorney who is responsible for prosecuting an 
141.26 	offense that is the basis for a forfeiture under sections 609.531 to 609.5318.
141.27 	(i) "Asserting person" means a person, other than the driver alleged to have used a vehicle 
141.28 	in the transportation or exchange of a controlled substance intended for distribution or sale, 
141.29 	claiming an ownership interest in a vehicle that has been seized or restrained under this 
141.30 	section.

142.1 	Sec. 7. Laws 2026, chapter 88, article 1, section 181, is amended to read:
142.2 	Sec. 181. Minnesota Statutes 2025 Supplement, section 299C.061, subdivision 1, is 
142.3 	amended to read:
142.4 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
142.5 	the meanings given.
142.6 	(b) "Fraud involving state funded or administered programs or services" includes any 
142.7 	violation of section 609.445, 609.465, Minnesota Statutes 2024, section609.466, section 
142.8 	609.467,609.52, 609.611, 609.651, 609.7475, or 609.821 involving a state agency or 
142.9 	state-funded or administered program or service.
142.10 	(c) "Peace officer" has the meaning given in section 626.84, subdivision 1, paragraph 
142.11 	(c).
142.12 	(d) "Section" means the Financial Crimes and Fraud Section of the Bureau of Criminal 
142.13 	Apprehension.
142.14 	(e) "State agency" has the meaning given in section 13.02, subdivision 17.
142.15 	(f) "Superintendent" means the superintendent of the Bureau of Criminal Apprehension.

142.16 	ARTICLE 9
142.17 	CHILDREN, YOUTH, AND FAMILIES POLICY

142.18 	Section 1. Minnesota Statutes 2024, section 124D.19, is amended by adding a subdivision 
142.19 	to read:
142.20 		Subd. 13a.School-age care programs; priority for children in foster care. Each 
142.21 	district operating a school-age care, youth after-school enrichment, or other before- and 
142.22 	after-school community education program under this section must ensure that children in 
142.23 	foster care, as defined under section 260C.007, subdivision 18, or in a voluntary or 
142.24 	involuntary foster care placement under the Minnesota Indian Family Preservation Act 
142.25 	receive priority for enrollment in community education programs. In order to give a child 
142.26 	priority under this paragraph, the district may require a letter or other documentation from 
142.27 	a responsible social services agency or child-placing agency verifying that the child is in 
142.28 	foster care.

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

145.4 	Sec. 3. Minnesota Statutes 2024, section 142B.10, subdivision 18, is amended to read:
145.5 		Subd. 18.Adoption agency; additional requirements. In addition to the other 
145.6 	requirements of this section, an individual or organization applying for a license to place 
145.7 	children for adoption must:
145.8 	(1) incorporate as a nonprofit corporation under chapter 317A or a nonprofit limited 
145.9 	liability company under chapter 322C;
145.10 	(2) file with the application for licensure a copy of the disclosure form required under 
145.11 	section 259.37, subdivision 2;
145.12 	(3) provide evidence that a bond has been obtained and will be continuously maintained 
145.13 	throughout the entire operating period of the agency, to cover the cost of transfer of records 
145.14 	to and storage of records by the agency which has agreed, according to rule established by 
145.15 	the commissioner, to receive the applicant agency's records if the applicant agency voluntarily 
145.16 	or involuntarily ceases operation and fails to provide for proper transfer of the records. The 
145.17 	bond must be made in favor of the agency which has agreed to receive the records; and
145.18 	(4) submit a financial review completed by an accountant to the commissioner each year 
145.19 	the license is renewed as required under section 142B.05, subdivision 1.

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

145.26 	Sec. 5. Minnesota Statutes 2024, section 142B.65, subdivision 7, is amended to read:
145.27 		Subd. 7.Abusive head trauma training. (a) Before caring for children under school 
145.28 	age, the director, staff persons, substitutes, and unsupervised volunteers must receive training 
145.29 	on the risk of abusive head trauma during orientation and each calendar year thereafter.
145.30 	(b) Abusive head trauma training under this subdivision must be at least one-half hour 
145.31 	in length. At a minimum, the training must address the risk factors related to shaking infants 
146.1 	and young children, means to reduce the risk of abusive head trauma in child care, and 
146.2 	license holder communication with parents regarding reducing the risk of abusive head 
146.3 	trauma. The training must be interactive and not only consist of reading or viewing 
146.4 	information.
146.5 	(c) Except if completed during orientation, training taken under this subdivision may 
146.6 	be used to meet the in-service training requirements under subdivision 9.
146.7 	(d) The commissioner shall make available for viewing a video presentation on the 
146.8 	dangers associated with shaking infants and young children, which may be used in 
146.9 	conjunction with the annual training required under paragraph (b).

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

146.11 	Sec. 6. Minnesota Statutes 2024, section 142B.70, subdivision 6, is amended to read:
146.12 		Subd. 6.Sudden unexpected infant death and abusive head trauma training. (a) 
146.13 	License holders must ensure and document that before the license holder, second adult 
146.14 	caregivers, substitutes, and helpers assist in the care of infants, they are instructed on the 
146.15 	standards in section 142B.46 and receive training on reducing the risk of sudden unexpected 
146.16 	infant death. In addition, license holders must ensure and document that before the license 
146.17 	holder, second adult caregivers, substitutes, and helpers assist in the care of infants and 
146.18 	children under school age, they receive training on reducing the risk of abusive head trauma 
146.19 	from shaking infants and young children. The training in this subdivision may be provided 
146.20 	as initial training under subdivision 1 or ongoing annual training under subdivision 8.
146.21 	(b) Sudden unexpected infant death reduction training required under this subdivision 
146.22 	must, at a minimum, address the risk factors related to sudden unexpected infant death, 
146.23 	means of reducing the risk of sudden unexpected infant death in child care, and license 
146.24 	holder communication with parents regarding reducing the risk of sudden unexpected infant 
146.25 	death.
146.26 	(c) Abusive head trauma training required under this subdivision must, at a minimum, 
146.27 	address the risk factors related to shaking infants and young children, means of reducing 
146.28 	the risk of abusive head trauma in child care, and license holder communication with parents 
146.29 	regarding reducing the risk of abusive head trauma. The training must be interactive and 
146.30 	not only consist of reading or viewing information.
146.31 	(d) Training for family and group family child care providers must be developed by the 
146.32 	commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved 
146.33 	by the Minnesota Center for Professional Development. Sudden unexpected infant death 
147.1 	reduction training and abusive head trauma training may be provided in a single course of 
147.2 	no more than two hours in length.
147.3 	(e) Sudden unexpected infant death reduction training and abusive head trauma training 
147.4 	required under this subdivision must be completed in person or as allowed under subdivision 
147.5 	11, clause (1) or (2), at least once every two years. On the years when the individual receiving 
147.6 	training is not receiving training in person or as allowed under subdivision 11, clause (1) 
147.7 	or (2), the individual receiving training in accordance with this subdivision must receive 
147.8 	sudden unexpected infant death reduction training and abusive head trauma training through 
147.9 	a video of no more than one hour in length. The video must be developed or approved by 
147.10 	the commissioner or online each calendar year.
147.11 	(f) An individual who is related to the license holder as defined in section 142B.01, 
147.12 	subdivision 15, and who is involved only in the care of the license holder's own infant or 
147.13 	child under school age and who is not designated to be a second adult caregiver, helper, or 
147.14 	substitute for the licensed program, is exempt from the sudden unexpected infant death and 
147.15 	abusive head trauma training.

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

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

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

147.24 	Sec. 8. Minnesota Statutes 2024, section 142D.05, subdivision 8, is amended to read:
147.25 		Subd. 8.Eligibility. (a) A child is eligible to participate in a school readiness program 
147.26 	if the child:
147.27 	(1) is at least three years old on September 1;
147.28 	(2) has completed health and developmental screening within 90 days of program 
147.29 	enrollment under sections 142D.09 to 142D.093; and
147.30 	(3) has one or more of the following risk factors:
147.31 	(i) qualifies for free or reduced-price meals;
148.1 	(ii) is an English learner;
148.2 	(iii) is homeless;
148.3 	(iv) has an individualized education program (IEP) or standardized written plan;
148.4 	(v) is identified, through health and developmental screenings under sections 142D.09
148.5 	to 142D.093, with a potential risk factor that may influence learning; or
148.6 	(vi) is in foster care; or
148.7 	(vii) is defined as at risk by the school district.
148.8 	(b) The commissioner may require a letter or other documentation from a responsible 
148.9 	social services agency or child-placing agency for a child eligible under paragraph (a), 
148.10 	clause (3), item (vi), verifying that the child is in foster care, as defined in section 260C.007, 
148.11 	subdivision 18, or in a voluntary or involuntary foster care placement under the Minnesota 
148.12 	Indian Family Preservation Act. The commissioner must process a verification letter or 
148.13 	other documentation within five business days of receiving the letter or documentation.

148.14 	Sec. 9. [142D.095] PRESCHOOL ASSESSMENT.
148.15 	(a) For programs serving children under section 142D.08, the commissioner of children, 
148.16 	youth, and families must implement a preschool assessment of children's development in 
148.17 	the year prior to kindergarten entry that is:
148.18 	(1) aligned to the state early childhood indicators of progress and based on the criteria 
148.19 	for an early learning assessment approved by the commissioner; and
148.20 	(2) based in part on information collected from teachers, early learning professionals, 
148.21 	families, and other partners.
148.22 	(b) The commissioner must evaluate and approve assessment tools that meet the 
148.23 	requirements in paragraph (a). School districts and charter schools operating a program 
148.24 	under section 142D.08 must choose an assessment tool approved under this paragraph.
148.25 	(c) The commissioner may provide technical assistance and professional development 
148.26 	related to the assessment to educators, school districts, and charter schools.

148.27 	Sec. 10. Minnesota Statutes 2024, section 142D.21, subdivision 6, is amended to read:
148.28 		Subd. 6.Payments. (a) The commissioner shall provide payments under this section to 
148.29 	all eligible programs on a noncompetitive basis. The payment amounts shall be based on 
149.1 	the number of full-time equivalent staff who regularly care for children in the program, 
149.2 	including any employees, sole proprietors, or independent contractors.
149.3 	(b) For purposes of this section, "one full-time equivalent" is defined as an individual 
149.4 	caring for children 32 hours per week, including associated required paid break time. An 
149.5 	individual can count as more or less than one full-time equivalent staff, but as no more than 
149.6 	two full-time equivalent staff.
149.7 	(c) The commissioner must establish an amount to award per full-time equivalent 
149.8 	individual who regularly cares for children in the program.
149.9 	(d) Payments must be increased by ten percent for programs receiving child care 
149.10 	assistance payments under section 142E.08 or 142E.17 or early learning scholarships under 
149.11 	section 142D.25, or for programs located in a child care access equity area. The commissioner 
149.12 	must develop a method for establishing child care access equity areas. For purposes of this 
149.13 	section, "child care access equity area" means an area with low access to child care, high 
149.14 	poverty rates, high unemployment rates, low homeownership rates, and low median 
149.15 	household incomes.
149.16 	(e) The commissioner shall establish the form, frequency, and manner for making 
149.17 	payments under this section.

149.18 	Sec. 11. Minnesota Statutes 2024, section 142D.25, subdivision 3, is amended to read:
149.19 		Subd. 3.Applications; priorities. (a) The commissioner shall establish application 
149.20 	timelines and determine the schedule for awarding scholarships that meet the operational 
149.21 	needs of eligible families and programs.
149.22 	(b) The commissioner must give highest priority on an equal basis to applications from 
149.23 	children who:
149.24 	(1) are not yet four years of age;
149.25 	(2) have a parent under age 21 who is pursuing a high school diploma or a course of 
149.26 	study for a high school equivalency test;
149.27 	(3) are in foster care;
149.28 	(4) have been referred as in need of child protection services;
149.29 	(5) have an incarcerated parent;
149.30 	(6) are in or have a parent in a substance use treatment program;
149.31 	(7) are in or have a parent in a mental health treatment program;
150.1 	(8) have experienced domestic violence;
150.2 	(9) have an individualized education program or individualized family service plan; or
150.3 	(10) have experienced homelessness in the last 24 months, as defined under the federal 
150.4 	McKinney-Vento Homeless Assistance Act, United States Code, title 42, section 1143a.
150.5 	(c) Notwithstanding paragraph (b), beginning July 1, 2025, the commissioner must give 
150.6 	highest priority to applications from children in families with income equal to or less than 
150.7 	the rate specified under subdivision 2, paragraph (a), clause (1), item (i), and within this 
150.8 	group must prioritize children who meet one or more of the criteria listed in paragraph (b).
150.9 	(d) The commissioner may prioritize applications on additional factors, including but 
150.10 	not limited to availability of funding, family income, geographic location, and whether the 
150.11 	child's family is on a waiting list for a publicly funded program providing early education 
150.12 	or child care services.
150.13 	(e) The commissioner may require a letter or other documentation from a responsible 
150.14 	social services agency or child-placing agency for a child receiving priority as a child in 
150.15 	foster care verifying that the child is in foster care, as defined in section 260C.007, 
150.16 	subdivision 18, or in a voluntary or involuntary foster care placement under the Minnesota 
150.17 	Indian Family Preservation Act. The commissioner must process a verification letter or 
150.18 	other documentation within five business days of receiving the letter or documentation.

150.19 	Sec. 12. Minnesota Statutes 2024, section 142E.04, subdivision 4, is amended to read:
150.20 		Subd. 4.Funding priorities. (a) In the event that inadequate funding necessitates the 
150.21 	use of waiting lists, priority for child care assistance under the basic sliding fee assistance 
150.22 	program shall be determined according to this subdivision.
150.23 	(b) First priority must be given to eligible non-MFIP families who do not have a high 
150.24 	school diploma or commissioner of education-selected high school equivalency certification 
150.25 	or who need remedial and basic skill courses in order to pursue employment or to pursue 
150.26 	education leading to employment and who need child care assistance to participate in the 
150.27 	education program. This includes student parents as defined under section 142E.01, 
150.28 	subdivision 26. Within this priority, the following subpriorities must be used:
150.29 	(1) child care needs of minor parents;
150.30 	(2) child care needs of parents under 21 years of age; and
150.31 	(3) child care needs of other parents within the priority group described in this paragraph.
151.1 	(c) Second priority must be given to families in which at least one parent is a veteran, 
151.2 	as defined under section 197.447.
151.3 	(d) Third priority must be given to eligible foster parents providing care to a child placed 
151.4 	in a family foster home under section 260C.007, subdivision 16b; eligible relative custodians 
151.5 	to whom permanent legal and physical custody of a child has been transferred pursuant to 
151.6 	section 260C.515, subdivision 4; or eligible individuals with whom an Indian child has been 
151.7 	placed under section 260.773.
151.8 	(e) Fourth priority must be given to eligible families who do not meet the specifications 
151.9 	of paragraph (b), (c), (e) (d), (f), or (f) (g).
151.10 	(e) Fourth (f) Fifth priority must be given to families who are eligible for portable basic 
151.11 	sliding fee assistance through the portability pool under subdivision 10.
151.12 	(f) Fifth (g) Sixth priority must be given to eligible families receiving services under 
151.13 	section 142E.01, subdivision 27, if the parents have completed their MFIP transition year.
151.14 	(g) (h) Families under paragraph (f) (g) must be added to the basic sliding fee waiting 
151.15 	list on the date they complete their transition year under section 142E.01, subdivision 28.

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

151.17 	Sec. 13. Minnesota Statutes 2024, section 245C.04, subdivision 1, is amended to read:
151.18 		Subdivision 1.Licensed programs; other child care programs. (a) The commissioner 
151.19 	shall conduct a background study of an individual required to be studied under section 
151.20 	245C.03, subdivision 1, at least upon application for initial license for all license types.
151.21 	(b) The commissioner shall conduct a background study of an individual required to be 
151.22 	studied under section 245C.03, subdivision 1, including a child care background study 
151.23 	subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed 
151.24 	child care center, certified license-exempt child care center, or legal nonlicensed child care 
151.25 	provider, on a schedule determined by the commissioner. Except as provided in section 
151.26 	245C.05, subdivision 5a, a child care background study must include submission of 
151.27 	fingerprints for a national criminal history record check and a review of the information 
151.28 	under section 245C.08. A background study for a child care program must be repeated 
151.29 	within five years from the most recent study conducted under this paragraph.
151.30 	(c) At reauthorization or When a new background study is needed under section 142E.16, 
151.31 	subdivision 2, for a legal nonlicensed child care provider authorized under chapter 142E:
152.1 	(1) for a background study affiliated with a legal nonlicensed child care provider, the 
152.2 	individual shall provide information required under section 245C.05, subdivision 1, 
152.3 	paragraphs (a), (b), and (d), to the commissioner and be fingerprinted and photographed 
152.4 	under section 245C.05, subdivision 5; and
152.5 	(2) the commissioner shall verify the information received under clause (1) and submit 
152.6 	the request in NETStudy 2.0 to complete the background study.
152.7 	(d) At reapplication for a family child care license:
152.8 	(1) for a background study affiliated with a licensed family child care center, the 
152.9 	individual shall provide information required under section 245C.05, subdivision 1, 
152.10 	paragraphs (a), (b), and (d), to the county agency, and be fingerprinted and photographed 
152.11 	under section 245C.05, subdivision 5;
152.12 	(2) the county agency shall verify the information received under clause (1) and forward 
152.13 	the information to the commissioner and submit the request in NETStudy 2.0 to complete 
152.14 	the background study; and
152.15 	(3) the background study conducted by the commissioner under this paragraph must 
152.16 	include a review of the information required under section 245C.08.
152.17 	(e) The commissioner is not required to conduct a study of an individual at the time of 
152.18 	reapplication for a license if the individual's background study was completed by the 
152.19 	commissioner of human services and the following conditions are met:
152.20 	(1) a study of the individual was conducted either at the time of initial licensure or when 
152.21 	the individual became affiliated with the license holder;
152.22 	(2) the individual has been continuously affiliated with the license holder since the last 
152.23 	study was conducted; and
152.24 	(3) the last study of the individual was conducted on or after October 1, 1995.
152.25 	(f) The commissioner of human services shall conduct a background study of an 
152.26 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), 
152.27 	who is newly affiliated with a child foster family setting license holder:
152.28 	(1) the county or private agency shall collect and forward to the commissioner the 
152.29 	information required under section 245C.05, subdivisions 1 and 5, when the child foster 
152.30 	family setting applicant or license holder resides in the home where child foster care services 
152.31 	are provided; and
153.1 	(2) the background study conducted by the commissioner of human services under this 
153.2 	paragraph must include a review of the information required under section 245C.08, 
153.3 	subdivisions 1, 3, and 4.
153.4 	(g) The commissioner shall conduct a background study of an individual specified under 
153.5 	section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated 
153.6 	with an adult foster care or family adult day services and with a family child care license 
153.7 	holder or a legal nonlicensed child care provider authorized under chapter 142E and:
153.8 	(1) except as provided in section 245C.05, subdivision 5a, the county shall collect and 
153.9 	forward to the commissioner the information required under section 245C.05, subdivision 
153.10 	1, paragraphs (a) and (b), and subdivision 5, paragraph (b), for background studies conducted 
153.11 	by the commissioner for all family adult day services, for adult foster care when the adult 
153.12 	foster care license holder resides in the adult foster care residence, and for family child care 
153.13 	and legal nonlicensed child care authorized under chapter 142E;
153.14 	(2) the license holder shall collect and forward to the commissioner the information 
153.15 	required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs 
153.16 	(a) and (b), for background studies conducted by the commissioner for adult foster care 
153.17 	when the license holder does not reside in the adult foster care residence; and
153.18 	(3) the background study conducted by the commissioner under this paragraph must 
153.19 	include a review of the information required under section 245C.08, subdivision 1, paragraph 
153.20 	(a), and subdivisions 3 and 4.
153.21 	(h) Applicants for licensure, license holders, and other entities as provided in this chapter 
153.22 	must submit completed background study requests to the commissioner using the electronic 
153.23 	system known as NETStudy before individuals specified in section 245C.03, subdivision 
153.24 	1, begin positions allowing direct contact in any licensed program.
153.25 	(i) For an individual who is not on the entity's active roster, the entity must initiate a 
153.26 	new background study through NETStudy when:
153.27 	(1) an individual returns to a position requiring a background study following an absence 
153.28 	of 120 or more consecutive days; or
153.29 	(2) a program that discontinued providing licensed direct contact services for 120 or 
153.30 	more consecutive days begins to provide direct contact licensed services again.
153.31 	The license holder shall maintain a copy of the notification provided to the commissioner 
153.32 	under this paragraph in the program's files. If the individual's disqualification was previously 
153.33 	set aside for the license holder's program and the new background study results in no new 
154.1 	information that indicates the individual may pose a risk of harm to persons receiving 
154.2 	services from the license holder, the previous set-aside shall remain in effect.
154.3 	(j) For purposes of this section, a physician licensed under chapter 147, advanced practice 
154.4 	registered nurse licensed under chapter 148, or physician assistant licensed under chapter 
154.5 	147A is considered to be continuously affiliated upon the license holder's receipt from the 
154.6 	commissioner of health or human services of the physician's, advanced practice registered 
154.7 	nurse's, or physician assistant's background study results.
154.8 	(k) For purposes of family child care, a substitute caregiver must receive repeat 
154.9 	background studies at the time of each license renewal.
154.10 	(l) A repeat background study at the time of license renewal is not required if the family 
154.11 	child care substitute caregiver's background study was completed by the commissioner on 
154.12 	or after October 1, 2017, and the substitute caregiver is on the license holder's active roster 
154.13 	in NETStudy 2.0.
154.14 	(m) Before and after school programs authorized under chapter 142E, are exempt from 
154.15 	the background study requirements under section 123B.03, for an employee for whom a 
154.16 	background study under this chapter has been completed.

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

155.1 	Sec. 15. Minnesota Statutes 2024, section 259.83, subdivision 1, as amended by Laws 
155.2 	2026, chapter 88, article 1, section 159, is amended to read:
155.3 		Subdivision 1.Services provided. (a) Agencies shall must provide assistance and 
155.4 	counseling services upon receiving a request for current information from adoptive parents, 
155.5 	birth parents, adopted persons aged 18 years of age and older, or adult siblings of adopted 
155.6 	persons. The agency shall must contact the other adult persons or the adoptive parents of a 
155.7 	minor child in a personal and confidential manner to determine whether there is a desire to 
155.8 	receive or share information or to have contact. If there is such a desire, the agency shall
155.9 	must provide the services requested. The agency shall must complete the search request 
155.10 	within six months of the request being made. If the agency is unable to complete the search 
155.11 	request within the specified time frame, the agency shall must inform the requester of the 
155.12 	status of the request and include a reasonable estimate of when the request can be completed.
155.13 	(b) Upon a request for assistance or services from an adoptive parent of a minor child, 
155.14 	birth parent, or an adopted person 18 years of age or older, the agency must inform the 
155.15 	person:
155.16 	(1) about the right of an adopted person to request and obtain a copy of the adopted 
155.17 	person's original birth record at the age and circumstances specified in section 144.2252; 
155.18 	and
155.19 	(2) about the right of the birth parent named on the adopted person's original birth record 
155.20 	to file a contact preference form with the state registrar pursuant to section 144.2253.
155.21 	When making or supervising an adoptive placement, the agency must provide in writing to 
155.22 	the birth parents listed on the original birth record the information required under this 
155.23 	paragraph and section 259.37, subdivision 2, clause (7).

155.24 	Sec. 16. Minnesota Statutes 2024, section 260.67, subdivision 1, is amended to read:
155.25 		Subdivision 1.Preference for permanency placement with a relative. Consistent with 
155.26 	section 260C.513, if an African American or disproportionately represented child cannot 
155.27 	be returned to the child's parent, permanency placement with a relative is preferred. The 
155.28 	court shallmust consider the requirements of and responsibilities under section 260.012, 
155.29 	paragraph (a), and, if possible and if requirements under section 260C.515, subdivision 4, 
155.30 	are met, transfer permanent legal and physical custody of the child to:
155.31 	(1) a noncustodial parent under section 260C.515, subdivision 4, if the child cannot 
155.32 	return to the care of the parent or custodian from whom the child was removed or who had 
155.33 	legal custody at the time that the child was placed in foster care; or
156.1 	(2) a willing and able relative, according to the requirements of section 260C.515, 
156.2 	subdivision 4. When the responsible social services agency is the petitioner, prior to the 
156.3 	court ordering a transfer of permanent legal and physical custody to a relative, the responsible 
156.4 	social services agency must inform the relative of Northstar kinship assistance benefits and 
156.5 	eligibility requirements and of the relative's ability to apply for benefits on behalf of the 
156.6 	child under chapter 256N sections 142A.60 to 142A.612.

156.7 	Sec. 17. Minnesota Statutes 2024, section 260C.190, subdivision 1, is amended to read:
156.8 		Subdivision 1.Placement. (a) An agency with legal responsibility for a child under 
156.9 	section 260C.178, subdivision 1, paragraph (c), or legal custody of a child under section 
156.10 	260C.201, subdivision 1, paragraph (a), clause (3) (2), may colocate a child with a parent 
156.11 	who is receiving services in a licensed residential family-based substance use disorder 
156.12 	treatment program for up to 12 months.
156.13 	(b) During the child's placement under paragraph (a), the agency: (1) may visit the child 
156.14 	as the agency deems necessary and appropriate; (2) shallmust continue to have access to 
156.15 	information under section 260C.208; and (3) shallmust continue to provide appropriate 
156.16 	services to both the parent and the child.
156.17 	(c) The agency may terminate the child's placement under paragraph (a) to protect the 
156.18 	child's health, safety, or welfare and may remove the child to foster care without a prior 
156.19 	court order or authorization.

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

162.20 	Sec. 19. Minnesota Statutes 2024, section 260C.212, subdivision 4a, is amended to read:
162.21 		Subd. 4a.Monthly caseworker visits. (a) Every child in foster care or on a trial home 
162.22 	visit shallmust be visited by the child's caseworker or another person who has responsibility 
162.23 	for visitation of the child on a monthly basis, with the majority of visits occurring in the 
162.24 	child's residence. The responsible social services agency may designate another person 
162.25 	responsible for monthly case visits. For the purposes of this section, the following definitions 
162.26 	apply:
162.27 	(1) "visit" is defined as a face-to-face contact between a child and the child's caseworker. 
162.28 	For a youth 18 years of age or older, a visit may be conducted via video conference with 
162.29 	the youth's informed consent;
162.30 	(2) "visited on a monthly basis" is defined as at least one visit per calendar month;
162.31 	(3) "the child's caseworker" is defined as the person who has responsibility for managing 
162.32 	the child's foster care placement case as assigned by the responsible social services agency;
163.1 	(4) "another person" means the professional staff whom the responsible social services 
163.2 	agency has assigned in the out-of-home placement plan or case plan. Another person must 
163.3 	be professionally trained to assess the child's safety, permanency, well-being, and case 
163.4 	progress. The agency may not designate the guardian ad litem, the child foster care provider, 
163.5 	residential facility staff, or a qualified individual as defined in section 260C.007, 
163.6 	subdivision26b, as another person; and
163.7 	(5) "the child's residence" is defined as the home where the child is residing, and can 
163.8 	include the foster home, child care institution, or the home from which the child was removed 
163.9 	if the child is on a trial home visit.
163.10 	(b) Caseworker visits shallmust be of sufficient substance and duration to address issues 
163.11 	pertinent to case planning and service delivery to ensure the safety, permanency, and 
163.12 	well-being of the child, including whether the child is enrolled and attending school as 
163.13 	required by law.
163.14 	(c) Every effort shallmust be made by the responsible social services agency and 
163.15 	professional staff to have the monthly visit with the child outside the presence of the child's 
163.16 	parents, foster parents, or facility staff. There may be situations related to the child's needs 
163.17 	when a caseworker visit cannot occur with the child alone. The reason the caseworker visit 
163.18 	occurred in the presence of others must be documented in the case record and may include:
163.19 	(1) that the child exhibits intense emotion or behavior indicating that visiting without 
163.20 	the presence of the parent, foster parent, or facility staff would be traumatic for the child;
163.21 	(2) that despite a caseworker's efforts, the child declines to visit with the caseworker 
163.22 	outside the presence of the parent, foster parent, or facility staff; and
163.23 	(3) that the child has a specific developmental delay, physical limitation, incapacity, 
163.24 	medical device, or significant medical need, such that the parent, foster parent, or facility 
163.25 	staff is required to be present with the child during the visit.

163.26 	Sec. 20. Minnesota Statutes 2024, section 260C.212, is amended by adding a subdivision 
163.27 	to read:
163.28 		Subd. 14a.Information on early childhood education and child care for children 
163.29 	in foster care. For a child not yet subject to compulsory school attendance under section 
163.30 	120A.22, the responsible social services agency; licensed child-placing agency, if applicable; 
163.31 	and the child's guardian ad litem must provide information to the foster parent about:
163.32 	(1) early childhood education and child care program options in the foster parent's 
163.33 	geographic area;
164.1 	(2) the Northstar foster care benefits child care allowance;
164.2 	(3) eligibility requirements for the child care assistance program and early learning 
164.3 	scholarships; and
164.4 	(4) application processes for the child care assistance program and early learning 
164.5 	scholarships.

164.6 	Sec. 21. Minnesota Statutes 2024, section 260C.451, subdivision 2, is amended to read:
164.7 		Subd. 2.Independent living plan. Upon the request of (a) For any child in foster care 
164.8 	who is 14 years of age or older, the responsible social services agency must, in conjunction 
164.9 	with the child and other appropriate parties, develop and update the child's independent 
164.10 	living plan required under section 260C.212, subdivision 1, paragraph (c), clause (12).
164.11 	(b) For any child in foster care immediately prior to the child's 18th birthday and who 
164.12 	is in foster care at the time of the request, the responsible social services agency shall must, 
164.13 	in conjunction with the child and other appropriate parties, update the child's independent 
164.14 	living plan required under section 260C.212, subdivision 1, paragraph (c), clause (12), 
164.15 	related to the child's employment, vocational, educational, social, or maturational needs and 
164.16 	submit the updated plan to the court as part of the required review under section 260C.202, 
164.17 	subdivision 3. The agency shall must provide continued services and foster care for the 
164.18 	child including those services that are necessary to implement the independent living plan.

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

165.1 	Sec. 23. Minnesota Statutes 2024, section 260C.451, subdivision 3a, is amended to read:
165.2 		Subd. 3a.Eligibility criteria. The child must meet at least one of the following conditions 
165.3 	to be considered eligible to continue in or return to foster care and remain there to age 21. 
165.4 	The child must be:
165.5 	(1) completing secondary education or a program leading to an equivalent credential, 
165.6 	including transition programs through a public or private school;
165.7 	(2) enrolled in an institution that provides postsecondary or vocational education;
165.8 	(3) participating in a program or activity designed to promote or remove barriers to 
165.9 	employment;
165.10 	(4) employed for at least 80 hours per month, including receiving benefits under chapter 
165.11 	268B; or
165.12 	(5) incapable of doing any of the activities described in clauses (1) to (4) due to a medical 
165.13 	condition.

165.14 	Sec. 24. Minnesota Statutes 2025 Supplement, section 260C.451, subdivision 8, is amended 
165.15 	to read:
165.16 		Subd. 8.Notice of termination of foster care. When a child in foster care between the 
165.17 	ages of 18 and 21 ceases to meet one of the eligibility criteria of subdivision 3a, the 
165.18 	responsible social services agency shall must give the child written notice that foster care 
165.19 	will terminate 30 days from the date the notice is sent. The agency must send a copy of the 
165.20 	written notice to the commissioner of children, youth, and families. The child or the child's 
165.21 	guardian ad litem may file a motion asking the court to review the agency's determination 
165.22 	within 15 days of receiving the notice. The child shall must not be discharged from foster 
165.23 	care until the motion is heard. The agency shall work must engage with the child to develop 
165.24 	a transition out of foster care plan as required under section 260C.452, subdivision 4, 
165.25 	paragraph (d), that addresses the goals listed in section 260C.203, subdivision 4, clause (2). 
165.26 	The written notice of termination of benefits shall must be on a form prescribed by the 
165.27 	commissioner and shall must also give notice of the right to have the agency's determination 
165.28 	reviewed by the court in the proceeding where the court conducts the reviews required under 
165.29 	section 260C.203, 260C.317, or 260C.515, subdivision 5 or 6. A copy of the termination 
165.30 	notice shall must be sent to the child and the child's attorney, if any, the foster care provider, 
165.31 	the child's guardian ad litem, the commissioner of children, youth, and families, and the 
165.32 	court. The agency is not responsible for paying foster care benefits for any period of time 
165.33 	after the child actually leaves foster care.

166.1 	ARTICLE 10
166.2 	CHILDREN, YOUTH, AND FAMILIES BUDGET

166.3 	Section 1. REGIONAL FOOD BANK GRANTS.
 166.4 		Subdivision 1.Establishment. The commissioner of children, youth, and families must 
166.5 	establish regional food bank grants to increase the availability of food to individuals and 
166.6 	families in need.
166.7 		Subd. 2.Distribution of appropriation. The commissioner must distribute money 
166.8 	appropriated under this section to regional food banks and Minnesota Tribal governments, 
166.9 	as defined in Minnesota Statutes, section 10.65, using a formula based on the number of 
166.10 	persons in households having incomes below the federal poverty level and the number of 
166.11 	unemployed persons in the service area of the food bank or Minnesota Tribal government.
166.12 		Subd. 3.Allowable use of money. (a) Grant money distributed under this section must 
166.13 	be used to purchase, transport, and coordinate the distribution of food to sites approved by 
166.14 	the commissioner. Grant money distributed under this section may also be used to purchase 
166.15 	personal hygiene products, including but not limited to diapers and toilet paper.
166.16 	(b) Food and other allowable products purchased with grant money under this section 
166.17 	must be available at no cost at sites approved by the commissioner.
166.18 	(c) Grant money distributed under this section must not be used for the compensation 
166.19 	of officers, directors, trustees, key employees, and highest compensated employees as 
166.20 	reported on Internal Revenue Service Form 990.
166.21 		Subd. 4.Reporting. (a) Food banks and Minnesota Tribal governments receiving grant 
166.22 	money under this section must retain records documenting expenditures of the grant money 
166.23 	and comply with any additional documentation requirements imposed by the commissioner.
166.24 	(b) Food banks and Minnesota Tribal governments must report on the use of grant money 
166.25 	received under this section to the commissioner. The commissioner must determine the 
166.26 	timing and form required for the reports.
166.27 		Subd. 5.Ineligible expenditures. If the commissioner determines that ineligible 
166.28 	expenditures were made by a food bank or Minnesota Tribal government under this section, 
166.29 	the ineligible amount must be repaid by the food bank or Tribal government to the 
166.30 	commissioner and deposited in the general fund.

167.1 	Sec. 2. DIRECTION TO COMMISSIONER OF CHILDREN, YOUTH, AND 
167.2 	FAMILIES; CRISIS NURSERY LICENSING.
 167.3 	The commissioner of children, youth, and families must develop a licensing framework 
167.4 	for crisis nurseries. The framework must include pathways for organizations to become 
167.5 	licensed crisis nurseries, a definition for crisis nurseries, background study and training 
167.6 	requirements, and ways to reduce redundancy and resolve conflicting requirements between 
167.7 	Minnesota Rules, parts 2960.0510 to 2960.0530, 2960.3000 to 2960.3100, and chapter 9502, 
167.8 	and Minnesota Statutes, chapter 142B. In developing the framework, the commissioner 
167.9 	must work with stakeholders seeking to develop a crisis nursery license. By January 15, 
167.10 	2028, the commissioner must submit a report to the chairs and ranking minority members 
167.11 	of the legislative committees with jurisdiction over children, youth, and families licensing. 
167.12 	The report must contain an overview of the licensing framework, a detailed explanation of 
167.13 	the framework, and proposed legislation to make any statutory changes that are needed to 
167.14 	implement the new license for crisis nurseries.

167.15 	ARTICLE 11
167.16 	MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD 
167.17 	WELFARE DISPROPORTIONALITY ACT CHANGES

167.18 	Section 1. Minnesota Statutes 2024, section 260.63, subdivision 10, is amended to read:
167.19 		Subd. 10.Disproportionately represented child. (a) "Disproportionately represented 
167.20 	child" means a person who is under the age of 18 and who is a member of a community 
167.21 	whose race, culture, ethnicity, disability status, or low-income socioeconomic status is 
167.22 	disproportionately encountered, engaged, or identified in the child welfare system as 
167.23 	compared to the representation in the state's total child population, as determined on an 
167.24 	annual basis by the commissioner under section 260.631. A child's race, culture, or ethnicity, 
167.25 	disability status, or low-income socioeconomic status is determined based upon by a child's 
167.26 	self-identification or identification of a child's race, culture, or ethnicity, disability status, 
167.27 	or low-income socioeconomic status as reported by the child's parent or guardian.
167.28 	(b) For the purposes of this subdivision:
167.29 	(1) disability means a physical, sensory, or mental impairment that materially limits one 
167.30 	or more major life activities, including an impairment that is episodic or in remission and 
167.31 	would materially limit a major life activity when active; and
167.32 	(2) low-income socioeconomic status is established by the child's household income 
167.33 	being below 300 percent of the federal poverty guidelines published by the United States 
167.34 	Department of Health and Human Services. For purposes of this subdivision, low-income 
168.1 	socioeconomic status is also established when a child or a member of the child's household 
168.2 	receives benefits from one or more means-tested public assistance programs, or when a 
168.3 	child meets income and resource requirements to be eligible for title IV-E foster care 
168.4 	maintenance payments under the federal Social Security Act.

168.5 	Sec. 2. [260.631] DETERMINATIONS.
168.6 		Subdivision 1.Determination of disproportionate overrepresentation. (a) The 
168.7 	commissioner must determine the communities that are disproportionately overrepresented 
168.8 	in Minnesota's child protection system pursuant to this section for the purposes of the 
168.9 	Minnesota African American Family Preservation and Child Welfare Disproportionality 
168.10 	Act. In making this determination, the commissioner may consider the recommendations 
168.11 	provided under paragraph (d). The commissioner's determination under this paragraph is 
168.12 	in effect until the effective date of the next determination issued by the commissioner.
168.13 	(b) The commissioner must make the initial determination under paragraph (a) by 
168.14 	September 1, 2026, and then by September 1 on every even-numbered year thereafter.
168.15 	(c) A responsible social services agency must use the commissioner's determination 
168.16 	under paragraph (a) to determine whether a child meets the definition of a disproportionately 
168.17 	represented child under section 260.63, subdivision 10.
168.18 	(d) The African American Child and Family Well-Being Advisory Council must submit 
168.19 	recommendations to the commissioner on the disproportionate overrepresentation of African 
168.20 	American children in Minnesota's child protection system using state and federal census 
168.21 	data. The council must provide its initial recommendations to the commissioner by August 
168.22 	1, 2026, and then provide recommendations by August 1 on every even-numbered year 
168.23 	thereafter.
168.24 	(e) If the commissioner makes a determination under paragraph (a) that differs from the 
168.25 	recommendations provided by the African American Child and Family Well-Being Advisory 
168.26 	Council under paragraph (d) regarding the disproportionate overrepresentation of African 
168.27 	American children in Minnesota's child protection system, the commissioner must provide 
168.28 	the reasons for diverging from the council's recommendations and identify the data the 
168.29 	commissioner relied upon in making the determination of disproportionate overrepresentation. 
168.30 	The commissioner must provide the information required under this paragraph to:
168.31 	(1) the chairs and ranking minority members of the legislative committees with 
168.32 	jurisdiction over the Minnesota African American Family Preservation and Child Welfare 
168.33 	Disproportionality Act;
169.1 	(2) the African American Child and Family Well-Being Advisory Council;
169.2 	(3) the Children's Justice Initiative; and
169.3 	(4) responsible social services agencies statewide.
169.4 	(f) By September 15, 2026, and every even-numbered year thereafter, the commissioner 
169.5 	must notify responsible social services agencies, the African American Child and Family 
169.6 	Well-Being Advisory Council, and the Children's Justice Initiative of the commissioner's 
169.7 	determination under paragraph (a). The notification must include but is not limited to:
169.8 	(1) a list of the communities the commissioner determined are disproportionately 
169.9 	represented in Minnesota's child protection system and whether there are any changes from 
169.10 	the previous notification;
169.11 	(2) how a responsible social services agency must implement the commissioner's 
169.12 	determination;
169.13 	(3) the effective date of the commissioner's determination; and
169.14 	(4) the method or methods the commissioner used, or the data the commissioner relied 
169.15 	upon, to make the determination.
169.16 		Subd. 2.Determination of child's status. The responsible social services agency must 
169.17 	document the efforts the agency takes when determining whether a child meets or does not 
169.18 	meet the definition of a disproportionately represented child under section 260.63, subdivision 
169.19 	10, and must provide that information to the commissioner upon the commissioner's request.
169.20 		Subd. 3.Exempt from rulemaking. Chapter 14 does not apply to determinations under 
169.21 	this section.

169.22 	Sec. 3. Minnesota Statutes 2024, section 260.64, subdivision 2, is amended to read:
169.23 		Subd. 2.Safety plan. (a) Prior to petitioning the court to remove an African American 
169.24 	or a disproportionately represented child from the child's home under section 260.66, a 
169.25 	responsible social services agency must work with the child's family to allow the child to 
169.26 	remain in the child's home while implementing a safety plan based on the family's needs. 
169.27 	The responsible social services agency must:
169.28 	(1) make active efforts to engage the child's parent or custodian and the child, when 
169.29 	appropriate;
169.30 	(2) assess the family's cultural and economic needs and, if applicable, needs and services 
169.31 	related to the child's disability;
170.1 	(3) hold a family group consultation meeting and connect the family with supports to 
170.2 	establish a safety network for the family; and
170.3 	(4) provide support, guidance, and input to assist the family and the family's safety 
170.4 	network with developing the safety plan.
170.5 	(b) The safety plan must:
170.6 	(1) address the specific allegations impacting the child's safety in the home. If neglect, 
170.7 	as defined in section 260E.03, subdivision 15, is alleged, the safety plan must incorporate 
170.8 	economic services and supports for the child and the child's family, if eligible, to address 
170.9 	the family's specific needs and prevent neglect;
170.10 	(2) incorporate family and community support to ensure the child's safety while keeping 
170.11 	the family intact; and
170.12 	(3) be adjusted as needed to address the child's and family's ongoing needs and support.
170.13 	(c) The responsible social services agency is not required to establish a safety plan:
170.14 	(1) in a case with allegations of sexual abuse or egregious harm;
170.15 	(2) when the parent is not willing to follow a safety plan;
170.16 	(3) when the parent has abandoned the child or is unavailable to follow a safety plan; 
170.17 	or
170.18 	(4) when the parent has chronic substance use disorder issues and is unable to parent 
170.19 	the child.

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

172.10 	Sec. 5. Minnesota Statutes 2024, section 260.69, subdivision 1, is amended to read:
172.11 		Subdivision 1.Applicability. (a) The commissioner of children, youth, and families 
172.12 	must collaborate with the Children's Justice Initiative to ensure that cultural competency 
172.13 	training is given or made available to individuals working in the child welfare system, 
172.14 	including child welfare workers and supervisors. Training must developed by the Child 
172.15 	Welfare Training Academy may also be made available to attorneys, juvenile court judges, 
172.16 	guardians ad litem, and family law judges. The commissioner must give priority to child 
172.17 	welfare workers and supervisors for in-person trainings or other trainings with limited 
172.18 	attendance or availability.
172.19 	(b) This subdivision does not require the commissioner or the Child Welfare Training 
172.20 	Academy to develop or provide training specifically for attorneys, juvenile court judges, 
172.21 	guardians ad litem, family law judges, or any other individuals beyond the primary training 
172.22 	audiences required to be served under Laws 2019, First Special Session chapter 9, article 
172.23 	1, section 37, subdivision 2, paragraph (e).

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

174.10 	Sec. 7. Minnesota Statutes 2025 Supplement, section 260.692, subdivision 1, is amended 
174.11 	to read:
174.12 		Subdivision 1.Duties. The African American Child and Family Well-Being Unit, 
174.13 	currently established by the commissioner, must:
174.14 	(1) assist with the development of African American cultural competency training and 
174.15 	review child welfare curriculum in the Minnesota Child Welfare Training Academy to 
174.16 	ensure that responsible social services agency staff and other child welfare professionals 
174.17 	are appropriately prepared to engage with African American children and their families and 
174.18 	to support family preservation and reunification;
174.19 	(2) provide technical assistance, including on-site technical assistance, and case 
174.20 	consultation to responsible social services agencies to assist agencies with implementing 
174.21 	and complying with the Minnesota African American Family Preservation and Child Welfare 
174.22 	Disproportionality Act;
174.23 	(3) monitor individual county and statewide disaggregated and nondisaggregated data 
174.24 	to identify trends and patterns in child welfare outcomes, including but not limited to 
174.25 	reporting, maltreatment, out-of-home placement, and permanency of African American 
174.26 	children and develop strategies to address disproportionality and disparities in the child 
174.27 	welfare system;
174.28 	(4) develop and implement a system for conducting case reviews when the commissioner 
174.29 	receives reports of noncompliance with the Minnesota African American Family Preservation 
174.30 	and Child Welfare Disproportionality Act or when requested by the parent or custodian of 
174.31 	an African American child. Case reviews may include but are not limited to a review of 
174.32 	placement prevention efforts, safety planning, case planning and service provision by the 
175.1 	responsible social services agency, relative placement consideration, and permanency 
175.2 	planning;
175.3 	(5) establish and administer a request for proposals process for African American and 
175.4 	disproportionately represented family preservation grants under section 260.693, monitor 
175.5 	grant activities, and provide technical assistance to grantees;
175.6 	(6) in coordination with the African American Child and Family Well-Being Advisory 
175.7 	Council, coordinate services and create internal and external partnerships to support adequate 
175.8 	access to services and resources for African American children and their families, including 
175.9 	but not limited to housing assistance, employment assistance, food and nutrition support, 
175.10 	health care, child care assistance, and educational support and training; and
175.11 	(7) develop public messaging and communication to inform the public about racial 
175.12 	disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities, 
175.13 	and resources available to African American children and their families involved in the 
175.14 	child welfare system.

175.15 	Sec. 8. Minnesota Statutes 2025 Supplement, section 260.692, subdivision 2, is amended 
175.16 	to read:
175.17 		Subd. 2.Case reviews. (a) The African American Child and Family Well-Being Unit 
175.18 	must conduct systemic case reviews to monitor targeted child welfare outcomes, including 
175.19 	but not limited to maltreatment, out-of-home placement, and permanency of African 
175.20 	American children.
175.21 	(b) The reviews under this subdivision must be conducted using a random sampling of 
175.22 	representative child welfare protection cases stratified for certain case related factors, 
175.23 	including but not limited to case type, maltreatment type, if the case involves out-of-home 
175.24 	placement, and other demographic variables. In conducting the reviews, unit staff may use 
175.25 	court records and documents, information from the social services information system, and 
175.26 	other available case file information to complete the case reviews.
175.27 	(c) The frequency of the reviews and the number of cases, child welfare outcomes, and 
175.28 	selected counties reviewed shall be determined by the unit in consultation with the African 
175.29 	American Child and Family Well-Being Advisory Council, with consideration given to the 
175.30 	availability of unit resources needed to conduct the reviews.
175.31 	(d) The unit must monitor all case reviews and use the collective case review information 
175.32 	and data to generate summary case review reports, ensure compliance with the Minnesota 
176.1 	African American Family Preservation and Child Welfare Disproportionality Act, and 
176.2 	identify trends or patterns in child welfare outcomes for African American children.
176.3 	(e) The unit must review information from members of the public received through the 
176.4 	compliance and feedback portal, including policy and practice concerns related to individual 
176.5 	child welfare protection cases. After assessing a case concern, the unit may determine if 
176.6 	further necessary action should be taken, which may include coordinating case remediation 
176.7 	with other relevant child welfare agencies in accordance with data privacy laws, including 
176.8 	the African American Child and Family Well-Being Advisory Council, and offering case 
176.9 	consultation and technical assistance to the responsible local social services agency as 
176.10 	needed or requested by the agency.

176.11 	Sec. 9. Minnesota Statutes 2025 Supplement, section 260.692, subdivision 3, is amended 
176.12 	to read:
176.13 		Subd. 3.Reports. (a) The African American Child and Family Well-Being Unit must 
176.14 	provide regular updates on unit activities, including summary reports of case reviews, to 
176.15 	the African American Child and Family Well-Being Advisory Council, and must publish 
176.16 	an annual census of African American children in out-of-home placements statewide. The 
176.17 	annual census must include data on the types of placements, age and sex of the children, 
176.18 	how long the children have been in out-of-home placements, and other relevant demographic 
176.19 	information.
176.20 	(b) The African American Child and Family Well-Being Unit shall gather summary data 
176.21 	about the practice and policy inquiries and individual case concerns received through the 
176.22 	compliance and feedback portal under subdivision 2, paragraph (e). The unit shall provide 
176.23 	regular reports of the nonidentifying compliance and feedback portal summary data to the 
176.24 	African American Child and Family Well-Being Advisory Council to identify child welfare 
176.25 	trends and patterns to assist with developing policy and practice recommendations to support 
176.26 	eliminating disparity and disproportionality disparities for African American children.

176.27 	Sec. 10. Minnesota Statutes 2024, section 260.693, subdivision 2, is amended to read:
176.28 		Subd. 2.Eligible services. (a) Services eligible for grants under this section include but 
176.29 	are not limited to:
176.30 	(1) child out-of-home placement prevention and reunification services;
176.31 	(2) family-based services and reunification therapy;
176.32 	(3) culturally specific individual and family counseling;
177.1 	(4) court advocacy;
177.2 	(5) training for and consultation to responsible social services agencies and private social 
177.3 	services agencies regarding this act;
177.4 	(6) development and promotion of culturally informed, affirming, and responsive 
177.5 	community-based prevention and family preservation services that target the children, youth, 
177.6 	families, and communities of African American and African heritage experiencing the 
177.7 	highest disparities, disproportionality, and overrepresentation in the Minnesota child welfare 
177.8 	system;
177.9 	(7) culturally affirming and responsive services that work with children and families in 
177.10 	their communities to address their needs and ensure child and family safety and well-being 
177.11 	within a culturally appropriate lens and framework;
177.12 	(8) services to support informal kinship care arrangements; and
177.13 	(9) other activities and services approved by the commissioner that further the goals of 
177.14 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
177.15 	Act, including but not limited to the recruitment of African American staff and staff from 
177.16 	other communities disproportionately represented in the child welfare system to work for 
177.17 	responsible social services agencies and licensed child-placing agencies.
177.18 	(b) The commissioner may specify the priority of an activity and service based on its 
177.19 	success in furthering these goals. The commissioner shall give preference to programs and 
177.20 	service providers that are located in or serve counties with the highest rates of child welfare 
177.21 	disproportionality disproportionate representation for African American and other 
177.22 	disproportionately represented children and their families and employ staff who represent 
177.23 	the population primarily served.

177.24 	Sec. 11. [260.694] MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION 
177.25 	AND CHILD WELFARE DISPROPORTIONALITY GRANT ALLOCATION.
177.26 		Subdivision 1.Formula for county staffing and services funds. (a) The commissioner 
177.27 	shall allocate state funds appropriated under this section to each county board on a calendar 
177.28 	year basis in an amount determined according to the following formula:
177.29 	(1) 50 percent must be distributed on the basis of the child population residing in the 
177.30 	county as determined by the most recent data of the state demographer;
178.1 	(2) 25 percent must be distributed on the basis of the number of screened-in reports of 
178.2 	child maltreatment under chapter 260E, and in the county as determined by the most recent 
178.3 	data of the commissioner; and
178.4 	(3) 25 percent must be distributed on the basis of the number of open child protection 
178.5 	case management cases in the county as determined by the most recent data of the 
178.6 	commissioner.
178.7 	(b) Notwithstanding this subdivision, no county shall be awarded an allocation of less 
178.8 	than $100,000.
178.9 		Subd. 2.Prohibition on supplanting existing funds. Funds received under this section 
178.10 	must be used to address staffing and services needed for child protection and expansion of 
178.11 	child protection services, including making active efforts to prevent entry into the child 
178.12 	protection system, prevent out-of-home placement, reunify children with families, and 
178.13 	finalize alternative permanency arrangements if reunification is not an option. Funds must 
178.14 	not be used to supplant current county expenditures for these purposes but may be used to 
178.15 	maintain staff and services paid for by temporary funding.

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

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

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

178.20 	Sec. 13. Laws 2024, chapter 117, section 21, is amended to read:
178.21 	Sec. 21. MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND 
178.22 	CHILD WELFARE DISPROPORTIONALITY ACT; WORKING GROUP.
 178.23 	(a) The commissioner of human services must establish a working group to provide 
178.24 	guidance and oversight for the Minnesota African American Family Preservation and Child 
178.25 	Welfare Disproportionality Act phase-in program.
178.26 	(b) The members of the working group must include representatives from the Minnesota 
178.27 	Association of County Social Service Administrators, the Association of Minnesota Counties, 
178.28 	the Minnesota Inter-County Association, the Minnesota County Attorneys Association, 
178.29 	Hennepin County, Ramsey County, the Department of Human Services, and community 
178.30 	organizations with experience in child welfare. The legislature may provide recommendations 
178.31 	to the commissioner on the selection of the representatives from the community organizations.
179.1 	(c) The working group must provide oversight of the phase-in program and evaluate the 
179.2 	cost of the phase-in program. The working group must also assess future costs of 
179.3 	implementing the Minnesota African American Family Preservation and Child Welfare 
179.4 	Disproportionality Act statewide.
179.5 	(d) By January 1, 2026, the working group must develop and submit an interim report 
179.6 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
179.7 	over child welfare detailing initial needs for the implementation of the Minnesota African 
179.8 	American Family Preservation and Child Welfare Disproportionality Act. The interim report 
179.9 	must also include recommendations for any statutory or policy changes necessary to 
179.10 	implement the act.
179.11 	(e) By September 1, 2026, the working group must develop an implementation plan and 
179.12 	best practices for the Minnesota African American Family Preservation and Child Welfare 
179.13 	Disproportionality Act to go into effect statewide.
179.14 	(f) The working group under this section expires December 31, 2026.

179.15 	Sec. 14. REPEALER.
 179.16 	Minnesota Statutes 2024, section 260.63, subdivision 9, is repealed.

179.17 	ARTICLE 12
179.18 	CHILD CARE CENTER LICENSING MODERNIZATION

179.19 	Section 1. [142H.01] DEFINITIONS.
179.20 		Subdivision 1.Scope. For the purposes of this chapter, the terms in this section have 
179.21 	the meanings given.
179.22 		Subd. 2.Accessible to children. "Accessible to children" means capable of being reached 
179.23 	or utilized by a child without the aid of an adult.
179.24 		Subd. 3.Accredited. "Accredited" means a postsecondary institution or technical college 
179.25 	recognized and listed in The Database of Accredited Postsecondary Institutions and Programs 
179.26 	maintained by the United States Department of Education.
179.27 		Subd. 4.Age categories.  (a) "Infant" means a child who is at least six weeks old but 
179.28 	less than 16 months old.
179.29 	(b) "Toddler" means a child who is at least 16 months old but less than 33 months old.
179.30 	(c) "Preschooler" means a child who is at least 33 months old up to school age.
180.1 	(d) "School age" means a child who is at least of sufficient age to have attended the first 
180.2 	day of kindergarten, or is eligible to enter kindergarten within the next four months, but is 
180.3 	younger than 13 years of age. A child who becomes 13 during the school year may continue 
180.4 	to be considered a school-age child for the remainder of the school year.
180.5 		Subd. 5.Applicant. "Applicant" has the meaning given in section 142B.01, subdivision 
180.6 	4.
180.7 		Subd. 6.Arrival and departure times. "Arrival and departure times" means the times 
180.8 	when children typically arrive at or depart from a center. A center cannot designate more 
180.9 	than 25 percent of licensed hours of operation as arrival and departure times. The designated 
180.10 	arrival and departure times must be used at the beginning or end of a center's licensed hours 
180.11 	of operation.
180.12 		Subd. 7.Building official. "Building official" means the person appointed pursuant to 
180.13 	section 326B.133 to administer the State Building Code or the building official's authorized 
180.14 	representative.
180.15 		Subd. 8.Center. "Center" means a child care program that is not excluded by section 
180.16 	142B.05, subdivision 2, and is not a family child care program, as defined in section 142I.01, 
180.17 	subdivision 22.
180.18 		Subd. 9.Child. "Child" means a person receiving child care services who falls within 
180.19 	the age categories in subdivision 4.
180.20 		Subd. 10.Child care program. "Child care program" means the organization or 
180.21 	arrangement of activities, personnel, materials, and equipment in a facility to promote the 
180.22 	physical, intellectual, social, and emotional development of a child in the absence of the 
180.23 	parent for a period of less than 24 hours a day.
180.24 		Subd. 11.Child care program plan. "Child care program plan" means the written 
180.25 	document that states specific activities that will be provided by the license holder to promote 
180.26 	the physical, intellectual, social, and emotional development of the children enrolled in the 
180.27 	center.
180.28 		Subd. 12.Clean. "Clean" means free from dirt or other contaminants that can be detected 
180.29 	by sight, smell, or touch.
180.30 		Subd. 13.Commissioner. "Commissioner" means the commissioner of children, youth, 
180.31 	and families or the commissioner's designated representative, including county agencies 
180.32 	and private agencies.
181.1 		Subd. 14.Day program. "Day program" means a nonresidential child care program 
181.2 	that operates during waking hours and does not provide overnight care.
181.3 		Subd. 15.Department. "Department" means the Department of Children, Youth, and 
181.4 	Families.
181.5 		Subd. 16.Direct contact. "Direct contact" has the meaning given in section 245C.02, 
181.6 	subdivision 11.
181.7 		Subd. 17.Disinfected. "Disinfected" means the chemical process to kill most germs and 
181.8 	viruses on surfaces and objects after they have been cleaned.
181.9 		Subd. 18.Drop-in child care program. "Drop-in child care program" means a 
181.10 	nonresidential program of child care in which children participate on a onetime only or 
181.11 	occasional basis up to a maximum of 90 hours per child, per month.
181.12 		Subd. 19.Experience. "Experience" means paid or unpaid employment:
181.13 	(1) caring for children as a teacher, assistant teacher, aide, or student intern:
181.14 	(i) in a licensed child care center, a licensed family child care program, or a Tribally 
181.15 	licensed child care program in any United States state or territory; or
181.16 	(ii) in a public or nonpublic school;
181.17 	(2) caring for children as a staff person or unsupervised volunteer in a certified 
181.18 	license-exempt child care center under chapter 142C; or
181.19 	(3) providing direct contact services in a home or residential facility serving children 
181.20 	with disabilities that requires a background study under section 245C.03.
181.21 		Subd. 20.Facility. "Facility" means the indoor and outdoor space where a child care 
181.22 	program is provided.
181.23 		Subd. 21.Fire marshal. "Fire marshal" means the person designated by section 299F.011 
181.24 	to administer and enforce the State Fire Code or the fire marshal's authorized representative.
181.25 		Subd. 22.Health care provider. "Health care provider" means a physician or physician's 
181.26 	assistant licensed to practice medicine under chapter 147 or an advanced practice registered 
181.27 	nurse licensed under chapter 148.
181.28 		Subd. 23.Health consultant. "Health consultant" means a registered nurse, a public 
181.29 	health nurse, or a health care provider as defined in subdivision 22 who performs health 
181.30 	consultation services for a child care center pursuant to section 142H.29, subdivision 2.
182.1 		Subd. 24.Inaccessible to children. "Inaccessible to children" means not capable of 
182.2 	being reached or utilized by a child without the aid of an adult.
182.3 		Subd. 25.License. "License" has the meaning given in section 142B.01, subdivision 
182.4 	16.
182.5 		Subd. 26.License holder. "License holder" has the meaning given in section 142B.01, 
182.6 	subdivision 17.
182.7 		Subd. 27.Licensed capacity. "Licensed capacity" means the maximum number of 
182.8 	children permitted at any one time in the program for which the license holder is licensed 
182.9 	to operate.
182.10 		Subd. 28.Medication. "Medication" means any substance or preparation that is used 
182.11 	to prevent or treat a wound, injury, infection, and disease; maintain health; heal; or relieve 
182.12 	pain. This includes medication that is over the counter, or prescribed by a physician, physician 
182.13 	assistant, dentist, or advance practice registered nurse certified to prescribe medication, and 
182.14 	permitted by the parent for administration or application. This term applies to medication 
182.15 	taken internally or applied externally.
182.16 		Subd. 29.Night care program. "Night care program" means a nonresidential child care 
182.17 	program that provides overnight care to children during sleeping hours, approximately 11:00 
182.18 	p.m. to 5:00 a.m. Night care programs are subject to the requirements in section 142H.16.
182.19 		Subd. 30.Parent. "Parent" means the person or persons who has the legal responsibility 
182.20 	for a child such as the child's mother, father, or legally appointed guardian.
182.21 		Subd. 31.Program staff person. "Program staff person" means an employee of the 
182.22 	child care center who  carries out the child care program plan and has direct contact with 
182.23 	children. This includes unsupervised volunteers and substitutes.
182.24 		Subd. 32.Sick care program. "Sick care program" means a nonresidential child care 
182.25 	program that exclusively cares for sick children. Sick care programs are subject to the 
182.26 	requirements in section 142H.19.
182.27 		Subd. 33.Staff supervision. "Staff supervision" means responsibility to hire, train, 
182.28 	assign duties, and direct staff in day-to-day activities and evaluate staff performance. A 
182.29 	"supervisor" is a person with staff supervision responsibility.
182.30 		Subd. 34.State Building Code. "State Building Code" means the codes and regulations 
182.31 	adopted by the commissioner of the administration according to section 326B.101, and 
182.32 	contained in Minnesota Rules, chapter 1300.
183.1 		Subd. 35.State Fire Code. "State Fire Code" means the codes and regulations adopted 
183.2 	by the state fire marshal pursuant to section 299F.011, and contained in Minnesota Rules, 
183.3 	chapter 7511.
183.4 		Subd. 36.Student intern. "Student intern" means a student of a postsecondary institution 
183.5 	assigned by that institution for a supervised experience with children. The experience must 
183.6 	be in a licensed center, an elementary school operated by the commissioner of education 
183.7 	or a legally constituted local school board, or a private school approved under rules 
183.8 	administered by the commissioner of education. Student intern includes a person who is 
183.9 	practice teaching, student teaching, or carrying out a practicum or internship.
183.10 		Subd. 37.Substitute. "Substitute" means a person who is temporarily filling a position 
183.11 	as a director, teacher, assistant teacher, or aide in a licensed child care center for less than 
183.12 	500 hours total in a calendar year due to the absence of a regularly employed program staff 
183.13 	person.
183.14 		Subd. 38.Supervision of children. "Supervision of children" means when a program 
183.15 	staff person:
183.16 	(1) is accountable for the child's care;
183.17 	(2) is able to intervene to protect the health and safety of the child; and
183.18 	(3) is within sight and hearing of the child at all times, except as described in section 
183.19 	142H.24, subdivision 1.
183.20 		Subd. 39.Variance. "Variance" means written permission by the department for a license 
183.21 	holder or applicant to depart from the provisions of a requirement in this chapter pursuant 
183.22 	to section 142B.10, subdivision 16.
183.23 		Subd. 40.Volunteer. (a) "Volunteer" means an individual who assists in the care of a 
183.24 	child and is not employed by the child care center.
183.25 	(b) "Supervised volunteer" means a volunteer who may only have direct contact with 
183.26 	children when a program staff person is able to intervene to protect the health and safety of 
183.27 	children.
183.28 	(c) "Unsupervised volunteer" means a volunteer who may have direct contact with 
183.29 	children without a program staff person present, must receive the training required under 
183.30 	section 142H.08, and may be counted in the staff-to-child ratios under section 142H.10.

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

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

184.11 	Sec. 4. [142H.04] POLICIES AND PROCEDURES FOR PROGRAM 
184.12 	ADMINISTRATION.
184.13 	(a) The license holder must maintain and enforce program policies and procedures 
184.14 	necessary to comply with licensing requirements under Minnesota Statutes and Minnesota 
184.15 	Rules.
184.16 	(b) The license holder must:
184.17 	(1) provide training to employees and volunteers related to their duties in implementing 
184.18 	the program's policies and procedures developed under paragraph (a);
184.19 	(2) document the provision of this training; and
184.20 	(3) monitor implementation of policies and procedures by employees and volunteers.
184.21 	(c) The license holder must keep program policies and procedures readily accessible to 
184.22 	employees and volunteers and index the policies and procedures with a table of contents or 
184.23 	another method approved by the commissioner.

184.24 	Sec. 5. [142H.05] DIRECTORS.
184.25 		Subdivision 1.General requirements for a director. (a) A center must have a director 
184.26 	who is responsible for overseeing implementation of written policies relating to the 
184.27 	management and control of the daily activities of the program, ensuring the health and safety 
184.28 	of program participants, and supervising staff and volunteers.
184.29 	(b) A director must:
184.30 	(1) be at least 21 years old;
185.1 	(2) be a graduate of a high school or hold an equivalent diploma attained through 
185.2 	successful completion of the commissioner of education-selected high school equivalency 
185.3 	test pursuant to section 124D.549;
185.4 	(3) have at least 1,040 hours of paid or unpaid staff supervision experience; and
185.5 	(4) have at least 12 semester credits in accredited coursework in postsecondary child 
185.6 	development education, supervision, management, administration, or leadership or 120 
185.7 	hours of training earned in the topics of child development, supervision, management, 
185.8 	administration, or leadership.
185.9 	(c) Paragraph (b), clauses (3) and (4), are satisfied if an individual has completed a 
185.10 	Minnesota Association for the Education of Young Children early childhood director's 
185.11 	credential; Child Care Aware Minnesota director's credential; Montessori administrator 
185.12 	credential; or diploma issued by the American Montessori Society, Association Montessori 
185.13 	International, or an institution accredited by the Montessori Accreditation Council for 
185.14 	Teacher Education.
185.15 		Subd. 2.Director or designee on site. (a) The director or a designee must be on site 
185.16 	while the center is in operation.
185.17 	(b) Any program staff person who is at least 18 years old may serve as the designee. 
185.18 	The designee does not have to meet the director qualifications in subdivision 1 but must be 
185.19 	aware of the designation and be able to perform the responsibilities.
185.20 		Subd. 3.Director functioning as a teacher. Notwithstanding section 142H.06, a director 
185.21 	may be used as a teacher in any classroom as needed.
185.22 		Subd. 4.Incumbent director recognition. Notwithstanding subdivision 1, an individual 
185.23 	who is designated as the director of a licensed child care center on July 1, 2027, meets the 
185.24 	director qualification requirements of this section as long as the individual continues to 
185.25 	work at the program.

185.26 	Sec. 6. [142H.06] TEACHERS.
185.27 		Subdivision 1.Teacher general qualifications. A teacher must:
185.28 	(1) be at least 18 years old; and
185.29 	(2) be a graduate of a high school or hold an equivalent diploma attained through 
185.30 	successful completion of the commissioner of education-selected high school equivalency 
185.31 	test pursuant to section 124D.549.
186.1 		Subd. 2.Teacher education and experience requirements. In addition to the general 
186.2 	requirements in subdivision 1, a teacher must have at least one of:
186.3 	(1) 12 postsecondary semester credits and 480 hours of experience;
186.4 	(2) 100 hours of commissioner-approved training within the previous five years and 480 
186.5 	hours of experience. After initial qualification, a teacher qualified under this clause must 
186.6 	fulfill at least 50 percent of in-service training requirements under section 142H.09, 
186.7 	subdivision 10, with commissioner-approved trainings;
186.8 	(3) a credential or diploma from the American Montessori Society, Association 
186.9 	Montessori International, or an institution accredited by the Montessori Accreditation 
186.10 	Council for Teacher Education;
186.11 	(4) an accredited certificate in child development or early childhood education from a 
186.12 	postsecondary institution;
186.13 	(5) an accredited diploma, associate's degree, or bachelor's degree in child development 
186.14 	or early childhood education from a postsecondary institution; or
186.15 	(6) a Child Development Associate (CDA) credential;

186.16 	Sec. 7. [142H.07] ASSISTANT TEACHERS.
186.17 		Subdivision 1.Assistant teacher general qualifications. An assistant teacher must 
186.18 	work under the supervision of a teacher and be:
186.19 	(1) at least 18 years old; and
186.20 	(2) a graduate of a high school or hold an equivalent diploma attained through successful 
186.21 	completion of the commissioner of education-selected high school equivalency test.
186.22 		Subd. 2.Assistant teacher education and experience requirements. In addition to 
186.23 	the general requirements in subdivision 1, an assistant teacher must have at least one of:
186.24 	(1) at least six postsecondary semester credits;
186.25 	(2) at least 50 hours of commissioner-approved training within the previous five years. 
186.26 	After initial qualification, an assistant teacher qualified under this clause must fulfill at least 
186.27 	50 percent of in-service training requirements under section 142H.09, subdivision 10, with 
186.28 	commissioner-approved trainings; or
186.29 	(3) at least 160 hours of experience and be making progress toward any of the teacher 
186.30 	qualifications in section 142H.06, subdivision 2, clauses (3) to (6). An assistant teacher 
186.31 	qualified under this clause must be able to provide:
187.1 	(i) documentation of current enrollment; and
187.2 	(ii) evidence of working toward the successful completion of the credential.

187.3 	Sec. 8. [142H.08] AIDES, VOLUNTEERS, AND SUBSTITUTES.
187.4 		Subdivision 1.Aide qualifications. (a) An aide must work under the supervision of a 
187.5 	teacher or assistant teacher, except when performing the tasks in paragraph (b). An aide 
187.6 	must be used pursuant to the staff distribution requirements in section 142H.10, subdivision 
187.7 	2.
187.8 	(b) An aide may work without being supervised by a teacher or assistant teacher when 
187.9 	they are assisting with the supervision of sleeping children; assisting children with washing, 
187.10 	toileting, and diapering; or accompanying children to and from the bus stop.
187.11 	(c) An aide must be at least 16 years old.
187.12 		Subd. 2.Volunteers. (a) A volunteer may work as a teacher, assistant teacher, aide, or 
187.13 	substitute if the volunteer meets the requirements of that position.
187.14 	(b) The license holder must maintain a list of all volunteers with relevant information, 
187.15 	including first and last name, whether the volunteer must be supervised at all times or may 
187.16 	occasionally be unsupervised, and the first date of direct contact with children.
187.17 	(c) Unsupervised volunteers must successfully complete training as required in section 
187.18 	142H.09.
187.19 	(d) Supervised volunteers must successfully complete the training required in section 
187.20 	142H.09, subdivision 7.
187.21 		Subd. 3.Substitutes. (a) A substitute must either meet the requirements for the assigned 
187.22 	staff position or be designated as an unqualified substitute by the director or the director 
187.23 	designee. A director or director designee can designate a substitute as unqualified if:
187.24 	(1) a teacher is continuously on site, except as provided in section 142H.10, subdivision 
187.25 	2, paragraph (e);
187.26 	(2) when substituting as a teacher or assistant teacher, the unqualified substitute is aware 
187.27 	of the unqualified substitute's designated staffing position; and
187.28 	(3) the unqualified substitute is at least 18 years of age.
187.29 	(b) All substitutes must successfully complete the required training under section 
187.30 	142H.09.
188.1 		Subd. 4.Tracking unqualified substitute hours. (a) The license holder must document 
188.2 	the use of unqualified substitute hours on the day the unqualified substitute works.
188.3 	(b) In a calendar year, a license holder must not use unqualified substitutes more than 
188.4 	60 hours multiplied by the number of the center's classrooms.
188.5 	(c) A license holder must maintain a log of the use of unqualified substitutes in the center 
188.6 	administrative record for review by the commissioner. The log must be on a form prescribed 
188.7 	by the commissioner.

188.8 	Sec. 9. [142H.09] STAFF ORIENTATION AND TRAINING.
188.9 		Subdivision 1.Orientation training. (a) Program staff persons must complete orientation 
188.10 	training before providing direct contact services to a child.
188.11 	(b) The orientation training must include the following topics:
188.12 	(1) abusive head trauma for staff working with a child under school age pursuant to 
188.13 	subdivision 8;
188.14 	(2) the center's policy on administration of medication pursuant to section 142H.29, 
188.15 	subdivision 5;
188.16 	(3) the center's policy on allergy prevention and response pursuant to section 142H.15, 
188.17 	subdivision 5;
188.18 	(4) the center's policy on behavior guidance pursuant to section 142H.13;
188.19 	(5) child passenger restraint systems pursuant to subdivision 9;
188.20 	(6) the center's child care program plan pursuant to section 142H.11;
188.21 	(7) the center's policy on cleaning, sanitizing, and disinfecting pursuant to section 
188.22 	142H.31;
188.23 	(8) the center's emergency preparedness plan and procedures pursuant to section 142H.23, 
188.24 	subdivision 1;
188.25 	(9) procedures for the handling and disposal of bodily fluids pursuant to section 142H.29, 
188.26 	subdivision 10;
188.27 	(10) the center's emergency and accident policies pursuant to section 142H.23, subdivision 
188.28 	2;
188.29 	(11) the center's health policies pursuant to section 142H.29;
189.1 	(12) individual child care program plan or plans pursuant to section 142H.15, if 
189.2 	applicable;
189.3 	(13) job responsibilities specific to the individual's position at the center;
189.4 	(14) prevention and control of infectious diseases pursuant to section 142H.18;
189.5 	(15) the center's policy on research, cameras, and social media participation procedures 
189.6 	pursuant to section 142H.22;
189.7 	(16) the center's policy on the use of alcohol, drugs, and tobacco products pursuant to 
189.8 	section 142B.10, subdivision 1, paragraph (c);
189.9 	(17) recognition and reporting of maltreatment, abuse and neglect pursuant to chapter 
189.10 	260E;
189.11 	(18) the center's risk reduction plan pursuant to section 142H.24;
189.12 	(19) reduction of risk of sudden unexpected infant death pursuant to the requirements 
189.13 	of subdivision 7 and section 142B.46; and
189.14 	(20) transportation and field trip safety procedures pursuant to section 142H.33.
189.15 	(c) Training for orientation may be used to meet in-service training requirements.
189.16 		Subd. 2.Child care basics training. (a) Any program staff person hired after July 1, 
189.17 	2027, must complete child care licensing basics training no more than 90 days after the first 
189.18 	date of direct contact with a child, unless the person has completed the training within the 
189.19 	previous two years.
189.20 	(b) Child care basics training covers information on effectively working in a child care 
189.21 	center setting in Minnesota. Child care basics training must be developed and updated by 
189.22 	the commissioner. Child care basics training may be used to meet in-service training 
189.23 	requirements.
189.24 		Subd. 3.Child development and learning training. (a) Program staff persons must 
189.25 	complete at least two hours of child development and learning training within 90 days after 
189.26 	the first date of direct contact with a child and every two calendar years thereafter. For the 
189.27 	purposes of this subdivision, "child development and learning training" means any training 
189.28 	in understanding how children develop physically, cognitively, emotionally, and socially 
189.29 	and learn as part of the children's family, culture, and community.
189.30 	(b) An individual is exempt from this subdivision if the individual:
190.1 	(1) has taken a three-credit college course on early childhood development within the 
190.2 	past five years;
190.3 	(2) has received a bachelor's or master's degree in early childhood education or school-age 
190.4 	child care within the past five years;
190.5 	(3) is licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
190.6 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
190.7 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
190.8 	(4) has received a Montessori certificate or diploma issued by American Montessori 
190.9 	Society, Association Montessori International, or an institution accredited by the Montessori 
190.10 	Accreditation Council for Teacher Education within the past five years.
190.11 		Subd. 4.Pediatric first aid.  (a) Before direct contact with a child, a program staff person 
190.12 	must satisfactorily complete pediatric first aid. Pediatric first aid training completed within 
190.13 	the previous two calendar years meets this requirement.
190.14 	(b) Notwithstanding paragraph (a), a program staff person who has yet to complete initial 
190.15 	pediatric first aid training may provide direct contact services within 90 days after the first 
190.16 	date of direct contact with a child while under the continuous direct supervision of an 
190.17 	individual who has met the pediatric first aid training requirements of this subdivision. For 
190.18 	purposes of this paragraph, "continuous direct supervision" means the program staff person 
190.19 	is within sight or hearing of the program's supervising individual and the program's 
190.20 	supervising individual is capable at all times of intervening to protect the health and safety 
190.21 	of the children served by the program.
190.22 	(c) The first aid training must have been provided by an individual approved to provide 
190.23 	pediatric first aid instruction.
190.24 	(d) A program staff person must complete training in pediatric first aid every two calendar 
190.25 	years. Documentation of the training must be maintained at the center.
190.26 	(e) Online training reviewed and approved by the commissioner satisfies the training 
190.27 	requirement of this subdivision.
190.28 	(f) Pediatric first aid training in this subdivision must not be used to meet in-service 
190.29 	training requirements under subdivision 10.
190.30 		Subd. 5.Pediatric cardiopulmonary resuscitation. (a) Before direct contact with a 
190.31 	child, a program staff person must satisfactorily complete pediatric cardiopulmonary 
190.32 	resuscitation (CPR) training, including CPR techniques for infants and children and the 
191.1 	treatment of obstructed airways. Pediatric CPR training completed within the previous two 
191.2 	calendar years meets this requirement.
191.3 	(b) Notwithstanding paragraph (a), a program staff person who has yet to complete initial 
191.4 	pediatric CPR training may provide direct contact services within 90 days after the first 
191.5 	date of direct contact with a child, if they are under the continuous direct supervision of an 
191.6 	individual who has met pediatric CPR training requirements under this subdivision. For the 
191.7 	purposes of this paragraph, "continuous direct supervision" means the individual is within 
191.8 	sight or hearing of the program's supervising individual to the extent that the program's 
191.9 	supervising individual is capable at all times of intervening to protect the health and safety 
191.10 	of the children served by the program.
191.11 	(c) A program staff person must complete training in pediatric CPR every two calendar 
191.12 	years. A center must maintain documentation of the trainings on site.
191.13 	(d) A pediatric CPR training under this subdivision must incorporate a hands-on skill 
191.14 	session to support the instruction and have been developed:
191.15 	(1) by the American Heart Association or the American Red Cross; or
191.16 	(2) using nationally recognized, evidence-based guidelines for pediatric CPR training.
191.17 	(e) Pediatric CPR training must not be used to meet in-service training requirements 
191.18 	under subdivision 10.
191.19 		Subd. 6.Sudden unexpected infant death training. (a) Before direct contact with 
191.20 	infants, program staff persons and volunteers must receive training on the standards under 
191.21 	section 142B.46 and on reducing the risk of sudden unexpected infant death during orientation 
191.22 	and each calendar year thereafter.
191.23 	(b) Sudden unexpected infant death reduction training required under this subdivision 
191.24 	must be at least one-half hour in length and include at minimum the infant sleep standards 
191.25 	under section 142B.46, the risk factors related to sudden unexpected infant death, methods 
191.26 	of reducing the risk of sudden unexpected infant death in child care, and license holder 
191.27 	communication with parents regarding reducing the risk of sudden unexpected infant death.
191.28 	(c) Training taken under this subdivision may be used to meet the in-service training 
191.29 	requirements under subdivision 10.
191.30 		Subd. 7.Abusive head trauma training. (a) Before direct contact with children under 
191.31 	school age, a program staff person must receive training on the risk of abusive head trauma 
191.32 	during orientation and each calendar year thereafter.
192.1 	(b) Abusive head trauma training under this subdivision must be at least one-half hour 
192.2 	in length and include at minimum the risk factors related to shaking infants and young 
192.3 	children, methods of reducing the risk of abusive head trauma in child care, and license 
192.4 	holder communication with parents regarding reducing the risk of abusive head trauma.
192.5 	(c) training taken under this subdivision may be used to meet the in-service training 
192.6 	requirements under subdivision 10.
192.7 		Subd. 8.Child passenger restraint systems; training requirement. (a) Before a license 
192.8 	holder transports a child or children under age nine in a motor vehicle, the person placing 
192.9 	the child or children in a passenger restraint must satisfactorily complete training on the 
192.10 	proper use and installation of child restraint systems in motor vehicles.
192.11 	(b) Training required under this subdivision must be repeated at least once every five 
192.12 	years and include at minimum the proper use of child restraint systems based on the size, 
192.13 	weight, and age of the child and the proper installation of a car seat or booster seat in the 
192.14 	motor vehicle used by the license holder to transport the child or children.
192.15 	(c) Training required under this subdivision must be provided by individuals who are 
192.16 	certified and approved by the Department of Public Safety, Office of Traffic Safety.
192.17 	(d) Training completed under this subdivision may be used to meet in-service training 
192.18 	requirements under subdivision 10. Staff training completed within the previous five years 
192.19 	is transferable upon change in employment to another child care center.
192.20 		Subd. 9.In-service training requirements. (a) A license holder must ensure that program 
192.21 	staff persons complete in-service training.
192.22 	(b) In-service training completed within the past 12 months by a program staff person 
192.23 	that is not specific to a child care center is transferable upon the program staff person's 
192.24 	change in employment to another child care program. The program staff person must provide 
192.25 	documentation of the completed training to the new child care program.
192.26 	(c) All program staff persons, except substitutes and unsupervised volunteers, who work 
192.27 	more than 20 hours per week must complete at least 20 hours of in-service training each 
192.28 	calendar year.
192.29 	(d) All program staff persons, except substitutes and unsupervised volunteers, who work 
192.30 	20 hours or less per week must complete at least ten hours of in-service training each calendar 
192.31 	year.
193.1 	(e) Substitutes and unsupervised volunteers must complete a minimum of two hours of 
193.2 	training each calendar year and the training must include the topics identified under 
193.3 	subdivision 11.
193.4 	(f) The number of in-service training hours may be prorated for center directors and 
193.5 	program staff persons not employed for an entire year or on a documented leave of absence.
193.6 	(g) Pediatric first aid and pediatric CPR training must not be used to meet in-service 
193.7 	training requirements.
193.8 		Subd. 10.In-service content. (a) Each calendar year, in-service training must include 
193.9 	the following:
193.10 	(1) abusive head trauma training of at least one-half hour duration for individuals working 
193.11 	with a child under school age pursuant to subdivision 8;
193.12 	(2) the center policies and procedures for maintaining health and safety, including:
193.13 	(i) allergy prevention and response training pursuant to section 142H.15, subdivision 5;
193.14 	(ii) emergency preparedness and procedures pursuant to section 142H.23, subdivision 
193.15 	1;
193.16 	(iii) handling emergencies, accidents, incidents, and injuries pursuant to section 142H.23, 
193.17 	subdivision 2; and
193.18 	(iv) handling and disposal of bodily fluids pursuant to section 142H.29, subdivision 10;
193.19 	(3) maltreatment, abuse, and neglect reporting pursuant to chapter 260E;
193.20 	(4) reduction of risk of sudden unexpected infant death training of at least one-half hour 
193.21 	duration for individuals working with infants pursuant to the requirements of subdivision 
193.22 	7 and section 142B.46;
193.23 	(5) a risk reduction plan pursuant to section 142H.24;
193.24 	(6) the center policies and procedures on behavior guidance pursuant to section 142H.13; 
193.25 	and
193.26 	(7) the center policies and procedures on supervision pursuant to section 142H.24.
193.27 	(b) At least once every two calendar years, in-service training must include the following:
193.28 	(1) child development and learning pursuant to subdivision 4;
193.29 	(2) at least one hour on cultural awareness and inclusion;
193.30 	(3) pediatric first aid that meets the requirements of subdivision 5;
194.1 	(4) pediatric cardiopulmonary resuscitation training that meets the requirements of 
194.2 	subdivision 5; and
194.3 	(5) at least one hour on identifying and supporting children with special needs.
194.4 	(c) At least once every five calendar years, training must include child passenger restraint 
194.5 	systems pursuant to subdivision 9, if applicable.
194.6 	(d) The remaining hours of the in-service training requirement must be met by completing 
194.7 	training in the Minnesota knowledge and competency framework areas.
194.8 		Subd. 11.Documentation required. (a) The license holder must document completed 
194.9 	training for program staff persons in a manner prescribed by the commissioner.
194.10 	(b) For pediatric first aid and CPR trainings, the license holder must maintain copies of 
194.11 	training cards or certificates issued by the training organization.

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

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

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

199.3 	Sec. 12. [142H.12] NAPS AND REST.
199.4 		Subdivision 1.Naps and rest policy. An applicant must develop and a license holder 
199.5 	must implement a policy for naps and rest that is consistent with the developmental level 
199.6 	of the children enrolled in the center. The policy must include but is not limited to the 
199.7 	requirements in this section, as applicable.
199.8 		Subd. 2.Parent consultation.  The parent of each child must be informed at the time 
199.9 	the child is enrolled of the center's policy on naps and rest and be offered the opportunity 
199.10 	to provide information specific to their child.
199.11 		Subd. 3.General nap and rest requirements.  (a) The child care center must provide 
199.12 	a quiet space for children to nap and rest.
199.13 	(b) Nap and rest time must be in accordance with the developmental needs of the child. 
199.14 	A child care center may not withhold sleep or rest from a child, including at a parent's 
199.15 	request, if such time is allowed in the child care center's naps and rest policy.
199.16 	(c) Nap and rest areas must be lighted to allow for visual supervision of all children at 
199.17 	all times.
199.18 	(d) Evacuation routes must not be blocked by resting or napping children. Each child 
199.19 	must have a free and direct means of escape, and the staff must have a clear path to each 
199.20 	resting child, including full access to at least one long side of a crib, cot, or mat.
199.21 	(e) A crib that meets the safety requirements of section 142B.45 must be provided for 
199.22 	each infant for whom the center is licensed to provide care.
199.23 	(f) The license holder must follow the infant safe sleep requirements under section 
199.24 	142B.46.
199.25 	(g) Cribs, cots, and mats must be placed directly on the floor and must not be stacked 
199.26 	when in use.
199.27 		Subd. 4.Monitoring napping infants. (a) An infant must be supervised as defined in 
199.28 	section 142H.01, subdivision 38, and pursuant to section 142H.24, subdivision 1, paragraph 
199.29 	(b).
199.30 	(b) Staff must conduct in-person checks of the sleeping infant every 15 minutes.
200.1 	(c) When a baby monitor or other mechanical equipment is used to hear or see infants 
200.2 	during sleep, the monitoring equipment must be:
200.3 	(1) able to pick up the sounds of all infants in the separate room;
200.4 	(2) actively monitored by program staff at all times; and
200.5 	(3) checked daily prior to use to ensure it is working correctly. If equipment is 
200.6 	malfunctioning, a program staff person must put in place an alternate means of supervision 
200.7 	until the equipment can be fixed.
200.8 		Subd. 5.Confinement limitation. A child who has completed a nap or rested quietly 
200.9 	for 30 minutes must not be required to remain on a cot, mat, or in a crib. Any child who 
200.10 	does not fall asleep during a designated nap time must have the opportunity to engage in 
200.11 	quiet activities.
200.12 		Subd. 6.Bedding and sleeping equipment. Separate bedding must be provided and 
200.13 	stored separately for each child in care.

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

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

206.9 	Sec. 15. [142H.141] NATURAL ELEMENTS AND MATERIALS.
206.10 		Subdivision 1.Natural elements and materials. A license holder may provide children 
206.11 	with access to natural elements and materials as equipment and play materials. Natural 
206.12 	elements and materials and appropriate uses of natural elements and materials include, but 
206.13 	are not limited to:
206.14 	(1) natural loose parts, such as sticks, leaves, pine cones, acorns, seeds, pods, bark, and 
206.15 	moss for construction, art, sensory exploration, and imaginative play;
206.16 	(2) natural materials, such as dirt, mud, sand, water, ice, and snow for sensory play and 
206.17 	exploration;
206.18 	(3) plants, flowers, seeds, vegetables, and gardening materials for science exploration 
206.19 	and learning;
206.20 	(4) rocks, pebbles, stones, and minerals for counting, sorting, building, and art;
206.21 	(5) natural areas such as gardens, prairie, forest, wetlands, and ponds for exploration 
206.22 	and learning; and
206.23 	(6) other natural elements as appropriate to age and development of children.
206.24 		Subd. 2.Supervision. A program staff person must supervise a child's use of natural 
206.25 	elements and materials and provide guidance on safe and appropriate use. Natural elements 
206.26 	and materials that are a choking hazard must not be accessible to children under the age of 
206.27 	three without direct supervision of a program staff person.
206.28 		Subd. 3.Other uses. Natural elements and materials may qualify as equipment and 
206.29 	materials from interest areas under section 142H.14, subdivision 4.

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

209.7 	Sec. 17. [142H.16] NIGHT CARE PROGRAM.
209.8 		Subdivision 1.Applicability. A license holder providing overnight care must comply 
209.9 	with this section.
209.10 		Subd. 2.Furnishings. Each child enrolled in a night care program must be provided 
209.11 	with a crib or bed, described as follows:
209.12 	(1) a crib that meets the requirements under section 142B.45 and two sets of sheets must 
209.13 	be provided for each infant and meet the requirements under section 142H.14;
209.14 	(2) an individual age-appropriate bed with two sets of sheets and a blanket or quilt must 
209.15 	be provided for each toddler, preschooler, or school-age child;
209.16 	(3) each bed or crib must have a waterproof mattress or mattress pad that can be cleaned 
209.17 	and disinfected;
209.18 	(4) bedding and sleeping equipment must be cleaned and disinfected as specified in 
209.19 	section 142H.31, subdivision 4, clause (3); and
209.20 	(5) separate bedding must be provided and stored separately for each child in care.
209.21 		Subd. 3.Clothing intended for sleeping. The license holder must ensure that all children 
209.22 	are put to bed in clothing for sleeping as designated by the parent of the child.
209.23 		Subd. 4.Personal care items. The license holder must ensure that all children have 
209.24 	personal items needed to clean up and prepare for sleep. The items must include an individual 
209.25 	washcloth, towel, toothbrush, toothpaste, and liquid hand soap.
209.26 		Subd. 5.Meals and snacks. (a) The license holder must ensure that a child who will be 
209.27 	present in the center has had or will be provided with an evening meal. A bedtime snack 
209.28 	must be available for all children in attendance. Eating times and schedules for the individual 
209.29 	child must be consistent with patterns established in consultation with the parent of the 
209.30 	child.
209.31 	(b) Night care programs are exempt from the requirements of section 142H.32, 
209.32 	subdivision 7.
210.1 		Subd. 6.Staffing. At least two program staff persons, one of whom must qualify as a 
210.2 	teacher under section 142H.06, must be present in the center at all times during the hours 
210.3 	the night program is in operation. When more than 80 percent of the children present are 
210.4 	asleep, the remaining program staff persons needed to meet the required staff-to-child ratio 
210.5 	must have at least the qualifications of an aide. Program staff must be awake, dressed, and 
210.6 	provide supervision as specified in sections 142H.01, subdivision 38, and 142H.12 to 
210.7 	children who are sleeping.
210.8 		Subd. 7.Hygiene assistance.  The license holder must ensure that children have the 
210.9 	opportunity to wash up and brush their teeth before bedtime. Program staff must assist 
210.10 	children during washing and changing clothes according to the developmental needs of the 
210.11 	child.
210.12 		Subd. 8.Showers and bathtubs. The license holder must ensure bathtubs and showers 
210.13 	are equipped to prevent slipping, if the center provides bathing.
210.14 		Subd. 9.Bathing procedures. The center must have written permission from the parent 
210.15 	prior to allowing the child to bathe and ensure bathtubs and showers are cleaned and 
210.16 	disinfected after each use. The tub or showers do not have to be disinfected between uses 
210.17 	if the children are siblings and the parent has provided written consent. All children must 
210.18 	bathe separately unless the children are siblings and the parent has provided written consent 
210.19 	that the children can be bathed together.
210.20 		Subd. 10.Privacy. To ensure privacy, school-age boys and girls must be separated 
210.21 	during bedtime washing and changing activities.
210.22 		Subd. 11.Sleeping arrangements. The center must provide sleeping arrangements so 
210.23 	that sleeping children are cared for separately from children who are awake and so that 
210.24 	sleeping children are not disturbed by arrivals and departures. Infants must have a sleep 
210.25 	area separate from the center's play and activity areas.
210.26 		Subd. 12.Bedtime. A child's bedtime must be scheduled in consultation with the child's 
210.27 	parent.
210.28 		Subd. 13.Light. The center must provide adequate lighting indoors in all areas, including 
210.29 	bathrooms, hallways, and sleeping rooms to ensure that staff are able to see all children at 
210.30 	all times.
210.31 		Subd. 14.Outdoor illumination. The center must ensure that parking areas, outdoor 
210.32 	walkways, and all building entrances are adequately lighted for safety and security.
211.1 		Subd. 15.Program emphasis. A license holder operating a night care program must 
211.2 	comply with the child care program standards in 142H.11.
211.3 		Subd. 16.Exceptions. The outdoor activity area required by section 142H.34, subdivision 
211.4 	7; outdoor activities required by section 142H.11, subdivision 2; and outdoor equipment 
211.5 	required by section 142H.14 need not be provided for children enrolled in a night care 
211.6 	program.

211.7 	Sec. 18. [142H.17] DROP-IN CHILD CARE PROGRAMS.
211.8 		Subdivision 1.Drop-in child care programs. If a license holder chooses to operate as 
211.9 	a drop-in child care program, the license holder must comply with the requirements in this 
211.10 	section.
211.11 		Subd. 2.Exemptions. (a) Drop-in child care programs that meet one of the requirements 
211.12 	in paragraph (b) are exempt from:
211.13 	(1) section 142H.10;
211.14 	(2) section 142H.11, subdivision 1, clauses (6) and (7); and
211.15 	(3) section 142H.12, subdivisions 3 and 5, except for infants and toddlers.
211.16 	(b) A drop-in child care program is exempt from the requirements in paragraph (a) if 
211.17 	the program operates:
211.18 	(1) in a child care center that houses no child care program except the drop-in child care 
211.19 	program;
211.20 	(2) in the same child care center but not during the same hours as a regularly scheduled 
211.21 	ongoing child care program with a stable enrollment; or
211.22 	(3) in a child care center at the same time as a regularly scheduled ongoing child care 
211.23 	program with a stable enrollment, but activities, except for bathroom use and outdoor play, 
211.24 	are conducted separately from each other.
211.25 		Subd. 3.Staffing requirements. (a) A drop-in child care program must have at least 
211.26 	two program staff persons on site whenever the program is operating: the director or a 
211.27 	designee and a program staff member who is qualified as a teacher.
211.28 	(b) If the drop-in child care program has additional staff who are on call as a mandatory 
211.29 	condition of their employment, the minimum child-to-staff ratio may be exceeded only for 
211.30 	preschool and school-age children by a maximum of four children for no more than 20 
211.31 	minutes while additional staff are in transit. If the ratio is exceeded for more than 20 minutes, 
212.1 	the license holder must review the mandatory on-call staff procedures and revise as necessary 
212.2 	to ensure compliance with this section, including hiring additional on-call staff as needed.
212.3 	(c) Whenever there is a total of 20 children or more at a drop-in child care center, children 
212.4 	that are younger than 30 months must be cared for in a separate group. The group may 
212.5 	contain children up to 60 months old. The group must be cared for in an area that is physically 
212.6 	separated from older children.
212.7 	(d) In drop-in care programs that serve both infants and older children, children up to 
212.8 	30 months old may be supervised by assistant teachers as long as other staff are present in 
212.9 	appropriate ratios.
212.10 	(e) A drop-in child care program may care for siblings who are all at least 16 months 
212.11 	old together in any group. For purposes of this section, "sibling" is defined as sister or 
212.12 	brother, half sister or half brother, or stepsister or stepbrother.
212.13 		Subd. 4.Staff-to-child ratio requirements in a drop-in program. The minimum 
212.14 	staff-to-child ratio that a license holder may maintain in a drop-in program is:
212.15 	(1) for infants, one program staff person for every four infants;
212.16 	(2) for toddlers, one program staff person for every seven children;
212.17 	(3) for preschoolers, one program staff person for every ten children; and
212.18 	(4) for school-age children, one program staff person for every 15 children.
212.19 		Subd. 5.Staff distribution. (a) The minimum staff distribution pattern for a drop-in 
212.20 	child care program is:
212.21 	(1) the first staff member needed to meet the required staff-to-child ratio must be a 
212.22 	teacher;
212.23 	(2) the second and third staff members must have at least the qualifications of a child 
212.24 	care aide; and
212.25 	(3) the fourth staff member must have at least the qualifications of an assistant teacher.
212.26 	(b) The pattern in paragraph (a) must be repeated until the number of staff needed to 
212.27 	meet the staff-to-child ratio for each age category has been achieved.

212.28 	Sec. 19. [142H.18] EXCLUSION OF SICK CHILDREN .
212.29 		Subdivision 1.Care of sick children. If a child becomes sick while at the center, the 
212.30 	child must be isolated from other children in care and the child's parent called immediately. 
212.31 	When determining if a child is sick and exclusion is necessary, license holders must follow:
213.1 	(1) the requirements on reportable diseases in Minnesota Rules, parts 4605.7040, 
213.2 	4605.7070, and 4605.7080; and
213.3 	(2) guidelines from the commissioner of health on infectious diseases in child care 
213.4 	settings.
213.5 		Subd. 2.Notification. (a) A child care center's program policies must require a parent 
213.6 	to inform the center within 24 hours, exclusive of weekends and holidays, when a child is 
213.7 	diagnosed by a child's health care provider or dental care provider as having a reportable 
213.8 	or infectious disease as specified in subdivision 1.
213.9 	(b) The license holder must ensure that the commissioner of health is notified of any 
213.10 	suspected case of reportable disease as specified in Minnesota Rules, parts 4605.7040, 
213.11 	4605.7050, or 4605.7080, within 24 hours of receiving the parent's or staff report. 
213.12 	Documentation of the notification must be kept at the center.
213.13 	(c) The license holder must notify the parents of exposed children within 24 hours of 
213.14 	when a parent, employee, or volunteer notifies the center of a reportable disease under 
213.15 	subdivision 1, lice, scabies, impetigo, ringworm, or chicken pox. The notice must be posted 
213.16 	in a clearly visible, accessible place or provided individually to each parent of a child who 
213.17 	was exposed.
213.18 		Subd. 3.Return to center. Children with a reportable or infectious disease as specified 
213.19 	in subdivision 1 must be excluded from the center for a length of time as specified in the 
213.20 	commissioner of health guidelines on infectious diseases in child care settings and until the 
213.21 	child can participate in routine activities without more staff supervision than usual. The 
213.22 	center must exclude a child for a longer period if the child's health care provider determines 
213.23 	that it is necessary.

213.24 	Sec. 20. [142H.19] SICK CARE PROGRAM.
213.25 		Subdivision 1.Licensure of sick care programs. If a license holder chooses to operate 
213.26 	as a sick care program, the license holder must operate a sick care program that complies 
213.27 	with the requirements in this section.
213.28 		Subd. 2.Review of admission and health policies and practices. (a) A licensed 
213.29 	physician, physician assistant, or advanced practice registered nurse with a specialization 
213.30 	in pediatric care must review and approve a sick care program's admission policy at the 
213.31 	time of initial license application, after the first six months of initial operation, and at least 
213.32 	once each calendar year.
214.1 	(b) The review must include consultation with the licensed registered nurse or physician 
214.2 	responsible for admissions.
214.3 	(c) A report of the findings must be sent to the commissioner with the initial application 
214.4 	for licensure, and subsequent reports must be placed in the center's administrative record.
214.5 		Subd. 3.Evaluation of a sick child. (a) A license holder that operates a sick care program 
214.6 	must evaluate the condition of a sick child before admitting the child to the center.
214.7 	(b) The evaluation must be based on the physical symptoms of the child each day of 
214.8 	admission, the probable contagion and risk to the health of others present, the ability of the 
214.9 	program to provide the care the child requires, and whether the child can be grouped together 
214.10 	with other children in care with contagious or noncontagious illnesses. Documentation of 
214.11 	the evaluation must be placed in the child's record.
214.12 	(c) Before admitting a child to a sick care program:
214.13 	(1) a parent must describe the child's symptoms over the phone;
214.14 	(2) a health care provider affiliated with the center must  tell the parent whether the parent 
214.15 	may bring the child to the center for further evaluation; and
214.16 	(3) the health care provider must conduct a physical assessment of the child and obtain 
214.17 	a health history from the parent at the center.
214.18 		Subd. 4.Information to parents. A summary of the sick care program's health care 
214.19 	policies and practices and the center's procedures for notification of parents in the event of 
214.20 	an emergency must be given to the parent the first time a child is admitted and every 
214.21 	admission following a change to any of the information.
214.22 		Subd. 5.Parent conference exception. Centers licensed to provide child care exclusively 
214.23 	to sick children are not required to provide parent conferences under section 142H.20, 
214.24 	subdivision 2.
214.25 		Subd. 6.Child care program emphasis exception. A sick care program does not need 
214.26 	to meet the child care program plan requirements under section 142H.11. However, the 
214.27 	child care program plan for the care of sick children must emphasize quiet activities.
214.28 		Subd. 7.Group size and age category grouping exceptions. The maximum group 
214.29 	sizes specified under section 142H.10, subdivision 1, and the age category grouping 
214.30 	restrictions under section 142H.10, subdivision 3, do not apply to sick care programs. There 
214.31 	must be no more than 16 children in sick care in the same room at the same time.
215.1 		Subd. 8.Staff-to-child ratios and staff distribution requirements. (a) A one-to-four 
215.2 	staff-to-child ratio must be maintained at all times in a room used to care for sick children.
215.3 	(b) At least two program staff persons must be present in a center operating a sick care 
215.4 	program whenever sick children are in care.
215.5 	(c) The first program staff person must be a registered nurse. The remaining program 
215.6 	staff persons must at least meet the qualifications and follow the staff distribution pattern 
215.7 	under section 142H.10.
215.8 		Subd. 9.Limitation on staff assignment. Staff must not care for nonsick children or 
215.9 	prepare food for nonsick children on the same day as sick children. Staff caring for sick 
215.10 	children must not enter the kitchen used to prepare food for nonsick children.
215.11 		Subd. 10.Food preparation. Food provided by the license holder and prepared at the 
215.12 	center must be prepared in a room separate from rooms where sick care is provided and 
215.13 	must be delivered to each sick care room in individual servings and in covered containers. 
215.14 	Procedures for preparing, handling, and serving food and washing food, utensils, and 
215.15 	equipment must comply with the requirements in the Minnesota Food Code, Minnesota 
215.16 	Rules, chapter 4626.
215.17 		Subd. 11.Menus. Menus for sick children must be modified to meet the individual needs 
215.18 	of the child.
215.19 		Subd. 12.Additional facility requirements. A license holder operating a sick care 
215.20 	program must provide:
215.21 	(1) a room or rooms that are exclusively used to care for sick children and that are not 
215.22 	used at any time for any other child care purpose; and
215.23 	(2) toilets and hand sinks that are within or immediately adjacent to the room or rooms 
215.24 	used for sick care and are not used by well children in care.
215.25 		Subd. 13.Outdoor activity area, activities, and equipment exception. Sick care 
215.26 	programs under this section are exempt from the requirements for an outdoor activity area 
215.27 	under section 142H.34, subdivision 7; outdoor activities under section 142H.11, subdivision 
215.28 	2; and outdoor equipment under section 142H.14.
215.29 		Subd. 14.Cleaning and disinfection. Floors in rooms where sick care is provided and 
215.30 	all linens, toileting equipment, sinks, furnishings, objects, and equipment used by sick 
215.31 	children must be cleaned and disinfected at least daily and as needed pursuant to the 
215.32 	requirements under section 142H.31.
216.1 		Subd. 15.Bedding and sleeping equipment. (a) Each sick child must be provided 
216.2 	appropriate bedding and sleeping equipment, depending on the age of the child, as follows:
216.3 	(1) a crib and crib sheets pursuant to the requirements of section 142B.45, cot, mat, or 
216.4 	bed, depending on the age of the child;
216.5 	(2) a pillow, except if the child is an infant;
216.6 	(3) a pillowcase, except if the child is an infant; and
216.7 	(4) a blanket or quilt, except if the child is an infant.
216.8 	(b) Bedding provided by the center must be laundered after each use. Sleeping equipment 
216.9 	must be cleaned and disinfected after each use.

216.10 	Sec. 21. [142H.20] INFORMATION TO PARENTS.
216.11 		Subdivision 1.Policies provided to parents. At the time of a child's enrollment, the 
216.12 	center must provide the parent with written notification of the:
216.13 	(1) ages and numbers of children the center is licensed to serve;
216.14 	(2) hours and days of operation;
216.15 	(3) child care program options the center is licensed to operate, including a description 
216.16 	of the program's educational methods; the program's religious, political, or philosophical 
216.17 	basis, if any; and how parents may review the center's child care program plan;
216.18 	(4) policy on parent conferences and notification to a parent of a child's intellectual, 
216.19 	physical, social, and emotional development;
216.20 	(5) policy requiring a health care summary and immunization record of a child;
216.21 	(6) policies and procedures for the care of children who become sick at the center and 
216.22 	parent notification practices for the onset of or exposure to a contagious illness or condition 
216.23 	pursuant to section 142H.18 or when there is an emergency or injury requiring medical 
216.24 	attention;
216.25 	(7) policies and procedures for administering first aid and sources of care to be used in 
216.26 	case of emergencies;
216.27 	(8) policies on the administration of medicine;
216.28 	(9) procedures for obtaining written parental permission for transportation of children 
216.29 	and field trips as required in section 142H.33, subdivision 4, paragraph (d);
217.1 	(10) procedures for obtaining written parental consent for research, cameras, and social 
217.2 	media participation pursuant to section 142H.22;
217.3 	(11) policies on transitioning a child to the next age group, pursuant to section 142H.10;
217.4 	(12) policies on the provision of meals and snacks;
217.5 	(13) behavior guidance policies and procedures;
217.6 	(14) presence of pets;
217.7 	(15) policy on visitation and parental access to children pursuant to section 142H.21;
217.8 	(16) policy on the prohibition of smoking, use of tobacco products, vaping, electronic 
217.9 	cigarettes, alcohol, and drugs on the premises of the program pursuant to section 142H.29, 
217.10 	subdivision 11;
217.11 	(17) policy on use of technology and screen time pursuant to section 142H.11, subdivision 
217.12 	1, clause (12);
217.13 	(18) telephone number of the Department of Children, Youth, and Families, Division 
217.14 	of Licensing;
217.15 	(19) policy on naps and rest pursuant to section 142H.12; and
217.16 	(20) procedures for notifying parents of an evacuation, including procedures for 
217.17 	reunification with families.
217.18 		Subd. 2.Parent conferences. The license holder must inform the parent of a child's 
217.19 	progress and:
217.20 	(1) complete individual assessments of each child's intellectual, physical, social, and 
217.21 	emotional development at least twice a year. Individual assessments for school-age children 
217.22 	must be completed at least once a year;
217.23 	(2) plan and offer parent conferences by program staff at least twice a year to review 
217.24 	and discuss the child's assessment. Parent conferences for school-age children must be 
217.25 	planned and offered at least once a year; and
217.26 	(3) maintain documentation of the child's assessment and that individual parent 
217.27 	conferences were planned and offered in each child's record.
217.28 		Subd. 3.Daily reports for infants and toddlers. Daily written individualized reports 
217.29 	must be provided to the parent of an infant or toddler about the child's food intake, 
217.30 	elimination, sleeping patterns, and general behavior.

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

218.8 	Sec. 23. [142H.22] CONSENT FOR RESEARCH, CAMERAS, AND SOCIAL MEDIA 
218.9 	PARTICIPATION.
218.10 		Subdivision 1.Policy. A center must have and follow a policy governing the center's 
218.11 	use of social media and the use of photos and videos of children in care. The policy must 
218.12 	include:
218.13 	(1) procedures for obtaining written consent from parents for release of photos and 
218.14 	videos of children for promotional or publicity purposes, including on social media accounts 
218.15 	or public digital platforms; and
218.16 	(2) a statement prohibiting any employee or volunteer from posting content of children 
218.17 	in care or enrolled families on a personal social media account or public digital platform, 
218.18 	including photos, videos, or personal identifying information of the children.
218.19 		Subd. 2.Participation in research, fundraising, or public relations projects. (a) The 
218.20 	license holder must obtain written permission from a parent before a child is involved in 
218.21 	research, fundraising, or public relations projects while at the center. A separate written 
218.22 	permission form must be obtained before each occasion of a research, fundraising, or public 
218.23 	relations activity.
218.24 	(b) The permission form must be maintained in the child's record.

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

221.9 	Sec. 25. [142H.24] SUPERVISION AND RISK REDUCTION.
221.10 		Subdivision 1.Supervision; sight and hearing exceptions. (a) A child is still supervised 
221.11 	as defined in section 142H.01, subdivision 38, when:
221.12 	(1) an infant is placed in a crib to sleep and a program staff person is within sight or 
221.13 	hearing of the infant pursuant to section 142H.12, subdivision 4;
221.14 	(2) a single school-age child uses a restroom that is not available to the public when the 
221.15 	child care center is operating and serving children and a program staff person has knowledge 
221.16 	of the child's activity and location and checks on the child at least every five minutes. When 
221.17 	services are provided away from the child care facility, including but not limited to field 
221.18 	trips, a school-age child who uses a restroom that is available to the public must be 
221.19 	accompanied by a program staff person;
221.20 	(3) a school-age child leaves the classroom but remains within the licensed child care 
221.21 	center space to deliver or retrieve items from the child's personal storage space and a program 
221.22 	staff person has knowledge of the child's activity and location and checks on the child at 
221.23 	least every five minutes; or
221.24 	(4) a single preschool child uses an individual, private restroom within the classroom 
221.25 	with the door closed and a program staff person has knowledge of the child's activity and 
221.26 	location, can hear the child, and checks on the child at least every five minutes.
221.27 	(b) A program must account for each exception in paragraph (a) in the risk reduction 
221.28 	plan under subdivision 2.
221.29 		Subd. 2.Risk reduction plan. (a) The license holder must develop a risk reduction plan 
221.30 	that identifies the general risks to children served by the child care center in a form and 
221.31 	manner prescribed by the commissioner.
222.1 	(b) The license holder must establish procedures to minimize identified risks, train staff 
222.2 	on the procedures, and review the procedures each calendar year.
222.3 	(c) The risk reduction plan must include an assessment of risk to children the center 
222.4 	serves or intends to serve and identify specific risks based on the outcome of the assessment. 
222.5 	The assessment of risk must be composed of:
222.6 	(1) an assessment of the risks presented by the facility where the licensed services are 
222.7 	provided, including an evaluation of:
222.8 	(i) the condition and design of the facility and its outdoor space, bathrooms, and storage 
222.9 	areas;
222.10 	(ii) the accessibility of medications and cleaning products that are harmful to children; 
222.11 	and
222.12 	(iii) the existence of areas that are difficult to supervise, including restrooms with multiple 
222.13 	entrances; and
222.14 	(2) an assessment of the risks presented by the environment for each facility and for 
222.15 	each site, including an evaluation of the type of grounds and terrain surrounding the building 
222.16 	and the proximity to hazards, busy roads, and publicly accessed businesses.
222.17 	(d) The risk reduction plan must include a statement of measures that will be taken to 
222.18 	minimize the risk of harm presented to children for each risk identified in the assessment 
222.19 	under paragraph (c) related to the facility and environment.
222.20 	(e) In addition to any program-specific risks identified in paragraph (c), the plan must 
222.21 	include specific policies and procedures that minimize the risk of harm or injury to children, 
222.22 	including from:
222.23 	(1) closing children's fingers in doors, including cabinet doors;
222.24 	(2) leaving children in the community without supervision;
222.25 	(3) children leaving the facility without supervision;
222.26 	(4) dislocation of children's elbows by program staff pulling or lifting children by the 
222.27 	hands or wrists or swinging by the arms;
222.28 	(5) burns, including from hot food or beverages, whether served to children or being 
222.29 	consumed by program staff, and devices used to warm food and beverages;
222.30 	(6) injuries from equipment, such as scissors and glue guns;
222.31 	(7) sunburn;
223.1 	(8) feeding children foods to which they are allergic;
223.2 	(9) children falling from changing tables;
223.3 	(10) children accessing dangerous items or chemicals or coming into contact with residue 
223.4 	from harmful cleaning products;
223.5 	(11) traffic and pedestrian accidents, including when walking with children on 
223.6 	neighborhood walks, to an off-site outdoor play area, or in areas with heavy traffic or difficult 
223.7 	terrain such as railroad tracks; and
223.8 	(12) children choking or suffocating.
223.9 	(f) The plan must ensure hazardous objects as defined in section 142H.34, subdivision 
223.10 	17, are inaccessible to children.
223.11 	(g) The plan must include specific policies and procedures to ensure adequate supervision 
223.12 	of children at all times as defined in subdivision 1 and section 142H.01, subdivision 38, 
223.13 	and pursuant to the staffing requirements of section 142H.10, subdivision 1, with particular 
223.14 	emphasis on:
223.15 	(1) times when children are transitioned from one area within the facility to another, 
223.16 	including the use of a name-to-face check during transition time;
223.17 	(2) nap-time supervision, including infant sleep supervision;
223.18 	(3) child arrival and departure times, including when children arrive or depart from the 
223.19 	center by bus;
223.20 	(4) supervision during outdoor play, outdoor learning activities, and community activities, 
223.21 	including but not limited to field trips and neighborhood walks;
223.22 	(5) supervision of children in hallways;
223.23 	(6) supervision of preschool children when using an individual private restroom within 
223.24 	the classroom; and
223.25 	(7) supervision of school-age children when using the restroom and visiting the child's 
223.26 	personal storage space.
223.27 		Subd. 3.Yearly review of risk reduction plan. (a) The license holder must review the 
223.28 	risk reduction plan each calendar year and document the review.
223.29 	(b) When conducting the review, the license holder must consider incidents that have 
223.30 	occurred in the center since the last review, including:
223.31 	(1) incidents covered by the assessment factors in subdivision 2;
224.1 	(2) the internal reviews conducted under section 142H.36, if any;
224.2 	(3) substantiated maltreatment findings, if any; and
224.3 	(4) any other incidents that caused injury or harm to a child.
224.4 	(c) Within ten days following any change to the risk reduction plan, the license holder 
224.5 	must train program staff on the change and document that the staff were trained on the 
224.6 	change.

224.7 	Sec. 26. [142H.25] CENTER ADMINISTRATIVE RECORDS.
224.8 	(a) In addition to the personnel records requirements under section 142B.03, subdivision 
224.9 	1, paragraph (a), a center must maintain the following records:
224.10 	(1) a record of the information given to parents specified in section 142H.20;
224.11 	(2) the personnel records specified in section 142H.26;
224.12 	(3) the children's records specified in section 142H.27;
224.13 	(4) health consultant reviews of the center's health policies and practices as specified in 
224.14 	section 142H.29, subdivision 2;
224.15 	(5) the child care program plan specified in section 142H.11;
224.16 	(6) the emergencies, accidents, incidents, and injuries records specified in section 
224.17 	142H.23, subdivision 2;
224.18 	(7) the child separation reports mandated in section 142H.13;
224.19 	(8) daily center and classroom attendance records specified in section 142H.30; and
224.20 	(9) staffing schedules.
224.21 	(b) The requirements in section 142B.03, subdivisions 1 and 2, apply to records retained 
224.22 	pursuant to this section.

224.23 	Sec. 27. [142H.26] PERSONNEL RECORDS.
224.24 	A license holder must maintain a current personnel record for each program staff person 
224.25 	in a manner prescribed by the commissioner and consistent with section 142B.03. The 
224.26 	personnel record for each program staff person must contain:
224.27 	(1) the program staff person's name, home address, telephone number, date of birth, and 
224.28 	emergency contact information;
225.1 	(2) the program staff person's first date of direct contact and first date of unsupervised 
225.2 	direct contact with a child;
225.3 	(3) documentation indicating that the program staff person meets the requirements of 
225.4 	the staff person's job in sections 142H.05 to 142H.08; and
225.5 	(4) the program staff person's hire date and last day of employment, as applicable.

225.6 	Sec. 28. [142H.27] CHILDREN'S RECORDS.
225.7 		Subdivision 1.Requirements. Prior to or on the day of enrollment in the center, the 
225.8 	license holder must maintain a record on site for each child served by the program. The 
225.9 	record must contain:
225.10 	(1) the child's full name, date of birth, and current home address;
225.11 	(2) the child's date of enrollment in the program;
225.12 	(3) the name, address, and telephone number of the child's parent;
225.13 	(4) the name and telephone number of at least one emergency contact person who can 
225.14 	be contacted if a parent cannot be reached in an emergency or when there is an injury 
225.15 	requiring medical attention;
225.16 	(5) the names and telephone numbers of any additional persons authorized by the parent 
225.17 	to pick up the child from the center;
225.18 	(6) the child's health and immunization information required by section 142H.29, 
225.19 	subdivisions 3 and 4;
225.20 	(7) written authorization for the license holder to act in an emergency or when a parent 
225.21 	or designee cannot be reached or is delayed;
225.22 	(8) the hours and days of the week the child will attend the center;
225.23 	(9) for infants and toddlers, a description of the child's eating, sleeping, toileting, and 
225.24 	communication habits and effective methods for comforting the child;
225.25 	(10) documentation of any dietary or medical needs of the child;
225.26 	(11) documentation of a child's individual child care program plan as required by section 
225.27 	142H.15; and
225.28 	(12) the date of parent conferences and a summary of the information provided to the 
225.29 	parent at the conferences.
226.1 		Subd. 2.Disclosure. The license holder must not disclose a child's record to any person 
226.2 	other than the child, the child's parent, the child's legal representative, employees of the 
226.3 	license holder, or the commissioner unless the child's parent has given written consent. This 
226.4 	subdivision does not apply to information needed by a first responder in the case of an 
226.5 	emergency.

226.6 	Sec. 29. [142H.28] REPORTING REQUIREMENTS.
226.7 		Subdivision 1.Maltreatment, abuse, and neglect reporting. The license holder must 
226.8 	comply with the reporting requirements for abuse and neglect specified in chapter 260E.
226.9 		Subd. 2.Other reporting. Within 24 hours, the license holder must notify the 
226.10 	commissioner of the following in a manner prescribed by the commissioner:
226.11 	(1) of the death or notification of the death of a child enrolled in the center as required 
226.12 	under section 142B.10, subdivision 24;
226.13 	(2) of the occurrence or notification of any injury to a child in care in the program that 
226.14 	required treatment by a dentist or health care provider as defined in section 142H.01, 
226.15 	subdivision 22. Treatment does not include application of or recommendation to use 
226.16 	nonprescription medication or diagnostic testing;
226.17 	(3) of the occurrence of structural damage to the building or a fire that requires the 
226.18 	service of a fire department; and
226.19 	(4) of the provision of any emergency medical service to a child while in care.

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

231.14 	Sec. 31. [142H.30] ATTENDANCE RECORDS.
231.15 		Subdivision 1.Attendance records. A child care center must maintain documentation 
231.16 	of actual attendance for each child receiving care. The records must be accessible to the 
231.17 	commissioner during the program's hours of operation, be completed on the actual day of 
231.18 	attendance, and include:
231.19 	(1) the first and last name of the child;
231.20 	(2) the time of day that the child was dropped off; and
231.21 	(3) the time of day that the child was picked up.
231.22 		Subd. 2.Daily classroom tracking. (a) A license holder must ensure that program staff 
231.23 	track children in their classroom on a daily basis to ensure the center has an active roster 
231.24 	of children present in their classroom.
231.25 	(b) Children must be tracked as they arrive in and depart from the classroom.
231.26 	(c) Tracking must include the first and last name of each child.
231.27 	(d) The classroom tracking documentation must remain with each group at all times 
231.28 	throughout the day including outdoor play, emergency evacuations, field trips, and when 
231.29 	groups are combined.

232.1 	Sec. 32. [142H.31] CLEANING, SANITIZING, AND DISINFECTING.
232.2 		Subdivision 1.Products and procedures. Cleaning and disinfecting must be done in 
232.3 	accordance with policies, procedures, and products approved by the program's health 
232.4 	consultant as specified in section 142H.29, subdivision 2.
232.5 		Subd. 2.Indoor and outdoor equipment. (a) The indoor and outdoor space and 
232.6 	equipment of the program must be clean.
232.7 	(b) Natural elements and materials used as equipment and play materials under section 
232.8 	142H.141; natural features used for outdoor play under section 142H.34, subdivision 7, 
232.9 	paragraph (h); and play materials used in outdoor settings are exempt from being clean, as 
232.10 	defined under section 142H.01, subdivision 12. A program staff person must inspect natural 
232.11 	elements and materials, natural features, and play materials used for outdoor play for 
232.12 	hazardous objects and other safety hazards, including animal feces, and remove or mitigate 
232.13 	the hazard before a child's use.
232.14 		Subd. 3.Pacifiers. Pacifiers must be labeled with each child's name or other individual 
232.15 	identifier and stored separately.
232.16 		Subd. 4.Cleaning frequency. The license holder must develop and follow a cleaning 
232.17 	schedule that requires:
232.18 	(1) cleaning and sanitizing food preparation areas, tables, high chairs, and food service 
232.19 	counters before and after each meal and snack. Sanitizing must be done by using an 
232.20 	Environmental Protection Agency-registered sanitizer or a bleach solution or by heating to 
232.21 	temperatures sufficient to destroy most germs, pursuant to guidelines from the commissioner 
232.22 	of health on infectious diseases in child care settings;
232.23 	(2) cleaning and sanitizing items that have been inside a child's mouth or come into 
232.24 	contact with bodily fluids prior to being used by another child;
232.25 	(3) cleaning sleeping equipment and bedding, including:
232.26 	(i) washing bedding used by a child before being used by another child;
232.27 	(ii) washing bedding used by the same child weekly or when soiled;
232.28 	(iii) cleaning and disinfecting sleeping equipment used by a child before being used by 
232.29 	another child; and
232.30 	(iv) cleaning and disinfecting sleeping equipment used by the same child weekly or 
232.31 	when soiled;
232.32 	(4) cleaning toileting areas daily, including:
233.1 	(i) emptying and disinfecting toilet training chairs after each use; and
233.2 	(ii) disinfecting toilets and seats when soiled or at least daily; and
233.3 	(5) emptying garbage cans and diaper receptacles on a daily basis and cleaning and 
233.4 	disinfecting the cans and receptacles as needed.

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

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

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

243.30 	Sec. 36. [142H.35] ENVIRONMENTAL HEALTH.
243.31 		Subdivision 1.Water supply. A child care center must have a safe water supply. Child 
243.32 	care centers that obtain water from privately owned wells or sources must test any water 
244.1 	used for cooking or drinking by a Department of Health-certified laboratory to verify safety. 
244.2 	License holders must follow the lead testing requirements in section 145.9273.
244.3 		Subd. 2.Radon testing. (a) The license holder must notify parents whether radon testing 
244.4 	has been conducted in the program upon enrollment and within 30 days of any subsequent 
244.5 	testing done after enrollment.
244.6 	(b) When notifying parents, the license holder must use a form prescribed by the 
244.7 	commissioner. The notice must include information from the Department of Health about 
244.8 	what radon is and the potential risks associated with radon exposure. If testing has been 
244.9 	completed, the notice must include:
244.10 	(1) the date of the most recent test;
244.11 	(2) the rooms or areas tested; and
244.12 	(3) the detected radon level or levels, stated in picocuries per liter.
244.13 	(c) A license holder must keep a copy of the most recent notice to parents and the radon 
244.14 	test results on site and make the notice and results available to parents and the commissioner 
244.15 	upon request. The provider may meet this requirement by posting the radon testing results 
244.16 	in a conspicuous place.

244.17 	Sec. 37. [142H.36] MALTREATMENT OF MINORS INTERNAL REVIEW.
244.18 	If a license holder has reason to know that an internal or external report of alleged or 
244.19 	suspected maltreatment has been made, the license holder must:
244.20 	(1) establish and maintain policies and procedures to ensure that an internal review is 
244.21 	completed within 30 calendar days and that corrective action is taken if necessary to protect 
244.22 	the health and safety of children in care. The review must include an evaluation of whether:
244.23 	(i) related policies and procedures were followed;
244.24 	(ii) the policies and procedures were adequate;
244.25 	(iii) there is a need for additional staff training;
244.26 	(iv) the reported event is similar to past events with the children or the services involved; 
244.27 	and
244.28 	(v) there is a need for corrective action by the license holder to protect the health and 
244.29 	safety of children in care;
245.1 	(2) develop, document, and implement a corrective action plan designed to correct any 
245.2 	current lapses and prevent future lapses in performance by individuals or the license holder, 
245.3 	based on the results of the review;
245.4 	(3) identify the primary and secondary person or position who will ensure that, when 
245.5 	required, internal reviews are completed. The secondary person must be involved when 
245.6 	there is reason to believe that the primary person was involved in the alleged or suspected 
245.7 	maltreatment; and
245.8 	(4) document and make internal reviews accessible to the commissioner immediately 
245.9 	upon the commissioner's request. For the purposes of this section, the documentation provided 
245.10 	to the commissioner by the license holder may consist of a completed checklist that verifies 
245.11 	completion of each of the requirements of the review.

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

245.17 	Sec. 39. REVISOR INSTRUCTION.
 245.18 	(a) The revisor of statutes must renumber Minnesota Statutes, section 142B.68, as 
245.19 	Minnesota Statutes, section 142H.37.
245.20 	(b) The revisor of statutes must make any necessary changes to statutory cross-references 
245.21 	to reflect the changes in this article.
245.22 	(c) The revisor of statutes must replicate the statutory history for all sections and 
245.23 	subdivisions repealed and reenacted in this article.

245.24 	Sec. 40. REPEALER.
 245.25 	(a) Minnesota Rules, parts 9503.0005; 9503.0010; 9503.0015; 9503.0030; 9503.0031; 
245.26 	9503.0032; 9503.0033; 9503.0034; 9503.0040; 9503.0045; 9503.0050; 9503.0055; 
245.27 	9503.0060; 9503.0065; 9503.0070; 9503.0075; 9503.0080; 9503.0085; 9503.0090; 
245.28 	9503.0095; 9503.0100; 9503.0105; 9503.0110; 9503.0115; 9503.0120; 9503.0125; 
245.29 	9503.0130; 9503.0140; 9503.0145; 9503.0150; 9503.0155; and 9503.0170, are repealed.
246.1 	(b) Minnesota Statutes 2024, sections 142B.01, subdivisions 11, 12, 25, 26, and 27; 
246.2 	142B.41, subdivisions 6, 7, 10, 11, 12, and 13; 142B.54, subdivisions 1, 2, and 3; 142B.65, 
246.3 	subdivisions 1, 2, 3, 4, 5, 6, 7, and 10; and 142B.66, subdivisions 1, 2, 4, and 5, are repealed.
246.4 	(c) Minnesota Statutes 2025 Supplement, sections 142B.65, subdivisions 8 and 9; and 
246.5 	142B.66, subdivision 3, are repealed.

246.6 	Sec. 41. EFFECTIVE DATE.
 246.7 	This article is effective July 1, 2027.

246.8 	ARTICLE 13
246.9 	FAMILY CHILD CARE LICENSING MODERNIZATION

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

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

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

254.13 	Sec. 4. [142I.04] AGENCY RECORDS.
254.14 		Subdivision 1.Agency records. An agency must maintain the following records for 
254.15 	each license holder:
254.16 	(1) a copy of the completed licensing application form signed by the applicant and the 
254.17 	agency;
254.18 	(2) a physical health report on any adult caregiver that was submitted prior to giving 
254.19 	care in the family child care program. The physical health report must verify that the adult 
254.20 	caregiver is physically able to care for children;
254.21 	(3) any written reports from a fire marshal, building official, or agent of a community 
254.22 	health board authorized under chapter 145A;
254.23 	(4) if the applicant has been licensed through another jurisdiction, a reference from the 
254.24 	licensing authority in that jurisdiction;
254.25 	(5) the initial and annual inspection by the agency of the license holder. Any comments 
254.26 	of the license holder about the inspections by the agency must also be noted in the agency 
254.27 	record;
254.28 	(6) a copy of the notification given to parents, prior to a child's admission, indicating 
254.29 	that pets are present in the residence and documentation as required in section 142I.19, 
254.30 	subdivision 4;
254.31 	(7) documentation of any variance requests and the approval or denial of the request in 
254.32 	accordance with section 142I.03; and
255.1 	(8) the results of each background study required under chapter 245C.
255.2 		Subd. 2.Data privacy. The agency, commissioner, and authorized agent as defined in 
255.3 	section 142B.01, subdivision 5, must have access to license holder records on children in 
255.4 	care to determine compliance with this chapter. All caregivers must maintain the privacy 
255.5 	of records on children by refraining from discussing or disclosing any records, including 
255.6 	electronic records, or information on children in care to any persons other than the parent 
255.7 	of the child, the agency, the commissioner, and medical or public safety persons if the 
255.8 	information is necessary to protect the health and safety of the child.

255.9 	Sec. 5. [142I.05] REPORTING TO AGENCY.
255.10 		Subdivision 1.Maltreatment, abuse, and neglect reporting. All caregivers who suspect, 
255.11 	know, or have reason to believe a child is being or has been maltreated under section 260E.03, 
255.12 	subdivision 12, must immediately report the information to the local welfare agency, agency 
255.13 	responsible for assessing or investigating the report, police department, county sheriff, 
255.14 	Tribal social services agency, or Tribal police as required by chapter 260E.
255.15 		Subd. 2.Other reporting. Primary providers of care must notify the agency:
255.16 	(1) prior to anyone moving into the residence where family child care services are 
255.17 	provided. A background study must be completed in accordance with section 245C.13, 
255.18 	subdivision 2;
255.19 	(2) within ten calendar days after a household member has moved out of the residence 
255.20 	where family child care services are provided;
255.21 	(3) before a new caregiver provides direct contact services for the first time, unless an 
255.22 	individual is acting as an emergency replacement according to section 142I.09, subdivision 
255.23 	2;
255.24 	(4) of any damage to the premises that may affect compliance with this chapter or any 
255.25 	incident at the premises that results in the loss of utility services, within 24 hours after the 
255.26 	occurrence;
255.27 	(5) within 24 hours after the occurrence of any serious injury, head injury, hospitalization, 
255.28 	or death of a child in care. For the purposes of this clause, "serious injury" means an injury 
255.29 	that reasonably requires the care of a health care provider or dentist; and
255.30 	(6) within 24 hours after the occurrence of an animal bite in accordance with section 
255.31 	142I.19, subdivision 4.

256.1 	Sec. 6. [142I.06] ADMISSIONS; RECORDS; REPORTING.
256.2 		Subdivision 1.Admission and ongoing information. (a) Prior to admission of a child 
256.3 	and annually while the child is enrolled, the parents and primary provider of care must 
256.4 	discuss family child care program policies and licensing requirements.
256.5 	(b) The license holder must not disclose a child's record to any person other than the 
256.6 	child, the child's parent or guardian, the child's legal representative, employees of the license 
256.7 	holder, and the agency unless the child's parent or guardian has given written consent or as 
256.8 	otherwise required by law.
256.9 		Subd. 2.Statutory summary for parents. A descriptive summary of this chapter must 
256.10 	be distributed to the parent by the license holder at the time a child is admitted to care. The 
256.11 	summary must be provided by the department to the agencies for distribution to license 
256.12 	holders and must:
256.13 	(1) state that this chapter and chapter 142B govern the licensing of family child care 
256.14 	programs;
256.15 	(2) specify the section headings contained in this chapter; and
256.16 	(3) state that a complete copy of this chapter is available at the family child care program, 
256.17 	agency, department, or State Law Library or through the revisor of statutes website.
256.18 		Subd. 3.Parental access. A parent who has enrolled a child must be allowed access to 
256.19 	the child and the licensed space at any time while the child is in care unless a court order 
256.20 	or other legal documentation restricts access. A copy of the order or other legal 
256.21 	documentation must be kept in the child's record at the family child care program.
256.22 		Subd. 4.Attendance records. A license holder must maintain documentation of 
256.23 	attendance for each child receiving care for a minimum of five years. The records must be 
256.24 	accessible to the commissioner during the family child care program's hours of operation, 
256.25 	must be completed on the day of attendance, and must include:
256.26 	(1) the first and last name of the child;
256.27 	(2) the time of day that the child was dropped off; and
256.28 	(3) the time of day that the child was picked up.
256.29 		Subd. 5.License holder policies. (a) The license holder must follow and monitor 
256.30 	implementation of the policies and procedures by all caregivers as required in section 
256.31 	142B.10, subdivision 21.
257.1 	(b) When applicable for the program, the license holder must have written policies 
257.2 	available for discussion with parents and the commissioner and provide an electronic or 
257.3 	hard copy to the parent at the time of admission or upon request. The policies must include, 
257.4 	at a minimum:
257.5 	(1) program operation policies, including:
257.6 	(i) the ages and numbers of children the family child care program is licensed to serve;
257.7 	(ii) the hours and days of operation, including plans for holiday closings, personal time, 
257.8 	and policies for inclement weather closings;
257.9 	(iii) fees, including payment schedule, overtime charges, and registration fees as 
257.10 	applicable;
257.11 	(iv) parental access to the family child care program that states a parent who enrolls a 
257.12 	child must be allowed access to the child and the licensed space at any time while the child 
257.13 	is in care;
257.14 	(v) nondiscrimination practices to comply with section 142I.21;
257.15 	(vi) the termination of child care and expulsion notice procedures; and
257.16 	(vii) the use of a helper, a substitute for personal leave or holidays, and an emergency 
257.17 	substitute according to the licensing requirements in section 142I.09;
257.18 	(2) health and safety policies, including on:
257.19 	(i) allergy prevention and response;
257.20 	(ii) the administration and storage of medication and topical products;
257.21 	(iii) the care of ill children, isolation precautions, symptoms for discharge and return, 
257.22 	immunizations, medicine permission policies, and whether the license holder will care for 
257.23 	an ill child;
257.24 	(iv) disease notification procedures, including notifying the parents of exposed children 
257.25 	within 24 hours of a parent or caregiver notifying the license holder of a reportable disease 
257.26 	under section 142I.19, subdivision 9. The notice must be posted in a clearly visible, accessible 
257.27 	place or provided individually to each parent of a child who was exposed;
257.28 	(v) meals, snacks, infant formula, breast milk, and supplemental foods to be provided, 
257.29 	including labeling requirements for food brought from the child's home;
257.30 	(vi) sleeping and resting arrangements;
258.1 	(vii) emergency procedures, fire and storm plans, and transportation in an emergency, 
258.2 	including whether parent permission is required;
258.3 	(viii) how the license holder prevents abuse of prescription medication or being in any 
258.4 	manner under the influence of a chemical that impairs the caregiver's ability to provide 
258.5 	services or care as required under section 142B.10, subdivision 1, paragraph (c); and
258.6 	(ix) the legal requirements for firearms in a family child care program through a statement 
258.7 	that must include the language under section 142I.19, subdivision 7; and
258.8 	(3) program environment policies, including:
258.9 	(i) behavior guidance and discipline;
258.10 	(ii) field trips, including by foot, and whether parent permission is required;
258.11 	(iii) the presence of pets in the family child care program, including notification prior 
258.12 	to the introduction of a new pet to the program;
258.13 	(iv) the use of screen time; and
258.14 	(v) the use of social media, images, and video in accordance with subdivision 7.
258.15 		Subd. 6.Records for each child. (a) The license holder must obtain the records in this 
258.16 	subdivision from parents prior to the admission of a child. The license holder must keep 
258.17 	this information up to date and on file for each child.  The license holder must have a parent 
258.18 	annually review the information in a child's record, update the information as necessary, 
258.19 	and keep the information on file.
258.20 	(b) For each enrolled child, the license holder must maintain a signed and completed 
258.21 	admission and arrangement form, as prescribed by the commissioner, and a completed 
258.22 	enrollment form, as developed and approved by the commissioner.
258.23 	(c) Immunization records must be kept in accordance with section 121A.15 and Minnesota 
258.24 	Rules, chapter 4604. Prior to enrollment, a license holder must request a child's immunization 
258.25 	record. The record must be kept on file and updated as follows:
258.26 	(1) for an infant, every six months;
258.27 	(2) for a toddler, annually;
258.28 	(3) for a preschooler, every 18 months; and
258.29 	(4) for a school-age child, every three years.
259.1 	(d) For each enrolled child, the license holder must obtain signed written consent from 
259.2 	a parent allowing the license holder to obtain emergency medical care or treatment for the 
259.3 	child.
259.4 	(e) A license holder must release a child from care only to a parent or other person 
259.5 	authorized in writing by the parent. The information must be reviewed at least annually by 
259.6 	the parent and updated when information changes.
259.7 		Subd. 7.Social media, images, and video sharing. (a) Caregivers are prohibited from 
259.8 	sharing photos, videos, or other personal identifying information of enrolled children, except 
259.9 	to provide updates to parents who have provided written consent. If a license holder wishes 
259.10 	to use photos or videos of the family child care program and the enrolled children for 
259.11 	promotional or publicity purposes, including on social media accounts or public digital 
259.12 	platforms, the license holder must obtain written consent from parents prior to use.
259.13 	(b) Notwithstanding paragraph (a), the license holder must share photos, videos, and 
259.14 	other personal identifying information of enrolled children with the commissioner upon 
259.15 	request.
259.16 		Subd. 8.Nondiscrimination. A caregiver is prohibited from discriminating in relation 
259.17 	to enrollment in their program based on race, color, creed, religion, national origin, sex, 
259.18 	gender identity, marital status, disability, sexual orientation, or familial status.

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

259.27259.28
259.29259.30	Class
	Capacity
	Minimum 
Adult 
Caregivers
	Maximum 
Children 
Under School 
Age
	Maximum 
Total Infants 
and Toddlers
	Maximum 
Infants
	
259.31	A
	10
	1
	6
	3
	2
	
259.32 	(c) License holders with a class C license must meet the following requirements:

260.1260.2
260.3260.4	Class
	Capacity
	Minimum 
Adult 
Caregivers
	Maximum 
Children 
Under School 
Age
	Maximum 
Total Infants 
and Toddlers
	Maximum 
Infants
	
260.5	C1
	5
	1
	5
	3
	3
	
260.6	C2
	10
	1
	8
	4
	2
	
260.7	C3
	12
	1
	10
	3
	2
	
260.8	C4
	14
	2
	10
	6
	4
	
260.9	C5
	18
	2
	12
	5
	2
	
260.10 		Subd. 3.Newborn care. When a newborn is in care and only one adult caregiver is 
260.11 	present, the newborn must be the only child under 12 months of age present, and the license 
260.12 	holder must not care for more than two other children at the same time unless the newborn 
260.13 	is the license holder's child. When a second adult caregiver is also present or the newborn 
260.14 	is the child of the license holder, then the newborn is considered an infant for the purposes 
260.15 	of child-to-adult ratios and age distribution restrictions.
260.16 		Subd. 4.Supervision, primary provider of care, and use of substitutes. (a) Children 
260.17 	in care must be supervised by an adult caregiver. The adult caregiver must have knowledge 
260.18 	of each child's needs, including but not limited to developmental and behavioral needs and 
260.19 	parental preferences, and be accountable for each child's care at all times. A caregiver must 
260.20 	be within sight or hearing of newborns, infants, toddlers, and preschoolers at all times 
260.21 	without the use of monitoring devices, except as provided in section 142I.18.
260.22 	(b) The primary provider of care must be the primary caregiver in the family child care 
260.23 	program unless a substitute is being used in accordance with section 142I.09. A helper may 
260.24 	be used in place of a second adult caregiver when there is no more than one newborn, infant, 
260.25 	or toddler present.
260.26 	(c) The use of a substitute caregiver must be in accordance with section 142I.09.
260.27 		Subd. 5.Overnight care. When a family child care program has a child in care after 11 
260.28 	p.m. and before 5 a.m.:
260.29 	(1) at least one adult caregiver must remain awake and available to respond to children's 
260.30 	needs at all times. The program must maintain required caregiver-to-child ratios. Additional 
260.31 	caregivers may sleep when ratios are maintained and must be available to resume supervision 
260.32 	when needed;
260.33 	(2) all awake children must be given the opportunity to engage in age-appropriate 
260.34 	activities in a separate room away from sleeping children; and
260.35 	(3) the child care emergency plan must include a plan tailored to sleeping children.
261.1 		Subd. 6.Class C5 licenses. (a) Class C5 licenses must always operate at the level of 
261.2 	exit discharge.
261.3 	(b) A family child care program with a class C license may operate as a lower C-class 
261.4 	level family child care program on days when the adult-to-child ratios allow it to operate 
261.5 	at a lower capacity.
261.6 		Subd. 7.Care of the license holder's own child or children. (a) With the license 
261.7 	holder's consent, an individual may be present in the licensed space and care for the license 
261.8 	holder's own child both inside and outside of the licensed space and is exempt from the 
261.9 	training and supervision requirements of section 142I.10 if the individual:
261.10 	(1) is related to the license holder or to the license holder's child, as defined in section 
261.11 	142I.01, subdivision 40, or is a household member who the license holder has reported to 
261.12 	the county agency;
261.13 	(2) is not a caregiver for the family child care program at the time that they are supervising 
261.14 	the license holder's own child;
261.15 	(3) only cares for the license holder's own child; and
261.16 	(4) does not have direct, unsupervised contact with any nonrelative children in care.
261.17 	(b) If the individual in paragraph (a) is not a household member, the individual is also 
261.18 	exempt from background study requirements under chapter 245C.
261.19 	(c) Where a caregiver is also a parent providing care to their own child in the family 
261.20 	child care program, sections 142I.13; 142I.17; 142I.20, subdivisions 1 to 3; and 142I.21 do 
261.21 	not apply to caregivers with regards to the care of their own children.
261.22 	(d) Notwithstanding paragraph (c), family child care programs with license holders or 
261.23 	caregivers providing care to their own child are not exempt from the capacity, ratio, and 
261.24 	age distribution requirements under this section. License holders and caregivers remain 
261.25 	subject to chapters 260E and 609 and other applicable statutes and rules.
261.26 	(e) Notwithstanding paragraph (c), the agency may enforce the standards in sections 
261.27 	142I.13; 142I.17; 142I.20, subdivisions 1 to 3; and 142I.21 when the caregiver's actions 
261.28 	with regards to the care of their own children affect the other children in the caregiver's 
261.29 	care.

261.30 	Sec. 8. [142I.08] QUALIFICATIONS.
261.31 		Subdivision 1.Age. An applicant for a family child care license must be an adult at the 
261.32 	time of application.
262.1 		Subd. 2.Physical and behavioral health. (a) An adult caregiver must be physically 
262.2 	and mentally able to care for children. An applicant or primary provider of care must provide 
262.3 	documentation to the agency along with the license application verifying that the applicant 
262.4 	has had a physical examination by a licensed physician, advanced practice registered nurse, 
262.5 	or physician assistant within 12 months prior to the application for initial licensure and that 
262.6 	the applicant or primary provider of care is physically able to care for children. Prior to 
262.7 	assisting in the care of children, the applicant must also provide documentation verifying 
262.8 	that any adult caregiver has had a physical examination by a licensed physician, advanced 
262.9 	practice registered nurse, or physician assistant within the past 12 months and is physically 
262.10 	able to care for children.
262.11 	(b) The commissioner may require a caregiver to provide reports on the caregiver's 
262.12 	physical or mental health from a health care provider when there is reason to believe that 
262.13 	a caregiver exhibits physical or mental health symptoms that could impair the caregiver's 
262.14 	ability to ensure the health and safety of children. The reports must not be used for any other 
262.15 	purpose than to determine whether the caregiver's physical or mental health impacts the 
262.16 	health and safety of children.
262.17 		Subd. 3.Additional class C5 license requirements. (a) An applicant or primary provider 
262.18 	of care receiving a class C5 license must have at least one of:
262.19 	(1) a minimum of one year of substantial compliance with this chapter as a 
262.20 	Minnesota-licensed family child care license holder, primary provider of care, or second 
262.21 	adult caregiver and a minimum of 1500 hours of direct care in a family child care program 
262.22 	serving children;
262.23 	(2) a minimum of six months of substantial compliance with this chapter as a family 
262.24 	child care license holder, primary provider of care, or second adult caregiver in Minnesota 
262.25 	and:
262.26 	(i) a minimum of 520 hours of experience as an assistant teacher, student teacher, or 
262.27 	intern in an elementary school, after-school program, or Minnesota-licensed child care 
262.28 	center or as an adult caregiver in a Minnesota-licensed family child care program and 30 
262.29 	hours of child care, health, and nutrition training as specified in section 142I.10; or
262.30 	(ii) a minimum of 520 hours of experience as a licensed practical or registered nurse, 
262.31 	and 30 hours of child development or early childhood education training, as specified in 
262.32 	section 142I.10;
262.33 	(3) certification or licensure indicating completion of one of the following:
263.1 	(i) a two-year child development or early childhood education associate or certificate 
263.2 	program at an accredited college or university;
263.3 	(ii) a child development associate certification;
263.4 	(iii) a certification from a recognized Montessori organization;
263.5 	(iv) a bachelor's degree or higher in early childhood education from an accredited college 
263.6 	or university; or
263.7 	(v) an elementary education degree from an accredited college or university that includes 
263.8 	a minimum of 30 hours of child development training; or
263.9 	(4) six months' experience working an average of 30 hours a week or more as a teacher, 
263.10 	as defined in section 142H.06, at a Minnesota-licensed child care center.
263.11 	(b) An applicant or primary provider of care must complete an additional large group 
263.12 	training created by the commissioner as a condition of receiving a class C5 license.

263.13 	Sec. 9. [142I.09] SUBSTITUTE CAREGIVERS AND REPLACEMENTS.
263.14 		Subdivision 1.Total hours allowed. The use of a substitute caregiver in a family child 
263.15 	care program is limited to a cumulative total of not more than 500 hours annually. When a 
263.16 	substitute is used, prior to the end of each business day the license holder must document 
263.17 	the name, date, and number of hours of each substitute who provided care.
263.18 		Subd. 2.Emergency replacement supervision. (a) In an emergency, a license holder 
263.19 	may allow an adult who has not completed the training requirements under this chapter or 
263.20 	the background study requirements under chapter 245C to supervise children in a family 
263.21 	child care program. For purposes of this subdivision, "emergency" means a situation in 
263.22 	which the license holder has begun operating the family child care program for the day and 
263.23 	for reasons beyond the control of the license holder, including but not limited to a serious 
263.24 	illness or injury, accident, or situation requiring the immediate attention of the license holder, 
263.25 	the license holder needs to leave the licensed space and close the program for the day.
263.26 	(b) To the extent practicable, the license holder must attempt to arrange for emergency 
263.27 	care by a substitute caregiver before using an emergency replacement.
263.28 	(c) When an emergency occurs:
263.29 	(1) the license holder or emergency replacement must contact the parents of the children 
263.30 	attending the family child care program and inform the parents that the program is closing 
263.31 	for the day and that the children need to be picked up as soon as practicable;
264.1 	(2) the license holder must not knowingly use a person as an emergency replacement 
264.2 	who has committed an action or has been convicted of a crime that would cause the person 
264.3 	to be disqualified from providing care to children if a background study was conducted 
264.4 	under chapter 245C;
264.5 	(3) the license holder must make reasonable efforts to minimize the amount of time the 
264.6 	emergency replacement has unsupervised contact with the children in care not to exceed 
264.7 	12 hours per emergency incident;
264.8 	(4) the family child care program must be closed for the day once the last unrelated child 
264.9 	has left the program; and
264.10 	(5) the license holder must notify the county licensing agency within seven days that an 
264.11 	emergency replacement was used and specify the circumstances that led to the use of the 
264.12 	emergency replacement.
264.13 	(d) The county licensing agency must notify the commissioner within three business 
264.14 	days after receiving the license holder's notice that an emergency replacement was used and 
264.15 	specify to the commissioner the circumstances that led to the use of the emergency 
264.16 	replacement.
264.17 	(e) A license holder is not required to provide the names of persons who may be used 
264.18 	as replacements in emergencies to parents or the county licensing agency. However, once 
264.19 	an emergency replacement has been used, the license holder must provide the name of the 
264.20 	individual used to the county licensing agency.

264.21 	Sec. 10. [142I.10] APPLICANT, PRIMARY PROVIDER OF CARE, AND SECOND 
264.22 	ADULT CAREGIVER TRAINING REQUIREMENTS.
264.23 		Subdivision 1.Initial training; applicant, primary provider of care, and second 
264.24 	adult caregiver. (a) Before providing care, an applicant, a primary provider of care, and 
264.25 	each second adult caregiver must have completed all required initial training within the 
264.26 	prior 24 months.
264.27 	(b) Initial training does not need to be completed before providing care in the following 
264.28 	circumstances:
264.29 	(1) a primary provider of care who voluntarily closes a license and reopens within 12 
264.30 	months has one year from the new license's effective date to complete annual and ongoing 
264.31 	training and is exempt from repeating initial training;
265.1 	(2) a primary provider of care who relocates within the state has until the end of the 
265.2 	calendar year to complete annual and ongoing training and is not required to repeat initial 
265.3 	training previously completed; and
265.4 	(3) a primary provider of care who relocates to a new county must not be required by 
265.5 	the new county to complete orientation or other training required for new applicants.
265.6 	(c) Each applicant, primary provider of care, and second adult caregiver must complete 
265.7 	and document the following before providing care:
265.8 	(1) at least four hours of child development, learning, or behavior guidance training. An 
265.9 	individual is exempt if the individual provides documentation verifying that the individual:
265.10 	(i) has completed a three-credit early childhood development course within the past five 
265.11 	years;
265.12 	(ii) holds a baccalaureate or master's degree in early childhood education or school-age 
265.13 	child care;
265.14 	(iii) holds a Minnesota teaching license in early childhood education, kindergarten 
265.15 	through grade 6, or special education; or
265.16 	(iv) holds a Montessori certificate;
265.17 	(2) the six-hour supervising for safety for family child care course developed by the 
265.18 	commissioner;
265.19 	(3) pediatric first aid training provided by an instructor certified to teach pediatric first 
265.20 	aid. Current training documentation must be maintained at the family child care program 
265.21 	and made available upon request. Online training reviewed and approved by the county 
265.22 	licensing agency satisfies this requirement;
265.23 	(4) pediatric cardiopulmonary resuscitation (CPR) training that:
265.24 	(i) is instructor led or blended with a hands-on skills component. Online-only CPR 
265.25 	courses without a hands-on component do not meet this requirement;
265.26 	(ii)(A) is developed by the American Heart Association or the American Red Cross; or
265.27 	(B) uses nationally recognized, evidence-based guidelines for CPR training; and
265.28 	(iii) is provided by an instructor approved by the commissioner to teach CPR;
265.29 	(5) for programs licensed for children younger than school age, training on reducing the 
265.30 	risk of sudden unexpected infant death and abusive head trauma, which may be combined 
265.31 	in a single commissioner-approved course. This training must, at a minimum, address the 
266.1 	risk factors related to sudden unexpected infant death and abusive head trauma and the 
266.2 	means of reducing the risk of each;
266.3 	(6) training on proper use and installation of child passenger restraint systems under 
266.4 	section 169.685 of at least one hour in length that is provided by an instructor certified and 
266.5 	approved by the Department of Public Safety. At a minimum, the training must address the 
266.6 	proper use of child restraint systems based on the child's size, weight, and age and the proper 
266.7 	installation of a car seat or booster seat in the motor vehicle used by the caregiver to transport 
266.8 	the child or children. This requirement does not apply to family child care programs that 
266.9 	transport only school-age children as defined in section 142I.01, subdivision 5, paragraph 
266.10 	(e), in child care buses as defined in section 169.448, subdivision 1, paragraph (e);
266.11 	(7) training on the child care emergency plan required under section 142I.19, subdivision 
266.12 	2;
266.13 	(8) training on allergy prevention and response required under section 142I.06, 
266.14 	subdivision 5, paragraph (b);
266.15 	(9) training on the community-based family child care program plan required under 
266.16 	section 142I.22, if applicable;
266.17 	(10) training on the family child care program policies and procedures required under 
266.18 	section 142I.06;
266.19 	(11) training on reporting suspected maltreatment of children as required under chapter 
266.20 	260E; and
266.21 	(12) swimming pool training under section 142I.14, subdivision 6, if a pool at the family 
266.22 	child care program is used by children in care.
266.23 	(d) County licensing staff must accept approved training on the primary provider of care 
266.24 	or second adult caregiver's learning record in the Develop data system for early education 
266.25 	and school-age care.
266.26 		Subd. 2.Annual training; primary provider of care and second adult caregiver. (a) 
266.27 	A primary provider of care and each second adult caregiver must annually complete and 
266.28 	document the following training:
266.29 	(1) at least two hours of child development, learning, or behavior guidance training. A 
266.30 	three-credit early childhood development course completed within the calendar year meets 
266.31 	this requirement;
266.32 	(2) a two-hour active supervision course developed or approved by the commissioner;
267.1 	(3) training on reducing the risk of sudden unexpected infant death if caring for infants 
267.2 	and training on reducing the risk of abusive head trauma if caring for children under school 
267.3 	age, which must:
267.4 	(i) be completed in person or online at least once every two years; and
267.5 	(ii) in alternating years, be completed through a commissioner-approved video not 
267.6 	exceeding one hour in length; and
267.7 	(4) at least four hours of ongoing training each calendar year that must include topics 
267.8 	identified in the Minnesota knowledge and competency framework. Repeat of topical training 
267.9 	requirements in subdivision 1 counts toward the annual ten-hour requirement.
267.10 	(b) A caregiver who is approved as a trainer through the Develop data system may count 
267.11 	up to two hours of training instruction toward the annual ten-hour training requirement in 
267.12 	paragraph (a), clause (4), if:
267.13 	(1) the training is the first instance in which the caregiver delivers a particular 
267.14 	content-specific training during each training year;
267.15 	(2) the caregiver is a Develop-approved active trainer; and
267.16 	(3) the hours counted as training instruction are approved through the Develop data 
267.17 	system with attendance verified on the trainer's individual learning record and are in the 
267.18 	knowledge and competency framework content areas VII A, establishing healthy practices, 
267.19 	or B, ensuring safety.
267.20 	(c) Unless specifically authorized in this section, one training does not fulfill two different 
267.21 	training requirements. Courses within the identified knowledge and competency areas that 
267.22 	are specific to child care centers or legal nonlicensed programs do not fulfill the requirements 
267.23 	of this section.
267.24 	(d) County licensing staff must accept training designated by the commissioner as 
267.25 	satisfying training requirements if the training is within the knowledge and competency 
267.26 	framework for child development and learning, behavior guidance, and active supervision 
267.27 	as indicated on the department's website.
267.28 		Subd. 3.Ongoing training; primary provider of care and second adult caregiver. (a) 
267.29 	A primary provider of care and each second adult caregiver must complete and document 
267.30 	the following training:
267.31 	(1) pediatric cardiopulmonary resuscitation training that meets the requirements of 
267.32 	subdivision 1, paragraph (c), clause (4), and is repeated every two years within 90 days of 
268.1 	the second anniversary of the previous training. Documentation must be maintained at the 
268.2 	family child care program or electronically and made available upon request;
268.3 	(2) pediatric first aid training by a certified instructor repeated every two years within 
268.4 	90 days of the second anniversary of the previous training. Documentation of the training 
268.5 	must be maintained at the family child care program or electronically and made available 
268.6 	upon request;
268.7 	(3) commissioner-developed Health and Safety I and Health and Safety II training at 
268.8 	least once every five years. Completion of either course in a given year meets the annual 
268.9 	active supervision training requirement in subdivision 2, paragraph (a), clause (2);
268.10 	(4) proper use and installation of child passenger restraint systems under section 169.685 
268.11 	that meets the requirements of subdivision 1, paragraph (c), clause (6), and is repeated at 
268.12 	least once every five years. This requirement does not apply to family child care programs 
268.13 	that transport only school-age children as defined in section 142I.01, subdivision 5, paragraph 
268.14 	(e), in child care buses as defined in section 169.448, subdivision 1, paragraph (e); and
268.15 	(5) fire safety training developed by the State Fire Marshal's Office that must be 
268.16 	completed once every five years.
268.17 	(b) If a license holder changes any of the policies and procedures under section 142I.06, 
268.18 	subdivision 5, the primary provider of care and each second adult caregiver must review 
268.19 	the revised policies and procedures within ten days of the change.
268.20 	(c) The license holder must maintain documentation of each review of the revised policies 
268.21 	and procedures at the family child care program. The documentation requirements under 
268.22 	this paragraph may be met by a date noted on the revised policies or procedures.
268.23 		Subd. 4.Commissioner designated training. Training designated by the commissioner 
268.24 	satisfies the training requirements under this section if the training is within the knowledge 
268.25 	and competency framework for child development and learning, behavior guidance, and 
268.26 	active supervision, as indicated on the department's website.

268.27 	Sec. 11. [142I.11] SUBSTITUTE AND INTERMITTENT CAREGIVER TRAINING 
268.28 	REQUIREMENTS.
268.29 		Subdivision 1.Initial training; substitute and intermittent caregiver. (a) Before 
268.30 	providing care, each substitute and intermittent caregiver must complete the following 
268.31 	training requirements within the previous 12 months:
269.1 	(1) the four-hour basics of family child care for substitutes course developed by the 
269.2 	commissioner;
269.3 	(2) pediatric first aid training provided by an instructor certified to teach pediatric first 
269.4 	aid. Current training documentation must be maintained at the family child care program 
269.5 	and made available upon request. Online training reviewed and approved by the county 
269.6 	licensing agency satisfies this requirement;
269.7 	(3) pediatric cardiopulmonary resuscitation  training that meets the requirements of 
269.8 	section 142I.10, subdivision 1, paragraph (c), clause (4);
269.9 	(4) for programs licensed for children younger than school age, training on reducing the 
269.10 	risk of sudden unexpected infant death and abusive head trauma, which may be combined 
269.11 	in a single commissioner-approved course. This training must, at a minimum, address the 
269.12 	risk factors related to sudden unexpected infant death and abusive head trauma and the 
269.13 	means of reducing the risk of each;
269.14 	(5) training on proper use and installation of child passenger restraint systems under 
269.15 	section 169.685 of at least one hour in length, provided by an instructor certified and 
269.16 	approved by the Department of Public Safety. This requirement does not apply to family 
269.17 	child care programs that transport only school-age children as defined in section 142I.01, 
269.18 	subdivision 5, paragraph (e), in child care buses as defined in section 169.448, subdivision 
269.19 	1, paragraph (e). At a minimum, the training must address the proper use of child restraint 
269.20 	systems based on the child's size, weight, and age and the proper installation of a car seat 
269.21 	or booster seat in the motor vehicle used by the caregiver to transport the child or children;
269.22 	(6) training on the child care emergency plan required under section 142I.19, subdivision 
269.23 	2;
269.24 	(7) training on allergy prevention and response required under section 142I.06, 
269.25 	subdivision 5, paragraph (b);
269.26 	(8) training on the community-based family child care program plan required under 
269.27 	section 142I.22, if applicable;
269.28 	(9) training on the family child care program policies and procedures required under 
269.29 	section 142I.06;
269.30 	(10) training on reporting suspected maltreatment of children as required under chapter 
269.31 	260E; and
269.32 	(11) swimming pool training under section 142I.14, subdivision 6, if a pool at the family 
269.33 	child care program is used by children in care.
270.1 	(b) County licensing staff must accept approved training on the substitute or intermittent 
270.2 	caregiver's learning record in the Develop data system for early education and school-age 
270.3 	care.
270.4 		Subd. 2.Annual training; substitute and intermittent caregiver. (a) Substitutes and 
270.5 	intermittent caregivers must complete a minimum of one hour of training each calendar 
270.6 	year, and the training must include the requirements in this section.
270.7 	(b) Each calendar year, a substitute or intermittent caregiver must receive training on 
270.8 	reducing the risk of abusive head trauma from shaking infants and young children if caring 
270.9 	for children under school age and reducing the risk of sudden unexpected infant death if 
270.10 	caring for infants. A substitute must complete each applicable course at least once every 
270.11 	two years either in person or online. In a year a substitute or intermittent caregiver is not 
270.12 	completing an applicable course under this paragraph in person or online, the individual 
270.13 	must watch a video on the respective topic of no more than one hour in length. The video 
270.14 	must be developed or approved by the commissioner. A license holder must maintain 
270.15 	documentation of compliance with this paragraph for each substitute and intermittent 
270.16 	caregiver employed.
270.17 		Subd. 3.Ongoing training; substitute and intermittent caregiver. (a) At least once 
270.18 	every three years, a substitute or intermittent caregiver must complete the four-hour basics 
270.19 	of family child care for substitutes course.
270.20 	(b) A substitute or intermittent caregiver must complete the following training:
270.21 	(1) pediatric cardiopulmonary resuscitation training  that meets the requirements of 
270.22 	section 142I.10, subdivision 1, paragraph (c), clause (4), and is repeated every two years 
270.23 	within 90 days of the second anniversary of the previous training. Documentation must be 
270.24 	maintained at the family child care program or electronically and made available upon 
270.25 	request;
270.26 	(2) pediatric first aid that is given by an instructor certified to provide pediatric first aid 
270.27 	and is repeated every two years within 90 days of the second anniversary of the previous 
270.28 	training. Documentation of the training must be maintained at the family child care program 
270.29 	or electronically and made available upon request; and
270.30 	(3) proper use and installation of child passenger restraint systems under section 169.685 
270.31 	that meets the requirements of section 142I.10, subdivision 1, paragraph (c), clause (6), and 
270.32 	is repeated at least once every five years. This requirement does not apply to family child 
270.33 	care programs that transport only school-age children as defined in section 142I.01, 
271.1 	subdivision 5, paragraph (e), in child care buses as defined in section 169.448, subdivision 
271.2 	1, paragraph (e).

271.3 	Sec. 12. [142I.12] HELPER TRAINING REQUIREMENTS.
271.4 		Subdivision 1.Initial training; helper. (a) Before assisting in care, a helper who assists 
271.5 	with care must complete a minimum of four hours of training within the previous 12 months. 
271.6 	The four hours must include courses on:
271.7 	(1) reducing the risk of sudden unexpected infant death if the program is licensed to care 
271.8 	for infants;
271.9 	(2) abusive head trauma if the program is licensed to care for children younger than 
271.10 	school age; and
271.11 	(3) reporting suspected maltreatment of children as required under chapter 260E.
271.12 	(b) The trainings required under paragraph (a) may be combined in a single 
271.13 	commissioner-approved course.
271.14 	(c) A license holder must maintain written or electronic documentation showing that 
271.15 	each helper has complied with this subdivision.
271.16 		Subd. 2.Annual training; helper. (a) Each calendar year, a helper who assists in the 
271.17 	care of children must receive training on reducing the risk of sudden unexpected infant 
271.18 	death if the program is licensed to care for infants, and abusive head trauma if the program 
271.19 	is licensed to care for children younger than school age. The trainings under this paragraph 
271.20 	may be combined in a single commissioner-approved course and must, at a minimum, 
271.21 	address risk factors, methods of risk reduction in child care, and communication with parents 
271.22 	regarding risk reduction.
271.23 	(b) A license holder must maintain documentation showing each helper has complied 
271.24 	with this subdivision.
271.25 	(c) County licensing staff must accept approved training on the helper's learning record 
271.26 	in the Develop data system.

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

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

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

283.12 	Sec. 16. [142I.16] ENVIRONMENTAL HEALTH.
283.13 		Subdivision 1.Water supply. (a) All family child care programs must have a safe water 
283.14 	supply.
283.15 	(b) Family child care programs that draw water from privately owned wells must test 
283.16 	the water annually by a Department of Health-certified laboratory for coliform bacteria and 
283.17 	nitrate nitrogen and receive confirmation that the water is safe. The family child care program 
283.18 	must submit a copy of the test results with the agency. Retesting and corrective measures 
283.19 	may be required by the agency if results do not meet state drinking water standards or where 
283.20 	the supply may be subject to off-site contamination. A copy of the most recent water testing 
283.21 	results must be kept on the licensed premises. If the water test results are at or above 
283.22 	Department of Health-recommended levels or if the license holder declines to test the water 
283.23 	supply in the program, the license holder must:
283.24 	(1) supply bottled or packaged water;
283.25 	(2) use water filtration devices that have been certified by the National Science 
283.26 	Foundation or American National Standards Institute to remove the contaminant. The water 
283.27 	filtration device must be attached directly to water faucets, inserted into the refrigerator 
283.28 	water dispenser, or inserted into water pitchers or bottles. The water filtration device must 
283.29 	be maintained according to manufacturer guidelines; or
283.30 	(3) close the family child care program to prevent children from using or consuming 
283.31 	unsafe water.
284.1 		Subd. 2.Radon testing. (a) The license holder must notify parents whether radon testing 
284.2 	has been conducted in the family child care program upon enrollment and within 30 days 
284.3 	of any subsequent testing done after enrollment.
284.4 	(b) When notifying parents, the license holder must use a form prescribed by the 
284.5 	commissioner. The notice must include information from the Department of Health about 
284.6 	what radon is and the potential risks associated with radon exposure. If testing has been 
284.7 	completed, the notice must include:
284.8 	(1) the date of the most recent test;
284.9 	(2) the rooms or areas tested; and
284.10 	(3) the detected radon level or levels, stated in picocuries per liter (pCi/L).
284.11 	(c) A copy of the most recent notice to parents and the radon test results must be kept 
284.12 	on site and made available to parents and the commissioner upon request.
284.13 	(d) The notification requirements under this subdivision may be met by posting the form 
284.14 	in a prominent place.

284.15 	Sec. 17. [142I.17] ACTIVITIES AND EQUIPMENT.
284.16 		Subdivision 1.General activities. Child care activities must provide for the physical, 
284.17 	intellectual, emotional, and social development of the children in care at a family child care 
284.18 	program. Activities must include infants, toddlers, preschoolers, and school-age children 
284.19 	and:
284.20 	(1) be scheduled indoors and outdoors daily, weather permitting. When determining if 
284.21 	the weather permits outdoor play, a license holder must defer to weather advisory 
284.22 	notifications, including air quality emergencies, provided by local weather experts, local or 
284.23 	state authority on air quality, or public health;
284.24 	(2) be appropriate to the age and developmental stage of the child;
284.25 	(3) include active and quiet activity; and
284.26 	(4) include both caregiver- and child-directed activities.
284.27 		Subd. 2.Equipment. (a) A license holder must provide children in a family child care 
284.28 	program with:
284.29 	(1) sufficient play equipment to allow each child a choice of at least three activities 
284.30 	involving equipment when all children are using equipment;
285.1 	(2) early learning materials, play equipment, and space that are age and developmentally 
285.2 	appropriate and support understanding of the culturally diverse world; and
285.3 	(3) play equipment that is safe, in good repair, and used in accordance with the 
285.4 	manufacturer's instructions, if applicable. Equipment and play materials not designed or 
285.5 	marketed for use by children, including but not limited to repurposed, homemade, and 
285.6 	open-ended items, must be appropriate to the age and size of children, in good repair, and 
285.7 	used under the supervision of a caregiver. Such equipment and play materials are not required 
285.8 	to have manufacturer's instructions and are subject to the requirements of this subdivision.
285.9 	(b) Equipment provided to children under this section may be new, used, commercially 
285.10 	made, or homemade. The equipment must be appropriate for the ages of the children and 
285.11 	for the activities for which it will be used. As appropriate, nature material may be used in 
285.12 	place of any equipment.
285.13 		Subd. 3.Newborn or infant activities. A caregiver must:
285.14 	(1) hold a newborn or infant during feedings until the child can hold the bottle. A bottle 
285.15 	cannot be propped up for a newborn or infant;
285.16 	(2) respond to a newborn's or infant's attempts to communicate;
285.17 	(3) develop infant language and communication by responding to a newborn's or infant's 
285.18 	attempts to communicate by mirroring similar sounds, sharing the child's focus of attention, 
285.19 	talking to the newborn or infant, naming objects, and describing actions;
285.20 	(4) provide a newborn or infant with freedom of movement to sit safely and comfortably, 
285.21 	crawl, toddle, walk, and play both indoors and outdoors throughout the day;
285.22 	(5) provide a newborn or infant an opportunity to stimulate the senses by providing a 
285.23 	variety of activities and objects to see, touch, feel, smell, hear, and taste;
285.24 	(6) provide activities for a newborn or infant that develop the child's manipulative and 
285.25 	fine motor skills;
285.26 	(7) provide activities for self-awareness;
285.27 	(8) provide activities to support a newborn or infant to develop social-emotional skills;
285.28 	(9) provide activities to support a newborn or infant to develop gross motor skills; and
285.29 	(10) allow a newborn or infant actively supervised tummy time. For the purposes of this 
285.30 	clause, "tummy time" means placing a newborn or infant in a nonrestrictive prone position, 
285.31 	lying on their stomach. Tummy time should occur throughout the day when a newborn or 
286.1 	infant is awake. A newborn or infant must not be wearing anything to restrict movement 
286.2 	during tummy time.
286.3 		Subd. 4.Newborn and infant equipment. When caring for newborns or infants, a 
286.4 	license holder must provide:
286.5 	(1) an infant seat or high chair, as appropriate, for each newborn and infant in attendance;
286.6 	(2) a crib or portable crib with a mattress or pad for each newborn and infant in attendance 
286.7 	that is in compliance with current Consumer Product Safety Commission safety standards 
286.8 	and chapter 142B.45. The license holder must maintain documentation on site that the 
286.9 	equipment used meets these requirements and provide it to the commissioner and parents 
286.10 	as requested;
286.11 	(3) books and literacy materials;
286.12 	(4) gross motor activity equipment; and
286.13 	(5) fine motor activity materials.
286.14 		Subd. 5.Toddler activities. When caring for toddlers, a license holder must:
286.15 	(1) provide the toddler with freedom of movement and freedom to explore outside the 
286.16 	crib or portable crib and allow the toddler to comfortably sit, crawl, toddle, walk, and play 
286.17 	according to the toddler's stage of development;
286.18 	(2) talk to, listen to, and interact with the toddler to encourage language development;
286.19 	(3) provide the toddler with activities that develop the toddler's fine and gross motor 
286.20 	skills;
286.21 	(4) give the toddler opportunities to stimulate the senses by providing a variety of 
286.22 	age-appropriate activities and objects to see, touch, feel, smell, hear, and taste; and
286.23 	(5) provide activities to support the toddler to develop social-emotional skills.
286.24 		Subd. 6.Toddler equipment. When caring for toddlers, a license holder must provide:
286.25 	(1) separate sleeping equipment for each toddler such as a mat, crib, cot, bed, sofa, or 
286.26 	sleeping bag that is cleaned and maintained as required in subdivision 10 and section 142I.15, 
286.27 	subdivision 5;
286.28 	(2) gross motor play equipment;
286.29 	(3) books and literacy materials;
286.30 	(4) fine motor, math, and science materials; and
287.1 	(5) music, movement, and art activity materials.
287.2 		Subd. 7.Preschooler activities. When caring for preschoolers, a license holder must:
287.3 	(1) encourage conversation between the preschooler and other children and adults;
287.4 	(2) provide opportunity to play near and with other children, provide time and space for 
287.5 	individual and group play, allow for quiet times to talk or rest, and allow for unplanned 
287.6 	time and individual play time;
287.7 	(3) foster understanding of personal and peer feelings and actions and allow for the 
287.8 	constructive release of a range of feelings through discussion or play;
287.9 	(4) give assistance in toileting and provide time to carry out self-help skills and provide 
287.10 	opportunities to be responsible for activities;
287.11 	(5) provide opportunities for each preschooler to make decisions about daily activities 
287.12 	and to learn from the decision-making experiences;
287.13 	(6) provide time and areas for age-appropriate gross motor play;
287.14 	(7) provide learning, fine-motor, manipulative, creative, or sensory activities; and
287.15 	(8) read stories, look at books, and talk about new words and ideas with the preschooler.
287.16 		Subd. 8.Preschooler equipment. When caring for preschoolers, a license holder must 
287.17 	provide:
287.18 	(1) separate sleeping equipment for each preschooler such as a mat, bed, cot, sofa, or 
287.19 	sleeping bag for each preschooler that is cleaned and maintained as required under 
287.20 	subdivision 10 and section 142I.15, subdivision 5;
287.21 	(2) dramatic play equipment;
287.22 	(3) books and literacy materials;
287.23 	(4) fine motor materials;
287.24 	(5) gross motor play equipment;
287.25 	(6) math materials;
287.26 	(7) science materials;
287.27 	(8) music and movement materials; and
287.28 	(9) art materials.
288.1 		Subd. 9.School-age activities and equipment. When caring for school-age children, 
288.2 	a license holder must:
288.3 	(1) provide opportunities for individual discussion about the day and planning for 
288.4 	activities;
288.5 	(2) provide space, opportunities, and materials or equipment for games, activities, or 
288.6 	sports using the whole body;
288.7 	(3) have available space, bedding materials, and opportunities for individual rest and 
288.8 	quiet time required under subdivision 10;
288.9 	(4) allow increased freedom as the school-age child demonstrates increased responsibility;
288.10 	(5) provide opportunities for group experiences with other children;
288.11 	(6) provide opportunities to develop or expand self-help skills or real-life experiences; 
288.12 	and
288.13 	(7) provide opportunities and materials for creative and dramatic activity, arts, and crafts.
288.14 		Subd. 10.Bedding. Clean, separate, and individual bedding such as sheets, towels, 
288.15 	blankets, or sleeping bags must be available for each child in care. For children not using 
288.16 	cribs or portable cribs, the license holder must provide developmentally appropriate mats, 
288.17 	cots, or other sleep equipment that can be cleaned and disinfected according to section 
288.18 	142I.15. Mats, cots, and other sleep equipment used in the family child care program must 
288.19 	be in good condition and have no tears or holes and be covered in individual bedding.
288.20 		Subd. 11.Separation of personal articles. Separate towels, wash cloths, water bottles, 
288.21 	and drinking cups must be used for each child and labeled appropriately.

288.22 	Sec. 18. [142I.171] NATURAL ELEMENTS AND MATERIALS.
288.23 		Subdivision 1.Natural elements and materials. A license holder may provide children 
288.24 	with access to natural elements and materials as equipment and play materials. Natural 
288.25 	elements and materials and appropriate uses of natural elements and materials include, but 
288.26 	are not limited to:
288.27 	(1) natural loose parts, such as sticks, leaves, pine cones, acorns, seeds, pods, bark, and 
288.28 	moss for construction, art, sensory exploration, and imaginative play;
288.29 	(2) natural materials, such as dirt, mud, sand, water, ice, and snow for sensory play and 
288.30 	exploration;
289.1 	(3) plants, flowers, seeds, vegetables, and gardening materials for science exploration 
289.2 	and learning;
289.3 	(4) rocks, pebbles, stones, and minerals for counting, sorting, building, and art;
289.4 	(5) natural areas such as gardens, prairie, forest, wetlands, and ponds for exploration 
289.5 	and learning; and
289.6 	(6) other natural elements as appropriate to age and development of children.
289.7 		Subd. 2.Supervision. A caregiver must supervise a child's use of natural elements and 
289.8 	materials and provide guidance on safe and appropriate use. Natural elements and materials 
289.9 	that are a choking hazard must not be accessible to children under the age of three without 
289.10 	direct supervision of a caregiver.
289.11 		Subd. 3.Other uses. Natural elements and materials may qualify as equipment and 
289.12 	materials under section 142I.17, subdivisions 4, 6, 8, and 9.

289.13 	Sec. 19. [142I.18] INFANT SLEEP AND CRIB REQUIREMENTS.
289.14 		Subdivision 1.Safety. All caregivers must follow the crib safety requirements in section 
289.15 	142B.45 and the requirements to reduce the risk of sudden unexpected infant deaths in 
289.16 	section 142B.46. During routine licensing inspections and when investigating complaints 
289.17 	regarding alleged violations of this section, the commissioner must review the license 
289.18 	holder's documentation required under section 142B.45.
289.19 		Subd. 2.Monitoring sleeping newborns and infants. (a) Caregivers must directly 
289.20 	supervise newborns once they are placed in a crib or portable crib.
289.21 	(b) License holders of programs that serve infants are encouraged to monitor sleeping 
289.22 	infants by conducting in-person checks on each infant in the license holder's care every 30 
289.23 	minutes.
289.24 	(c) Upon enrollment of an infant, the license holder is encouraged to conduct in-person 
289.25 	checks on the sleeping infant every 15 minutes during the first four months of care.
289.26 	(d) When an infant has an upper respiratory infection, the license holder is encouraged 
289.27 	to conduct in-person checks on the sleeping infant every 15 minutes throughout the hours 
289.28 	of sleep.
289.29 	(e) Monitors may be used to supervise infants when the infants are sleeping. However, 
289.30 	the use of monitors does not replace the in-person checks encouraged under paragraphs (b) 
289.31 	to (d). When in use, monitors must meet the following conditions:
290.1 	(1) the sound monitoring equipment must be able to pick up the sounds of all infants in 
290.2 	the separate room;
290.3 	(2) the receiver of the sound monitoring equipment must be actively monitored by the 
290.4 	adult caregiver at all times; and
290.5 	(3) sound monitoring equipment must be checked daily prior to use to ensure it is working 
290.6 	correctly. If the sound equipment is not functioning, infants must sleep in the same room 
290.7 	as the adult caregiver.
290.8 	(f) If music or other sounds are played in the infant sleep area, the music or other sound 
290.9 	equipment must not be played at a volume that would prevent infants from being heard by 
290.10 	the adult caregiver. This paragraph applies to fans used to create sound.

290.11 	Sec. 20. [142I.19] HEALTH POLICIES AND SAFETY REQUIREMENTS.
290.12 		Subdivision 1.Handling and disposal of bodily fluids. (a) Surfaces that come in contact 
290.13 	with bodily fluids must be cleaned and disinfected as described in section 142I.15.
290.14 	(b) Blood-contaminated material must be disposed of in a plastic bag and securely tied.
290.15 	(c) If a program cares for a child with a health care need that requires injectable 
290.16 	medication, the program must have a sharps container available.
290.17 	(d) A license holder must keep disposable gloves, disposal bags, and eye protection 
290.18 	available. Prescription eyewear does not meet the requirements of this paragraph.
290.19 		Subd. 2.Emergencies. (a) A license holder must have a written child care emergency 
290.20 	plan for emergencies that require evacuation, sheltering, or other protection of children, 
290.21 	including for fires, natural disasters, intruders, or other threatening situations that may pose 
290.22 	a health or safety hazard to children. The plan must be written on a form prescribed by the 
290.23 	commissioner and updated at least annually. The plan must include:
290.24 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
290.25 	(2) a designated relocation site and evacuation route;
290.26 	(3) procedures for notifying a child's parent of an evacuation, shelter-in-place, or 
290.27 	lockdown, including procedures for reunification with families;
290.28 	(4) accommodations for a child with a disability or a medical condition;
290.29 	(5) procedures for storing a child's medically necessary medicine that facilitate easy 
290.30 	removal during an evacuation or relocation;
290.31 	(6) procedures for continuing operations in the period during and after a crisis;
291.1 	(7) procedures for communicating with local emergency management officials, law 
291.2 	enforcement officials, or other appropriate state or local authorities; and
291.3 	(8) accommodations for infants and toddlers.
291.4 	(b) The license holder must train each caregiver on the child care emergency plan before 
291.5 	the caregiver provides care and document this training. The information must be reviewed 
291.6 	at least annually and updated when information changes.
291.7 	(c) The child care emergency plan must be available for review by the agency during 
291.8 	inspections.
291.9 	(d) In addition to the emergency plan required under paragraph (a), the license holder 
291.10 	must maintain preparedness for emergencies. An operable telephone must be located in the 
291.11 	family child care program. A cellular telephone may be used if it is sufficiently charged for 
291.12 	use at all times. Emergency phone numbers for parents must be readily available within the 
291.13 	program and taken on all emergency drills and evacuations.
291.14 	(e) For severe storms and tornadoes, the license holder must have a designated area that 
291.15 	children can go to for shelter, a battery-operated flashlight, and a portable radio or TV 
291.16 	available. An application on a smartphone may be used to meet the requirements of this 
291.17 	paragraph. The license holder must follow guidance and instructions from the Emergency 
291.18 	Alert System or local alerting systems.
291.19 	(f) The license holder must have a written fire escape plan that includes:
291.20 	(1) the address of the family child care program;
291.21 	(2) emergency phone numbers;
291.22 	(3) a designated place to meet and confirm that all children in attendance are present;
291.23 	(4) fire extinguisher locations;
291.24 	(5) plans for monthly fire and storm drills; and
291.25 	(6) escape routes to the outside from all levels used by children. In buildings with three 
291.26 	or more dwelling units, enclosed exit stairs must be indicated.
291.27 	(g) The license holder must complete a monthly fire and storm drill and have 
291.28 	documentation of completed fire drills available for review by the agency during inspections. 
291.29 	The log must include the date of the drill, the time of day the drill occurred, the name of 
291.30 	the caregiver who conducted the drill, and the length of time taken to evacuate all children 
291.31 	safely.
292.1 		Subd. 3.Transporting children. Children must only be transported in an enclosed 
292.2 	passenger vehicle capable of using car seats or a bus operated by a common carrier. When 
292.3 	transporting children in an enclosed passenger vehicle other than a bus operated by a common 
292.4 	carrier, a license holder must:
292.5 	(1) ensure compliance with all seat belt and child passenger restraint system requirements 
292.6 	under sections 169.685 and 169.686;
292.7 	(2) ensure that the child is fastened in a safety seat, seat belt, or harness appropriate to 
292.8 	the age and weight of the child and the restraint is installed and used in accordance with the 
292.9 	manufacturer's instructions;
292.10 	(3) only use a vehicle licensed in accordance with the laws of the state and driven by a 
292.11 	caregiver with a current, valid driver's license. A copy of the current driver's license for 
292.12 	each caregiver who transports a child in care must be kept at the family child care program;
292.13 	(4) receive written permission to transport children from parents prior to transport; and
292.14 	(5) not allow a child to remain unattended in any vehicle.
292.15 		Subd. 4.Pets and animals. When keeping pets or animals on the site of a family child 
292.16 	care program or allowing children to have contact with pets or animals, the primary provider 
292.17 	of care must:
292.18 	(1) maintain the pets or animals in good health and proper housing. Pets or animals must 
292.19 	be appropriately immunized, and rabies vaccinations must be documented with a current 
292.20 	certificate from a veterinarian when appropriate;
292.21 	(2) follow all local and state ordinances regarding the keeping, licensing, number, and 
292.22 	health status of animals;
292.23 	(3) restrict any animals that pose a risk of injury or illness to children from indoor and 
292.24 	outdoor areas used by children;
292.25 	(4) inform parents in writing of the presence of pets and animals on the premises. If pets 
292.26 	or animals are allowed to roam in areas occupied by children, the license holder must obtain 
292.27 	written acknowledgment from parents. Parents must be notified in writing prior to the 
292.28 	introduction of a new pet;
292.29 	(5) keep any reptiles, amphibians, ferrets, poisonous animals, psittacine birds, exotic 
292.30 	animals, and wild animals inaccessible to children. Licensed animal exhibitions, such as 
292.31 	mobile petting zoos, reptile shows, and educational presentations are exempt from this 
292.32 	clause with written parental notice and consent;
293.1 	(6) not allow any contact between children and pets or animals that is not directly 
293.2 	supervised by an adult caregiver who is in close physical proximity and able to immediately 
293.3 	intervene if the child or animal shows distress or aggression or if the child is treating the 
293.4 	animal inappropriately;
293.5 	(7) immediately intervene to protect a child when necessary;
293.6 	(8) prevent pets and animals from accessing food preparation, storage, and serving areas 
293.7 	when food is being prepared or served, unless confined in a cage or kennel. Litter boxes 
293.8 	are prohibited in any food preparation, storage, or serving areas;
293.9 	(9) keep indoor and outdoor areas accessible to children free of animal waste, including 
293.10 	litter boxes and their contents. Pet cages, enclosures, and aquariums accessible to children 
293.11 	must be located and cleaned away from food areas;
293.12 	(10) immediately notify a parent of a child who receives an animal bite or scratch;
293.13 	(11) notify the local animal authority whenever an individual is bitten by an animal on 
293.14 	the day of injury. The notification must be made before any steps are taken to euthanize the 
293.15 	animal, and the license holder must take reasonable steps to confine the animal; and
293.16 	(12) notify the licensing agency within 24 hours of any animal bite from an animal 
293.17 	housed at the family child care program.
293.18 		Subd. 5.Pest control. (a) A license holder must take effective measures to protect the 
293.19 	family child care program against pests. The license holder must take steps to prevent 
293.20 	attracting pests and, if pests are present inside the family child care program, to remove or 
293.21 	exterminate the pests.
293.22 	(b) Chemicals for pest control must not be applied in areas accessible to children when 
293.23 	children are present. The license holder must use chemicals according to manufacturer 
293.24 	instructions. Only approved, Environmental Protection Agency-registered insecticides, 
293.25 	rodenticides, and herbicides may be used. Application must strictly follow all label 
293.26 	instructions.
293.27 		Subd. 6.Garbage. Garbage must be inaccessible to infants and toddlers. Garbage is 
293.28 	considered inaccessible when the garbage container has a lid on.
293.29 		Subd. 7.Firearms. Ammunition and firearms must be stored in locked areas separated 
293.30 	from areas accessible to children. Firearms must be unloaded while stored.
294.1 		Subd. 8.First aid kit. A license holder must have a first aid kit that is accessible to 
294.2 	caregivers in the family child care program at all times and taken on field trips. A caregiver 
294.3 	must have access to first aid instructions. The first aid kit must contain:
294.4 	(1) adhesive bandages in assorted sizes and tape;
294.5 	(2) sterile compresses;
294.6 	(3) scissors;
294.7 	(4) an ice bag or cold pack;
294.8 	(5) a thermometer;
294.9 	(6) mild liquid soap, hand sanitizer, or alcohol wipes; and
294.10 	(7) disposable powder-free, latex-free gloves.
294.11 		Subd. 9.Care of sick children. (a) If the child becomes sick while at the family child 
294.12 	care program, the child must be separated from other children in care to the extent possible 
294.13 	while still maintaining appropriate supervision, and the child's parent must be called 
294.14 	immediately. When determining if a child is sick and exclusion is necessary, a license holder 
294.15 	must follow:
294.16 	(1) the requirements on reportable diseases in Minnesota Rules, parts 4605.7040, 
294.17 	4605.7070, and 4605.7080; and
294.18 	(2) the guidelines from the commissioner of health on infectious diseases in child care 
294.19 	settings.
294.20 	(b) When notified a child in care is sick with a reportable disease under Minnesota Rules, 
294.21 	part 4605.7040, 4605.7050, or 4605.7080, the license holder must:
294.22 	(1) follow the family child care program policies on reportable or infectious diseases; 
294.23 	and
294.24 	(2) notify the commissioner of health within 24 hours of receiving the parent or staff 
294.25 	report. Documentation of the notification must be kept at the family child care program.
294.26 	(c) Children with a reportable disease in paragraph (b) must be excluded from the family 
294.27 	child care program for the length of time specified in the commissioner of health guidelines 
294.28 	on infectious diseases in child care settings, until the child can participate in routine activities 
294.29 	without more caregiver supervision than usual or until the child's health care provider 
294.30 	determines that exclusion is no longer necessary, whichever is longer.
295.1 		Subd. 10.Medication administration requirements. (a) A license holder must obtain 
295.2 	written permission from the parent of a child prior to administering nonprescription medicine, 
295.3 	diapering products, sunscreen lotions, and insect repellents. These items must be administered 
295.4 	according to the manufacturer instructions unless written instructions for their use are 
295.5 	provided by a health care provider.
295.6 	(b) A license holder must obtain and follow written instructions from a health care 
295.7 	provider or dentist prior to administering each prescribed medication. For the purposes of 
295.8 	this paragraph, "instructions" means the label on a medicine container with the child's name 
295.9 	and current prescription information.

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

297.1 	Sec. 22. [142I.21] CHILDREN WITH SPECIAL HEALTH CARE NEEDS OR 
297.2 	DISABILITIES.
297.3 	(a) For children with disabilities who require therapy, additional behavior guidance, 
297.4 	programming, or alternative accommodations, a parent or health care provider must provide 
297.5 	written instructions for the license holder to follow.
297.6 	(b) All activities must be designed to include all children unless a specific medical 
297.7 	contraindication exists.
297.8 	(c) All caregivers responsible for the care of a child with a disability or special health 
297.9 	care need must explain to a parent and the agency how the child's specific needs are being 
297.10 	met.
297.11 	(d) Before enrolling a child for care, the license holder must obtain documentation of 
297.12 	any known allergies on a form prescribed by the commissioner. The form must be readily 
297.13 	available to all caregivers and reviewed by the license holder and each caregiver annually 
297.14 	and when any updates or changes are made.
297.15 	(e) If a child has a known allergy, the primary provider of care must maintain current 
297.16 	information about the allergy in the child's record, ensure that required medication is on 
297.17 	hand, and follow the allergy plan signed by a treating medical professional. The child's plan 
297.18 	must include:
297.19 	(1) a description of the allergy;
297.20 	(2) specific triggers and avoidance techniques;
297.21 	(3) symptoms of an allergic reaction; and
297.22 	(4) procedures for responding to an allergic reaction, including any medication and 
297.23 	dosage to be administered in an emergency situation.
297.24 	(f) A caregiver must call emergency medical services when epinephrine is administered 
297.25 	to a child in the license holder's care.
297.26 	(g) The caregiver must contact the child's parent immediately after any instance of 
297.27 	exposure to an allergen or allergic reaction.

297.28 	Sec. 23. [142I.22] COMMUNITY-BASED FAMILY CHILD CARE.
297.29 	(a) A family child care program located on a site other than the license holder's primary 
297.30 	residence must be licensed under this section if:
298.1 	(1) the family child care program is conducted in a dwelling on a residential lot or in a 
298.2 	commercial space other than the license holder's primary residence;
298.3 	(2) the license holder is an organization, employer, church, or religious entity; or
298.4 	(3) the license holder is a community collaborative child care provider. For purposes of 
298.5 	this clause, a "community collaborative child care provider" is a provider participating in 
298.6 	a cooperative agreement with a community action agency as defined in section 142F.301.
298.7 	(b) Programs licensed under paragraph (a) must comply with local zoning regulations, 
298.8 	the applicable State Fire Code, and the State Building Code. Any age and capacity limitations 
298.9 	established by the fire code must be printed on the license.
298.10 	(c) A license holder under this section must designate at least one primary provider of 
298.11 	care as follows:
298.12 	(1) one individual for programs operating eight or fewer hours per day;
298.13 	(2) up to two individuals for programs operating more than eight but no more than 16 
298.14 	hours per day; and
298.15 	(3) up to three individuals for programs operating more than 16 hours per day.
298.16 	(d) The license issued under this section must include the statement: "This 
298.17 	community-based family child care license holder is not licensed as a child care center."
298.18 	(e) The commissioner may approve up to six licenses at the same location or under one 
298.19 	contiguous roof if each license holder independently meets all applicable requirements and 
298.20 	the program location site does not have an R-2 residential occupancy designation. Each 
298.21 	family child care program must operate as a distinct family child care program within its 
298.22 	licensed capacity, age, and ratio limits as determined by the state fire marshal. Only one 
298.23 	license may be issued per single-family residential home.
298.24 	(f) The license holder must notify the commissioner in writing before any change in the 
298.25 	persons designated as primary providers of care. A primary provider of care is authorized 
298.26 	to communicate with the commissioner on licensing matters.
298.27 	(g) Each license holder must complete the commissioner-developed community-based 
298.28 	family child care program plan at the time of initial application, review the plan each calendar 
298.29 	year, and update the plan before any change in program information occurs.

299.1 	Sec. 24. REVISOR INSTRUCTION.
 299.2 	(a) The revisor of statutes must make any necessary changes to statutory cross-references 
299.3 	to reflect the changes in this article.
299.4 	(b) The revisor of statutes must replicate the statutory history for all sections and 
299.5 	subdivisions repealed and reenacted in this article.

299.6 	Sec. 25. REPEALER.
 299.7 	(a) Minnesota Statutes 2024, sections 142B.01, subdivision 13; 142B.41, subdivisions 
299.8 	4 and 8; 142B.62; 142B.70, subdivisions 1, 2, 3, 4, 5, 6, 9, 10, 11, and 12; 142B.71; 142B.72; 
299.9 	142B.74; 142B.75; 142B.76; and 142B.77, are repealed.
299.10 	(b) Minnesota Statutes 2025 Supplement, sections 142B.41, subdivision 9; and 142B.70, 
299.11 	subdivisions 7 and 8, are repealed.
299.12 	(c) Minnesota Rules, parts 9502.0300; 9502.0315; 9502.0325; 9502.0335; 9502.0341; 
299.13 	9502.0345; 9502.0355; 9502.0365; 9502.0367; 9502.0375; 9502.0395; 9502.0405; 
299.14 	9502.0415; 9502.0425; 9502.0435; and 9502.0445, are repealed.

299.15 	Sec. 26. EFFECTIVE DATE.
 299.16 	This article is effective July 1, 2027.

299.17 	ARTICLE 14
299.18 	MISCELLANEOUS

299.19 	Section 1. Minnesota Statutes 2024, section 62A.01, is amended by adding a subdivision 
299.20 	to read:
299.21 		Subd. 5.Direct primary care service agreements. (a) A direct primary care service 
299.22 	agreement under section 62Q.20 is not insurance and is not subject to this chapter. Entering 
299.23 	into a direct primary care service agreement is not the business of insurance and is not 
299.24 	subject to this chapter or chapter 60A.
299.25 	(b) A health care provider or agent of a health care provider is not required to obtain a 
299.26 	certificate of authority or license under this chapter or chapter 60A, 62C, 62D, or 62N to 
299.27 	market, sell, or offer to sell a direct primary care service agreement that meets the 
299.28 	requirements of section 62Q.20.

300.1 	Sec. 2. Minnesota Statutes 2024, section 62A.011, subdivision 3, is amended to read:
300.2 		Subd. 3.Health plan. "Health plan" means a policy or certificate of accident and sickness 
300.3 	insurance as defined in section 62A.01 offered by an insurance company licensed under 
300.4 	chapter 60A; a subscriber contract or certificate offered by a nonprofit health service plan 
300.5 	corporation operating under chapter 62C; a health maintenance contract or certificate offered 
300.6 	by a health maintenance organization operating under chapter 62D; a health benefit certificate 
300.7 	offered by a fraternal benefit society operating under chapter 64B; or health coverage offered 
300.8 	by a joint self-insurance employee health plan operating under chapter 62H. Health plan 
300.9 	means individual and group coverage, unless otherwise specified. Health plan does not 
300.10 	include coverage that is:
300.11 	(1) limited to disability or income protection coverage;
300.12 	(2) automobile medical payment coverage;
300.13 	(3) liability insurance, including general liability insurance and automobile liability 
300.14 	insurance, or coverage issued as a supplement to liability insurance;
300.15 	(4) designed solely to provide payments on a per diem, fixed indemnity, or 
300.16 	non-expense-incurred basis, including coverage only for a specified disease or illness or 
300.17 	hospital indemnity or other fixed indemnity insurance, if the benefits are provided under a 
300.18 	separate policy, certificate, or contract for insurance; there is no coordination between the 
300.19 	provision of benefits and any exclusion of benefits under any group health plan maintained 
300.20 	by the same plan sponsor; and the benefits are paid with respect to an event without regard 
300.21 	to whether benefits are provided with respect to such an event under any group health plan 
300.22 	maintained by the same plan sponsor;
300.23 	(5) credit accident and health insurance as defined in section 62B.02;
300.24 	(6) designed solely to provide hearing, dental, or vision care;
300.25 	(7) blanket accident and sickness insurance as defined in section 62A.11;
300.26 	(8) accident-only coverage;
300.27 	(9) a long-term care policy as defined in section 62A.46 or 62S.01;
300.28 	(10) issued as a supplement to Medicare, as defined in sections 62A.3099 to 62A.44, or 
300.29 	policies, contracts, or certificates that supplement Medicare issued by health maintenance 
300.30 	organizations or those policies, contracts, or certificates governed by section 1833 or 1876, 
300.31 	section 1851, et seq.; or section 1860D-1, et seq., of title XVIII of the federal Social Security 
300.32 	Act, et seq., as amended;
301.1 	(11) workers' compensation insurance;
301.2 	(12) issued solely as a companion to a health maintenance contract as described in section 
301.3 	62D.12, subdivision 1a, so long as the health maintenance contract meets the definition of 
301.4 	a health plan;
301.5 	(13) coverage for on-site medical clinics; or
301.6 	(14) coverage supplemental to the coverage provided under United States Code, title 
301.7 	10, chapter 55, Civilian Health and Medical Program of the Uniformed Services 
301.8 	(CHAMPUS).; or
301.9 	(15) coverage provided under a direct primary care service agreement described under 
301.10 	section 62Q.20.

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

304.19 	Sec. 4. Minnesota Statutes 2024, section 116.943, subdivision 2, is amended to read:
304.20 		Subd. 2.Information required. (a) On or before January 1, 2026, a manufacturer of a 
304.21 	product manufactured after July 1, 2023; sold, offered for sale, or distributed in the state; 
304.22 	and that contains intentionally added PFAS must submit to the commissioner information 
304.23 	that includes:
304.24 	(1) a brief description of the product, including a universal product code (UPC), stock 
304.25 	keeping unit (SKU), or other numeric code assigned to the product;
304.26 	(2) the purpose for which PFAS are used in the product, including in any product 
304.27 	components;
304.28 	(3) the amount of each PFAS, identified by its chemical abstracts service registry number, 
304.29 	in the product, reported as an exact quantity determined using commercially available 
304.30 	analytical methods or as falling within a range approved for reporting purposes by the 
304.31 	commissioner;
305.1 	(4) the name and address of the manufacturer and the name, address, and phone number 
305.2 	of a contact person for the manufacturer; and
305.3 	(5) any additional information requested by the commissioner as necessary to implement 
305.4 	the requirements of this section.
305.5 	(b) With the approval of the commissioner, a manufacturer may supply the information 
305.6 	required in paragraph (a) for a category or type of product rather than for each individual 
305.7 	product.
305.8 	(c) A manufacturer must submit the information required under this subdivision whenever 
305.9 	a new product that contains intentionally added PFAS is sold, offered for sale, or distributed 
305.10 	in the state and update and revise the information whenever there is significant change in 
305.11 	the information or when requested to do so by the commissioner.
305.12 	(d) A person may not sell, offer for sale, or distribute for sale in the state a product 
305.13 	containing intentionally added PFAS if the manufacturer has failed to provide the information 
305.14 	required under this subdivision and the person has received notification under subdivision 
305.15 	4.

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

305.17 	Sec. 5. Minnesota Statutes 2025 Supplement, section 145C.18, subdivision 3, is amended 
305.18 	to read:
305.19 		Subd. 3.Compliance with nonopioid directive; exception. (a) Except as specified in 
305.20 	paragraph paragraphs (b) and (c), prescribers and health professionals must comply with a 
305.21 	nonopioid directive executed under this section.
305.22 	(b) A prescriber or a health professional acting on the order of a prescriber may administer 
305.23 	an opioid to a patient with a nonopioid directive if:
305.24 	(1) the patient is being treated, in emergency circumstances, in a hospital setting or in 
305.25 	a setting outside a hospital;
305.26 	(2) in the prescriber's professional opinion, it is medically necessary to administer an 
305.27 	opioid to the patient in order to treat the patient, including but not limited to during a surgical 
305.28 	procedure when one or more complications arise; and
305.29 	(3) it is not practical or feasible for the prescriber or health professional to access the 
305.30 	patient's health care record.
306.1 	If an opioid is administered according to this paragraph to a patient with a nonopioid 
306.2 	directive, the prescriber must ensure that the patient is provided with information on substance 
306.3 	use disorder services.
306.4 	(c) A prescriber or a health professional acting on the order of a prescriber may prescribe 
306.5 	or administer an opioid to a patient with a nonopioid directive if the opioid is prescribed or 
306.6 	administered to treat the patient for a substance use disorder.

306.7 	Sec. 6. Minnesota Statutes 2025 Supplement, section 145C.18, subdivision 4, is amended 
306.8 	to read:
306.9 		Subd. 4.Immunities. Except as otherwise provided by law, the following persons or 
306.10 	entities are not subject to criminal prosecution, civil liability, or professional disciplinary 
306.11 	action for failing to prescribe, administer, or dispense an opioid to a patient with a nonopioid 
306.12 	directive; for the administration of an opioid in the circumstances in subdivision 3, paragraph 
306.13 	(b), to a patient with a nonopioid directive; for the prescribing or administration of an opioid 
306.14 	in the circumstances in subdivision 3, paragraph (c), to a patient with a nonopioid directive; 
306.15 	or for the inadvertent administration of an opioid to a patient with a nonopioid directive, if 
306.16 	the act or failure to act was performed in good faith and in accordance with the applicable 
306.17 	standard of care:
306.18 	(1) a health professional whose scope of practice includes prescribing, administering, 
306.19 	or dispensing a controlled substance;
306.20 	(2) an employee of a health professional described in clause (1);
306.21 	(3) a health care facility or an employee of a health care facility; or
306.22 	(4) an emergency medical services provider.

306.23 	Sec. 7. Minnesota Statutes 2024, section 471.6161, is amended by adding a subdivision 
306.24 	to read:
306.25 		Subd. 9.School districts and charter schools; reports. (a) For purposes of this 
306.26 	subdivision, an entity offering or providing group health insurance includes both health 
306.27 	plan companies and third-party administrators of health plans.
306.28 	(b) By July 15, 2026, and July 1 each year thereafter, the Legislative Budget Office must 
306.29 	send an annual survey regarding health insurance costs to all school districts and charter 
306.30 	schools in the state.
307.1 	(c) The annual survey must be completed by the school district or charter school using 
307.2 	data from its most recent plan year, be returned to the Legislative Budget Office by September 
307.3 	1 each year, and provide the following information about school employees who meet the 
307.4 	definition of public employee under section 179A.03, subdivision 14:
307.5 	(1) the total number of salaried employees;
307.6 	(2) the total number of nonsalaried or hourly employees;
307.7 	(3) for employees participating in the group health insurance offered by the school district 
307.8 	or charter school, the total number of people, as of May 1, in each of the following categories:
307.9 	(i) salaried employees;
307.10 	(ii) nonsalaried or hourly employees; and
307.11 	(iii) retirees and any other persons who continue to receive coverage through the school 
307.12 	district's or charter school's health plan after separation from employment;
307.13 	(4) the total number of employees not participating in the health plan;
307.14 	(5) the total number of insured persons covered by the health plan;
307.15 	(6) the total dollar amount the school district or charter school paid in health insurance 
307.16 	premiums on behalf of all employees, not including employee contributions transmitted to 
307.17 	an entity providing group health insurance coverage or payments made on behalf of former 
307.18 	employees;
307.19 	(7) if a school district or charter school funds an individual coverage health reimbursement 
307.20 	arrangement, the total amount contributed by the school district or charter school;
307.21 	(8) the total amount employees paid in health insurance premiums;
307.22 	(9) an accounting of all forms of compensation, either direct or indirect, including but 
307.23 	not limited to fees, commissions, incentives, or rewards of any kind paid to a broker or 
307.24 	agent, regardless of whether it was billed as a flat fee or percentage of premium and whether 
307.25 	paid directly by the school district or charter school or through the entity offering group 
307.26 	health insurance;
307.27 	(10) the name of any entity providing group health insurance the school district or charter 
307.28 	school has contracted with and the expiration date of the contract;
307.29 	(11) the date range of the most recent plan year;
307.30 	(12) for each type of health plan offered to employees of a school district or charter 
307.31 	school:
308.1 	(i) the name of the plan and its actuarial value, using the minimum value calculator 
308.2 	information required in bid proposals under section 471.6161, subdivision 8, paragraph (d), 
308.3 	clause (2), and described in Code of Federal Regulations, title 45, section 156.145. The plan 
308.4 	data must also delineate amounts for single, family, and two-party plans, if offered;
308.5 	(ii) the monthly contribution by the school district or charter school for each employee 
308.6 	group per plan, including contributions to individual coverage health reimbursement 
308.7 	arrangements;
308.8 	(iii) the amount per month an employee must pay in health insurance premiums for the 
308.9 	plan; and
308.10 	(iv) the plan design for each type of plan, including:
308.11 	(A) in-network deductibles;
308.12 	(B) in-network out-of-pocket limits;
308.13 	(C) out-of-network limits;
308.14 	(D) co-payments;
308.15 	(E) the employee's share of coinsurance; and
308.16 	(F) the prescription annual out-of-pocket maximum, if separate from subitem (B);
308.17 	(13) the dollar or percentage cost for all prescription levels, commonly generic or tier 
308.18 	1, formulary or tier 2, and nonformulary or tier 3;
308.19 	(14) the total amount of annual contributions, per employee, paid by the school district 
308.20 	or charter school to an individual coverage health reimbursement arrangement or health 
308.21 	savings account, excluding amounts contributed solely to a health care retirement account;
308.22 	(15) the total amount assessed by the entity providing group health insurance as an 
308.23 	administrative fee and the rate of the fee assessed;
308.24 	(16) if a school district is self-insured, the total amount that is in a district set-aside health 
308.25 	insurance reserve account; and
308.26 	(17) any additional items as determined by the Legislative Budget Office.
308.27 	(d) The Legislative Budget Office must compile information from the surveys described 
308.28 	above and provide a report by December 1 each year to the chairs and ranking minority 
308.29 	members of the legislative committees with jurisdiction over education and health insurance. 
308.30 	The Legislative Budget Office must post the report, including the executive summary and 
309.1 	all underlying data received from school districts and charter schools, on its public website. 
309.2 	Data posted on the Legislative Budget Office's website must be in a standardized format.

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

309.4 	Sec. 8. REPEALER.
 309.5 	Minnesota Statutes 2024, sections 62U.10, subdivision 4; and 256B.69, subdivision 31a,
309.6 	are repealed.

309.7 	ARTICLE 15
309.8 	DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENTS

309.9	Section 1. HUMAN SERVICES FORECAST ADJUSTMENTS.
 	
309.10 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
309.11 	parentheses, subtracted from the appropriations in Laws 2025, First Special Session chapter 
309.12 	3, article 20, and Laws 2025, First Special Session chapter 9, article 12, to the commissioner 
309.13 	of human services from the general fund or other named fund for the purposes specified in 
309.14 	section 2 and are available for the fiscal years indicated for each purpose. The figures "2026" 
309.15 	and "2027" used in this article mean that the addition to or subtraction from the appropriation 
309.16 	listed under them is available for the fiscal year ending June 30, 2026, or June 30, 2027, 
309.17 	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 HUMAN 
SERVICES.

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

309.25	Appropriations by Fund
	
309.26	General Fund
	652,953,000
	615,407,000
	
309.27
309.28	Health Care Access 
Fund
	86,681,000
	159,628,000

309.29	Subd. 2.Forecasted Programs

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

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

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

309.33	(d) MinnesotaCare
		86,681,000
		159,628,000
	
310.1 	These appropriations are from the health care 
310.2 	access fund.

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

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

310.5 	Sec. 3. EFFECTIVE DATE.
 310.6 	This article is effective the day following final enactment.

310.7 	ARTICLE 16
310.8 	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES FORECAST 
310.9 	ADJUSTMENTS

310.10	Section 1. CHILDREN, YOUTH, AND FAMILIES FORECAST ADJUSTMENTS.
 	
310.11 	The sums shown in the columns marked "Appropriations" are added to or, if shown in 
310.12 	parentheses, subtracted from the appropriations in Laws 2025, First Special Session chapter 
310.13 	3, article 22, to the commissioner of children, youth, and families from the general fund or 
310.14 	other named fund for the purposes specified in section 2 and are available for the fiscal 
310.15 	years indicated for each purpose. The figures "2026" and "2027" used in this article mean 
310.16 	that the addition to or subtraction from the appropriation listed under them is available for 
310.17 	the fiscal year ending June 30, 2026, or June 30, 2027, respectively.

310.18				APPROPRIATIONS
	
310.19				Available for the Year
	
310.20				Ending June 30
	
310.21					2026
		2027

310.22
310.23	Sec. 2. COMMISSIONER OF CHILDREN, 
YOUTH, AND FAMILIES.

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

310.25	Appropriations by Fund
	
310.26	General Fund
	(22,395,000)
	(10,320,000)
	
310.27	Federal TANF
	(22,766,000)
	(26,131,000)

310.28	Subd. 2.Forecasted Programs

310.29	(a) MFIP/DWP

310.30	Appropriations by Fund
	
310.31	General Fund
	(7,245,000)
	(3,125,000)
	
310.32	Federal TANF
	(22,766,000)
	(26,131,000)

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

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

311.2 	Sec. 3. EFFECTIVE DATE.
 311.3 	This article is effective the day following final enactment.

311.4 	ARTICLE 17
311.5 	DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS

311.6	Section 1. DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS.
 	
311.7 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
311.8 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
311.9 	Session chapter 3, article 20, from the general fund or any fund named for the purposes 
311.10 	specified in this article, to be available for the fiscal year indicated for each purpose. The 
311.11 	figures "2026" and "2027" used in this article mean that the appropriations listed under them 
311.12 	are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The 
311.13 	first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is 
311.14 	fiscal years 2026 and 2027.

311.15				APPROPRIATIONS
	
311.16				Available for the Year
	
311.17				Ending June 30
	
311.18					2026
		2027

311.19
311.20	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES
 	$
	-0-
	$
	132,522,000
	
311.21 	The amounts that may be spent for each 
311.22 	purpose are specified in this article.

311.23	Sec. 3. CENTRAL OFFICE; OPERATIONS
 	$
	-0-
	$
	2,154,000
	
311.24 	The general fund base is increased by 
311.25 	$6,741,000 in fiscal year 2028 and increased 
311.26 	by $7,577,000 in fiscal year 2029.

311.27	Sec. 4. CENTRAL OFFICE; HEALTH CARE
 	$
	-0-
	$
	19,403,000
	
311.28 	The general fund base is increased by 
311.29 	$59,838,000 in fiscal year 2028 and increased 
311.30 	by $60,350,000 in fiscal year 2029.

311.31
311.32	Sec. 5. CENTRAL OFFICE; BEHAVIORAL 
HEALTH
 	$
	-0-
	$
	896,000
	
312.1 	This is a onetime appropriation.

312.2
312.3	Sec. 6. CENTRAL OFFICE; OFFICE OF 
INSPECTOR GENERAL
 	$
	-0-
	$
	330,000

312.4
312.5	Subdivision 1.Crisis Nursery Licensing 
Framework
 					
312.6 	$304,000 in fiscal year 2027 is to develop a 
312.7 	licensing framework for crisis nurseries. The 
312.8 	base for this appropriation is $358,000 in fiscal 
312.9 	year 2028 and $0 in fiscal year 2029.

312.10	Subd. 2.Base Level Adjustments
 					
312.11 	The general fund base is increased by 
312.12 	$384,000 in fiscal year 2028 and increased by 
312.13 	$26,000 in fiscal year 2029.

312.14
312.15	Sec. 7. FORECASTED PROGRAMS; 
MEDICAL ASSISTANCE
 	$
	-0-
	$
	94,505,000
	
312.16 	$100,000,000 in fiscal year 2027 is for the 
312.17 	nonfederal share of the directed payment 
312.18 	arrangement under Minnesota Statutes, section 
312.19 	256B.1973. This is a onetime appropriation 
312.20 	and is available until June 30, 2028. This 
312.21 	appropriation is not effective until the day 
312.22 	following final enactment of H.F. 2438 in the 
312.23 	2026 regular legislative session.

312.24
312.25	Sec. 8. GRANT PROGRAMS; CHILD AND 
ECONOMIC SUPPORT GRANTS
 	$
	-0-
	$
	(407,000)
	
312.26 	Any unexpended amount in fiscal year 2027 
312.27 	and any amounts in the planning estimate for 
312.28 	fiscal year 2028 and fiscal year 2029 for the 
312.29 	emergency shelter facility grant and 
312.30 	emergency services grants must be transferred 
312.31 	from child and economic support grants to 
312.32 	housing support grants.

312.33
312.34	Sec. 9. GRANT PROGRAMS; FRAUD 
PREVENTION GRANTS
 	$
	-0-
	$
	(425,000)

313.1
313.2	Sec. 10. GRANT PROGRAMS; HEALTH 
CARE GRANTS
 	$
	-0-
	$
	1,500,000

313.3
313.4	Subdivision 1.Health Care Navigator Incentive 
Payment Grants
 					
313.5 	$250,000 in fiscal year 2027 is for application 
313.6 	assistance bonuses to organizations and 
313.7 	licensed insurance producers for applicants 
313.8 	successfully enrolled in medical assistance 
313.9 	under Minnesota Statutes, section 256.962, 
313.10 	subdivision 5. The base for this appropriation 
313.11 	is $500,000 in fiscal year 2028 and $500,000 
313.12 	in fiscal year 2029.

313.13	Subd. 2.Community Minigrant Program
 					
313.14 	$1,250,000 in fiscal year 2027 is for the 
313.15 	community minigrant program under 
313.16 	Minnesota Statutes, section 256.01, 
313.17 	subdivision 2, paragraph (a), clause (6). Grants 
313.18 	under this subdivision are subject to the grant 
313.19 	requirements under Minnesota Statutes, 
313.20 	chapter 16B. The base for this appropriation 
313.21 	is $1,250,000 in fiscal year 2028 and $625,000 
313.22 	in fiscal year 2029.

313.23	Subd. 3.Base Level Adjustments
 					
313.24 	The general fund base is increased by 
313.25 	$1,750,000 in fiscal year 2028 and $1,125,000 
313.26 	in fiscal year 2029.

313.27
313.28	Sec. 11. GRANT PROGRAMS; HOUSING AND 
SUPPORT SERVICES GRANTS
 	$
	-0-
	$
	192,000

313.29
313.30	Sec. 12. GRANT PROGRAMS; ADULT 
MENTAL HEALTH GRANTS
 	$
	-0-
	$
	2,483,000

313.31	Subdivision 1.Mobile Crisis Grants
 					
313.32 	$3,800,000 in fiscal year 2027 is for the 
313.33 	mobile crisis grants under Minnesota Statutes, 
313.34 	sections 245.4661, subdivision 9, paragraph 
313.35 	(b), clause (15), and 245.4889, subdivision 1, 
314.1 	paragraph (b), clause (4). This is a onetime 
314.2 	appropriation and is available until June 30, 
314.3 	2029.

314.4	Subd. 2.Base Level Adjustments
 					
314.5 	The general fund base is reduced by 
314.6 	$1,317,000 in fiscal year 2028 and reduced 
314.7 	by $1,317,000 in fiscal year 2029.

314.8
314.9	Sec. 13. GRANT PROGRAMS; CHILD 
MENTAL HEALTH GRANTS
 	$
	-0-
	$
	12,252,000

314.10
314.11	Subdivision 1.School-Linked Behavioral Health 
Grants
 					
314.12 	$11,891,000 in fiscal year 2027 is for 
314.13 	school-linked behavioral health grants under 
314.14 	Minnesota Statutes, section 245.4901. Grant 
314.15 	awards under this subdivision must allow a 
314.16 	grantee to use grant funds for a partnership 
314.17 	with a nonpublic school or a Tribal contract 
314.18 	school to provide services to students 
314.19 	attending a nonpublic or Tribal contract school 
314.20 	and to provide staff professional development 
314.21 	activities for school's licensed and unlicensed 
314.22 	staff. This is a onetime appropriation and is 
314.23 	available until June 30, 2029.

314.24	Subd. 2.Base Level Adjustments
 					
314.25 	The general fund base is increased by 
314.26 	$361,000 in fiscal year 2028 and increased by 
314.27 	$361,000 in fiscal year 2029.

314.28
314.29
314.30	Sec. 14. GRANT PROGRAMS; CHEMICAL 
DEPENDENCY TREATMENT SUPPORT 
GRANTS
 	$
	-0-
	$
	(361,000)

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

315.1 	Sec. 16. EXPIRATION OF UNCODIFIED LANGUAGE.
 315.2 	All uncodified language contained in this article expires on June 30, 2027, unless a 
315.3 	different expiration date is explicit or an appropriation is made available beyond June 30, 
315.4 	2027.

315.5 	Sec. 17. APPROPRIATIONS GIVEN EFFECT ONCE.
 315.6 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
315.7 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
315.8 	effect once.

315.9 	ARTICLE 18
315.10 	DEPARTMENT OF HEALTH APPROPRIATIONS

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

315.19				APPROPRIATIONS
	
315.20				Available for the Year
	
315.21				Ending June 30
	
315.22					2026
		2027

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

315.24	Appropriations by Fund
	
315.25		2026
	2027
	
315.26	General
	50,000,000
	88,383,000
	
315.27
315.28	State Government 
Special Revenue
	440,000
	627,000
	
315.29 	The amounts that may be spent for each 
315.30 	purpose are specified in the following sections.

315.31	Sec. 3. HEALTH IMPROVEMENT

315.32	Subdivision 1.Total Appropriation

316.1	Appropriations by Fund
	
316.2	General
	50,000,000
	86,330,000
	
316.3
316.4	State Government 
Special Revenue
	440,000
	627,000

316.5	Subd. 2.Helping Paws
 					
316.6 	(a) Helping Paws Grant. $200,000 in fiscal 
316.7 	year 2027 is from the general fund for a grant 
316.8 	to Helping Paws, Inc., to breed, train, and 
316.9 	place service or facility dogs with individuals 
316.10 	who have physical disabilities; veterans and 
316.11 	first responders living with service-related 
316.12 	post-traumatic stress disorder; and 
316.13 	professionals in courthouse, educational, and 
316.14 	mental health settings. This is a onetime 
316.15 	appropriation in memory of Speaker Emerita 
316.16 	Melissa Hortman. Up to $10,000 in fiscal year 
316.17 	2027 may be used for administration.
316.18 	(b) Helping Paws; Private Donations. The 
316.19 	commissioner of health may accept private 
316.20 	donations to supplement the state money 
316.21 	appropriated under paragraph (a). All 
316.22 	donations accepted by the commissioner under 
316.23 	this paragraph must be deposited in the gift 
316.24 	fund and are appropriated to the commissioner 
316.25 	for the purposes of paragraph (a).

316.26	Subd. 3.Crisis Telephone Services
 					
316.27 	$1,125,000 in fiscal year 2027 is from the 
316.28 	general fund for regional coordination and 
316.29 	24-hour-a-day, seven-day-a-week statewide 
316.30 	crisis telephone services. Up to $112,500 in 
316.31 	fiscal year 2027 is for administration.

316.32	Subd. 4.Hospital Stabilization Program
 					
316.33 	$30,000,000 in fiscal year 2027 is from the 
316.34 	general fund for the hospital stabilization 
317.1 	program. This is a onetime appropriation. Of 
317.2 	this appropriation, $600,000 in fiscal year 
317.3 	2027 is for the commissioner to administer 
317.4 	the program.

317.5
317.6	Subd. 5.Hennepin Healthcare Stabilization 
Payments
 					
317.7 	$50,000,000 in fiscal year 2026 and 
317.8 	$54,950,000 in fiscal year 2027 are for direct 
317.9 	payments to Hennepin Healthcare System, 
317.10 	Inc., to avoid closure of the Hennepin County 
317.11 	Medical Center. The commissioner must make 
317.12 	a payment of the amount appropriated in fiscal 
317.13 	year 2026 by June 30, 2026. For the purposes 
317.14 	of these payments, the statewide grant-making 
317.15 	requirements, including but not limited to 
317.16 	those under Minnesota Statutes, sections 
317.17 	16A.15; 16B.97; 16C.05, subdivisions 1 to 4 
317.18 	and 6 to 8; and 16C.06, do not apply. The 
317.19 	commissioner may use up to $350,000 in fiscal 
317.20 	year 2027 for administration. This is a onetime 
317.21 	appropriation. Notwithstanding section 8, this 
317.22 	appropriation is not effective until the day 
317.23 	following final enactment of House File No. 
317.24 	2438 from the 2026 regular session.

317.25
317.26	Subd. 6.Licensing and Regulation of Health 
Maintenance Organizations
 					
317.27 	$440,000 in fiscal year 2026 and $440,000 in 
317.28 	fiscal year 2027 are from the state government 
317.29 	special revenue fund for licensing and 
317.30 	regulation of health maintenance organizations 
317.31 	under Minnesota Statutes, chapter 62D.

317.32
317.33	Subd. 7.All-Payer Claims Database; 
Administration
 					
317.34 	$187,000 in fiscal year 2027 is from the state 
317.35 	government special revenue fund for 
318.1 	administering the all-payer claims database 
318.2 	under Minnesota Statutes, section 62U.04. The 
318.3 	state government special revenue fund base 
318.4 	for this subdivision is increased by $233,000 
318.5 	in fiscal year 2028 and increased by $291,000 
318.6 	in fiscal year 2029.

318.7
318.8	Subd. 8.All-Payer Claims Database; Data on 
Fully Denied Claims
 					
318.9 	$55,000 in fiscal year 2027 is from the general 
318.10 	fund for the collection of data on fully denied 
318.11 	claims according to Minnesota Statutes, 
318.12 	section 62U.04, subdivision 4. This is a 
318.13 	onetime appropriation.

318.14	Subd. 9.Base Adjustment
 					
318.15 	The general fund base is increased by 
318.16 	$1,125,000 in fiscal year 2028 and increased 
318.17 	by $1,125,000 in fiscal year 2029. The state 
318.18 	government special revenue fund base is 
318.19 	increased by $673,000 in fiscal year 2028 and 
318.20 	increased by $731,000 in fiscal year 2029.

318.21	Sec. 4. HEALTH PROTECTION
 	$
	-0-
	$
	2,053,000
	
318.22 	$2,053,000 in fiscal year 2027 is for 
318.23 	rulemaking and administrative activities under 
318.24 	Minnesota Statutes, section 103I.706. This is 
318.25 	a onetime appropriation and is available until 
318.26 	December 31, 2029.

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

319.1 	Sec. 6. EXPIRATION OF UNCODIFIED LANGUAGE.
 319.2 	All uncodified language contained in this article expires on June 30, 2027, unless a 
319.3 	different expiration date is explicit or an appropriation is made available beyond June 30, 
319.4 	2027.

319.5 	Sec. 7. APPROPRIATIONS GIVEN EFFECT ONCE.
 319.6 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
319.7 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
319.8 	effect once.

319.9 	Sec. 8. EFFECTIVE DATE.
 319.10 	This article is effective the day following final enactment.

319.11 	ARTICLE 19
319.12 	DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS

319.13	Section 1. CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS.
 	
319.14 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
319.15 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
319.16 	Session chapter 3, article 22, from the general fund or any fund named for the purposes 
319.17 	specified in this article, to be available for the fiscal year indicated for each purpose. The 
319.18 	figures "2026" and "2027" used in this article mean that the appropriations listed under them 
319.19 	are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The 
319.20 	first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is 
319.21 	fiscal years 2026 and 2027.

319.22				APPROPRIATIONS
	
319.23				Available for the Year
	
319.24				Ending June 30
	
319.25					2026
		2027

319.26
319.27	Sec. 2. COMMISSIONER OF CHILDREN, 
YOUTH, AND FAMILIES
 	$
	-0-
	$
	46,952,000
	
319.28 	The amounts that may be spent for each 
319.29 	purpose are specified in the following sections.

319.30
319.31
319.32	Sec. 3. OPERATIONS AND 
ADMINISTRATION; AGENCY-WIDE 
SUPPORTS
 	$
	-0-
	$
	6,546,000

320.1
320.2	Subdivision 1.Crisis Nursery Licensing 
Framework
 					
320.3 	$212,000 in fiscal year 2027 is to develop a 
320.4 	licensing framework for crisis nurseries. The 
320.5 	base for this appropriation is $441,000 in fiscal 
320.6 	year 2028 and $0 in fiscal year 2029.

320.7	Subd. 2.Base Adjustments
 					
320.8 	The base is increased by $6,260,000 in fiscal 
320.9 	year 2028 and increased by $5,819,000 in 
320.10 	fiscal year 2029.

320.11
320.12	Sec. 4. OPERATIONS AND 
ADMINISTRATION; EARLY CHILDHOOD
 	$
	-0-
	$
	281,000

320.13
320.14
320.15	Sec. 5. OPERATIONS AND 
ADMINISTRATION; ECONOMIC 
OPPORTUNITY AND YOUTH SERVICES
 	$
	-0-
	$
	147,000
	
320.16 	This is a onetime appropriation.

320.17
320.18	Sec. 6. OPERATIONS AND 
ADMINISTRATION; FAMILY WELL-BEING
 	$
	-0-
	$
	2,818,000
	
320.19 	The general fund base is increased by 
320.20 	$3,308,000 in fiscal year 2028 and increased 
320.21 	by $3,308,000 in fiscal year 2029.

320.22
320.23	Sec. 7. GRANT PROGRAMS; SUPPORT 
SERVICES GRANTS
 	$
	-0-
	$
	10,728,000
	
320.24 	County allocation for SNAP administrative 
320.25 	costs. $10,728,000 in fiscal year 2027 is for 
320.26 	an allocation to counties for SNAP 
320.27 	administrative costs. The commissioner must 
320.28 	allocate money under this section to counties 
320.29 	based on each county's proportional share of 
320.30 	SNAP administrative costs in the most recent 
320.31 	year for which data are available. This is a 
320.32 	onetime appropriation.

320.33
320.34	Sec. 8. GRANT PROGRAMS; CHILD CARE 
DEVELOPMENT GRANTS
 	$
	-0-
	$
	450,000

321.1
321.2	Subdivision 1.Child Care Licensing Basics 
Training Contract
 					
321.3 	$450,000 in fiscal year 2027 is for a contract 
321.4 	with a vendor to provide child care licensing 
321.5 	basics training, including course content 
321.6 	creation, translation, marketing, promotion, 
321.7 	and underwriting. The base for this 
321.8 	appropriation is $338,000 in fiscal year 2028 
321.9 	and $338,000 in fiscal year 2029.

321.10	Subd. 2.Base Adjustment
 					
321.11 	The general fund base is increased by 
321.12 	$338,000 in fiscal year 2028 and increased by 
321.13 	$338,000 in fiscal year 2029.

321.14
321.15	Sec. 9. GRANT PROGRAMS; CHILDREN'S 
SERVICES GRANTS
 	$
	-0-
	$
	250,000
	
321.16 	Forensic Interview Training Scholarships.
321.17 	$250,000 in fiscal year 2027 is for grants to 
321.18 	provide training scholarships for recipients to 
321.19 	attend nationally recognized forensic interview 
321.20 	protocol training. Eligible grantees must award 
321.21 	scholarships for recipients to attend basic 
321.22 	forensic interview training, advanced forensic 
321.23 	interview training, and specialized interview 
321.24 	topics training. Scholarship recipients may 
321.25 	include individuals in law enforcement, child 
321.26 	protection, and prosecution; health 
321.27 	professionals investigating, treating, and 
321.28 	managing child maltreatment cases in 
321.29 	Minnesota; advocates working with a 
321.30 	multidisciplinary team; and forensic 
321.31 	interviewers at children's advocacy centers. 
321.32 	This is a onetime appropriation.

321.33
321.34	Sec. 10. GRANT PROGRAMS; CHILD AND 
COMMUNITY SERVICES GRANTS
 	$
	-0-
	$
	15,000,000
	
322.1 	County Implementation of Minnesota 
322.2 	African American Family Preservation and 
322.3 	Child Welfare Disproportionality Act.
322.4 	$15,000,000 in fiscal year 2027 is for initial 
322.5 	county implementation of the Minnesota 
322.6 	African American Family Preservation and 
322.7 	Child Welfare Disproportionality Act under 
322.8 	Minnesota Statutes, chapter 260. The 
322.9 	commissioner must distribute this 
322.10 	appropriation to counties under Minnesota 
322.11 	Statutes, section 260.694. This is a onetime 
322.12 	appropriation.

322.13
322.14	Sec. 11. GRANT PROGRAMS; CHILD AND 
ECONOMIC SUPPORT GRANTS
 	$
	-0-
	$
	10,732,000

322.15	Subdivision 1.Regional Food Bank Grants
 					
322.16 	$4,900,000 in fiscal year 2027 is for regional 
322.17 	food bank grants. This is a onetime 
322.18 	appropriation.

322.19	Subd. 2.Minnesota Food Shelf Program
 					
322.20 	$5,000,000 in fiscal year 2027 is for food shelf 
322.21 	programs under Minnesota Statutes, section 
322.22 	142F.14. This is a onetime appropriation.

322.23	Subd. 3.Base Adjustment
 					
322.24 	The general fund base is increased by 
322.25 	$832,000 in fiscal year 2028 and increased by 
322.26 	$832,000 in fiscal year 2029.

322.27 	Sec. 12. Minnesota Statutes 2025 Supplement, section 256.043, subdivision 3, is amended 
322.28 	to read:
322.29 		Subd. 3.Appropriations from registration and license fee account. (a) The 
322.30 	appropriations in paragraphs (b) to (n) shall be made from the registration and license fee 
322.31 	account on a fiscal year basis in the order specified.
323.1 	(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs 
323.2 	(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be 
323.3 	made accordingly.
323.4 	(c) $100,000 is appropriated to the commissioner of human services for grants for opiate 
323.5 	antagonist distribution. Grantees may utilize funds for opioid overdose prevention, 
323.6 	community asset mapping, education, and opiate antagonist distribution.
323.7 	(d) $2,000,000 is appropriated to the commissioner of human services for direct payments 
323.8 	to Tribal nations and five urban Indian communities for traditional healing practices for 
323.9 	American Indians and to increase the capacity of culturally specific providers in the 
323.10 	behavioral health workforce. Any evaluations of practices under this paragraph must be 
323.11 	designed cooperatively by the commissioner and Tribal nations or urban Indian communities. 
323.12 	The commissioner must not require recipients to provide the details of specific ceremonies 
323.13 	or identities of healers.
323.14 	(e) $400,000 is appropriated to the commissioner of human services for competitive 
323.15 	grants for opioid-focused Project ECHO programs.
323.16 	(f) $277,000 $321,000 in fiscal year 2024 2027 and $321,000 each year thereafter is 
323.17 	appropriated to the commissioner of human services children, youth, and families to 
323.18 	administer the funding distribution and reporting requirements in paragraph (o) (m).
323.19 	(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated 
323.20 	to the commissioner of human services for safe recovery sites start-up and capacity building 
323.21 	grants under section 254B.18.
323.22 	(h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to 
323.23 	the commissioner of human services for the opioid overdose surge alert system under section 
323.24 	245.891.
323.25 	(i) $300,000 is appropriated to the commissioner of management and budget for 
323.26 	evaluation activities under section 256.042, subdivision 1, paragraph (c).
323.27 	(j) $261,000 is appropriated to the commissioner of human services for the provision of 
323.28 	administrative services to the Opiate Epidemic Response Advisory Council and for the 
323.29 	administration of the grants awarded under paragraph (n).
323.30 	(k) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration 
323.31 	fees under section 151.066.
324.1 	(l) $672,000 is appropriated to the commissioner of public safety for the Bureau of 
324.2 	Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies 
324.3 	and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
324.4 	(m) After the appropriations in paragraphs (b) to (l) are made, 50 percent of the remaining 
324.5 	amount is appropriated to the commissioner of children, youth, and families for distribution 
324.6 	to county social service agencies and Tribal social service agency initiative projects 
324.7 	authorized under section 256.01, subdivision 14b, to provide prevention and child protection 
324.8 	services to children and families who are affected by addiction. The commissioner shall 
324.9 	distribute this money proportionally to county social service agencies and Tribal social 
324.10 	service agency initiative projects through a formula based on intake data from the previous 
324.11 	three calendar years related to substance use and out-of-home placement episodes where 
324.12 	parental drug abuse is a reason for the out-of-home placement. County social service agencies 
324.13 	and Tribal social service agency initiative projects receiving funds from the opiate epidemic 
324.14 	response fund must annually report to the commissioner on how the funds were used to 
324.15 	provide prevention and child protection services, including measurable outcomes, as 
324.16 	determined by the commissioner. County social service agencies and Tribal social service 
324.17 	agency initiative projects must not use funds received under this paragraph to supplant 
324.18 	current state or local funding received for child protection services for children and families 
324.19 	who are affected by addiction.
324.20 	(n) After the appropriations in paragraphs (b) to (m) are made, the remaining amount in 
324.21 	the account is appropriated to the commissioner of human services to award grants as 
324.22 	specified by the Opiate Epidemic Response Advisory Council in accordance with section 
324.23 	256.042, unless otherwise appropriated by the legislature.
324.24 	(o) Beginning in fiscal year 2022 and each year thereafter, funds for county social service 
324.25 	agencies and Tribal social service agency initiative projects under paragraph (m) and grant 
324.26 	funds specified by the Opiate Epidemic Response Advisory Council under paragraph (n) 
324.27 	may be distributed on a calendar year basis.
324.28 	(p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs 
324.29 	(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.

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

325.1 	Sec. 13. Laws 2024, chapter 117, section 22, is amended to read:
325.2 	Sec. 22. APPROPRIATIONS; MINNESOTA AFRICAN AMERICAN FAMILY 
325.3 	PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT.
 325.4 	(a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the 
325.5 	commissioner of human services for grants to Hennepin and Ramsey Counties to implement 
325.6 	the Minnesota African American Family Preservation and Child Welfare Disproportionality 
325.7 	Act phase-in program. Of this amount, $2,500,000 must be provided to Hennepin County 
325.8 	and $2,500,000 must be provided to Ramsey County. This is a onetime appropriation and 
325.9 	is available until June 30 December 31, 2026.
325.10 	(b) $1,000,000 in fiscal year 2025 is appropriated from the general fund to the 
325.11 	commissioner of human services for the African American and disproportionately represented 
325.12 	family preservation grant program under Minnesota Statutes, section 260.693. 
325.13 	Notwithstanding Minnesota Statutes, section 16B.98, subdivision 14, the amount for 
325.14 	administrative costs under this paragraph is $0.
325.15 	(c) $2,367,000 in fiscal year 2025 is appropriated from the general fund to the 
325.16 	commissioner of human services to implement the African American Family Preservation 
325.17 	and Child Welfare Disproportionality Act. The base for this appropriation is $3,251,000 in 
325.18 	fiscal year 2026 and $3,110,000 in fiscal year 2027.

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

325.23 	Sec. 15. EXPIRATION OF UNCODIFIED LANGUAGE.
 325.24 	All uncodified language contained in this article expires on June 30, 2027, unless a 
325.25 	different expiration date is explicit or an appropriation is made available beyond June 30, 
325.26 	2027.

325.27 	Sec. 16. APPROPRIATIONS GIVEN EFFECT ONCE.
 325.28 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
325.29 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
325.30 	effect once.

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

326.3 	ARTICLE 20
326.4 	OTHER AGENCY APPROPRIATIONS

326.5	Section 1. OTHER AGENCY APPROPRIATIONS.
 	
326.6 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
326.7 	shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special 
326.8 	Session chapter 3, articles 23 and 24, from the general fund or any fund named for the 
326.9 	purposes specified in this article, to be available for the fiscal year indicated for each purpose. 
326.10 	The figures "2026" and "2027" used in this article mean that the appropriations listed under 
326.11 	them are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. 
326.12 	"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" 
326.13 	is fiscal years 2026 and 2027.

326.14				APPROPRIATIONS
	
326.15				Available for the Year
	
326.16				Ending June 30
	
326.17					2026
		2027

326.18
326.19	Sec. 2. LEGISLATIVE COORDINATING 
COMMISSION
 	$
	17,000
	$
	74,000

326.20
326.21	Subdivision 1.Education Group Insurance 
Program Report
 					
326.22 	$17,000 in fiscal year 2026 and $74,000 in 
326.23 	fiscal year 2027 are for the Legislative Budget 
326.24 	Office to complete the annual report under 
326.25 	Minnesota Statutes, section 471.6161, 
326.26 	subdivision 9. The base for this appropriation 
326.27 	is $36,000 in fiscal year 2028 and $36,000 in 
326.28 	fiscal year 2029.

326.29	Subd. 2.Base Adjustment
 					
326.30 	The general fund base is increased by $36,000 
326.31 	in fiscal year 2028 and increased by $36,000 
326.32 	in fiscal year 2029.

326.33
326.34	Sec. 3. COMMISSIONER OF PUBLIC 
SAFETY
 	$
	-0-
	$
	-0-

327.1
327.2	Subdivision 1.Child Care Licensing 
Modernization
 					
327.3 	The base in fiscal year 2029 must include 
327.4 	$544,000 for child care licensing 
327.5 	modernization under Minnesota Statutes, 
327.6 	chapters 142H and 142I.

327.7	Subd. 2.Base Adjustment
 					
327.8 	The general fund base is increased by 
327.9 	$544,000 in fiscal year 2029.

327.10	Sec. 4. COMMISSIONER OF EDUCATION
 	$
	-0-
	$
	(281,000)
	
327.11 	This reduction is for preschool assessment 
327.12 	funding.

327.13
327.14	Sec. 5. COMMISSIONER OF MANAGEMENT 
AND BUDGET
 	$
	-0-
	$
	193,000
	
327.15 	$193,000 in fiscal year 2027 is for 
327.16 	administration of the advisory task force on 
327.17 	governance and financing of Hennepin 
327.18 	Healthcare System, Inc. This is a onetime 
327.19 	appropriation.

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

327.21	Subdivision 1.Medicaid Fraud Control Unit
 					
327.22 	$1,230,000 in fiscal year 2027 is for the 
327.23 	Medicaid fraud control unit. The base for this 
327.24 	appropriation is $1,230,000 in fiscal year 2028 
327.25 	and $1,230,000 in fiscal year 2029.

327.26	Subd. 2.Base Adjustment
 					
327.27 	The general fund base is increased by 
327.28 	$1,230,000 in fiscal year 2028 and increased 
327.29 	by $1,230,000 in fiscal year 2029.

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

327.31	Sec. 7. BOARD OF DIRECTORS OF MNSURE
 	$
	-0-
	$
	2,330,000
	
328.1 	(a) Information Technology to Implement 
328.2 	Federal Deferred Action for Childhood 
328.3 	Arrivals Regulatory Requirements.
328.4 	$2,330,000 in fiscal year 2025 is for 
328.5 	information technology to implement federal 
328.6 	Deferred Action for Childhood Arrivals 
328.7 	regulatory requirements for technology and 
328.8 	operational needs. This appropriation is for 
328.9 	information technology enhancements, system 
328.10 	readiness, consumer communications, and 
328.11 	operational changes to maintain service 
328.12 	continuity and improve the consumer 
328.13 	experience. This is a onetime appropriation 
328.14 	and is available until June 30, 2027.
328.15 	(b) Transfer to Enterprise Account. The 
328.16 	Board of Directors of MNsure must transfer 
328.17 	$2,330,000 in fiscal year 2025 from the 
328.18 	general fund to the enterprise account under 
328.19 	Minnesota Statutes, section 62V.07. This is a 
328.20 	onetime transfer.

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

328.25 	Sec. 9. EXPIRATION OF UNCODIFIED LANGUAGE.
 328.26 	All uncodified language contained in this article expires on June 30, 2027, unless a 
328.27 	different expiration date is explicit or an appropriation is made available beyond June 30, 
328.28 	2027.

328.29 	Sec. 10. APPROPRIATIONS GIVEN EFFECT ONCE.
 328.30 	If an appropriation, transfer, or cancellation in this article is enacted more than once 
328.31 	during the 2026 legislative session, the appropriation, transfer, or cancellation must be given 
328.32 	effect once.
329.1 	Delete the title and insert:
329.2 	A bill for an act
329.3 	relating to state government; modifying provisions relating to the Department of 
329.4 	Health, gas resource development, hospital stabilization, health licensing boards, 
329.5 	health care, federal conformity, medical assistance fraud prevention and conforming 
329.6 	changes, children, youth, and families policy, children, youth, and families budget, 
329.7 	the Minnesota African American Family Preservation and Child Welfare 
329.8 	Disproportionality Act, child care center licensing modernization, and family child 
329.9 	care licensing modernization; making forecast adjustments for the Department of 
329.10 	Human Services and Department of Children, Youth, and Families; appropriating 
329.11 	money for the Department of Children, Youth, and Families, Department of Human 
329.12 	Services, and other agencies; requiring reports; authorizing rulemaking; providing 
329.13 	criminal penalties;amending Minnesota Statutes 2024, sections 8.16, subdivision 
329.14 	1; 16A.152, subdivisions 2, 4, by adding subdivisions; 62A.01, by adding a 
329.15 	subdivision; 62A.011, subdivision 3; 62J.17, subdivision 6a; 62J.2930, subdivision 
329.16 	1; 62K.02, subdivision 2; 62K.03, subdivision 6; 62K.075; 62K.105; 62K.14; 
329.17 	62U.04, subdivisions 4, 13, by adding a subdivision; 62V.05, subdivision 7; 62V.13; 
329.18 	93.514; 103I.001; 103I.005, subdivisions 9, 21, by adding subdivisions; 103I.601, 
329.19 	subdivision 1, by adding subdivisions; 116.943, subdivision 2; 116J.035, by adding 
329.20 	a subdivision; 124D.19, by adding a subdivision; 142A.43; 142B.10, subdivision 
329.21 	18; 142B.30, by adding a subdivision; 142B.65, subdivision 7; 142B.70, subdivision 
329.22 	6; 142C.12, subdivision 3; 142D.05, subdivision 8; 142D.21, subdivision 6; 
329.23 	142D.25, subdivision 3; 142E.04, subdivision 4; 144.059, subdivision 8; 144.1222, 
329.24 	subdivision 4, by adding a subdivision; 144.1501, subdivision 2; 144.1503, 
329.25 	subdivision 7; 144.1505, subdivisions 1, 2, 3; 144.1507, subdivisions 1, 2, 4, by 
329.26 	adding a subdivision; 144.1911, subdivisions 1, 5, 6; 144.293, subdivision 7; 
329.27 	144.551, subdivision 1, as amended; 145.56, subdivision 5; 145.561, subdivision 
329.28 	2; 145.882, by adding subdivisions; 145A.04, subdivision 15; 145A.14, subdivision 
329.29 	2a; 148.01, subdivisions 1, 4, by adding subdivisions; 148.09; 148.10, by adding 
329.30 	a subdivision; 148.102, subdivision 3; 148.105, subdivision 1; 148.517, subdivisions 
329.31 	1, 2; 148.5191, subdivision 4; 149A.91, subdivision 3; 149A.94, subdivision 1; 
329.32 	149A.955, subdivision 14; 151.01, subdivision 35, by adding a subdivision; 
329.33 	151.555, subdivision 7; 151.741, subdivision 4; 214.10, subdivision 2a; 214.41; 
329.34 	245A.211, subdivision 1; 245C.04, subdivision 1; 245C.15, subdivisions 2, 3, 4; 
329.35 	256.01, by adding a subdivision; 256.969, subdivisions 2b, 25; 256B.04, subdivision 
329.36 	27; 256B.05, subdivision 5, by adding a subdivision; 256B.055, subdivision 17; 
329.37 	256B.056, subdivisions 1, 2a, 3d, 7, 7a; 256B.0561, subdivision 2; 256B.06, 
329.38 	subdivision 4; 256B.061; 256B.0631, subdivision 1a, by adding subdivisions; 
329.39 	256B.75; 256L.05, subdivision 3; 256L.06, subdivision 3; 259.83, subdivision 1, 
329.40 	as amended; 260.63, subdivision 10; 260.64, subdivision 2; 260.67, subdivision 
329.41 	1; 260.68, subdivision 2; 260.69, subdivision 1; 260.693, subdivision 2; 260C.190, 
329.42 	subdivision 1; 260C.212, subdivisions 1, 4a, by adding a subdivision; 260C.451, 
329.43 	subdivisions 2, 3, 3a; 295.52, subdivision 8; 383B.903, subdivisions 1, 4; 383B.904, 
329.44 	subdivision 1; 383B.908, subdivisions 5, 7; 471.6161, by adding a subdivision; 
329.45 	609.52, subdivision 2; Minnesota Statutes 2025 Supplement, sections 3.732, 
329.46 	subdivision 1; 62K.10, subdivision 2; 144.125, subdivision 1; 145A.061, 
329.47 	subdivision 3; 145C.18, subdivisions 3, 4; 148.108, subdivision 5; 151.741, 
329.48 	subdivision 5; 256.043, subdivision 3; 256.9657, subdivision 2b; 256.969, 
329.49 	subdivision 2f; 256B.0625, subdivision 8; 256B.12; 256B.1973, subdivision 9; 
329.50 	256B.69, subdivision 6d; 256B.695, subdivision 5; 260.691, subdivision 1; 260.692, 
329.51 	subdivisions 1, 2, 3; 260C.451, subdivision 8; 268.19, subdivision 1; 609.531, 
329.52 	subdivision 1; 609.902, subdivision 4; 628.26; Laws 2023, chapter 68, article 1, 
329.53 	sections 2, subdivision 2, as amended; 3, subdivision 2, as amended; Laws 2024, 
329.54 	chapter 117, sections 9; 21; 22; Laws 2024, chapter 127, article 67, section 7; Laws 
329.55 	2025, First Special Session chapter 3, article 8, section 25; article 23, section 2, 
329.56 	subdivision 12; Laws 2026, chapter 88, article 1, section 181; proposing coding 
329.57 	for new law in Minnesota Statutes, chapters 62Q; 103I; 142D; 144; 148; 256B; 
330.1 	260; 609; proposing coding for new law as Minnesota Statutes, chapters 142H; 
330.2 	142I; repealing Minnesota Statutes 2024, sections 13D.08, subdivision 4; 62J.06; 
330.3 	62J.156; 62J.2930, subdivision 4; 62J.57; 62U.10, subdivision 4; 142B.01, 
330.4 	subdivisions 11, 12, 13, 25, 26, 27; 142B.41, subdivisions 4, 6, 7, 8, 10, 11, 12, 
330.5 	13; 142B.54, subdivisions 1, 2, 3; 142B.62; 142B.65, subdivisions 1, 2, 3, 4, 5, 6, 
330.6 	7, 10; 142B.66, subdivisions 1, 2, 4, 5; 142B.70, subdivisions 1, 2, 3, 4, 5, 6, 9, 
330.7 	10, 11, 12; 142B.71; 142B.72; 142B.74; 142B.75; 142B.76; 142B.77; 144.9821; 
330.8 	151.741, subdivisions 2, 3, 6; 256B.198; 256B.69, subdivision 31a; 260.63, 
330.9 	subdivision 9; 609.466; Minnesota Statutes 2025 Supplement, sections 142B.41, 
330.10 	subdivision 9; 142B.65, subdivisions 8, 9; 142B.66, subdivision 3; 142B.70, 
330.11 	subdivisions 7, 8; Minnesota Rules, parts 2500.0100, subparts 5b, 6, 12; 2500.1900; 
330.12 	2500.2020; 2500.2040; 2500.2100; 2500.2110; 6800.0400; 6800.1150; 9502.0300; 
330.13 	9502.0315; 9502.0325; 9502.0335; 9502.0341; 9502.0345; 9502.0355; 9502.0365; 
330.14 	9502.0367; 9502.0375; 9502.0395; 9502.0405; 9502.0415; 9502.0425; 9502.0435; 
330.15 	9502.0445; 9503.0005; 9503.0010; 9503.0015; 9503.0030; 9503.0031; 9503.0032; 
330.16 	9503.0033; 9503.0034; 9503.0040; 9503.0045; 9503.0050; 9503.0055; 9503.0060; 
330.17 	9503.0065; 9503.0070; 9503.0075; 9503.0080; 9503.0085; 9503.0090; 9503.0095; 
330.18 	9503.0100; 9503.0105; 9503.0110; 9503.0115; 9503.0120; 9503.0125; 9503.0130; 
330.19 	9503.0140; 9503.0145; 9503.0150; 9503.0155; 9503.0170.

331.1	We request the adoption of this report and repassage of the bill.
	
331.2	Senate Conferees:
........			
331.3	........
		........
	
331.4	Melissa Wiklund
		Alice Mann
	
331.5	........
		........
	
331.6	Liz Boldon
		Paul Utke
	
331.7	House Conferees:
........			
331.8	........
		........
	
331.9	Robert Bierman
		Liz Reyer
	
331.10	........
		........
	
331.11	Jeff Backer
		Danny Nadeau