SF 4612
2nd Engrossment - 94th Legislature (2025 - 2026)
Posted on 04/27/2026 11:33 a.m.
2.28 2.29
2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15
3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 5.1 5.2
5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21
5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19
6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13
7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 8.1 8.2 8.3
8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 9.1 9.2 9.3 9.4 9.5 9.6
9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16
9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31
11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21
12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10
13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10
14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 15.1 15.2 15.3
15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14
15.15 15.16 15.17 15.18 15.19
15.20 15.21 15.22 15.23 15.24 15.25 15.26
15.27 15.28 15.29 15.30 15.31 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10
16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21
17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30
18.1 18.2
18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22
18.23
18.24 18.25 18.26 18.27 18.28 18.29 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23
21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15
25.16 25.17
25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 26.1 26.2 26.3 26.4
26.5 26.6
26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21
26.22
26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9
27.10
27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 28.1 28.2
28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31
30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13
32.14
32.15 32.16
32.17 32.18
32.19 32.20 32.21 32.22 32.23 32.24 32.25
32.26 32.27 32.28 32.29 32.30 33.1 33.2 33.3 33.4 33.5
33.6 33.7 33.8 33.9 33.10 33.11 33.12
33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 34.1 34.2 34.3 34.4
34.5
34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8
35.9
35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20
35.21
35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 36.1 36.2 36.3 36.4 36.5
36.6
36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 37.1 37.2
37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28
37.29
38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22
38.23
38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20
39.21
39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24
43.25
43.26 43.27 43.28 43.29 43.30 43.31 43.32 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 47.34 48.1 48.2 48.3
48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 49.33 49.34 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 50.34 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25
51.26 51.27 51.28 51.29 51.30 51.31 51.32 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11
52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 52.34 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11
53.12
53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29
54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18
54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13
55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13
57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10
58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 59.1 59.2 59.3
59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 59.33 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21
60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 61.1 61.2 61.3 61.4
61.5 61.6
61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 62.1 62.2 62.3
62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15
63.16
63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32 63.33 64.1 64.2 64.3 64.4 64.5
64.6 64.7 64.8
64.9 64.10
64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28
71.29 71.30 71.31 71.32 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9
72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 73.1 73.2 73.3
73.4 73.5 73.6 73.7 73.8 73.9
73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17
73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12
74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24
75.25 75.26 75.27 75.28 75.29 75.30 75.31 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21
76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33 77.1 77.2
77.3 77.4
77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14
81.15 81.16 81.17 81.18 81.19 81.20 81.21
81.22 81.23 81.24
81.25 81.26 81.27 81.28 81.29 81.30 82.1 82.2 82.3 82.4 82.5 82.6 82.7
82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9
83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30
84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18
84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24
85.25 85.26 85.27 85.28 85.29 85.30 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 87.33 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 90.31 90.32 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24
91.25 91.26 91.27 91.28 91.29 91.30 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16
94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15
96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23
97.24 97.25 97.26 97.27 97.28 97.29 97.30 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17
101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 101.30 101.31 101.32 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 104.1 104.2 104.3 104.4 104.5 104.6 104.7
104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13
106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15
108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 110.1 110.2 110.3 110.4 110.5
110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32
111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19
113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8
115.9 115.10 115.11 115.12 115.13 115.14 115.15
115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31
116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16
118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15
121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 122.1 122.2
122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13
122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12
123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26
123.27 123.28 123.29 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24
128.25 128.26 128.27 128.28 128.29 128.30 128.31 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9
129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14
130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22
133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28
136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8
141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27
141.28 141.29 141.30 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21
142.22 142.23 142.24 142.25 142.26
142.27 142.28 142.29 142.30 142.31 143.1 143.2
143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13
143.14 143.15
143.16 143.17
143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10
148.11 148.12 148.13 148.14 148.15 148.16 148.17
148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 149.33 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17
151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13
152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 153.1 153.2 153.3 153.4 153.5
153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19
156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 157.33 157.34 157.35 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29
158.30 158.31 158.32 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12
160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20
161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26
165.27 165.28 165.29 165.30 165.31 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 166.33 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 167.33 168.1 168.2
168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26
168.27 168.28 168.29 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24
170.25 170.26 170.27 170.28 170.29 170.30 170.31 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20
178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11
180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14
181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10
186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8
187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14
192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 194.1 194.2 194.3 194.4 194.5 194.6 194.7
194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 195.1 195.2 195.3 195.4
195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 196.1 196.2 196.3 196.4 196.5 196.6
196.7 196.8 196.9 196.10 196.11
196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20
196.21 196.22
196.23 196.24 196.25
196.26 196.27 196.28 196.29 196.30 197.1 197.2 197.3 197.4
197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11
199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10
200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31
201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31
203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14
203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 205.1 205.2
205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 205.33 206.1 206.2 206.3 206.4 206.5 206.6
206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 207.1 207.2
207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18
207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17
208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12
209.13 209.14
209.15 209.16
209.17 209.18 209.19 209.20 209.21 209.22
209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 211.33 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16
212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15
214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23
214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28
217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32
219.1
219.2 219.3
219.4 219.5 219.6
219.7
219.8 219.9 219.10 219.11
219.12
219.13 219.14 219.15 219.16 219.17
219.18
219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8
220.9
220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21
220.22
220.23 220.24 220.25 220.26 220.27 220.28 220.29
220.30
221.1 221.2 221.3 221.4
221.5
221.6 221.7 221.8 221.9
221.10
221.11 221.12 221.13 221.14 221.15 221.16 221.17
221.18
221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 222.34 222.35 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9
224.10
224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8
225.9
225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14
226.15
226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 226.34 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16
227.17
227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28
228.29
228.30 228.31 228.32 228.33 229.1 229.2 229.3 229.4 229.5
229.6
229.7 229.8 229.9 229.10 229.11
229.12
229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19
230.20
230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32
230.33
231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9
231.10
231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20
231.21
231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31
232.1
232.2 232.3 232.4 232.5 232.6 232.7
232.8
232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19
232.20
232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30
232.31
233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10
233.11
233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 233.34 234.1 234.2 234.3 234.4 234.5
234.6
234.7 234.8 234.9 234.10 234.11 234.12 234.13
234.14
234.15 234.16 234.17 234.18 234.19
234.20
234.21 234.22 234.23 234.24 234.25 234.26 234.27
234.28
235.1 235.2 235.3 235.4 235.5 235.6
235.7
235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23
235.24
235.25 235.26 235.27 235.28 235.29 235.30
235.31
236.1 236.2 236.3 236.4 236.5
236.6
236.7 236.8 236.9 236.10 236.11
236.12
236.13 236.14 236.15 236.16 236.17
236.18
236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28
236.29
237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26
237.27
237.28 237.29 237.30 237.31 237.32 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26
238.27
238.28 238.29 238.30 238.31 238.32 238.33 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20
241.21
241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29
241.30
242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10
242.11
242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20
242.21
242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18
243.19
243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9
244.10
244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8
245.9
245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24
245.25
245.26 245.27 245.28 245.29 245.30 245.31
246.1
246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 247.1 247.2 247.3 247.4 247.5
247.6
247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17
247.18
247.19 247.20
247.21 247.22 247.23 247.24 247.25
247.26 247.27 247.28 247.29 247.30 248.1 248.2
248.3 248.4 248.5
248.6 248.7 248.8 248.9
248.10 248.11 248.12 248.13
248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28
249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13
249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 250.1 250.2 250.3
250.4 250.5 250.6 250.7
250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17
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259.10
259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22
259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12
260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 261.32 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9
262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32
264.1
264.2 264.3 264.4 264.5 264.6 264.7
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265.3 265.4 265.5 265.6
265.7 265.8 265.9 265.10
265.11 265.12 265.13 265.14
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265.21 265.22
265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 265.32 265.33 265.34 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14
266.15 266.16
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266.21 266.22 266.23
266.24 266.25 266.26 266.27
266.28 266.29 266.30 266.31
267.1 267.2 267.3 267.4
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267.20 267.21 267.22 267.23
267.24 267.25 267.26 267.27 267.28
267.29 267.30 267.31 267.32 267.33
267.34 267.35
268.1 268.2 268.3 268.4
268.5 268.6 268.7 268.8 268.9
268.10 268.11 268.12 268.13 268.14 268.15
268.16 268.17
268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32
268.33 268.34 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10
269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30
270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34
272.1
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272.20 272.21 272.22 272.23
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273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20
273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 274.33 274.34 274.35 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 275.33 275.34 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24
276.25 276.26
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277.5 277.6 277.7 277.8
277.9 277.10
277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23
277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33
278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 278.33 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 279.34 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10
281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24
281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 281.33 282.1 282.2 282.3 282.4
282.5 282.6 282.7
282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26
282.27 282.28 282.29 282.30 282.31
283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22
283.23 283.24 283.25 283.26
283.27 283.28 283.29 283.30
284.1 284.2 284.3 284.4
A bill for an act
relating to state government; modifying provisions relating to the Departments of
Health, Human Services, and Children, Youth, and Families; making changes for
federal compliance; establishing work or community engagement requirements;
providing for pharmacy dispensing reimbursements; modifying reimbursement
rates for mental health services; modifying mental health provider credentialing
requirements; modifying the county share for Supplemental Nutrition Assistance
Program costs; modernizing child care and family child care licensing; modifying
the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act; establishing a committee, legislative commission, and
advisory task force; establishing a hospital stabilization program; transferring
regulatory oversight of health maintenance organizations to the commissioner of
commerce; requiring coverage of infertility treatment; regulating gas resource
development; requiring reports; authorizing rulemaking; requiring transfer;
appropriating money; amending Minnesota Statutes 2024, sections 16A.103, by
adding a subdivision; 60A.50, subdivision 3; 60A.951, subdivision 3; 60A.985,
subdivision 8; 60A.9853, subdivision 1; 60A.9854; 60B.03, subdivision 2; 60G.01,
subdivisions 2, 4; 62A.02, subdivision 8; 62A.021, subdivision 1; 62A.61; 62A.65,
subdivisions 7, 8; 62D.08, subdivisions 1, 2, 3, 7; 62D.12, subdivision 1; 62D.124,
subdivision 5; 62D.221, subdivisions 1, 2; 62E.11, subdivisions 9, 13; 62J.60,
subdivision 5; 62L.02, subdivision 8; 62L.08, subdivision 11; 62L.09, subdivision
3; 62L.10, subdivision 4; 62L.11, subdivision 2; 62M.11; 62Q.01, subdivision 2;
62Q.096; 62Q.106; 62Q.188, subdivision 2; 62Q.37, subdivision 2; 62Q.47;
62Q.51, subdivision 3; 62Q.556, subdivisions 3, 4; 62Q.679; 62Q.69, subdivisions
2, 3; 62Q.71; 62Q.73, subdivisions 3, 10; 62Q.81, subdivision 7; 62U.04,
subdivision 13, by adding a subdivision; 103I.001; 103I.005, subdivisions 9, 21,
by adding subdivisions; 103I.601, subdivision 1, by adding subdivisions; 142D.21,
subdivision 3; 142F.05, by adding subdivisions; 144.1222, subdivision 4, by adding
a subdivision; 144.1501, subdivision 2; 144.1503, subdivision 7; 144.1505,
subdivisions 1, 2, 3; 144.1507, subdivisions 1, 2, 4, by adding a subdivision;
144.1911, subdivisions 1, 5, 6; 145A.14, subdivision 2a; 151.741, subdivision 4;
245.462, by adding a subdivision; 245.4711, subdivision 5; 245.4881, subdivision
5; 245A.211, subdivision 1; 256.01, by adding a subdivision; 256.017, subdivision
2; 256B.04, subdivision 27; 256B.056, subdivisions 1, 2a, 7, 7a; 256B.0561,
subdivision 2; 256B.06, subdivision 4; 256B.0625, by adding a subdivision;
256B.076, subdivision 1, by adding subdivisions; 256B.094, subdivisions 2, 3, 6;
256B.75; 256B.76, subdivision 2; 260.63, subdivision 10; 260.64, subdivision 2;
260.67, subdivision 2; 260.68, subdivision 2; 260.69, subdivision 1; 260.693,
subdivision 2; 295.52, subdivision 8; Minnesota Statutes 2025 Supplement, sections
62D.21; 62D.211; 142A.03, subdivision 2; 144.125, subdivision 1; 151.741,
subdivision 5; 245A.07, subdivision 3; 245C.02, subdivision 15a; 245C.05,
subdivision 5; 256.043, subdivision 3; 256.9657, subdivision 2b; 256.969,
subdivision 2f; 256B.0625, subdivisions 8, 20; 256B.0924, subdivision 6;
256B.1973, subdivision 9; 256B.69, subdivision 6d; 256B.761, by adding a
subdivision; 260.691, subdivision 1; 260.692, subdivisions 1, 2, 3; Laws 2024,
chapter 117, sections 21; 22; Laws 2024, chapter 127, article 67, section 7;
proposing coding for new law in Minnesota Statutes, chapters 62D; 62Q; 103I;
142D; 144; 245A; 256; 256B; 260; proposing coding for new law as Minnesota
Statutes, chapters 142H; 142I; repealing Minnesota Statutes 2024, sections 142B.01,
subdivisions 11, 12, 13, 25, 26, 27; 142B.41, subdivisions 4, 6, 7, 8, 10, 11, 12,
13; 142B.54, subdivisions 1, 2, 3; 142B.62; 142B.65, subdivisions 1, 2, 3, 4, 5, 6,
7, 10; 142B.66, subdivisions 1, 2, 4, 5; 142B.70, subdivisions 1, 2, 3, 4, 5, 6, 9,
10, 11, 12; 142B.71; 142B.72; 142B.74; 142B.75; 142B.76; 142B.77; 151.741,
subdivisions 2, 3, 6; 256B.0625, subdivision 38; 256B.198; 260.63, subdivision
9; Minnesota Statutes 2025 Supplement, sections 142B.41, subdivision 9; 142B.65,
subdivisions 8, 9; 142B.66, subdivision 3; 142B.70, subdivisions 7, 8; 256B.69,
subdivision 6i; Minnesota Rules, parts 9502.0300; 9502.0315; 9502.0325;
9502.0335; 9502.0341; 9502.0345; 9502.0355; 9502.0365; 9502.0367; 9502.0375;
9502.0395; 9502.0405; 9502.0415; 9502.0425; 9502.0435; 9502.0445; 9503.0005;
9503.0010; 9503.0015; 9503.0030; 9503.0031; 9503.0032; 9503.0033; 9503.0034;
9503.0040; 9503.0045; 9503.0050; 9503.0055; 9503.0060; 9503.0065; 9503.0070;
9503.0075; 9503.0080; 9503.0085; 9503.0090; 9503.0095; 9503.0100; 9503.0105;
9503.0110; 9503.0115; 9503.0120; 9503.0125; 9503.0130; 9503.0140; 9503.0145;
9503.0150; 9503.0155; 9503.0170.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
DEPARTMENT OF HEALTH
Section 1.
Minnesota Statutes 2024, section 62U.04, subdivision 13, is amended to read:
Subd. 13.
Expanded access to and use of the all-payer claims data.
(a) The
commissioner or the commissioner's designee shall make the data submitted under
subdivisions 4, 5, 5a, and 5b, including data classified as private or nonpublic, available to
individuals and organizations engaged in research on, or efforts to effect transformation in,
health care outcomes, access, quality, disparities, or spending, provided the use of the data
serves a public benefit. Data made available under this subdivision may not be used to:
(1) create an unfair market advantage for any participant in the health care market in
Minnesota, including health plan companies, payers, and providers;
(2) reidentify or attempt to reidentify an individual in the data; or
(3) publicly report contract details between a health plan company and provider and
derived from the data.
(b) To implement paragraph (a), the commissioner shall:
(1) establish detailed requirements for data access; a process for data users to apply to
access and use the data; legally enforceable data use agreements to which data users must
consent; a clear and robust oversight process for data access and use, including a data
management plan, that ensures compliance with state and federal data privacy laws;
agreements for state agencies and the University of Minnesota to ensure proper and efficient
use and security of data; and technical assistance for users of the data and for stakeholders;
(2) deleted text begin develop adeleted text end new text begin assess fees according to thenew text end fee schedule new text begin in subdivision 14 new text end to support the
cost of expanded access to and use of the data, provided the fees charged under the schedule
do not create a barrier to access or use for those most affected by disparities; deleted text begin and
deleted text end
(3) create a research advisory group to advise the commissioner on applications for data
use under this subdivision, including an examination of the rigor of the research approach,
the technical capabilities of the proposed user, and the ability of the proposed user to
successfully safeguard the datadeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) annually publish on the Department of Health website a list of projects authorized
under this subdivision.
new text end
Sec. 2.
Minnesota Statutes 2024, section 62U.04, is amended by adding a subdivision to
read:
new text begin Subd. 14. new text end
new text begin Fees for expanded access to and use of the all-payer claims database. new text end
new text begin
(a)
For purposes of this section:
new text end
new text begin
(1) "custom data set or analysis" means a de-identified data set or report for which a
standard data set or limited use data sets are not appropriate, that only provides the minimum
necessary data, and that is de-identified using the expert determination method as defined
in Code of Federal Regulations, title 45, section 164.514(b)(1);
new text end
new text begin
(2) "data file" means a data file derived from medical claims, pharmacy claims, dental
claims, eligibility information, membership information, or provider information for a single
year;
new text end
new text begin
(3) "limited use data set" means a data set that meets the requirements in Code of Federal
Regulations, title 45, section 164.514(e)(2), and may include protected health information
from which certain direct identifiers of individuals have been removed under the principle
of minimum information necessary; and
new text end
new text begin
(4) "standard data set" means a static data release, designed by the commissioner to
serve a wide range of projects, in which nearly all de-identified data elements are disclosed
in one release after applying the safe harbor de-identification method defined in Code of
Federal Regulations, title 45, section 164.514(b)(2), and from which protected health
information and any combination of data elements that directly identify any person are
excluded.
new text end
new text begin
(b) The commissioner must assess fees on an individual or organization that receives
data under subdivision 13 for the cost of accessing or receiving the data. Costs under this
paragraph may include but are not limited to the cost of producing and releasing data to the
individual or organization under subdivision 13 and the cost of managing infrastructure and
operations. The commissioner must assess fees according to the following schedule based
on the type of data requested and number of years for which access is requested:
new text end
new text begin
(1) the fee for a standard data set is $3,500 per data file per year;
new text end
new text begin
(2) the fee for a limited use data set is $7,000 per data file per year; and
new text end
new text begin
(3) the fee for a custom data set or analysis is $89 per hour of staff time expended, but
the fee must not exceed $5,785.
new text end
new text begin
(c) An individual or organization that receives approval to access or receive data under
subdivision 13 must pay all the required fees in full before accessing or receiving the
requested data.
new text end
new text begin
(d) The commissioner may grant a partial or full waiver of the fees in paragraph (b) if
the individual or organization requesting the data meets at least one of the following criteria:
new text end
new text begin
(1) the fees represent a financial hardship to the individual or organization;
new text end
new text begin
(2) the organization is a self-insured data submitter under this section;
new text end
new text begin
(3) the individual or organization is affiliated with an academic institution;
new text end
new text begin
(4) the individual or organization requests a high volume of data files; or
new text end
new text begin
(5) the request is from a Tribal health director for, or the governing body of, one of the
11 federally recognized Tribes in Minnesota.
new text end
new text begin
In determining whether to grant a waiver under this paragraph, the commissioner may
consult the research advisory group established under subdivision 13.
new text end
new text begin
(e) Fees paid by an individual or organization approved to access or receive data under
subdivision 13 are nonrefundable. Fees collected under this subdivision must be deposited
into an account in the special revenue fund. Money in that account does not cancel and is
appropriated to the commissioner to offset the cost of providing access to data under
subdivision 13 and the cost of maintaining data submitted under subdivisions 4 to 5b.
new text end
new text begin
(f) The commissioner must publish the fee schedule in paragraph (b) on the Department
of Health website.
new text end
Sec. 3.
new text begin
[103I.2091] SUBMERGED CLOSED LOOP HEAT EXCHANGER SYSTEM;
VARIANCES.
new text end
new text begin
(a) The commissioner must consider a variance for an undue burden under Minnesota
Rules, part 4717.7010, to isolation distance requirements for a water supply well used in a
submerged closed loop heat exchanger system if:
new text end
new text begin
(1) the water supply well will be used for the sole purpose of heating and cooling;
new text end
new text begin
(2) the water supply well will be constructed with additional protective casing and grout
to prevent potential contamination of the well and groundwater and will exceed the well
construction standards in Minnesota Rules, parts 4725.3050, subpart 3, and 4725.4825,
sufficient to protect against potential contamination sources associated with the isolation
distance requirements; and
new text end
new text begin
(3) strict compliance with the isolation distance requirements would prevent the property
owner from installing an effectively designed submerged closed loop heat exchanger system.
new text end
new text begin
(b) The variance application must include an evaluation by a third-party licensed
professional engineer that quantifies a loss of system efficiency or describes a loss of
construction feasibility for the submerged closed loop heat exchanger system that results
from complying with isolation distance requirements. Any licensed professional engineer
who is not employed by the variance applicant or the firm designing the submerged closed
loop heat exchanger system is considered a third party under this statute.
new text end
Sec. 4.
Minnesota Statutes 2024, section 144.1222, is amended by adding a subdivision
to read:
new text begin Subd. 2e. new text end
new text begin Private residential pool used for certified swimming classes. new text end
new text begin
Notwithstanding
Minnesota Rules, part 4717.0250, subpart 7, a private residential pool may be used as part
of a business if the private residential pool is used by a paying guest of the homeowner and
the guest is participating in a certified swimming class conducted by the homeowner,
provided that:
new text end
new text begin
(1) the homeowner is a certified swimming instructor and is conducting a certified
swimming class on a one-on-one basis;
new text end
new text begin
(2) not more than four individuals are in the pool at the same time during the class;
new text end
new text begin
(3) prior to each new paying guest beginning participation in a certified swimming class:
new text end
new text begin
(i) the guest, or the guest's parent or legal guardian if the guest is a minor, provides
written consent to use of the pool. The written consent must include a statement that the
guest, or the guest's parent or legal guardian if the guest is a minor, has received and read
materials provided by the Department of Health with information on the risk of disease
transmission and other risks associated with pools; and a statement that the Department of
Health does not monitor or inspect the homeowner's pool to ensure compliance with the
requirements in this section or Minnesota Rules, chapter 4717; and
new text end
new text begin
(ii) the homeowner tests the pool's water for the concentration of chlorine or bromine,
pH, and alkalinity, and the water in the pool meets the requirements for disinfection residual,
pH, and alkalinity in Minnesota Rules, part 4717.1750, subparts 3 to 6; and
new text end
new text begin
(4) the following notice is conspicuously posted at the pool and, prior to each new paying
guest beginning participation in a certified swimming class, is provided to the guest or to
the guest's parent or legal guardian if the guest is a minor:
new text end
new text begin
"NOTICE
new text end
new text begin
This pool is exempt from state and local anti-entrapment and sanitary requirements that
prevent waterborne diseases such as Legionnaires' disease, Pseudomonas folliculitis (hot
tub rash), and chemical burns and is not subject to inspection.
new text end
new text begin
USE AT YOUR OWN RISK"
new text end
Sec. 5.
Minnesota Statutes 2024, section 144.1222, subdivision 4, is amended to read:
Subd. 4.
Definitions.
(a) For purposes of this section, the following terms have the
meanings given them.
(b) "ASME/ANSI standard" means a safety standard accredited by the American National
Standards Institute and published by the American Society of Mechanical Engineers.
(c) "ASTM standard" means a safety standard issued by ASTM International, formerly
known as the American Society for Testing and Materials.
(d) "Public pool" means any pool other than a private residential pool, that is: (1) open
to the public generally, whether for a fee or free of charge; (2) open exclusively to members
of an organization and their guests; (3) open to residents of a multiunit apartment building,
apartment complex, residential real estate development, or other multifamily residential
area; (4) open to patrons of a hotel or lodging or other public accommodation facility; or
(5) operated by a person in a park, school, licensed child care facility, group home, motel,
camp, resort, club, condominium, manufactured home park, or political subdivision with
the exception of swimming pools at family day care homes licensed under section 142B.41,
subdivision 9, paragraph (a).
(e) "Unblockable suction outlet or drain" means a drain of any size and shape that a
human body cannot sufficiently block to create a suction entrapment hazard and meets
ASME/ANSI standards.
new text begin
(f) "Certified swimming class" means an infant swimming resource (ISR) class; an
American Red Cross swimming class, swimming lesson, or learn-to-swim class; or any
other swimming class certified by a nationally accredited organization that operates in all
50 states.
new text end
new text begin
(g) "Certified swimming instructor" means a certified ISR instructor; a certified American
Red Cross swimming instructor or swim coach; or any other swimming instructor certified
by a nationally accredited organization that operates in all 50 states.
new text end
Sec. 6.
Minnesota Statutes 2025 Supplement, section 144.125, subdivision 1, is amended
to read:
Subdivision 1.
Duty to perform testing.
(a) It is the duty of (1) the administrative officer
or other person in charge of each institution caring for infants 28 days or less of age, (2) the
person required in pursuance of the provisions of section 144.215, to register the birth of a
child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have
administered to every infant or child in its care tests for heritable and congenital disorders
according to subdivision 2 and rules prescribed by the state commissioner of health.
(b) Testing, recording of test results, reporting of test results, and follow-up of infants
with heritable congenital disorders, including hearing loss detected through the early hearing
detection and intervention program in section 144.966, shall be performed at the times and
in the manner prescribed by the commissioner of health.
(c) The fee to support the newborn screening program, including tests administered
under this section and section 144.966, shall be $184.35 per specimen. This fee amount
shall be deposited in the state treasury and credited to the state government special revenue
fund.new text begin If the individual described in paragraph (a) submits a claim for reimbursement to an
insurer but does not receive reimbursement, the individual may request a special fee
exemption form from the newborn screening program. To qualify for the exemption, the
individual must provide documentation to the newborn screening program that the insurer
did not reimburse them.
new text end
(d) The fee to offset the cost of the support services provided under section 144.966,
subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
and credited to the general fund.
Sec. 7.
Minnesota Statutes 2024, section 144.1501, subdivision 2, is amended to read:
Subd. 2.
Availability.
(a) The commissioner of health shall use money appropriated for
health professional education loan forgiveness in this section:
(1) for medical residents, physicians, mental health professionals, and alcohol and drug
counselors agreeing to practice in designated rural areas or underserved urban communities
or specializing in the area of pediatric psychiatry;
(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach
at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
at the undergraduate level or the equivalent at the graduate level;
(3) for nurses who agree to practice in a Minnesota nursing home; in an intermediate
care facility for persons with developmental disability; in a hospital if the hospital owns
and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked
by the nurse is in the nursing home; in an assisted living facility as defined in section
144G.08, subdivision 7; or for a home care provider as defined in section 144A.43,
subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing
field in a postsecondary program at the undergraduate level or the equivalent at the graduate
level;
(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with the
Healthcare Education-Industry Partnership, shall determine the health care fields where the
need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory
technology, radiologic technology, and surgical technology;
(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
who agree to practice in designated rural areas;
(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by the
United States Department of Health and Human Services under Code of Federal Regulations,
title 42, section 51c.303; and
(7) for nurses employed as a hospital nurse by a nonprofit hospital and providing direct
care to patients at the nonprofit hospital.
(b) Appropriations made for health professional education loan forgiveness in this section
do not cancel and are available until expendeddeleted text begin , except that at the end of each biennium, any
remaining balance in the account that is not committed by contract and not needed to fulfill
existing commitments shall cancel to the funddeleted text end .
Sec. 8.
Minnesota Statutes 2024, section 144.1503, subdivision 7, is amended to read:
Subd. 7.
Selection process.
The commissioner shall determine a maximum award for
grants and loan forgiveness, and shall make selections based on the information provided
in the grant application, including the demonstrated need for an applicant provider to enhance
the education of its workforce, the proposed employee scholarship or loan forgiveness
selection process, the applicant's proposed budget, and other criteria as determined by the
commissioner. Notwithstanding any law or rule to the contrary, amounts appropriated for
purposes of this section do not cancel and are available until expendeddeleted text begin , except that at the
end of each biennium, any remaining amount that is not committed by contract and not
needed to fulfill existing commitments shall cancel to the general funddeleted text end .
Sec. 9.
Minnesota Statutes 2024, section 144.1505, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
For purposes of this section, the following definitions apply:
(1) "eligible advanced practice registered nurse program" means a program that is located
in Minnesota and is currently accredited as a master's, doctoral, or postgraduate level
advanced practice registered nurse program by the Commission on Collegiate Nursing
Education or by the Accreditation Commission for Education in Nursing, or deleted text begin isdeleted text end new text begin presents a
credible plan asnew text end a candidate for accreditation;
(2) "eligible dental therapy program" means a dental therapy education program or
advanced dental therapy education program that is located in Minnesota and deleted text begin is eitherdeleted text end :
(i) new text begin is new text end approved by the Board of Dentistry; deleted text begin or
deleted text end
(ii) new text begin is new text end currently accredited by the Commission on Dental Accreditation;new text begin or
new text end
new text begin
(iii) presents a credible plan as a candidate for accreditation;
new text end
(3) "eligible mental health professional program" means a program that is located in
Minnesota and is deleted text begin listeddeleted text end new text begin currently accredited new text end as a mental health professional program by the
appropriate accrediting body for clinical social work, psychology, marriage and family
therapy, or licensed professional clinical counseling, or deleted text begin isdeleted text end new text begin presents a credible plan asnew text end a
candidate for accreditation;
(4) "eligible pharmacy program" means a program that is located in Minnesotanew text begin ,new text end deleted text begin anddeleted text end is
currently accredited as a doctor of pharmacy program by the Accreditation Council on
Pharmacy Educationnew text begin , or presents a credible plan as a candidate for accreditationnew text end ;
(5) "eligible physician assistant program" means a program that is located in Minnesotanew text begin ,new text end
deleted text begin anddeleted text end is currently accredited as a physician assistant program by the Accreditation Review
Commission on Education for the Physician Assistant, or deleted text begin isdeleted text end new text begin presents a credible plan asnew text end a
candidate for accreditation;
(6) "mental health professional" means an individual providing clinical services in the
treatment of mental illness who meets one of the qualifications under section 245.462,
subdivision 18;
(7) "eligible physician training program" means new text begin a medical school training program or new text end a
physician residency training program located in Minnesota deleted text begin anddeleted text end that is currently accredited
by the accrediting body or has presented a credible plan as a candidate for accreditation;
(8) "eligible dental program" means a dental education program or a dental residency
training program located in Minnesota and that is currently accredited by the accrediting
body or has presented a credible plan as a candidate for accreditation; deleted text begin and
deleted text end
(9) new text begin "rural community" means a Tribal Nation, statutory city, home rule charter city, or
township in Minnesota that is outside the seven-county metropolitan area as defined in
section 473.121, subdivision 2;
new text end
new text begin
(10) "underserved community" means a Minnesota area or population included in the
list of designated primary medical care health professional shortage areas, medically
underserved areas, or medically underserved populations maintained and updated by the
United States Department of Health and Human Services; and
new text end
new text begin (11) new text end "project" means a project to deleted text begin establish or expanddeleted text end new text begin (i) plan or implement a new eligible
new text end clinical training deleted text begin for physician assistants, advanced practice registered nurses, pharmacists,
dental therapists, advanced dental therapists, or mental health professionals in Minnesotadeleted text end new text begin
program or increase the base number of trainees in an existing eligible clinical training
program, or (ii) add or expand rural rotations or clinical training experiences in an existing
eligible clinical training programnew text end .
Sec. 10.
Minnesota Statutes 2024, section 144.1505, subdivision 2, is amended to read:
Subd. 2.
Programs.
(a) For advanced practice provider clinical training expansion grants,
the commissioner of health shall award deleted text begin health professional training sitedeleted text end grants to eligible
physician assistant, advanced practice registered nurse, pharmacy, dental therapy, and mental
health professional programs to plan and implement deleted text begin expandeddeleted text end new text begin a new eligible clinical training
program or increase the base number of trainees in an existing eligible new text end clinical trainingnew text begin
programnew text end . new text begin Clinical training must take place in a rural community or an underserved
community. new text end A planning grant shall not exceed $75,000, and a three-year training grant shall
not exceed $300,000 per project. The commissioner may provide a deleted text begin one-year,deleted text end no-cost
extension for grants.
(b) For health professional rural deleted text begin and underserveddeleted text end clinical rotations grants, the
commissioner of health shall award deleted text begin health professional training sitedeleted text end grants to new text begin existing new text end eligible
physician, physician assistant, advanced practice registered nurse, pharmacy, dentistry,
dental therapy, and mental health professional new text begin training new text end programs to deleted text begin augment existing clinical
deleted text end deleted text begin training programs todeleted text end addnew text begin , expand, or enhancenew text end rural deleted text begin and underserveddeleted text end rotations or clinical
training experiences, such as credential or certificate rural tracks or other specialized training.
new text begin Rotations and clinical training experiences must take place in rural communities, excluding
the cities of Duluth, Moorhead, Rochester, and St. Cloud. new text end For physician and dentist training,
the expanded training must include rotations in primary care settings such as community
clinics, hospitals, health maintenance organizations, or practices in rural communities.
(c) new text begin Advanced practice provider clinical training expansion grant new text end funds may be used for:
(1) deleted text begin establishing or expanding rotationsdeleted text end new text begin planningnew text end and new text begin implementing a new new text end clinical trainingnew text begin
program or increasing the base number of trainees in an existing clinical training program
as described in paragraph (a)new text end ;
(2) recruitment, training, and retention of students deleted text begin anddeleted text end new text begin ,new text end facultynew text begin , and preceptorsnew text end ;
(3) connecting students with appropriate clinical training sites, internships, practicums,
or externship deleted text begin activitiesdeleted text end new text begin opportunitiesnew text end ;
(4) travel and lodging for students;
(5) faculty, student, and preceptor salaries, incentives, or other financial support;
(6) development and implementation of new text begin health equity and new text end cultural deleted text begin competencydeleted text end
new text begin responsiveness new text end training;
(7) evaluationsnew text begin of the clinical training program to inform program improvementsnew text end ;
(8) training site improvements, fees, equipment, and supplies required to establish,
maintain, or expand a training program; deleted text begin and
deleted text end
(9) supporting clinical education in which trainees are part of a primary care team modeldeleted text begin .deleted text end new text begin ;
and
new text end
new text begin
(10) onboarding expenses for trainees to meet clinical training site requirements.
new text end
new text begin
(d) Health professional rural clinical rotation grant funds may be used for:
new text end
new text begin
(1) adding, expanding, or enhancing rural rotations and clinical training experiences in
an existing clinical training program as described in paragraph (b);
new text end
new text begin
(2) recruitment, training, and retention of students, faculty, and preceptors;
new text end
new text begin
(3) connecting students with appropriate clinical training sites, internships, practicums,
or externship opportunities;
new text end
new text begin
(4) travel and lodging for students;
new text end
new text begin
(5) faculty, student, and preceptor salaries, stipends, or other financial support;
new text end
new text begin
(6) development and implementation of health equity and cultural responsiveness training;
new text end
new text begin
(7) evaluations of the rural rotation or clinical training experience to inform program
improvements;
new text end
new text begin
(8) training site improvements, fees, equipment, and supplies required to establish or
expand rural rotations or clinical training experiences;
new text end
new text begin
(9) supporting clinical education in which trainees are part of a primary care team model;
and
new text end
new text begin
(10) onboarding expenses for trainees to meet clinical training site requirements.
new text end
Sec. 11.
Minnesota Statutes 2024, section 144.1505, subdivision 3, is amended to read:
Subd. 3.
Applications.
Eligible physician assistant, advanced practice registered nurse,
pharmacy, dental therapy, dental, physician, and mental health professional programs seeking
a grant shall apply to the commissioner. Applications new text begin for advanced practice provider clinical
training expansion grants new text end must include a description of the number of additional students
who will be trained using grant fundsdeleted text begin ;deleted text end new text begin and new text end attestation that funding will be used to support
an increase in the number of clinical training slotsdeleted text begin ;deleted text end new text begin .
new text end
new text begin All applications must includenew text end a description of the problem that the proposed project will
address; a description of the project, including all costs associated with the projectdeleted text begin ,deleted text end new text begin ;new text end sources
of funds for the projectdeleted text begin ,deleted text end new text begin ;new text end detailed uses of all funds for the project, and the results expected;
and a plan to maintain or operate deleted text begin any component included indeleted text end the project after the grant
periodnew text begin , including a description of potential barriers to sustainabilitynew text end .
deleted text begin The applicantdeleted text end new text begin Applicantsnew text end must describe achievable objectives, a timetable, and roles
and capabilities of responsible individuals in the organization.
deleted text begin Applicants applying under subdivision 2, paragraph (b),deleted text end new text begin Applications for rural clinical
rotation grantsnew text end must include new text begin a description of the new, expanded, or enhanced rural rotations
or clinical training experiences; attestation that funding will be used to support improved
rural clinical training experiences; and new text end information about length of training and training site
settings, geographic location of rural sites, and rural populations expected to be served.
Sec. 12.
Minnesota Statutes 2024, section 144.1507, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given.
(b) "Eligible program" means a program that meets the following criteria:
(1) is located in Minnesota;
(2) trains medical residents in the specialties of family medicine, general internal
medicine, general pediatrics, psychiatry, geriatrics, or general surgery in rural residency
training programs or in community-based ambulatory care centers that primarily serve the
underservednew text begin , or trains postdoctoral psychology residentsnew text end ; and
(3) is accredited by the Accreditation Council for Graduate Medical Education new text begin or the
American Psychological Association new text end or presents a credible plan to obtain accreditation.
new text begin
(c) "Rural community" means a Tribal Nation, statutory city, home rule charter city, or
township in Minnesota that is outside the seven-county metropolitan area as defined in
section 473.121, subdivision 2, excluding the cities of Duluth, Mankato, Moorhead,
Rochester, and St. Cloud.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end "Rural residency training program" means a new text begin rural medical new text end residency program new text begin or
a rural psychology residency program new text end that provides deleted text begin an initial year ofdeleted text end training in an accredited
residency program in Minnesota. deleted text begin The subsequent years of the residency program aredeleted text end new text begin At
least two-thirds of the residency training must benew text end based in rural communities, utilizing local
clinics and community hospitals, with specialty rotations in nearby regional medical centers.new text begin
When specialty rotations cannot take place within rural communities, training may occur
in nonrural sites provided that at least one-half of all training occurs in rural communities.
For residency training programs in general surgery, pediatrics, and psychiatry, at least
one-half of the residency training must be based in communities outside the seven-county
metropolitan area, with rotations in rural communities.
new text end
deleted text begin (d)deleted text end new text begin (e)new text end "Community-based ambulatory care centers" means federally qualified health
centers, community mental health centers, rural health clinics, health centers operated by
the Indian Health Service, an Indian Tribe or Tribal organization, or an urban American
Indian organization or an entity receiving funds under Title X of the Public Health Service
Act.
deleted text begin (e)deleted text end new text begin (f)new text end "Eligible project" means a project to establish and maintain a rural residency
training program.
Sec. 13.
Minnesota Statutes 2024, section 144.1507, subdivision 2, is amended to read:
Subd. 2.
Rural residency training program.
(a) The commissioner of health shall
award rural residency training program grants to eligible programs to plan, implement, and
sustain rural residency training programs. A rural new text begin medical new text end residency training program grant
shall not exceed $250,000 per year for up to three years for planning and development, and
$225,000 per resident per year for each year thereafter to sustain the program.new text begin A rural
psychology residency training program grant shall not exceed $150,000 per year for up to
three years for planning and development and $150,000 per resident per year for each year
thereafter to sustain the program. Medical and psychology residency programs that meet
eligibility guidelines and continue to demonstrate financial need shall be granted sustaining
funds, renewable every five years.
new text end
(b) Funds may be spent to cover the costs of:
(1) planning related to establishing accredited rural residency training programs;
(2) obtaining accreditation by the Accreditation Council for Graduate Medical Educationnew text begin ,
the American Psychological Association,new text end or another national body that accredits rural
residency training programs;
(3) establishing new rural residency training programs;
(4) recruitment, training, and retention of new residents and faculty related to the new
rural residency training program;
(5) travel and lodging for new residents;
(6) faculty, new resident, and preceptor salaries related to new rural residency training
programs;
(7) training site improvements, fees, equipment, and supplies required for new rural
residency training programs; and
(8) supporting clinical education in which trainees are part of a primary care team model.
Sec. 14.
Minnesota Statutes 2024, section 144.1507, subdivision 4, is amended to read:
Subd. 4.
Consideration of grant applications.
The commissioner shall review each
application to determine if the residency program application is complete, if the proposed
rural residency program and residency slots are eligible for a grant, and if the program is
eligible for federal graduate medical education funding, and when the funding is available.
If eligible programs are not eligible for federal graduate medical education funding, the
commissioner may award continuation funding to the eligible program beyond the initial
grant periodnew text begin without requiring a competitive applicationnew text end . The commissioner shall award
grants to support training programs in family medicine, general internal medicine, general
pediatrics, psychiatry, geriatrics, general surgery,new text begin psychology,new text end and other primary care focus
areas.
Sec. 15.
Minnesota Statutes 2024, section 144.1507, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Clinical training program coordination. new text end
new text begin
The commissioner may award grants
to the University of Minnesota to provide technical assistance to residency training programs
for coordinated development of rural clinical training programs statewide.
new text end
Sec. 16.
Minnesota Statutes 2024, section 144.1911, subdivision 1, is amended to read:
Subdivision 1.
Establishment.
The international medical graduates assistance program
is established to address barriers to practice and facilitate pathways to assist immigrant
international medical graduates to integrate into the Minnesota health care delivery system,
with the goal of increasing access to primary care in rural and underserved areas of the state.new text begin
Notwithstanding any law to the contrary, appropriations made to the program do not cancel
and are available until expended.
new text end
Sec. 17.
Minnesota Statutes 2024, section 144.1911, subdivision 5, is amended to read:
Subd. 5.
Clinical preparation.
(a) The commissioner shall award grants to support
clinical preparation for Minnesota international medical graduates needing additional clinical
preparation or experience to qualify for residency. The grant program shall include:
(1) proposed training curricula;
(2) associated policies and procedures for clinical training sites, which must be part of
existing clinical medical education programs in Minnesota; and
(3) monthly stipends for international medical graduate participants. Priority shall be
given to primary care sites in rural or underserved areas of the statedeleted text begin , anddeleted text end new text begin .new text end International
medical graduate participants new text begin who receive funding through the international medical graduate
primary care residency grant program new text end must commit to serving at least five years in a rural
or underserved community of the state.
(b) The policies and procedures for the clinical preparation grants must be developed
by December 31, 2015, including an implementation schedule that begins awarding grants
to clinical preparation programs beginning in June of 2016.
Sec. 18.
Minnesota Statutes 2024, section 144.1911, subdivision 6, is amended to read:
Subd. 6.
International medical graduate primary care residency grant program
and revolving account.
(a) The commissioner shall award grants to support primary care
residency positions designated for Minnesota immigrant physicians who are willing to serve
in rural or underserved areas of the state. No grant shall exceed $150,000 per residency
position per year. Eligible primary care residency grant recipients include accredited family
medicine, general surgery, internal medicine, obstetrics and gynecology, psychiatry, and
pediatric residency programs. Eligible primary care residency programs shall apply to the
commissioner. Applications must include the number of anticipated residents to be funded
using grant funds and a budget. deleted text begin Notwithstanding any law to the contrary, funds awarded to
grantees in a grant agreement do not lapse until the grant agreement expires.deleted text end Before any
funds are distributed, a grant recipient shall provide the commissioner with the following:
(1) a copy of the signed contract between the primary care residency program and the
participating international medical graduate;
(2) certification that the participating international medical graduate has lived in
Minnesota for at least two years and is certified by the Educational Commission on Foreign
Medical Graduates. Residency programs may also require that participating international
medical graduates hold a Minnesota certificate of clinical readiness for residency, once the
certificates become available; and
(3) verification that the participating international medical graduate has executed a
participant agreement pursuant to paragraph (b).
(b) Upon acceptance by a participating residency program, international medical graduates
shall enter into an agreement with the commissioner to provide primary care for at least
five years in a rural or underserved area of Minnesota after graduating from the residency
program and make payments to the revolving international medical graduate residency
account for five years beginning in their second year of postresidency employment.
Participants shall pay $15,000 or ten percent of their annual compensation each year,
whichever is less.
(c) A revolving international medical graduate residency account is established as an
account in the special revenue fund in the state treasury. The commissioner of management
and budget shall credit to the account appropriations, payments, and transfers to the account.
Earnings, such as interest, dividends, and any other earnings arising from fund assets, must
be credited to the account. Funds in the account are appropriated annually to the
commissioner to award grants and administer the grant program established in paragraph
(a). Notwithstanding any law to the contrary, any funds deposited in the account do not
expire. The commissioner may accept contributions to the account from private sector
entities subject to the following provisions:
(1) the contributing entity may not specify the recipient or recipients of any grant issued
under this subdivision;
(2) the commissioner shall make public the identity of any private contributor to the
account, as well as the amount of the contribution provided; and
(3) a contributing entity may not specify that the recipient or recipients of any funds use
specific products or services, nor may the contributing entity imply that a contribution is
an endorsement of any specific product or service.
Sec. 19.
Minnesota Statutes 2024, section 145A.14, subdivision 2a, is amended to read:
Subd. 2a.
Tribal governments.
(a) Of the funding available for local public health
grants, $1,500,000 per year is available to Tribal governments for:
(1) maternal and child health activities deleted text begin under section 145.882, subdivision 7deleted text end ;
(2) activities to reduce health disparities deleted text begin under section deleted text end deleted text begin 145.928, subdivision 10deleted text end ; deleted text begin and
deleted text end
(3) emergency preparednessnew text begin ; and
new text end
new text begin (4) additional public health activities identified by each Tribal governmentnew text end .
(b) The commissioner, in consultation with Tribal governments, shall establish a formula
for distributing the funds and developing the outcomes to be measured.
ARTICLE 2
DEPARTMENT OF HUMAN SERVICES
Section 1.
new text begin
[245A.034] CONDUCT TOWARD PUBLIC OFFICIALS.
new text end
new text begin
(a) Applicants, license holders, certification holders, and controlling individuals must
not engage in conduct that threatens the safety or well-being of Department of Human
Services staff, county employees, or other individuals acting under the authority of the
commissioner for duties authorized under this chapter, chapter 260E, or section 626.557.
The conduct described under this paragraph includes but is not limited to:
new text end
new text begin
(1) assault, including attempts, under sections 609.221, 609.222, 609.223, 609.2231,
and 609.224, regardless of whether there is a criminal proceeding or conviction;
new text end
new text begin
(2) threats of violence under section 609.713, regardless of whether there is a criminal
proceeding or conviction;
new text end
new text begin
(3) harassment or stalking under section 609.749, regardless of whether there is a criminal
proceeding or conviction;
new text end
new text begin
(4) damage to property under section 609.595, regardless of whether there is a criminal
proceeding or conviction; or
new text end
new text begin
(5) any other act with the intent to cause harm to personal safety.
new text end
new text begin
(b) If the commissioner determines that an applicant, license holder, certification holder,
or controlling individual engaged in conduct described under paragraph (a) against an
individual performing licensing, certification, investigation, or compliance activities, the
commissioner may take action under section 245A.05, 245A.06, or 245A.07 against the
applicant, license holder, certification holder, or controlling individual.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 2.
Minnesota Statutes 2025 Supplement, section 245A.07, subdivision 3, is amended
to read:
Subd. 3.
License suspension, revocation, or fine.
(a) The commissioner may suspend
or revoke a license, or impose a fine if:
(1) a license holder fails to comply fully with applicable laws or rules including but not
limited to the requirements of this chapter and chapter 245C;
(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
been disqualified and the disqualification was not set aside and no variance has been granted;
(3) a license holder knowingly withholds relevant information from or gives false or
misleading information to the commissioner in connection with an application for a license,
in connection with the background study status of an individual, during an investigation,
or regarding compliance with applicable laws or rules;
(4) a license holder is excluded from any program administered by the commissioner
under section 245.095;
(5) revocation is required under section 245A.04, subdivision 7, paragraph (d); or
(6) suspension is necessary under subdivision 2a, paragraph (b), clause (2).
A license holder who has had a license issued under this chapter suspended, revoked,
or has been ordered to pay a fine must be given notice of the action by certified mail, by
personal service, or through the provider licensing and reporting hub. If mailed, the notice
must be mailed to the address shown on the application or the last known address of the
license holder. The notice must state in plain language the reasons the license was suspended
or revoked, or a fine was ordered.
(b) If the license was suspended or revoked, the notice must inform the license holder
of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
a license. The appeal of an order suspending or revoking a license must be made in writing
by certified mail, by personal service, or through the provider licensing and reporting hub.
If mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
days after the license holder receives notice that the license has been suspended or revoked.
If a request is made by personal service, it must be received by the commissioner within
ten calendar days after the license holder received the order. If the order is issued through
the provider hub, the appeal must be received by the commissioner within ten calendar days
from the date the commissioner issued the order through the hub. Except as provided in
subdivision 2a, paragraph (c), if a license holder submits a timely appeal of an order
suspending or revoking a license, the license holder may continue to operate the program
as provided in section 245A.04, subdivision 7, paragraphs (i) and (j), until the commissioner
issues a final order on the suspension or revocation.
(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
holder of the responsibility for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
order to pay a fine must be made in writing by certified mail, by personal service, or through
the provider licensing and reporting hub. If mailed, the appeal must be postmarked and sent
to the commissioner within ten calendar days after the license holder receives notice that
the fine has been ordered. If a request is made by personal service, it must be received by
the commissioner within ten calendar days after the license holder received the order. If the
order is issued through the provider hub, the appeal must be received by the commissioner
within ten calendar days from the date the commissioner issued the order through the hub.
(2) The license holder shall pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies. If the license holder
receives state funds, the state, county, or municipal agencies or departments responsible for
administering the funds shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.
(3) A license holder shall promptly notify the commissioner of human services, in writing,
when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected as indicated by the order
to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
the license holder by certified mail, by personal service, or through the provider licensing
and reporting hub that a second fine has been assessed. The license holder may appeal the
second fine as provided under this subdivision.
(4) Fines shall be assessed as follows:
(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);
(ii) if the commissioner determines that a determination of maltreatment for which the
license holder is responsible is the result of maltreatment that meets the definition of serious
maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
$5,000;
(iii) the license holder shall forfeit deleted text begin $200deleted text end new text begin $500new text end for each occurrence of a violation of law
or rule governing matters of health, safety, or supervision, including but not limited to the
provision of adequate staff-to-child or adult ratios, and failure to comply with background
study requirements under chapter 245C; and
(iv) the license holder shall forfeit deleted text begin $100deleted text end new text begin $300new text end for each occurrence of a violation of law
or rule other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iii).
For purposes of this section, "occurrence" means each violation identified in the
commissioner's fine order. Fines assessed against a license holder that holds a license to
provide home and community-based services, as identified in section 245D.03, subdivision
1, and a community residential setting or day services facility license under chapter 245D
where the services are provided, may be assessed against both licenses for the same
occurrence, but the combined amount of the fines shall not exceed the amount specified in
this clause for that occurrence.
(5) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the case of a corporation, each
controlling individual is personally and jointly liable for payment.
(d) Except for background study violations involving the failure to comply with an order
to immediately remove an individual or an order to provide continuous, direct supervision,
the commissioner shall not issue a fine under paragraph (c) relating to a background study
violation to a license holder who self-corrects a background study violation before the
commissioner discovers the violation. A license holder who has previously exercised the
provisions of this paragraph to avoid a fine for a background study violation may not avoid
a fine for a subsequent background study violation unless at least 365 days have passed
since the license holder self-corrected the earlier background study violation.
Sec. 3.
Minnesota Statutes 2025 Supplement, section 256.9657, subdivision 2b, is amended
to read:
Subd. 2b.
Hospital assessment.
(a) For purposes of this subdivision, the following terms
have the meanings given:
(1) "eligible hospital" means:
(i) PrairieCare psychiatric hospital; or
(ii) a hospital licensed under section 144.50, located in Minnesota, and with a Medicare
cost report filed and showing in the Healthcare Cost Report Information System (HCRIS),
except for the following:
(A) federal Indian Health Service facilities;
(B) state-owned or state-operated regional treatment centers and all state-operated
services;
(C) federal Veterans Administration Medical Centers; and
(D) long-term acute care hospitals;
(2) "net outpatient revenue" means total outpatient revenue less Medicare revenue as
calculated from:
(i) values on Worksheet G of the hospital's Medicare cost report; or
(ii) for PrairieCare psychiatric hospital, data available to the commissioner; and
(3) "total patient days" means total hospital inpatient days as reported on:
(i) Worksheet S-3 of the hospital's Medicare cost report; or
(ii) for PrairieCare psychiatric hospital, data available to the commissioner.
(b) Subject to paragraphs (m) to deleted text begin (o)deleted text end new text begin (p)new text end , each eligible hospital must pay assessments to
the hospital directed payment program account in the special revenue fund, with an aggregate
annual assessment amount equal to the sum of the following:
(1) $120.22 multiplied by total patient days; and
(2) 5.96 percent of the hospital's net outpatient revenue.
(c) The assessment amount for calendar years 2026 and 2027 must be based on the total
patient days and net outpatient revenue reflected on an eligible hospital's Medicare cost
report as follows:
(1) an eligible hospital with a fiscal year ending on March 31 or June 30 must use data
from a cost report from the hospital's fiscal year 2022; and
(2) an eligible hospital with a fiscal year ending on September 30 or December 31 must
use data from a cost report from the hospital's fiscal year 2021.
(d) The annual assessment amount for calendar years after 2027 must be set for a two-year
period and must be based on the total patient days and net outpatient revenue reflected on
an eligible hospital's most recent Medicare cost report filed and showing in HCRIS as of
August 1 of the year prior to the subsequent two-year period.
(e) The commissioner may, after consultation with the Minnesota Hospital Association,
modify the rates of assessment in paragraph (b) as necessary to comply with federal law,
obtain or maintain a waiver under Code of Federal Regulations, title 42, section 433.72, or
otherwise maximize under this section federal financial participation for medical assistance.
Notwithstanding the foregoing authorization to maximize federal financial participation for
medical assistance, the commissioner must reduce the rates of assessment in paragraph (b)
as necessary to ensure:
(1) the state's aggregated health care-related taxes on inpatient hospital services do not
exceed 5.75 percent of the net patient revenue attributable to those services; and
(2) the state's aggregated health care-related taxes on outpatient hospital services do not
exceed 5.75 percent of the net patient revenue attributable to those services.
(f) Eligible hospitals must pay the annual assessment amount under paragraph (b) to the
commissioner by paying four equal, quarterly assessments. Eligible hospitals must pay the
quarterly assessments by January 1, April 1, July 1, and October 1 each year. Assessments
must be paid in the form and manner specified by the commissioner. An eligible hospital
is prohibited from paying a quarterly assessment until the eligible hospital has received the
applicable invoice under paragraph (g).
(g) The commissioner must provide eligible hospitals with an invoice by December 1
for the assessment due January 1, March 1 for the assessment due April 1, June 1 for the
assessment due July 1, and September 1 for the assessment due October 1 each year.
(h) The commissioner must notify each eligible hospital of the hospital's estimated annual
assessment amount for the subsequent calendar year by October 15 each year.
(i) If any of the dates for assessments or invoices in paragraphs (f) to (h) fall on a holiday,
the applicable date is the next business day.
(j) A hospital that has merged with another hospital must have the surviving hospital's
assessment revised at the start of the hospital's first full fiscal year after the merger is
complete. A closed hospital is retroactively responsible for assessments owed for services
provided through the final date of operations.
(k) If the commissioner determines that a hospital has underpaid or overpaid an
assessment, the commissioner must notify the hospital of the unpaid assessment or of any
refund due. The commissioner must refund a hospital's overpayment from the hospital
directed payment program account created in section 256B.1975, subdivision 1.
(l) Revenue from an assessment under this subdivision must only be used by the
commissioner to pay the nonfederal share of the directed payment program under section
256B.1974.
(m) The commissioner is prohibited from collecting any assessment under this subdivision
during any period of time when:
(1) federal financial participation is unavailable or disallowed, or if the approved
aggregate federal financial participation for the directed payment under section 256B.1974
is less than 51 percent; or
(2) a directed payment under section 256B.1974 is not approved by the Centers for
Medicare and Medicaid Services.
(n) The commissioner must make the following discounts from the inpatient portion of
the assessment under paragraph (b), clause (1), in the stated amount or as necessary to
achieve federal approval of the assessment in this section:
(1) Hennepin Healthcare, with a discount of 25 percent;
(2) Mayo Rochester, with a discount of ten percent;
(3) Gillette Children's Hospital, with a discount of 90 percent;
(4) each hospital not included in another discount category, and with greater than
$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service
and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service
and managed care claims data, with a discount of five percent; and
(5) any hospital responsible for greater than 12 percent of the total assessment annually
collected statewide, with a discount in the amount necessary such that the hospital is
responsible for 12 percent of the total assessment annually collected statewide.
(o) The commissioner must make the following discounts from the outpatient portion
of the assessment under paragraph (b), clause (2), in the stated amount or as necessary to
achieve federal approval of the assessment in this section:
(1) each critical access hospital or independent hospital located outside a city of the first
class and paid under the Medicare prospective payment system, with a discount of 40 percent;
(2) Gillette Children's Hospital, with a discount of 90 percent;
(3) Hennepin Healthcare, with a discount of 60 percent;
(4) Mayo Rochester, with a discount of 20 percent; and
(5) each hospital not included in another discount category, and with greater than
$200,000,000 in total medical assistance inpatient and outpatient revenue in fee-for-service
and managed care, as reported in state fiscal year 2022 medical assistance fee-for-service
and managed care claims data, with a discount of ten percent.
new text begin
(p) The commissioner must not impose any assessment under this subdivision on a
hospital that does not receive payments under section 256B.1974.
new text end
deleted text begin (p)deleted text end new text begin (q)new text end If the federal share of the hospital directed payment program under section
256B.1974 is increased as the result of an increase to the federal medical assistance
percentage, the commissioner must reduce the assessment on a uniform percentage basis
across eligible hospitals on which the assessment is imposed, such that the aggregate amount
collected from hospitals under this subdivision does not exceed the total amount needed to
maintain the same aggregate state and federal funding level for the directed payments
authorized by section 256B.1974.
deleted text begin (q)deleted text end new text begin (r)new text end Eligible hospitals must submit to the commissioner on an annual basis, in the
form and manner specified by the commissioner in consultation with the Minnesota Hospital
Association, all documentation necessary to determine the assessment amounts under this
subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the date that Laws 2025, First Special
Session chapter 3, article 8, section 4, becomes effective.
new text end
Sec. 4.
Minnesota Statutes 2025 Supplement, section 256.969, subdivision 2f, is amended
to read:
Subd. 2f.
Alternate inpatient payment rate.
(a) Effective January 1, 2022, for a hospital
eligible to receive disproportionate share hospital payments under subdivision 9, paragraph
(d), clause (6), the commissioner shall reduce the amount calculated under subdivision 9,
paragraph (d), clause (6), by deleted text begin 99deleted text end new text begin onenew text end percent and compute an alternate inpatient payment
rate. The alternate payment rate shall be structured to target a total aggregate reimbursement
amount equal to what the hospital would have received for providing fee-for-service inpatient
services under this section to patients enrolled in medical assistance had the hospital received
the entire amount calculated under subdivision 9, paragraph (d), clause (6). This paragraph
expires when paragraph (b) becomes effective.
(b) For hospitals eligible to receive payment under section 256B.1973 or 256B.1974
and meeting the criteria in subdivision 9, paragraph (d), the commissioner deleted text begin mustdeleted text end new text begin maynew text end reduce
the amount calculated under subdivision 9, paragraph (d), by one percent and compute an
alternate inpatient payment rate. The alternate payment rate must be structured to target a
total aggregate reimbursement amount equal to the amount that the hospital would have
received for providing fee-for-service inpatient services under this section to patients enrolled
in medical assistance had the hospital received 99 percent of the entire amount calculated
under subdivision 9, paragraph (d). Hospitals that do not meet federal requirements for
Medicaid disproportionate share hospitals are not eligible for the alternate payment rate.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the date that Laws 2025, First Special
Session chapter 3, article 8, section 5, becomes effective.
new text end
Sec. 5.
Minnesota Statutes 2024, section 256B.056, subdivision 1, is amended to read:
Subdivision 1.
Residency.
(a) To be eligible for medical assistance, a person must reside
in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota, in
accordance with Code of Federal Regulations, title 42, section 435.403.new text begin A child who is
placed in a family foster home in Minnesota by another state is a Minnesota resident in
accordance with Minnesota's interstate agreements and Code of Federal Regulations, title
42, section 435.403(k). For the purposes of this paragraph, "family foster home" has the
meaning given in section 260C.007, subdivision 16b.
new text end
(b) The commissioner shall identify individuals who are enrolled in medical assistance
and who are absent from the state for more than 30 consecutive days, but who continue to
qualify for medical assistance in accordance with paragraph (a).
(c) If the individual is absent from the state for more than 30 consecutive days but still
deemed a resident of Minnesota in accordance with paragraph (a), any covered service
provided to the individual must be paid through the fee-for-service system and not through
the managed care capitated rate payment system under section 256B.69 or 256L.12.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 6.
Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 8, is amended
to read:
Subd. 8.
Physical therapy.
(a) Medical assistance covers physical therapy and related
services. Specialized maintenance therapy is covered for recipients age 20 and under.
(b) Services provided by a physical therapy assistant shall be reimbursed at the same
rate as services performed by a physical therapist when the services of the physical therapy
assistant are provided under the direction of a physical therapist who is on the premises.
Services provided by a physical therapy assistant that are provided under the direction of a
physical therapist who is not on the premises shall be reimbursed at 65 percent of the physical
therapist rate.
(c) Payment for physical therapy and related services is limited to 14 visits per year
unless prior authorization of a greater number of visits is obtained.new text begin This paragraph expires
upon the effective date of paragraph (d).
new text end
new text begin
(d) Effective January 1, 2027, or upon federal approval, whichever is later, payment for
physical therapy and related services is limited to the following number of visits per year
unless prior authorization of a greater number of visits is obtained:
new text end
new text begin
(1) for children following an inpatient or outpatient hospital-based surgery, 30 visits;
and
new text end
new text begin
(2) for all other recipients, 14 visits.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 7.
Minnesota Statutes 2025 Supplement, section 256B.1973, subdivision 9, is amended
to read:
Subd. 9.
Interaction with other directed payments.
new text begin (a) new text end An eligible provider under
subdivision 3 may participate in the hospital directed payment program under section
256B.1974 for inpatient hospital services, outpatient hospital services, or both. A provider
participating in the hospital directed payment program must not receive a directed payment
under this section for any provider classes paid via the hospital directed payment program.
A hospital subject to this section must notify the commissioner in writing no later than 30
days after enactment of this subdivision of the hospital's intention to participate in the
hospital directed payment program under section 256B.1974 for inpatient hospital services,
outpatient hospital services, or both.
new text begin (b) new text end The election under this subdivision is a onetime election, except that if an eligible
provider elects to participate in the hospital directed payment program, and the hospital
directed payment program expires or is not federally approved, the eligible provider may
subsequently elect to participate in the directed payment under this section.
new text begin
(c) If an eligible provider elects not to participate in the hospital directed payment
program under section 256B.1974 and the federal statutes or regulations related to hospital
directed payment programs are subsequently substantially changed, the eligible provider
may elect to participate in the hospital directed payment program under section 256B.1974.
new text end
new text begin
(d) The effective date of the election to participate in the hospital directed payment
program under this section must align with the beginning of the calendar year in which
payment rates under this section are updated. The eligible provider must notify the
commissioner of the eligible provider's intention to make the election ten months before
the effective date of the election.
new text end
Sec. 8.
Minnesota Statutes 2024, section 256B.75, is amended to read:
256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
(a) For outpatient hospital facility fee payments for services rendered on or after October
1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
which there is a federal maximum allowable payment. Effective for services rendered on
or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
emergency room facility fees shall be increased by eight percent over the rates in effect on
December 31, 1999, except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall be paid
at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
upper limit. If it is determined that a provision of this section conflicts with existing or
future requirements of the United States government with respect to federal financial
participation in medical assistance, the federal requirements prevail. The commissioner
may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper limitations.
(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in 2017, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics. Effective for services delivered on or after January 1, 2024, the
rates paid to critical access hospitals under this section must be adjusted to include the
amount of any distributions under section 62J.692, subdivision 4, paragraph (a), that were
not included in the rate adjustment described under section 256.969, subdivision 2b,
paragraph (k).
(c) Effective for services provided on or after July 1, 2003, rates that are based on the
Medicare outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this provision.
When implementing prospective payment methodologies, the commissioner shall use general
methods and rate calculation parameters similar to the applicable Medicare prospective
payment systems for services delivered in outpatient hospital and ambulatory surgical center
settings unless other payment methodologies for these services are specified in this chapter.
(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory rate.
(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
this paragraph.
(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three percent
from the current statutory rates. Mental health services and facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.
new text begin
(g) Critical access hospitals that convert to rural emergency hospitals in accordance with
section 1861(kkk) of the Social Security Act must be paid the rate described in paragraph
(b). The rate must be classified as either an outpatient hospital rate or a clinic rate as
determined upon federal approval.
new text end
Sec. 9.
Minnesota Statutes 2024, section 256B.76, subdivision 2, is amended to read:
Subd. 2.
Dental reimbursement.
(a) Effective for services rendered on or after October
1, 1992, the commissioner shall make payments for dental services as follows:
(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent
above the rate in effect on June 30, 1992; and
(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile
of 1989, less the percent in aggregate necessary to equal the above increases.
(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
(c) Effective for services rendered on or after January 1, 2000, payment rates for dental
services shall be increased by three percent over the rates in effect on December 31, 1999.
(d) Effective for services provided on or after January 1, 2002, payment for diagnostic
examinations and dental x-rays provided to children under age 21 shall be the lower of (1)
the submitted charge, or (2) 85 percent of median 1999 charges.
(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000,
for managed care.
(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated
dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare
principles of reimbursement. This payment shall be effective for services rendered on or
after January 1, 2011, to recipients enrolled in managed care plans or county-based
purchasing plans.
(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in
paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a
supplemental state payment equal to the difference between the total payments in paragraph
(f) and $1,850,000 shall be paid from the general fund to state-operated services for the
operation of the dental clinics.
(h) Effective for services rendered on or after January 1, 2014, through December 31,
2021, payment rates for dental services shall be increased by five percent from the rates in
effect on December 31, 2013. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2014, payments made to managed care plans and county-based
purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment
increase described in this paragraph.
(i) Effective for services provided on or after January 1, 2017, through December 31,
2021, the commissioner shall increase payment rates by 9.65 percent for dental services
provided outside of the seven-county metropolitan area. This increase does not apply to
state-operated dental clinics in paragraph (f), federally qualified health centers, rural health
centers, or Indian health services. Effective January 1, 2017, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph.
(j) Effective for services provided on or after July 1, 2017, through December 31, 2021,
the commissioner shall increase payment rates by 23.8 percent for dental services provided
to enrollees under the age of 21. This rate increase does not apply to state-operated dental
clinics in paragraph (f), federally qualified health centers, rural health centers, or Indian
health centers. This rate increase does not apply to managed care plans and county-based
purchasing plans.
(k) Effective for services provided on or after January 1, 2022, the commissioner shall
exclude from medical assistance and MinnesotaCare payments for dental services to public
health and community health clinics the 20 percent increase authorized under Laws 1989,
chapter 327, section 5, subdivision 2, paragraph (b).
(l) Effective for services provided on or after January 1, 2022, the commissioner shall
increase payment rates by 98 percent for all dental services. This rate increase does not
apply to state-operated dental clinics, federally qualified health centers, rural health centers,
or Indian health services.
new text begin
(m) Effective for services provided on or after January 1, 2028, payment for dental
services shall be the lower of submitted charges, or 50 percent of the 50th percentile of 2024
submitted charges. This paragraph does not apply to federally qualified health centers, rural
health centers, state-operated dental clinics, or Indian health centers.
new text end
new text begin
(n) Beginning January 1, 2030, and every two years thereafter, the commissioner must
rebase payment rates for dental services to a percentile of submitted charges for the applicable
base year using charge data from claims paid by the commissioner so that the total aggregate
expenditures does not exceed the total spend as outlined in paragraph (m) plus the change
in the Medical Economic Index (MEI). In 2030, the change in MEI must be measured from
midyear of 2028 and 2030. For each subsequent rebasing, the change in MEI must be
measured between the years that are one year after the rebasing years. The base year used
for each rebasing shall be the calendar year that is two years prior to the effective date of
the rebasing. This paragraph does not apply to federally qualified health centers, rural health
centers, state-operated dental clinics, or Indian health centers.
new text end
deleted text begin (m)deleted text end new text begin (o)new text end Managed care plans and county-based purchasing plans shall reimburse providers
at a level that is at least equal to the rate paid under fee-for-service for dental services. If,
for any coverage year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 10. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 256B.198,
new text end
new text begin
is repealed.
new text end
ARTICLE 3
HUMAN SERVICES FEDERAL COMPLIANCE
Section 1.
Minnesota Statutes 2024, section 245.462, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Case management contact. new text end
new text begin
"Case management contact" means interactive
communication conducted either in person, by interactive video that meets the requirements
of section 256B.0625, subdivision 20b, or by telephone with the client; client's parent; legal
guardian, guardian ad litem, or attorney for clients that are children or youth under 19 years
of age; or client's attorney for clients that are adults 19 years of age or older.
new text end
Sec. 2.
Minnesota Statutes 2024, section 245.4711, subdivision 5, is amended to read:
Subd. 5.
Coordination between case manager and community support services.
new text begin (a)
new text end The county board must establish procedures that ensure ongoing contact and coordination
between the case manager and the community support services program as well as other
mental health services.
new text begin
(b) The case manager must have at least one case management contact in every calendar
month with a documented core service component, as defined by the commissioner, to claim
reimbursement for adult mental health targeted case management. Adult mental health case
managers must not conduct the case management contact by telephone with the adult client
or the adult client's legal representative for more than two consecutive calendar months.
new text end
Sec. 3.
Minnesota Statutes 2024, section 245.4881, subdivision 5, is amended to read:
Subd. 5.
Coordination between case manager and family community support
services.
new text begin (a) new text end The county board must establish procedures that ensure ongoing contact and
coordination between the case manager and the family community support services as well
as other mental health services for each child.
new text begin
(b) The case manager must have at least one case management contact in every calendar
month with the child, the child's parents, or the child's legal representative.
new text end
Sec. 4.
Minnesota Statutes 2025 Supplement, section 245C.02, subdivision 15a, is amended
to read:
Subd. 15a.
Reasonable cause to require a national criminal history record check.
(a)
"Reasonable cause to require a national criminal history record check" means information
or circumstances exist that provide the commissioner with articulable suspicion that further
pertinent information may exist concerning a background study subject that merits conducting
a national criminal history record check on that subject. The commissioner has reasonable
cause to require a national criminal history record check when:
(1) information from the Bureau of Criminal Apprehension indicates that the subject is
a multistate offender;
(2) information from the Bureau of Criminal Apprehension indicates that multistate
offender status is undetermined;
(3) the commissioner has received a report from the subject or a third party indicating
that the subject has a criminal history in a jurisdiction other than Minnesota; or
(4) information from the Bureau of Criminal Apprehension for a state-based name and
date of birth background study in which the subject is a minor that indicates that the subject
has a criminal history.
(b) In addition to the circumstances described in paragraph (a), the commissioner has
reasonable cause to require a national criminal history record check if the subject is not
currently residing in Minnesota or resided in a jurisdiction other than Minnesota during the
previous five years.
(c) Reasonable cause to require a national criminal history check does not apply to family
child foster care deleted text begin ordeleted text end new text begin ,new text end adoptionnew text begin , adult day services, or adult foster carenew text end studies.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 25, 2028.
new text end
Sec. 5.
Minnesota Statutes 2025 Supplement, section 245C.05, subdivision 5, is amended
to read:
Subd. 5.
Fingerprints and photograph.
(a) Notwithstanding paragraph (c), for
background studies conducted by the commissioner for current or prospective child foster
or adoptive parents, and for any adult working in a children's residential facility, the subject
of the background study shall provide the commissioner with a set of classifiable fingerprints
obtained from an authorized agency for a national criminal history record check.
(b) Notwithstanding paragraph (c), for background studies conducted by the commissioner
for Head Start programs, the subject of the background study shall provide the commissioner
with a set of classifiable fingerprints obtained from an authorized agency for a national
criminal history record check.
(c) For background studies initiated on or after the implementation of NETStudy 2.0,
except as provided under subdivision 5a, every subject of a background study must provide
the commissioner with a set of the background study subject's classifiable fingerprints and
photograph. The photograph and fingerprints must be recorded at the same time by the
authorized fingerprint collection vendor or vendors and sent to the commissioner through
the commissioner's secure data system described in section 245C.32, subdivision 1a,
paragraph (b).
(d) The fingerprints shall be submitted by the commissioner to the Bureau of Criminal
Apprehension and, when specifically required by law, submitted to the Federal Bureau of
Investigation for a national criminal history record check.
(e) The fingerprints must not be retained by the Department of Public Safety, Bureau
of Criminal Apprehension, or the commissioner. The Federal Bureau of Investigation will
not retain background study subjects' fingerprints.
(f) The authorized fingerprint collection vendor or vendors shall, for purposes of verifying
the identity of the background study subject, be able to view the identifying information
entered into NETStudy 2.0 by the entity that initiated the background study, but shall not
retain the subject's fingerprints, photograph, or information from NETStudy 2.0. The
authorized fingerprint collection vendor or vendors shall retain no more than the name and
date and time the subject's fingerprints were recorded and sent, only as necessary for auditing
and billing activities.
(g) For any background study conducted under this chapter, except for family child
foster care deleted text begin ordeleted text end new text begin ,new text end adoptionnew text begin , adult day services, or adult foster carenew text end studies, the subject shall
provide the commissioner with a set of classifiable fingerprints when the commissioner has
reasonable cause to require a national criminal history record check as defined in section
245C.02, subdivision 15a.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 25, 2028.
new text end
Sec. 6.
Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to
read:
new text begin Subd. 45. new text end
new text begin Health care eligibility oversight unit. new text end
new text begin
(a) The commissioner shall establish
and maintain a Department of Human Services health care eligibility oversight unit
responsible for collaboration at a regional level to ensure federal and state Medicaid eligibility
requirements are consistently applied by all processing entities.
new text end
new text begin
(b) The oversight unit must monitor compliance, identify systemic issues, and provide
guidance and technical assistance to lead agencies.
new text end
new text begin
(c) The commissioner shall require lead agencies to work directly with the oversight
unit on corrective action planning and implementation to achieve compliance and strengthen
performance outcomes.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 7.
Minnesota Statutes 2024, section 256B.04, subdivision 27, is amended to read:
Subd. 27.
Disenrollment under medical assistance and MinnesotaCare.
(a) The
commissioner shall regularly new text begin obtain and use information from reliable data sources, including
but not limited to managed care and county-based purchasing plans, state health and human
services programs, mail returned by the United States Postal Service with a forwarding
address, and the National Change of Address database maintained by the United States
Postal Service, to new text end update mailing addresses and other contact information for medical
assistance and MinnesotaCare enrollees deleted text begin in cases of returned mail and nonresponse using
information available through managed care and county-based purchasing plans, state health
and human services programs, and other sourcesdeleted text end .
(b) The commissioner shall not disenroll an individual from medical assistance or
MinnesotaCare in cases of returned mail until the commissioner makes at least two attempts
by phone, email, or other methods to contact the individual. The commissioner may disenroll
the individual after providing no less than 30 days for the individual to respond to the most
recent contact attempt.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027.
new text end
Sec. 8.
Minnesota Statutes 2024, section 256B.056, subdivision 2a, is amended to read:
Subd. 2a.
Home equity limit for medical assistance payment of long-term care
services.
(a) Effective for requests of medical assistance payment of long-term care services
filed on or after July 1, 2006, and for renewals on or after July 1, 2006, for persons who
received payment of long-term care services under a request filed on or after January 1,
2006, the equity interest in the home of a person whose eligibility for long-term care services
is determined on or after January 1, 2006, shall not exceed $500,000, unless it is the lawful
residence of the person's spouse or child who is under age 21, or a child of any age who is
blind or permanently and totally disabled as defined in the Supplemental Security Income
program. The amount specified in this paragraph shall be increased beginning in year 2011,
from year to year based on the percentage increase in the Consumer Price Index for all urban
consumers (all items; United States city average), rounded to the nearest $1,000.
new text begin
(b) Effective January 1, 2028, the amount specified in paragraph (a) must not exceed
$1,000,000.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end For purposes of this subdivision, a "home" means any real or personal property
interest, including an interest in an agricultural homestead as defined under section 273.124,
subdivision 1, that, at the time of the request for medical assistance payment of long-term
care services, is the primary dwelling of the person or was the primary dwelling of the
person before receipt of long-term care services began outside of the home.
deleted text begin (c)deleted text end new text begin (d)new text end A person denied or terminated from medical assistance payment of long-term
care services because the person's home equity exceeds the home equity limit may seek a
waiver based upon a hardship by filing a written request with the county agency. Hardship
is an imminent threat to the person's health and well-being that is demonstrated by
documentation of no alternatives for payment of long-term care services. The county agency
shall make a decision regarding the written request to waive the home equity limit within
30 days if all necessary information has been provided. The county agency shall send the
person and the person's representative a written notice of decision on the request for a
demonstrated hardship waiver that also advises the person of appeal rights under the fair
hearing process of section 256.045.
Sec. 9.
Minnesota Statutes 2024, section 256B.056, subdivision 7, is amended to read:
Subd. 7.
Period of eligibility.
(a) Eligibility is available for the month of application
and for three months prior to application if the person was eligible in those prior months.
deleted text begin A redetermination of eligibility must occur every 12 months.
deleted text end
(b) Notwithstanding any other law to the contrary:
(1) a child under 19 years of age who is determined eligible for medical assistance must
remain eligible for a period of 12 months;
(2) a child 19 years of age and older but under 21 years of age who is determined eligible
for medical assistance must remain eligible for a period of 12 months; and
(3) a child under six years of age who is determined eligible for medical assistance must
remain eligible through the month in which the child reaches six years of age.
(c) A child's eligibility under paragraph (b) may be terminated earlier if:
(1) the child or the child's representative requests voluntary termination of eligibility;
(2) the child ceases to be a resident of this state;
(3) the child dies;
(4) the child attains the maximum age; or
(5) the agency determines eligibility was erroneously granted at the most recent eligibility
determination due to agency error or fraud, abuse, or perjury attributed to the child or the
child's representative.
(d) For a person eligible for an insurance affordability program as defined in section
256B.02, subdivision 19, who reports a change that makes the person eligible for medical
assistance, eligibility is available for the month the change was reported and for three months
prior to the month the change was reported, if the person was eligible in those prior months.
new text begin
(e) The period of eligibility for a person eligible for medical assistance under section
256B.055, subdivision 15, is six months. The period of eligibility for all other medical
assistance enrollees is 12 months.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027.
new text end
Sec. 10.
Minnesota Statutes 2024, section 256B.056, subdivision 7a, is amended to read:
Subd. 7a.
Periodic renewal of eligibility.
(a) new text begin Except as provided in paragraphs (d) and
(e), new text end the commissioner shall make an annual redetermination of eligibility based on
information contained in the enrollee's case file and other information available to the
agency, including but not limited to information accessed through an electronic database,
without requiring the enrollee to submit any information when sufficient data is available
for the agency to renew eligibility.
(b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the
commissioner must provide the enrollee with a prepopulated renewal form containing
eligibility information available to the agency and permit the enrollee to submit the form
with any corrections or additional information to the agency and sign the renewal form via
any of the modes of submission specified in section 256B.04, subdivision 18.
(c) An enrollee who is terminated for failure to complete the renewal process may
subsequently submit the renewal form and required information within four months after
the date of termination and have coverage reinstated without a lapse, if otherwise eligible
under this chapter. The local agency may close the enrollee's case file if the required
information is not submitted within four months of termination.
(d) Notwithstanding paragraph (a), a person who is eligible under subdivision 5 deleted text begin shall
bedeleted text end new text begin isnew text end subject to a review of the person's income every six months.
new text begin
(e) Notwithstanding paragraph (a), a person who is eligible under section 256B.055,
subdivision 15, and who is not an American Indian or Alaska Native is subject to a
redetermination of eligibility every six months.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027.
new text end
Sec. 11.
Minnesota Statutes 2024, section 256B.0561, subdivision 2, is amended to read:
Subd. 2.
Periodic data matching.
(a) The commissioner shall conduct periodic data
matching to identify recipients who, based on available electronic data, may not meet
eligibility criteria for the public health care program in which the recipient is enrolled. The
commissioner shall conduct data matching for medical assistance or MinnesotaCare recipients
at least once during a recipient's 12-month period of eligibilitynew text begin , except as provided in
paragraph (f)new text end .
(b) If data matching indicates a recipient may no longer qualify for medical assistance
or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no
more than 30 days to confirm the information obtained through the periodic data matching
or provide a reasonable explanation for the discrepancy to the state or county agency directly
responsible for the recipient's case. If a recipient does not respond within the advance notice
period or does not respond with information that demonstrates eligibility or provides a
reasonable explanation for the discrepancy within the 30-day time period, the commissioner
shall terminate the recipient's eligibility in the manner provided for by the laws and
regulations governing the health care program for which the recipient has been identified
as being ineligible.
(c) The commissioner shall not terminate eligibility for a recipient who is cooperating
with the requirements of paragraph (b) and needs additional time to provide information in
response to the notification.
(d) A recipient whose eligibility was terminated according to paragraph (b) may be
eligible for medical assistance no earlier than the first day of the month in which the recipient
provides information that demonstrates the recipient's eligibility.
(e) Any termination of eligibility for benefits under this section may be appealed as
provided for in sections 256.045 to 256.0451, and the laws governing the health care
programs for which eligibility is terminated.
new text begin
(f) Effective January 1, 2027, a person receiving medical assistance under section
256B.055, subdivision 15, who is subject to a redetermination of eligibility every six months
under section 256B.056, subdivision 7a, paragraph (e), is exempt from periodic data matching
under this subdivision.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 12.
new text begin
[256B.0562] WORK OR COMMUNITY ENGAGEMENT REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Medical assistance eligibility requirement. new text end
new text begin
(a) To be eligible for medical
assistance under section 256B.055, subdivision 15, a person must either demonstrate work
or community engagement or meet an exemption in accordance with section 71119 of the
One Big Beautiful Bill Act, Public Law 119-21.
new text end
new text begin
(b) An applicant must meet the requirements under this section for the month immediately
preceding the month during which the person submits an application for medical assistance.
new text end
new text begin
(c) To renew eligibility pursuant to section 256B.056, subdivision 7a, a person enrolled
in and receiving medical assistance must meet the requirements under this section for at
least one month during the person's previous period of eligibility.
new text end
new text begin Subd. 2. new text end
new text begin Compliance and exemptions. new text end
new text begin
(a) A person demonstrates work or community
engagement under this section for a given month if the person meets at least one of the
following conditions with respect to that month:
new text end
new text begin
(1) the person works at least 80 hours;
new text end
new text begin
(2) the person completes at least 80 hours of community service;
new text end
new text begin
(3) the person participates in a work program for at least 80 hours;
new text end
new text begin
(4) the person is enrolled in an educational program at least half time;
new text end
new text begin
(5) the person engages in any combination of the activities in clauses (1) to (4) for a
total of at least 80 hours;
new text end
new text begin
(6) the person has a monthly income that is not less than the applicable minimum wage
requirement under section 6 of the Fair Labor Standards Act of 1938, multiplied by 80
hours; or
new text end
new text begin
(7) the person has an average monthly income during the preceding six months that is
equal to or greater than the applicable minimum wage requirement under section 6 of the
Fair Labor Standards Act of 1938, multiplied by 80 hours and is a seasonal worker as defined
in section 45R(d)(5)(B) of the Internal Revenue Code of 1986.
new text end
new text begin
(b) A person is exempt from the requirement to demonstrate work or community
engagement if the person:
new text end
new text begin
(1) is an American Indian or Alaska Native;
new text end
new text begin
(2) is a family caregiver, as defined in section 2 of the RAISE Family Caregivers Act,
of a disabled individual;
new text end
new text begin
(3) is a veteran with a disability rated as total under United States Code, title 38, section
1155;
new text end
new text begin
(4) is medically frail or has special medical needs, including a person who:
new text end
new text begin
(i) is blind or disabled, as defined in section 1614 of the Social Security Act;
new text end
new text begin
(ii) has a substance use disorder;
new text end
new text begin
(iii) has a disabling mental disorder;
new text end
new text begin
(iv) has a physical, intellectual, or developmental disability that significantly impairs
the person's ability to perform daily living routines; or
new text end
new text begin
(v) has a serious or complex medical condition;
new text end
new text begin
(5) meets the work requirements imposed by the Minnesota family investment program;
new text end
new text begin
(6) is a member of a household that receives Supplemental Nutrition Assistance Program
benefits and is not exempt from the requirements under section 142F.10;
new text end
new text begin
(7) is participating in a drug addiction or alcoholic treatment and rehabilitation program;
or
new text end
new text begin
(8) is incarcerated.
new text end
new text begin
(c) A person is exempt from the requirement to demonstrate work or community
engagement for a given month if for part or all of that month the person is:
new text end
new text begin
(1) described in paragraph (b);
new text end
new text begin
(2) under 21 years of age;
new text end
new text begin
(3) entitled to or enrolled in benefits under Medicare Part A or enrolled in benefits under
Medicare Part B;
new text end
new text begin
(4) enrolled in medical assistance under an eligibility category described in section
1902(a)(10)(A)(i), subclauses (I) to (VII), of the Social Security Act; or
new text end
new text begin
(5) incarcerated at any point during the three-month period ending on the first day of
the given month.
new text end
new text begin Subd. 3. new text end
new text begin Short-term hardship events. new text end
new text begin
(a) The commissioner shall seek any approvals
necessary from the federal Secretary of Health and Human Services to implement the
short-term hardship exemptions described in this subdivision.
new text end
new text begin
(b) A person is exempt from the requirement to demonstrate work or community
engagement for a given month if the person experiences a short-term hardship event for
part or all of that month.
new text end
new text begin
(c) For purposes of this section, "short-term hardship event" means an event in which a
person:
new text end
new text begin
(1) receives inpatient hospital or nursing facility services, services in an intermediate
care facility for individuals with intellectual disabilities, inpatient psychiatric hospital
services, or other services of similar acuity;
new text end
new text begin
(2) resides in a county in which there is an emergency or disaster declared by the President
of the United States pursuant to the National Emergencies Act or the Robert T. Stafford
Disaster Relief and Emergency Assistance Act;
new text end
new text begin
(3) resides in a county that has an unemployment rate at or above the lesser of eight
percent or 1.5 times the national unemployment rate; or
new text end
new text begin
(4) must travel outside of the person's community for an extended period of time to
receive medical services that are not available within the community of residence necessary
to treat a serious or complex medical condition of the person or the person's dependent.
new text end
new text begin
(d) A person must request the short-term hardship event exceptions described in paragraph
(c), clauses (1) and (4), to be granted the exception.
new text end
new text begin Subd. 4. new text end
new text begin Noncompliance procedure. new text end
new text begin
(a) Before denying or terminating medical
assistance eligibility for failure to demonstrate work or community engagement or meet an
exemption, the commissioner must provide an applicant or enrollee:
new text end
new text begin
(1) a notice of noncompliance; and
new text end
new text begin
(2) a period of 30 calendar days to provide evidence of compliance or exemption from
the requirement.
new text end
new text begin
(b) The commissioner must continue to provide medical assistance to an enrollee during
the 30-day period under paragraph (a), clause (2). If the person does not provide evidence
of compliance or exemption from the requirement within the 30-day period, the commissioner
must deny the application or terminate eligibility by the end of the month following the
month in which the 30-day period ends.
new text end
new text begin
(c) Before denial or termination of eligibility, the commissioner must:
new text end
new text begin
(1) provide the person with advance notice in accordance with Code of Federal
Regulations, title 42, section 431.211; and
new text end
new text begin
(2) determine whether the person may qualify for medical assistance under any other
eligibility category or for another insurance affordability program.
new text end
new text begin Subd. 5. new text end
new text begin Limitation and suspension of implementation and enforcement. new text end
new text begin
(a) The
commissioner must implement and enforce this section only to the extent required under
federal law as a condition of receiving federal financial participation for the medical
assistance program.
new text end
new text begin
(b) The commissioner must immediately suspend implementation and enforcement of
this section if any of the following conditions are met:
new text end
new text begin
(1) federal law no longer requires states to impose work or community engagement
requirements as a condition of receiving federal financial participation for the medical
assistance program;
new text end
new text begin
(2) federal law, regulation, or federal administrative guidance allows the state to
discontinue enforcement of medical assistance work or community engagement requirements
without the loss, reduction, or withholding of federal financial participation or any other
federal financial penalty; or
new text end
new text begin
(3) the commissioner determines that the conditions for the expiration of this section
under subdivision 6 have been met.
new text end
new text begin
(c) If implementation and enforcement are suspended under paragraph (a), the
commissioner must notify the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services finance and policy and the
revisor of statutes.
new text end
new text begin
(d) The commissioner must not enforce the work or community engagement requirements
established under this section if implementation is suspended under this subdivision.
new text end
new text begin Subd. 6. new text end
new text begin Contingent expiration. new text end
new text begin
(a) This section expires if federal law requiring or
authorizing work or community engagement requirements for individuals eligible for medical
assistance, including but not limited to provisions enacted in Public Law 119-21, is repealed
or otherwise no longer in effect.
new text end
new text begin
(b) The commissioner must determine whether the conditions in paragraph (a) have been
met. Upon making that determination, the commissioner must notify the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services finance and policy and the revisor of statutes.
new text end
new text begin Subd. 7. new text end
new text begin Expedited rulemaking authority. new text end
new text begin
The commissioner may adopt rules necessary
to implement and administer this section using the expedited rulemaking process under
section 14.389. The 18-month time limit under section 14.125 does not apply to the
rulemaking authority under this subdivision.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027.
new text end
Sec. 13.
Minnesota Statutes 2024, section 256B.06, subdivision 4, is amended to read:
Subd. 4.
Citizenship requirements.
(a) Eligibility for medical assistance is limited to
citizens of the United States, qualified noncitizens as defined in this subdivision, and other
persons residing lawfully in the United States. Citizens or nationals of the United States
must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality
according to the requirements of the federal Deficit Reduction Act of 2005, Public Law
109-171.
(b) "Qualified noncitizen" means a person who meets one of the following immigration
criteria:
(1) admitted for lawful permanent residence according to United States Code, title 8;
(2) admitted to the United States as a refugee according to United States Code, title 8,
section 1157;
(3) granted asylum according to United States Code, title 8, section 1158;
(4) granted withholding of deportation according to United States Code, title 8, section
1253(h);
(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);
(6) granted conditional entrant status according to United States Code, title 8, section
1153(a)(7);
(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
(8) is a child of a noncitizen determined to be a battered noncitizen by the United States
Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility
Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
or
(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.
(c) All qualified noncitizens who were residing in the United States before August 22,
1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical
assistance with federal financial participation.
(d) Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:
(1) refugees admitted to the United States according to United States Code, title 8, section
1157;
(2) persons granted asylum according to United States Code, title 8, section 1158;
(3) persons granted withholding of deportation according to United States Code, title 8,
section 1253(h);
(4) veterans of the United States armed forces with an honorable discharge for a reason
other than noncitizen status, their spouses and unmarried minor dependent children; or
(5) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.
Beginning July 1, 2010, children and pregnant women who are noncitizens described
in paragraph (b) or who are lawfully present in the United States as defined in Code of
Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements
of this chapter, are eligible for medical assistance with federal financial participation as
provided by the federal Children's Health Insurance Program Reauthorization Act of 2009,
Public Law 111-3.
(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are
eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision,
a "nonimmigrant" is a person in one of the classes listed in United States Code, title 8,
section 1101(a)(15).
(f) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of this
chapter, if such care and services are necessary for the treatment of an emergency medical
condition.
(g) For purposes of this subdivision, the term "emergency medical condition" means a
medical condition that meets the requirements of United States Code, title 42, section
1396b(v).
(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of
an emergency medical condition are limited to the following:
(i) services delivered in an emergency room or by an ambulance service licensed under
chapter 144E that are directly related to the treatment of an emergency medical condition;
(ii) services delivered in an inpatient hospital setting following admission from an
emergency room or clinic for an acute emergency condition; and
(iii) follow-up services that are directly related to the original service provided to treat
the emergency medical condition and are covered by the global payment made to the
provider.
(2) Services for the treatment of emergency medical conditions do not include:
(i) services delivered in an emergency room or inpatient setting to treat a nonemergency
condition;
(ii) organ transplants, stem cell transplants, and related care;
(iii) services for routine prenatal care;
(iv) continuing care, including long-term care, nursing facility services, home health
care, adult day care, day training, or supportive living services;
(v) elective surgery;
(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part
of an emergency room visit;
(vii) preventative health care and family planning services;
(viii) rehabilitation services;
(ix) physical, occupational, or speech therapy;
(x) transportation services;
(xi) case management;
(xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
(xiii) dental services;
(xiv) hospice care;
(xv) audiology services and hearing aids;
(xvi) podiatry services;
(xvii) chiropractic services;
(xviii) immunizations;
(xix) vision services and eyeglasses;
(xx) waiver services;
(xxi) individualized education programs; or
(xxii) substance use disorder treatment.
(i) Pregnant noncitizens who are ineligible for federally funded medical assistance
because of immigration status, are not covered by a group health plan or health insurance
coverage according to Code of Federal Regulations, title 42, section 457.310, and who
otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance
through the period of pregnancy, including labor and delivery, and 12 months postpartum.
(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services
from a nonprofit center established to serve victims of torture and are otherwise ineligible
for medical assistance under this chapter are eligible for medical assistance without federal
financial participation. These individuals are eligible only for the period during which they
are receiving services from the center. Individuals eligible under this paragraph shall not
be required to participate in prepaid medical assistance. The nonprofit center referenced
under this paragraph may establish itself as a provider of mental health targeted case
management services through a county contract under section 256.0112, subdivision 6. If
the nonprofit center is unable to secure a contract with a lead county in its service area, then,
notwithstanding the requirements of section 256B.0625, subdivision 20, the commissioner
may negotiate a contract with the nonprofit center for provision of mental health targeted
case management services. When serving clients who are not the financial responsibility
of their contracted lead county, the nonprofit center must gain the concurrence of the county
of financial responsibility prior to providing mental health targeted case management services
for those clients.
(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
emergency medical conditions under paragraph (f) except where coverage is prohibited
under federal law for services under clauses (1) and (2):
(1) dialysis services provided in a hospital or freestanding dialysis facility;
(2) surgery and the administration of chemotherapy, radiation, and related services
necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and
requires surgery, chemotherapy, or radiation treatment; and
(3) kidney transplant if the person has been diagnosed with end stage renal disease, is
currently receiving dialysis services, and is a potential candidate for a kidney transplant.
(l) Effective July 1, 2013, recipients of emergency medical assistance under this
subdivision are eligible for coverage of the elderly waiver services provided under chapter
256S, and coverage of rehabilitative services provided in a nursing facility. The age limit
for elderly waiver services does not apply. In order to qualify for coverage, a recipient of
emergency medical assistance is subject to the assessment and reassessment requirements
of section 256B.0911. Initial and continued enrollment under this paragraph is subject to
the limits of available funding.
new text begin
(m) Notwithstanding paragraph (i), medical assistance is only available to noncitizens
who are eligible for coverage with federal financial participation provided by Medicaid or
the Children's Health Insurance Program.
new text end
Sec. 14.
Minnesota Statutes 2025 Supplement, section 256B.0625, subdivision 20, is
amended to read:
Subd. 20.
Mental health case management.
(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illness and children with serious mental illness. Services provided
under this section must meet the relevant standards in sections 245.461 to 245.4887, the
Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 9520.0900
to 9520.0926, and 9505.0322, excluding subpart 10.
(b) deleted text begin Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with serious mental
illness when these services meet the program standards in Minnesota Rules, parts 9520.0900
to 9520.0926 and 9505.0322, excluding subparts 6 and 10.deleted text end new text begin To be eligible for medical
assistance reimbursement, an entity must document:
new text end
new text begin
(1) face-to-face contacts between the case manager and the recipient;
new text end
new text begin
(2) telephone contacts between the case manager and the recipient; the recipient's mental
health provider or other service providers; the recipient's family members, legal
representative, or primary caregiver; or other interested persons;
new text end
new text begin
(3) face-to-face contacts between the case manager and the recipient's mental health
provider or other service providers; the recipient's family members, legal representative, or
primary caregiver; or other interested persons;
new text end
new text begin
(4) contacts between the case manager and the case manager's clinical supervisor about
the recipient;
new text end
new text begin
(5) individual community support plan and assessment development, review, and revision
required under section 245.4711, subdivision 4, for an adult, or section 245.4881, subdivision
4, for a child;
new text end
new text begin
(6) travel time spent by the case manager to meet face-to-face with the recipient who
resides outside of the county of financial responsibility; and
new text end
new text begin
(7) travel time spent by the case manager within the county of financial responsibility
to meet face-to-face with the recipient or the recipient's family, legal representative, or
primary caregiver.
new text end
new text begin
(c) For purposes of paragraph (b), clauses (6) and (7), if a case manager arrives on time
for a scheduled face-to-face appointment with a recipient or the recipient's family member,
legal representative, or primary caregiver and the person fails to keep the appointment, the
time spent by the case manager traveling to and from the site of the scheduled appointment
is eligible for medical assistance payment. Provider entities must meet all program standards
set out in rules governing family community support services as defined in section 245.4871,
subdivision 17, and Minnesota Rules, parts 9520.0900 to 9520.0926, and 9505.0322, subpart
9.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end Medical assistance and MinnesotaCare payment for mental health case
management deleted text begin shalldeleted text end new text begin mustnew text end be made deleted text begin on a monthly basisdeleted text end new text begin in accordance with section 256B.076,
subdivisions 1, 2, 5, and 6new text end . deleted text begin In order to receive payment for an eligible child, the provider
must document at least a face-to-face contact either in person or by interactive video that
meets the requirements of subdivision 20b with the child, the child's parents, or the child's
legal representative. To receive payment for an eligible adult, the provider must document:
deleted text end
deleted text begin
(1) at least a face-to-face contact with the adult or the adult's legal representative either
in person or by interactive video that meets the requirements of subdivision 20b; or
deleted text end
deleted text begin
(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact either in person or by interactive video that meets the
requirements of subdivision 20b with the adult or the adult's legal representative within the
preceding two months.
deleted text end
deleted text begin (d)deleted text end new text begin (e)new text end Payment for mental health case management provided by county or state staff
deleted text begin shalldeleted text end new text begin mustnew text end be based on the deleted text begin monthlydeleted text end rate methodology under section deleted text begin 256B.094, subdivision
6, paragraph (b), with separate rates calculated for child welfare and mental health, and
within mental health, separate rates for children and adultsdeleted text end new text begin 256B.076, subdivisions 5 and
7new text end .
deleted text begin (e)deleted text end new text begin (f)new text end Payment for mental health case management provided by Indian health services
or by agencies operated by Indian tribes may be made according to this section or other
relevant federally approved rate setting methodology.
deleted text begin (f)deleted text end new text begin (g)new text end Payment for mental health case management provided by vendors who contract
with a county must be calculated in accordance with section 256B.076, subdivision 2.
Payment for mental health case management provided by vendors who contract with a Tribe
must be based on a monthly rate negotiated by the Tribe. The rate must not exceed the rate
charged by the vendor for the same service to other payers. If the service is provided by a
team of contracted vendors, the team shall determine how to distribute the rate among its
members. No reimbursement received by contracted vendors shall be returned to the county
or tribe, except to reimburse the county or tribe for advance funding provided by the county
or tribe to the vendor.
deleted text begin (g)deleted text end new text begin (h)new text end If the service is provided by a team which includes contracted vendors, tribal
staff, and county or state staff, the costs for county or state staff participation in the team
shall be included in the rate for county-provided services. In this case, the contracted vendor,
the tribal agency, and the county may each receive separate payment for services provided
by each entity in the same month. In order to prevent duplication of services, each entity
must document, in the recipient's file, the need for team case management and a description
of the roles of the team members.
deleted text begin (h)deleted text end new text begin (i)new text end Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs
for mental health case management shall be provided by the recipient's county of
responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
funds or funds used to match other federal funds. If the service is provided by a tribal agency,
the nonfederal share, if any, shall be provided by the recipient's tribe. When this service is
paid by the state without a federal share through fee-for-service, 50 percent of the cost shall
be provided by the recipient's county of responsibility.
deleted text begin (i)deleted text end new text begin (j)new text end Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.
deleted text begin (j)deleted text end new text begin (k)new text end The commissioner may suspend, reduce, or terminate the reimbursement to a
provider that does not meet the deleted text begin reporting or otherdeleted text end requirements of this sectionnew text begin or section
245.4711, 245.4881, 256B.0924, 256B.094, or 256F.10new text end . The county of responsibility, as
defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, is responsible
for any federal disallowances. The county or tribe may share this responsibility with its
contracted vendors.
deleted text begin (k)deleted text end new text begin (l)new text end The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (n). The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
deleted text begin (l)deleted text end new text begin (m)new text end Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.
deleted text begin (m)deleted text end new text begin (n)new text end Case management services under this subdivision do not include therapy,
treatment, legal, or outreach services.
deleted text begin (n)deleted text end new text begin (o)new text end If the recipient is a resident of a nursing facility, intermediate care facility, or
hospital, and the recipient's institutional care is paid by medical assistance, payment for
case management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
deleted text begin (o)deleted text end new text begin (p)new text end Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.
deleted text begin (p)deleted text end new text begin (q)new text end If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.
new text begin
(r) Counties may receive payment for up to 12 15-minute units for use at case initiation
and case closing to facilitate the recipient's needs assessments, individualized plan
development, referrals, or case documentation without needing to meet the contact
requirements specified under sections 245.4711, 245.4881, 256B.0924, 256B.094, and
256F.10.
new text end
Sec. 15.
Minnesota Statutes 2024, section 256B.076, subdivision 1, is amended to read:
Subdivision 1.
Generally.
(a) It is the policy of this state to ensure that individuals on
medical assistance receive cost-effective and coordinated care, including efforts to address
the profound effects of housing instability, food insecurity, and other social determinants
of health. Therefore, subject to federal approval, medical assistance covers targeted case
management services as described in this sectionnew text begin and sections 245.4711; 245.4881;
256B.0625, subdivisions 20 to 20b; 256B.0924; 256B.094; and 256F.10new text end .
(b) The commissioner, in collaboration with Tribes, counties, providers, and individuals
served, must propose further modifications to targeted case management services to ensure
a program that complies with all federal requirements, delivers services in a cost-effective
and efficient manner, creates uniform expectations for targeted case management services,
addresses health disparities, and promotes person- and family-centered services.
new text begin
(c) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
that does not meet the requirements of this section or section 245.4711; 245.4881; 256B.0625,
subdivisions 20 and 20b; 256B.0924; 256B.094; or 256F.10. The county of financial
responsibility, as determined under chapter 256G or, if applicable, the Tribal agency, is
responsible for any federal disallowances. The county or Tribal agency may share the
financial responsibility with the county's or Tribal agency's contracted vendors.
new text end
Sec. 16.
Minnesota Statutes 2024, section 256B.076, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin County-provided fee-for-service rate setting and reconciliation. new text end
new text begin
(a) Effective
January 1 of the implementation year determined in the joint governance agreement under
subdivision 6, or upon federal approval, whichever is later, the commissioner must pay
targeted case management services for which counties provide the nonfederal share of
money and county staff provide the services on a fee-for-service basis according to the
cost-based payment methodology in this subdivision and consistent with the federal
regulations related to certified public expenditures. To receive federal reimbursement for
these services, a county providing eligible targeted case management services must complete
a federally approved cost report in accordance with section 256.01, subdivision 2, paragraph
(o).
new text end
new text begin
(b) The commissioner must reimburse submitted claims based on an interim rate and
must determine a final rate on a calendar-year basis following completion of a cost report
reconciliation. The commissioner must notify counties of the final rate and post final rates
publicly.
new text end
new text begin
(c) To appeal a final rate determined by the commissioner under paragraph (b), a county
must submit a written appeal request to the commissioner within 60 days after the date the
commissioner issued the final rate determination. The appeal request must specify the
disputed items and the name and address of the person to contact regarding the appeal.
new text end
new text begin
(d) The payment methodology under this section must only be used to reimburse
allowable medical assistance costs. The county of financial responsibility, as determined
under chapter 256G, is responsible for any federal disallowances.
new text end
new text begin
(e) Upon implementation, the commissioner must base interim rates on data from the
testing period. The commissioner must base subsequent interim rates for a calendar year
on the most recently completed reconciliation. The commissioner must notify counties of
the interim rate by June 30 each year and post interim rates publicly. If the commissioner
is unable to notify the counties by June 30, the commissioner must notify each county in
writing no later than June 30 that the new interim rate is delayed and must provide an
estimate of when the new interim rate will be available.
new text end
new text begin
(f) Payments to counties for targeted case management expenditures under this section
must be made only from federal earnings from services provided under this section.
new text end
new text begin
(g) Counties must submit all claims for targeted case management services described
in this section using a 15-minute unit.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 17.
Minnesota Statutes 2024, section 256B.076, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Testing and implementation. new text end
new text begin
The commissioners of human services and
children, youth, and families; the Association of Minnesota Counties (AMC); and the
Minnesota Association of County Social Service Administrators (MACSSA) must collaborate
to establish a joint governance agreement. The joint governance agreement must:
new text end
new text begin
(1) establish system functionality requirements to (i) meet the business needs of local
agencies providing targeted case management services and (ii) comply with applicable state
and federal regulations for the Social Services Information System (SSIS), SSIS's
replacement, and adjacent systems and the targeted case management cost report under
subdivision 5;
new text end
new text begin
(2) establish a schedule for transition planning, including but not limited to fiscal impact
assessment and training; and
new text end
new text begin
(3) specify that the rate method established in subdivision 5 must not be implemented
without both the completion of a required testing period of 12 calendar months and the
express approval by the commissioners of human services and children, youth, and families;
AMC; and MACSSA.
new text end
Sec. 18.
Minnesota Statutes 2024, section 256B.076, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin
Managed care plan units and rates for mental health targeted case
management.
new text end
new text begin
The commissioner must ensure that the prepaid health plans providing covered
health services for eligible persons pursuant to this chapter and section 256L.03, subdivisions
1a and 1b, reimburse counties at a rate that is at least equal to the fee-for-service rate
described in subdivision 5 for targeted case management services provided to Minnesota
health care program (MHCP) health plan enrollees covered by medical assistance. If, for
any contract year, federal approval is not received for this subdivision, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this subdivision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this
subdivision applies must allow recovery of payments from those providers if capitation
rates are adjusted in accordance with this subdivision. Payment recoveries must not exceed
the amount equal to any increase in rates that results from this subdivision. This subdivision
expires if federal approval is not received for this subdivision at any time. This subdivision
does not obligate MHCP health plans to contract with counties for the provision of targeted
case management services.
new text end
Sec. 19.
Minnesota Statutes 2024, section 256B.076, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Targeted case management gap funding. new text end
new text begin
(a) For purposes of this subdivision,
"unacceptable loss" means when a county's finalized amount of targeted case management
federal reimbursement following the commissioner's reconciliation for a calendar year for
targeted case management under subdivision 5 is less than 90 percent of the average federal
reimbursement received by that county during the base calendar years determined in
paragraph (c).
new text end
new text begin
(b) The commissioner must pay targeted case management gap funding in the amount
and time frame specified in paragraph (c) to an individual county for calendar years in which
the county experiences an unacceptable loss.
new text end
new text begin
(c) The base calendar years are the three calendar years immediately before the testing
period of 12 calendar months determined under subdivision 6. In consultation with the
county that experienced the unacceptable loss, the commissioner must make appropriate
adjustments to base year amounts as needed to prevent the base amounts from being unduly
influenced by onetime events, anomalies, or small changes that appear large compared to
a narrow historical base. The commissioner must not make adjustments to the eight county
human services agencies that received the greatest amount of targeted case management
federal reimbursement during the base calendar years. For agencies other than the eight
county human services agencies that received the greatest amount, the total of all adjustments
for a given calendar year must not exceed two percent of statewide federal targeted case
management federal reimbursement that calendar year.
new text end
new text begin
(d) The commissioner must pay targeted case management gap funding to the applicable
county in an amount equaling the difference between the finalized amount of targeted case
management federal reimbursement after reconciliation for that calendar year and 90 percent
of the average federal reimbursement received by that county during the base calendar years,
including any adjustments under paragraph (c). The commissioner must pay the county
within 90 days of completing the reconciliation under subdivision 5.
new text end
new text begin
(e) Targeted case management gap funding is a forecasted program under section 16A.11.
new text end
Sec. 20.
Minnesota Statutes 2025 Supplement, section 256B.0924, subdivision 6, is
amended to read:
Subd. 6.
Payment for targeted case management.
(a) deleted text begin Medical assistance and
MinnesotaCare payment for targeted case management shall be made on a monthly basis.
In order to receive payment for an eligible adult,deleted text end The provider must deleted text begin document at least one
contact per month and not more than two consecutive months without a face-to-facedeleted text end new text begin meet
thenew text end contact deleted text begin either in person ordeleted text end new text begin requirements under section 256B.094, subdivision 6. Contactnew text end
by interactive video deleted text begin that meetsdeleted text end new text begin must meetnew text end the requirements in section 256B.0625, subdivision
20b, with the adult or the adult's legal representative, family, primary caregiver, or other
relevant deleted text begin personsdeleted text end new text begin personnew text end identified as necessary to the development or implementation of
the goals of the personal service plan.
(b) Except as provided under paragraph (m), payment for targeted case management
provided by county staff under this subdivision deleted text begin shalldeleted text end new text begin mustnew text end be based on the deleted text begin monthlydeleted text end rate
deleted text begin methodology under section 256B.094, subdivision 6, paragraph (b), calculated as one
combined average rate together with adult mental health case management under section
256B.0625, subdivision 20, except for calendar year 2002. In calendar year 2002, the rate
for case management under this section shall be the same as the rate for adult mental health
case management in effect as of December 31, 2001deleted text end new text begin established in section 256B.076,
subdivisions 5 and 7new text end . Billing and payment must identify the recipient's primary population
group to allow tracking of revenues.
(c) Payment for targeted case management provided by county-contracted vendors shall
be based on a monthly rate calculated in accordance with section 256B.076, subdivision 2.
The rate must not exceed the rate charged by the vendor for the same service to other payers.
If the service is provided by a team of contracted vendors, the team shall determine how to
distribute the rate among its members. No reimbursement received by contracted vendors
shall be returned to the county, except to reimburse the county for advance funding provided
by the county to the vendor.
(d) If the service is provided by a team that includes contracted vendors and county staff,
the costs for county staff participation on the team shall be included in the rate for
county-provided services. In this case, the contracted vendor and the county may each
receive separate payment for services provided by each entity in the same month. In order
to prevent duplication of services, the county must document, in the recipient's file, the need
for team targeted case management and a description of the different roles of the team
members.
(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
targeted case management shall be provided by the recipient's county of responsibility, as
defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds.
(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted vendors.
(g) The commissioner shall set aside five percent of the federal funds received under
this section for use in reimbursing the state for costs of developing and implementing this
section.
(h) Payments to counties for targeted case management expenditures under this section
shall only be made from federal earnings from services provided under this section. Payments
to contracted vendors shall include both the federal earnings and the county share.
(i) Notwithstanding section 256B.041, county payments for the cost of case management
services provided by county staff shall not be made to the commissioner of management
and budget. For the purposes of targeted case management services provided by county
staff under this section, the centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services provided under this section.
(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for targeted case
management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
(k) Payment for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.
(l) Any growth in targeted case management services and cost increases under this
section shall be the responsibility of the counties.
(m) The commissioner may make payments for Tribes according to section 256B.0625,
subdivision 34, or other relevant federally approved rate setting methodologies for vulnerable
adult and developmental disability targeted case management provided by Indian health
services and facilities operated by a Tribe or Tribal organization.
Sec. 21.
Minnesota Statutes 2024, section 256B.094, subdivision 2, is amended to read:
Subd. 2.
Eligible services.
Services eligible for medical assistance reimbursement
include:
(1) assessment of the recipient's need for case management services to gain access to
new text begin available new text end medical, social, educational,new text begin economic support,new text end and other related services;
(2) development, completion, and regular review of a written individual service plan
based on the assessment of need for case management services to ensure access tonew text begin availablenew text end
medical, social, educational, new text begin economic support, new text end and other related services;
(3) routine contact or other communication with the client, the client's family, primary
caregiver, legal representative, substitute care provider, service providers, or other relevant
persons identified as necessary to the development or implementation of the goals of the
individual service plan, regarding the status of the client, the individual service plan, or the
goals for the client, exclusive of transportation of the child;
(4) coordinating referrals for, and the provision of, case management services for the
client with appropriate service providers, consistent with section 1902(a)(23) of the Social
Security Act;
(5) coordinating and monitoring the overall service delivery to ensure quality of services;
(6) monitoring and evaluating services on a regular basis to ensure appropriateness and
continued neednew text begin based on the child's and family's or caregiver's current circumstancesnew text end ;
(7) completing and maintaining necessary documentation that supports and verifies the
activities in this subdivision;
(8) traveling to conduct a visit with the client or other relevant person necessary to the
development or implementation of the goals of the individual service plan; and
(9) coordinating with the medical assistance facility discharge planner in the 30-day
period before the client's discharge into the community. This case management service
provided to patients or residents in a medical assistance facility is limited to a maximum of
two 30-day periods per calendar year.
Sec. 22.
Minnesota Statutes 2024, section 256B.094, subdivision 3, is amended to read:
Subd. 3.
Coordination and provision of services.
(a) In a county or reservation where
a deleted text begin prepaid medical assistance providerdeleted text end new text begin managed care organization (MCO) or county-based
purchasing (CBP) plannew text end has contracted under section 256B.69 to provide new text begin medical and new text end mental
health services, the case management provider shall coordinate with the deleted text begin prepaid providerdeleted text end new text begin
MCO or CBP plannew text end to ensure that all necessary new text begin medical and new text end mental health services required
under the contract are provided to recipients of case management services.
deleted text begin
(b) When the case management provider determines that a prepaid provider is not
providing mental health services as required under the contract, the case management
provider shall assist the recipient to appeal the prepaid provider's denial pursuant to section
256.045, and may make other arrangements for provision of the covered services.
deleted text end
deleted text begin
(c) The case management provider may bill the provider of prepaid health care services
for any mental health services provided to a recipient of case management services which
the county or tribal social services arranges for or provides and which are included in the
prepaid provider's contract, and which were determined to be medically necessary as a result
of an appeal pursuant to section 256.045. The prepaid provider must reimburse the mental
health provider, at the prepaid provider's standard rate for that service, for any services
delivered under this subdivision.
deleted text end
new text begin
(b) Child welfare targeted case management is carved out of Minnesota health care
programs managed care contracts. The case management provider must assist the recipient
to ensure access to all medically necessary services listed in section 256B.0625, whether
delivered on a fee-for-service basis or by a MCO or CBP plan.
new text end
deleted text begin (d)deleted text end new text begin (c)new text end If the county or Tribal social services has not obtained prior authorization for this
service, or an appeal results in a determination that the services were not medically necessary,
the county or Tribal social services may not seek reimbursement from the prepaid provider.
Sec. 23.
Minnesota Statutes 2024, section 256B.094, subdivision 6, is amended to read:
Subd. 6.
Medical assistance reimbursement of case management services.
(a) Medical
assistance reimbursement for services under this section deleted text begin shalldeleted text end new text begin mustnew text end be made deleted text begin on a monthly
basisdeleted text end new text begin in accordance with section 256B.076new text end . Payment is based on face-to-face contacts either
in person or by interactive video, or telephone contacts between the case manager and the
client, client's family, primary caregiver, legal representative, or other relevant person
identified as necessary to the development or implementation of the goals of the individual
service plan regarding the status of the client, the individual service plan, or the goals for
the client. These contacts must meet the following requirements:
(1) there must be a face-to-face contact either in person or by interactive video that meets
the requirements of section 256B.0625, subdivision 20b, at least once a month except as
provided in clause (2); and
(2) for a client placed outside of the county of financial responsibility, or a client served
by Tribal social services placed outside the reservation, in an excluded time facility under
section 256G.02, subdivision 6, or through the Interstate Compact for the Placement of
Children, section 260.93, and the placement in either case is more than 60 miles beyond
the county or reservation boundaries, there must be at least one contact per month and not
more than two consecutive months without a face-to-face, in-person contact.
deleted text begin
(b) Except as provided under paragraph (c), the payment rate is established using time
study data on activities of provider service staff and reports required under sections 245.482
and 256.01, subdivision 2, paragraph (o).
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end Payments for Tribes may be made according to section 256B.0625 or other
relevant federally approved rate setting methodology for child welfare targeted case
management provided by Indian health services and facilities operated by a Tribe or Tribal
organization.
deleted text begin (d)deleted text end new text begin (c)new text end Payment for case management provided by county contracted vendors must be
calculated in accordance with section 256B.076, subdivision 2. Payment for case management
provided by vendors who contract with a Tribe must be based on a monthly rate negotiated
by the Tribe. The rate must not exceed the rate charged by the vendor for the same service
to other payers. deleted text begin If the service is provided by a team of contracted vendors, the team shall
determine how to distribute the rate among its members.deleted text end No reimbursement received by
contracted vendors shall be returned to the county or Tribal social services, except to
reimburse the county or Tribal social services for advance funding provided by the county
or Tribal social services to the vendor.
deleted text begin (e)deleted text end new text begin (d)new text end If the service is provided by a team that includes contracted vendors and county
or Tribal social services staff, the costs for county or Tribal social services staff participation
in the team shall be included in the rate for county or Tribal social services provided services.
In this case, the contracted vendor and the county or Tribal social services may each receive
separate payment for services provided by each entity in the same month. To prevent
duplication of services, each entity must document, in the recipient's file, the need for team
case management and a description of the roles and services of the team members.
deleted text begin
Separate payment rates may be established for different groups of providers to maximize
reimbursement as determined by the commissioner. The payment rate will be reviewed
annually and revised periodically to be consistent with the most recent time study and other
data. Payment for services will be made upon submission of a valid claim and verification
of proper documentation described in subdivision 7. Federal administrative revenue earned
through the time study, or under paragraph (c), shall be distributed according to earnings,
to counties, reservations, or groups of counties or reservations which have the same payment
rate under this subdivision, and to the group of counties or reservations which are not
certified providers under section 256F.10. The commissioner shall modify the requirements
set out in Minnesota Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish this.
deleted text end
Sec. 24.
Minnesota Statutes 2024, section 295.52, subdivision 8, is amended to read:
Subd. 8.
Contingent reduction in tax rate.
(a) By December 1 of each year, beginning
in 2011, the commissioner of management and budget shall determine the projected balance
in the health care access fund for the biennium.
(b) If the commissioner of management and budget determines that the projected balance
in the health care access fund for the biennium reflects a ratio of revenues to expenditures
and transfers greater than 125 percent, and if the actual cash balance in the fund is adequate,
as determined by the commissioner of management and budget, the commissioner, in
consultation with the deleted text begin commissionerdeleted text end new text begin commissionersnew text end of revenuenew text begin and human servicesnew text end , shall
reduce the tax rates levied under subdivisions 1, 1a, 2, 3, and 4, for the subsequent calendar
year sufficient to reduce the structural balance in the fund. The rate may be reduced to the
extent that the projected revenues for the biennium do not exceed 125 percent of expenditures
and transfers. The new rate shall be rounded to the nearest one-tenth of one percent. The
rate reduction under this paragraph expires at the end of each calendar year and is subject
to an annual redetermination by the commissioner of management and budget.
(c) For purposes of the analysis defined in paragraph (b), the commissioner of
management and budget shall include projected revenues.
ARTICLE 4
PROVIDER BRIDGE REIMBURSEMENTS
Section 1.
Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 13l. new text end
new text begin Bridge pharmacy dispensing payment. new text end
new text begin
(a) The commissioner must provide,
exclusively using state funds, a pharmacy dispensing payment of $2.25 per filled prescription
to eligible outpatient retail pharmacies in Minnesota to improve and maintain access to
pharmaceutical services in rural and underserved areas of the state. The pharmacy dispensing
payment is in addition to any other dispensing fee paid by the commissioner to the pharmacy.
Filled prescriptions eligible for a pharmacy dispensing payment under this subdivision
include all prescriptions covered under medical assistance, including fee-for-service and
managed care medical assistance.
new text end
new text begin
(b) For purposes of this subdivision, "eligible outpatient retail pharmacy" means an
outpatient retail pharmacy licensed under chapter 151 that is not owned, either directly or
indirectly or through an affiliate or subsidiary, by a pharmacy benefit manager licensed
under chapter 62W or a health carrier, as defined in section 62A.011, subdivision 2, and
that:
new text end
new text begin
(1) is located in a medically underserved area or primarily serves a medically underserved
population, as defined by the United States Department of Health and Human Services
Health Resources and Services Administration under United States Code, title 42, section
254; or
new text end
new text begin
(2) shares common ownership with 13 or fewer Minnesota pharmacies.
new text end
new text begin
(c) In order to receive the pharmacy dispensing payment, a pharmacy must submit to
the commissioner a form, developed by the commissioner, attesting that the pharmacy meets
the requirements under paragraph (b).
new text end
new text begin
(d) The commissioner must pay the pharmacy dispensing payment to eligible outpatient
retail pharmacies for eligible pharmacy claims from July 1, 2025, through June 30, 2026,
by October 1, 2026. The commissioner must pay a second payment for eligible claims from
July 1, 2026, through December 31, 2026, by April 1, 2027.
new text end
new text begin
(e) This subdivision expires on July 1, 2027.
new text end
Sec. 2.
Minnesota Statutes 2025 Supplement, section 256B.69, subdivision 6d, is amended
to read:
Subd. 6d.
Prescription drugs.
(a) The commissioner may exclude or modify coverage
for prescription drugs from the prepaid managed care contracts entered into under this
section in order to increase savings to the state by collecting additional prescription drug
rebates.
(b) The contracts must maintain incentives for the managed care plan to manage drug
costs and utilization and may require that the managed care plans maintain an open drug
formulary. In order to manage drug costs and utilization, the contracts may authorize the
managed care plans to use preferred drug lists and prior authorization. The contracts must
require that the managed care plans enter into contracts with the state's selected pharmacy
benefit manager vendor to administer the pharmacy benefit.
(c) This subdivision is contingent on federal approval of the managed care contract
changes and the collection of additional prescription drug rebates.
new text begin
(d) The commissioner must require that the final reimbursement to a pharmacy from
managed care and county-based purchasing plans and any pharmacy benefit managers under
contract with these entities be at least a dispensing fee of $11.55 per claim for prescriptions
filled with drugs meeting the definition of covered outpatient drugs. The commissioner
must require the payment of a dispensing fee of at least $3.65 for drugs not meeting the
definition of covered outpatient drug.
new text end
new text begin
(e) In addition to the dispensing fee set forth in paragraph (d), the commissioner must
require that the final reimbursement to a pharmacy from managed care and county-based
purchasing plans and any pharmacy benefit managers under contract with these entities be
equal to the ingredient cost for a drug as either:
new text end
new text begin
(1) the lower of the National Average Drug Acquisition Cost (NADAC) or the Minnesota
actual acquisition cost (MNAAC) under section 256B.0625, subdivision 13, paragraph (g);
new text end
new text begin
(2) the maximum allowable cost, if a drug ingredient cost is unreported in the NADAC
and the MNAAC; or
new text end
new text begin
(3) the wholesale acquisition cost minus two percent, if a drug ingredient cost is
unreported in the NADAC and the MNAAC and a maximum allowable cost is unavailable.
new text end
new text begin
(f) The commissioner must monitor the effect of this requirement on access to
pharmaceutical services in rural and underserved areas of the state. If, for any contract year,
federal approval is not received for paragraphs (d) and (e), the commissioner must adjust
the capitation rates paid to managed care plans and county-based purchasing plans for that
contract year to reflect removal of paragraphs (d) and (e). A contract between a managed
care plan or county-based purchasing plan, or any pharmacy benefit manager under contract
with one of those entities, and a provider to whom paragraphs (d) and (e) apply must allow
recovery of payments from those providers if capitation rates are adjusted in accordance
with this paragraph. Payment recoveries must not exceed the amount equal to any increase
in rates that results from paragraphs (d) and (e). This subdivision expires if federal approval
is not received for paragraphs (d) and (e) at any time.
new text end
new text begin
(g) Paragraphs (d) to (g) expire upon the effective date of a master contract under section
256B.696. The commissioner shall notify the revisor of statutes of the effective date.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027.
new text end
Sec. 3.
Minnesota Statutes 2025 Supplement, section 256B.761, is amended by adding a
subdivision to read:
new text begin Subd. 5. new text end
new text begin Psychological testing and assessment rates. new text end
new text begin
(a) Effective for services rendered
on or after January 1, 2027, or on or after the date of federal approval, whichever is later,
and notwithstanding other rate increases or decreases, the commissioner must pay 100
percent of the total published Medicare payment rate, as defined in Code of Federal
Regulations, title 42, section 438.6, for the following services:
new text end
new text begin
(1) neuropsychological assessments under section 256B.0671, subdivision 8;
new text end
new text begin
(2) neuropsychological testing under section 256B.0671, subdivision 9; and
new text end
new text begin
(3) psychological testing under section 256B.0671, subdivision 10.
new text end
new text begin
(b) Managed care and county-based purchasing plans must reimburse providers at an
amount that is at least equal to the fee-for-service rate for services under this subdivision.
The commissioner must monitor the effect of this rate adjustment on enrollee access to
mental health services. If for any contract year federal approval is not received for this
paragraph, the commissioner must adjust the capitation rates paid to managed care and
county-based purchasing plans for that contract year to reflect the removal of this paragraph.
Contracts between managed care and county-based purchasing plans and providers to whom
this paragraph applies must allow recovery of payments from those providers if capitation
rates are adjusted in accordance with this paragraph. Payment recoveries must not exceed
the amount equal to any increase in rates that results from this paragraph.
new text end
new text begin
(c) This subdivision expires on the effective date of Laws 2025, First Special Session
chapter 3, article 8, section 29.
new text end
Sec. 4. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2024, section 256B.0625, subdivision 38,
new text end
new text begin
is repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2025 Supplement, section 256B.69, subdivision 6i,
new text end
new text begin
is repealed.
new text end
ARTICLE 5
CHILDREN, YOUTH, AND FAMILIES
Section 1.
Minnesota Statutes 2025 Supplement, section 142A.03, subdivision 2, is
amended to read:
Subd. 2.
Duties of the commissioner.
(a) The commissioner may apply for and accept
on behalf of the state any grants, bequests, gifts, or contributions for the purpose of carrying
out the duties and responsibilities of the commissioner. Any money received under this
paragraph is appropriated and dedicated for the purpose for which the money is granted.
The commissioner must biennially report to the chairs and ranking minority members of
relevant legislative committees and divisions by January 15 of each even-numbered year a
list of all grants and gifts received under this subdivision.
(b) Pursuant to law, the commissioner may apply for and receive money made available
from federal sources for the purpose of carrying out the duties and responsibilities of the
commissioner.
(c) The commissioner may make contracts with and grants to Tribal Nations, public and
private agencies, for-profit and nonprofit organizations, and individuals using appropriated
money.
(d) The commissioner must develop program objectives and performance measures for
evaluating progress toward achieving the objectives. The commissioner must identify the
objectives, performance measures, and current status of achieving the measures in a biennial
report to the chairs and ranking minority members of relevant legislative committees and
divisions. The report is due no later than January 15 each even-numbered year. The report
must include, when possible, the following objectives:
(1) centering and including the lived experiences of children and youth, including those
with disabilities and mental illness and their families, in all aspects of the department's work;
(2) increasing the effectiveness of the department's programs in addressing the needs of
children and youth facing racial, economic, or geographic inequities;
(3) increasing coordination and reducing inefficiencies among the department's programs
and the funding sources that support the programs;
(4) increasing the alignment and coordination of family access to child care and early
learning programs and improving systems of support for early childhood and learning
providers and services;
(5) improving the connection between the department's programs and the kindergarten
through grade 12 and higher education systems; and
(6) minimizing and streamlining the effort required of youth and families to receive
services to which the youth and families are entitled.
(e) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end administer and supervise the forms of public assistance
and other activities or services that are vested in the commissioner. Administration and
supervision of activities or services includes but is not limited to assuring timely and accurate
distribution of benefits, completeness of service, and quality program management. In
addition to administering and supervising activities vested by law in the department, the
commissioner has the authority to:
(1) require county agency participation in training and technical assistance programs to
promote compliance with statutes, rules, federal laws, regulations, and policies governing
the programs and activities administered by the commissioner;
(2) monitor, on an ongoing basis, the performance of county agencies in the operation
and administration of activities and programs; enforce compliance with statutes, rules,
federal laws, regulations, and policies governing welfare services; and promote excellence
of administration and program operation;
(3) develop a quality control program or other monitoring program to review county
performance and accuracy of benefit determinations;
(4) require county agencies to make an adjustment to the public assistance benefits issued
to any individual consistent with federal law and regulation and state law and rule and to
issue or recover benefits as appropriate;
(5) delay or deny payment of all or part of the state and federal share of benefits and
administrative reimbursement according to the procedures set forth in section 142A.10;
(6) make contracts with and grants to public and private agencies and organizations,
both for-profit and nonprofit, and individuals, using appropriated funds; and
(7) enter into contractual agreements with federally recognized Indian Tribes with a
reservation in Minnesota to the extent necessary for the Tribe to operate a federally approved
family assistance program or any other program under the supervision of the commissioner.
The commissioner deleted text begin shalldeleted text end new text begin mustnew text end consult with the affected county or counties in the contractual
agreement negotiations, if the county or counties wish to be included, in order to avoid the
duplication of county and Tribal assistance program services. The commissioner may
establish necessary accounts for the purposes of receiving and disbursing funds as necessary
for the operation of the programs.
The commissioner deleted text begin shalldeleted text end new text begin mustnew text end work in conjunction with the commissioner of human services
to carry out the duties of this paragraph when necessary and feasible.
(f) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end inform county agencies, on a timely basis, of changes
in statute, rule, federal law, regulation, and policy necessary to county agency administration
of the programs and activities administered by the commissioner.
(g) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end administer and supervise child welfare activities,
including promoting the enforcement of laws preventing child maltreatment and protecting
children with a disability and children who are in need of protection or services, licensing
and supervising child care and child-placing agencies, and supervising the care of children
in foster care. The commissioner deleted text begin shalldeleted text end new text begin mustnew text end coordinate with the commissioner of human
services on activities impacting children overseen by the Department of Human Services,
such as disability services, behavioral health, and substance use disorder treatment.
(h) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end assist and cooperate with local, state, and federal
departments, agencies, and institutions.
(i) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end establish and maintain any administrative units
reasonably necessary for the performance of administrative functions common to all divisions
of the department.
(j) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end act as designated guardian of children pursuant to
chapter 260C. For children under the guardianship of the commissioner or a Tribe in
Minnesota recognized by the Secretary of the Interior whose interests would be best served
by adoptive placement, the commissioner may contract with a licensed child-placing agency
or a Minnesota Tribal social services agency to provide adoption services. For children in
out-of-home care whose interests would be best served by a transfer of permanent legal and
physical custody to a relative under section 260C.515, subdivision 4, or equivalent in Tribal
code, the commissioner may contract with a licensed child-placing agency or a Minnesota
Tribal social services agency to provide permanency services. A contract with a licensed
child-placing agency must be designed to supplement existing county efforts and may not
replace existing county programs or Tribal social services, unless the replacement is agreed
to by the county board and the appropriate exclusive bargaining representative, Tribal
governing body, or the commissioner has evidence that child placements of the county
continue to be substantially below that of other counties. Funds encumbered and obligated
under an agreement for a specific child deleted text begin shalldeleted text end new text begin mustnew text end remain available until the terms of the
agreement are fulfilled or the agreement is terminated.
(k) The commissioner has the authority to conduct and administer experimental projects
to test methods and procedures of administering assistance and services to recipients or
potential recipients of public benefits. To carry out the experimental projects, the
commissioner may waive the enforcement of existing specific statutory program
requirements, rules, and standards in one or more counties. The order establishing the waiver
must provide alternative methods and procedures of administration and must not conflict
with the basic purposes, coverage, or benefits provided by law. deleted text begin No projectdeleted text end new text begin Projectsnew text end under
this paragraph deleted text begin shalldeleted text end new text begin must notnew text end exceed four years. No order establishing an experimental
project as authorized by this paragraph is effective until the following conditions have been
met:
(1) the United States Secretary of Health and Human Services has agreed, for the same
project, to waive state plan requirements relative to statewide uniformity; and
(2) a comprehensive plan, including estimated project costs, has been approved by the
Legislative Advisory Commission and filed with the commissioner of administration.
(l) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end , according to federal requirements and in coordination
with the commissioner of human services, establish procedures to be followed by local
welfare boards in creating citizen advisory committees, including procedures for selection
of committee members.
(m) The commissioner deleted text begin shall allocatedeleted text end new text begin must bear the total amount of anynew text end federal fiscal
disallowances or sanctions that are based on quality control error rates for deleted text begin the aid to families
with dependent children (AFDC) program formerly codified in sections 256.72 to 256.87
ordeleted text end the Supplemental Nutrition Assistance Program (SNAP) deleted text begin in the following manner:
deleted text end
deleted text begin (1) one-half of the total amount of the disallowance shall be borne by the county boards
responsible for administering the programs. For AFDC, disallowances shall be shared by
each county board in the same proportion as that county's expenditures to the total of all
counties' expenditures for AFDC. For SNAP, sanctions shall be shared by each county
board, with 50 percent of the sanction being distributed to each county in the same proportion
as that county's administrative costs for SNAP benefits are to the total of all SNAP
administrative costs for all counties, and 50 percent of the sanctions being distributed to
each county in the same proportion as that county's value of SNAP benefits issued are to
the total of all benefits issued for all countiesdeleted text end new text begin , except if the federal fiscal disallowance or
sanction results from knowing noncompliance by one or more counties with a specific
program instruction, and that knowing noncompliance is a matter of official county board
record, the commissioner may require payment or recover from the county or counties an
amount equal to the portion of the total disallowance or sanction that resulted from the
noncompliancenew text end . Each county deleted text begin shalldeleted text end new text begin responsible for knowing noncompliance mustnew text end pay its
share of the disallowance to the state of Minnesota. When a county fails to pay the amount
due under this paragraph, the commissioner may deduct the amount from reimbursement
otherwise due the county, or the attorney general, upon the request of the commissioner,
may institute civil action to recover the amount duedeleted text begin ; and
deleted text end
deleted text begin (2) notwithstanding the provisions of clause (1), if the disallowance results from knowing
noncompliance by one or more counties with a specific program instruction, and that knowing
noncompliance is a matter of official county board record, the commissioner may require
payment or recover from the county or counties, in the manner prescribed in clause (1), an
amount equal to the portion of the total disallowance that resulted from the noncompliance
and may distribute the balance of the disallowance according to clause (1)deleted text end .
(n) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end develop and implement special projects that maximize
reimbursements and result in the recovery of money to the state. For the purpose of recovering
state money, the commissioner may enter into contracts with third parties. Any recoveries
that result from projects or contracts entered into under this paragraph deleted text begin shalldeleted text end new text begin mustnew text end be deposited
in the state treasury and credited to a special account until the balance in the account reaches
$1,000,000. When the balance in the account exceeds $1,000,000, the excess deleted text begin shalldeleted text end new text begin mustnew text end be
transferred and credited to the general fund. All money in the account is appropriated to the
commissioner for the purposes of this paragraph.
(o) The commissioner has the authority to establish and enforce the following county
reporting requirements:
(1) the commissioner deleted text begin shalldeleted text end new text begin mustnew text end establish fiscal and statistical reporting requirements
necessary to account for the expenditure of funds allocated to counties for programs
administered by the commissioner. When establishing financial and statistical reporting
requirements, the commissioner deleted text begin shalldeleted text end new text begin mustnew text end evaluate all reports, in consultation with the
counties, to determine if the reports can be simplified or the number of reports can be
reduced;
(2) the county board deleted text begin shalldeleted text end new text begin mustnew text end submit monthly or quarterly reports to the department
as required by the commissioner. Monthly reports are due no later than 15 working days
after the end of the month. Quarterly reports are due no later than 30 calendar days after
the end of the quarter, unless the commissioner determines that the deadline must be
shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines or
risking a loss of federal funding. new text begin The commissioner must new text end only new text begin accept new text end reports that are
complete, legible, and in the required format deleted text begin shall be accepted by the commissionerdeleted text end ;
(3) if the required reports are not received by the deadlines established in clause (2), the
commissioner may delay payments and withhold funds from the county board until the next
reporting period. When the report is needed to account for the use of federal funds and the
late report results in a reduction in federal funding, the commissioner deleted text begin shalldeleted text end new text begin mustnew text end withhold
from the county boards with late reports an amount equal to the reduction in federal funding
until full federal funding is received;
(4) a county board that submits reports that are late, illegible, incomplete, or not in the
required format for two out of three consecutive reporting periods is considered
noncompliant. When a county board is found to be noncompliant, the commissioner deleted text begin shalldeleted text end new text begin
mustnew text end notify the county board of the reason the county board is considered noncompliant
and request that the county board develop a corrective action plan stating how the county
board plans to correct the problem. The corrective action plan must be submitted to the
commissioner within 45 days after the date the county board received notice of
noncompliance;
(5) the final deadline for fiscal reports or amendments to fiscal reports is one year after
the date the report was originally due. If the commissioner does not receive a report by the
final deadline, the county board forfeits the funding associated with the report for that
reporting period and the county board must repay any funds associated with the report
received for that reporting period;
(6) the commissioner may not delay payments, withhold funds, or require repayment
under clause (3) or (5) if the county demonstrates that the commissioner failed to provide
appropriate forms, guidelines, and technical assistance to enable the county to comply with
the requirements. If the county board disagrees with an action taken by the commissioner
under clause (3) or (5), the county board may appeal the action according to sections 14.57
to 14.69; and
(7) counties subject to withholding of funds under clause (3) or forfeiture or repayment
of funds under clause (5) deleted text begin shalldeleted text end new text begin mustnew text end not reduce or withhold benefits or services to clients
to cover costs incurred due to actions taken by the commissioner under clause (3) or (5).
(p) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end allocate federal fiscal disallowances or sanctions for
audit exceptions when federal fiscal disallowances or sanctions are based on a statewide
random sample in direct proportion to each county's claim for that period.
(q) The commissioner is responsible for ensuring the detection, prevention, investigation,
and resolution of fraudulent activities or behavior by applicants, recipients, and other
participants in the programs administered by the department. The commissioner deleted text begin shalldeleted text end new text begin mustnew text end
cooperate with the commissioner of education to enforce the requirements for program
integrity and fraud prevention for investigation for child care assistance under chapter 142E.
(r) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end require county agencies to identify overpayments,
establish claims, and utilize all available and cost-beneficial methodologies to collect and
recover these overpayments in the programs administered by the department.
(s) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end develop recommended standards for child foster care
homes that address the components of specialized therapeutic services to be provided by
child foster care homes with those services.
(t) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end authorize the method of payment to or from the
department as part of the programs administered by the department. This authorization
includes the receipt or disbursement of funds held by the department in a fiduciary capacity
as part of the programs administered by the department.
(u) In coordination with the commissioner of human services, the commissioner deleted text begin shalldeleted text end new text begin
mustnew text end create and provide county and Tribal agencies with blank applications, affidavits, and
other forms as necessary for public assistance programs.
(v) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end cooperate with the federal government and its public
welfare agencies in any reasonable manner as may be necessary to qualify for federal aid
for temporary assistance for needy families and in conformity with Title I of Public Law
104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
and successor amendments, including making reports that contain information required by
the federal Social Security Advisory Board and complying with any provisions the board
may find necessary to assure the correctness and verification of the reports.
(w) On or before January 15 in each even-numbered year, the commissioner deleted text begin shalldeleted text end new text begin mustnew text end
make a biennial report to the governor concerning the activities of the agency.
(x) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end enter into agreements with other departments of the
state as necessary to meet all requirements of the federal government.
(y) The commissioner may cooperate with other state agencies in establishing reciprocal
agreements in instances where a child receiving Minnesota family investment program
(MFIP) assistance or its out-of-state equivalent moves or contemplates moving into or out
of the state, in order that the child may continue to receive MFIP or equivalent aid from the
state moved from until the child has resided for one year in the state moved to.
(z) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end provide appropriate technical assistance to county
agencies to develop methods to have county financial workers remind and encourage
recipients of aid to families with dependent children, the Minnesota family investment
program, the Minnesota family investment plan, family general assistance, or SNAP benefits
whose assistance unit includes at least one child under the age of five to have each young
child immunized against childhood diseases. The commissioner must examine the feasibility
of utilizing the capacity of a statewide computer system to assist county agency financial
workers in performing this function at appropriate intervals.
(aa) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end have the power and authority to accept on behalf of
the state contributions and gifts for the use and benefit of children under the guardianship
or custody of the commissioner. The commissioner may also receive and accept on behalf
of such children money due and payable to them as old age and survivors insurance benefits,
veterans benefits, pensions, or other such monetary benefits. Gifts, contributions, pensions,
and benefits under this paragraph must be deposited in and disbursed from the social welfare
fund provided for in sections 256.88 to 256.92.
(bb) The specific enumeration of powers and duties in this section must not be construed
to be a limitation upon the general powers granted to the commissioner.
Sec. 2.
new text begin
[142D.095] PRESCHOOL ASSESSMENT.
new text end
new text begin
(a) For programs serving children under section 142D.08, the commissioner of children,
youth, and families must implement a preschool assessment of children's development in
the year prior to kindergarten entry that is:
new text end
new text begin
(1) aligned to the state early childhood indicators of progress and based on the criteria
for an early learning assessment approved by the commissioner; and
new text end
new text begin
(2) based, in part, on information collected from teachers, early learning professionals,
families, and other partners.
new text end
new text begin
(b) The commissioner must evaluate and approve assessment tools that meet the
requirements in paragraph (a). School districts and charter schools operating a program
under section 142D.08 must choose an assessment tool approved under this paragraph.
new text end
new text begin
(c) The commissioner may provide technical assistance and professional development
related to the assessment to educators, school districts, and charter schools.
new text end
Sec. 3.
Minnesota Statutes 2024, section 142D.21, subdivision 3, is amended to read:
Subd. 3.
Requirements.
(a) As a condition of payment under this section, a program
must:
(1) complete an application developed by the commissioner for each payment period
for which the program applies for fundingnew text begin . For full-time equivalent staff who regularly care
for children in the program, the application must allow required paid break time to count
as qualifying hours toward a program's reporting of eligible full-time equivalent staffnew text end ;
(2) submit data on child enrollment and attendance to the commissioner in the form and
manner specified by the commissioner; and
(3) attest and agree in writing that the program was open and operating and served a
minimum number of children, as determined by the commissioner, during the funding
period, with the exceptions of:
(i) service disruptions that are necessary to protect the safety and health of children and
child care programs based on public health guidance issued by the Centers for Disease
Control and Prevention, the commissioner of health, the commissioner of children, youth,
and families, or a local public health agency; and
(ii) planned temporary closures for provider vacation and holidays during each payment
period. The commissioner must establish the maximum allowed duration for vacations and
holidays.
(b) A program must expend money received under this section no later than six months
after the date the payment was received.
(c) A program that receives a payment under this section must comply with all
requirements listed in the application. The commissioner must establish methods to determine
that the application requirements have been met.
Sec. 4.
Minnesota Statutes 2024, section 142F.05, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin State share of SNAP benefit costs. new text end
new text begin
The commissioner of children, youth, and
families must pay the state share of SNAP benefit costs as determined by the United States
Department of Agriculture to meet the state cost share requirements under United States
Code, title 7, section 2013(a)(2)(B).
new text end
Sec. 5.
Minnesota Statutes 2024, section 142F.05, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin County administrative cost share limitation. new text end
new text begin
(a) A county agency must not
contribute more than 50 percent of the total administrative costs of SNAP. The commissioner
must reimburse each county agency for the difference between the federal reimbursement
of administrative costs and the county administrative cost share under this subdivision.
new text end
new text begin
(b) SNAP administrative costs eligible for reimbursement under this subdivision are
administrative costs as defined by United States Code, title 7, section 2025(a).
new text end
Sec. 6.
Minnesota Statutes 2024, section 256.017, subdivision 2, is amended to read:
Subd. 2.
Definitions.
The following terms have the meanings given for purposes of this
section.
(a) "Administrative penalty" means an adjustment against the county agency's state and
federal benefit and federal administrative reimbursement when the commissioner determines
that the county agency is not in compliance with the policies and procedures established by
the commissioner.
(b) "Commissioner" means the commissioner of human services for programs listed in
subdivision 1, paragraph deleted text begin (b)deleted text end new text begin (a)new text end , and the commissioner of children, youth, and families for
programs listed in subdivision 1, paragraph deleted text begin (c)deleted text end new text begin (b)new text end .
(c) "Quality control case penalty" means an adjustment against the county agency's
federal administrative reimbursement and state and federal benefit reimbursement when
the commissioner determines through a quality control review that the county agency has
made incorrect payments, terminations, or denials of benefits as determined by state quality
control procedures for the aid to families with dependent children program formerly codified
in sections 256.72 to 256.87, Minnesota family investment program, SNAP, or medical
assistance programs, or any other programs for which the commissioner has developed a
quality control system. Quality control case penalties apply only to agency errors as defined
by state quality control procedures.
(d) "Quality control/quality assurance" means a review system of a statewide random
sample of cases, designed to provide data on program outcomes and the accuracy with which
state and federal policies are being applied in issuing benefits and as a fiscal audit to ensure
the accuracy of expenditures. The quality control/quality assurance system is administered
by the department. For the aid to families with dependent children program formerly codified
in sections 256.72 to 256.87, SNAP, and medical assistance, the quality control system is
that required by federal regulation, or those developed by the commissioner.
Sec. 7. new text begin PREPARED MEALS FOOD RELIEF GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of children, youth, and families must
establish a prepared meals grant program to provide hunger relief to Minnesotans
experiencing food insecurity and who have difficulty preparing meals due to limited mobility,
disability, or limited resources.
new text end
new text begin Subd. 2. new text end
new text begin Eligible grantees. new text end
new text begin
(a) Eligible grantees are nonprofit organizations and
Minnesota Tribal governments, as defined in Minnesota Statutes, section 10.65, with a
demonstrated history of providing and distributing prepared meals customized for the
population that they serve, including tailoring meals to cultural, religious, and dietary needs.
Eligible grantees must prepare meals in a licensed commercial kitchen and distribute meals
according to ServSafe guidelines.
new text end
new text begin
(b) An individual or nonprofit organization affiliated with Feeding Our Future is
prohibited from receiving grant money under this section.
new text end
new text begin Subd. 3. new text end
new text begin Application. new text end
new text begin
Applicants for grant money under this section must apply to the
commissioner on the forms and in the time and manner established by the commissioner.
new text end
new text begin Subd. 4. new text end
new text begin Allowable uses of grant money. new text end
new text begin
Eligible grantees must use grant money
awarded under this section to fund a prepared meals program that primarily targets individuals
18 years of age or older and under 61 years of age, and their dependents experiencing food
insecurity. Grantees must not receive funding from other state and federal meal programs
for activities funded under this section.
new text end
new text begin Subd. 5. new text end
new text begin Duties of the commissioner. new text end
new text begin
(a) The commissioner must develop a process
for determining eligible grantees under this section.
new text end
new text begin
(b) When awarding grants under this section, the commissioner must prioritize applicants
that:
new text end
new text begin
(1) have demonstrated the ability to provide prepared meals to racially, ethnically, and
geographically diverse populations at greater risk for food insecurity;
new text end
new text begin
(2) work with external community partners to distribute meals targeting nontraditional
meal sites reaching those most in need; and
new text end
new text begin
(3) have a demonstrated history of sourcing at least 50 percent of the prepared meal
ingredients from:
new text end
new text begin
(i) Minnesota food producers and processors; or
new text end
new text begin
(ii) food that is donated or would otherwise be waste.
new text end
new text begin
(c) The commissioner must consider geographic distribution to ensure statewide coverage
when awarding grants and minimize the number of grantees to simplify administrative
burdens and costs.
new text end
new text begin Subd. 6. new text end
new text begin Reporting. new text end
new text begin
(a) Grantees must retain records documenting expenditure of the
money and comply with any additional documentation requirements imposed by the
commissioner.
new text end
new text begin
(b) Grantees must report on the use of grant money received under this section to the
commissioner. The commissioner must determine the timing and form required for the
reports.
new text end
new text begin
(c) If the commissioner determines that ineligible expenditures were made by a grantee
under this section, the ineligible amount must be repaid by the grantee to the commissioner
and deposited in the general fund.
new text end
Sec. 8. new text begin REGIONAL FOOD BANK GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of children, youth, and families must
establish regional food bank grants to increase the availability of food to individuals and
families in need.
new text end
new text begin Subd. 2. new text end
new text begin Distribution of appropriation. new text end
new text begin
The commissioner must distribute money
appropriated under this section to regional food banks and Minnesota Tribal governments,
as defined in Minnesota Statutes, section 10.65, using a formula based on the number of
persons in households having incomes below the federal poverty level and the number of
unemployed persons in the service area of the food bank or Minnesota Tribal government.
new text end
new text begin Subd. 3. new text end
new text begin Allowable use of money. new text end
new text begin
(a) Grant money distributed under this section must
be used to purchase, transport, and coordinate the distribution of food to sites approved by
the commissioner. Grant money distributed under this section may also be used to purchase
personal hygiene products, including but not limited to diapers and toilet paper.
new text end
new text begin
(b) Food and other allowable products purchased with grant money under this section
must be available at no cost at sites approved by the commissioner.
new text end
new text begin
(c) Grant money distributed under this section must not be used for the compensation
of officers, directors, trustees, key employees, and highest compensated employees as
reported on Internal Revenue Service Form 990.
new text end
new text begin Subd. 4. new text end
new text begin Reporting. new text end
new text begin
(a) Food banks and Minnesota Tribal governments receiving grant
money under this section must retain records documenting expenditures of the grant money
and comply with any additional documentation requirements imposed by the commissioner.
new text end
new text begin
(b) Food banks and Minnesota Tribal governments must report on the use of grant money
received under this section to the commissioner. The commissioner must determine the
timing and form required for the reports.
new text end
new text begin Subd. 5. new text end
new text begin Ineligible expenditures. new text end
new text begin
If the commissioner determines that ineligible
expenditures were made by a food bank or Minnesota Tribal government under this section,
the ineligible amount must be repaid by the food bank or Tribal government to the
commissioner and deposited in the general fund.
new text end
Sec. 9. new text begin DIRECTION TO COMMISSIONER OF CHILDREN, YOUTH, AND
FAMILIES; CRISIS NURSERY LICENSING.
new text end
new text begin
The commissioner of children, youth, and families must develop a licensing framework
for crisis nurseries. The framework must include pathways for organizations to become
licensed crisis nurseries, a definition for crisis nurseries, background study and training
requirements, and ways to reduce redundancy and resolve conflicting requirements between
Minnesota Rules, parts 2960.0510 to 2960.0530, 2960.3000 to 2960.3100, and chapter 9502,
and Minnesota Statutes, chapter 142B. In developing the framework, the commissioner
must work with stakeholders seeking to develop a crisis nursery license. By January 15,
2028, the commissioner must submit a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over children, youth, and families licensing.
The report must contain an overview of the licensing framework, a detailed explanation of
the framework, and proposed legislation to make any statutory changes that are needed to
implement the new license for crisis nurseries.
new text end
ARTICLE 6
CHILD CARE CENTER LICENSING MODERNIZATION
Section 1.
new text begin
[142H.01] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
For the purposes of this chapter, the terms in this section have
the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Accessible to children. new text end
new text begin
"Accessible to children" means capable of being reached
or utilized by a child without the aid of an adult.
new text end
new text begin Subd. 3. new text end
new text begin Accredited. new text end
new text begin
"Accredited" means a postsecondary institution or technical college
recognized and listed in The Database of Accredited Postsecondary Institutions and Programs
maintained by the United States Department of Education.
new text end
new text begin Subd. 4. new text end
new text begin Age categories. new text end
new text begin
(a) "Infant" means a child who is at least six weeks old but
less than 16 months old.
new text end
new text begin
(b) "Toddler" means a child who is at least 16 months old but less than 33 months old.
new text end
new text begin
(c) "Preschooler" means a child who is at least 33 months old up to school age.
new text end
new text begin
(d) "School age" means a child who is at least of sufficient age to have attended the first
day of kindergarten, or is eligible to enter kindergarten within the next four months, but is
younger than 13 years of age. A child who becomes 13 during the school year may continue
to be considered a school-age child for the remainder of the school year.
new text end
new text begin Subd. 5. new text end
new text begin Applicant. new text end
new text begin
"Applicant" has the meaning given in section 142B.01, subdivision
4.
new text end
new text begin Subd. 6. new text end
new text begin Arrival and departure times. new text end
new text begin
"Arrival and departure times" means the times
when children typically arrive at or depart from a center. A center cannot designate more
than 25 percent of licensed hours of operation as arrival and departure times. The designated
arrival and departure times must be used at the beginning or end of a center's licensed hours
of operation.
new text end
new text begin Subd. 7. new text end
new text begin Building official. new text end
new text begin
"Building official" means the person appointed pursuant to
section 326B.133 to administer the State Building Code or the building official's authorized
representative.
new text end
new text begin Subd. 8. new text end
new text begin Center. new text end
new text begin
"Center" means a child care program that is not excluded by section
142B.05, subdivision 2, and is not a family child care program, as defined in section 142I.01,
subdivision 22.
new text end
new text begin Subd. 9. new text end
new text begin Child. new text end
new text begin
"Child" means a person receiving child care services who falls within
the age categories in subdivision 4.
new text end
new text begin Subd. 10. new text end
new text begin Child care program. new text end
new text begin
"Child care program" means the organization or
arrangement of activities, personnel, materials, and equipment in a facility to promote the
physical, intellectual, social, and emotional development of a child in the absence of the
parent for a period of less than 24 hours a day.
new text end
new text begin Subd. 11. new text end
new text begin Child care program plan. new text end
new text begin
"Child care program plan" means the written
document that states specific activities that will be provided by the license holder to promote
the physical, intellectual, social, and emotional development of the children enrolled in the
center.
new text end
new text begin Subd. 12. new text end
new text begin Clean. new text end
new text begin
"Clean" means free from dirt or other contaminants that can be detected
by sight, smell, or touch.
new text end
new text begin Subd. 13. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of children, youth,
and families or the commissioner's designated representative, including county agencies
and private agencies.
new text end
new text begin Subd. 14. new text end
new text begin Day program. new text end
new text begin
"Day program" means a nonresidential child care program
that operates during waking hours and does not provide overnight care.
new text end
new text begin Subd. 15. new text end
new text begin Department. new text end
new text begin
"Department" means the Department of Children, Youth, and
Families.
new text end
new text begin Subd. 16. new text end
new text begin Direct contact. new text end
new text begin
"Direct contact" has the meaning given in section 245C.02,
subdivision 11.
new text end
new text begin Subd. 17. new text end
new text begin Disinfected. new text end
new text begin
"Disinfected" means the chemical process to kill most germs and
viruses on surfaces and objects after they have been cleaned.
new text end
new text begin Subd. 18. new text end
new text begin Drop-in child care program. new text end
new text begin
"Drop-in child care program" means a
nonresidential program of child care in which children participate on a onetime only or
occasional basis up to a maximum of 90 hours per child, per month.
new text end
new text begin Subd. 19. new text end
new text begin Experience. new text end
new text begin
"Experience" means paid or unpaid employment:
new text end
new text begin
(1) caring for children as a teacher, assistant teacher, aide, or student intern:
new text end
new text begin
(i) in a licensed child care center, a licensed family child care program, or a Tribally
licensed child care program in any United States state or territory; or
new text end
new text begin
(ii) in a public or nonpublic school;
new text end
new text begin
(2) caring for children as a staff person or unsupervised volunteer in a certified
license-exempt child care center under chapter 142C; or
new text end
new text begin
(3) providing direct contact services in a home or residential facility serving children
with disabilities that requires a background study under section 245C.03.
new text end
new text begin Subd. 20. new text end
new text begin Facility. new text end
new text begin
"Facility" means the indoor and outdoor space where a child care
program is provided.
new text end
new text begin Subd. 21. new text end
new text begin Fire marshal. new text end
new text begin
"Fire marshal" means the person designated by section 299F.011
to administer and enforce the State Fire Code or the fire marshal's authorized representative.
new text end
new text begin Subd. 22. new text end
new text begin Health care provider. new text end
new text begin
"Health care provider" means a physician or physician's
assistant licensed to practice medicine under chapter 147 or an advanced practice registered
nurse licensed under chapter 148.
new text end
new text begin Subd. 23. new text end
new text begin Health consultant. new text end
new text begin
"Health consultant" means a registered nurse, a public
health nurse, or a health care provider as defined in subdivision 22 who performs health
consultation services for a child care center pursuant to section 142H.29, subdivision 2.
new text end
new text begin Subd. 24. new text end
new text begin Inaccessible to children. new text end
new text begin
"Inaccessible to children" means not capable of
being reached or utilized by a child without the aid of an adult.
new text end
new text begin Subd. 25. new text end
new text begin License. new text end
new text begin
"License" has the meaning given in section 142B.01, subdivision
16.
new text end
new text begin Subd. 26. new text end
new text begin License holder. new text end
new text begin
"License holder" has the meaning given in section 142B.01,
subdivision 17.
new text end
new text begin Subd. 27. new text end
new text begin Licensed capacity. new text end
new text begin
"Licensed capacity" means the maximum number of
children permitted at any one time in the program for which the license holder is licensed
to operate.
new text end
new text begin Subd. 28. new text end
new text begin Medication. new text end
new text begin
"Medication" means any substance or preparation that is used
to prevent or treat a wound, injury, infection, and disease; maintain health; heal; or relieve
pain. This includes medication that is over the counter, or prescribed by a physician, physician
assistant, dentist, or advance practice registered nurse certified to prescribe medication, and
permitted by the parent for administration or application. This term applies to medication
taken internally or applied externally.
new text end
new text begin Subd. 29. new text end
new text begin Night care program. new text end
new text begin
"Night care program" means a nonresidential child care
program that provides overnight care to children during sleeping hours, approximately 11:00
p.m. to 5:00 a.m. Night care programs are subject to the requirements in section 142H.16.
new text end
new text begin Subd. 30. new text end
new text begin Parent. new text end
new text begin
"Parent" means the person or persons who has the legal responsibility
for a child such as the child's mother, father, or legally appointed guardian.
new text end
new text begin Subd. 31. new text end
new text begin Program staff person. new text end
new text begin
"Program staff person" means an employee of the
child care center who carries out the child care program plan and has direct contact with
children. This includes unsupervised volunteers and substitutes.
new text end
new text begin Subd. 32. new text end
new text begin Sick care program. new text end
new text begin
"Sick care program" means a nonresidential child care
program that exclusively cares for sick children. Sick care programs are subject to the
requirements in section 142H.19.
new text end
new text begin Subd. 33. new text end
new text begin Staff supervision. new text end
new text begin
"Staff supervision" means responsibility to hire, train,
assign duties, and direct staff in day-to-day activities and evaluate staff performance. A
"supervisor" is a person with staff supervision responsibility.
new text end
new text begin Subd. 34. new text end
new text begin State Building Code. new text end
new text begin
"State Building Code" means the codes and regulations
adopted by the commissioner of the administration according to section 326B.101, and
contained in Minnesota Rules, chapter 1300.
new text end
new text begin Subd. 35. new text end
new text begin State Fire Code. new text end
new text begin
"State Fire Code" means the codes and regulations adopted
by the state fire marshal pursuant to section 299F.011, and contained in Minnesota Rules,
chapter 7511.
new text end
new text begin Subd. 36. new text end
new text begin Student intern. new text end
new text begin
"Student intern" means a student of a postsecondary institution
assigned by that institution for a supervised experience with children. The experience must
be in a licensed center, an elementary school operated by the commissioner of education
or a legally constituted local school board, or a private school approved under rules
administered by the commissioner of education. Student intern includes a person who is
practice teaching, student teaching, or carrying out a practicum or internship.
new text end
new text begin Subd. 37. new text end
new text begin Substitute. new text end
new text begin
"Substitute" means a person who is temporarily filling a position
as a director, teacher, assistant teacher, or aide in a licensed child care center for less than
500 hours total in a calendar year due to the absence of a regularly employed program staff
person.
new text end
new text begin Subd. 38. new text end
new text begin Supervision of children. new text end
new text begin
"Supervision of children" means when a program
staff person:
new text end
new text begin
(1) is accountable for the child's care;
new text end
new text begin
(2) is able to intervene to protect the health and safety of the child; and
new text end
new text begin
(3) is within sight and hearing of the child at all times, except as described in section
142H.24, subdivision 1.
new text end
new text begin Subd. 39. new text end
new text begin Variance. new text end
new text begin
"Variance" means written permission by the commissioner for a
license holder or applicant to depart from the provisions of a requirement in this chapter
pursuant to section 142B.10, subdivision 16.
new text end
new text begin Subd. 40. new text end
new text begin Volunteer. new text end
new text begin
(a) "Volunteer" means an individual who assists in the care of a
child and is not employed by the child care center.
new text end
new text begin
(b) "Supervised volunteer" means a volunteer who may only have direct contact with
children when a program staff person is able to intervene to protect the health and safety of
children.
new text end
new text begin
(c) "Unsupervised volunteer" means a volunteer who may have direct contact with
children without a program staff person present, must receive the training required under
section 142H.08, and may be counted in the staff-to-child ratios under section 142H.10.
new text end
Sec. 2.
new text begin
[142H.02] APPLICABILITY AND LICENSING PROCESS.
new text end
new text begin
(a) No child care center may operate in Minnesota without a license pursuant to this
chapter and chapter 142B. An applicant for a license and the license holder is governed by,
and must comply with, the general requirements in this chapter and chapters 142B, 245C,
and 260E.
new text end
new text begin
(b) The department may grant variances to the requirements in this chapter if the
conditions in section 142B.10, subdivision 16, are met.
new text end
Sec. 3.
new text begin
[142H.03] OPERATING OPTIONS.
new text end
new text begin
A license holder must operate a day program, drop-in child care program, night care
program, sick child care program, or a combination of two or more kinds of programs.
new text end
Sec. 4.
new text begin
[142H.04] POLICIES AND PROCEDURES FOR PROGRAM
ADMINISTRATION.
new text end
new text begin
(a) The license holder must maintain and enforce program policies and procedures
necessary to comply with licensing requirements under Minnesota Statutes and Minnesota
Rules.
new text end
new text begin
(b) The license holder must:
new text end
new text begin
(1) provide training to employees and volunteers related to their duties in implementing
the program's policies and procedures developed under paragraph (a);
new text end
new text begin
(2) document the provision of this training; and
new text end
new text begin
(3) monitor implementation of policies and procedures by employees and volunteers.
new text end
new text begin
(c) The license holder must keep program policies and procedures readily accessible to
employees and volunteers and index the policies and procedures with a table of contents or
another method approved by the commissioner.
new text end
Sec. 5.
new text begin
[142H.05] DIRECTORS.
new text end
new text begin Subdivision 1. new text end
new text begin General requirements for a director. new text end
new text begin
(a) A center must have a director
who is responsible for overseeing implementation of written policies relating to the
management and control of the daily activities of the program, ensuring the health and safety
of program participants, and supervising staff and volunteers.
new text end
new text begin
(b) A director must:
new text end
new text begin
(1) be at least 21 years old;
new text end
new text begin
(2) be a graduate of a high school or hold an equivalent diploma attained through
successful completion of the commissioner of education-selected high school equivalency
test pursuant to section 124D.549;
new text end
new text begin
(3) have at least 1,040 hours of paid or unpaid staff supervision experience; and
new text end
new text begin
(4) have at least 12 semester credits in accredited coursework in postsecondary child
development education, supervision, management, administration, or leadership or 120
hours of training earned in the topics of child development, supervision, management,
administration, or leadership.
new text end
new text begin
(c) Paragraph (b), clauses (3) and (4), are satisfied if an individual has completed a
Minnesota Association for the Education of Young Children early childhood director's
credential; Child Care Aware Minnesota director's credential; Montessori administrator
credential; or diploma issued by the American Montessori Society, Association Montessori
International, or an institution accredited by the Montessori Accreditation Council for
Teacher Education.
new text end
new text begin Subd. 2. new text end
new text begin Director or designee on site. new text end
new text begin
(a) The director or a designee must be on site
while the center is in operation.
new text end
new text begin
(b) Any program staff person who is at least 18 years old may serve as the designee.
The designee does not have to meet the director qualifications in subdivision 1 but must be
aware of the designation and be able to perform the responsibilities.
new text end
new text begin Subd. 3. new text end
new text begin Director functioning as a teacher. new text end
new text begin
Notwithstanding section 142H.06, a director
may be used as a teacher in any classroom as needed.
new text end
new text begin Subd. 4. new text end
new text begin Incumbent director recognition. new text end
new text begin
Notwithstanding subdivision 1, an individual
who is designated as the director of a licensed child care center on July 1, 2027, meets the
director qualification requirements of this section as long as the individual continues to
work at the program.
new text end
Sec. 6.
new text begin
[142H.06] TEACHERS.
new text end
new text begin Subdivision 1. new text end
new text begin Teacher general qualifications. new text end
new text begin
A teacher must:
new text end
new text begin
(1) be at least 18 years old; and
new text end
new text begin
(2) be a graduate of a high school or hold an equivalent diploma attained through
successful completion of the commissioner of education-selected high school equivalency
test pursuant to section 124D.549.
new text end
new text begin Subd. 2. new text end
new text begin Teacher education and experience requirements. new text end
new text begin
In addition to the general
requirements in subdivision 1, a teacher must have at least one of:
new text end
new text begin
(1) 12 postsecondary semester credits and 480 hours of experience;
new text end
new text begin
(2) 100 hours of commissioner-approved training within the previous five years and 480
hours of experience. After initial qualification, a teacher qualified under this clause must
fulfill at least 50 percent of in-service training requirements under section 142H.09,
subdivision 10, with commissioner-approved trainings;
new text end
new text begin
(3) a credential or diploma from the American Montessori Society, Association
Montessori International, or an institution accredited by the Montessori Accreditation
Council for Teacher Education;
new text end
new text begin
(4) an accredited certificate in child development or early childhood education from a
postsecondary institution;
new text end
new text begin
(5) an accredited diploma, associate's degree, or bachelor's degree in child development
or early childhood education from a postsecondary institution; or
new text end
new text begin
(6) a Child Development Associate (CDA) credential;
new text end
Sec. 7.
new text begin
[142H.07] ASSISTANT TEACHERS.
new text end
new text begin Subdivision 1. new text end
new text begin Assistant teacher general qualifications. new text end
new text begin
An assistant teacher must
work under the supervision of a teacher and be:
new text end
new text begin
(1) at least 18 years old; and
new text end
new text begin
(2) a graduate of a high school or hold an equivalent diploma attained through successful
completion of the commissioner of education-selected high school equivalency test.
new text end
new text begin Subd. 2. new text end
new text begin Assistant teacher education and experience requirements. new text end
new text begin
In addition to
the general requirements in subdivision 1, an assistant teacher must have at least one of:
new text end
new text begin
(1) at least six postsecondary semester credits;
new text end
new text begin
(2) at least 50 hours of commissioner-approved training within the previous five years.
After initial qualification, an assistant teacher qualified under this clause must fulfill at least
50 percent of in-service training requirements under section 142H.09, subdivision 10, with
commissioner-approved trainings; or
new text end
new text begin
(3) at least 160 hours of experience and be making progress toward any of the teacher
qualifications in section 142H.06, subdivision 2, clauses (3) to (6). An assistant teacher
qualified under this clause must be able to provide:
new text end
new text begin
(i) documentation of current enrollment; and
new text end
new text begin
(ii) evidence of working toward the successful completion of the credential.
new text end
Sec. 8.
new text begin
[142H.08] AIDES, VOLUNTEERS, AND SUBSTITUTES.
new text end
new text begin Subdivision 1. new text end
new text begin Aide qualifications. new text end
new text begin
(a) An aide must work under the supervision of a
teacher or assistant teacher, except when performing the tasks in paragraph (b). An aide
must be used pursuant to the staff distribution requirements in section 142H.10, subdivision
2.
new text end
new text begin
(b) An aide may work without being supervised by a teacher or assistant teacher when
they are assisting with the supervision of sleeping children; assisting children with washing,
toileting, and diapering; or accompanying children to and from the bus stop.
new text end
new text begin
(c) An aide must be at least 16 years old.
new text end
new text begin Subd. 2. new text end
new text begin Volunteers. new text end
new text begin
(a) A volunteer may work as a teacher, assistant teacher, aide, or
substitute if the volunteer meets the requirements of that position.
new text end
new text begin
(b) The license holder must maintain a list of all volunteers with relevant information,
including first and last name, whether the volunteer must be supervised at all times or may
occasionally be unsupervised, and the first date of direct contact with children.
new text end
new text begin
(c) Unsupervised volunteers must successfully complete training as required in section
142H.09.
new text end
new text begin
(d) Supervised volunteers must successfully complete the training required in section
142H.09, subdivision 7.
new text end
new text begin Subd. 3. new text end
new text begin Substitutes. new text end
new text begin
(a) A substitute must either meet the requirements for the assigned
staff position or be designated as an unqualified substitute by the director or the director
designee. A director or director designee can designate a substitute as unqualified if:
new text end
new text begin
(1) a teacher is continuously on site, except as provided in section 142H.10, subdivision
2, paragraph (e);
new text end
new text begin
(2) when substituting as a teacher or assistant teacher, the unqualified substitute is aware
of the unqualified substitute's designated staffing position; and
new text end
new text begin
(3) the unqualified substitute is at least 18 years of age.
new text end
new text begin
(b) All substitutes must successfully complete the required training under section
142H.09.
new text end
new text begin Subd. 4. new text end
new text begin Tracking unqualified substitute hours. new text end
new text begin
(a) The license holder must document
the use of unqualified substitute hours on the day the unqualified substitute works.
new text end
new text begin
(b) In a calendar year, a license holder must not use unqualified substitutes more than
60 hours multiplied by the number of the center's classrooms.
new text end
new text begin
(c) A license holder must maintain a log of the use of unqualified substitutes in the center
administrative record for review by the commissioner. The log must be on a form prescribed
by the commissioner.
new text end
Sec. 9.
new text begin
[142H.09] STAFF ORIENTATION AND TRAINING.
new text end
new text begin Subdivision 1. new text end
new text begin Orientation training. new text end
new text begin
(a) Program staff persons must complete orientation
training before providing direct contact services to a child.
new text end
new text begin
(b) The orientation training must include the following topics:
new text end
new text begin
(1) abusive head trauma for staff working with a child under school age pursuant to
subdivision 8;
new text end
new text begin
(2) the center's policy on administration of medication pursuant to section 142H.29,
subdivision 5;
new text end
new text begin
(3) the center's policy on allergy prevention and response pursuant to section 142H.15,
subdivision 5;
new text end
new text begin
(4) the center's policy on behavior guidance pursuant to section 142H.13;
new text end
new text begin
(5) child passenger restraint systems pursuant to subdivision 9;
new text end
new text begin
(6) the center's child care program plan pursuant to section 142H.11;
new text end
new text begin
(7) the center's policy on cleaning, sanitizing, and disinfecting pursuant to section
142H.31;
new text end
new text begin
(8) the center's emergency preparedness plan and procedures pursuant to section 142H.23,
subdivision 1;
new text end
new text begin
(9) procedures for the handling and disposal of bodily fluids pursuant to section 142H.29,
subdivision 10;
new text end
new text begin
(10) the center's emergency and accident policies pursuant to section 142H.23, subdivision
2;
new text end
new text begin
(11) the center's health policies pursuant to section 142H.29;
new text end
new text begin
(12) individual child care program plan or plans pursuant to section 142H.15, if
applicable;
new text end
new text begin
(13) job responsibilities specific to the individual's position at the center;
new text end
new text begin
(14) prevention and control of infectious diseases pursuant to section 142H.18;
new text end
new text begin
(15) the center's policy on research, cameras, and social media participation procedures
pursuant to section 142H.22;
new text end
new text begin
(16) the center's policy on the use of alcohol, drugs, and tobacco products pursuant to
section 142B.10, subdivision 1, paragraph (c);
new text end
new text begin
(17) recognition and reporting of maltreatment, abuse and neglect pursuant to chapter
260E;
new text end
new text begin
(18) the center's risk reduction plan pursuant to section 142H.24;
new text end
new text begin
(19) reduction of risk of sudden unexpected infant death pursuant to the requirements
of subdivision 7 and section 142B.46; and
new text end
new text begin
(20) transportation and field trip safety procedures pursuant to section 142H.33.
new text end
new text begin
(c) Training for orientation may be used to meet in-service training requirements.
new text end
new text begin Subd. 2. new text end
new text begin Child care basics training. new text end
new text begin
(a) Any program staff person hired after July 1,
2027, must complete child care licensing basics training no more than 90 days after the first
date of direct contact with a child, unless the person has completed the training within the
previous two years.
new text end
new text begin
(b) Child care basics training covers information on effectively working in a child care
center setting in Minnesota. Child care basics training must be developed and updated by
the commissioner. Child care basics training may be used to meet in-service training
requirements.
new text end
new text begin Subd. 3. new text end
new text begin Child development and learning training. new text end
new text begin
(a) Program staff persons must
complete at least two hours of child development and learning training within 90 days after
the first date of direct contact with a child and every two calendar years thereafter. For the
purposes of this subdivision, "child development and learning training" means any training
in understanding how children develop physically, cognitively, emotionally, and socially
and learn as part of the children's family, culture, and community.
new text end
new text begin
(b) An individual is exempt from this subdivision if the individual:
new text end
new text begin
(1) has taken a three-credit college course on early childhood development within the
past five years;
new text end
new text begin
(2) has received a bachelor's or master's degree in early childhood education or school-age
child care within the past five years;
new text end
new text begin
(3) is licensed in Minnesota as a prekindergarten teacher, an early childhood educator,
a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood
special education teacher, or an elementary teacher with a kindergarten endorsement; or
new text end
new text begin
(4) has received a Montessori certificate or diploma issued by American Montessori
Society, Association Montessori International, or an institution accredited by the Montessori
Accreditation Council for Teacher Education within the past five years.
new text end
new text begin Subd. 4. new text end
new text begin Pediatric first aid. new text end
new text begin
(a) Before direct contact with a child, a program staff person
must satisfactorily complete pediatric first aid. Pediatric first aid training completed within
the previous two calendar years meets this requirement.
new text end
new text begin
(b) Notwithstanding paragraph (a), a program staff person who has yet to complete initial
pediatric first aid training may provide direct contact services within 90 days after the first
date of direct contact with a child while under the continuous direct supervision of an
individual who has met the pediatric first aid training requirements of this subdivision. For
purposes of this paragraph, "continuous direct supervision" means the program staff person
is within sight or hearing of the program's supervising individual and the program's
supervising individual is capable at all times of intervening to protect the health and safety
of the children served by the program.
new text end
new text begin
(c) The first aid training must have been provided by an individual approved to provide
pediatric first aid instruction.
new text end
new text begin
(d) A program staff person must complete training in pediatric first aid every two calendar
years. Documentation of the training must be maintained at the center.
new text end
new text begin
(e) Online training reviewed and approved by the commissioner satisfies the training
requirement of this subdivision.
new text end
new text begin
(f) Pediatric first aid training in this subdivision must not be used to meet in-service
training requirements under subdivision 10.
new text end
new text begin Subd. 5. new text end
new text begin Pediatric cardiopulmonary resuscitation. new text end
new text begin
(a) Before direct contact with a
child, a program staff person must satisfactorily complete pediatric cardiopulmonary
resuscitation (CPR) training, including CPR techniques for infants and children and the
treatment of obstructed airways. Pediatric CPR training completed within the previous two
calendar years meets this requirement.
new text end
new text begin
(b) Notwithstanding paragraph (a), a program staff person who has yet to complete initial
pediatric CPR training may provide direct contact services within 90 days after the first
date of direct contact with a child, if they are under the continuous direct supervision of an
individual who has met pediatric CPR training requirements under this subdivision. For the
purposes of this paragraph, "continuous direct supervision" means the individual is within
sight or hearing of the program's supervising individual to the extent that the program's
supervising individual is capable at all times of intervening to protect the health and safety
of the children served by the program.
new text end
new text begin
(c) A program staff person must complete training in pediatric CPR every two calendar
years. A center must maintain documentation of the trainings on site.
new text end
new text begin
(d) A pediatric CPR training under this subdivision must incorporate a hands-on skill
session to support the instruction and have been developed:
new text end
new text begin
(1) by the American Heart Association or the American Red Cross; or
new text end
new text begin
(2) using nationally recognized, evidence-based guidelines for pediatric CPR training.
new text end
new text begin
(e) Pediatric CPR training must not be used to meet in-service training requirements
under subdivision 10.
new text end
new text begin Subd. 6. new text end
new text begin Sudden unexpected infant death training. new text end
new text begin
(a) Before direct contact with
infants, program staff persons and volunteers must receive training on the standards under
section 142B.46 and on reducing the risk of sudden unexpected infant death during orientation
and each calendar year thereafter.
new text end
new text begin
(b) Sudden unexpected infant death reduction training required under this subdivision
must be at least one-half hour in length and include at minimum the infant sleep standards
under section 142B.46, the risk factors related to sudden unexpected infant death, methods
of reducing the risk of sudden unexpected infant death in child care, and license holder
communication with parents regarding reducing the risk of sudden unexpected infant death.
new text end
new text begin
(c) Training taken under this subdivision may be used to meet the in-service training
requirements under subdivision 10.
new text end
new text begin Subd. 7. new text end
new text begin Abusive head trauma training. new text end
new text begin
(a) Before direct contact with children under
school age, a program staff person must receive training on the risk of abusive head trauma
during orientation and each calendar year thereafter.
new text end
new text begin
(b) Abusive head trauma training under this subdivision must be at least one-half hour
in length and include at minimum the risk factors related to shaking infants and young
children, methods of reducing the risk of abusive head trauma in child care, and license
holder communication with parents regarding reducing the risk of abusive head trauma.
new text end
new text begin
(c) training taken under this subdivision may be used to meet the in-service training
requirements under subdivision 10.
new text end
new text begin Subd. 8. new text end
new text begin Child passenger restraint systems; training requirement. new text end
new text begin
(a) Before a license
holder transports a child or children under age nine in a motor vehicle, the person placing
the child or children in a passenger restraint must satisfactorily complete training on the
proper use and installation of child restraint systems in motor vehicles.
new text end
new text begin
(b) Training required under this subdivision must be repeated at least once every five
years and include at minimum the proper use of child restraint systems based on the size,
weight, and age of the child and the proper installation of a car seat or booster seat in the
motor vehicle used by the license holder to transport the child or children.
new text end
new text begin
(c) Training required under this subdivision must be provided by individuals who are
certified and approved by the Department of Public Safety, Office of Traffic Safety.
new text end
new text begin
(d) Training completed under this subdivision may be used to meet in-service training
requirements under subdivision 10. Staff training completed within the previous five years
is transferable upon change in employment to another child care center.
new text end
new text begin Subd. 9. new text end
new text begin In-service training requirements. new text end
new text begin
(a) A license holder must ensure that program
staff persons complete in-service training.
new text end
new text begin
(b) In-service training completed within the past 12 months by a program staff person
that is not specific to a child care center is transferable upon the program staff person's
change in employment to another child care program. The program staff person must provide
documentation of the completed training to the new child care program.
new text end
new text begin
(c) All program staff persons, except substitutes and unsupervised volunteers, who work
more than 20 hours per week must complete at least 20 hours of in-service training each
calendar year.
new text end
new text begin
(d) All program staff persons, except substitutes and unsupervised volunteers, who work
20 hours or less per week must complete at least ten hours of in-service training each calendar
year.
new text end
new text begin
(e) Substitutes and unsupervised volunteers must complete a minimum of two hours of
training each calendar year and the training must include the topics identified under
subdivision 11.
new text end
new text begin
(f) The number of in-service training hours may be prorated for center directors and
program staff persons not employed for an entire year.
new text end
new text begin
(g) Pediatric first aid and pediatric CPR training must not be used to meet in-service
training requirements.
new text end
new text begin Subd. 10. new text end
new text begin In-service content. new text end
new text begin
(a) Each calendar year, in-service training must include
the following:
new text end
new text begin
(1) abusive head trauma training of at least one-half hour duration for individuals working
with a child under school age pursuant to subdivision 8;
new text end
new text begin
(2) the center policies and procedures for maintaining health and safety, including:
new text end
new text begin
(i) allergy prevention and response training pursuant to section 142H.15, subdivision 5;
new text end
new text begin
(ii) emergency preparedness and procedures pursuant to section 142H.23, subdivision
1;
new text end
new text begin
(iii) handling emergencies, accidents, incidents, and injuries pursuant to section 142H.23,
subdivision 2; and
new text end
new text begin
(iv) handling and disposal of bodily fluids pursuant to section 142H.29, subdivision 10;
new text end
new text begin
(3) maltreatment, abuse, and neglect reporting pursuant to chapter 260E;
new text end
new text begin
(4) reduction of risk of sudden unexpected infant death training of at least one-half hour
duration for individuals working with infants pursuant to the requirements of subdivision
7 and section 142B.46;
new text end
new text begin
(5) a risk reduction plan pursuant to section 142H.24;
new text end
new text begin
(6) the center policies and procedures on behavior guidance pursuant to section 142H.13;
and
new text end
new text begin
(7) the center policies and procedures on supervision pursuant to section 142H.24.
new text end
new text begin
(b) At least once every two calendar years, in-service training must include the following:
new text end
new text begin
(1) child development and learning pursuant to subdivision 4;
new text end
new text begin
(2) at least one hour on cultural awareness and inclusion;
new text end
new text begin
(3) pediatric first aid that meets the requirements of subdivision 5;
new text end
new text begin
(4) pediatric cardiopulmonary resuscitation training that meets the requirements of
subdivision 5; and
new text end
new text begin
(5) at least one hour on identifying and supporting children with special needs.
new text end
new text begin
(c) At least once every five calendar years, training must include child passenger restraint
systems pursuant to subdivision 9, if applicable.
new text end
new text begin
(d) The remaining hours of the in-service training requirement must be met by completing
training in the Minnesota knowledge and competency framework areas.
new text end
new text begin Subd. 11. new text end
new text begin Documentation required. new text end
new text begin
(a) The license holder must document completed
training for program staff persons in a manner prescribed by the commissioner.
new text end
new text begin
(b) For pediatric first aid and CPR trainings, the license holder must maintain copies of
training cards or certificates issued by the training organization.
new text end
Sec. 10.
new text begin
[142H.10] STAFF RATIOS, GROUP SIZE, AND STAFF DISTRIBUTION.
new text end
new text begin Subdivision 1. new text end
new text begin Staff-to-child ratios and maximum group size. new text end
new text begin
(a) Except as provided
in this subdivision and section 142H.12 regarding naps and rest, the minimally acceptable
staff-to-child ratios and the maximum group size within each age category are:
new text end
|
new text begin
Age Category new text end |
new text begin
Staff-to-Child Ratio new text end |
new text begin
Maximum Group Size new text end |
|
new text begin
Infant new text end |
new text begin
1:4 new text end |
new text begin
8 new text end |
|
new text begin
Toddler new text end |
new text begin
1:7 new text end |
new text begin
14 new text end |
|
new text begin
Preschooler new text end |
new text begin
1:10 new text end |
new text begin
20 new text end |
|
new text begin
School-age child new text end |
new text begin
1:15 new text end |
new text begin
30 new text end |
new text begin
(b) Except for groups that include an infant, the staff-to-child ratio may be doubled for
no more than two hours during nap time. During the nap time, there must be enough program
staff persons in the facility to meet staff-to-child ratio and staff distribution requirements
under paragraph (a) and subdivision 2 for the groups in case of an emergency. The program
must return to following the staff-to-child ratios and staff distribution requirements under
paragraph (a) and subdivision 2 when the number of awake children exceeds the number
of children who could be supervised by one program staff person under subdivision 1.
new text end
new text begin
(c) The maximum group size applies at all times except during meals, outdoor activities,
field trips, naps and rest, and special activities at the center such as guest speakers and
holiday programs.
new text end
new text begin Subd. 2. new text end
new text begin Staff distribution. new text end
new text begin
(a) The license holder must ensure that the following
requirements for staff distribution are met and a documented staff schedule is kept in the
administrative record.
new text end
new text begin
(b) Except as provided in paragraphs (d) and (e), staff distribution within each age
category must be as follows:
new text end
new text begin
(1) the first staff member needed to meet the required staff child ratio must be a teacher;
new text end
new text begin
(2) the second staff member must have at least the qualifications of an aide;
new text end
new text begin
(3) the third staff member must have at least the qualifications of an assistant teacher;
and
new text end
new text begin
(4) the fourth staff member must have at least the qualifications of an aide.
new text end
new text begin
(c) Only a program staff person can be included in meeting the staff-to-child ratios in
this section.
new text end
new text begin
(d) An aide must not work alone with a child unless the aide is performing certain duties
as specified in section 142H.08, subdivision 1, paragraph (b).
new text end
new text begin
(e) An assistant teacher or an aide may be substituted for a teacher during arrival and
departure times if the total arrival and departure time does not exceed 25 percent of the
center's daily hours of operation. For an aide to be substituted for a teacher under this
subdivision, the aide must:
new text end
new text begin
(1) be 18 years of age or older;
new text end
new text begin
(2) have been employed by the child care center for a minimum of 30 days; and
new text end
new text begin
(3) have completed the training required under section 142H.09, including orientation
and the training required within the first 90 days of the first date of direct contact with a
child.
new text end
new text begin
(f) A volunteer who is included in the staff-to-child ratio must meet the requirements
for the assigned staff position in sections 142H.06 to 142H.08.
new text end
new text begin
(g) The pattern in paragraph (e) must be repeated until the number of staff needed to
meet the staff-to-child ratio for each age category has been achieved.
new text end
new text begin Subd. 3. new text end
new text begin Age category grouping. new text end
new text begin
(a) Each center must specify arrival and departure
times of the day in their program's policies. Children in different age categories may be
grouped according to paragraphs (b) and (c).
new text end
new text begin
(b) During arrival and departure times, children in different age categories may be
grouped together if:
new text end
new text begin
(1) the staff-to-child ratio, group size, and staff distribution applied are for the age
category of the youngest child present; and
new text end
new text begin
(2) the group is divided when the number of children present reaches the maximum
group size of the youngest child present.
new text end
new text begin
(c) Outside of arrival and departure times, children in different age categories may be
mixed within a group if:
new text end
new text begin
(1) infants are not grouped with children of other age categories;
new text end
new text begin
(2) there is no more than a 36-month range in age among children in a group, unless all
children in the group are school age; and
new text end
new text begin
(3) the staff-to-child ratios, group size, and staff distribution applied are for the youngest
child present.
new text end
new text begin Subd. 4. new text end
new text begin Age designation. new text end
new text begin
(a) Except as provided in this subdivision, a child must be
designated as a member of the age category that is consistent with the date of birth of the
child.
new text end
new text begin
(b) A child with special health care needs must be included in the group that best meets
the child's developmental needs, best interest of the child, and in accordance with the
individual child care program plan for the child.
new text end
new text begin
(c) A child may be designated as an "infant" up to the age of 18 months if the parent,
teacher, and director determine that such a designation is in the best interest of the child.
The center must document the determination and designation in the file of the child.
new text end
new text begin
(d) A child may be designated as a "toddler" up to the age of 35 months if the parent,
teacher, and director determine that the designation is in the best interest of the child. The
center must document the determination and designation in the file of the child.
new text end
new text begin
(e) A child may be designated as a "preschooler" at the age of 31 months if the parent,
teacher, and director determine that the designation is in the best interest of the child. The
center must document the determination and designation in the file of the child.
new text end
new text begin
(f) When a child is transitioning age groups pursuant to subdivision 5 and with the child's
new class, the child must be designated as if the child has already aged into the class.
new text end
new text begin Subd. 5. new text end
new text begin Transitioning children. new text end
new text begin
(a) Transitions to the next age group may occur up to
two weeks prior to the child aging into the next age group. The transition must be planned
in advance based on the child's readiness and in consultation with parents and program staff.
new text end
new text begin
(b) A center must develop a written policy on transitioning children to the next age
group.
new text end
Sec. 11.
new text begin
[142H.11] CHILD CARE PROGRAM PLAN AND ACTIVITIES.
new text end
new text begin Subdivision 1. new text end
new text begin General requirements. new text end
new text begin
The child care program plan must:
new text end
new text begin
(1) include a statement mandating that children are supervised at all times as defined in
section 142H.01, subdivision 38, and pursuant to the requirements of section 142H.24,
subdivision 1;
new text end
new text begin
(2) specify the age categories and number of children to be served by the program;
new text end
new text begin
(3) specify the days and hours of operation of the program;
new text end
new text begin
(4) describe the general educational methods to be used by the program and the religious,
political, or philosophical basis, if any;
new text end
new text begin
(5) be developed and evaluated in writing each calendar year by a program staff person
qualified as a teacher or director under sections 142H.05 and 142H.06. Documentation of
the evaluation, the date of the evaluation, and the signature of the teacher or director
completing the evaluation must be maintained in the center administrative records;
new text end
new text begin
(6) specify planned activities designed to support and nurture the whole child in all areas
of the development and learning of the child, including but not limited to the following:
intellectual, social, emotional, and physical development. The activities must be in a manner
consistent with the cultural and ethnic backgrounds of a child, as feasible;
new text end
new text begin
(7) specify that the intellectual, social, emotional, and physical development of each
child be documented in the record of the child and conveyed to the parent during the
conferences specified under section 142H.20, subdivision 2;
new text end
new text begin
(8) include a daily schedule of planned indoor and outdoor activities for each age category
served;
new text end
new text begin
(9) specify activities that are quiet, active, teacher directed, and child initiated;
new text end
new text begin
(10) specify a variety of activities that require the use of varied equipment and materials;
new text end
new text begin
(11) include a schedule if equipment is rotated between groups of children;
new text end
new text begin
(12) describe use of technology and screen time for each age category; and
new text end
new text begin
(13) be available to a parent for review upon request.
new text end
new text begin Subd. 2. new text end
new text begin Outdoor activities. new text end
new text begin
(a) Child care activities must promote the physical,
intellectual, social, and emotional development of the child. To facilitate child development,
programs must include daily outdoor activities when weather conditions allow, as defined
in this subdivision.
new text end
new text begin
(b) The applicant must develop a written outdoor weather and activity policy. The license
holder must ensure that the policies and procedures are carried out. The policies and
procedures must incorporate guidance from national, state, or local authorities in public
health and at a minimum require the provider to consider the following conditions when
determining if outdoor play poses a health and safety risk:
new text end
new text begin
(1) heat in excess of 100 degrees Fahrenheit accounting for heat index, or pursuant to
advice of the local authority;
new text end
new text begin
(2) cold less than 15 degrees Fahrenheit accounting for wind chill, or pursuant to advice
of the local authority;
new text end
new text begin
(3) extreme weather, including but not limited to a lightning storm, blizzard, tornado,
or flooding;
new text end
new text begin
(4) an air quality emergency order by a local or state authority on air quality or public
health; or
new text end
new text begin
(5) a lockdown notification ordered by a public safety authority.
new text end
new text begin
(c) The center's outdoor weather and activity policy must specify, if children are to go
outside beyond the temperature range specified in paragraph (b), clauses (1) and (2), what
procedures will be used to keep the children safe, including but not limited to ensuring
children have appropriate clothing, providing frequent indoor breaks, or matching the
intensity of the activity level to the weather conditions.
new text end
new text begin
(d) For toddlers, preschool, and school-age children attending four or more hours per
day, the license holder must provide at least one opportunity for outdoor activity per day
pursuant to paragraph (b).
new text end
new text begin
(e) For infants attending four or more hours per day, the license holder must provide at
least one opportunity for outdoor activity per day as practicable, pursuant to paragraph (b)
and the individual needs of the infants in care.
new text end
new text begin
(f) Programs operating three or fewer hours per day are exempt from the daily outdoor
activity requirement.
new text end
new text begin
(g) If the weather is not suitable for outdoor activities, the program must provide indoor
gross motor play activities that support physical development.
new text end
Sec. 12.
new text begin
[142H.12] NAPS AND REST.
new text end
new text begin Subdivision 1. new text end
new text begin Naps and rest policy. new text end
new text begin
An applicant must develop and a license holder
must implement a policy for naps and rest that is consistent with the developmental level
of the children enrolled in the center. The policy must include but is not limited to the
requirements in this section, as applicable.
new text end
new text begin Subd. 2. new text end
new text begin Parent consultation. new text end
new text begin
The parent of each child must be informed at the time
the child is enrolled of the center's policy on naps and rest and be offered the opportunity
to provide information specific to their child.
new text end
new text begin Subd. 3. new text end
new text begin General nap and rest requirements. new text end
new text begin
(a) The child care center must provide
a quiet space for children to nap and rest.
new text end
new text begin
(b) Nap and rest time must be in accordance with the developmental needs of the child.
new text end
new text begin
(c) Nap and rest areas must be lighted to allow for visual supervision of all children at
all times.
new text end
new text begin
(d) Evacuation routes must not be blocked by resting or napping children. Each child
must have a free and direct means of escape, and the staff must have a clear path to each
resting child, including full access to at least one long side of a crib, cot, or mat.
new text end
new text begin
(e) A crib that meets the safety requirements of section 142B.45 must be provided for
each infant for whom the center is licensed to provide care.
new text end
new text begin
(f) The license holder must follow the infant safe sleep requirements under section
142B.46.
new text end
new text begin
(g) Cribs, cots, and mats must be placed directly on the floor and must not be stacked
when in use.
new text end
new text begin Subd. 4. new text end
new text begin Monitoring napping infants. new text end
new text begin
(a) An infant must be supervised as defined in
section 142H.01, subdivision 38, and pursuant to section 142H.24, subdivision 1, paragraph
(b).
new text end
new text begin
(b) Staff must conduct in-person checks of the sleeping infant every 15 minutes.
new text end
new text begin
(c) When a baby monitor or other mechanical equipment is used to hear or see infants
during sleep, the monitoring equipment must be:
new text end
new text begin
(1) able to pick up the sounds of all infants in the separate room;
new text end
new text begin
(2) actively monitored by program staff at all times; and
new text end
new text begin
(3) checked daily prior to use to ensure it is working correctly. If equipment is
malfunctioning, a program staff person must put in place an alternate means of supervision
until the equipment can be fixed.
new text end
new text begin Subd. 5. new text end
new text begin Confinement limitation. new text end
new text begin
A child who has completed a nap or rested quietly
for 30 minutes must not be required to remain on a cot, mat, or in a crib. Any child who
does not fall asleep during a designated nap time must have the opportunity to engage in
quiet activities.
new text end
new text begin Subd. 6. new text end
new text begin Bedding and sleeping equipment. new text end
new text begin
Separate bedding must be provided and
stored separately for each child in care.
new text end
Sec. 13.
new text begin
[142H.13] BEHAVIOR GUIDANCE.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the following terms have
the meanings given.
new text end
new text begin
(b) "Behavior guidance" means an ongoing process where a program staff person offers
constructive, positive, and developmentally appropriate guidance to a child to help manage
the child's behavior in a socially acceptable manner.
new text end
new text begin
(c) "Persistent unacceptable behavior" means when a child:
new text end
new text begin
(1) exhibits behaviors that present a serious safety risk for the child or others and the
program is not able to reduce or eliminate the safety concern; or
new text end
new text begin
(2) significantly disrupts the learning environment and requires an increased amount of
staff guidance and time to address the child's behavior. Significantly disruptive behavior
may include physical aggression, verbal threats, or repetitive behaviors that have been
addressed through standard behavior guidance techniques without improvement.
new text end
new text begin
(d) "Redirection" means a positive guidance technique where a program staff person
intervenes and guides a child away from potential problems toward constructive activity or
talks with a child to help the child calm down and self-regulate.
new text end
new text begin
(e) "Separation" means a form of behavior guidance that involves interruption of
unacceptable behavior by the removal of a child from a situation with the intention of
allowing the child an opportunity to pause and gain self-control. During a separation a child
is isolated from participating in activities with other children. Separation of children must
be done pursuant to subdivision 7.
new text end
new text begin Subd. 2. new text end
new text begin Behavior guidance policies and procedures. new text end
new text begin
The applicant must develop
written behavior guidance policies and procedures approved by the commissioner. The
license holder must ensure that the policies and procedures are carried out. The policies and
procedures must include:
new text end
new text begin
(1) methods of promoting positive behavior as specified under subdivision 3;
new text end
new text begin
(2) prohibited actions as specified under subdivision 4;
new text end
new text begin
(3) addressing persistent unacceptable behavior as specified under subdivision 6; and
new text end
new text begin
(4) separation from the group as specified in subdivision 7.
new text end
new text begin Subd. 3. new text end
new text begin Methods of promoting positive behavior. new text end
new text begin
A license holder must promote
positive behavior by:
new text end
new text begin
(1) ensuring that each child is provided with a positive model of acceptable behavior;
new text end
new text begin
(2) tailoring methods of promoting positive behavior to the developmental level of the
children the center is licensed to serve;
new text end
new text begin
(3) ensuring redirection is used, as appropriate in addressing the behavior of a child, to
guide a child away from potential problems and toward constructive activity or to talk with
a child to help them calm down and self-regulate;
new text end
new text begin
(4) teaching children how to use acceptable alternatives to problem behavior to reduce
conflict;
new text end
new text begin
(5) protecting the safety and well-being of children, employees, and volunteers; and
new text end
new text begin
(6) providing immediate and directly related consequences for the unacceptable behavior
of a child.
new text end
new text begin Subd. 4. new text end
new text begin Prohibited actions. new text end
new text begin
A license holder must prohibit the following actions by or
at the direction of employees or volunteers:
new text end
new text begin
(1) subjecting a child to corporal or physical punishment, including but not limited to
rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching,
spitting, hitting, or spanking;
new text end
new text begin
(2) subjecting a child to name calling, ostracism, shaming, derogatory remarks about
the child or the child's family, cultural or racial slurs, yelling, or profane language that
threatens, humiliates, or frightens the child;
new text end
new text begin
(3) forcing a child to maintain an uncomfortable position or to continuously repeat
physical movements;
new text end
new text begin
(4) utilizing group punishments for the behavior of an individual child;
new text end
new text begin
(5) separation of a child from the group except as provided in subdivision 7;
new text end
new text begin
(6) punishment for not resting, napping, or sleeping; toileting accidents; failing to eat
all or part of meals or snacks; or failing to complete an activity;
new text end
new text begin
(7) denial of food or drink or forcing food or drink upon a child;
new text end
new text begin
(8) denial of light, warmth, clothing, or medical care as a punishment for unacceptable
behavior;
new text end
new text begin
(9) the use of physical restraint other than to physically hold a child when containment
is necessary to protect the child or others from harm;
new text end
new text begin
(10) the use of mechanical restraints, including tying a child up, or any device or
equipment intended to restrict or prevent movement as a means of discipline or for reasons
unrelated to the child's care, safety, or planned activity;
new text end
new text begin
(11) the use of prone or contraindicated restraints as prohibited in section 245A.211;
new text end
new text begin
(12) the use of any substance given to a child to subdue or restrict movement or behavior;
new text end
new text begin
(13) discipline and punishment must not be delegated to another child; and
new text end
new text begin
(14) punishing or shaming a child for the actions of a parent, including but not limited
to failure to pay fees, failure to provide appropriate clothing, failure to provide materials
for an activity, or any conflict between the license holder or staff and the parent.
new text end
new text begin Subd. 5. new text end
new text begin Additional provisions. new text end
new text begin
(a) When providing services to a child with a
developmental disability or related condition, the license holder must follow section 142B.63.
new text end
new text begin
(b) A program that cares for a child with a developmental disability or related condition
must comply with the individual child care program plan requirements under section 142H.15.
new text end
new text begin Subd. 6. new text end
new text begin Persistent unacceptable behavior. new text end
new text begin
(a) A program staff person who observes
persistent unacceptable behavior must document the behavior of the child and staff response
to the behavior, including:
new text end
new text begin
(1) information on where the child was, what activity the child was doing, and the
employees or volunteers present when the incident occurred; and
new text end
new text begin
(2) staff actions, including the positive guidance techniques that were tried.
new text end
new text begin
(b) When persistent unacceptable behavior as defined in subdivision 1, paragraph (c),
occurs, a behavior plan must be developed to address the behavior documented in paragraph
(a) in consultation with the child's parent, the program staff, and other professionals involved
in the care and treatment of the child, as appropriate. The behavior plan must include but
is not limited to the following:
new text end
new text begin
(1) a description of the specific behavior;
new text end
new text begin
(2) the planned behavior management method to be used in response to the behavior
pursuant to subdivision 3 or any other previously approved methods; and
new text end
new text begin
(3) an area to document the effectiveness of the plan and progress of the child.
new text end
new text begin
(c) The plan must be signed and dated by the child's parent, the director, and other
professionals involved in the care and treatment of the child, as applicable, and kept in the
child's record.
new text end
new text begin
(d) The plan and the child's progress must be reviewed at least twice each calendar year,
or more frequently as needed, and changes must be made based on the child's needs and
the input of the child's parent, program staff, or other individuals involved in the provision
of care and treatment of the child. Documentation of the review must be kept in the child's
record. If the child's parent and the program staff agree that the behavior plan is no longer
needed, the license holder must document the date the behavior plan is no longer in effect.
new text end
new text begin
(e) The license holder must ensure that all staff who work directly with the child are
trained on the behavior plan prior to working with the child or when a new behavior plan
is developed. Documentation of staff training must be maintained on file.
new text end
new text begin
(f) The license holder must ensure that all staff who work directly with the child are
trained on the behavior plan prior to working with the child or when a new behavior plan
is developed. Documentation of staff training must be maintained on file.
new text end
new text begin Subd. 7. new text end
new text begin Separation time from the group. new text end
new text begin
No child may be separated from the group
unless the license holder has tried less intrusive methods of guiding the child's behavior
that have been ineffective and the behavior of the child threatens the well-being of the child
or other children in the center. Separation from the group must meet the following
requirements:
new text end
new text begin
(1) the separation time must be limited to the amount of time necessary for the child to
gain self-control and rejoin the group;
new text end
new text begin
(2) the duration of separation of the child must be documented, including the beginning
and end time of the separation;
new text end
new text begin
(3) infants and toddlers must not be separated from the group as a means of behavior
guidance. Positive behavior guidance techniques such as redirection may be used with
toddlers; and
new text end
new text begin
(4) the child must be supervised as defined under section 142H.01, subdivision 38, while
separated.
new text end
Sec. 14.
new text begin
[142H.14] FURNISHINGS, EQUIPMENT, MATERIALS AND SUPPLIES.
new text end
new text begin Subdivision 1. new text end
new text begin General requirements. new text end
new text begin
(a) Each center must have on the premises the
quantity and type of equipment and materials necessary to implement the child care program
plan under section 142H.11 and the indoor and outdoor equipment requirements in
subdivisions 2 and 3.
new text end
new text begin
(b) Equipment and furniture must be durable, in good repair, structurally sound, stable,
and free of sharp edges, dangerous protrusions, points where extremities of a child could
be pinched or crushed, and openings or angles that could trap part of a child.
new text end
new text begin
(c) License holders and program staff must ensure equipment and furnishings are not
hazardous objects as specified in section 142H.34, subdivision 17.
new text end
new text begin
(d) Equipment designed and marketed for use by children must be appropriate to the
age and size of children and used in accordance with the manufacturer's instructions.
Equipment and play materials not designed or marketed for use by children, including but
not limited to repurposed, homemade, and open-ended items, must be appropriate to the
age and size of children, in good repair, and used under the supervision of a program staff
person. Such equipment and play materials are not required to have manufacturer's
instructions and are subject to the requirements of this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Indoor play equipment. new text end
new text begin
The license holder must provide sufficient indoor
play equipment and materials so that at any point in the day when children are indoors and
using equipment every child can choose from at least three activities involving equipment
or materials. The quantity of indoor equipment provided must be based on the maximum
licensed capacity of the classroom and must be accessible to children as specified in
subdivision 6.
new text end
new text begin Subd. 3. new text end
new text begin Outdoor play equipment. new text end
new text begin
The license holder must provide sufficient outdoor
play equipment and materials so that when all children are outdoors every child can choose
from at least one activity involving equipment or materials. The quantity of outdoor
equipment and materials provided must be based on the maximum licensed capacity and
must be accessible to children as specified in subdivision 6.
new text end
new text begin Subd. 4. new text end
new text begin Natural elements and materials. new text end
new text begin
(a) A license holder may provide children
with access to natural elements and materials as equipment and play materials. Natural
elements and materials and appropriate uses of natural elements and materials include, but
are not limited to:
new text end
new text begin
(1) natural loose parts, such as sticks, leaves, pinecones, acorns, seeds, pods, bark, and
moss for construction, art, sensory exploration, and imaginative play;
new text end
new text begin
(2) natural materials, such as dirt, mud, sand, water, ice, and snow for sensory play and
exploration;
new text end
new text begin
(3) plants, flowers, seeds, vegetables, and gardening materials for science exploration
and learning;
new text end
new text begin
(4) rocks, pebbles, stones, and minerals for counting, sorting, building, and art;
new text end
new text begin
(5) natural areas such as gardens, prairie, forest, wetlands, and ponds for exploration
and learning; and
new text end
new text begin
(6) other natural elements as appropriate to age and development of children.
new text end
new text begin
(b) A program staff person must supervise a child's use of natural elements and materials
and provide guidance on safe and appropriate use. Natural elements and materials that are
a choking hazard must not be accessible to children under the age of three without direct
supervision of a program staff person.
new text end
new text begin
(c) Natural elements and materials may qualify as equipment and materials from interest
areas under subdivision 6.
new text end
new text begin Subd. 5. new text end
new text begin Interest areas. new text end
new text begin
The license holder must have equipment and materials in each
of the following developmental and interest areas to support a child's learning and growth:
new text end
new text begin
(1) creative arts and crafts;
new text end
new text begin
(2) construction and building;
new text end
new text begin
(3) social interaction, dramatic play, or practical life activities;
new text end
new text begin
(4) math and science;
new text end
new text begin
(5) music;
new text end
new text begin
(6) fine motor skills;
new text end
new text begin
(7) physical and movement activities;
new text end
new text begin
(8) sensory exploration activities; and
new text end
new text begin
(9) language and literacy.
new text end
new text begin Subd. 6. new text end
new text begin Equipment rotation and accessibility. new text end
new text begin
A child care program may rotate
equipment throughout the day as specified in the child care program plan if the number of
choices required in subdivisions 2 and 3 is available for each child in attendance. Equipment
and materials from each interest area must be accessible to children at least once per day.
new text end
new text begin Subd. 7. new text end
new text begin Furnishings. new text end
new text begin
The license holder must ensure that each child has access to
furniture that is developmentally appropriate and the appropriate size, including at a
minimum:
new text end
new text begin
(1) one diaper changing table for every 12 infants or 14 toddlers. The same table may
not be counted to fulfill the requirement under this clause for both infants and toddlers;
new text end
new text begin
(2) one hands-free covered diaper container per diaper changing table;
new text end
new text begin
(3) one crib and waterproof mattress per infant, including enough cribs with wheels to
evacuate the number of infants the program is licensed to serve;
new text end
new text begin
(4) one cot or mat per toddler or preschooler. This clause does not apply to programs
operating for less than five hours per day if rest is not indicated as part of the center's child
care program;
new text end
new text begin
(5) for infants, one nonfolding seating option per child based on licensed capacity; and
new text end
new text begin
(6) for toddlers, preschoolers, and school-age children, one nonfolding seating option
per child based on licensed capacity, with a corresponding amount of table space to allow
the child to do table work or eat a meal while seated.
new text end
new text begin Subd. 8. new text end
new text begin Supplies. new text end
new text begin
(a) The license holder must maintain enough diapers, disposable
paper for the diaper changing table, facial tissues, liquid hand soap, and single-service towels
to maintain cleanliness and sanitation for children in care.
new text end
new text begin
(b) The license holder must provide at least two sets of sheets for each crib.
new text end
Sec. 15.
new text begin
[142H.15] CHILDREN WITH SPECIAL HEALTH CARE NEEDS OR
DISABILITIES.
new text end
new text begin Subdivision 1. new text end
new text begin Child with special health care needs or disabilities. new text end
new text begin
For the purposes
of this section, "child with special health care needs or disabilities" means a child who:
new text end
new text begin
(1) has developmental disabilities or is otherwise eligible for case management pursuant
to Minnesota Rules, parts 9525.0004 to 9525.0036;
new text end
new text begin
(2) has been identified by the local school district as a child with a disability as defined
in section 125A.02, subdivision 1; or
new text end
new text begin
(3) has been determined by a health care provider as defined in section 142H.01,
subdivision 22; licensed psychiatrist; licensed psychologist; or licensed consulting
psychologist as having a special health care need or disability relating to physical, social,
or emotional development.
new text end
new text begin Subd. 2. new text end
new text begin Report to parent. new text end
new text begin
The license holder must inform the parent when there is a
developmental concern or potential special health care need of a child that was not previously
identified.
new text end
new text begin Subd. 3. new text end
new text begin Individual child care program plan. new text end
new text begin
(a) When a license holder admits a child
with a disability or special health care need or a special need is identified, the license holder
must ensure that an individual child care program plan (ICCPP) is developed in a form and
manner prescribed by the commissioner to meet the child's individual needs.
new text end
new text begin
(b) When developing or updating the ICCPP, the license holder must obtain relevant
information from the child's parent and program staff who work directly with the child.
new text end
new text begin
(c) For a child who meets the criteria in subdivision 1, clause (1), the ICCPP must be
coordinated with the child's individual service plan (ISP).
new text end
new text begin
(d) For a child who meets the criteria in subdivision 1, clause (2), the ICCPP must be
coordinated with the child's individualized educational plan (IEP).
new text end
new text begin
(e) For a child who meets the criteria in subdivision 1, clause (3), the ICCPP must be
coordinated with the child's health care provider or other necessary medical professionals.
new text end
new text begin
(f) The license holder must ensure that all program staff who work directly with the
child are trained on the ICCPP prior to working with the child. Documentation of staff
training must be maintained on file.
new text end
new text begin
(g) Before the ICCPP is implemented, the parent and the director must sign and date the
form. The ICCPP must be kept in the child's record.
new text end
new text begin
(h) The ICCPP must be reviewed and updated at least once each calendar year and more
frequently if needed. The ICCPP must be signed and dated by the parent and the director
upon their yearly review.
new text end
new text begin
(i) The most recent ICCPP must be available at all times to program staff when the child
is in care.
new text end
new text begin Subd. 4. new text end
new text begin Inclusion. new text end
new text begin
All activities must be designed to include all children unless a specific
medical contraindication exists or an exclusion is otherwise specified in a child's ICCPP.
new text end
new text begin Subd. 5. new text end
new text begin Allergy prevention and response. new text end
new text begin
(a) An applicant must develop a written
policy on allergy prevention and response. A license holder must ensure the policy is carried
out and provided to parents at the time of enrollment.
new text end
new text begin
(b) Before admitting a child for care, the license holder must obtain documentation of
any known allergy from the child's parent or the child's health care provider.
new text end
new text begin
(c) If a child has a known allergy, the license holder must maintain current information
about the allergy in the child's record and develop an ICCPP pursuant to subdivision 3,
including:
new text end
new text begin
(1) a description of the allergy;
new text end
new text begin
(2) specific triggers and avoidance techniques;
new text end
new text begin
(3) symptoms of an allergic reaction;
new text end
new text begin
(4) procedures for responding to an allergic reaction, including medication to be
administered in an emergency situation and dosages; and
new text end
new text begin
(5) the child's health care provider contact information.
new text end
new text begin
(d) If a child has an ICCPP related to a food allergy, the ICCPP must be readily available
to the person in the area where food is prepared and served to the child. If food is prepared
off site, the center must notify the person or entity preparing the food of any food allergies
of children in their care. Food allergy information for all children in care must be readily
available to staff in the classroom and wherever food is served.
new text end
new text begin
(e) The license holder must contact the parent of the child immediately after any instance
of exposure or allergic reaction.
new text end
new text begin
(f) The license holder must call 911 when epinephrine is administered to a child in care.
new text end
new text begin Subd. 6. new text end
new text begin Temporary physical needs. new text end
new text begin
If a child has a temporary physical need as
identified by their health care provider, including but not limited to a brace, cast, or helmet,
the license holder must maintain current documentation about the temporary physical need
from the child's health care provider and any necessary accommodations in the child's record.
The license holder must ensure staff who work with the child are aware of the child's
temporary physical need and follow the identified necessary accommodations. An ICCPP
is not required for documenting a temporary physical need under this subdivision and the
accommodation.
new text end
Sec. 16.
new text begin
[142H.16] NIGHT CARE PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
A license holder providing overnight care must comply
with this section.
new text end
new text begin Subd. 2. new text end
new text begin Furnishings. new text end
new text begin
Each child enrolled in a night care program must be provided
with a crib or bed, described as follows:
new text end
new text begin
(1) a crib that meets the requirements under section 142B.45 and two sets of sheets must
be provided for each infant and meet the requirements under section 142H.14;
new text end
new text begin
(2) an individual age-appropriate bed with two sets of sheets and a blanket or quilt must
be provided for each toddler, preschooler, or school-age child;
new text end
new text begin
(3) each bed or crib must have a waterproof mattress or mattress pad that can be cleaned
and disinfected;
new text end
new text begin
(4) bedding and sleeping equipment must be cleaned and disinfected as specified in
section 142H.31, subdivision 4, clause (3); and
new text end
new text begin
(5) separate bedding must be provided and stored separately for each child in care.
new text end
new text begin Subd. 3. new text end
new text begin Clothing intended for sleeping. new text end
new text begin
The license holder must ensure that all children
are put to bed in clothing for sleeping as designated by the parent of the child.
new text end
new text begin Subd. 4. new text end
new text begin Personal care items. new text end
new text begin
The license holder must ensure that all children have
personal items needed to clean up and prepare for sleep. The items must include an individual
washcloth, towel, toothbrush, toothpaste, and liquid hand soap.
new text end
new text begin Subd. 5. new text end
new text begin Meals and snacks. new text end
new text begin
(a) The license holder must ensure that a child who will be
present in the center has had or will be provided with an evening meal. A bedtime snack
must be available for all children in attendance. Eating times and schedules for the individual
child must be consistent with patterns established in consultation with the parent of the
child.
new text end
new text begin
(b) Night care programs are exempt from the requirements of section 142H.32,
subdivision 7.
new text end
new text begin Subd. 6. new text end
new text begin Staffing. new text end
new text begin
At least two program staff persons, one of whom must qualify as a
teacher under section 142H.06, must be present in the center at all times during the hours
the night program is in operation. When more than 80 percent of the children present are
asleep, the remaining program staff persons needed to meet the required staff-to-child ratio
must have at least the qualifications of an aide. Program staff must be awake, dressed, and
provide supervision as specified in sections 142H.01, subdivision 38, and 142H.12 to
children who are sleeping.
new text end
new text begin Subd. 7. new text end
new text begin Hygiene assistance. new text end
new text begin
The license holder must ensure that children have the
opportunity to wash up and brush their teeth before bedtime. Program staff must assist
children during washing and changing clothes according to the developmental needs of the
child.
new text end
new text begin Subd. 8. new text end
new text begin Showers and bathtubs. new text end
new text begin
The license holder must ensure bathtubs and showers
are equipped to prevent slipping, if the center provides bathing.
new text end
new text begin Subd. 9. new text end
new text begin Bathing procedures. new text end
new text begin
The center must have written permission from the parent
prior to allowing the child to bathe and ensure bathtubs and showers are cleaned and
disinfected after each use. The tub or showers do not have to be disinfected between uses
if the children are siblings and the parent has provided written consent. All children must
bathe separately unless the children are siblings and the parent has provided written consent
that the children can be bathed together.
new text end
new text begin Subd. 10. new text end
new text begin Privacy. new text end
new text begin
To ensure privacy, school-age boys and girls must be separated
during bedtime washing and changing activities.
new text end
new text begin Subd. 11. new text end
new text begin Sleeping arrangements. new text end
new text begin
The center must provide sleeping arrangements so
that sleeping children are cared for separately from children who are awake and so that
sleeping children are not disturbed by arrivals and departures. Infants must have a sleep
area separate from the center's play and activity areas.
new text end
new text begin Subd. 12. new text end
new text begin Bedtime. new text end
new text begin
A child's bedtime must be scheduled in consultation with the child's
parent.
new text end
new text begin Subd. 13. new text end
new text begin Light. new text end
new text begin
The center must provide adequate lighting indoors in all areas, including
bathrooms, hallways, and sleeping rooms to ensure that staff are able to see all children at
all times.
new text end
new text begin Subd. 14. new text end
new text begin Outdoor illumination. new text end
new text begin
The center must ensure that parking areas, outdoor
walkways, and all building entrances are adequately lighted for safety and security.
new text end
new text begin Subd. 15. new text end
new text begin Program emphasis. new text end
new text begin
A license holder operating a night care program must
comply with the child care program standards in 142H.11.
new text end
new text begin Subd. 16. new text end
new text begin Exceptions. new text end
new text begin
The outdoor activity area required by section 142H.34, subdivision
7; outdoor activities required by section 142H.11, subdivision 2; and outdoor equipment
required by section 142H.14 need not be provided for children enrolled in a night care
program.
new text end
Sec. 17.
new text begin
[142H.17] DROP-IN CHILD CARE PROGRAMS.
new text end
new text begin Subdivision 1. new text end
new text begin Drop-in child care programs. new text end
new text begin
If a license holder chooses to operate as
a drop-in child care program, the license holder must comply with the requirements in this
section.
new text end
new text begin Subd. 2. new text end
new text begin Exemptions. new text end
new text begin
(a)
new text end
new text begin
Drop-in child care programs that meet one of the requirements
in paragraph (b) are exempt from:
new text end
new text begin
(1) section 142H.10;
new text end
new text begin
(2) section 142H.11, subdivision 1, clauses (6) and (7); and
new text end
new text begin
(3) section 142H.12, subdivisions 3 and 5, except for infants and toddlers.
new text end
new text begin
(b) A drop-in child care program is exempt from the requirements in paragraph (a) if
the program operates:
new text end
new text begin
(1) in a child care center that houses no child care program except the drop-in child care
program;
new text end
new text begin
(2) in the same child care center but not during the same hours as a regularly scheduled
ongoing child care program with a stable enrollment; or
new text end
new text begin
(3) in a child care center at the same time as a regularly scheduled ongoing child care
program with a stable enrollment, but activities, except for bathroom use and outdoor play,
are conducted separately from each other.
new text end
new text begin Subd. 3. new text end
new text begin Staffing requirements. new text end
new text begin
(a) A drop-in child care program must have at least
two program staff persons on site whenever the program is operating: the director or a
designee and a program staff member who is qualified as a teacher.
new text end
new text begin
(b) If the drop-in child care program has additional staff who are on call as a mandatory
condition of their employment, the minimum child-to-staff ratio may be exceeded only for
preschool and school-age children by a maximum of four children for no more than 20
minutes while additional staff are in transit. If the ratio is exceeded for more than 20 minutes,
the license holder must review the mandatory on-call staff procedures and revise as necessary
to ensure compliance with this section, including hiring additional on-call staff as needed.
new text end
new text begin
(c) Whenever there is a total of 20 children or more at a drop-in child care center, children
that are younger than 30 months must be cared for in a separate group. The group may
contain children up to 60 months old. The group must be cared for in an area that is physically
separated from older children.
new text end
new text begin
(d) In drop-in care programs that serve both infants and older children, children up to
30 months old may be supervised by assistant teachers as long as other staff are present in
appropriate ratios.
new text end
new text begin
(e) A drop-in child care program may care for siblings who are all at least 16 months
old together in any group. For purposes of this section, "sibling" is defined as sister or
brother, half sister or half brother, or stepsister or stepbrother.
new text end
new text begin Subd. 4. new text end
new text begin Staff-to-child ratio requirements in a drop-in program. new text end
new text begin
The minimum
staff-to-child ratio that a license holder may maintain in a drop-in program is:
new text end
new text begin
(1) for infants, one program staff person for every four infants;
new text end
new text begin
(2) for toddlers, one program staff person for every seven children;
new text end
new text begin
(3) for preschoolers, one program staff person for every ten children; and
new text end
new text begin
(4) for school-age children, one program staff person for every 15 children.
new text end
new text begin Subd. 5. new text end
new text begin Staff distribution. new text end
new text begin
(a) The minimum staff distribution pattern for a drop-in
child care program is:
new text end
new text begin
(1) the first staff member needed to meet the required staff-to-child ratio must be a
teacher;
new text end
new text begin
(2) the second and third staff members must have at least the qualifications of a child
care aide; and
new text end
new text begin
(3) the fourth staff member must have at least the qualifications of an assistant teacher.
new text end
new text begin
(b) The pattern in paragraph (a) must be repeated until the number of staff needed to
meet the staff-to-child ratio for each age category has been achieved.
new text end
Sec. 18.
new text begin
[142H.18] EXCLUSION OF SICK CHILDREN .
new text end
new text begin Subdivision 1. new text end
new text begin Care of sick children. new text end
new text begin
If a child becomes sick while at the center, the
child must be isolated from other children in care and the child's parent called immediately.
When determining if a child is sick and exclusion is necessary, license holders must follow:
new text end
new text begin
(1) the requirements on reportable diseases in Minnesota Rules, parts 4605.7040,
4605.7070, and 4605.7080; and
new text end
new text begin
(2) guidelines from the commissioner of health on infectious diseases in child care
settings.
new text end
new text begin Subd. 2. new text end
new text begin Notification. new text end
new text begin
(a) A child care center's program policies must require a parent
to inform the center within 24 hours, exclusive of weekends and holidays, when a child is
diagnosed by a child's health care provider or dental care provider as having a reportable
or infectious disease as specified in subdivision 1.
new text end
new text begin
(b) The license holder must ensure that the commissioner of health is notified of any
suspected case of reportable disease as specified in Minnesota Rules, parts 4605.7040,
4605.7050, or 4605.7080, within 24 hours of receiving the parent's or staff report.
Documentation of the notification must be kept at the center.
new text end
new text begin
(c) The license holder must notify the parents of exposed children within 24 hours of
when a parent, employee, or volunteer notifies the center of a reportable disease under
subdivision 1, lice, scabies, impetigo, ringworm, or chicken pox. The notice must be posted
in a clearly visible, accessible place or provided individually to each parent of a child who
was exposed.
new text end
new text begin Subd. 3. new text end
new text begin Return to center. new text end
new text begin
Children with a reportable or infectious disease as specified
in subdivision 1 must be excluded from the center for a length of time as specified in the
commissioner of health guidelines on infectious diseases in child care settings and until the
child can participate in routine activities without more staff supervision than usual. The
center must exclude a child for a longer period if the child's health care provider determines
that it is necessary.
new text end
Sec. 19.
new text begin
[142H.19] SICK CARE PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Licensure of sick care programs. new text end
new text begin
If a license holder chooses to operate
as a sick care program, the license holder must operate a sick care program that complies
with the requirements in this section.
new text end
new text begin Subd. 2. new text end
new text begin Review of admission and health policies and practices. new text end
new text begin
(a) A licensed
physician, physician assistant, or advanced practice registered nurse with a specialization
in pediatric care must review and approve a sick care program's admission policy at the
time of initial license application, after the first six months of initial operation, and at least
once each calendar year.
new text end
new text begin
(b) The review must include consultation with the licensed registered nurse or physician
responsible for admissions.
new text end
new text begin
(c) A report of the findings must be sent to the commissioner with the initial application
for licensure, and subsequent reports must be placed in the center's administrative record.
new text end
new text begin Subd. 3. new text end
new text begin Evaluation of a sick child. new text end
new text begin
(a) A license holder that operates a sick care program
must evaluate the condition of a sick child before admitting the child to the center.
new text end
new text begin
(b) The evaluation must be based on the physical symptoms of the child each day of
admission, the probable contagion and risk to the health of others present, the ability of the
program to provide the care the child requires, and whether the child can be grouped together
with other children in care with contagious or noncontagious illnesses. Documentation of
the evaluation must be placed in the child's record.
new text end
new text begin
(c) Before admitting a child to a sick care program:
new text end
new text begin
(1) a parent must describe the child's symptoms over the phone;
new text end
new text begin
(2) a health care provider affiliated with the center must tell the parent whether the parent
may bring the child to the center for further evaluation; and
new text end
new text begin
(3) the health care provider must conduct a physical assessment of the child and obtain
a health history from the parent at the center.
new text end
new text begin Subd. 4. new text end
new text begin Information to parents. new text end
new text begin
A summary of the sick care program's health care
policies and practices and the center's procedures for notification of parents in the event of
an emergency must be given to the parent the first time a child is admitted and every
admission following a change to any of the information.
new text end
new text begin Subd. 5. new text end
new text begin Parent conference exception. new text end
new text begin
Centers licensed to provide child care exclusively
to sick children are not required to provide parent conferences under section 142H.20,
subdivision 2.
new text end
new text begin Subd. 6. new text end
new text begin Child care program emphasis exception. new text end
new text begin
A sick care program does not need
to meet the child care program plan requirements under section 142H.11. However, the
child care program plan for the care of sick children must emphasize quiet activities.
new text end
new text begin Subd. 7. new text end
new text begin Group size and age category grouping exceptions. new text end
new text begin
The maximum group
sizes specified under section 142H.10, subdivision 1, and the age category grouping
restrictions under section 142H.10, subdivision 3, do not apply to sick care programs. There
must be no more than 16 children in sick care in the same room at the same time.
new text end
new text begin Subd. 8. new text end
new text begin Staff-to-child ratios and staff distribution requirements. new text end
new text begin
(a) A one-to-four
staff-to-child ratio must be maintained at all times in a room used to care for sick children.
new text end
new text begin
(b) At least two program staff persons must be present in a center operating a sick care
program whenever sick children are in care.
new text end
new text begin
(c) The first program staff person must be a registered nurse. The remaining program
staff persons must at least meet the qualifications and follow the staff distribution pattern
under section 142H.10.
new text end
new text begin Subd. 9. new text end
new text begin Limitation on staff assignment. new text end
new text begin
Staff must not care for nonsick children or
prepare food for nonsick children on the same day as sick children. Staff caring for sick
children must not enter the kitchen used to prepare food for nonsick children.
new text end
new text begin Subd. 10. new text end
new text begin Food preparation. new text end
new text begin
Food provided by the license holder and prepared at the
center must be prepared in a room separate from rooms where sick care is provided and
must be delivered to each sick care room in individual servings and in covered containers.
Procedures for preparing, handling, and serving food and washing food, utensils, and
equipment must comply with the requirements in the Minnesota Food Code, Minnesota
Rules, chapter 4626.
new text end
new text begin Subd. 11. new text end
new text begin Menus. new text end
new text begin
Menus for sick children must be modified to meet the individual needs
of the child.
new text end
new text begin Subd. 12. new text end
new text begin Additional facility requirements. new text end
new text begin
A license holder operating a sick care
program must provide:
new text end
new text begin
(1) a room or rooms that are exclusively used to care for sick children and that are not
used at any time for any other child care purpose; and
new text end
new text begin
(2) toilets and hand sinks that are within or immediately adjacent to the room or rooms
used for sick care and are not used by well children in care.
new text end
new text begin Subd. 13. new text end
new text begin Outdoor activity area, activities, and equipment exception. new text end
new text begin
Sick care
programs under this section are exempt from the requirements for an outdoor activity area
under section 142H.34, subdivision 7; outdoor activities under section 142H.11, subdivision
2; and outdoor equipment under section 142H.14.
new text end
new text begin Subd. 14. new text end
new text begin Cleaning and disinfection. new text end
new text begin
Floors in rooms where sick care is provided and
all linens, toileting equipment, sinks, furnishings, objects, and equipment used by sick
children must be cleaned and disinfected at least daily and as needed pursuant to the
requirements under section 142H.31.
new text end
new text begin Subd. 15. new text end
new text begin Bedding and sleeping equipment. new text end
new text begin
(a) Each sick child must be provided
appropriate bedding and sleeping equipment, depending on the age of the child, as follows:
new text end
new text begin
(1) a crib and crib sheets pursuant to the requirements of section 142B.45, cot, mat, or
bed, depending on the age of the child;
new text end
new text begin
(2) a pillow, except if the child is an infant;
new text end
new text begin
(3) a pillowcase, except if the child is an infant; and
new text end
new text begin
(4) a blanket or quilt, except if the child is an infant.
new text end
new text begin
(b) Bedding provided by the center must be laundered after each use. Sleeping equipment
must be cleaned and disinfected after each use.
new text end
Sec. 20.
new text begin
[142H.20] INFORMATION TO PARENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Policies provided to parents. new text end
new text begin
At the time of a child's enrollment, the
center must provide the parent with written notification of the:
new text end
new text begin
(1) ages and numbers of children the center is licensed to serve;
new text end
new text begin
(2) hours and days of operation;
new text end
new text begin
(3) child care program options the center is licensed to operate, including a description
of the program's educational methods; the program's religious, political, or philosophical
basis, if any; and how parents may review the center's child care program plan;
new text end
new text begin
(4) policy on parent conferences and notification to a parent of a child's intellectual,
physical, social, and emotional development;
new text end
new text begin
(5) policy requiring a health care summary and immunization record of a child;
new text end
new text begin
(6) policies and procedures for the care of children who become sick at the center and
parent notification practices for the onset of or exposure to a contagious illness or condition
pursuant to section 142H.18 or when there is an emergency or injury requiring medical
attention;
new text end
new text begin
(7) policies and procedures for administering first aid and sources of care to be used in
case of emergencies;
new text end
new text begin
(8) policies on the administration of medicine;
new text end
new text begin
(9) procedures for obtaining written parental permission for transportation of children
and field trips as required in section 142H.33, subdivision 4, paragraph (d);
new text end
new text begin
(10) procedures for obtaining written parental consent for research, cameras, and social
media participation pursuant to section 142H.22;
new text end
new text begin
(11) policies on transitioning a child to the next age group, pursuant to section 142H.10;
new text end
new text begin
(12) policies on the provision of meals and snacks;
new text end
new text begin
(13) behavior guidance policies and procedures;
new text end
new text begin
(14) presence of pets;
new text end
new text begin
(15) policy on visitation and parental access to children pursuant to section 142H.21;
new text end
new text begin
(16) policy on the prohibition of smoking, use of tobacco products, vaping, electronic
cigarettes, alcohol, and drugs on the premises of the program pursuant to section 142H.29,
subdivision 11;
new text end
new text begin
(17) policy on use of technology and screen time pursuant to section 142H.11, subdivision
1, clause (12);
new text end
new text begin
(18) telephone number of the Department of Children, Youth, and Families, Division
of Licensing;
new text end
new text begin
(19) policy on naps and rest pursuant to section 142H.12; and
new text end
new text begin
(20) procedures for notifying parents of an evacuation, including procedures for
reunification with families.
new text end
new text begin Subd. 2. new text end
new text begin Parent conferences. new text end
new text begin
The license holder must inform the parent of a child's
progress and:
new text end
new text begin
(1) complete individual assessments of each child's intellectual, physical, social, and
emotional development at least twice a year. Individual assessments for school-age children
must be completed at least once a year;
new text end
new text begin
(2) plan and offer parent conferences by program staff at least twice a year to review
and discuss the child's assessment. Parent conferences for school-age children must be
planned and offered at least once a year; and
new text end
new text begin
(3) maintain documentation of the child's assessment and that individual parent
conferences were planned and offered in each child's record.
new text end
new text begin Subd. 3. new text end
new text begin Daily reports for infants and toddlers. new text end
new text begin
Daily written individualized reports
must be provided to the parent of an infant or toddler about the child's food intake,
elimination, sleeping patterns, and general behavior.
new text end
Sec. 21.
new text begin
[142H.21] PARENT VISITATION AND ACCESS TO PROGRAM.
new text end
new text begin
(a) The center must have a parent visitation and access policy that meets the requirements
of this section at a minimum.
new text end
new text begin
(b) An enrolled child's parent must be allowed access to their child at any time while
the child is in care unless a legal restriction or court order restricts access.
new text end
new text begin
(c) A copy of the order or other legal restriction in paragraph (b) must be kept in the
child's record.
new text end
Sec. 22.
new text begin
[142H.22] CONSENT FOR RESEARCH, CAMERAS, AND SOCIAL MEDIA
PARTICIPATION.
new text end
new text begin Subdivision 1. new text end
new text begin Policy. new text end
new text begin
A center must have and follow a policy governing the center's
use of social media and the use of photos and videos of children in care. The policy must
include:
new text end
new text begin
(1) procedures for obtaining written consent from parents for release of photos and
videos of children for promotional or publicity purposes; and
new text end
new text begin
(2) a statement prohibiting any employee or volunteer from posting content of children
in care or enrolled families on a personal social media account or public digital platform,
including photos, videos, or personal identifying information of the children.
new text end
new text begin Subd. 2. new text end
new text begin Participation in research, fundraising, or public relations projects. new text end
new text begin
(a) The
license holder must obtain written permission from a parent before a child is involved in
research, fundraising, or public relations projects while at the center. A separate written
permission form must be obtained before each occasion of a research, fundraising, or public
relations activity.
new text end
new text begin
(b) The permission form must be maintained in the child's record.
new text end
Sec. 23.
new text begin
[142H.23] EMERGENCY AND ACCIDENT POLICIES AND RECORDS.
new text end
new text begin Subdivision 1. new text end
new text begin Emergency preparedness plan. new text end
new text begin
(a) An applicant must develop a written
plan for emergencies that require evacuation, relocation, sheltering in place, or lockdown
resulting from a fire, blizzard, tornado or other natural disaster, or other threatening situations
that may pose a health or safety hazard to a child, such as an intruder or violence at the
facility. A license holder must carry out the emergency plan during emergencies. The plan
must be written on a form developed by the commissioner and include:
new text end
new text begin
(1) procedures for an evacuation, including building evacuation routes and identification
of primary and secondary exits;
new text end
new text begin
(2) procedures for relocation, including a designated relocation site;
new text end
new text begin
(3) procedures for sheltering in place and lockdown;
new text end
new text begin
(4) procedures for notifying a child's parent of an evacuation, relocation, sheltering in
place, or lockdown, including procedures for reunification with families;
new text end
new text begin
(5) accommodations for a child with a disability or a chronic medical condition;
new text end
new text begin
(6) accommodations for infants and toddlers;
new text end
new text begin
(7) procedures for storing a child's medically necessary medicine that facilitates easy
removal during an evacuation or relocation;
new text end
new text begin
(8) procedures for continuing operations in the period during and after a crisis; and
new text end
new text begin
(9) procedures for communicating with local emergency management officials, law
enforcement officials, or other appropriate state or local authorities.
new text end
new text begin
(b) A license holder must review and update the emergency plan at least once each
calendar year and as needed when changes to the circumstances or facilities necessitate an
updated plan. Documentation of the yearly review and when changes are made must be
maintained in the program's administrative records.
new text end
new text begin
(c) Program staff must be trained on the emergency plan at orientation as specified under
section 142H.09 when changes are made to the plan and at least once each calendar year.
Training must be documented and maintained on site.
new text end
new text begin
(d) A center must have an operable on-site flashlight for use in an emergency situation.
A cell phone may not be used to meet this requirement.
new text end
new text begin
(e) A license holder must conduct fire drills every month and hold tornado drills monthly
from April 1 through September 30. Fire and tornado drills must be documented and include
the date of the drill, the start and end time of the drill, and the name of the program staff
person completing the documentation. Documentation must be maintained in the program's
administrative records.
new text end
new text begin
(f) Primary and secondary exits and evacuation routes must remain unblocked.
new text end
new text begin Subd. 2. new text end
new text begin Emergencies, accidents, incidents, and injuries. new text end
new text begin
(a) The policies and
procedures for emergencies, accidents, incidents, and injuries must include:
new text end
new text begin
(1) procedures for administering first aid;
new text end
new text begin
(2) procedures for the daily inspection of potential hazards;
new text end
new text begin
(3) procedures for fire prevention and procedures to follow in the event of a fire, persons
responsible for the evacuation of children and areas for which they are responsible, instruction
on how to use a fire extinguisher, and instructions on how to close off the fire area;
new text end
new text begin
(4) procedures to follow when a child is missing, including when a school-age child
does not arrive at the center when expected after school;
new text end
new text begin
(5) procedures to follow if a person who is unknown, unauthorized, incapacitated, or
suspected of abuse attempts to pick up a child or if no one comes to pick up a child. The
procedure must include a practice for verifying a person's identity;
new text end
new text begin
(6) procedures for obtaining emergency medical care; and
new text end
new text begin
(7) procedures for recording emergencies, accidents, incidents, and injuries involving a
child enrolled in the center. The written record must include:
new text end
new text begin
(i) the name and age of the child involved;
new text end
new text begin
(ii) the name of employees or volunteers present;
new text end
new text begin
(iii) the date, time, and place of the emergency, accident, incident, or injury;
new text end
new text begin
(iv) the type of injury;
new text end
new text begin
(v) actions taken by staff; and
new text end
new text begin
(vi) to whom the emergency, accident, incident, or injury was reported.
new text end
new text begin
(b) At a minimum, the emergency, accident, incident, or injury must be reported in
writing to the parent and as otherwise required in section 142H.28.
new text end
new text begin
(c) Each calendar year, the license holder must conduct an analysis of the emergencies,
accidents, incidents, and injuries that have been documented pursuant to paragraph (a),
clause (7). Documentation of the yearly analysis and any modification of the center's policies
based on the analysis must be maintained in the program's administrative records.
new text end
new text begin
(d) The license holder must post a facility floor plan in a visible location in each classroom
and other areas in the facility where child care is provided. The posted floor plan in each
area must include:
new text end
new text begin
(1) identification of primary and secondary exits;
new text end
new text begin
(2) building evacuation routes;
new text end
new text begin
(3) identification of tornado shelter and other shelter-in-place locations;
new text end
new text begin
(4) identification of staff positions responsible for the evacuation or sheltering of children;
new text end
new text begin
(5) the name and address of the designated relocation site; and
new text end
new text begin
(6) phone numbers and sources of emergency medical services, the poison control center,
the fire department, and the department's licensing division.
new text end
new text begin
(e) The license holder must ensure program staff are trained on the emergency, accident,
incident, and injury policies and procedures at orientation as required in section 142H.09
when changes are made to the policies and procedures and at least once each calendar year.
Training must be documented and maintained on site.
new text end
Sec. 24.
new text begin
[142H.24] SUPERVISION AND RISK REDUCTION.
new text end
new text begin Subdivision 1. new text end
new text begin Supervision; sight and hearing exceptions. new text end
new text begin
(a) A child is still supervised
as defined in section 142H.01, subdivision 38, when:
new text end
new text begin
(1) an infant is placed in a crib to sleep and a program staff person is within sight or
hearing of the infant pursuant to section 142H.12, subdivision 4;
new text end
new text begin
(2) a single school-age child uses a restroom that is not available to the public when the
child care center is operating and serving children and a program staff person has knowledge
of the child's activity and location and checks on the child at least every five minutes. When
services are provided away from the child care facility, including but not limited to field
trips, a school-age child who uses a restroom that is available to the public must be
accompanied by a program staff person;
new text end
new text begin
(3) a school-age child leaves the classroom but remains within the licensed child care
center space to deliver or retrieve items from the child's personal storage space and a program
staff person has knowledge of the child's activity and location and checks on the child at
least every five minutes; or
new text end
new text begin
(4) a single preschool child uses an individual, private restroom within the classroom
with the door closed and a program staff person has knowledge of the child's activity and
location, can hear the child, and checks on the child at least every five minutes. A shared
restroom between two separate rooms that has a door into each room is not considered an
individual, private restroom for the purposes of this clause.
new text end
new text begin
(b) A program must account for each exception in paragraph (a) in the risk reduction
plan under subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Risk reduction plan. new text end
new text begin
(a) The license holder must develop a risk reduction plan
that identifies the general risks to children served by the child care center in a form and
manner prescribed by the commissioner.
new text end
new text begin
(b) The license holder must establish procedures to minimize identified risks, train staff
on the procedures, and review the procedures each calendar year.
new text end
new text begin
(c) The risk reduction plan must include an assessment of risk to children the center
serves or intends to serve and identify specific risks based on the outcome of the assessment.
The assessment of risk must be composed of:
new text end
new text begin
(1) an assessment of the risks presented by the facility where the licensed services are
provided, including an evaluation of:
new text end
new text begin
(i) the condition and design of the facility and its outdoor space, bathrooms, and storage
areas;
new text end
new text begin
(ii) the accessibility of medications and cleaning products that are harmful to children;
and
new text end
new text begin
(iii) the existence of areas that are difficult to supervise; and
new text end
new text begin
(2) an assessment of the risks presented by the environment for each facility and for
each site, including an evaluation of the type of grounds and terrain surrounding the building
and the proximity to hazards, busy roads, and publicly accessed businesses.
new text end
new text begin
(d) The risk reduction plan must include a statement of measures that will be taken to
minimize the risk of harm presented to children for each risk identified in the assessment
under paragraph (c) related to the facility and environment.
new text end
new text begin
(e) In addition to any program-specific risks identified in paragraph (c), the plan must
include specific policies and procedures that minimize the risk of harm or injury to children,
including from:
new text end
new text begin
(1) closing children's fingers in doors, including cabinet doors;
new text end
new text begin
(2) leaving children in the community without supervision;
new text end
new text begin
(3) children leaving the facility without supervision;
new text end
new text begin
(4) dislocation of children's elbows by program staff pulling or lifting children by the
hands or wrists or swinging by the arms;
new text end
new text begin
(5) burns, including from hot food or beverages, whether served to children or being
consumed by program staff, and devices used to warm food and beverages;
new text end
new text begin
(6) injuries from equipment, such as scissors and glue guns;
new text end
new text begin
(7) sunburn;
new text end
new text begin
(8) feeding children foods to which they are allergic;
new text end
new text begin
(9) children falling from changing tables;
new text end
new text begin
(10) children accessing dangerous items or chemicals or coming into contact with residue
from harmful cleaning products;
new text end
new text begin
(11) traffic and pedestrian accidents, including when walking with children on
neighborhood walks, to an off-site outdoor play area, or in areas with heavy traffic or difficult
terrain such as railroad tracks; and
new text end
new text begin
(12) children choking or suffocating.
new text end
new text begin
(f) The plan must ensure hazardous objects as defined in section 142H.34, subdivision
17, are inaccessible to children.
new text end
new text begin
(g) The plan must include specific policies and procedures to ensure adequate supervision
of children at all times as defined in subdivision 1 and section 142H.01, subdivision 38,
and pursuant to the staffing requirements of section 142H.10, subdivision 1, with particular
emphasis on:
new text end
new text begin
(1) times when children are transitioned from one area within the facility to another,
including the use of a name-to-face check during transition time;
new text end
new text begin
(2) nap-time supervision, including infant sleep supervision;
new text end
new text begin
(3) child arrival and departure times, including when children arrive or depart from the
center by bus;
new text end
new text begin
(4) supervision during outdoor play, outdoor learning activities, and community activities,
including but not limited to field trips and neighborhood walks;
new text end
new text begin
(5) supervision of children in hallways;
new text end
new text begin
(6) supervision of preschool children when using an individual private restroom within
the classroom; and
new text end
new text begin
(7) supervision of school-age children when using the restroom and visiting the child's
personal storage space.
new text end
new text begin Subd. 3. new text end
new text begin Yearly review of risk reduction plan. new text end
new text begin
(a) The license holder must review the
risk reduction plan each calendar year and document the review.
new text end
new text begin
(b) When conducting the review, the license holder must consider incidents that have
occurred in the center since the last review, including:
new text end
new text begin
(1) incidents covered by the assessment factors in subdivision 2;
new text end
new text begin
(2) the internal reviews conducted under section 142H.36, if any;
new text end
new text begin
(3) substantiated maltreatment findings, if any; and
new text end
new text begin
(4) any other incidents that caused injury or harm to a child.
new text end
new text begin
(c) Within ten days following any change to the risk reduction plan, the license holder
must train program staff on the change and document that the staff were trained on the
change.
new text end
Sec. 25.
new text begin
[142H.25] CENTER ADMINISTRATIVE RECORDS.
new text end
new text begin
(a) In addition to the personnel records requirements under section 142B.03, subdivision
1, paragraph (a), a center must maintain the following records:
new text end
new text begin
(1) a record of the information given to parents specified in section 142H.20;
new text end
new text begin
(2) the personnel records specified in section 142H.26;
new text end
new text begin
(3) the children's records specified in section 142H.27;
new text end
new text begin
(4) health consultant reviews of the center's health policies and practices as specified in
section 142H.29, subdivision 2;
new text end
new text begin
(5) the child care program plan specified in section 142H.11;
new text end
new text begin
(6) the emergencies, accidents, incidents, and injuries records specified in section
142H.23, subdivision 2;
new text end
new text begin
(7) the child separation reports mandated in section 142H.13;
new text end
new text begin
(8) daily center and classroom attendance records specified in section 142H.30; and
new text end
new text begin
(9) staffing schedules.
new text end
new text begin
(b) The requirements in section 142B.03, subdivisions 1 and 2, apply to records retained
pursuant to this section.
new text end
Sec. 26.
new text begin
[142H.26] PERSONNEL RECORDS.
new text end
new text begin
A license holder must maintain a current personnel record for each program staff person
in a manner prescribed by the commissioner and consistent with section 142B.03. The
personnel record for each program staff person must contain:
new text end
new text begin
(1) the program staff person's name, home address, telephone number, date of birth, and
emergency contact information;
new text end
new text begin
(2) the program staff person's first date of direct contact and first date of unsupervised
direct contact with a child;
new text end
new text begin
(3) documentation indicating that the program staff person meets the requirements of
the staff person's job in sections 142H.05 to 142H.08; and
new text end
new text begin
(4) the program staff person's hire date and last day of employment, as applicable.
new text end
Sec. 27.
new text begin
[142H.27] CHILDREN'S RECORDS.
new text end
new text begin Subdivision 1. new text end
new text begin Requirements. new text end
new text begin
Prior to or on the day of enrollment in the center, the
license holder must maintain a record on site for each child served by the program. The
record must contain:
new text end
new text begin
(1) the child's full name, date of birth, and current home address;
new text end
new text begin
(2) the child's date of enrollment in the program;
new text end
new text begin
(3) the name, address, and telephone number of the child's parent;
new text end
new text begin
(4) the name and telephone number of at least one emergency contact person who can
be contacted if a parent cannot be reached in an emergency or when there is an injury
requiring medical attention;
new text end
new text begin
(5) the names and telephone numbers of any additional persons authorized by the parent
to pick up the child from the center;
new text end
new text begin
(6) the child's health and immunization information required by section 142H.29,
subdivisions 3 and 4;
new text end
new text begin
(7) written authorization for the license holder to act in an emergency or when a parent
or designee cannot be reached or is delayed;
new text end
new text begin
(8) the hours and days of the week the child will attend the center;
new text end
new text begin
(9) for infants and toddlers, a description of the child's eating, sleeping, toileting, and
communication habits and effective methods for comforting the child;
new text end
new text begin
(10) documentation of any dietary or medical needs of the child;
new text end
new text begin
(11) documentation of a child's individual child care program plan as required by section
142H.15; and
new text end
new text begin
(12) the date of parent conferences and a summary of the information provided to the
parent at the conferences.
new text end
new text begin Subd. 2. new text end
new text begin Disclosure. new text end
new text begin
The license holder must not disclose a child's record to any person
other than the child, the child's parent, the child's legal representative, employees of the
license holder, or the commissioner unless the child's parent has given written consent. This
subdivision does not apply to information needed by a first responder in the case of an
emergency.
new text end
Sec. 28.
new text begin
[142H.28] REPORTING REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Maltreatment, abuse, and neglect reporting. new text end
new text begin
The license holder must
comply with the reporting requirements for abuse and neglect specified in chapter 260E.
new text end
new text begin Subd. 2. new text end
new text begin Other reporting. new text end
new text begin
Within 24 hours, the license holder must notify the
commissioner of the following in a manner prescribed by the commissioner:
new text end
new text begin
(1) of the death or notification of the death of a child enrolled in the center as required
under section 142B.10, subdivision 24;
new text end
new text begin
(2) of the occurrence or notification of any injury to a child in care in the program that
required treatment by a dentist or health care provider as defined in section 142H.01,
subdivision 22. Treatment does not include application of or recommendation to use
nonprescription medication or diagnostic testing;
new text end
new text begin
(3) of the occurrence of structural damage to the building or a fire that requires the
service of a fire department; and
new text end
new text begin
(4) of the provision of any emergency medical service to a child while in care.
new text end
Sec. 29.
new text begin
[142H.29] HEALTH.
new text end
new text begin Subdivision 1. new text end
new text begin Health policies. new text end
new text begin
An applicant must develop written health policies
approved by the commissioner.
new text end
new text begin Subd. 2. new text end
new text begin Health consultation. new text end
new text begin
(a) The center must have a health consultant as defined
in section 142H.01, subdivision 23, review the center's health policies and practices in
person and certify that the policies and practices are adequate to protect the health of children
in care.
new text end
new text begin
(b) The health consultant's review, including an on-site visit, must be done before initial
licensure and must be repeated each calendar year.
new text end
new text begin
(c) For programs serving infants, an in-person review must be done before initial licensure
and at least quarterly thereafter. At least every other quarter, a health consultant may conduct
the health review visit virtually.
new text end
new text begin
(d) A health consultant must review the center's health policies and practices before
implementing a change in the center's health policies or practices and after an outbreak of
a contagious reportable illness as specified in Minnesota Rules, parts 4605.7040, 4605.7050,
and 4605.7080.
new text end
new text begin
(e) The consultant must review and approve:
new text end
new text begin
(1) the emergencies, accidents, incidents, and injuries policies and procedures required
by section 142H.23, subdivision 2;
new text end
new text begin
(2) the diapering procedures and practices specified in subdivision 6;
new text end
new text begin
(3) the programs' cleaning and disinfecting products and procedures; and
new text end
new text begin
(4) the sanitation procedures and practices for food catered in or provided by the child's
parent as specified in section 142H.32, subdivision 6, and for infants as specified in section
142H.32, subdivision 11.
new text end
new text begin Subd. 3. new text end
new text begin Health information at admission. new text end
new text begin
Before a child is admitted to a center or
within 30 days of admission, the license holder must obtain a report on a current physical
examination of the child signed by the child's health care provider.
new text end
new text begin Subd. 4. new text end
new text begin Immunizations. new text end
new text begin
(a) Before a child is admitted to a center, the license holder
must obtain documentation of current immunization records according to section 121A.15
and Minnesota Rules, chapter 4604; a signed notarized statement of parental objection to
the immunization; or a medical exemption. The license holder must maintain record of
current immunizations, a signed notarized statement of parental objection to the
immunization, or a medical exemption throughout the child's enrollment at the center.
new text end
new text begin
(b) License holders must file an immunization report each calendar year with the
Department of Health, as required under the Minnesota School and Child Care Immunization
Law, section 121A.15, subdivision 8, and Minnesota Rules, part 4604.0410.
new text end
new text begin Subd. 5. new text end
new text begin Administration of medication. new text end
new text begin
(a) A license holder that administers medication
must:
new text end
new text begin
(1) get written permission from the child's parent before administering medication;
new text end
new text begin
(2) get written permission from the child's parent before administering items that may
be applied externally, including but not limited to diapering products, sunscreen lotions,
hand sanitizer, lip balm, body lotion, and insect repellents. Items under this clause must be
administered according to the manufacturer's instructions unless a dentist or health care
provider gives alternative written instructions;
new text end
new text begin
(3) get and follow written instructions from a dentist or a health care provider before
administering each prescription. Medication with the child's name and current prescription
information on the label constitutes instructions;
new text end
new text begin
(4) follow written dosage instructions from a child's parent or health care provider for
over-the-counter medication that is intended to be ingested and does not include dosage
information within the manufacturer's instructions;
new text end
new text begin
(5) keep all medication in its original container and have a legible label stating the child's
first and last name. The medication must be given only to the child whose name is on the
label, unless as described in paragraph (b);
new text end
new text begin
(6) not give medication after an expiration date on the label, return any unused portion
to the child's parent if possible, and destroy any unused portion that cannot be returned;
new text end
new text begin
(7) document the administration of any ingested nonprescription medication and all
prescription medication. The documentation must include the first and last name of the
child, name of the medication or prescription number, date, time, dosage, and printed name
and signature or initials of the person who administered the medication. This documentation
must be available to the parent and maintained in the child's record;
new text end
new text begin
(8) store all medications, insect repellents, sunscreen lotions, and diaper rash control
products according to directions on the original container and in a place inaccessible to
children; and
new text end
new text begin
(9) not use herbal remedies and essential oils, unless prescribed or recommended by a
dentist or a health care provider. If these are administered, they must be administered in
compliance with the requirements of this subdivision.
new text end
new text begin
(b) Sunscreen lotions and insect repellents supplied by the license holder may be used
on more than one child and must be labeled for use for all children. A product to control or
prevent diaper rash, including premoistened commercial wipes that cannot be dispensed in
a manner that prevents cross contamination of the product and container as determined by
the health consultant, must be labeled with the child's first and last name and used only for
the individual child whose name is written on the label.
new text end
new text begin Subd. 6. new text end
new text begin Diapers, changing areas, and disposal. new text end
new text begin
Sanitary diaper procedures must be
used to reduce the spread of communicable disease. A license holder must:
new text end
new text begin
(1) make an adequate supply of clean diapers available for each child and store the
diapers in a clean place;
new text end
new text begin
(2) change diapers following the diaper changing procedure reviewed and approved by
the center's health consultant pursuant to subdivision 2, paragraph (e), clause (2);
new text end
new text begin
(3) post diaper changing procedures reviewed and certified by the center's health
consultant in the diaper changing area;
new text end
new text begin
(4) keep children in diapers clean and dry. Diapers and clothing must be changed
immediately or as soon as practicable when wet or soiled. Soiled clothing must be placed
in a plastic bag and sent home with the parent daily;
new text end
new text begin
(5) use single-service wipes for cleaning a wet or soiled child;
new text end
new text begin
(6) clean and disinfect changing tables and changing pads between children;
new text end
new text begin
(7) use smooth, nonabsorbent surfaces for the diaper changing area and flooring;
new text end
new text begin
(8) require the program staff person to maintain a hand on the child at all times during
diapering. Children must not be left unattended on the changing table;
new text end
new text begin
(9) clean and disinfect diaper changing areas, including but not limited to counters, sinks,
and floors, daily or immediately when soiled;
new text end
new text begin
(10) keep a covered diaper disposal receptacle lined with a disposable plastic bag in the
diaper changing area. Diapers cannot be disposed of in a kitchen disposal area;
new text end
new text begin
(11) empty, clean, and disinfect diaper receptacles daily or more often as needed; and
new text end
new text begin
(12) only change a diaper in the diaper changing area. The diaper changing area must
be separate from areas used for food storage, food preparation, and eating.
new text end
new text begin Subd. 7. new text end
new text begin Hand washing; child. new text end
new text begin
(a) A child's hands must be washed with soap and water
after a diaper change, after use of a toilet or toilet training chair, and immediately before
eating a meal or snack.
new text end
new text begin
(b) Program staff must monitor hand washing and assist a child who needs help.
new text end
new text begin
(c) The use of a common basin or a hand sink filled with standing water is prohibited.
new text end
new text begin
(d) Hands must be dried on a single-use towel or warm air hand dryer. The use of a
common or shared cloth or towel is prohibited.
new text end
new text begin
(e) In sinks accessible to children, the water temperature must not exceed 120 degrees
Fahrenheit to prevent children from scalding themselves while washing.
new text end
new text begin
(f) A hand sanitizer with at least 60 percent alcohol may be used to clean a child's hands
when soap and water are unavailable.
new text end
new text begin Subd. 8. new text end
new text begin Hand washing; program staff. new text end
new text begin
Program staff must wash their hands with soap
and water after changing a child's diaper, after assisting a child on the toilet, after washing
the diapering surface, after using toilet facilities, and before handling food or eating. Hands
must be dried on a single-use towel or warm air hand dryer. The use of a common or shared
cloth or towel is prohibited. Program staff may use a hand sanitizer with at least 60 percent
alcohol when soap and water are unavailable.
new text end
new text begin Subd. 9. new text end
new text begin First aid kit. new text end
new text begin
The license holder must have a first aid kit that is accessible in
the center at all times and whenever children are off site that includes:
new text end
new text begin
(1) adhesive bandages in assorted sizes and tape;
new text end
new text begin
(2) sterile compresses;
new text end
new text begin
(3) elastic bandage wrap;
new text end
new text begin
(4) scissors;
new text end
new text begin
(5) ice bag or cold pack;
new text end
new text begin
(6) digital thermometer;
new text end
new text begin
(7) mild liquid soap or hand sanitizer that is at least 60 percent alcohol;
new text end
new text begin
(8) bottled water;
new text end
new text begin
(9) disposable powder-free, latex-free gloves;
new text end
new text begin
(10) face shield or protective barrier for giving CPR; and
new text end
new text begin
(11) first aid instructions.
new text end
new text begin Subd. 10. new text end
new text begin Handling and disposal of bodily fluids. new text end
new text begin
A license holder must comply with
the following procedures for safely handling and disposing of bodily fluids:
new text end
new text begin
(1) surfaces that come in contact with urine, feces, vomit, and blood must be cleaned
and disinfected;
new text end
new text begin
(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
new text end
new text begin
(3) sharp items used for a child with special care needs must be disposed of in a sharps
container. The sharps container must be inaccessible to a child when stored;
new text end
new text begin
(4) the license holder must have bodily fluid disposal supplies in the center, including
disposable gloves, disposal bags, and eye protection; and
new text end
new text begin
(5) each employee and volunteer must follow universal precautions to reduce the risk
of spreading infectious disease.
new text end
new text begin Subd. 11. new text end
new text begin Tobacco products, vaping, drugs, and alcohol use prohibitions. new text end
new text begin
(a) A
license holder must comply with the drug and alcohol policy requirements in section 142B.10,
subdivision 1, paragraph (c), including ensuring that no employee, subcontractor, or volunteer
is under the influence of a chemical that impairs the individual's ability to provide services
or care.
new text end
new text begin
(b) The possession or use of marijuana, products containing THC, alcohol, and illegal
drugs is prohibited on the premises of the program during operating hours, including all
indoor and outdoor licensed program environments and in any vehicles used by the program.
new text end
new text begin
(c) The use of tobacco products, vaping devices, and electronic cigarettes is prohibited
indoors, in vehicles used by the program, and in outdoor areas where children are present.
new text end
new text begin
(d) The license holder must post in a prominent location at the main entrance of the
center a notice stating that use of tobacco products is prohibited inside the building and in
outdoor areas where children are present.
new text end
Sec. 30.
new text begin
[142H.30] ATTENDANCE RECORDS.
new text end
new text begin Subdivision 1. new text end
new text begin Attendance records. new text end
new text begin
A child care center must maintain documentation
of actual attendance for each child receiving care. The records must be accessible to the
commissioner during the program's hours of operation, be completed on the actual day of
attendance, and include:
new text end
new text begin
(1) the first and last name of the child;
new text end
new text begin
(2) the time of day that the child was dropped off; and
new text end
new text begin
(3) the time of day that the child was picked up.
new text end
new text begin Subd. 2. new text end
new text begin Daily classroom tracking. new text end
new text begin
(a) A license holder must ensure that program staff
track children in their classroom on a daily basis to ensure the center has an active roster
of children present in their classroom.
new text end
new text begin
(b) Children must be tracked as they arrive in and depart from the classroom.
new text end
new text begin
(c) Tracking must include the first and last name of each child.
new text end
new text begin
(d) The classroom tracking documentation must remain with each group at all times
throughout the day including outdoor play, emergency evacuations, field trips, and when
groups are combined.
new text end
Sec. 31.
new text begin
[142H.31] CLEANING, SANITIZING, AND DISINFECTING.
new text end
new text begin Subdivision 1. new text end
new text begin Products and procedures. new text end
new text begin
Cleaning and disinfecting must be done in
accordance with policies, procedures, and products approved by the program's health
consultant as specified in section 142H.29, subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Indoor and outdoor equipment. new text end
new text begin
(a) The indoor and outdoor space and
equipment of the program must be clean.
new text end
new text begin
(b) Natural elements and materials used as equipment and play materials under section
142H.14, subdivision 4; natural features used for outdoor play under section 142H.34,
subdivision 7, paragraph (h); and play materials used in outdoor settings are exempt from
being clean, as defined under section 142H.01, subdivision 12. A program staff person must
inspect natural elements and materials, natural features, and play materials used for outdoor
play for hazardous objects and other safety hazards, including animal feces, and remove or
mitigate the hazard before a child's use.
new text end
new text begin Subd. 3. new text end
new text begin Pacifiers. new text end
new text begin
Pacifiers must be labeled with each child's name or other individual
identifier and stored separately.
new text end
new text begin Subd. 4. new text end
new text begin Cleaning frequency. new text end
new text begin
The license holder must develop and follow a cleaning
schedule that requires:
new text end
new text begin
(1) cleaning and sanitizing food preparation areas, tables, high chairs, and food service
counters before and after each meal and snack. Sanitizing must be done by using an
Environmental Protection Agency-registered sanitizer or a bleach solution or by heating to
temperatures sufficient to destroy most germs, pursuant to guidelines from the commissioner
of health on infectious diseases in child care settings;
new text end
new text begin
(2) cleaning and sanitizing items that have been inside a child's mouth or come into
contact with bodily fluids prior to being used by another child;
new text end
new text begin
(3) cleaning sleeping equipment and bedding, including:
new text end
new text begin
(i) washing bedding used by a child before being used by another child;
new text end
new text begin
(ii) washing bedding used by the same child weekly or when soiled;
new text end
new text begin
(iii) cleaning and disinfecting sleeping equipment used by a child before being used by
another child; and
new text end
new text begin
(iv) cleaning and disinfecting sleeping equipment used by the same child weekly or
when soiled;
new text end
new text begin
(4) cleaning toileting areas daily, including:
new text end
new text begin
(i) emptying and disinfecting toilet training chairs after each use; and
new text end
new text begin
(ii) disinfecting toilets and seats when soiled or at least daily; and
new text end
new text begin
(5) emptying garbage cans and diaper receptacles on a daily basis and cleaning and
disinfecting the cans and receptacles as needed.
new text end
Sec. 32.
new text begin
[142H.32] FOOD, DRINKING WATER, AND NUTRITION.
new text end
new text begin Subdivision 1. new text end
new text begin On-site food preparation. new text end
new text begin
A license holder that prepares, handles, or
serves food or washes food, utensils, or equipment on site must comply with applicable
requirements for food and beverage service establishments in chapter 157 and Minnesota
Rules, chapter 4626, and local health department requirements.
new text end
new text begin Subd. 2. new text end
new text begin Off-site food preparation. new text end
new text begin
(a) Meals or snacks may be provided by an off-site,
licensed food and beverage service establishment.
new text end
new text begin
(b) The center must maintain on file a copy of the off-site food and beverage service
establishment's current license and the contract to provide food for the center.
new text end
new text begin Subd. 3. new text end
new text begin Providing food. new text end
new text begin
A license holder must provide meals and snacks to the children
in attendance. The license holder must supplement food provided by the parent if it does
not meet United States Department of Agriculture Child and Adult Care Food Program
(CACFP) nutritional requirements.
new text end
new text begin Subd. 4. new text end
new text begin Drinking water. new text end
new text begin
(a) The center must have a safe supply of drinking water
pursuant to section 142H.35.
new text end
new text begin
(b) Drinking water must be available to children throughout the hours of operation and
offered at frequent intervals. Drinking water for children must be provided in single-service
drinking cups, in reusable water bottles, in reusable cups, or from drinking fountains
accessible to children.
new text end
new text begin
(c) A license holder may provide drinking water to a child in a reusable water bottle or
reusable cup if the center develops and ensures implementation of a written policy that at
a minimum includes the following procedures:
new text end
new text begin
(1) each day the water bottle or cup is used, the license holder must clean the water bottle
or cup or allow the child's parent to bring the water bottle or cup home to clean it;
new text end
new text begin
(2) a water bottle or cup must be assigned to a specific child and labeled with the child's
first and last name;
new text end
new text begin
(3) water bottles and cups must be stored in a manner that reduces the risk of a child
using the wrong water bottle or cup; and
new text end
new text begin
(4) a water bottle or cup must be used only for water.
new text end
new text begin Subd. 5. new text end
new text begin Menus. new text end
new text begin
The license holder must ensure:
new text end
new text begin
(1) meals and snacks prepared or provided by the license holder or catered by a licensed
food and beverage caterer comply with the meal pattern and nutritional requirements
contained in the most current edition of the CACFP standards in Code of Federal Regulations,
title 7, section 226.20;
new text end
new text begin
(2) menus comply with the meal pattern and nutritional requirements contained in the
most current edition of the CACFP standards in Code of Federal Regulations, title 7, section
226.20;
new text end
new text begin
(3) the current menu is posted or made readily available to parents; and
new text end
new text begin
(4) any food substitutions are noted on the menu at the time of the change.
new text end
new text begin Subd. 6. new text end
new text begin Sanitation. new text end
new text begin
(a) Procedures for preparing, handling, storing, and serving food
and washing food, utensils, and equipment must comply with the requirements for food and
beverage establishments in Minnesota Rules, chapter 4626.
new text end
new text begin
(b) If the food is prepared off site by another facility or if food service is provided
according to a contract with a food service provider, the facility or license holder must
ensure that food is prepared in compliance with Minnesota Rules, chapter 4626.
new text end
new text begin
(c) The license holder must provide refrigeration for dairy products and other perishable
foods, whether supplied by the license holder or supplied by the parent. The refrigeration
must have a temperature of 41 degrees Fahrenheit or less.
new text end
new text begin Subd. 7. new text end
new text begin Meals and snacks. new text end
new text begin
Except for infants under subdivision 11, the license holder
must serve meals and snacks to children as follows:
new text end
new text begin
(1) one snack for a child in attendance for two to five hours;
new text end
new text begin
(2) one meal and two snacks or two meals and one snack for a child in attendance for
five to ten hours;
new text end
new text begin
(3) a minimum of two meals and two snacks for a child in attendance for more than ten
hours; and
new text end
new text begin
(4) a minimum of three meals and two snacks for a child in attendance for more than 14
hours.
new text end
new text begin Subd. 8. new text end
new text begin Prescribed diet requirements. new text end
new text begin
(a) If a child is unable to follow the CACFP
meal pattern requirements due to a diet-related medical condition, a prescribed diet
accommodation is required.
new text end
new text begin
(b) The license holder must obtain documentation from the child's health care provider
about the child's special dietary needs and keep that information current. The license holder
must use this information to accommodate the child's dietary needs.
new text end
new text begin
(c) When a license holder enrolls a child who requires a prescribed diet, the license
holder must ensure that an individual child care program plan is developed and maintained
in the child's record, pursuant to sections 142H.15, subdivision 3, and 142H.27.
new text end
new text begin
(d) The license holder must provide for a child's prescribed dietary needs or require the
parent to provide the prescribed diet items that are not part of the center's menu plan.
new text end
new text begin Subd. 9. new text end
new text begin Cultural or religious diet accommodations. new text end
new text begin
(a) When special diets are
requested for cultural or religious reasons, the center must obtain written, dated, and signed
instructions from the child's parent on how to accommodate the diet.
new text end
new text begin
(b) The license holder must provide for a child's special diet for cultural or religious
reasons or require the parent to provide the food items that are not part of the center's menu
plan.
new text end
new text begin Subd. 10. new text end
new text begin Food allergy information. new text end
new text begin
Information about food allergies of the children
in the center must follow the requirements in section 142H.15, subdivision 5.
new text end
new text begin Subd. 11. new text end
new text begin Infant food and feeding schedule. new text end
new text begin
The diet and feeding schedule of an infant
must be determined by the infant's parent. The license holder of a center serving infants
must:
new text end
new text begin
(1) obtain written dietary instructions from the parent of the child that are used to develop
the infant's feeding schedule and are updated as needed as the child's feeding needs change;
new text end
new text begin
(2) have each individual infant's feeding schedule available in the food preparation area;
new text end
new text begin
(3) offer the child formula or milk and nutritionally adequate solid foods in quantities
at specified time intervals as determined by the parent;
new text end
new text begin
(4) ensure infants are held or fed sitting up for bottled feedings. A bottle must not be
propped at any time for an infant or fed to an infant in a crib, infant seat, or playpen;
new text end
new text begin
(5) use sanitary procedures and practices to prepare, handle, and store formula, milk,
breast milk, solid foods, and supplements, including having procedures to ensure bottles
are matched to the correct infant. Procedures must be reviewed and certified by a health
consultant;
new text end
new text begin
(6) not warm or heat bottles in a microwave;
new text end
new text begin
(7) not allow children access to bottle-warming devices; and
new text end
new text begin
(8) label all bottles, breast milk, or prepared parent-provided food with the child's first
and last name and date of preparation. All formula must be refrigerated immediately after
preparation or upon arrival if the formula is prepared by the parent.
new text end
new text begin Subd. 12. new text end
new text begin Additional requirements. new text end
new text begin
(a) The center must serve food that is not a choking
hazard and that is developmentally appropriate in size, amount, and texture.
new text end
new text begin
(b) Program staff must be seated with the children during meal and snack times.
new text end
Sec. 33.
new text begin
[142H.33] TRANSPORTATION AND FIELD TRIP REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Requirements. new text end
new text begin
A license holder that provides transportation for children
or that takes children off site must comply with the requirements in this section.
new text end
new text begin Subd. 2. new text end
new text begin Driver requirements. new text end
new text begin
(a) A driver who transports children for a license holder
must:
new text end
new text begin
(1) be at least 18 years old;
new text end
new text begin
(2) hold a current and valid driver's license appropriate to the vehicle used to transport
children;
new text end
new text begin
(3) have a copy of the driver's current driver's license on file at the center;
new text end
new text begin
(4) be free from the influence of any substance that could impair driving abilities; and
new text end
new text begin
(5) follow seat belt and child passenger restraint system requirements under sections
169.685 and 169.686.
new text end
new text begin
(b) Parents who are not employed by the center who use personal vehicles for
transportation to occasional field trips do not have to meet the requirements of paragraph
(a), clause (3). For the purposes of this subdivision, "occasional" means three or fewer times
per calendar year.
new text end
new text begin Subd. 3. new text end
new text begin Requirements during transportation. new text end
new text begin
(a) One program staff is required per
vehicle when transporting school-age children. Two program staff are required per vehicle
when transporting infants, toddlers, and preschoolers. An additional program staff person
is required in the vehicle if there are 12 or more infants and toddlers. The driver of the
vehicle is considered a program staff person, unless the driver is employed by a contractor
or third party.
new text end
new text begin
(b) A two-way communication system and first aid kit must be present in the vehicle
during transportation.
new text end
new text begin
(c) Once children have exited, the vehicle must be checked to ensure that no child has
been left in the vehicle.
new text end
new text begin
(d) When the license holder provides transportation to and from the center, children
must not be transported more than one hour per one-way trip.
new text end
new text begin
(e) When children board or exit the vehicle, the license holder must ensure that each
child safely boards and exits the vehicle from the curb side of the street whenever physically
possible and out of the path of moving vehicles.
new text end
new text begin
(f) Drop off or pick up must be conducted in a safe manner with supervision by the
program staff responsible for the child.
new text end
new text begin Subd. 4. new text end
new text begin Field trip requirements. new text end
new text begin
(a) For the purposes of this section, a field trip is
defined as any time the center takes children off the property, including routine outings
such as walking around the neighborhood. A center providing transportation for children
to and from the center is not considered a field trip.
new text end
new text begin
(b) Staff-to-child ratios must be maintained on all field trips.
new text end
new text begin
(c) Written permission must be obtained from each child's parent before taking a child
on a field trip. The written permission form must be obtained before each field trip or on a
form that yearly summarizes all field trips that will be taken. The permission forms must
be kept on file at the center.
new text end
new text begin
(d) The parent's written permission form must include:
new text end
new text begin
(1) the date and destination of the field trip;
new text end
new text begin
(2) the times of departure from and return to the facility;
new text end
new text begin
(3) the method of transportation; and
new text end
new text begin
(4) if the method of transportation is walking, an estimated total distance of the walk.
new text end
new text begin
(e) Unscheduled neighborhood walks may be taken, provided the program has obtained
advance written parental permission for the general plan for neighborhood walks.
new text end
new text begin
(f) A child care program that includes daily or regular off-site outdoor activities in its
child care program plan may use an annual permission form for these activities. Parents
must be informed of specific destinations and any substantial changes to the general plan
outlined in the annual permission form through the child care program's regular
communication methods. The annual permission form must include the following
information:
new text end
new text begin
(1) the general geographic area or areas where the off-site outdoor activities will occur;
new text end
new text begin
(2) the general hours during which off-site activities may occur;
new text end
new text begin
(3) the typical method of transportation; and
new text end
new text begin
(4) the typical maximum distance of walks, if the method of transportation is walking.
new text end
new text begin
(g) When centers take children on a walk or field trip, program staff must bring:
new text end
new text begin
(1) a first aid kit as required under section 142H.29, subdivision 9;
new text end
new text begin
(2) a child's allergy information as required under section 142H.15, including the
individual child care program plan;
new text end
new text begin
(3) the name and telephone number of each child's parent and at least one emergency
contact person;
new text end
new text begin
(4) medication and supplies needed for a child who has a health condition that could
need medication, special procedures, or precautions during the course of the trip; and
new text end
new text begin
(5) a working cell phone or other means of immediate communication.
new text end
Sec. 34.
new text begin
[142H.34] FACILITY.
new text end
new text begin Subdivision 1. new text end
new text begin Occupancy designation. new text end
new text begin
(a) At initial licensure, an applicant must
demonstrate compliance with the standards specified by the State Building Code and any
applicable local building ordinances.
new text end
new text begin
(b) Prior to the child care facility being remodeled, substantially improved, renovated,
or reconstructed, the license holder must verify whether approval from the applicable state
or local building officials is needed. If needed, the license holder must obtain written
verification of compliance with the State Building Code and any applicable local building
ordinances.
new text end
new text begin Subd. 2. new text end
new text begin Fire inspection. new text end
new text begin
(a) The center must be inspected by a fire marshal within 12
months prior to initial licensure. The commissioner must not grant an initial license until
receiving written approval of compliance with the State Fire Code from the fire marshal
with jurisdiction.
new text end
new text begin
(b) The center must have a fire inspection at least once every five calendar years from
the date of the last fire inspection report. The fire inspection must include written approval
of compliance with the State Fire Code from the fire marshal with jurisdiction.
new text end
new text begin
(c) Prior to the use of any areas of the structure not previously inspected and approved
for child care use, the center must:
new text end
new text begin
(1) receive written confirmation from the state fire marshal that approval from the state
fire marshal is not needed; or
new text end
new text begin
(2) conduct a fire inspection, which must include written approval of compliance with
the State Fire Code from the fire marshal with jurisdiction.
new text end
new text begin
(d) For centers holding a valid license as of July 1, 2027:
new text end
new text begin
(1) centers initially licensed before January 1, 1998, must meet the requirement under
paragraph (b) no later than July 1, 2029;
new text end
new text begin
(2) centers initially licensed on or after January 1, 1998, but before January 1, 2013,
must meet the requirement under paragraph (b) no later than July 1, 2030;
new text end
new text begin
(3) centers initially licensed on or after January 1, 2013, but before January 1, 2021,
must meet the requirement under paragraph (b) no later than July 1, 2031; and
new text end
new text begin
(4) centers initially licensed on or after January 1, 2021, must meet the requirement
under paragraph (b) no later than July 1, 2032.
new text end
new text begin
(e) Centers that have already completed a fire inspection within five years of July 1,
2027, are exempt from paragraph (d).
new text end
new text begin Subd. 3. new text end
new text begin Reinspection for cause. new text end
new text begin
If the commissioner has reasonable cause to believe
that a potential hazard exists or the license holder is operating out of compliance with
applicable codes, the commissioner may request another inspection and written report by
a fire marshal, building official, or health authority.
new text end
new text begin Subd. 4. new text end
new text begin Facility floor plan and designated areas. new text end
new text begin
(a) Indoor and outdoor space to be
used for child care must be designated on a facility floor plan.
new text end
new text begin
(b) Space designated on a facility floor plan must be exclusively used for child care by
the center during the hours of operation.
new text end
new text begin
(c) The initial application for licensure and the center's administrative record must contain
a floor plan of the center. Precise scale drawings are not required. The plan must indicate:
new text end
new text begin
(1) the dimensions and location of all areas of the center designated for the provision of
child care including planned use of each area; and
new text end
new text begin
(2) the size and location of areas used for outdoor activity.
new text end
new text begin Subd. 5. new text end
new text begin Child's personal storage space. new text end
new text begin
A center must have storage space for each
child's clothing and personal belongings. The space must be at a height appropriate for the
age of the child.
new text end
new text begin Subd. 6. new text end
new text begin Space for children who become sick. new text end
new text begin
(a) Space must be provided in the center
for a child who becomes sick at a center not licensed to operate a sick care program under
section 142H.19.
new text end
new text begin
(b) The space must be separate from activity areas used by other children but may still
be within the classroom.
new text end
new text begin
(c) A cot, mat, or crib and blanket must be provided as appropriate to the developmental
level of the child.
new text end
new text begin
(d) The space must be supervised by a program staff person when occupied by a sick
child.
new text end
new text begin Subd. 7. new text end
new text begin Outdoor learning environment and play space. new text end
new text begin
(a) A center must provide
or have available an outdoor activity area that complies with this subdivision unless licensed
to exclusively provide night care as specified under section 142H.16, licensed to provide
drop-in care as specified under section 142H.17, licensed to provide sick care as specified
under section 142H.19, or operating for fewer than three hours a day.
new text end
new text begin
(b) A center must have an outdoor activity area of at least 1,500 square feet, and there
must be at least 75 square feet of space per child within the outdoor play area at any given
time during use.
new text end
new text begin
(c) The outdoor activity area must be enclosed if it is located adjacent to a hazard,
including but not limited to traffic, rail, water, or machinery, unless the area is a public park
or playground.
new text end
new text begin
(d) An outdoor activity area used daily by children under school age must be within
2,000 feet of the center or transportation must be provided by the license holder. The outdoor
activity area must not be farther than one-half mile from the center.
new text end
new text begin
(e) The area must contain the outdoor equipment required under section 142H.14.
new text end
new text begin
(f) The play area must be free of potential hazards, including but not limited to broken
glass, toxic materials, machinery, unlocked vehicles, feces, and sewage contaminants.
new text end
new text begin
(g) An energy-absorbing surface is required under installed climbing equipment, swings,
and slides. An energy-absorbing surface can be loose sand, pea gravel, or mulch in a depth
of at least nine inches; any material that meets ASTM F1292 specifications; or shredded
rubber and poured energy-absorbing surfacing installed to manufacturer's specifications
based on the height of the equipment. A fall zone is required around the equipment.
new text end
new text begin
(h) Natural features used for outdoor play that are not installed as equipment are not
subject to the requirements of paragraph (g). When a child uses natural features for outdoor
play, a program staff person must remove hazardous objects as specified in subdivision 17
and mitigate hazards whenever possible from the surrounding area where children might
fall. Natural features used for outdoor play must be appropriate to the age and size of children,
in safe condition, and used under the supervision of a program staff person.
new text end
new text begin Subd. 8. new text end
new text begin Indoor space. new text end
new text begin
A center must have a minimum of 35 square feet of indoor space
available per child in attendance. Hallways, stairways, closets, utility rooms, restrooms,
kitchens, and space occupied by cribs are not indoor space for the purposes of this
subdivision. Twenty-five percent of the space occupied by furniture or equipment used by
staff or children may be counted as indoor space.
new text end
new text begin Subd. 9. new text end
new text begin Shielding of hot surfaces. new text end
new text begin
Heating appliances must be installed and maintained
in accordance with the manufacturer's instruction and the State Building Code. Radiators,
fireplaces, hot pipes, and other hot surfaces in areas used by children must be shielded or
insulated to prevent burns.
new text end
new text begin Subd. 10. new text end
new text begin Electrical outlets. new text end
new text begin
Except in a center that serves only school-age children,
electrical outlets must be tamper proof or shielded when not in use.
new text end
new text begin Subd. 11. new text end
new text begin Water hazards. new text end
new text begin
Bodies of water within or adjacent to the center must be
inaccessible to children. When using a pool or beach, children must be supervised at all
times.
new text end
new text begin Subd. 12. new text end
new text begin Room temperature. new text end
new text begin
An indoor temperature of 68 degrees Fahrenheit to 82
degrees Fahrenheit must be maintained in all rooms used by children.
new text end
new text begin Subd. 13. new text end
new text begin Hazardous areas. new text end
new text begin
Kitchens, stairs, and other hazardous areas must be
inaccessible to children except during periods of supervised use.
new text end
new text begin Subd. 14. new text end
new text begin Fire extinguisher inspection. new text end
new text begin
Fire extinguishers must be serviced by a qualified
inspector at least once every 365 days. The name of the inspector and date of the inspection
must be written on a tag attached to the extinguisher.
new text end
new text begin Subd. 15. new text end
new text begin Toilet articles. new text end
new text begin
As needed, a license holder must provide and make available
toilet paper, liquid hand soap, facial tissues, and single-use paper towels or warm air hand
dryers.
new text end
new text begin Subd. 16. new text end
new text begin Toilets and hand sinks. new text end
new text begin
(a) The center must have at least one hand sink for
every 15 children in the center's licensed capacity.
new text end
new text begin
(b) The center must have at least one toilet for every 15 children, excluding infants, in
the center's licensed capacity. Toilet training chairs may be used for toddlers in lieu of a
toilet.
new text end
new text begin
(c) The center must provide handwashing sinks within three feet of the diaper changing
surface. The sink must have hot and cold running water. In newly constructed centers or
those undergoing major remodeling to the plumbing system, foot- or wrist-operated sinks
must be provided in the diaper changing area.
new text end
new text begin
(d) Any hand sink required for children other than infants must be in the toilet area. The
temperature of hot water in the hand sinks used by children must not exceed 120 degrees
Fahrenheit. Hand sinks for children must not be used for custodial work or food preparation,
including preparing infant bottles. Single-service towels or air dryers must be available to
dry hands and designed for easy use by children.
new text end
new text begin
(e) Toilets, sinks, faucets, and hand-drying devices in the toilet area used by children
under school age other than infants must be placed at a height appropriate to the ages of the
children. A sturdy nonslip platform on which children may stand may be used to meet the
height requirement in this paragraph for toddlers and preschoolers.
new text end
new text begin
(f) Plungers and toilet-cleaning devices must be inaccessible to children.
new text end
new text begin Subd. 17. new text end
new text begin Hazardous objects. new text end
new text begin
(a) The license holder must prevent children from
accessing hazardous objects, including any item that could reasonably cause injury, choking,
poisoning, burning, cutting, or other harm to a child, or any item designated by the
manufacturer to be stored out of reach of children.
new text end
new text begin
(b) Activities that are part of the program plan may include the use of hazardous objects
when supervised by program staff.
new text end
new text begin
(c) Supplies and materials used by children must be labeled "nontoxic" by the
manufacturer.
new text end
new text begin Subd. 18. new text end
new text begin Telephone. new text end
new text begin
(a) A working telephone that is capable of making outgoing calls
and receiving incoming calls must be located within the licensed child care center at all
times. The telephone must be accessible to staff as needed and be sufficiently charged for
use at all times.
new text end
new text begin
(b) Program staff must have access to a working telephone while providing care and
supervision to children in care outside of the child care facility.
new text end
new text begin Subd. 19. new text end
new text begin Animals. new text end
new text begin
A license holder must:
new text end
new text begin
(1) keep each animal housed in the program up to date on vaccines required for that
species under state law or local ordinance and maintain documentation of vaccinations, if
any;
new text end
new text begin
(2) notify parents prior to their child's enrollment of the presence of animals in the
program, before new animals are housed, and prior to any animals visiting the program;
new text end
new text begin
(3) not let children handle animals without adult supervision; and
new text end
new text begin
(4) notify the parent of a child whose skin is broken by an animal bite or scratch or who
is otherwise injured by an animal in writing of the injury.
new text end
new text begin Subd. 20. new text end
new text begin Pest control. new text end
new text begin
(a) Effective measures must be taken to protect the center against
rodents and insects. If rodents, insects, or other pests are found, the license holder must take
steps to remove or exterminate them. Chemicals, baits, and traps for insect and rodent control
must not be used in areas accessible to children when children are present and must be used
according to the manufacturer's instructions.
new text end
new text begin
(b) Chemicals to control weeds, rodents, insects, and other pests must be used only after
other means have been used for control, such as eliminating harborages, removing access
to food, and sealing points of entry. These compounds must be used according to labeled
instructions. If chemicals are used, the license holder must notify the parents of enrolled
children what pesticide will be applied and where it will be applied no less than 48 hours
before application, unless in cases of emergency. Only approved, United States
Environmental Protection Agency-registered insecticides, rodenticides, and herbicides may
be used. Application must strictly follow all label instructions and must be authorized by
the director.
new text end
new text begin Subd. 21. new text end
new text begin Posting license. new text end
new text begin
A license holder must post the license in a clearly visible
place within the child care center that is accessible to parents and guardians.
new text end
Sec. 35.
new text begin
[142H.35] ENVIRONMENTAL HEALTH.
new text end
new text begin Subdivision 1. new text end
new text begin Water supply. new text end
new text begin
A child care center must have a safe water supply. Child
care centers that obtain water from privately owned wells or sources must test any water
used for cooking or drinking by a Department of Health-certified laboratory to verify safety.
License holders must follow the lead testing requirements in section 145.9273.
new text end
new text begin Subd. 2. new text end
new text begin Radon testing. new text end
new text begin
(a) The license holder must notify parents whether radon testing
has been conducted in the program upon enrollment and within 30 days of any subsequent
testing done after enrollment.
new text end
new text begin
(b) When notifying parents, the license holder must use a form prescribed by the
commissioner. The notice must include information from the Department of Health about
what radon is and the potential risks associated with radon exposure. If testing has been
completed, the notice must include:
new text end
new text begin
(1) the date of the most recent test;
new text end
new text begin
(2) the rooms or areas tested; and
new text end
new text begin
(3) the detected radon level or levels, stated in picocuries per liter.
new text end
new text begin
(c) A license holder must keep a copy of the most recent notice to parents and the radon
test results on site and make the notice and results available to parents and the commissioner
upon request. The provider may meet this requirement by posting the radon testing results
in a conspicuous place.
new text end
Sec. 36.
new text begin
[142H.36] MALTREATMENT OF MINORS INTERNAL REVIEW.
new text end
new text begin
If a license holder has reason to know that an internal or external report of alleged or
suspected maltreatment has been made, the license holder must:
new text end
new text begin
(1) establish and maintain policies and procedures to ensure that an internal review is
completed within 30 calendar days and that corrective action is taken if necessary to protect
the health and safety of children in care. The review must include an evaluation of whether:
new text end
new text begin
(i) related policies and procedures were followed;
new text end
new text begin
(ii) the policies and procedures were adequate;
new text end
new text begin
(iii) there is a need for additional staff training;
new text end
new text begin
(iv) the reported event is similar to past events with the children or the services involved;
and
new text end
new text begin
(v) there is a need for corrective action by the license holder to protect the health and
safety of children in care;
new text end
new text begin
(2) develop, document, and implement a corrective action plan designed to correct any
current lapses and prevent future lapses in performance by individuals or the license holder,
based on the results of the review;
new text end
new text begin
(3) identify the primary and secondary person or position who will ensure that, when
required, internal reviews are completed. The secondary person must be involved when
there is reason to believe that the primary person was involved in the alleged or suspected
maltreatment; and
new text end
new text begin
(4) document and make internal reviews accessible to the commissioner immediately
upon the commissioner's request. For the purposes of this section, the documentation provided
to the commissioner by the license holder may consist of a completed checklist that verifies
completion of each of the requirements of the review.
new text end
Sec. 37.
Minnesota Statutes 2024, section 245A.211, subdivision 1, is amended to read:
Subdivision 1.
Applicability.
This section applies to all programs licensed or certified
under this chapter, chapters 142C, new text begin 142H, 142I, new text end 245D, 245F, 245G, and sections 245I.20
and 245I.23. The requirements in this section are in addition to any applicable requirements
for the use of holds or restraints for each license or certification type.
Sec. 38. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) The revisor of statutes must renumber Minnesota Statutes, section 142B.68, as
Minnesota Statutes, section 142H.37.
new text end
new text begin
(b) The revisor of statutes must make any necessary changes to statutory cross-references
to reflect the changes in this article.
new text end
new text begin
(c) The revisor of statutes must replicate the statutory history for all sections and
subdivisions repealed and reenacted in this article.
new text end
Sec. 39. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Rules, parts 9503.0005; 9503.0010; 9503.0015; 9503.0030; 9503.0031;
9503.0032; 9503.0033; 9503.0034; 9503.0040; 9503.0045; 9503.0050; 9503.0055;
9503.0060; 9503.0065; 9503.0070; 9503.0075; 9503.0080; 9503.0085; 9503.0090;
9503.0095; 9503.0100; 9503.0105; 9503.0110; 9503.0115; 9503.0120; 9503.0125;
9503.0130; 9503.0140; 9503.0145; 9503.0150; 9503.0155; and 9503.0170,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2024, sections 142B.01, subdivisions 11, 12, 25, 26, and 27;
142B.41, subdivisions 6, 7, 10, 11, 12, and 13; 142B.54, subdivisions 1, 2, and 3; 142B.65,
subdivisions 1, 2, 3, 4, 5, 6, 7, and 10; and 142B.66, subdivisions 1, 2, 4, and 5,
new text end
new text begin
are repealed.
new text end
new text begin
(c)
new text end
new text begin
Minnesota Statutes 2025 Supplement, sections 142B.65, subdivisions 8 and 9; and
142B.66, subdivision 3,
new text end
new text begin
are repealed.
new text end
Sec. 40. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2027.
new text end
ARTICLE 7
FAMILY CHILD CARE LICENSING MODERNIZATION
Section 1.
new text begin
[142I.01] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
For the purposes of this chapter, the terms in this section have
the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Accessible to children. new text end
new text begin
"Accessible to children" means capable of being reached
or used by a child without the aid of an adult.
new text end
new text begin Subd. 3. new text end
new text begin Accredited. new text end
new text begin
"Accredited" means a postsecondary institution or technical college
recognized and listed in the database of accredited postsecondary institutions and programs
maintained by the federal Department of Education.
new text end
new text begin Subd. 4. new text end
new text begin Adult. new text end
new text begin
"Adult" means a person at least 18 years of age.
new text end
new text begin Subd. 5. new text end
new text begin Age categories. new text end
new text begin
(a) "Newborn" means a child from birth up to six weeks old.
new text end
new text begin
(b) "Infant" means a child who is at least six weeks old but less than 12 months old.
new text end
new text begin
(c) "Toddler" means a child who is at least 12 months old but less than 24 months old.
new text end
new text begin
(d) "Preschooler" means a child who is at least 24 months old but less than five years
of age.
new text end
new text begin
(e) "School age" means a child who is at least five years of age but is less than 11 years
of age.
new text end
new text begin Subd. 6. new text end
new text begin Agency. new text end
new text begin
"Agency" means a county or multicounty social or human services
agency governed by a county board or a multicounty human services board.
new text end
new text begin Subd. 7. new text end
new text begin Annual or annually. new text end
new text begin
"Annual" or "annually" means at least once each calendar
year.
new text end
new text begin Subd. 8. new text end
new text begin Applicant. new text end
new text begin
"Applicant" has the same meaning as section 142B.01, subdivision
4.
new text end
new text begin Subd. 9. new text end
new text begin Behavior guidance. new text end
new text begin
"Behavior guidance" means an ongoing process whereby
caregivers offer constructive, positive, and developmentally appropriate guidance to children
to help them manage their own behavior in a socially acceptable manner.
new text end
new text begin Subd. 10. new text end
new text begin Bodily fluid. new text end
new text begin
"Bodily fluid" means urine, feces, vomit, blood, and other bodily
fluids with blood present.
new text end
new text begin Subd. 11. new text end
new text begin Building official. new text end
new text begin
"Building official" means the person appointed pursuant to
section 326B.133 to administer the State Building Code or the building official's authorized
representative.
new text end
new text begin Subd. 12. new text end
new text begin Caregiver. new text end
new text begin
"Caregiver" means the license holder, primary provider of care,
second adult caregiver, intermittent caregiver, helper, or substitute.
new text end
new text begin Subd. 13. new text end
new text begin Child. new text end
new text begin
"Child" means a person receiving child care services who falls within
the age categories in subdivision 5.
new text end
new text begin Subd. 14. new text end
new text begin Child care. new text end
new text begin
"Child care" means the care of a child in a family child care
program. This includes the children of the license holder and any other caregivers in the
family child care program who receive child care during child care hours.
new text end
new text begin Subd. 15. new text end
new text begin Child with special health care needs or disabilities. new text end
new text begin
"Child with special
health care needs or disabilities" means a child who:
new text end
new text begin
(1) has developmental disabilities or is otherwise eligible for case management as
specified in Minnesota Rules, parts 9525.0004 to 9525.0036;
new text end
new text begin
(2) has been identified by the local school district as a child with a disability as specified
in section 125A.02, subdivision 1; or
new text end
new text begin
(3) has been determined to be a child with a disability by a health care provider as defined
in subdivision 25.
new text end
new text begin Subd. 16. new text end
new text begin Clean. new text end
new text begin
"Clean" means free from dirt or other contaminants that can be detected
by sight, smell, or touch.
new text end
new text begin Subd. 17. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of children, youth,
and families or the commissioner's designated representative, including county agencies
and private agencies.
new text end
new text begin Subd. 18. new text end
new text begin Community-based family child care program. new text end
new text begin
"Community-based family
child care program" means a family child care program that operates at a location other than
the primary residence of the license holder.
new text end
new text begin Subd. 19. new text end
new text begin Department. new text end
new text begin
"Department" means the Department of Children, Youth, and
Families.
new text end
new text begin Subd. 20. new text end
new text begin Disinfect. new text end
new text begin
"Disinfect" means the chemical process to kill most germs and
viruses on surfaces and objects after the surfaces and objects have been cleaned.
new text end
new text begin Subd. 21. new text end
new text begin Emergency replacement. new text end
new text begin
"Emergency replacement" means an adult who
supervises children in a family child care program due to an emergency and who has not
completed the training requirements under this chapter or the background study requirements
under chapter 245C.
new text end
new text begin Subd. 22. new text end
new text begin Family child care program. new text end
new text begin
"Family child care program" means a child care
program licensed under this chapter and chapter 142B operating from the license holder's
residence or other approved space that serves up to 18 children and is provided for less than
24 hours a day.
new text end
new text begin Subd. 23. new text end
new text begin Fire marshal. new text end
new text begin
"Fire marshal" means the person designated by section 299F.011
to administer and enforce the State Fire Code or a local fire code inspector approved by the
fire marshal.
new text end
new text begin Subd. 24. new text end
new text begin Hazardous materials. new text end
new text begin
"Hazardous materials" means any item that could
reasonably cause injury, choking, poisoning, burning, cutting, or other harm to a child, or
any item designated by the manufacturer to be stored out of reach of children.
new text end
new text begin Subd. 25. new text end
new text begin Health care provider. new text end
new text begin
"Health care provider" means a physician or physician's
assistant licensed to practice medicine under chapter 147; an advanced practice registered
nurse licensed under section 148.171; or a licensed psychiatrist, licensed psychologist, or
licensed consulting psychologist.
new text end
new text begin Subd. 26. new text end
new text begin Helper. new text end
new text begin
"Helper" means a minor, 14 through 17 years of age, who assists an
adult caregiver with the care of children.
new text end
new text begin Subd. 27. new text end
new text begin Inaccessible to children. new text end
new text begin
"Inaccessible to children" means not capable of
being reached or utilized by a child without the aid of an adult.
new text end
new text begin Subd. 28. new text end
new text begin Intermittent caregiver. new text end
new text begin
"Intermittent caregiver" means an adult who cares
for children in a family child care program alongside another adult caregiver for a cumulative
total of no more than 500 hours annually.
new text end
new text begin Subd. 29. new text end
new text begin License. new text end
new text begin
"License" has the meaning given in section 142B.01, subdivision
16.
new text end
new text begin Subd. 30. new text end
new text begin License holder. new text end
new text begin
"License holder" has the meaning given in section 142B.01,
subdivision 17, for a family child care program.
new text end
new text begin Subd. 31. new text end
new text begin Licensed capacity. new text end
new text begin
"Licensed capacity" means the total number of children
ten years of age or younger permitted at any one time on the premises of a family child care
program. All children ten years of age or younger on the premises count toward the capacity
of the family child care program.
new text end
new text begin Subd. 32. new text end
new text begin Medication. new text end
new text begin
"Medication" means any substance or preparation that is used
to prevent or treat a wound, injury, infection, or disease; maintain health; heal; or relieve
pain, including substances purchased over the counter or prescribed by a health care provider
or dentist. Medication includes substances taken internally or applied externally.
new text end
new text begin Subd. 33. new text end
new text begin Owner or renter. new text end
new text begin
"Owner" or "renter" means the individual, individuals,
organization, or government entity listed in the property title, deed, lease, or equivalent
legal document.
new text end
new text begin Subd. 34. new text end
new text begin Parent. new text end
new text begin
"Parent" means a person who has the legal responsibility for a child,
such as the child's mother, father, or legally appointed guardian.
new text end
new text begin Subd. 35. new text end
new text begin Pests. new text end
new text begin
"Pests" means any animals, insects, or other living creatures that are
not housed within the family child care program and are considered harmful or detrimental
to the health, safety, and well-being of individuals within a family child care program. This
includes but is not limited to ants, rodents, cockroaches, bedbugs, or bats.
new text end
new text begin Subd. 36. new text end
new text begin Pets. new text end
new text begin
"Pets" means all animals housed at the family child care program or that
have contact with children.
new text end
new text begin Subd. 37. new text end
new text begin Premises. new text end
new text begin
"Premises" means the indoor and outdoor space in which a family
child care program is located.
new text end
new text begin Subd. 38. new text end
new text begin Primary provider of care. new text end
new text begin
"Primary provider of care" means the person
responsible for providing care to children during the hours of operation and operating a
family child care program in compliance with all applicable laws and regulations under this
chapter and chapters 142B and 245C. All individual license holders are primary providers
of care, as are individuals designated under section 142I.22, paragraph (f).
new text end
new text begin Subd. 39. new text end
new text begin Radon testing. new text end
new text begin
"Radon testing" means the measurement of radon gas levels
in the indoor air of the building.
new text end
new text begin Subd. 40. new text end
new text begin Related. new text end
new text begin
"Related" means any of the following relationships by marriage,
blood, or adoption: a spouse, a parent, an adoptive parent, a birth or adopted child or
stepchild, a stepparent, a stepbrother, a stepsister, a niece, a nephew, a grandparent, a
grandchild, a sibling, an aunt, an uncle, or a legal guardian.
new text end
new text begin Subd. 41. new text end
new text begin Second adult caregiver. new text end
new text begin
"Second adult caregiver'' means an adult who cares
for children in the family child care program for a cumulative total of more than 500 hours
annually along with the primary provider of care or substitute caregiver.
new text end
new text begin Subd. 42. new text end
new text begin Separation. new text end
new text begin
"Separation" is a form of behavior guidance that involves
interruption of unacceptable behavior by the removal of a child from a situation with the
intention of allowing the child an opportunity to pause and gain self-control. During a
separation a child is not allowed to participate in activities with other children.
new text end
new text begin Subd. 43. new text end
new text begin State Building Code. new text end
new text begin
"State Building Code" means the codes and regulations
adopted by the commissioner of administration pursuant to section 326B.107 and contained
in Minnesota Rules, chapter 1300.
new text end
new text begin Subd. 44. new text end
new text begin State Fire Code. new text end
new text begin
"State Fire Code" means the codes and regulations adopted
by the state fire marshal pursuant to section 299F.011 and contained in Minnesota Rules,
chapter 7511.
new text end
new text begin Subd. 45. new text end
new text begin Substitute. new text end
new text begin
"Substitute" means an adult who is responsible for the duties of
a primary provider of care when the primary provider of care is not present at the family
child care program. A substitute may not provide care for more than 500 hours per calendar
year.
new text end
new text begin Subd. 46. new text end
new text begin Supervision. new text end
new text begin
"Supervision" means:
new text end
new text begin
(1) caregivers must be within sight or hearing of newborns, infants, toddlers, and
preschoolers at all times and must intervene in an effort to protect the health and safety of
the child. Electronic monitoring devices can only be used to monitor infants, toddlers, and
preschoolers when they are asleep;
new text end
new text begin
(2) for a school-age child, a caregiver is available for assistance and care without the
aid of a mechanical or electronic device so that the child's health and safety is protected;
and
new text end
new text begin
(3) the caregiver has an awareness of and responsibility for the activity of each child
and is near enough to respond and reach children immediately, including responding to the
child's basic needs and intervening to protect them from harm.
new text end
new text begin Subd. 47. new text end
new text begin Variance. new text end
new text begin
"Variance" means written permission from the county licensing
unit pursuant to the requirements in section 142B.10, subdivision 16, paragraph (c) for a
license holder or applicant to depart from a specific requirement in this chapter or chapter
142B.
new text end
Sec. 2.
new text begin
[142I.02] LICENSING OF PROGRAMS.
new text end
new text begin Subdivision 1. new text end
new text begin Purpose. new text end
new text begin
The purpose of this chapter is to establish procedures and
standards for licensing family child care and community-based family child care programs
to ensure that minimum standards of care and service are given and the protection, care,
health, safety, and development of the children are assured.
new text end
new text begin Subd. 2. new text end
new text begin Applicability. new text end
new text begin
A family child care program must be licensed under this chapter
and chapter 142B to operate in Minnesota.
new text end
Sec. 3.
new text begin
[142I.03] LICENSING PROCESS.
new text end
new text begin Subdivision 1. new text end
new text begin License application. new text end
new text begin
(a) An applicant for a family child care license
must follow the requirements of this section and section 142B.10.
new text end
new text begin
(b) Applicants must use the application issued by the department. The application must
be made in the county where the family child care program will operate.
new text end
new text begin
(c) Applicants must be the proposed license holders of the family child care program.
new text end
new text begin
(d) An application for licensure is complete and ready for the agency's review after the
applicant completes, signs, and submits all department forms and documentation needed
for licensure to the agency and the agency receives all inspection, zoning, evaluation, and
investigative reports, documentation, and information required to verify compliance with
this chapter and applicable statutes, including a completed background study for individuals
subject to a study, as required under chapter 245C.
new text end
new text begin Subd. 2. new text end
new text begin Licensing study. new text end
new text begin
(a) The applicant must give the agency access to the family
child care program for a licensing study to determine compliance with all applicable rules
and statutes.
new text end
new text begin
(b) If the commissioner determines a potentially hazardous condition exists due to
noncompliance with this chapter or local ordinances, the applicant must obtain an inspection
from a fire marshal, building official, or authorized community health board agent under
section 145A.04 to verify the absence of hazard or identify needed corrections. Any condition
cited as hazardous and creating an immediate danger of fire or threat to life or safety must
be corrected.
new text end
new text begin
(c) An applicant must undergo an initial inspection of the family child care program by
a fire marshal to determine compliance with the State Fire Code and compliance with orders
issued if the program:
new text end
new text begin
(1) has freestanding solid-fuel-heating appliances;
new text end
new text begin
(2) will operate in a manufactured or mobile home;
new text end
new text begin
(3) will use a basement for child care;
new text end
new text begin
(4) is located in mixed- or multiple-occupancy buildings. For the purposes of this clause,
"mixed-occupancy building" means a structure that contains nonresidential occupancies,
such as an attached garage, and "multiple-occupancy building" means a structure with two
or more residential dwelling units, such as a duplex, apartment building, or townhome; or
new text end
new text begin
(5) is located in a commercial space.
new text end
new text begin Subd. 3. new text end
new text begin Ineligibility factors. new text end
new text begin
(a) An applicant, caregiver, or any person who resides
where the family child care program operates and who is present when children are in care
or works with the children in care is prohibited from:
new text end
new text begin
(1) abusing prescribed or nonprescribed drugs or use alcohol or controlled substances
specified in chapter 152 to the extent that the use or abuse has or may have a negative effect
on the ability of the primary provider of care to give care or is apparent during the hours of
operation;
new text end
new text begin
(2) having had a child placed in foster care within the prior 12 months for reasons that
the agency determines reflect on the ability of the license holder or the primary provider of
care to safely provide family child care. This clause does not apply if the primary reason
for the placement was due to a physical illness of the parent due to a disability of the child,
including developmental disability of the child; or for the temporary care of a newborn or
infant being relinquished for adoption;
new text end
new text begin
(3) having had a child placed in a residential facility within the prior 12 months for
reasons that the agency determines reflect on the ability of the license holder or the primary
provider of care to safely provide family child care; or
new text end
new text begin
(4) exhibiting behavior that could pose a risk to children being served in the family child
care program. Additional assessments or documentation may be requested to determine the
impact on the provider's ability to provide care.
new text end
new text begin
(b) Caregivers who have abused prescribed or nonprescribed drugs or have been
dependent on alcohol or controlled substances specified in chapter 152, such that the use,
abuse, or dependency has negatively affected the ability to give care, was apparent during
the hours of operation, or required treatment or therapy, must have 12 months of verified
abstinence before licensure.
new text end
new text begin Subd. 4. new text end
new text begin Variances. new text end
new text begin
The county licensing unit may grant variances to this chapter.
new text end
new text begin Subd. 5. new text end
new text begin Posting license. new text end
new text begin
The license holder must post the license in the family child
care program in a location where parents, visitors, and authorized representatives of the
commissioner can easily access and view the license.
new text end
new text begin Subd. 6. new text end
new text begin Change in license terms. new text end
new text begin
A license holder must submit a new application form
in accordance with section 142B.10 before:
new text end
new text begin
(1) relocating the family child care program;
new text end
new text begin
(2) changing the type of license from class A, C1, or C2 to C3, C4, or C5;
new text end
new text begin
(3) changing the type of license from class C4 or C5 to A, C1, C2, or C3;
new text end
new text begin
(4) changing from family child care to community-based family child care; or
new text end
new text begin
(5) changing from community-based family child care to family child care.
new text end
new text begin Subd. 7. new text end
new text begin Number of licenses. new text end
new text begin
Each individual applicant is limited to one family child
care license.
new text end
new text begin Subd. 8. new text end
new text begin Access to program. new text end
new text begin
As required in section 142B.10, subdivision 12, caregivers
must give authorized representatives of the commissioner access to the family child care
program premises during the hours of operation.
new text end
new text begin Subd. 9. new text end
new text begin Disposal of license. new text end
new text begin
When a family child care program is closed, or if a license
is revoked, suspended, or not renewed, the license holder must remove the license from
being posted in the home within 14 days of ceasing operation or upon the final order of
revocation, denial, or suspension of license; stop all advertising; and refrain from providing
care to children as required in section 142B.05, subdivision 1.
new text end
new text begin Subd. 10. new text end
new text begin Local government authority. new text end
new text begin
The authority of local units of government to
establish requirements for family child care programs is limited by section 299F.011,
subdivision 4a, paragraph (a), clauses (1) and (2).
new text end
new text begin Subd. 11. new text end
new text begin Background studies. new text end
new text begin
All individuals subject to a background study must
comply with the requirements of chapter 245C.
new text end
new text begin Subd. 12. new text end
new text begin Child care license holder insurance. new text end
new text begin
(a) The license holder must complete
and provide to parents a form prescribed by the commissioner that includes information
about the license holder's liability insurance status. The license holder must update the form
and obtain each parent's signature whenever insurance coverage changes, a policy lapses,
or a new policy takes effect. If the license holder has a continuous insurance policy that
renews each year, the license holder may indicate the policy's renewal date in the initial
written notice to parents, and no further notices are required until the insurance coverage
changes or the policy lapses.
new text end
new text begin
(b) The form under this subdivision must include the date of the policy's expiration or
renewal or indicate if the license holder does not carry liability insurance.
new text end
new text begin
(c) A copy of the current certificate of liability insurance must be made available upon
request to parents, the commissioner, and agency licensing staff.
new text end
Sec. 4.
new text begin
[142I.04] AGENCY RECORDS.
new text end
new text begin Subdivision 1. new text end
new text begin Agency records. new text end
new text begin
An agency must maintain the following records for
each license holder:
new text end
new text begin
(1) a copy of the completed licensing application form signed by the applicant and the
agency;
new text end
new text begin
(2) a physical health report on any adult caregiver that was submitted prior to giving
care in the family child care program. The physical health report must verify that the adult
caregiver is physically able to care for children;
new text end
new text begin
(3) any written reports from a fire marshal, building official, or agent of a community
health board authorized under chapter 145A;
new text end
new text begin
(4) if the applicant has been licensed through another jurisdiction, a reference from the
licensing authority in that jurisdiction;
new text end
new text begin
(5) the initial and annual inspection by the agency of the license holder. Any comments
of the license holder about the inspections by the agency must also be noted in the agency
record;
new text end
new text begin
(6) a copy of the notification given to parents, prior to a child's admission, indicating
that pets are present in the residence and documentation as required in section 142I.19,
subdivision 4;
new text end
new text begin
(7) documentation of any variance requests and the approval or denial of the request in
accordance with section 142I.03; and
new text end
new text begin
(8) the results of each background study required under chapter 245C.
new text end
new text begin Subd. 2. new text end
new text begin Data privacy. new text end
new text begin
The agency, commissioner, and authorized agent as defined in
section 142B.01, subdivision 5, must have access to license holder records on children in
care to determine compliance with this chapter. All caregivers must maintain the privacy
of records on children by refraining from discussing or disclosing any records, including
electronic records, or information on children in care to any persons other than the parent
of the child, the agency, the commissioner, and medical or public safety persons if the
information is necessary to protect the health and safety of the child.
new text end
Sec. 5.
new text begin
[142I.05] REPORTING TO AGENCY.
new text end
new text begin Subdivision 1. new text end
new text begin Maltreatment, abuse, and neglect reporting. new text end
new text begin
All caregivers who suspect,
know, or have reason to believe a child is being or has been maltreated under section 260E.03,
subdivision 12, must immediately report the information to the local welfare agency, agency
responsible for assessing or investigating the report, police department, county sheriff,
Tribal social services agency, or Tribal police as required by chapter 260E.
new text end
new text begin Subd. 2. new text end
new text begin Other reporting. new text end
new text begin
Primary providers of care must notify the agency:
new text end
new text begin
(1) prior to anyone moving into the residence where family child care services are
provided. A background study must be completed in accordance with section 245C.13,
subdivision 2;
new text end
new text begin
(2) within ten calendar days after a household member has moved out of the residence
where family child care services are provided;
new text end
new text begin
(3) before a new caregiver provides direct contact services for the first time, unless an
individual is acting as an emergency replacement according to section 142I.09, subdivision
2;
new text end
new text begin
(4) of any damage to the premises that may affect compliance with this chapter or any
incident at the premises that results in the loss of utility services, within 24 hours after the
occurrence;
new text end
new text begin
(5) within 24 hours after the occurrence of any serious injury, head injury, hospitalization,
or death of a child in care. For the purposes of this clause, "serious injury" means an injury
that reasonably requires the care of a health care provider or dentist; and
new text end
new text begin
(6) within 24 hours after the occurrence of an animal bite in accordance with section
142I.19, subdivision 4.
new text end
Sec. 6.
new text begin
[142I.06] ADMISSIONS; RECORDS; REPORTING.
new text end
new text begin Subdivision 1. new text end
new text begin Admission and ongoing information. new text end
new text begin
(a) Prior to admission of a child
and annually while the child is enrolled, the parents and primary provider of care must
discuss family child care program policies and licensing requirements.
new text end
new text begin
(b) The license holder must not disclose a child's record to any person other than the
child, the child's parent or guardian, the child's legal representative, employees of the license
holder, and the agency unless the child's parent or guardian has given written consent or as
otherwise required by law.
new text end
new text begin Subd. 2. new text end
new text begin Statutory summary for parents. new text end
new text begin
A descriptive summary of this chapter must
be distributed to the parent by the license holder at the time a child is admitted to care. The
summary must be provided by the department to the agencies for distribution to license
holders and must:
new text end
new text begin
(1) state that this chapter and chapter 142B govern the licensing of family child care
programs;
new text end
new text begin
(2) specify the section headings contained in this chapter; and
new text end
new text begin
(3) state that a complete copy of this chapter is available at the family child care program,
agency, department, or State Law Library or through the revisor of statutes website.
new text end
new text begin Subd. 3. new text end
new text begin Parental access. new text end
new text begin
A parent who has enrolled a child must be allowed access to
the child and the licensed space at any time while the child is in care unless a court order
or other legal documentation restricts access. A copy of the order or other legal
documentation must be kept in the child's record at the family child care program.
new text end
new text begin Subd. 4. new text end
new text begin Attendance records. new text end
new text begin
A license holder must maintain documentation of
attendance for each child receiving care for a minimum of five years. The records must be
accessible to the commissioner during the family child care program's hours of operation,
must be completed on the day of attendance, and must include:
new text end
new text begin
(1) the first and last name of the child;
new text end
new text begin
(2) the time of day that the child was dropped off; and
new text end
new text begin
(3) the time of day that the child was picked up.
new text end
new text begin Subd. 5. new text end
new text begin License holder policies. new text end
new text begin
(a) The license holder must follow and monitor
implementation of the policies and procedures by all caregivers as required in section
142B.10, subdivision 21.
new text end
new text begin
(b) When applicable for the program, the license holder must have written policies
available for discussion with parents and the commissioner and provide an electronic or
hard copy to the parent at the time of admission or upon request. The policies must include,
at a minimum:
new text end
new text begin
(1) program operation policies, including:
new text end
new text begin
(i) the ages and numbers of children the family child care program is licensed to serve;
new text end
new text begin
(ii) the hours and days of operation, including plans for holiday closings, personal time,
and policies for inclement weather closings;
new text end
new text begin
(iii) fees, including payment schedule, overtime charges, and registration fees as
applicable;
new text end
new text begin
(iv) parental access to the family child care program that states a parent who enrolls a
child must be allowed access to the child and the licensed space at any time while the child
is in care;
new text end
new text begin
(v) nondiscrimination practices to comply with section 142I.21;
new text end
new text begin
(vi) the termination of child care and expulsion notice procedures; and
new text end
new text begin
(vii) the use of a helper, a substitute for personal leave or holidays, and an emergency
substitute according to the licensing requirements in section 142I.09;
new text end
new text begin
(2) health and safety policies, including on:
new text end
new text begin
(i) allergy prevention and response;
new text end
new text begin
(ii) the administration and storage of medication and topical products;
new text end
new text begin
(iii) the care of ill children, isolation precautions, symptoms for discharge and return,
immunizations, medicine permission policies, and whether the license holder will care for
an ill child;
new text end
new text begin
(iv) disease notification procedures, including notifying the parents of exposed children
within 24 hours of a parent or caregiver notifying the license holder of a reportable disease
under section 142I.19, subdivision 9. The notice must be posted in a clearly visible, accessible
place or provided individually to each parent of a child who was exposed;
new text end
new text begin
(v) meals, snacks, infant formula, breast milk, and supplemental foods to be provided,
including labeling requirements for food brought from the child's home;
new text end
new text begin
(vi) sleeping and resting arrangements;
new text end
new text begin
(vii) emergency procedures, fire and storm plans, and transportation in an emergency,
including whether parent permission is required;
new text end
new text begin
(viii) how the license holder prevents abuse of prescription medication or being in any
manner under the influence of a chemical that impairs the caregiver's ability to provide
services or care as required under section 142B.10, subdivision 1, paragraph (c); and
new text end
new text begin
(ix) firearms at the residence in accordance with section 142I.19, subdivision 7; and
new text end
new text begin
(3) program environment policies, including:
new text end
new text begin
(i) behavior guidance and discipline;
new text end
new text begin
(ii) field trips, including by foot, and whether parent permission is required;
new text end
new text begin
(iii) the presence of pets in the family child care program, including notification prior
to the introduction of a new pet to the program;
new text end
new text begin
(iv) the use of screen time; and
new text end
new text begin
(v) the use of social media, images, and video in accordance with subdivision 7.
new text end
new text begin Subd. 6. new text end
new text begin Records for each child. new text end
new text begin
(a) The license holder must obtain the records in this
subdivision from parents prior to the admission of a child. The license holder must keep
this information up to date and on file for each child. The license holder must have a parent
annually review the information in a child's record, update the information as necessary,
and keep the information on file.
new text end
new text begin
(b) For each enrolled child, the license holder must maintain a signed and completed
admission and arrangement form, as prescribed by the commissioner, and a completed
enrollment form, as developed and approved by the commissioner.
new text end
new text begin
(c) Immunization records must be kept in accordance with section 121A.15 and Minnesota
Rules, chapter 4604. Prior to enrollment, a license holder must request a child's immunization
record. The record must be kept on file and updated as follows:
new text end
new text begin
(1) for an infant, every six months;
new text end
new text begin
(2) for a toddler, annually;
new text end
new text begin
(3) for a preschooler, every 18 months; and
new text end
new text begin
(4) for a school-age child, every three years.
new text end
new text begin
(d) For each enrolled child, the license holder must obtain signed written consent from
a parent allowing the license holder to obtain emergency medical care or treatment for the
child.
new text end
new text begin
(e) A license holder must release a child from care only to a parent or other person
authorized in writing by the parent. The information must be reviewed at least annually by
the parent and updated when information changes.
new text end
new text begin Subd. 7. new text end
new text begin Social media, images, and video sharing. new text end
new text begin
(a) Caregivers are prohibited from
sharing photos, videos, or other personal identifying information of enrolled children, except
to provide updates to parents who have provided written consent. If a license holder wishes
to use photos or videos of the family child care program and the enrolled children for
promotional or publicity purposes, including on social media accounts or public digital
platforms, the license holder must obtain written consent from parents prior to use.
new text end
new text begin
(b) Notwithstanding paragraph (a), the license holder must share photos, videos, and
other personal identifying information of enrolled children with the commissioner upon
request.
new text end
new text begin Subd. 8. new text end
new text begin Nondiscrimination. new text end
new text begin
A caregiver is prohibited from discriminating in relation
to enrollment in their program based on race, color, creed, religion, national origin, sex,
gender identity, marital status, disability, sexual orientation, or familial status.
new text end
Sec. 7.
new text begin
[142I.07] CAPACITY AND RATIOS.
new text end
new text begin Subdivision 1. new text end
new text begin Capacity limits. new text end
new text begin
License holders must be licensed for the total number
of children ten years of age or younger who are present on the premises of the family child
care program at any one time during child care hours, including the caregiver's own children
and foster children.
new text end
new text begin Subd. 2. new text end
new text begin Capacity, ratios, and age distribution restrictions. new text end
new text begin
(a) The commissioner
must issue licenses based on the capacity and ratios in this subdivision.
new text end
new text begin
(b) License holders with a class A license must meet the following requirements:
new text end
|
new text begin
Class new text end |
new text begin
Capacity new text end |
new text begin
Minimum Adult Caregivers new text end |
new text begin
Maximum Children Under School Age new text end |
new text begin
Maximum Total Infants and Toddlers new text end |
new text begin
Maximum Infants new text end |
|
new text begin
A new text end |
new text begin
10 new text end |
new text begin
1 new text end |
new text begin
6 new text end |
new text begin
3 new text end |
new text begin
2 new text end |
new text begin
(c) License holders with a class C license must meet the following requirements:
new text end
|
new text begin
Class new text end |
new text begin
Capacity new text end |
new text begin
Minimum Adult Caregivers new text end |
new text begin
Maximum Children Under School Age new text end |
new text begin
Maximum Total Infants and Toddlers new text end |
new text begin
Maximum Infants new text end |
|
new text begin
C1 new text end |
new text begin
5 new text end |
new text begin
1 new text end |
new text begin
5 new text end |
new text begin
3 new text end |
new text begin
3 new text end |
|
new text begin
C2 new text end |
new text begin
10 new text end |
new text begin
1 new text end |
new text begin
8 new text end |
new text begin
4 new text end |
new text begin
2 new text end |
|
new text begin
C3 new text end |
new text begin
12 new text end |
new text begin
1 new text end |
new text begin
10 new text end |
new text begin
3 new text end |
new text begin
2 new text end |
|
new text begin
C4 new text end |
new text begin
14 new text end |
new text begin
2 new text end |
new text begin
12 new text end |
new text begin
6 new text end |
new text begin
4 new text end |
|
new text begin
C5 new text end |
new text begin
18 new text end |
new text begin
2 new text end |
new text begin
12 new text end |
new text begin
5 new text end |
new text begin
2 new text end |
new text begin Subd. 3. new text end
new text begin Newborn care. new text end
new text begin
When a newborn is in care and only one adult caregiver is
present, the newborn must be the only child under 12 months of age present, and the license
holder must not care for more than two other children at the same time unless the newborn
is the license holder's child. When a second adult caregiver is also present or the newborn
is the child of the license holder, then the newborn is considered an infant for the purposes
of child-to-adult ratios and age distribution restrictions.
new text end
new text begin Subd. 4. new text end
new text begin Supervision, primary provider of care, and use of substitutes. new text end
new text begin
(a) Children
in care must be supervised by an adult caregiver. The adult caregiver must have knowledge
of each child's needs, including but not limited to developmental and behavioral needs and
parental preferences, and be accountable for each child's care at all times. A caregiver must
be within sight or hearing of newborns, infants, toddlers, and preschoolers at all times
without the use of monitoring devices, except as provided in section 142I.18.
new text end
new text begin
(b) The primary provider of care must be the primary caregiver in the family child care
program unless a substitute is being used in accordance with section 142I.09. A helper may
be used in place of a second adult caregiver when there is no more than one newborn, infant,
or toddler present.
new text end
new text begin
(c) The use of a substitute caregiver must be in accordance with section 142I.09.
new text end
new text begin Subd. 5. new text end
new text begin Overnight care. new text end
new text begin
When a family child care program has a child in care after 11
p.m. and before 5 a.m.:
new text end
new text begin
(1) at least one adult caregiver must remain awake and available to respond to children's
needs at all times. The program must maintain required caregiver-to-child ratios. Additional
caregivers may sleep when ratios are maintained and must be available to resume supervision
when needed;
new text end
new text begin
(2) all awake children must be given the opportunity to engage in age-appropriate
activities in a separate room away from sleeping children; and
new text end
new text begin
(3) the child care emergency plan must include a plan tailored to sleeping children.
new text end
new text begin Subd. 6. new text end
new text begin Class C5 licenses. new text end
new text begin
(a) Class C5 licenses must always operate at the level of
exit discharge.
new text end
new text begin
(b) A family child care program with a class C license may operate as a lower C-class
level family child care program on days when the adult-to-child ratios allow it to operate
at a lower capacity.
new text end
new text begin Subd. 7. new text end
new text begin Care of the license holder's own child or children. new text end
new text begin
(a) With the license
holder's consent, an individual may be present in the licensed space and care for the license
holder's own child both inside and outside of the licensed space and is exempt from the
training and supervision requirements of section 142I.10 if the individual:
new text end
new text begin
(1) is related to the license holder or to the license holder's child, as defined in section
142I.01, subdivision 40, or is a household member who the license holder has reported to
the county agency;
new text end
new text begin
(2) is not a caregiver for the family child care program at the time that they are supervising
the license holder's own child;
new text end
new text begin
(3) only cares for the license holder's own child; and
new text end
new text begin
(4) does not have direct, unsupervised contact with any nonrelative children in care.
new text end
new text begin
(b) If the individual in paragraph (a) is not a household member, the individual is also
exempt from background study requirements under chapter 245C.
new text end
new text begin
(c) Where a caregiver is also a parent providing care to their own child in the family
child care program, sections 142I.13; 142I.17; 142I.20, subdivisions 1 to 3; and 142I.21 do
not apply to caregivers with regards to the care of their own children.
new text end
new text begin
(d) Notwithstanding paragraph (c), family child care programs with license holders or
caregivers providing care to their own child are not exempt from the capacity, ratio, and
age distribution requirements under this section. License holders and caregivers remain
subject to chapters 260E and 609 and other applicable statutes and rules.
new text end
new text begin
(e) Notwithstanding paragraph (c), the agency may enforce the standards in sections
142I.13; 142I.17; 142I.20, subdivisions 1 to 3; and 142I.21 when the caregiver's actions
with regards to the care of their own children affect the other children in the caregiver's
care.
new text end
Sec. 8.
new text begin
[142I.08] QUALIFICATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Age. new text end
new text begin
An applicant for a family child care license must be an adult at the
time of application.
new text end
new text begin Subd. 2. new text end
new text begin Physical and behavioral health. new text end
new text begin
(a) An adult caregiver must be physically
and mentally able to care for children. An applicant or primary provider of care must provide
documentation to the agency along with the license application verifying that the applicant
has had a physical examination by a licensed physician, advanced practice registered nurse,
or physician assistant within 12 months prior to the application for initial licensure and that
the applicant or primary provider of care is physically able to care for children. Prior to
assisting in the care of children, the applicant must also provide documentation verifying
that any adult caregiver has had a physical examination by a licensed physician, advanced
practice registered nurse, or physician assistant within the past 12 months and is physically
able to care for children.
new text end
new text begin
(b) The commissioner may require a caregiver to provide reports on the caregiver's
physical or mental health from a health care provider when there is reason to believe that
a caregiver exhibits physical or mental health symptoms that could impair the caregiver's
ability to ensure the health and safety of children. The reports must not be used for any other
purpose than to determine whether the caregiver's physical or mental health impacts the
health and safety of children.
new text end
new text begin Subd. 3. new text end
new text begin Additional class C5 license requirements. new text end
new text begin
(a) An applicant or primary provider
of care receiving a class C5 license must have at least one of:
new text end
new text begin
(1) a minimum of one year of substantial compliance with this chapter as a
Minnesota-licensed family child care license holder, primary provider of care, or second
adult caregiver and a minimum of 1500 hours of direct care in a family child care program
serving children;
new text end
new text begin
(2) a minimum of six months of substantial compliance with this chapter as a family
child care license holder, primary provider of care, or second adult caregiver in Minnesota
and:
new text end
new text begin
(i) a minimum of 520 hours of experience as an assistant teacher, student teacher, or
intern in an elementary school, after-school program, or Minnesota-licensed child care
center or as an adult caregiver in a Minnesota-licensed family child care program and 30
hours of child care, health, and nutrition training as specified in section 142I.10; or
new text end
new text begin
(ii) a minimum of 520 hours of experience as a licensed practical or registered nurse,
and 30 hours of child development or early childhood education training, as specified in
section 142I.10;
new text end
new text begin
(3) certification or licensure indicating completion of one of the following:
new text end
new text begin
(i) a two-year child development or early childhood education associate or certificate
program at an accredited college or university;
new text end
new text begin
(ii) a child development associate certification;
new text end
new text begin
(iii) a certification from a recognized Montessori organization;
new text end
new text begin
(iv) a bachelor's degree or higher in early childhood education from an accredited college
or university; or
new text end
new text begin
(v) an elementary education degree from an accredited college or university that includes
a minimum of 30 hours of child development training; or
new text end
new text begin
(4) six months' experience working an average of 30 hours a week or more as a teacher,
as defined in section 142H.06, at a Minnesota-licensed child care center.
new text end
new text begin
(b) An applicant or primary provider of care must complete an additional large group
training created by the commissioner as a condition of receiving a class C5 license.
new text end
Sec. 9.
new text begin
[142I.09] SUBSTITUTE CAREGIVERS AND REPLACEMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Total hours allowed. new text end
new text begin
The use of a substitute caregiver in a family child
care program is limited to a cumulative total of not more than 500 hours annually. When a
substitute is used, prior to the end of each business day the license holder must document
the name, date, and number of hours of each substitute who provided care.
new text end
new text begin Subd. 2. new text end
new text begin Emergency replacement supervision. new text end
new text begin
(a) In an emergency, a license holder
may allow an adult who has not completed the training requirements under this chapter or
the background study requirements under chapter 245C to supervise children in a family
child care program. For purposes of this subdivision, "emergency" means a situation in
which the license holder has begun operating the family child care program for the day and
for reasons beyond the control of the license holder, including but not limited to a serious
illness or injury, accident, or situation requiring the immediate attention of the license holder,
the license holder needs to leave the licensed space and close the program for the day.
new text end
new text begin
(b) To the extent practicable, the license holder must attempt to arrange for emergency
care by a substitute caregiver before using an emergency replacement.
new text end
new text begin
(c) When an emergency occurs:
new text end
new text begin
(1) the license holder or emergency replacement must contact the parents of the children
attending the family child care program and inform the parents that the program is closing
for the day and that the children need to be picked up as soon as practicable;
new text end
new text begin
(2) the license holder must not knowingly use a person as an emergency replacement
who has committed an action or has been convicted of a crime that would cause the person
to be disqualified from providing care to children if a background study was conducted
under chapter 245C;
new text end
new text begin
(3) the license holder must make reasonable efforts to minimize the amount of time the
emergency replacement has unsupervised contact with the children in care not to exceed
12 hours per emergency incident;
new text end
new text begin
(4) the family child care program must be closed for the day once the last unrelated child
has left the program; and
new text end
new text begin
(5) the license holder must notify the county licensing agency within seven days that an
emergency replacement was used and specify the circumstances that led to the use of the
emergency replacement.
new text end
new text begin
(d) The county licensing agency must notify the commissioner within three business
days after receiving the license holder's notice that an emergency replacement was used and
specify to the commissioner the circumstances that led to the use of the emergency
replacement.
new text end
new text begin
(e) A license holder is not required to provide the names of persons who may be used
as replacements in emergencies to parents or the county licensing agency. However, once
an emergency replacement has been used, the license holder must provide the name of the
individual used to the county licensing agency.
new text end
Sec. 10.
new text begin
[142I.10] APPLICANT, PRIMARY PROVIDER OF CARE, AND SECOND
ADULT CAREGIVER TRAINING REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin
Initial training; applicant, primary provider of care, and second
adult caregiver.
new text end
new text begin
(a) Before providing care, an applicant, a primary provider of care, and
each second adult caregiver must have completed all required initial training within the
prior 24 months.
new text end
new text begin
(b) Initial training does not need to be completed before providing care in the following
circumstances:
new text end
new text begin
(1) a primary provider of care who voluntarily closes a license and reopens within 12
months has one year from the new license's effective date to complete annual and ongoing
training and is exempt from repeating initial training;
new text end
new text begin
(2) a primary provider of care who relocates within the state has until the end of the
calendar year to complete annual and ongoing training and is not required to repeat initial
training previously completed; and
new text end
new text begin
(3) a primary provider of care who relocates to a new county must not be required by
the new county to complete orientation or other training required for new applicants.
new text end
new text begin
(c) Each applicant, primary provider of care, and second adult caregiver must complete
and document the following before providing care:
new text end
new text begin
(1) at least four hours of child development, learning, or behavior guidance training. An
individual is exempt if the individual provides documentation verifying that the individual:
new text end
new text begin
(i) has completed a three-credit early childhood development course within the past five
years;
new text end
new text begin
(ii) holds a baccalaureate or master's degree in early childhood education or school-age
child care;
new text end
new text begin
(iii) holds a Minnesota teaching license in early childhood education, kindergarten
through grade 6, or special education; or
new text end
new text begin
(iv) holds a Montessori certificate;
new text end
new text begin
(2) the six-hour supervising for safety for family child care course developed by the
commissioner;
new text end
new text begin
(3) pediatric first aid training provided by an instructor certified to teach pediatric first
aid. Current training documentation must be maintained at the family child care program
and made available upon request. Online training reviewed and approved by the county
licensing agency satisfies this requirement;
new text end
new text begin
(4) pediatric cardiopulmonary resuscitation (CPR) training that:
new text end
new text begin
(i) is instructor led or blended with a hands-on skills component. Online-only CPR
courses without a hands-on component do not meet this requirement;
new text end
new text begin
(ii)(A) is developed by the American Heart Association or the American Red Cross; or
new text end
new text begin
(B) uses nationally recognized, evidence-based guidelines for CPR training; and
new text end
new text begin
(iii) is provided by an instructor approved by the commissioner to teach CPR;
new text end
new text begin
(5) for programs licensed for children younger than school age, training on reducing the
risk of sudden unexpected infant death and abusive head trauma, which may be combined
in a single commissioner-approved course. This training must, at a minimum, address the
risk factors related to sudden unexpected infant death and abusive head trauma and the
means of reducing the risk of each;
new text end
new text begin
(6) training on proper use and installation of child passenger restraint systems under
section 169.685 of at least one hour in length that is provided by an instructor certified and
approved by the Department of Public Safety. At a minimum, the training must address the
proper use of child restraint systems based on the child's size, weight, and age and the proper
installation of a car seat or booster seat in the motor vehicle used by the caregiver to transport
the child or children. This requirement does not apply to family child care programs that
transport only school-age children as defined in section 142I.01, subdivision 5, paragraph
(e), in child care buses as defined in section 169.448, subdivision 1, paragraph (e);
new text end
new text begin
(7) training on the child care emergency plan required under section 142I.19, subdivision
2;
new text end
new text begin
(8) training on allergy prevention and response required under section 142I.06,
subdivision 5, paragraph (b);
new text end
new text begin
(9) training on the community-based family child care program plan required under
section 142I.22, if applicable;
new text end
new text begin
(10) training on the family child care program policies and procedures required under
section 142I.06;
new text end
new text begin
(11) training on reporting suspected maltreatment of children as required under chapter
260E; and
new text end
new text begin
(12) swimming pool training under section 142I.14, subdivision 6, if a pool at the family
child care program is used by children in care.
new text end
new text begin
(d) County licensing staff must accept approved training on the primary provider of care
or second adult caregiver's learning record in the Develop data system for early education
and school-age care.
new text end
new text begin Subd. 2. new text end
new text begin Annual training; primary provider of care and second adult caregiver. new text end
new text begin
(a)
A primary provider of care and each second adult caregiver must annually complete and
document the following training:
new text end
new text begin
(1) at least two hours of child development, learning, or behavior guidance training. A
three-credit early childhood development course completed within the calendar year meets
this requirement;
new text end
new text begin
(2) a two-hour active supervision course developed or approved by the commissioner;
new text end
new text begin
(3) training on reducing the risk of sudden unexpected infant death if caring for infants
and training on reducing the risk of abusive head trauma if caring for children under school
age, which must:
new text end
new text begin
(i) be completed in person or online at least once every two years; and
new text end
new text begin
(ii) in alternating years, be completed through a commissioner-approved video not
exceeding one hour in length; and
new text end
new text begin
(4) at least four hours of ongoing training each calendar year that must include topics
identified in the Minnesota knowledge and competency framework. Repeat of topical training
requirements in subdivision 1 counts toward the annual ten-hour requirement.
new text end
new text begin
(b) A caregiver who is approved as a trainer through the Develop data system may count
up to two hours of training instruction toward the annual ten-hour training requirement in
paragraph (a), clause (4), if:
new text end
new text begin
(1) the training is the first instance in which the caregiver delivers a particular
content-specific training during each training year;
new text end
new text begin
(2) the caregiver is a Develop-approved active trainer; and
new text end
new text begin
(3) the hours counted as training instruction are approved through the Develop data
system with attendance verified on the trainer's individual learning record and are in the
knowledge and competency framework content areas VII A, establishing healthy practices,
or B, ensuring safety.
new text end
new text begin
(c) Unless specifically authorized in this section, one training does not fulfill two different
training requirements. Courses within the identified knowledge and competency areas that
are specific to child care centers or legal nonlicensed programs do not fulfill the requirements
of this section.
new text end
new text begin
(d) County licensing staff must accept training designated by the commissioner as
satisfying training requirements if the training is within the knowledge and competency
framework for child development and learning, behavior guidance, and active supervision
as indicated on the department's website.
new text end
new text begin Subd. 3. new text end
new text begin Ongoing training; primary provider of care and second adult caregiver. new text end
new text begin
(a)
A primary provider of care and each second adult caregiver must complete and document
the following training:
new text end
new text begin
(1) pediatric cardiopulmonary resuscitation training that meets the requirements of
subdivision 1, paragraph (c), clause (4), and is repeated every two years within 90 days of
the second anniversary of the previous training. Documentation must be maintained at the
family child care program or electronically and made available upon request;
new text end
new text begin
(2) pediatric first aid training by a certified instructor repeated every two years within
90 days of the second anniversary of the previous training. Documentation of the training
must be maintained at the family child care program or electronically and made available
upon request;
new text end
new text begin
(3) commissioner-developed Health and Safety I and Health and Safety II training at
least once every five years. Completion of either course in a given year meets the annual
active supervision training requirement in subdivision 2, paragraph (a), clause (2);
new text end
new text begin
(4) proper use and installation of child passenger restraint systems under section 169.685
that meets the requirements of subdivision 1, paragraph (c), clause (6), and is repeated at
least once every five years. This requirement does not apply to family child care programs
that transport only school-age children as defined in section 142I.01, subdivision 5, paragraph
(e), in child care buses as defined in section 169.448, subdivision 1, paragraph (e); and
new text end
new text begin
(5) fire safety training developed by the State Fire Marshal's Office that must be
completed once every five years.
new text end
new text begin
(b) If a license holder changes any of the policies and procedures under section 142I.06,
subdivision 5, the primary provider of care and each second adult caregiver must review
the revised policies and procedures within ten days of the change.
new text end
new text begin
(c) The license holder must maintain documentation of each review of the revised policies
and procedures at the family child care program. The documentation requirements under
this paragraph may be met by a date noted on the revised policies or procedures.
new text end
new text begin Subd. 4. new text end
new text begin Commissioner designated training. new text end
new text begin
Training designated by the commissioner
satisfies the training requirements under this section if the training is within the knowledge
and competency framework for child development and learning, behavior guidance, and
active supervision, as indicated on the department's website.
new text end
Sec. 11.
new text begin
[142I.11] SUBSTITUTE AND INTERMITTENT CAREGIVER TRAINING
REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Initial training; substitute and intermittent caregiver. new text end
new text begin
(a) Before
providing care, each substitute and intermittent caregiver must complete the following
training requirements within the previous 12 months:
new text end
new text begin
(1) the four-hour basics of family child care for substitutes course developed by the
commissioner;
new text end
new text begin
(2) pediatric first aid training provided by an instructor certified to teach pediatric first
aid. Current training documentation must be maintained at the family child care program
and made available upon request. Online training reviewed and approved by the county
licensing agency satisfies this requirement;
new text end
new text begin
(3) pediatric cardiopulmonary resuscitation training that meets the requirements of
section 142I.10, subdivision 1, paragraph (c), clause (4);
new text end
new text begin
(4) for programs licensed for children younger than school age, training on reducing the
risk of sudden unexpected infant death and abusive head trauma, which may be combined
in a single commissioner-approved course. This training must, at a minimum, address the
risk factors related to sudden unexpected infant death and abusive head trauma and the
means of reducing the risk of each;
new text end
new text begin
(5) training on proper use and installation of child passenger restraint systems under
section 169.685 of at least one hour in length, provided by an instructor certified and
approved by the Department of Public Safety. This requirement does not apply to family
child care programs that transport only school-age children as defined in section 142I.01,
subdivision 5, paragraph (e), in child care buses as defined in section 169.448, subdivision
1, paragraph (e). At a minimum, the training must address the proper use of child restraint
systems based on the child's size, weight, and age and the proper installation of a car seat
or booster seat in the motor vehicle used by the caregiver to transport the child or children;
new text end
new text begin
(6) training on the child care emergency plan required under section 142I.19, subdivision
2;
new text end
new text begin
(7) training on allergy prevention and response required under section 142I.06,
subdivision 5, paragraph (b);
new text end
new text begin
(8) training on the community-based family child care program plan required under
section 142I.22, if applicable;
new text end
new text begin
(9) training on the family child care program policies and procedures required under
section 142I.06;
new text end
new text begin
(10) training on reporting suspected maltreatment of children as required under chapter
260E; and
new text end
new text begin
(11) swimming pool training under section 142I.14, subdivision 6, if a pool at the family
child care program is used by children in care.
new text end
new text begin
(b) County licensing staff must accept approved training on the substitute or intermittent
caregiver's learning record in the Develop data system for early education and school-age
care.
new text end
new text begin Subd. 2. new text end
new text begin Annual training; substitute and intermittent caregiver. new text end
new text begin
(a) Substitutes and
intermittent caregivers must complete a minimum of one hour of training each calendar
year, and the training must include the requirements in this section.
new text end
new text begin
(b) Each calendar year, a substitute or intermittent caregiver must receive training on
reducing the risk of abusive head trauma from shaking infants and young children if caring
for children under school age and reducing the risk of sudden unexpected infant death if
caring for infants. A substitute must complete each applicable course at least once every
two years either in person or online. In a year a substitute or intermittent caregiver is not
completing an applicable course under this paragraph in person or online, the individual
must watch a video on the respective topic of no more than one hour in length. The video
must be developed or approved by the commissioner. A license holder must maintain
documentation of compliance with this paragraph for each substitute and intermittent
caregiver employed.
new text end
new text begin Subd. 3. new text end
new text begin Ongoing training; substitute and intermittent caregiver. new text end
new text begin
(a) At least once
every three years, a substitute or intermittent caregiver must complete the four-hour basics
of family child care for substitutes course.
new text end
new text begin
(b) A substitute or intermittent caregiver must complete the following training:
new text end
new text begin
(1) pediatric cardiopulmonary resuscitation training that meets the requirements of
section 142I.10, subdivision 1, paragraph (c), clause (4), and is repeated every two years
within 90 days of the second anniversary of the previous training. Documentation must be
maintained at the family child care program or electronically and made available upon
request;
new text end
new text begin
(2) pediatric first aid that is given by an instructor certified to provide pediatric first aid
and is repeated every two years within 90 days of the second anniversary of the previous
training. Documentation of the training must be maintained at the family child care program
or electronically and made available upon request; and
new text end
new text begin
(3) proper use and installation of child passenger restraint systems under section 169.685
that meets the requirements of section 142I.10, subdivision 1, paragraph (c), clause (6), and
is repeated at least once every five years. This requirement does not apply to family child
care programs that transport only school-age children as defined in section 142I.01,
subdivision 5, paragraph (e), in child care buses as defined in section 169.448, subdivision
1, paragraph (e).
new text end
Sec. 12.
new text begin
[142I.12] HELPER TRAINING REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Initial training; helper. new text end
new text begin
(a) Before assisting in care, a helper who assists
with care must complete a minimum of four hours of training within the previous 12 months.
The four hours must include courses on:
new text end
new text begin
(1) reducing the risk of sudden unexpected infant death if the program is licensed to care
for infants;
new text end
new text begin
(2) abusive head trauma if the program is licensed to care for children younger than
school age; and
new text end
new text begin
(3) reporting suspected maltreatment of children as required under chapter 260E.
new text end
new text begin
(b) The trainings required under paragraph (a) may be combined in a single
commissioner-approved course.
new text end
new text begin
(c) A license holder must maintain written or electronic documentation showing that
each helper has complied with this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Annual training; helper. new text end
new text begin
(a) Each calendar year, a helper who assists in the
care of children must receive training on reducing the risk of sudden unexpected infant
death if the program is licensed to care for infants, and abusive head trauma if the program
is licensed to care for children younger than school age. The trainings under this paragraph
may be combined in a single commissioner-approved course and must, at a minimum,
address risk factors, methods of risk reduction in child care, and communication with parents
regarding risk reduction.
new text end
new text begin
(b) A license holder must maintain documentation showing each helper has complied
with this subdivision.
new text end
new text begin
(c) County licensing staff must accept approved training on the helper's learning record
in the Develop data system.
new text end
Sec. 13.
new text begin
[142I.13] BEHAVIOR GUIDANCE.
new text end
new text begin Subdivision 1. new text end
new text begin Methods of promoting positive behavior. new text end
new text begin
A license holder must:
new text end
new text begin
(1) positively role model acceptable behavior to each child;
new text end
new text begin
(2) tailor methods of promoting positive behavior to the developmental level of the
children the family child care program is licensed to serve;
new text end
new text begin
(3) ensure redirection is used as appropriate in addressing a child's behavior, to guide a
child away from potential challenges toward constructive activity. For the purposes of this
clause, "redirection" means when a caregiver intervenes and guides a child toward
constructive activity through positive techniques;
new text end
new text begin
(4) teach children how to use acceptable alternatives to reduce conflict; and
new text end
new text begin
(5) protect the safety and well-being of children and caregivers.
new text end
new text begin Subd. 2. new text end
new text begin Prohibited actions. new text end
new text begin
A license holder must prohibit every caregiver from:
new text end
new text begin
(1) subjecting a child to corporal or physical punishment. This includes but is not limited
to rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting,
pinching, spitting, hitting, and spanking;
new text end
new text begin
(2) subjecting a child to name calling, ostracism, shaming, making derogatory remarks
about the child or the child's family, cultural or racial slurs, and yelling or using profane
language that threatens, humiliates, or frightens the child;
new text end
new text begin
(3) forcing a child to maintain an uncomfortable position or to continuously repeat
physical movements;
new text end
new text begin
(4) separating a child from the group except as provided in subdivision 3;
new text end
new text begin
(5) punishing a child for:
new text end
new text begin
(i) not resting, napping, or sleeping;
new text end
new text begin
(ii) toileting accidents;
new text end
new text begin
(iii) failing to eat all or part of meals or snacks; or
new text end
new text begin
(iv) failing to complete an activity;
new text end
new text begin
(6) denying a child food or drink or forcing food or drink upon a child;
new text end
new text begin
(7) denying light, warmth, clothing, or medical care as a punishment for unacceptable
behavior;
new text end
new text begin
(8) the use of physical restraint other than to physically hold a child when containment
is necessary to protect a child or others from harm;
new text end
new text begin
(9) the use of prone restraints, as prohibited by section 245A.211;
new text end
new text begin
(10) the use of mechanical restraints, such as tying, or any device or equipment intended
to restrict or prevent movement as a means of discipline or for reasons unrelated to the
child's care, safety, or planned activity;
new text end
new text begin
(11) giving a child any nonprescribed substance to subdue or restrict movement or
behavior;
new text end
new text begin
(12) delegating the discipline or punishment of a child to another child; and
new text end
new text begin
(13) punishing or shaming a child for the actions of a parent. This includes but is not
limited to failure to pay fees, failure to provide appropriate clothing, failure to provide
materials for an activity, or any conflict between the license holder or caregiver and the
parent.
new text end
new text begin Subd. 3. new text end
new text begin Separation time from the group. new text end
new text begin
A caregiver must not separate a child from
the child's group as a means of behavior guidance unless the caregiver has tried less intrusive
methods of guiding the child's behavior that have been ineffective and the child's behavior
threatens the well-being of the child or other children in the family child care program.
Separation from the group must meet the following requirements:
new text end
new text begin
(1) children younger than three years old must not be separated from the group as a
means of behavior guidance;
new text end
new text begin
(2) the separation time must be limited to the amount of time necessary for the child to
gain self-control and rejoin the group while being supported by the caregiver;
new text end
new text begin
(3) the child must be supervised;
new text end
new text begin
(4) the child must not be placed in a locked room to separate the child from the group;
and
new text end
new text begin
(5) the caregiver must provide the separation time in an age-appropriate, nonhumiliating
manner for the child.
new text end
Sec. 14.
new text begin
[142I.14] PHYSICAL SPACE REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Indoor space. new text end
new text begin
(a) The licensed capacity of the family child care program
must be limited by the amount of usable indoor space available to children. A minimum of
35 square feet of usable indoor space is required per child.
new text end
new text begin
(b) Bathrooms, closets, space occupied by major appliances, and other space not used
by children may not be counted as usable space. Space occupied by adult furniture, if it is
used by children, may be counted as usable indoor space.
new text end
new text begin
(c) Usable indoor space may include a basement if it has been inspected and approved
by a fire marshal, is free of hazards, and meets the requirements of subdivision 4.
new text end
new text begin
(d) All exits leading from indoor to outdoor space must be fully clear of obstruction.
new text end
new text begin Subd. 2. new text end
new text begin Escape routes. new text end
new text begin
(a) The main means of escape must be a stairway or door leading
to the floor with an exit to the outside.
new text end
new text begin
(b) Any room that has sleeping children must have an escape route separate from the
main exit referenced in paragraph (a). This escape route must be a door or an egress window
leading directly outside.
new text end
new text begin
(c) When the basement is used for care, the basement must have at least one escape route
separate from the main exit under paragraph (a). This escape route must be a door or an
egress window leading directly outside.
new text end
new text begin
(d) Required escape routes must not be obstructed and must be accessible and openable
without special knowledge.
new text end
new text begin Subd. 3. new text end
new text begin Outdoor learning environment and play space. new text end
new text begin
(a) A family child care
program must have an outdoor play space of at least 50 square feet per child the program
is licensed to serve for regular use or a park, playground, or play space within 1,500 feet of
the family child care program.
new text end
new text begin
(b) During outdoor play:
new text end
new text begin
(1) the adult caregiver must remain outdoors with infants, toddlers, and preschoolers at
all times;
new text end
new text begin
(2) school-age children may be permitted in the approved outdoor play space at the
family child care program without a caregiver if:
new text end
new text begin
(i) the children are engaged in age-appropriate activities using age-appropriate equipment;
and
new text end
new text begin
(ii) a caregiver remains accessible to provide supervision when needed in accordance
with section 142I.01, subdivision 46; and
new text end
new text begin
(3) when the outdoor play space is not at the family child care program, a caregiver must
accompany and supervise all children in transit and at the outdoor play space.
new text end
new text begin
(c) Caregivers must prevent children from accessing hazardous materials.
new text end
new text begin
(d) Outdoor play areas must be protected from traffic and nearby hazards. If traffic or
other hazards are present, the family child care program must have:
new text end
new text begin
(1) a continuous fence in good condition with functioning gates or a continuous natural
barrier or a combination of fence and naturally occurring or landscaping barrier. The fence
or natural barrier must ensure that children are not able to leave the outdoor play area
unsupervised; or
new text end
new text begin
(2) a supervision and safety plan if a fence is not used that includes alternative methods
to ensure the health, safety, and protection of children in care.
new text end
new text begin
(e) Electrical fences must be inaccessible to children in care.
new text end
new text begin
(f) Caregivers must take measures to protect children from the dangers of sun exposure,
extreme heat or cold, and air quality.
new text end
new text begin
(g) Outdoor equipment, whether stationary or portable, must be safe, be in good repair,
be assembled according to the manufacturer's guidelines, and meet the developmental needs
of the age groups of children using the space.
new text end
new text begin
(h) Equipment including but not limited to climbing gyms, swings, and slides must:
new text end
new text begin
(1) not have openings between 3-1/2 inches and nine inches in size to prevent entrapment
of the head or other body parts;
new text end
new text begin
(2) have guardrails or protective barriers on platforms that are 30 inches or higher. A
protective barrier is a continuous structure surrounding the platform that is designed to
prevent a person from falling or passing through, whether intentionally or accidentally; and
new text end
new text begin
(3) be assembled, installed, and utilized according to the manufacturer's guidelines.
new text end
new text begin Subd. 4. new text end
new text begin Conditions of the program. new text end
new text begin
The licensed space must be maintained in a manner
that protects the health and safety of children in care. The license holder must ensure that:
new text end
new text begin
(1) the family child care program space is free from conditions that endanger the health
or safety of children, including unsanitary conditions or excessive accumulation of materials
that can start a fire or create other safety hazards;
new text end
new text begin
(2) the furnishings, equipment, and materials are arranged and stored so that hallways,
stairways, doors, and exit routes remain unobstructed and usable for safe exit; and
new text end
new text begin
(3) the amount and placement of stored items do not create an increased risk of fire or
injury or impede the safe supervision of children.
new text end
new text begin Subd. 5. new text end
new text begin Portable wading pools. new text end
new text begin
(a) A child must not use a portable wading pool as
defined in section 144.1222, subdivision 2a, at a family child care program unless the parent
of the child has provided written consent. The written consent must include a statement that
the parent has received and read material provided by the Department of Health on wading
pool safety for parents related to the risk of disease transmission as well as other health
risks associated with the use of portable wading pools.
new text end
new text begin
(b) The license holder must empty wading pools daily.
new text end
new text begin
(c) A caregiver must supervise children at all times while a wading pool is in use and
must be able to clearly see all parts of the wading area. When not in use under the supervision
of a caregiver, wading pools must be inaccessible to children.
new text end
new text begin Subd. 6. new text end
new text begin Swimming pools. new text end
new text begin
(a) For the purposes of this subdivision, "swimming pool"
has the meaning in section 144.1222, subdivision 2b, and does not include a portable wading
pool as defined in section 144.1222, subdivision 2a, or a spa pool as defined in Minnesota
Rules, part 4717.0250.
new text end
new text begin
(b) A license holder must comply with the following requirements in order for children
in the program to use a swimming pool located at the program:
new text end
new text begin
(1) not have had a licensing sanction under section 142B.18 or a correction order or
conditional license under section 142B.16 relating to the supervision or health and safety
of children during the prior 24 months;
new text end
new text begin
(2) notify the county agency before initial use of the swimming pool each calendar year;
new text end
new text begin
(3) obtain written consent from a child's parent allowing the child to use the swimming
pool and renew the parent's written consent at least annually. The written consent must
include a statement that the parent has received and read materials provided by the
Department of Health related to the risk of disease transmission as well as other health risks
associated with swimming pools. The written consent must also include a statement that
neither the Department of Health nor the county agency will monitor or inspect the license
holder's swimming pool;
new text end
new text begin
(4) attend and successfully complete a swimming pool supervision training course
annually;
new text end
new text begin
(5) attend and successfully complete one of the following swimming pool operator
training courses once every five years:
new text end
new text begin
(i) both of the National Spa and Pool Institute Tech I and Tech II courses; or
new text end
new text begin
(ii) the National Recreation and Park Association aquatic facility operator course;
new text end
new text begin
(6) ensure all toilet-trained children use the bathroom before the children enter the
swimming pool;
new text end
new text begin
(7) require all children who are not toilet trained to wear swim diapers while in the
swimming pool;
new text end
new text begin
(8) if fecal material enters the swimming pool water, add three times the normal shock
treatment to the pool water to raise the chlorine level to at least 20 parts per million and
close the pool to swimming for the 24 hours following the entrance of fecal material into
the water or until the water pH and disinfectant concentration levels have returned to the
standards specified in clause (10), whichever is later;
new text end
new text begin
(9) prevent any person from entering the swimming pool who has an open wound or has
or is suspected of having a communicable disease;
new text end
new text begin
(10) maintain the swimming pool water at a pH of not less than 7.2 and not more than
8.0, maintain the disinfectant concentration between two and five parts per million for
chlorine or between 2.3 and 4.5 parts per million for bromine, and maintain a daily record
of the swimming pool's operation with pH and disinfectant concentration readings on days
when children cared for at the family child care program are present;
new text end
new text begin
(11) have a disinfectant feeder or feeders;
new text end
new text begin
(12) have a recirculation system that will clarify and disinfect the swimming pool volume
of water in ten hours or less;
new text end
new text begin
(13) maintain the swimming pool's water clarity so that an object on the pool floor at
the pool's deepest point is easily visible;
new text end
new text begin
(14) comply with the provisions in section 144.1222, subdivisions 1c and 1d;
new text end
new text begin
(15) have in place and enforce written safety rules and swimming pool policies;
new text end
new text begin
(16) have in place at all times a safety rope that divides the shallow and deep portions
of the swimming pool;
new text end
new text begin
(17) maintain compliance with any existing local ordinances regarding swimming pool
installation, decks, and fencing;
new text end
new text begin
(18) maintain a water temperature of not more than 104 degrees Fahrenheit and not less
than 70 degrees Fahrenheit;
new text end
new text begin
(19) cover the swimming pool when not in use;
new text end
new text begin
(20) follow the requirements of subdivision 7; and
new text end
new text begin
(21) for lifesaving equipment, have a United States Coast Guard-approved life ring
attached to a rope, an exit ladder, and a shepherd's hook available at all times to the caregiver
supervising the swimming pool.
new text end
new text begin Subd. 7. new text end
new text begin Water hazards. new text end
new text begin
(a) Swimming and wading pools, beaches, wells, or other
bodies of water on or adjacent to the site of the family child care program must be
inaccessible to children except during periods of supervised use.
new text end
new text begin
(b) All water hazards, such as inground or aboveground swimming pools, hot tubs,
stationary wading pools, fish ponds, and water retention or detention basins on the site of
the family child care program must be enclosed with a permanent fence, wall, building wall,
other physical barrier, or combination thereof that is at least four feet in height. A house
exterior wall can constitute one side of a fence if the wall has no openings capable of
providing direct access to the hazard, including but not limited to doors or windows.
new text end
new text begin
(c) The family child care program may not allow a child in care to use a swimming pool
or beach without an adult caregiver trained in first aid and CPR present.
new text end
new text begin
(d) Bodies of water must be separated from the play area by a fence or other physical
barrier that prevents children from accessing the water. The house door alone is not a
sufficient barrier.
new text end
new text begin Subd. 8. new text end
new text begin Water play. new text end
new text begin
(a) Parental permission is not required for children to use splash
pads, sprinklers, or other water toys that spray or jet water on the users and do not have
standing water. Splash pads, sprinklers, or other water toys that retain water are considered
wading pools and are required to meet the requirements of subdivision 5.
new text end
new text begin
(b) Water tables designed for children to play with their hands must be emptied daily.
The caregiver must supervise children at all times while a water table is in use and must be
able to clearly see all parts of the water table. When not in use under the supervision of a
caregiver, water tables must be inaccessible to children.
new text end
new text begin Subd. 9. new text end
new text begin Separation between attached garage and family child care program. new text end
new text begin
The
separation wall between the residence and garage must meet the requirements of Minnesota
Rules, part 1309.0302.
new text end
new text begin Subd. 10. new text end
new text begin Ventilation, heating, and cooling systems. new text end
new text begin
(a) Heating, ventilation, and air
conditioning systems must be operated according to the manufacturer's instructions and in
good repair. Gas, coal, wood, kerosene, or oil heaters must be vented to the outside in
accordance with the State Building Code.
new text end
new text begin
(b) Items that can be ignited and support combustion, including but not limited to plastic,
fabric, and wood products, must not be located within:
new text end
new text begin
(1) 18 inches of a gas or fuel-oil heater or furnace; or
new text end
new text begin
(2) 36 inches of a solid-fuel-burning appliance.
new text end
new text begin
(c) If a license holder produces manufacturer instructions listing a distance closer than
the requirements under paragraph (b), the manufacturer instructions control the required
distance of combustible items from gas, fuel-oil, or solid-fuel-burning heaters or furnaces.
new text end
new text begin
(d) When in use, fireplaces, wood-burning stoves, solid-fuel-burning appliances, space
heaters, steam radiators, outdoor fire pits, and other potentially hot surfaces, such as steam
pipes, must be protected by guards or protective covering to keep hands and bodies away,
prevent burns, and prevent fires. All fireplaces, wood-burning stoves, space heaters, steam
radiators, and furnaces must be installed according to the State Building Code. The furnace,
hot water heater, and utility rooms must be inaccessible to children.
new text end
new text begin
(e) Ventilation of usable space must meet the requirements of the State Building Code.
Outside doors and windows used for ventilation in summer months must be screened when
biting insects are prevalent. The screens must be in good repair. Sources of harmful and
unpleasant odors including urine and pet waste must be removed to the extent possible by
removing the source of the odor or by removing odors through cleaning and ventilation.
new text end
new text begin Subd. 11. new text end
new text begin Temperature. new text end
new text begin
A minimum temperature of 62 degrees Fahrenheit must be
maintained in indoor areas used by children.
new text end
new text begin Subd. 12. new text end
new text begin Sewage disposal. new text end
new text begin
Family child care programs must have working toilets and
a sewage disposal system that conform to the State Building Code or local septic system
ordinances. Toilet training equipment must be emptied and cleaned after each use. Outdoor
toilets, including compostable toilets, are permissible in accordance with local septic system
ordinances.
new text end
new text begin Subd. 13. new text end
new text begin Construction or remodeling. new text end
new text begin
During construction or remodeling, children
must not have access to construction or remodeling areas within or around the premises.
new text end
new text begin Subd. 14. new text end
new text begin Interior walls and ceilings. new text end
new text begin
The walls and ceilings within a family child care
program, including those in corridors, stairways, and lobbies, must have a flame spread
rating of 200 or less.
new text end
new text begin Subd. 15. new text end
new text begin Electrical services. new text end
new text begin
(a) All electric outlets in a family child care program
accessible to children must be tamper-proof or shielded when not in use. All major electrical
appliances must be properly installed and grounded in accordance with the State Electrical
Code and in good working order.
new text end
new text begin
(b) Electrical wiring must be sized to provide for the load and be in good repair. Extension
cords must not be used as a substitute for permanent wiring.
new text end
new text begin Subd. 16. new text end
new text begin Fire extinguisher. new text end
new text begin
A portable, operational, multipurpose, and dry chemical
fire extinguisher with a minimum 2-A 10-BC rating must be located near the required exit
door of the program at all times. The fire extinguisher must be serviced annually by a
qualified inspector and evidence of annual service must be documented. All caregivers must
know how to properly use the fire extinguisher.
new text end
new text begin Subd. 17. new text end
new text begin Carbon monoxide and smoke alarms. new text end
new text begin
(a) A family child care program must
have an approved and operational carbon monoxide alarm installed within ten feet of each
area used for sleeping children in care.
new text end
new text begin
(b) A family child care program must properly install and maintain smoke alarms models
that have been approved by the Underwriter Laboratory on all levels, including basements,
and in hallways outside rooms used for sleeping children in care. Smoke alarms are not
required in crawl spaces and uninhabitable attics. For family child care programs in buildings
that began construction on or after March 31, 2020, smoke alarms must be installed and
maintained in each room used for children in care to sleep.
new text end
new text begin Subd. 18. new text end
new text begin Stairways. new text end
new text begin
All family child care programs with stairways must:
new text end
new text begin
(1) have handrails on at least one side of stairways of four or more steps;
new text end
new text begin
(2) enclose any open area between the handrail and stair tread with a protective guardrail
as specified in the State Building Code. The back of the stair risers must also be enclosed;
new text end
new text begin
(3) use gates at the top and bottom of stairways when children who are six to 18 months
old are in care; and
new text end
new text begin
(4) keep stairways well lit, in good repair, and free of clutter and obstructions.
new text end
new text begin Subd. 19. new text end
new text begin Lofted spaces. new text end
new text begin
Decks, balconies, or lofts that are used by children and are
more than 30 inches above the ground or floor must be surrounded by a protective guardrail
and be constructed in compliance with the State Building Code. The State Building Code
allows appropriate openings for access to the spaces under this subdivision, such as a
doorway or a gate. Wooden decks must be free of splinters and in good repair.
new text end
new text begin Subd. 20. new text end
new text begin Locks and latches. new text end
new text begin
(a) A door latch on a closet or other confining space must
be able to be unlatched so that the door can be opened from inside the closet or other
confining space.
new text end
new text begin
(b) Every interior door lock must permit opening of the locked door from the outside
and the opening device must be readily accessible to all caregivers.
new text end
new text begin
(c) Exit doors must not have double cylinder locks where a key is required on both sides.
new text end
new text begin
(d) Locks may not be used in place of supervision.
new text end
new text begin Subd. 21. new text end
new text begin
Tobacco products, cannabis, vaping, drugs, and alcohol use
prohibitions.
new text end
new text begin
(a) Smoking of tobacco, cannabis, or any other product, including through
electronic delivery devices, is prohibited in both indoor and outdoor family child care
program environments and in any vehicles used by the family child care program during
hours of operation.
new text end
new text begin
(b) The use of alcohol or illegal or recreational drugs is prohibited on the premises of a
family child care program during hours of operation.
new text end
new text begin
(c) If the license holder allows smoking of tobacco, cannabis, or any other product,
including through electronic delivery devices, on the premises outside of child care hours,
the license holder must verbally provide notice to parents and must post written notice in
an obvious location disclosing this information.
new text end
new text begin
(d) While caring for children, a caregiver must not be under the influence of any substance
that impairs the individual's ability to supervise children or perform the individual's duties.
new text end
Sec. 15.
new text begin
[142I.15] CLEANING AND DISINFECTING.
new text end
new text begin Subdivision 1. new text end
new text begin General requirements. new text end
new text begin
(a) The family child care program must be free
from accumulations of dirt, peeling paint, visible or known debris, soiled items, hazardous
clutter, and pet waste.
new text end
new text begin
(b) Disinfectants must:
new text end
new text begin
(1) not be used prior to or in place of cleaning compounds;
new text end
new text begin
(2) be mixed and used according to the manufacturer's instructions; and
new text end
new text begin
(3) be used on surfaces that are contaminated with bodily fluids.
new text end
new text begin Subd. 2. new text end
new text begin Toys. new text end
new text begin
A caregiver must clean and disinfect a toy that has been in a child's mouth
prior to use by another child. Toys that come into contact with bodily fluids must be cleaned
and disinfected prior to next use. Toys must be cleaned and disinfected as needed if there
are visible or known contaminants or debris on them.
new text end
new text begin Subd. 3. new text end
new text begin Food and eating areas. new text end
new text begin
Surfaces and tools that are used for preparing or serving
food must be cleaned.
new text end
new text begin Subd. 4. new text end
new text begin Indoor and outdoor equipment. new text end
new text begin
(a) The indoor and outdoor space and
equipment of the family child care program must be clean.
new text end
new text begin
(b) Natural features, elements, and materials used as equipment and play materials for
outdoor play under section 142I.14, subdivision 3, are exempt from being clean, as defined
under section 142I.01, subdivision 16. A caregiver must inspect natural features, elements,
and materials used for outdoor play for hazardous objects and other safety hazards, including
animal feces, and remove or mitigate the hazard before a child's use.
new text end
new text begin Subd. 5. new text end
new text begin Sleeping. new text end
new text begin
Bedding, as defined in section 142I.17, subdivision 10, must be
cleaned and disinfected at least weekly or when visibly dirty.
new text end
new text begin Subd. 6. new text end
new text begin Toilet training equipment. new text end
new text begin
Toilet training chairs and seats must be cleaned
and disinfected after each use.
new text end
new text begin Subd. 7. new text end
new text begin Hand washing. new text end
new text begin
(a) A child's hands must be washed with soap and running
water when soiled, after the use of a toilet or toilet training chair, and before eating a meal
or snack. The caregiver must monitor and assist a child who needs help. Children's hands
must be dried on a separate or single-use towel.
new text end
new text begin
(b) In sinks and tubs accessible to children, the water temperature must not be able to
exceed 120 degrees Fahrenheit.
new text end
new text begin
(c) Caregivers must wash their hands with soap and water after each diaper change, after
assisting a child on the toilet, after washing the diapering surface, and before food
preparation. The caregiver's hands must be dried on a separate or single-use towel.
new text end
new text begin Subd. 8. new text end
new text begin Diapers, changing areas, and disposal. new text end
new text begin
(a) An adequate supply of clean diapers
must be available for each child who uses diapers. Diapers may be disposable or made of
cloth. Diapers must be stored in a clean space that is inaccessible to children.
new text end
new text begin
(b) If a family child care program uses cloth diapers, then:
new text end
new text begin
(1) the cloth diapers must have an absorbent inner layer that is completely covered with
an outer waterproof layer that has a waist closure;
new text end
new text begin
(2) the cloth diaper and waterproof layer must be changed at the same time; and
new text end
new text begin
(3) the cloth diapers supplied by parents, except those supplied by a commercial diaper
service, must be labeled with the child's name and must be placed in a plastic bag after
removal with any soiled clothing and sent home with the parent daily.
new text end
new text begin
(c) Single-service disposable wipes or clean washcloths must be used for washing a
soiled child before rediapering.
new text end
new text begin
(d) The diaper changing area must be covered with a smooth, nonabsorbent surface.
Changing tables, changing pads, and other diaper changing areas must be cleaned and
disinfected between children, even if using a nonabsorbent covering that is discarded after
each use. Diapering must not take place in a food preparation area.
new text end
new text begin
(e) Disposable diapers must be disposed of in a covered container located in the diaper
changing area and lined with a disposable plastic bag or directly outdoors in a garbage can.
new text end
Sec. 16.
new text begin
[142I.16] ENVIRONMENTAL HEALTH.
new text end
new text begin Subdivision 1. new text end
new text begin Water supply. new text end
new text begin
(a) All family child care programs must have a safe water
supply.
new text end
new text begin
(b) Family child care programs that draw water from privately owned wells must test
the water annually by a Department of Health-certified laboratory for coliform bacteria and
nitrate nitrogen and receive confirmation that the water is safe. The family child care program
must submit a copy of the test results with the agency. Retesting and corrective measures
may be required by the agency if results do not meet state drinking water standards or where
the supply may be subject to off-site contamination. A copy of the most recent water testing
results must be kept on the licensed premises. If the water test results are at or above
Department of Health-recommended levels or if the license holder declines to test the water
supply in the program, the license holder must:
new text end
new text begin
(1) supply bottled or packaged water;
new text end
new text begin
(2) use water filtration devices that have been certified by the National Science
Foundation or American National Standards Institute to remove the contaminant. The water
filtration device must be attached directly to water faucets, inserted into the refrigerator
water dispenser, or inserted into water pitchers or bottles. The water filtration device must
be maintained according to manufacturer guidelines; or
new text end
new text begin
(3) close the family child care program to prevent children from using or consuming
unsafe water.
new text end
new text begin Subd. 2. new text end
new text begin Radon testing. new text end
new text begin
(a) The license holder must notify parents whether radon testing
has been conducted in the family child care program upon enrollment and within 30 days
of any subsequent testing done after enrollment.
new text end
new text begin
(b) When notifying parents, the license holder must use a form prescribed by the
commissioner. The notice must include information from the Department of Health about
what radon is and the potential risks associated with radon exposure. If testing has been
completed, the notice must include:
new text end
new text begin
(1) the date of the most recent test;
new text end
new text begin
(2) the rooms or areas tested; and
new text end
new text begin
(3) the detected radon level or levels, stated in picocuries per liter (pCi/L).
new text end
new text begin
(c) A copy of the most recent notice to parents and the radon test results must be kept
on site and made available to parents and the commissioner upon request.
new text end
new text begin
(d) The notification requirements under this subdivision may be met by posting the form
in a prominent place.
new text end
Sec. 17.
new text begin
[142I.17] ACTIVITIES AND EQUIPMENT.
new text end
new text begin Subdivision 1. new text end
new text begin General activities. new text end
new text begin
Child care activities must provide for the physical,
intellectual, emotional, and social development of the children in care at a family child care
program. Activities must include infants, toddlers, preschoolers, and school-age children
and:
new text end
new text begin
(1) be scheduled indoors and outdoors daily, weather permitting. When determining if
the weather permits outdoor play, a license holder must defer to weather advisory
notifications, including air quality emergencies, provided by local weather experts, local or
state authority on air quality, or public health;
new text end
new text begin
(2) be appropriate to the age and developmental stage of the child;
new text end
new text begin
(3) include active and quiet activity; and
new text end
new text begin
(4) include both caregiver- and child-directed activities.
new text end
new text begin Subd. 2. new text end
new text begin Equipment. new text end
new text begin
(a) A license holder must provide children in a family child care
program with:
new text end
new text begin
(1) sufficient play equipment to allow each child a choice of at least three activities
involving equipment when all children are using equipment;
new text end
new text begin
(2) early learning materials, play equipment, and space that are age and developmentally
appropriate and support understanding of the culturally diverse world; and
new text end
new text begin
(3) play equipment that is safe, in good repair, and used in accordance with the
manufacturer's instructions, if applicable. Equipment and play materials not designed or
marketed for use by children, including but not limited to repurposed, homemade, and
open-ended items, must be appropriate to the age and size of children, in good repair, and
used under the supervision of a caregiver. Such equipment and play materials are not required
to have manufacturer's instructions and are subject to the requirements of this subdivision.
new text end
new text begin
(b) Equipment provided to children under this section may be new, used, commercially
made, or homemade. The equipment must be appropriate for the ages of the children and
for the activities for which it will be used. As appropriate, nature material may be used in
place of any equipment.
new text end
new text begin Subd. 3. new text end
new text begin Newborn or infant activities. new text end
new text begin
A caregiver must:
new text end
new text begin
(1) hold a newborn or infant during feedings until the child can hold the bottle. A bottle
cannot be propped up for a newborn or infant;
new text end
new text begin
(2) respond to a newborn's or infant's attempts to communicate;
new text end
new text begin
(3) develop infant language and communication by responding to a newborn's or infant's
attempts to communicate by mirroring similar sounds, sharing the child's focus of attention,
talking to the newborn or infant, naming objects, and describing actions;
new text end
new text begin
(4) provide a newborn or infant with freedom of movement to sit safely and comfortably,
crawl, toddle, walk, and play both indoors and outdoors throughout the day;
new text end
new text begin
(5) provide a newborn or infant an opportunity to stimulate the senses by providing a
variety of activities and objects to see, touch, feel, smell, hear, and taste;
new text end
new text begin
(6) provide activities for a newborn or infant that develop the child's manipulative and
fine motor skills;
new text end
new text begin
(7) provide activities for self-awareness;
new text end
new text begin
(8) provide activities to support a newborn or infant to develop social-emotional skills;
new text end
new text begin
(9) provide activities to support a newborn or infant to develop gross motor skills; and
new text end
new text begin
(10) allow a newborn or infant actively supervised tummy time. For the purposes of this
clause, "tummy time" means placing a newborn or infant in a nonrestrictive prone position,
lying on their stomach. Tummy time should occur throughout the day when a newborn or
infant is awake. A newborn or infant must not be wearing anything to restrict movement
during tummy time.
new text end
new text begin Subd. 4. new text end
new text begin Newborn and infant equipment. new text end
new text begin
When caring for newborns or infants, a
license holder must provide:
new text end
new text begin
(1) an infant seat or high chair, as appropriate, for each newborn and infant in attendance;
new text end
new text begin
(2) a crib or portable crib with a mattress or pad for each newborn and infant in attendance
that is in compliance with current Consumer Product Safety Commission safety standards
and chapter 142B.45. The license holder must maintain documentation on site that the
equipment used meets these requirements and provide it to the commissioner and parents
as requested;
new text end
new text begin
(3) books and literacy materials;
new text end
new text begin
(4) gross motor activity equipment; and
new text end
new text begin
(5) fine motor activity materials.
new text end
new text begin Subd. 5. new text end
new text begin Toddler activities. new text end
new text begin
When caring for toddlers, a license holder must:
new text end
new text begin
(1) provide the toddler with freedom of movement and freedom to explore outside the
crib or portable crib and allow the toddler to comfortably sit, crawl, toddle, walk, and play
according to the toddler's stage of development;
new text end
new text begin
(2) talk to, listen to, and interact with the toddler to encourage language development;
new text end
new text begin
(3) provide the toddler with activities that develop the toddler's fine and gross motor
skills;
new text end
new text begin
(4) give the toddler opportunities to stimulate the senses by providing a variety of
age-appropriate activities and objects to see, touch, feel, smell, hear, and taste; and
new text end
new text begin
(5) provide activities to support the toddler to develop social-emotional skills.
new text end
new text begin Subd. 6. new text end
new text begin Toddler equipment. new text end
new text begin
When caring for toddlers, a license holder must provide:
new text end
new text begin
(1) separate sleeping equipment for each toddler such as a mat, crib, cot, bed, sofa, or
sleeping bag that is cleaned and maintained as required in subdivision 11 and section 142I.15,
subdivision 5;
new text end
new text begin
(2) gross motor play equipment;
new text end
new text begin
(3) books and literacy materials;
new text end
new text begin
(4) fine motor, math, and science materials; and
new text end
new text begin
(5) music, movement, and art activity materials.
new text end
new text begin Subd. 7. new text end
new text begin Preschooler activities. new text end
new text begin
When caring for preschoolers, a license holder must:
new text end
new text begin
(1) encourage conversation between the preschooler and other children and adults;
new text end
new text begin
(2) provide opportunity to play near and with other children, provide time and space for
individual and group play, allow for quiet times to talk or rest, and allow for unplanned
time and individual play time;
new text end
new text begin
(3) foster understanding of personal and peer feelings and actions and allow for the
constructive release of a range of feelings through discussion or play;
new text end
new text begin
(4) give assistance in toileting and provide time to carry out self-help skills and provide
opportunities to be responsible for activities;
new text end
new text begin
(5) provide opportunities for each preschooler to make decisions about daily activities
and to learn from the decision-making experiences;
new text end
new text begin
(6) provide time and areas for age-appropriate gross motor play;
new text end
new text begin
(7) provide learning, fine-motor, manipulative, creative, or sensory activities; and
new text end
new text begin
(8) read stories, look at books, and talk about new words and ideas with the preschooler.
new text end
new text begin Subd. 8. new text end
new text begin Preschooler equipment. new text end
new text begin
When caring for preschoolers, a license holder must
provide:
new text end
new text begin
(1) separate sleeping equipment for each preschooler such as a mat, bed, cot, sofa, or
sleeping bag for each preschooler that is cleaned and maintained as required under
subdivision 11 and section 142I.15, subdivision 5;
new text end
new text begin
(2) dramatic play equipment;
new text end
new text begin
(3) books and literacy materials;
new text end
new text begin
(4) fine motor materials;
new text end
new text begin
(5) gross motor play equipment;
new text end
new text begin
(6) math materials;
new text end
new text begin
(7) science materials;
new text end
new text begin
(8) music and movement materials; and
new text end
new text begin
(9) art materials.
new text end
new text begin Subd. 9. new text end
new text begin School-age activities and equipment. new text end
new text begin
When caring for school-age children,
a license holder must:
new text end
new text begin
(1) provide opportunities for individual discussion about the day and planning for
activities;
new text end
new text begin
(2) provide space, opportunities, and materials or equipment for games, activities, or
sports using the whole body;
new text end
new text begin
(3) have available space, bedding materials, and opportunities for individual rest and
quiet time required under subdivision 11;
new text end
new text begin
(4) allow increased freedom as the school-age child demonstrates increased responsibility;
new text end
new text begin
(5) provide opportunities for group experiences with other children;
new text end
new text begin
(6) provide opportunities to develop or expand self-help skills or real-life experiences;
and
new text end
new text begin
(7) provide opportunities and materials for creative and dramatic activity, arts, and crafts.
new text end
new text begin Subd. 10. new text end
new text begin Natural elements and materials. new text end
new text begin
(a) A license holder may provide children
with access to natural elements and materials as equipment and play materials. Natural
elements and materials and appropriate uses of natural elements and materials include, but
are not limited to:
new text end
new text begin
(1) natural loose parts, such as sticks, leaves, pinecones, acorns, seeds, pods, bark, and
moss for construction, art, sensory exploration, and imaginative play;
new text end
new text begin
(2) natural materials, such as dirt, mud, sand, water, ice, and snow for sensory play and
exploration;
new text end
new text begin
(3) plants, flowers, seeds, vegetables, and gardening materials for science exploration
and learning;
new text end
new text begin
(4) rocks, pebbles, stones, and minerals for counting, sorting, building, and art;
new text end
new text begin
(5) natural areas such as gardens, prairie, forest, wetlands, and ponds for exploration
and learning; and
new text end
new text begin
(6) other natural elements as appropriate to age and development of children.
new text end
new text begin
(b) A caregiver must supervise a child's use of natural elements and materials and provide
guidance on safe and appropriate use. Natural elements and materials that are a choking
hazard must not be accessible to children under the age of three without direct supervision
of a caregiver.
new text end
new text begin
(c) Natural elements and materials may qualify as equipment and materials under
subdivisions 4, 6, 8, and 9.
new text end
new text begin Subd. 11. new text end
new text begin Bedding. new text end
new text begin
Clean, separate, and individual bedding such as sheets, towels,
blankets, or sleeping bags must be available for each child in care. For children not using
cribs or portable cribs, the license holder must provide developmentally appropriate mats,
cots, or other sleep equipment that can be cleaned and disinfected according to section
142I.15. Mats, cots, and other sleep equipment used in the family child care program must
be in good condition and have no tears or holes and be covered in individual bedding.
new text end
new text begin Subd. 12. new text end
new text begin Separation of personal articles. new text end
new text begin
Separate towels, wash cloths, water bottles,
and drinking cups must be used for each child and labeled appropriately.
new text end
Sec. 18.
new text begin
[142I.18] INFANT SLEEP AND CRIB REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Safety. new text end
new text begin
All caregivers must follow the crib safety requirements in section
142B.45 and the requirements to reduce the risk of sudden unexpected infant deaths in
section 142B.46. During routine licensing inspections and when investigating complaints
regarding alleged violations of this section, the commissioner must review the license
holder's documentation required under section 142B.45.
new text end
new text begin Subd. 2. new text end
new text begin Monitoring sleeping newborns and infants. new text end
new text begin
(a) Caregivers must directly
supervise newborns once they are placed in a crib or portable crib.
new text end
new text begin
(b) License holders of programs that serve infants are encouraged to monitor sleeping
infants by conducting in-person checks on each infant in the license holder's care every 30
minutes.
new text end
new text begin
(c) Upon enrollment of an infant, the license holder is encouraged to conduct in-person
checks on the sleeping infant every 15 minutes during the first four months of care.
new text end
new text begin
(d) When an infant has an upper respiratory infection, the license holder is encouraged
to conduct in-person checks on the sleeping infant every 15 minutes throughout the hours
of sleep.
new text end
new text begin
(e) Monitors may be used to supervise infants when the infants are sleeping. However,
the use of monitors does not replace the in-person checks encouraged under paragraphs (b)
to (d). When in use, monitors must meet the following conditions:
new text end
new text begin
(1) the sound monitoring equipment must be able to pick up the sounds of all infants in
the separate room;
new text end
new text begin
(2) the receiver of the sound monitoring equipment must be actively monitored by the
adult caregiver at all times; and
new text end
new text begin
(3) sound monitoring equipment must be checked daily prior to use to ensure it is working
correctly. If the sound equipment is not functioning, infants must sleep in the same room
as the adult caregiver.
new text end
new text begin
(f) If music or other sounds are played in the infant sleep area, the music or other sound
equipment must not be played at a volume that would prevent infants from being heard by
the adult caregiver. This paragraph applies to fans used to create sound.
new text end
Sec. 19.
new text begin
[142I.19] HEALTH POLICIES AND SAFETY REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Handling and disposal of bodily fluids. new text end
new text begin
(a) Surfaces that come in contact
with bodily fluids must be cleaned and disinfected as described in section 142I.15.
new text end
new text begin
(b) Blood-contaminated material must be disposed of in a plastic bag and securely tied.
new text end
new text begin
(c) If a program cares for a child with a health care need that requires injectable
medication, the program must have a sharps container available.
new text end
new text begin
(d) A license holder must keep disposable gloves, disposal bags, and eye protection
available. Prescription eyewear does not meet the requirements of this paragraph.
new text end
new text begin Subd. 2. new text end
new text begin Emergencies. new text end
new text begin
(a) A license holder must have a written child care emergency
plan for emergencies that require evacuation, sheltering, or other protection of children,
including for fires, natural disasters, intruders, or other threatening situations that may pose
a health or safety hazard to children. The plan must be written on a form prescribed by the
commissioner and updated at least annually. The plan must include:
new text end
new text begin
(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
new text end
new text begin
(2) a designated relocation site and evacuation route;
new text end
new text begin
(3) procedures for notifying a child's parent of an evacuation, shelter-in-place, or
lockdown, including procedures for reunification with families;
new text end
new text begin
(4) accommodations for a child with a disability or a medical condition;
new text end
new text begin
(5) procedures for storing a child's medically necessary medicine that facilitate easy
removal during an evacuation or relocation;
new text end
new text begin
(6) procedures for continuing operations in the period during and after a crisis;
new text end
new text begin
(7) procedures for communicating with local emergency management officials, law
enforcement officials, or other appropriate state or local authorities; and
new text end
new text begin
(8) accommodations for infants and toddlers.
new text end
new text begin
(b) The license holder must train each caregiver on the child care emergency plan before
the caregiver provides care and document this training. The information must be reviewed
at least annually and updated when information changes.
new text end
new text begin
(c) The child care emergency plan must be available for review by the agency during
inspections.
new text end
new text begin
(d) In addition to the emergency plan required under paragraph (a), the license holder
must maintain preparedness for emergencies. An operable telephone must be located in the
family child care program. A cellular telephone may be used if it is sufficiently charged for
use at all times. Emergency phone numbers for parents must be readily available within the
program and taken on all emergency drills and evacuations.
new text end
new text begin
(e) For severe storms and tornadoes, the license holder must have a designated area that
children can go to for shelter, a battery-operated flashlight, and a portable radio or TV
available. An application on a smartphone may be used to meet the requirements of this
paragraph. The license holder must follow guidance and instructions from the Emergency
Alert System or local alerting systems.
new text end
new text begin
(f) The license holder must have a written fire escape plan that includes:
new text end
new text begin
(1) the address of the family child care program;
new text end
new text begin
(2) emergency phone numbers;
new text end
new text begin
(3) a designated place to meet and confirm that all children in attendance are present;
new text end
new text begin
(4) fire extinguisher locations;
new text end
new text begin
(5) plans for monthly fire and storm drills; and
new text end
new text begin
(6) escape routes to the outside from all levels used by children. In buildings with three
or more dwelling units, enclosed exit stairs must be indicated.
new text end
new text begin
(g) The license holder must complete a monthly fire and storm drill and have
documentation of completed fire drills available for review by the agency during inspections.
The log must include the date of the drill, the time of day the drill occurred, the name of
the caregiver who conducted the drill, and the length of time taken to evacuate all children
safely.
new text end
new text begin Subd. 3. new text end
new text begin Transporting children. new text end
new text begin
Children must only be transported in an enclosed
passenger vehicle capable of using car seats or a bus operated by a common carrier. When
transporting children in an enclosed passenger vehicle other than a bus operated by a common
carrier, a license holder must:
new text end
new text begin
(1) ensure compliance with all seat belt and child passenger restraint system requirements
under sections 169.685 and 169.686;
new text end
new text begin
(2) ensure that the child is fastened in a safety seat, seat belt, or harness appropriate to
the age and weight of the child and the restraint is installed and used in accordance with the
manufacturer's instructions;
new text end
new text begin
(3) only use a vehicle licensed in accordance with the laws of the state and driven by a
caregiver with a current, valid driver's license. A copy of the current driver's license for
each caregiver who transports a child in care must be kept at the family child care program;
new text end
new text begin
(4) receive written permission to transport children from parents prior to transport; and
new text end
new text begin
(5) not allow a child to remain unattended in any vehicle.
new text end
new text begin Subd. 4. new text end
new text begin Pets and animals. new text end
new text begin
When keeping pets or animals on the site of a family child
care program or allowing children to have contact with pets or animals, the primary provider
of care must:
new text end
new text begin
(1) maintain the pets or animals in good health and proper housing. Pets or animals must
be appropriately immunized, and rabies vaccinations must be documented with a current
certificate from a veterinarian when appropriate;
new text end
new text begin
(2) follow all local and state ordinances regarding the keeping, licensing, number, and
health status of animals;
new text end
new text begin
(3) restrict any animals that pose a risk of injury or illness to children from indoor and
outdoor areas used by children;
new text end
new text begin
(4) inform parents in writing of the presence of pets and animals on the premises. If pets
or animals are allowed to roam in areas occupied by children, the license holder must obtain
written acknowledgment from parents. Parents must be notified in writing prior to the
introduction of a new pet;
new text end
new text begin
(5) keep any reptiles, amphibians, ferrets, poisonous animals, psittacine birds, exotic
animals, and wild animals inaccessible to children. Licensed animal exhibitions, such as
mobile petting zoos, reptile shows, and educational presentations are exempt from this
clause with written parental notice and consent;
new text end
new text begin
(6) not allow any contact between children and pets or animals that is not directly
supervised by an adult caregiver who is in close physical proximity and able to immediately
intervene if the child or animal shows distress or aggression or if the child is treating the
animal inappropriately;
new text end
new text begin
(7) immediately intervene to protect a child when necessary;
new text end
new text begin
(8) prevent pets and animals from accessing food preparation, storage, and serving areas
when food is being prepared or served, unless confined in a cage or kennel. Litter boxes
are prohibited in any food preparation, storage, or serving areas;
new text end
new text begin
(9) keep indoor and outdoor areas accessible to children free of animal waste, including
litter boxes and their contents. Pet cages, enclosures, and aquariums accessible to children
must be located and cleaned away from food areas;
new text end
new text begin
(10) immediately notify a parent of a child who receives an animal bite or scratch;
new text end
new text begin
(11) notify the local animal authority whenever an individual is bitten by an animal on
the day of injury. The notification must be made before any steps are taken to euthanize the
animal, and the license holder must take reasonable steps to confine the animal; and
new text end
new text begin
(12) notify the licensing agency within 24 hours of any animal bite from an animal
housed at the family child care program.
new text end
new text begin Subd. 5. new text end
new text begin Pest control. new text end
new text begin
(a) A license holder must take effective measures to protect the
family child care program against pests. The license holder must take steps to prevent
attracting pests and, if pests are present inside the family child care program, to remove or
exterminate the pests.
new text end
new text begin
(b) Chemicals for pest control must not be applied in areas accessible to children when
children are present. The license holder must use chemicals according to manufacturer
instructions. Only approved, Environmental Protection Agency-registered insecticides,
rodenticides, and herbicides may be used. Application must strictly follow all label
instructions.
new text end
new text begin Subd. 6. new text end
new text begin Garbage. new text end
new text begin
Garbage must be inaccessible to infants and toddlers. Garbage is
considered inaccessible when the garbage container has a lid on.
new text end
new text begin Subd. 7. new text end
new text begin Firearms. new text end
new text begin
(a) All caregivers, parents, household members, and visitors to a
family child care program must comply with the requirements of this subdivision during
program hours.
new text end
new text begin
(b) Ammunition and firearms must be stored in locked areas separated from areas
accessible to children. Firearms must be unloaded while stored.
new text end
new text begin
(c) License holders must notify parents upon admission of the presence of firearms. If
a firearm is added to the property, a license holder must notify parents by the end of the
following business day.
new text end
new text begin
(d) Loaded and unloaded firearms may be carried by a law enforcement official who is
a household member or a parent of a child in care and can document that their jurisdiction
requires ready and immediate access to the firearm.
new text end
new text begin Subd. 8. new text end
new text begin First aid kit. new text end
new text begin
A license holder must have a first aid kit that is accessible to
caregivers in the family child care program at all times and taken on field trips. A caregiver
must have access to first aid instructions. The first aid kit must contain:
new text end
new text begin
(1) adhesive bandages in assorted sizes and tape;
new text end
new text begin
(2) sterile compresses;
new text end
new text begin
(3) scissors;
new text end
new text begin
(4) an ice bag or cold pack;
new text end
new text begin
(5) a thermometer;
new text end
new text begin
(6) mild liquid soap, hand sanitizer, or alcohol wipes; and
new text end
new text begin
(7) disposable powder-free, latex-free gloves.
new text end
new text begin Subd. 9. new text end
new text begin Care of sick children. new text end
new text begin
(a) If the child becomes sick while at the family child
care program, the child must be separated from other children in care to the extent possible
while still maintaining appropriate supervision, and the child's parent must be called
immediately. When determining if a child is sick and exclusion is necessary, a license holder
must follow:
new text end
new text begin
(1) the requirements on reportable diseases in Minnesota Rules, parts 4605.7040,
4605.7070, and 4605.7080; and
new text end
new text begin
(2) the guidelines from the commissioner of health on infectious diseases in child care
settings.
new text end
new text begin
(b) When notified a child in care is sick with a reportable disease under Minnesota Rules,
part 4605.7040, 4605.7050, or 4605.7080, the license holder must:
new text end
new text begin
(1) follow the family child care program policies on reportable or infectious diseases;
and
new text end
new text begin
(2) notify the commissioner of health within 24 hours of receiving the parent or staff
report. Documentation of the notification must be kept at the family child care program.
new text end
new text begin
(c) Children with a reportable disease in paragraph (b) must be excluded from the family
child care program for the length of time specified in the commissioner of health guidelines
on infectious diseases in child care settings, until the child can participate in routine activities
without more caregiver supervision than usual or until the child's health care provider
determines that exclusion is no longer necessary, whichever is longer.
new text end
new text begin Subd. 10. new text end
new text begin Medication administration requirements. new text end
new text begin
(a) A license holder must obtain
written permission from the parent of a child prior to administering nonprescription medicine,
diapering products, sunscreen lotions, and insect repellents. These items must be administered
according to the manufacturer instructions unless written instructions for their use are
provided by a health care provider.
new text end
new text begin
(b) A license holder must obtain and follow written instructions from a health care
provider or dentist prior to administering each prescribed medication. For the purposes of
this paragraph, "instructions" means the label on a medicine container with the child's name
and current prescription information.
new text end
Sec. 20.
new text begin
[142I.20] FOOD AND NUTRITION.
new text end
new text begin Subdivision 1. new text end
new text begin Feeding. new text end
new text begin
(a) Bottles of frozen breast milk or formula must be thawed
under warm running water, in a container of warm water, with a warming device, or in a
refrigerator. Thawed milk must be used, sent home, or disposed of the same day it is thawed.
new text end
new text begin
(b) Caregivers must not warm plastic bottles, sippy cups, or other plastic food containers
in a microwave.
new text end
new text begin
(c) Once bottle feeding is complete, any unused portion must be disposed of or stored
inaccessible to children in care. Bottles provided by or stored at the family child care program
must be washed prior to the next use.
new text end
new text begin
(d) Caregivers must not serve food to infants or toddlers using polystyrene foam
(Styrofoam) cups, bowls, or plates.
new text end
new text begin Subd. 2. new text end
new text begin Milk. new text end
new text begin
Cow's milk served to children in care must be pasteurized. Milk
alternatives that are nutritionally equivalent to cow's milk can be served in place of milk
for children who require it.
new text end
new text begin Subd. 3. new text end
new text begin Drinking water. new text end
new text begin
Drinking water from a safe source according to section 142I.16
must be readily available and offered to the children throughout the day in indoor and
outdoor areas.
new text end
new text begin Subd. 4. new text end
new text begin Meals and snacks. new text end
new text begin
(a) Well-balanced meals and snacks must be supplied by
the license holder or parents daily. Every meal and snack served to children in care must
meet the following requirements:
new text end
new text begin
(1) breakfast must contain at least three of the following:
new text end
new text begin
(i) pasteurized milk or milk alternatives;
new text end
new text begin
(ii) vegetables;
new text end
new text begin
(iii) fruit; or
new text end
new text begin
(iv) grains;
new text end
new text begin
(2) lunch and dinner must contain at least four of the following:
new text end
new text begin
(i) pasteurized milk or milk alternatives;
new text end
new text begin
(ii) meat or meat alternatives;
new text end
new text begin
(iii) vegetables;
new text end
new text begin
(iv) fruit; or
new text end
new text begin
(v) grains; and
new text end
new text begin
(3) snacks must contain at least two of the following:
new text end
new text begin
(i) pasteurized milk or milk alternatives;
new text end
new text begin
(ii) meat or meat alternatives;
new text end
new text begin
(iii) vegetables;
new text end
new text begin
(iv) fruit; or
new text end
new text begin
(v) grains.
new text end
new text begin
(b) Food, liquids, and bottles brought from home must be labeled with the first and last
name of each child.
new text end
new text begin
(c) Flexible feeding schedules must be provided for infants.
new text end
new text begin
(d) When special diets are required for cultural, religious, or medical reasons, the provider
must obtain written, dated, and signed instructions from the child's parent.
new text end
new text begin Subd. 5. new text end
new text begin Food and liquid safety. new text end
new text begin
(a) Food and liquids must be handled and stored
properly to prevent contamination and spoilage. Foods and liquids requiring refrigeration
must be refrigerated and maintained at no more than 40 degrees Fahrenheit. Food requiring
heating must be maintained at no less than 140 degrees Fahrenheit until ready to serve.
Frozen foods must be kept frozen until use and cooked according to the manufacturer's
instructions.
new text end
new text begin
(b) Appliances used in food and liquid storage and preparation must be safe and clean.
new text end
new text begin
(c) All canned food provided by the license holder must be commercially processed.
Locally grown fresh and frozen fruits and vegetables may be served at the family child care
program. Food canned or preserved at home and home-butchered meats, poultry, and fish
may not be served to children in care.
new text end
Sec. 21.
new text begin
[142I.21] CHILDREN WITH SPECIAL HEALTH CARE NEEDS OR
DISABILITIES.
new text end
new text begin
(a) For children with disabilities who require therapy, additional behavior guidance,
programming, or alternative accommodations, a parent or health care provider must provide
written instructions for the license holder to follow.
new text end
new text begin
(b) All activities must be designed to include all children unless a specific medical
contraindication exists.
new text end
new text begin
(c) All caregivers responsible for the care of a child with a disability or special health
care need must explain to a parent and the agency how the child's specific needs are being
met.
new text end
new text begin
(d) Before enrolling a child for care, the license holder must obtain documentation of
any known allergies on a form prescribed by the commissioner. The form must be readily
available to all caregivers and reviewed by the license holder and each caregiver annually
and when any updates or changes are made.
new text end
new text begin
(e) If a child has a known allergy, the primary provider of care must maintain current
information about the allergy in the child's record, ensure that required medication is on
hand, and follow the allergy plan signed by a treating medical professional. The child's plan
must include:
new text end
new text begin
(1) a description of the allergy;
new text end
new text begin
(2) specific triggers and avoidance techniques;
new text end
new text begin
(3) symptoms of an allergic reaction; and
new text end
new text begin
(4) procedures for responding to an allergic reaction, including any medication and
dosage to be administered in an emergency situation.
new text end
new text begin
(f) A caregiver must call emergency medical services when epinephrine is administered
to a child in the license holder's care.
new text end
new text begin
(g) The caregiver must contact the child's parent immediately after any instance of
exposure to an allergen or allergic reaction.
new text end
Sec. 22.
new text begin
[142I.22] COMMUNITY-BASED FAMILY CHILD CARE.
new text end
new text begin
(a) A family child care program located on a site other than the license holder's primary
residence must be licensed under this section if:
new text end
new text begin
(1) the family child care program is conducted in a dwelling on a residential lot or in a
commercial space other than the license holder's primary residence;
new text end
new text begin
(2) the license holder is an organization, employer, church, or religious entity; or
new text end
new text begin
(3) the license holder is a community collaborative child care provider. For purposes of
this clause, a "community collaborative child care provider" is a provider participating in
a cooperative agreement with a community action agency as defined in section 142F.301.
new text end
new text begin
(b) Programs licensed under paragraph (a) must comply with local zoning regulations,
the applicable State Fire Code, and the State Building Code. Any age and capacity limitations
established by the fire code must be printed on the license.
new text end
new text begin
(c) A license holder under this section must designate at least one primary provider of
care as follows:
new text end
new text begin
(1) one individual for programs operating eight or fewer hours per day;
new text end
new text begin
(2) up to two individuals for programs operating more than eight but no more than 16
hours per day; and
new text end
new text begin
(3) up to three individuals for programs operating more than 16 hours per day.
new text end
new text begin
(d) The license issued under this section must include the statement: "This
community-based family child care license holder is not licensed as a child care center."
new text end
new text begin
(e) The commissioner may approve up to four licenses at the same location or under one
contiguous roof if each license holder independently meets all applicable requirements.
Each family child care program must operate as a distinct family child care program within
its licensed capacity, age, and ratio limits as determined by the state fire marshal. Only one
license may be issued per single-family residential home.
new text end
new text begin
(f) The license holder must notify the commissioner in writing before any change in the
persons designated as primary providers of care. A primary provider of care is authorized
to communicate with the commissioner on licensing matters.
new text end
new text begin
(g) Each license holder must complete the commissioner-developed community-based
family child care program plan at the time of initial application, review the plan each calendar
year, and update the plan before any change in program information occurs.
new text end
Sec. 23. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) The revisor of statutes must make any necessary changes to statutory cross-references
to reflect the changes in this article.
new text end
new text begin
(b) The revisor of statutes must replicate the statutory history for all sections and
subdivisions repealed and reenacted in this article.
new text end
Sec. 24. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2024, sections 142B.01, subdivision 13; 142B.41, subdivisions
4 and 8; 142B.62; 142B.70, subdivisions 1, 2, 3, 4, 5, 6, 9, 10, 11, and 12; 142B.71; 142B.72;
142B.74; 142B.75; 142B.76; and 142B.77,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Statutes 2025 Supplement, sections 142B.41, subdivision 9; and 142B.70,
subdivisions 7 and 8,
new text end
new text begin
are repealed.
new text end
new text begin
(c)
new text end
new text begin
Minnesota Rules, parts 9502.0300; 9502.0315; 9502.0325; 9502.0335; 9502.0341;
9502.0345; 9502.0355; 9502.0365; 9502.0367; 9502.0375; 9502.0395; 9502.0405;
9502.0415; 9502.0425; 9502.0435; and 9502.0445,
new text end
new text begin
are repealed.
new text end
Sec. 25. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2027.
new text end
ARTICLE 8
MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND CHILD
WELFARE DISPROPORTIONALITY ACT CHANGES
Section 1.
Minnesota Statutes 2024, section 260.63, subdivision 10, is amended to read:
Subd. 10.
Disproportionately represented child.
"Disproportionately represented child"
means a person who is under the age of 18 and who is a member of a community whose
race, deleted text begin culture,deleted text end ethnicity, disability status, or low-income socioeconomic status is
disproportionately encountered, engaged, or identified in the child welfare system as
compared to the representation in the state's total child population, as determined deleted text begin on an
annual basisdeleted text end by the commissionernew text begin under section 260.631new text end . A child's racedeleted text begin , culture,deleted text end or ethnicity
deleted text begin isdeleted text end new text begin may also benew text end determined deleted text begin based upondeleted text end new text begin bynew text end a child's self-identification or identification of a
child's racedeleted text begin , culture,deleted text end or ethnicity as reported by the child's parent or guardian.
Sec. 2.
new text begin
[260.631] DETERMINATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Determination of disproportionate representation. new text end
new text begin
(a) The
commissioner must determine the communities that are disproportionately represented in
Minnesota's child protection system pursuant to this section for the purposes of the Minnesota
African American Family Preservation and Child Welfare Disproportionality Act. In making
this determination, the commissioner must consider the recommendations provided under
paragraph (d). The commissioner's determination under this paragraph is in effect until the
effective date of the next determination issued by the commissioner.
new text end
new text begin
(b) The commissioner must make the initial determination under paragraph (a) by
September 1, 2026, and then by September 1 on every even-numbered year thereafter.
new text end
new text begin
(c) A responsible social services agency must use the commissioner's determination
under paragraph (a) to determine whether a child meets the definition of a disproportionately
represented child under section 260.63, subdivision 10.
new text end
new text begin
(d) The African American Child and Family Well-Being Advisory Council must submit
recommendations to the commissioner on the disproportionate representation of African
American children in Minnesota's child protection system using state and federal census
data. The council must provide its initial recommendations to the commissioner by August
1, 2026, and then provide recommendations by August 1 on every even-numbered year
thereafter.
new text end
new text begin
(e) If the commissioner makes a determination under paragraph (a) that differs from the
recommendations provided by the African American Child and Family Well-Being Advisory
Council under paragraph (d) regarding the disproportionate representation of African
American children in Minnesota's child protection system, the commissioner must provide
the reasons for diverging from the council's recommendations and identify the data the
commissioner relied upon in making the determination of disproportionate representation.
The commissioner must provide the information required under this paragraph to:
new text end
new text begin
(1) the chairs and ranking minority members of the legislative committees with
jurisdiction over the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act;
new text end
new text begin
(2) the African American Child and Family Well-Being Advisory Council;
new text end
new text begin
(3) the Children's Justice Initiative; and
new text end
new text begin
(4) responsible social services agencies statewide.
new text end
new text begin
(f) By September 15, 2026, and every even-numbered year thereafter, the commissioner
must notify responsible social services agencies, the African American Child and Family
Well-Being Advisory Council, and the Children's Justice Initiative of the commissioner's
determination under paragraph (a). The notification must include but is not limited to:
new text end
new text begin
(1) a list of the communities the commissioner determined are disproportionately
represented in Minnesota's child protection system and whether there are any changes from
the previous notification;
new text end
new text begin
(2) how a responsible social services agency must implement the commissioner's
determination;
new text end
new text begin
(3) the effective date of the commissioner's determination; and
new text end
new text begin
(4) the method or methods the commissioner used, or the data the commissioner relied
upon, to make the determination.
new text end
new text begin Subd. 2. new text end
new text begin Definition of disability; low-income socioeconomic status. new text end
new text begin
(a) The
commissioner must define what constitutes disability and low-income socioeconomic status
for purposes of the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act. The commissioner's definitions under this paragraph are in effect
until the effective date of the next definitions issued by the commissioner.
new text end
new text begin
(b) The commissioner must develop the initial definitions under paragraph (a) by
September 1, 2026, and then by September 1 on every even-numbered year thereafter.
new text end
new text begin
(c) A responsible social services agency must use the commissioner's definitions under
paragraph (a) to determine whether a child meets the definition of a disproportionately
represented child under section 260.63, subdivision 10.
new text end
new text begin
(d) By September 15, 2026, and by September 15 on every even-numbered year thereafter,
the commissioner must notify responsible social services agencies, the African American
Child and Family Well-Being Council, and the Children's Justice Initiative of the definitions
developed by the commissioner under paragraph (a). The notification must include but is
not limited to:
new text end
new text begin
(1) the definitions of disability and low-income socioeconomic status and whether there
are any changes from the previous definitions;
new text end
new text begin
(2) how a responsible social services agency must implement the commissioner's
definitions;
new text end
new text begin
(3) the effective date of the commissioner's definitions; and
new text end
new text begin
(4) the method or methods the commissioner used, or the data the commissioner relied
upon, to develop the definitions.
new text end
new text begin Subd. 3. new text end
new text begin Determination of child's status. new text end
new text begin
The responsible social services agency must
document the efforts the agency takes when determining whether a child meets or does not
meet the definition of a disproportionately represented child under section 260.63, subdivision
10, and must provide that information to the commissioner upon the commissioner's request.
new text end
new text begin Subd. 4. new text end
new text begin Exempt from rulemaking. new text end
new text begin
Chapter 14 does not apply to determinations under
this section.
new text end
Sec. 3.
Minnesota Statutes 2024, section 260.64, subdivision 2, is amended to read:
Subd. 2.
Safety plan.
(a) Prior to petitioning the court to remove an African American
or a disproportionately represented child from the child's home under section 260.66, a
responsible social services agency must work with the child's family to allow the child to
remain in the child's home while implementing a safety plan based on the family's needs.
The responsible social services agency must:
(1) make active efforts to engage the child's parent or custodian and the child, when
appropriate;
(2) assess the family's cultural and economic needs and, if applicable, needs and services
related to the child's disability;
(3) hold a family group consultation meeting and connect the family with supports to
establish a safety network for the family; and
(4) provide support, guidance, and input to assist the family and the family's safety
network with developing the safety plan.
(b) The safety plan must:
(1) address the specific allegations impacting the child's safety in the home. If neglectnew text begin ,
as defined in section 260E.03, subdivision 15,new text end is alleged, the safety plan must incorporate
economic services and supports for the child and the child's family, if eligible, to address
the family's specific needs and prevent neglect;
(2) incorporate family and community support to ensure the child's safety while keeping
the family intact; and
(3) be adjusted as needed to address the child's and family's ongoing needs and support.
(c) The responsible social services agency is not required to establish a safety plan:
(1) in a case with allegations of sexual abuse or egregious harm;
(2) when the parent is not willing to follow a safety plan;
(3) when the parent has abandoned the child or is unavailable to follow a safety plan;
or
(4) when the parent has chronic substance use disorder issues and is unable to parent
the child.
Sec. 4.
Minnesota Statutes 2024, section 260.67, subdivision 2, is amended to read:
Subd. 2.
Termination of parental rights restrictions.
(a) A court shall not terminate
the parental rights of a parent of an African American or a disproportionately represented
child based solely on the parent's failure to complete case plan requirements.
(b) Except as provided in deleted text begin paragraph (c)deleted text end new text begin subdivision 3new text end , a court shall not terminate the
parental rights of a parent of an African American or a disproportionately represented child
in a child placement proceeding unless the allegations against the parent involve sexual
abuse; egregious harm as defined in section 260C.007, subdivision 14; murder in the first,
second, or third degree under section 609.185, 609.19, or 609.195; murder of an unborn
child in the first, second, or third degree under section 609.2661, 609.2662, or 609.2663;
manslaughter of an unborn child in the first or second degree under section 609.2664 or
609.2665; domestic assault by strangulation under section 609.2247; felony domestic assault
under section 609.2242 or 609.2243; kidnapping under section 609.25; solicitation,
inducement, and promotion of prostitution under section 609.322, subdivision 1, and
subdivision 1a if one or more aggravating factors are present; criminal sexual conduct under
sections 609.342 to 609.3451; engaging in, hiring, or agreeing to hire a minor to engage in
prostitution under section 609.324, subdivision 1; solicitation of children to engage in sexual
conduct under section 609.352; possession of pornographic work involving minors under
section 617.247; malicious punishment or neglect or endangerment of a child under section
609.377 or 609.378; use of a minor in sexual performance under section 617.246; or failing
to protect a child from an overt act or condition that constitutes egregious harm.
Sec. 5.
Minnesota Statutes 2024, section 260.68, subdivision 2, is amended to read:
Subd. 2.
Case review.
(a) deleted text begin Each responsible social services agencydeleted text end new text begin The commissionernew text end
shall conduct a review of deleted text begin all child welfaredeleted text end new text begin ten percent of each responsible social services
agency's child protectionnew text end cases for African American and other disproportionately represented
children handled by deleted text begin the agency. Each responsible social services agency shall create a
summary report of trends identified under paragraphs (b) and (c), a remediation plan as
provided in paragraph (d), and an update on implementation of any previous remediation
plans. The first report shall be provided to the African American Child Well-Being Advisory
Council, the commissioner, and the chairs and ranking minority members of the legislative
committees with jurisdiction over child welfare by October 1, 2029, and annually thereafter.
For purposes of determining outcomes in this subdivision, responsible social services
agencies shall use guidance from the commissioner. The commissioner shall provide guidance
starting on November 1, 2028, and annually thereafterdeleted text end new text begin responsible social services agencies.
Responsible social services agencies must provide the commissioner with any information
requested for the purposes of this subdivision in a form and within a time frame prescribed
by the commissionernew text end .
(b) The case review must include:
(1) the number of African American and disproportionately represented children
represented in the county child deleted text begin welfaredeleted text end new text begin protectionnew text end system;
(2) the number and sources of maltreatment reports received and reports screened in for
investigation or referred for family assessment and the race of the children and parents or
custodians involved in each report;
(3) the number and race of children and parents or custodians who receive in-home
preventive case management services;
(4) the number and race of children whose parents or custodians are referred to
community-based, culturally appropriate, strength-based, or trauma-informed services;
(5) the number and race of children removed from their homes;
(6) the number and race of children reunified with their parents or custodians;
(7) the number and race of children whose parents or custodians are offered family group
decision-making services;
(8) the number and race of children whose parents or custodians are offered the parent
support outreach program;
(9) the number and race of children in foster care or out-of-home placement at the time
that the data is gathered;
(10) the number and race of children who achieve permanency through a transfer of
permanent legal and physical custody to a relative or an adoption; and
(11) the number and race of children who are under the guardianship of the commissioner
or awaiting a permanency disposition.
(c) The required case review must also:
(1) identify barriers to reunifying children with their families;
(2) identify the family conditions that led to the out-of-home placement;
(3) identify any barriers to accessing culturally informed mental health or substance use
disorder treatment services for the parents or children;
(4) document efforts to identify fathers and maternal and paternal relatives and to provide
services to custodial and noncustodial fathers, if appropriate; and
(5) document and summarize court reviews of active efforts.
(d) new text begin For new text end any responsible social services agency deleted text begin that hasdeleted text end new text begin the commissioner identifies innew text end a
case review new text begin as new text end showing deleted text begin disproportionality anddeleted text end disparities in child welfare outcomes for
African American and other disproportionately represented children and the children's
familiesdeleted text begin ,deleted text end compared to the agency's overall outcomes,new text begin the commissionernew text end must deleted text begin include in
their case review summary reportdeleted text end new text begin developnew text end a remediation plannew text begin with the agencynew text end with
measurable outcomes to identify, address, and reduce the factors that led to the
deleted text begin disproportionality anddeleted text end disparities in the agency's child welfare outcomes. The remediation
plan shall also include information about how the responsible social services agency will
achieve and document trauma-informed, positive child well-being outcomes through
remediation efforts.
new text begin
(e) The commissioner shall create a summary report of trends identified under paragraphs
(b) and (c), a summary of remediation plans developed as provided in paragraph (d), and
an update on implementation of any previous remediation plans. The commissioner shall
provide the first report to the African American Child Well-Being Advisory Council, the
responsible social services agencies, and the chairs and ranking minority members of the
legislative committees with jurisdiction over children, youth, and families by October 1,
2029, and annually thereafter.
new text end
Sec. 6.
Minnesota Statutes 2024, section 260.69, subdivision 1, is amended to read:
Subdivision 1.
Applicability.
new text begin (a) new text end The commissioner of children, youth, and families
must collaborate with the Children's Justice Initiative to ensure that cultural competency
training is given new text begin or made available new text end to individuals working in the child welfare system,
including child welfare workers and supervisors. Training deleted text begin mustdeleted text end new text begin developed by the Child
Welfare Training Academy maynew text end also be made available to attorneys, juvenile court judges,
new text begin guardians ad litem, new text end and family law judges.new text begin The commissioner must give priority to child
welfare workers and supervisors for in-person trainings or other trainings with limited
attendance or availability.
new text end
new text begin
(b) This subdivision does not require the commissioner or the Child Welfare Training
Academy to develop or provide training specifically for attorneys, juvenile court judges,
guardians ad litem, family law judges, or any other individuals beyond the primary training
audiences required to be served under Laws 2019, First Special Session chapter 9, article
1, section 37, subdivision 2, paragraph (e).
new text end
Sec. 7.
Minnesota Statutes 2025 Supplement, section 260.691, subdivision 1, is amended
to read:
Subdivision 1.
Establishment and duties.
(a) The African American Child and Family
Well-Being Advisory Council is established for the Department of Children, Youth, and
Families.
(b) The council shall consist of 31 members appointed by the commissioner and must
include representatives with lived personal or professional experience within African
American communities. Members may include but are not limited to youth who have exited
the child welfare system; parents; legal custodians; relative and kinship caregivers or foster
care providers; community service providers, advocates, and members; county and private
social services agency case managers; representatives from faith-based institutions; academic
professionals; a representative from the Council for Minnesotans of African Heritage; the
Ombudsperson for African American Families; and other individuals with experience and
knowledge of African American communities. Council members must be selected through
an open appointments process under section 15.0597. The terms, compensation, and removal
of council members are governed by section 15.059.
(c) The council must:
(1) review annual reports related to African American children involved in the child
welfare system. These reports may include but are not limited to the maltreatment,
out-of-home placement, and permanency of African American children;
(2) assist with and make recommendations to the commissioner for developing strategies
to reduce maltreatment determinations, prevent unnecessary out-of-home placement, promote
culturally appropriate foster care and shelter or facility placement decisions and settings for
African American children in need of out-of-home placement, ensure timely achievement
of permanency, and improve child welfare outcomes for African American children and
their families;
(3) review summary reports on targeted case reviews prepared by the commissioner to
ensure that responsible social services agencies meet the needs of African American children
and their families. Based on data collected from those reviews, the council shall assist the
commissioner with developing strategies needed to improve any identified child welfare
outcomes, including but not limited to maltreatment, out-of-home placement, and permanency
for African American children;
(4) make recommendations to the commissioner and the legislature for public policy
and statutory changes that specifically consider the needs of African American children and
their families involved in the child welfare system;
(5) advise the commissioner on stakeholder engagement strategies and actions that the
commissioner and responsible social services agencies may take to improve child welfare
outcomes for African American children and their families;
(6) assist the commissioner with developing strategies for public messaging and
communication related to racial deleted text begin disproportionality anddeleted text end disparities in child welfare outcomes
for African American children and their families;
(7) assist the commissioner with identifying and developing internal and external
partnerships to support adequate access to services and resources for African American
children and their families, including but not limited to housing assistance, employment
assistance, food and nutrition support, health care, child care assistance, and educational
support and training; and
(8) assist the commissioner with developing strategies to promote the development of
a culturally diverse and representative child welfare workforce in Minnesota that includes
professionals who are reflective of the community served and who have been directly
impacted by lived experiences within the child welfare system. The council must also assist
the commissioner with exploring strategies and partnerships to address education and training
needs, hiring, recruitment, retention, and professional advancement practices.
Sec. 8.
Minnesota Statutes 2025 Supplement, section 260.692, subdivision 1, is amended
to read:
Subdivision 1.
Duties.
The African American Child and Family Well-Being Unit,
currently established by the commissioner, must:
(1) assist with the development of African American cultural competency training and
review child welfare curriculum in the Minnesota Child Welfare Training Academy to
ensure that responsible social services agency staff and other child welfare professionals
are appropriately prepared to engage with African American children and their families and
to support family preservation and reunification;
(2) provide technical assistance, including on-site technical assistance, and case
consultation to responsible social services agencies to assist agencies with implementing
and complying with the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act;
(3) monitor individual county and statewide disaggregated and nondisaggregated data
to identify trends and patterns in child welfare outcomes, including but not limited to
reporting, maltreatment, out-of-home placement, and permanency of African American
children and develop strategies to address deleted text begin disproportionality anddeleted text end disparities in the child
welfare system;
(4) develop and implement a system for conducting case reviews when the commissioner
receives reports of noncompliance with the Minnesota African American Family Preservation
and Child Welfare Disproportionality Act or when requested by the parent or custodian of
an African American child. Case reviews may include but are not limited to a review of
placement prevention efforts, safety planning, case planning and service provision by the
responsible social services agency, relative placement consideration, and permanency
planning;
(5) establish and administer a request for proposals process for African American and
disproportionately represented family preservation grants under section 260.693, monitor
grant activities, and provide technical assistance to grantees;
(6) in coordination with the African American Child and Family Well-Being Advisory
Council, coordinate services and create internal and external partnerships to support adequate
access to services and resources for African American children and their families, including
but not limited to housing assistance, employment assistance, food and nutrition support,
health care, child care assistance, and educational support and training; and
(7) develop public messaging and communication to inform the public about racial
disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities,
and resources available to African American children and their families involved in the
child welfare system.
Sec. 9.
Minnesota Statutes 2025 Supplement, section 260.692, subdivision 2, is amended
to read:
Subd. 2.
Case reviews.
(a) The African American Child and Family Well-Being Unit
must conduct systemic case reviews to monitor targeted child welfare outcomes, including
but not limited to maltreatment, out-of-home placement, and permanency of African
American children.
(b) The reviews under this subdivision must be conducted using a random sampling of
representative child deleted text begin welfaredeleted text end new text begin protectionnew text end cases stratified for certain case related factors,
including but not limited to case type, maltreatment type, if the case involves out-of-home
placement, and other demographic variables. In conducting the reviews, unit staff may use
court records and documents, information from the social services information system, and
other available case file information to complete the case reviews.
(c) The frequency of the reviews and the number of cases, child welfare outcomes, and
selected counties reviewed shall be determined by the unit in consultation with the African
American Child and Family Well-Being Advisory Council, with consideration given to the
availability of unit resources needed to conduct the reviews.
(d) The unit must monitor all case reviews and use the collective case review information
and data to generate summary case review reports, ensure compliance with the Minnesota
African American Family Preservation and Child Welfare Disproportionality Act, and
identify trends or patterns in child welfare outcomes for African American children.
(e) The unit must review information from members of the public received through the
compliance and feedback portal, including policy and practice concerns related to individual
child deleted text begin welfaredeleted text end new text begin protectionnew text end cases. After assessing a case concern, the unit may determine if
further necessary action should be taken, which may include coordinating case remediation
with other relevant child welfare agencies in accordance with data privacy laws, including
the African American Child and Family Well-Being Advisory Council, and offering case
consultation and technical assistance to the responsible local social services agency as
needed or requested by the agency.
Sec. 10.
Minnesota Statutes 2025 Supplement, section 260.692, subdivision 3, is amended
to read:
Subd. 3.
Reports.
(a) The African American Child and Family Well-Being Unit must
provide regular updates on unit activities, including summary reports of case reviews, to
the African American Child and Family Well-Being Advisory Council, and must publish
an annual census of African American children in out-of-home placements statewide. The
annual census must include data on the types of placements, age and sex of the children,
how long the children have been in out-of-home placements, and other relevant demographic
information.
(b) The African American Child and Family Well-Being Unit shall gather summary data
about the practice and policy inquiries and individual case concerns received through the
compliance and feedback portal under subdivision 2, paragraph (e). The unit shall provide
regular reports of the nonidentifying compliance and feedback portal summary data to the
African American Child and Family Well-Being Advisory Council to identify child welfare
trends and patterns to assist with developing policy and practice recommendations to support
eliminating deleted text begin disparity and disproportionalitydeleted text end new text begin disparitiesnew text end for African American children.
Sec. 11.
Minnesota Statutes 2024, section 260.693, subdivision 2, is amended to read:
Subd. 2.
Eligible services.
(a) Services eligible for grants under this section include but
are not limited to:
(1) child out-of-home placement prevention and reunification services;
(2) family-based services and reunification therapy;
(3) culturally specific individual and family counseling;
(4) court advocacy;
(5) training for and consultation to responsible social services agencies and private social
services agencies regarding this act;
(6) development and promotion of culturally informed, affirming, and responsive
community-based prevention and family preservation services that target the children, youth,
families, and communities of African American and African heritage experiencing the
highest disparitiesdeleted text begin , disproportionality,deleted text end and overrepresentation in the Minnesota child welfare
system;
(7) culturally affirming and responsive services that work with children and families in
their communities to address their needs and ensure child and family safety and well-being
within a culturally appropriate lens and framework;
(8) services to support informal kinship care arrangements; and
(9) other activities and services approved by the commissioner that further the goals of
the Minnesota African American Family Preservation and Child Welfare Disproportionality
Act, including but not limited to the recruitment of African American staff and staff from
other communities disproportionately represented in the child welfare system to work for
responsible social services agencies and licensed child-placing agencies.
(b) The commissioner may specify the priority of an activity and service based on its
success in furthering these goals. The commissioner shall give preference to programs and
service providers that are located in or serve counties with the highest rates of child welfare
deleted text begin disproportionalitydeleted text end new text begin disproportionate representationnew text end for African American and other
disproportionately represented children and their families and employ staff who represent
the population primarily served.
Sec. 12.
Laws 2024, chapter 117, section 21, is amended to read:
Sec. 21. MINNESOTA AFRICAN AMERICAN FAMILY PRESERVATION AND
CHILD WELFARE DISPROPORTIONALITY ACT; WORKING GROUP.
(a) The commissioner of human services must establish a working group to provide
guidance and oversight for the Minnesota African American Family Preservation and Child
Welfare Disproportionality Act phase-in program.
(b) The members of the working group must include representatives from the Minnesota
Association of County Social Service Administrators, the Association of Minnesota Counties,
the Minnesota Inter-County Association, the Minnesota County Attorneys Association,
Hennepin County, Ramsey County, the Department of Human Services, and community
organizations with experience in child welfare. The legislature may provide recommendations
to the commissioner on the selection of the representatives from the community organizations.
(c) The working group must provide oversight of the phase-in program and evaluate the
cost of the phase-in program. The working group must also assess future costs of
implementing the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act statewide.
(d) By January 1, 2026, the working group must develop and submit an interim report
to the chairs and ranking minority members of the legislative committees with jurisdiction
over child welfare detailing initial needs for the implementation of the Minnesota African
American Family Preservation and Child Welfare Disproportionality Act. The interim report
must also include recommendations for any statutory or policy changes necessary to
implement the act.
(e) By September 1, 2026, the working group must develop an implementation plan and
best practices for the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act to go into effect statewide.
new text begin
(f) The working group under this section expires December 31, 2027.
new text end
Sec. 13. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 260.63, subdivision 9,
new text end
new text begin
is repealed.
new text end
ARTICLE 9
HOSPITAL STABILIZATION
Section 1.
Minnesota Statutes 2024, section 16A.103, is amended by adding a subdivision
to read:
new text begin Subd. 1k. new text end
new text begin Report on financial stability of hospitals. new text end
new text begin
The commissioner of management
and budget must submit with each February forecast under this section the report on the
financial stability of Minnesota's hospitals prepared by the commissioner of health under
section 144.5913.
new text end
Sec. 2.
new text begin
[144.5911] HOSPITAL STABILIZATION PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of health must establish a hospital
stabilization program to provide financial relief to hospitals that experience financial distress
and a disproportionate level of uncompensated care.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms have the
meanings given.
new text end
new text begin
(b) "Commissioner" means the commissioner of health.
new text end
new text begin
(c) "Qualifying hospital" means a hospital:
new text end
new text begin
(1) licensed under section 144.50;
new text end
new text begin
(2) located within the state;
new text end
new text begin
(3) that has filed a Medicare cost report in the Healthcare Cost Report Information
System; and
new text end
new text begin
(4) that meets the following criteria:
new text end
new text begin
(i) critical access hospital or rural emergency hospital; or
new text end
new text begin
(ii) medical disproportionate share hospital with less than 75 days of cash on hand.
new text end
new text begin
(d) "Qualifying uncompensated episode of care" means the provision by a qualifying
hospital of one or more services that are covered under medical assistance to an individual
during a single patient encounter or episode of care when the:
new text end
new text begin
(1) individual is not enrolled in medical assistance, MinnesotaCare, or Medicare and
does not have other health coverage;
new text end
new text begin
(2) individual is determined to be ineligible for medical assistance and MinnesotaCare
for the date of service following any retroactive eligibility determination; and
new text end
new text begin
(3) total cumulative reimbursement amount for the services provided, if paid under
medical assistance payment methodologies using a cost to charge methodology as defined
in the Minnesota Health Care Cost Information System, would be at least $2,000 but not
more than $50,000.
new text end
new text begin Subd. 3. new text end
new text begin Application for payments. new text end
new text begin
(a) A qualifying hospital seeking payment under
this section must submit to the commissioner documentation identifying qualifying
uncompensated episodes of care within a reporting period.
new text end
new text begin
(b) The reporting periods are:
new text end
new text begin
(1) January 1 through June 30; and
new text end
new text begin
(2) July 1 through December 31.
new text end
new text begin
(c) The initial reporting period begins January 1, 2026.
new text end
new text begin
(d) For services provided during the January 1 through June 30 reporting period, a
qualifying hospital must submit the required documentation to the commissioner by
September 15 of the same calendar year.
new text end
new text begin
(e) For services provided during the July 1 through December 31 reporting period, a
qualifying hospital must submit the required documentation to the commissioner by March
15 of the next calendar year.
new text end
new text begin
(f) Qualifying hospitals must submit documentation in a form and manner specified by
the commissioner and must provide supporting documentation as requested by the
commissioner.
new text end
new text begin Subd. 4. new text end
new text begin Calculation of payments. new text end
new text begin
(a) For each reporting period, the commissioner
must determine each qualifying hospital's share of the total value of qualifying
uncompensated episodes of care submitted under subdivision 3.
new text end
new text begin
(b) The commissioner must distribute payments proportionally based on each qualifying
hospital's share of the statewide total among qualifying hospitals.
new text end
new text begin
(c) A qualifying hospital must not receive more than ten percent of the money available
for a reporting period.
new text end
new text begin
(d) If money remains after the payment limitation in paragraph (c), the commissioner
must redistribute the remaining money among qualifying hospitals that have not reached
the limit in paragraph (c) in proportion to their share of the value of qualifying
uncompensated episodes of care.
new text end
new text begin
(e) The commissioner may establish procedures to reconcile adjustments, corrected
claims, or late submissions in a subsequent reporting period.
new text end
new text begin Subd. 5. new text end
new text begin Distribution of payments. new text end
new text begin
(a) One half of the annual appropriation for this
program must be allocated to each reporting period.
new text end
new text begin
(b) For the January 1 through June 30 reporting period, the commissioner must distribute
payments no later than November 15 of the same calendar year.
new text end
new text begin
(c) For the July 1 through December 31 reporting period, the commissioner must
distribute payments no later than May 15 of the next calendar year.
new text end
new text begin Subd. 6. new text end
new text begin Reporting requirements. new text end
new text begin
(a) A qualifying hospital receiving payment under
this section must submit to the commissioner any information necessary to evaluate the
appropriate use of funds. Such information must include, at minimum, by June 30, 2027, a
detailed analysis of how the funds were used to preserve regional and local access to essential
health care services, including emergency care, inpatient hospital care, maternal care and
obstetrical services, behavioral and mental health care, and primary care and clinic services.
new text end
new text begin
(b) A qualifying hospital receiving payment under this section must submit to the
commissioner, by June 30, 2027, an organizational chart presenting the identities of and
interrelationships among affiliated entities within the hospital system. No subsidiary of an
entity specified on the chart need be shown if the equity or membership interest of the
subsidiary held by the entity is less than ten percent of the subsidiary. As to each entity
specified in the chart, the qualifying hospital must indicate the type of organization and the
state of domicile.
new text end
new text begin
(c) Upon receipt of notice by a qualifying hospital receiving payment under this section
submitted pursuant to section 144.555, the commissioner must provide notice of the hospital's
planned actions and documentation of the amount of any payment distributed to the hospital
under this section to:
new text end
new text begin
(1) the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services finance and policy; and
new text end
new text begin
(2) the majority and minority leaders of the senate and house of representatives.
new text end
new text begin
(d) The commissioner must determine the reporting requirement for payments under
this section in addition to those reporting requirements under section 16B.98, subdivision
12.
new text end
new text begin Subd. 7. new text end
new text begin Prohibited uses. new text end
new text begin
Funds received under this section must not be used to:
new text end
new text begin
(1) supplant any other funding sources; or
new text end
new text begin
(2) increase the salary, benefits, or other discretionary payment to an officer, director,
manager, or any other executive.
new text end
Sec. 3.
new text begin
[144.5912] COMMUNITY-BASED SAFETY NET PROVIDER
STABILIZATION PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of health must establish a
community-based safety net provider stabilization program to provide financial relief to
community-based safety net providers that experience a disproportionate level of
uncompensated care.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms have the
meanings given.
new text end
new text begin
(b) "Commissioner" means the commissioner of health.
new text end
new text begin
(c) "Qualifying community-based safety net provider" means a:
new text end
new text begin
(1) federally qualified health center under section 145.9269, subdivision 1;
new text end
new text begin
(2) certified community behavioral health clinic under section 245.735; or
new text end
new text begin
(3) community mental health center under section 256B.0625, subdivision 5.
new text end
new text begin
(d) "Qualifying uncompensated episode of care" means the provision by a qualifying
community-based safety net provider of one or more services that are covered under medical
assistance to an individual during a single patient encounter or episode of care when the:
new text end
new text begin
(1) individual is not enrolled in medical assistance, MinnesotaCare, or Medicare and
does not have other health coverage;
new text end
new text begin
(2) individual is determined to be ineligible for medical assistance and MinnesotaCare
for the date of service following any retroactive eligibility determination; and
new text end
new text begin
(3) total cumulative reimbursement amount for the services provided, if paid under
medical assistance payment methodologies, would be at least $200 but not more than $2,000.
new text end
new text begin Subd. 3. new text end
new text begin Application for payments. new text end
new text begin
(a) A qualifying community-based safety net
provider seeking payment under this section must submit to the commissioner documentation
identifying qualifying uncompensated episodes of care within the reporting period.
new text end
new text begin
(b) The reporting periods are:
new text end
new text begin
(1) January 1 through June 30; and
new text end
new text begin
(2) July 1 through December 31.
new text end
new text begin
(c) The initial reporting period begins January 1, 2026.
new text end
new text begin
(d) For services provided during the January 1 through June 30 reporting period, a
qualifying community-based safety net provider must submit the required documentation
to the commissioner by September 15 of the same calendar year.
new text end
new text begin
(e) For services provided during the July 1 through December 31 reporting period, a
qualifying community-based safety net provider must submit the required documentation
to the commissioner by March 15 of the next calendar year.
new text end
new text begin
(f) Qualifying community-based safety net providers must submit documentation in a
form and manner specified by the commissioner and must provide supporting documentation
as requested by the commissioner.
new text end
new text begin Subd. 4. new text end
new text begin Calculation of payments. new text end
new text begin
(a) For each reporting period, the commissioner
must determine each qualifying community-based safety net provider's share of the total
value of qualifying uncompensated episodes of care submitted under subdivision 3.
new text end
new text begin
(b) The commissioner must distribute payments proportionally based on each qualifying
community-based safety net provider's share of the statewide total.
new text end
new text begin
(c) A qualifying community-based safety net provider must not receive more than ten
percent of the money available for a reporting period.
new text end
new text begin
(d) If money remains after the payment limitation in paragraph (c), the commissioner
must redistribute the remaining money among qualifying community-based safety net
providers that have not reached the limit in paragraph (c) in proportion to the
community-based safety net provider's share of the value of qualifying uncompensated
episodes of care.
new text end
new text begin
(e) The commissioner may establish procedures to reconcile adjustments, corrected
claims, or late submissions in a subsequent reporting period.
new text end
new text begin Subd. 5. new text end
new text begin Distribution of payments. new text end
new text begin
(a) One half of the annual appropriation for this
program must be allocated to each reporting period.
new text end
new text begin
(b) For the January 1 through June 30 reporting period, the commissioner must distribute
payments no later than November 15 of the same calendar year.
new text end
new text begin
(c) For the July 1 through December 31 reporting period, the commissioner must
distribute payments no later than May 15 of the next calendar year.
new text end
Sec. 4.
new text begin
[144.5913] REPORT ON FINANCIAL STABILITY OF HOSPITALS.
new text end
new text begin
The commissioner of health must prepare and submit to the commissioner of management
and budget, to be delivered with each February forecast under section 16A.103, a report on
the financial stability of Minnesota's hospitals. The report must consider the core financial
metrics of hospitals; expenses and staffing data; revenue, including payer mix; utilization
data; financial liquidity and a balance sheet analysis; and other data determined by the
commissioners. The report must include information about financially distressed hospitals,
and whether any hospitals in Minnesota are determined to be financially distressed.
new text end
Sec. 5. new text begin HENNEPIN HEALTHCARE STABILIZATION GRANT.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of health must award a grant to
Hennepin Healthcare to stabilize the HCMC operations, avoid closure of HCMC, ensure
continuation of high-quality care for HCMC patients, and preserve access to essential
services at HCMC that support the health care needs of the communities served by HCMC
and the state of Minnesota.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms have the
meanings given.
new text end
new text begin
(b) "Commissioner" means the commissioner of health.
new text end
new text begin
(c) "HCMC" has the meaning given in Minnesota Statutes, section 383B.902.
new text end
new text begin
(d) "Hennepin Healthcare" is the public corporation created by Minnesota Statutes,
section 383B.901.
new text end
new text begin Subd. 3. new text end
new text begin Accountability requirements. new text end
new text begin
(a) The commissioner must collect from
Hennepin Healthcare any information necessary to complete the commissioner's reporting
requirements under subdivision 4. Such information must include at minimum:
new text end
new text begin
(1) a comprehensive financial analysis that describes the sources and magnitude of
HCMC's fiscal instability;
new text end
new text begin
(2) quarterly reports of financial information, including the following:
new text end
new text begin
(i) unaudited quarterly updates of audited information currently required to be submitted
annually to the Department of Health;
new text end
new text begin
(ii) total inpatient gross revenues by payer, including Medicare, medical assistance,
MinnesotaCare, commercial coverage, self-pay, other third-party payers, and other payers;
new text end
new text begin
(iii) deductions from revenue in total and by component, including but not limited to
contractual adjustments, bad debt, charity care, restricted donations, and teaching allowances;
new text end
new text begin
(iv) total capital expenditures by project;
new text end
new text begin
(v) total number of inpatient days, outpatient visits, and discharges by payer, including
Medicare, medical assistance, MinnesotaCare, commercial coverage, other third parties,
self-pay, and other payers;
new text end
new text begin
(vi) total net patient revenues by payer, including Medicare, medical assistance,
MinnesotaCare, commercial coverage, other third parties, self-pay, and other payers;
new text end
new text begin
(vii) other operating revenue; and
new text end
new text begin
(viii) nonoperating revenue net of nonoperating expenses;
new text end
new text begin
(3) long-term capital spending priorities, including mandatory maintenance and
replacement of existing facilities and equipment; and
new text end
new text begin
(4) a strategic plan for long-term fiscal sustainability. The plan must include, at minimum,
detailed proposals to:
new text end
new text begin
(i) ensure the continued operation of critical specialized services by HCMC that are
essential to Minnesota's comprehensive statewide hospital network of rural, regional, and
safety net hospitals; and
new text end
new text begin
(ii) transition governance and control of HCMC away from the Hennepin County Board
of Commissioners acting as the governing board of Hennepin Healthcare System, Inc. and
ensure long-term management stability of Hennepin Healthcare.
new text end
new text begin
(b) Upon receipt of notice by HCMC provided pursuant to Minnesota Statutes, section
144.555, the commissioner must provide notice of HCMC's planned actions to:
new text end
new text begin
(1) the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services finance and policy; and
new text end
new text begin
(2) the majority and minority leaders of the senate and house of representatives.
new text end
new text begin Subd. 4. new text end
new text begin Reporting requirements. new text end
new text begin
(a) By January 15, 2027, and annually thereafter
until January 15, 2030, the commissioner must report to the legislative committees with
jurisdiction over health and human services finance and policy on:
new text end
new text begin
(1) the financial stabilization of Hennepin Healthcare and HCMC, including
recommendations to improve stabilization of those entities; and
new text end
new text begin
(2) the financial stabilization of hospitals statewide, including recommendations to
improve stabilization of those entities.
new text end
new text begin
(b) By January 15, 2027, and annually thereafter until January 15, 2030, the legislative
auditor must report to the legislative committees with jurisdiction over health and human
services finance and policy to:
new text end
new text begin
(1) confirm whether Hennepin Healthcare and HCMC:
new text end
new text begin
(i) have met the requirements of this section; and
new text end
new text begin
(ii) have adhered to the strategic plan for long-term fiscal sustainability provided under
subdivision 3, paragraph (a), clause (4); and
new text end
new text begin
(2) assess the overall financial health and stability of Hennepin Healthcare and HCMC.
new text end
new text begin
(c) Hennepin Healthcare and HCMC must provide the commissioner and legislative
auditor with all information and documents requested by the commissioner or legislative
auditor for purposes of this subdivision.
new text end
new text begin Subd. 5. new text end
new text begin Hospital stabilization program ineligibility. new text end
new text begin
HCMC is ineligible for payment
under Minnesota Statutes, sections 144.5911 and 144.5912, in fiscal year 2027.
new text end
Sec. 6. new text begin HENNEPIN HEALTHCARE FUTURE STRUCTURE AND GOVERNANCE
ADVISORY TASK FORCE.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; purpose. new text end
new text begin
The Hennepin Healthcare Future Structure
and Governance Advisory Task Force is established to develop recommendations to the
legislature regarding the future ownership, governance, and financing structure of Hennepin
Healthcare System, Inc. (Hennepin Healthcare), including its integrated system of health
care facilities and services that includes Hennepin County Medical Center (HCMC). The
advisory task force must evaluate options that recognize HCMC as a regional and statewide
public health and public safety asset that provides critical health care services, including
Level I trauma care, hyperbaric medicine, treatment services for burns and complex wounds,
comprehensive cancer care, accredited poison control services, and supports education and
training of health care professionals in Minnesota.
new text end
new text begin Subd. 2. new text end
new text begin Leadership; composition. new text end
new text begin
(a) The advisory task force must consist of 14
members appointed by the governor. Members must include:
new text end
new text begin
(1) one member with expertise in health care sector leadership and state public health
systems;
new text end
new text begin
(2) three members with professional experience in hospital and clinical system operations,
specifically those providing safety net care;
new text end
new text begin
(3) three members with professional experience in health care finance and public health
insurance programs;
new text end
new text begin
(4) two members with professional experience in public sector governance and public
authorities;
new text end
new text begin
(5) three members representing the health care sector workforce; and
new text end
new text begin
(6) two members representing patient and community perspectives, particularly
communities disproportionately impacted by lack of access to health care.
new text end
new text begin
(b) The governor must make appointments by August 1, 2026.
new text end
new text begin
(c) Members appointed under this subdivision serve until the advisory task force expires.
new text end
new text begin Subd. 3. new text end
new text begin Organization and meetings. new text end
new text begin
(a) The member appointed under subdivision 2,
clause (1), must serve as chair of the advisory task force. The chair must convene the first
meeting of the advisory task force by September 1, 2026. The advisory task force must meet
at least once per month and more frequently at the call of the chair.
new text end
new text begin
(b) Members of the advisory task force receive no compensation for their services but
must be reimbursed as provided in Minnesota Statutes, section 15.059, for expenses incurred
as a result of their duties as members of the advisory task force.
new text end
new text begin Subd. 4. new text end
new text begin Duties and powers. new text end
new text begin
(a) The advisory task force must:
new text end
new text begin
(1) evaluate the current governance structure of Hennepin Healthcare;
new text end
new text begin
(2) evaluate governance and ownership models at hospital systems comparable to
Hennepin Healthcare;
new text end
new text begin
(3) evaluate financing and funding mechanisms to achieve sustainable, long-term funding
of Hennepin Healthcare;
new text end
new text begin
(4) engage public health stakeholders throughout the state, including but not limited to
counties, health systems, labor organizations, patient and community representatives, state
agencies, and experts in public finance and governance; and
new text end
new text begin
(5) develop specific recommendations for structures of ownership, governance, and
sustainable, long-term funding of Hennepin Healthcare, as well as strategies for any
ownership or governance transitions and a timeline to implement such transitions.
new text end
new text begin
(b) In conducting evaluations under paragraph (a), the advisory task force must consider
a full range of potential ownership, governance, and structural models, including models
that may involve regional, multicounty, state, or public authority ownership structures. Such
evaluations are not limited to the ownership of Hennepin Healthcare by Hennepin County.
new text end
new text begin Subd. 5. new text end
new text begin Administrative support. new text end
new text begin
The commissioner of health must provide meeting
space and administrative services for the advisory task force. State agencies must provide
technical assistance upon the request of the advisory task force.
new text end
new text begin Subd. 6. new text end
new text begin Report. new text end
new text begin
By February 15, 2027, the advisory task force must submit to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
and human services, taxation, and state government. The report must include the following
at minimum:
new text end
new text begin
(1) specific recommendations for structures of ownership, governance, and sustainable,
long-term funding of Hennepin Healthcare, a fiscal analysis of all recommendations, and
a timeline to implement such recommendations; and
new text end
new text begin
(2) draft legislation necessary to implement the specific recommendations.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
The advisory task force expires June 30, 2027, or upon submission
of the required report, whichever is later.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
ARTICLE 10
HEALTH PLAN REGULATORY ALIGNMENT
Section 1.
Minnesota Statutes 2024, section 60A.50, subdivision 3, is amended to read:
Subd. 3.
Commissioner.
"Commissioner" means the commissioner of commerce deleted text begin or the
commissioner of health, whichever commissioner otherwise regulates the health organizationdeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 2.
Minnesota Statutes 2024, section 60A.951, subdivision 3, is amended to read:
Subd. 3.
Commissioner.
"Commissioner" means the commissioner of commerce deleted text begin for
insurers regulated by the commissioner of commerce, and means the commissioner of health
for insurers regulated by the commissioner of healthdeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 3.
Minnesota Statutes 2024, section 60A.985, subdivision 8, is amended to read:
Subd. 8.
Licensee.
"Licensee" means any person licensed, authorized to operate, or
registered, or required to be licensed, authorized, or registered by the Department of
Commerce deleted text begin or the Department of Healthdeleted text end under chapters 59A to 62M, 62Q to 62V, and 64B
to 79A.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 4.
Minnesota Statutes 2024, section 60A.9853, subdivision 1, is amended to read:
Subdivision 1.
Notification to the commissioner.
Each licensee shall notify the
commissioner of commerce deleted text begin or commissioner of health, whichever commissioner otherwise
regulates the licensee,deleted text end without unreasonable delay but in no event later than five business
days from a determination that a cybersecurity event has occurred when either of the
following criteria has been met:
(1) this state is the licensee's state of domicile, in the case of an insurer, or this state is
the licensee's home state, in the case of a producer, as those terms are defined in chapter
60K and the cybersecurity event has a reasonable likelihood of materially harming:
(i) any consumer residing in this state; or
(ii) any part of the normal operations of the licensee; or
(2) the licensee reasonably believes that the nonpublic information involved is of 250
or more consumers residing in this state and that is either of the following:
(i) a cybersecurity event impacting the licensee of which notice is required to be provided
to any government body, self-regulatory agency, or any other supervisory body pursuant
to any state or federal law; or
(ii) a cybersecurity event that has a reasonable likelihood of materially harming:
(A) any consumer residing in this state; or
(B) any part of the normal operations of the licensee.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 5.
Minnesota Statutes 2024, section 60A.9854, is amended to read:
60A.9854 POWER OF COMMISSIONER.
(a) The commissioner of commerce deleted text begin or commissioner of health, whichever commissioner
otherwise regulates the licensee, shall havedeleted text end new text begin hasnew text end power to examine and investigate into the
affairs of any licensee to determine whether the licensee has been or is engaged in any
conduct in violation of sections 60A.985 to 60A.9857. This power is in addition to the
powers which the commissioner has under section 60A.031. Any such investigation or
examination shall be conducted pursuant to section 60A.031.
(b) Whenever the commissioner of commerce deleted text begin or commissioner of healthdeleted text end has reason to
believe that a licensee has been or is engaged in conduct in this state which violates sections
60A.985 to 60A.9857, the commissioner of commerce deleted text begin or commissioner of healthdeleted text end may take
action that is necessary or appropriate to enforce those sections.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 6.
Minnesota Statutes 2024, section 60B.03, subdivision 2, is amended to read:
Subd. 2.
Commissioner.
"Commissioner" means the commissioner of commerce deleted text begin of the
state of Minnesotadeleted text end and, in that commissioner's absence or disability, a deputy or other person
duly designated to act in that commissioner's place. deleted text begin In the context of rehabilitation or
liquidation of a health maintenance organization, "commissioner" means the commissioner
of health of the state of Minnesota and, in that commissioner's absence or disability, a deputy
or other person duly designated to act in that commissioner's place.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 7.
Minnesota Statutes 2024, section 60G.01, subdivision 2, is amended to read:
Subd. 2.
Commissioner.
"Commissioner" means the commissioner of commercedeleted text begin , except
that "commissioner" means the commissioner of health for administrative supervision of
health maintenance organizationsdeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 8.
Minnesota Statutes 2024, section 60G.01, subdivision 4, is amended to read:
Subd. 4.
Department.
"Department" means the Department of Commercedeleted text begin , except that
"department" means the Department of Health for administrative supervision of health
maintenance organizationsdeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 9.
Minnesota Statutes 2024, section 62A.02, subdivision 8, is amended to read:
Subd. 8.
Filing by health carriers for purposes of complying with the certification
requirements of MNsure.
No qualified health plan shall be offered through MNsure until
its form and the premium rates pertaining to the form have been approved by the
commissioner of commerce deleted text begin or health, as appropriate,deleted text end and the health plan has been determined
to comply with the certification requirements of MNsure in accordance with an agreement
between the commissioners of commerce and health and MNsure.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 10.
Minnesota Statutes 2024, section 62A.021, subdivision 1, is amended to read:
Subdivision 1.
Loss ratio standards.
(a) Notwithstanding section 62A.02, subdivision
3, relating to loss ratios, and except as otherwise authorized by section 62A.02, subdivision
3a, for individual policies or certificates, health care policies or certificates shall not be
delivered or issued for delivery to an individual or to a small employer as defined in section
62L.02, unless the policies or certificates can be expected, as estimated for the entire period
for which rates are computed to provide coverage, to return to Minnesota policyholders and
certificate holders in the form of aggregate benefits not including anticipated refunds or
credits, provided under the policies or certificates, (1) at least 75 percent of the aggregate
amount of premiums earned in the case of policies issued in the small employer market, as
defined in section 62L.02, subdivision 27, calculated on an aggregate basis; and (2) at least
65 percent of the aggregate amount of premiums earned in the case of each policy form or
certificate form issued in the individual market; calculated on the basis of incurred claims
experience or incurred health care expenses where coverage is provided by a health
maintenance organization on a service rather than reimbursement basis and earned premiums
for the period and according to accepted actuarial principles and practices. Assessments by
the reinsurance association created in chapter 62L and all types of taxes, surcharges, or
assessments created by Laws 1992, chapter 549, or created on or after April 23, 1992, are
included in the calculation of incurred claims experience or incurred health care expenses.
The applicable percentage for policies and certificates issued in the small employer market,
as defined in section 62L.02, increases by one percentage point on July 1 of each year,
beginning on July 1, 1994, until an 82 percent loss ratio is reached on July 1, 2000. The
applicable percentage for policy forms and certificate forms issued in the individual market
increases by one percentage point on July 1 of each year, beginning on July 1, 1994, until
a 72 percent loss ratio is reached on July 1, 2000. A health carrier that enters a market after
July 1, 1993, does not start at the beginning of the phase-in schedule and must instead
comply with the loss ratio requirements applicable to other health carriers in that market
for each time period. Premiums earned and claims incurred in markets other than the small
employer and individual markets are not relevant for purposes of this section.
(b) All filings of rates and rating schedules shall demonstrate that actual expected claims
in relation to premiums comply with the requirements of this section when combined with
actual experience to date. Filings of rate revisions shall also demonstrate that the anticipated
loss ratio over the entire future period for which the revised rates are computed to provide
coverage can be expected to meet the appropriate loss ratio standards, and aggregate loss
ratio from inception of the policy form or certificate form shall equal or exceed the
appropriate loss ratio standards.
(c) A health carrier that issues health care policies and certificates to individuals or to
small employers, as defined in section 62L.02, in this state shall file annually its rates, rating
schedule, and supporting documentation including ratios of incurred losses to earned
premiums by policy form or certificate form duration for approval by the commissioner
according to the filing requirements and procedures prescribed by the commissioner. The
supporting documentation shall also demonstrate in accordance with actuarial standards of
practice using reasonable assumptions that the appropriate loss ratio standards can be
expected to be met over the entire period for which rates are computed. The demonstration
shall exclude active life reserves. If the data submitted does not confirm that the health
carrier has satisfied the loss ratio requirements of this section, the commissioner shall notify
the health carrier in writing of the deficiency. The health carrier shall have 30 days from
the date of the commissioner's notice to file amended rates that comply with this section.
If the health carrier fails to file amended rates within the prescribed time, the commissioner
shall order that the health carrier's filed rates for the nonconforming policy form or certificate
form be reduced to an amount that would have resulted in a loss ratio that complied with
this section had it been in effect for the reporting period of the supplement. The health
carrier's failure to file amended rates within the specified time or the issuance of the
commissioner's order amending the rates does not preclude the health carrier from filing an
amendment of its rates at a later time. The commissioner shall annually make the submitted
data available to the public at a cost not to exceed the cost of copying. The data must be
compiled in a form useful for consumers who wish to compare premium charges and loss
ratios.
(d) Each sale of a policy or certificate that does not comply with the loss ratio
requirements of this section is an unfair or deceptive act or practice in the business of
insurance and is subject to the penalties in sections 72A.17 to 72A.32.
(e)(1) For purposes of this section, health care policies issued as a result of solicitations
of individuals through the mail or mass media advertising, including both print and broadcast
advertising, shall be treated as individual policies.
(2) For purposes of this section, (i) "health care policy" or "health care certificate" is a
health plan as defined in section 62A.011; and (ii) "health carrier" has the meaning given
in section 62A.011 and includes all health carriers delivering or issuing for delivery health
care policies or certificates in this state or offering these policies or certificates to residents
of this state.
(f) The loss ratio phase-in as described in paragraph (a) does not apply to individual
policies and small employer policies issued by a health plan company that is assessed less
than three percent of the total annual amount assessed by the Minnesota Comprehensive
Health Association. These policies must meet a 68 percent loss ratio for individual policies,
a 71 percent loss ratio for small employer policies with fewer than ten employees, and a 75
percent loss ratio for all other small employer policies.
(g) Notwithstanding paragraphs (a) and (f), the loss ratio shall be 60 percent for a health
plan as defined in section 62A.011, offered by an insurance company licensed under chapter
60A that is assessed less than ten percent of the total annual amount assessed by the
Minnesota Comprehensive Health Association. For purposes of the percentage calculation
of the association's assessments, an insurance company's assessments include those of its
affiliates.
(h) The deleted text begin commissionersdeleted text end new text begin commissionernew text end of commerce deleted text begin and health shall eachdeleted text end new text begin mustnew text end annually
issue a public report listing, by health plan company, the actual loss ratios experienced in
the individual and small employer markets in this state deleted text begin by the health plan companies that
the commissioners respectively regulate. The commissioners shall coordinate release of
these reports so as to release them as a joint report or as separate reports issued the same
daydeleted text end . The report or reports shall be released no later than June 1 for loss ratios experienced
for the preceding calendar year. Health plan companies shall provide to the deleted text begin commissionersdeleted text end new text begin
commissionernew text end any information requested by the deleted text begin commissionersdeleted text end new text begin commissionernew text end for purposes
of this paragraph.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 11.
Minnesota Statutes 2024, section 62A.61, is amended to read:
62A.61 DISCLOSURE OF METHODS USED BY HEALTH CARRIERS TO
DETERMINE USUAL AND CUSTOMARY FEES.
(a) A health carrier that bases reimbursement to health care providers upon a usual and
customary fee must maintain in its office a copy of a description of the methodology used
to calculate fees including at least the following:
(1) the frequency of the determination of usual and customary fees;
(2) a general description of the methodology used to determine usual and customary
fees; and
(3) the percentile of usual and customary fees that determines the maximum allowable
reimbursement.
(b) A health carrier must provide a copy of the information described in paragraph (a)
to the commissioner of health or the commissioner of commerce, upon request.
(c) The deleted text begin commissioner of health or thedeleted text end commissioner of commercedeleted text begin , as appropriate,deleted text end may
use deleted text begin to enforce this sectiondeleted text end any enforcement powers otherwise available to the commissioner
with respect to the health carriernew text begin to enforce this sectionnew text end . The commissioner of deleted text begin health ordeleted text end
commercedeleted text begin , as appropriate,deleted text end may require health carriers to provide the information required
under this section and may use any powers granted under other laws relating to the regulation
of health carriers to enforce compliance.
(d) For purposes of this section, "health carrier" has the meaning given in section
62A.011.
(e) "Usual and customary" means the normal charge, in the absence of insurance, of the
provider for a service or article, but not more than the prevailing charge in the area for like
service or article. A "like service" is the same nature and duration, requires the same skill,
and is performed by a provider of similar training and experience. A "like article" is one
that is identically or substantially equivalent. "Area" means the municipality or, in the case
of a large city, a subdivision of the city, in which the service or article is actually provided
or a greater area as is necessary to obtain a representative cross-section of charges for like
service or article.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 12.
Minnesota Statutes 2024, section 62A.65, subdivision 7, is amended to read:
Subd. 7.
Short-term coverage.
(a) For purposes of this section, "short-term coverage"
means an individual health plan that:
(1) is issued to provide coverage for a period of 185 days or less, except that the health
plan may permit coverage to continue until the end of a period of hospitalization for a
condition for which the covered person was hospitalized on the day that coverage would
otherwise have ended;
(2) is nonrenewable, provided that the health carrier may provide coverage for one or
more subsequent periods that satisfy clause (1), if the total of the periods of coverage do
not exceed a total of 365 days out of any 555-day period, plus any additional days covered
as a result of hospitalization on the day that a period of coverage would otherwise have
ended;
(3) does not cover any preexisting conditions, including ones that originated during a
previous identical policy or contract with the same health carrier where coverage was
continuous between the previous and the current policy or contract; and
(4) is available with an immediate effective date without underwriting upon receipt of
a completed application indicating eligibility under the health carrier's eligibility
requirements, provided that coverage that includes optional benefits may be offered on a
basis that does not meet this requirement.
(b) Short-term coverage is not subject to subdivisions 2 and 5. Short-term coverage may
exclude as a preexisting condition any injury, illness, or condition for which the covered
person had medical treatment, symptoms, or any manifestations before the effective date
of the coverage, but dependent children born or placed for adoption during the policy period
must not be subject to this provision.
(c) Notwithstanding subdivision 3, and section 62A.021, a health carrier may combine
short-term coverage with its most commonly sold individual qualified plan, as defined in
section 62E.02, other than short-term coverage, for purposes of complying with the loss
ratio requirement.
(d) The 365-day coverage limitation provided in paragraph (a) applies to the total number
of days of short-term coverage that covers a person, regardless of the number of policies,
contracts, or health carriers that provide the coverage. A written application for short-term
coverage must ask the applicant whether the applicant has been covered by short-term
coverage by any health carrier within the 555 days immediately preceding the effective date
of the coverage being applied for. Short-term coverage issued in violation of the 365-day
limitation is valid until the end of its term and does not lose its status as short-term coverage,
in spite of the violation. A health carrier that knowingly issues short-term coverage in
violation of the 365-day limitation is subject to the administrative penalties otherwise
available to the commissioner of commerce deleted text begin or the commissioner of health, as appropriatedeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 13.
Minnesota Statutes 2024, section 62A.65, subdivision 8, is amended to read:
Subd. 8.
Cessation of individual business.
Notwithstanding the provisions of
subdivisions 1 to 7, a health carrier may elect to cease doing business in the individual health
plan market in this state if it complies with the requirements of this subdivision. For purposes
of this section, "cease doing business" means to discontinue issuing new individual health
plans and to refuse to renew all of the health carrier's existing individual health plans issued
in this state whose terms permit refusal to renew under the circumstances specified in this
subdivision. This subdivision does not permit cancellation of an individual health plan,
unless the terms of the health plan permit cancellation under the circumstances specified in
this subdivision. A health carrier electing to cease doing business in the individual health
plan market in this state shall notify the commissioner 180 days prior to the effective date
of the cessation. Within 30 days after the termination, the health carrier shall submit to the
commissioner a complete list of policyholders that have been terminated. The cessation of
business does not include the failure of a health carrier to offer or issue new business in the
individual health plan market or continue an existing product line in that market, provided
that a health carrier does not terminate, cancel, or fail to renew its current individual health
plan business. A health carrier electing to cease doing business in the individual health plan
market shall provide 120 days' written notice to each policyholder covered by an individual
health plan issued by the health carrier. This notice must also inform each policyholder of
the existence of the Minnesota Comprehensive Health Association, the requirements for
being accepted, the procedures for applying for coverage, and the telephone numbers at the
deleted text begin Department of Health and thedeleted text end Department of Commerce for information about private
individual or family health coverage. A health carrier that ceases to write new business in
the individual health plan market shall continue to be governed by this section with respect
to continuing individual health plan business conducted by the health carrier. A health carrier
that ceases to do business in the individual health plan market after July 1, 1994, is prohibited
from writing new business in the individual health plan market in this state for a period of
five years from the date of notice to the commissioner. This subdivision applies to any
health maintenance organization that ceases to do business in the individual health plan
market in one service area with respect to that service area only. Nothing in this subdivision
prohibits an affiliated health maintenance organization from continuing to do business in
the individual health plan market in that same service area. The right to refuse to renew an
individual health plan under this subdivision does not apply to individual health plans issued
on a guaranteed renewable basis that does not permit refusal to renew under the circumstances
specified in this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 14.
new text begin
[62D.015] REGULATORY DUTIES; TRANSFER.
new text end
new text begin Subdivision 1. new text end
new text begin Transfer and restructuring. new text end
new text begin
(a) The regulatory oversight with respect
to health maintenance organizations transfers from the commissioner of health to the
commissioner of commerce on July 1, 2027.
new text end
new text begin
(b) The agency restructuring under this section must be conducted in accordance with
sections 15.039 and 43A.045.
new text end
new text begin Subd. 2. new text end
new text begin Succession; employees; liability. new text end
new text begin
(a) Employees related to the functions
assigned to the commissioner of health are transferred to the Department of Commerce 30
days after the date the commissioner of health approves the transfer.
new text end
new text begin
(b) An employee transferred under paragraph (a):
new text end
new text begin
(1) must not have the employee's employment status or job classification altered as a
result of the transfer;
new text end
new text begin
(2) if represented by an exclusive representative before the transfer, remains represented
by the same exclusive representative after the transfer occurs;
new text end
new text begin
(3) if an applicable collective bargaining agreement with an exclusive representative
was effective before the transfer, remains subject to the collective bargaining agreement
for the remainder of the agreement's term; and
new text end
new text begin
(4) if employed in a temporary unclassified position, the total length of time that the
employee has served in the appointment includes all time served in the appointment at the
transferring agency and the time served in the appointment at the department. An employee
in a temporary unclassified position who was hired by a transferring agency through an
open competitive selection process in accordance with a policy enacted by the commissioner
of management and budget is considered to have been hired through an open competitive
selection process after the transfer.
new text end
new text begin
(c) The state must meet and negotiate with the exclusive representatives of transferred
employees regarding proposed changes that affect or relate to the transferred employees'
terms and conditions of employment to the extent that the proposed changes are not addressed
in the applicable collective bargaining agreement.
new text end
new text begin
(d) If the state transfers ownership or control of a department facility, service, or operation
to a private or public entity by subcontracting, sale, assignment, lease, or other transfer, the
state must require as a written condition of the transfer of ownership or control:
new text end
new text begin
(1) an employee who performs work in the facility, service, or operation must be offered
employment with the entity acquiring ownership or control before the entity offers
employment to another individual who was not employed by the transferring agency at the
time the transfer occurs; and
new text end
new text begin
(2) the entity acquiring ownership or control is prohibited from reducing the transferred
employee's wage and benefit standards until the collective bargaining agreement in effect
at the time the transfer occurs expires or for a period of two years after the transfer occurs,
whichever is longer.
new text end
new text begin
(e) The state of Minnesota and the state's officers or agents are not liable for and are not
subject to a cause of action arising from the action or inaction of an entity acquiring
ownership or control of a department facility, service, or operation.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 15.
Minnesota Statutes 2024, section 62D.08, subdivision 1, is amended to read:
Subdivision 1.
Notice of changes.
A health maintenance organization shall, unless
otherwise provided for by rules adopted by the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end , file
notice with the commissioner of deleted text begin health prior to any modification ofdeleted text end new text begin commerce before
modifyingnew text end the operations or documents described in the information submitted undernew text begin section
62D.03, subdivision 4,new text end clauses (a), (b), (e), (f), (g), (i), (j), (l), (m), (n), (o), (p), (q), (r), (s),
and (t) deleted text begin of section 62D.03, subdivision 4deleted text end . If the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end does not
disapprove of the filing within 60 days, it shall be deemed approved and may be implemented
by the health maintenance organization.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 16.
Minnesota Statutes 2024, section 62D.08, subdivision 2, is amended to read:
Subd. 2.
Annual report required.
Every health maintenance organization shall annually,
on or before April 1, file a verified report with the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end
covering the preceding calendar year. However, utilization data required under subdivision
3, clause (c), shall be filed on or before July 1.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 17.
Minnesota Statutes 2024, section 62D.08, subdivision 3, is amended to read:
Subd. 3.
Report requirements.
deleted text begin Suchdeleted text end new text begin Thenew text end report shall benew text begin submittednew text end on forms prescribed
by the commissioner of deleted text begin health,deleted text end new text begin commercenew text end and shall include:
(a) a financial statement of the organization, including its balance sheet and receipts and
disbursements for the preceding year certified by an independent certified public accountant,
reflecting at least (1) all prepayment and other payments received for health care services
rendered, (2) expenditures to all providers, by classes or groups of providers, and insurance
companies or nonprofit health service plan corporations engaged to fulfill obligations arising
out of the health maintenance contract, (3) expenditures for capital improvements, or
additions thereto, including but not limited to construction, renovation or purchase of
facilities and capital equipment, and (4) a supplementary statement of assets, liabilities,
premium revenue, and expenditures for risk sharing business under section 62D.04,
subdivision 1, on forms prescribed by the commissioner;
(b) the number of new enrollees enrolled during the year, the number of group enrollees
and the number of individual enrollees as of the end of the year and the number of enrollees
terminated during the year;
(c) a summary of information compiled pursuant to section 62D.04, subdivision 1, clause
(c), in such form as may be required by the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end ;
(d) a report of the names and addresses of all persons set forth in section 62D.03,
subdivision 4, clause (c), who were associated with the health maintenance organization or
the major participating entity during the preceding year, and the amount of wages, expense
reimbursements, or other payments to such individuals for services to the health maintenance
organization or the major participating entity, as those services relate to the health
maintenance organization, including a full disclosure of all financial arrangements during
the preceding year required to be disclosed pursuant to section 62D.03, subdivision 4, clause
(d);
(e) a separate report addressing health maintenance contracts sold to individuals covered
by Medicare, title XVIII of the Social Security Act, as amended, including the information
required under section 62D.30, subdivision 6;
(f) data on the number of complaints received and the category of each complaint as
defined by the commissioner. The categories must include access, communication and
behavior, health plan administration, facilities and environment, coordination of care, and
technical competence and appropriateness. The commissioner, in consultation with interested
stakeholders, shall define complaint categories to be used by each health maintenance
organization by July 1, 2017, and the categories must be used by each health maintenance
organization beginning calendar year 2018; and
(g) such other information relating to the performance of the health maintenance
organization as is reasonably necessary to enable the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end to
carry out the duties under sections 62D.01 to 62D.30.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 18.
Minnesota Statutes 2024, section 62D.08, subdivision 7, is amended to read:
Subd. 7.
Consistent administrative expenses and investment income reporting.
(a)
Every health maintenance organization must directly allocate administrative expenses to
specific lines of business or products when such information is available. Remaining expenses
that cannot be directly allocated must be allocated based on other methods, as recommended
by the Advisory Group on Administrative Expenses. Health maintenance organizations
must submit this information, including administrative expenses for dental services, using
the reporting template provided by the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end .
(b) Every health maintenance organization must allocate investment income based on
cumulative net income over time by business line or product and must submit this
information, including investment income for dental services, using the reporting template
provided by the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 19.
Minnesota Statutes 2024, section 62D.12, subdivision 1, is amended to read:
Subdivision 1.
False representations.
No health maintenance organization or
representative thereof may cause or knowingly permit the use of advertising or solicitation
which is untrue or misleading, or any form of evidence of coverage which is deceptive.
Each health maintenance organization deleted text begin shall bedeleted text end new text begin isnew text end subject to sections 72A.17 to 72A.32deleted text begin ,
relating to the regulation of trade practices, except (a) to the extent that the nature of a health
maintenance organization renders such sections clearly inappropriate and (b) that enforcement
shall be by the commissioner of health and not by the commissioner of commercedeleted text end . Every
health maintenance organization deleted text begin shall bedeleted text end new text begin isnew text end subject to sections 8.31 and 325F.69.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 20.
Minnesota Statutes 2024, section 62D.124, subdivision 5, is amended to read:
Subd. 5.
Provider networks.
The deleted text begin commissioner of health, thedeleted text end commissioner of
commercedeleted text begin ,deleted text end and the commissioner of human services shall merge reporting requirements
for health maintenance organizations and county-based purchasing plans related to Minnesota
Department of deleted text begin Healthdeleted text end new text begin Commercenew text end oversight of network adequacy under this section and the
provider network list reported to the Department of Human Services under Minnesota Rules,
part 4685.2100. The commissioners shall work with health maintenance organizations and
county-based purchasing plans to ensure that the report merger is done in a manner that
simplifies health maintenance organization and county-based purchasing plan reporting
processes.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 21.
Minnesota Statutes 2025 Supplement, section 62D.21, is amended to read:
62D.21 FEES.
Every health maintenance organization subject to sections 62D.01 to 62D.30 shall pay
to the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end the following fees:
(1) filing an application for a certificate of authority: $10,000;
(2) filing an amendment to a certificate of authority: $125;
(3) filing each annual report: $400;
(4) filing each quarterly report: $200; and
(5) filing annual plan review documents, amendments to plan documents, and quality
plans: $125.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 22.
Minnesota Statutes 2025 Supplement, section 62D.211, is amended to read:
62D.211 RENEWAL FEE.
Each health maintenance organization subject to sections 62D.01 to 62D.30 shall submit
to the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end each year before June 15 a certificate of authority
renewal fee in the amount of $30,000 each plus 88 cents per person enrolled in the health
maintenance organization on December 31 of the preceding year.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 23.
new text begin
[62D.212] HEALTH MAINTENANCE ORGANIZATION REGULATION
ACCOUNT.
new text end
new text begin
(a) A health maintenance organization regulation account is established as a separate
account in the special revenue fund in the state treasury. The commissioner of commerce
must credit to the account filing fees and renewal fees collected under sections 62D.21 and
62D.211, appropriations and transfers, and other revenue related to the activities identified
in paragraph (b). Earnings, including interest, dividends, other earnings arising from the
account's assets, and remaining money from fiscal years occurring before July 1, 2027, must
be credited to the account. The commissioner of commerce must manage the account.
new text end
new text begin
(b) Money in the account is appropriated to the commissioner of commerce to administer
this chapter and to reimburse the department's costs incurred to administer this section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 24.
Minnesota Statutes 2024, section 62D.221, subdivision 1, is amended to read:
Subdivision 1.
Insurance provisions applicable to health maintenance
organizations.
Health maintenance organizations are subject to sections 60A.135, 60A.136,
60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with the
provisions of these sections applicable to insurers. In applying these sections to health
maintenance organizations, "commissioner" means the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end .
Health maintenance organizations are subject to Minnesota Rules, chapter 2720, as applicable
to sections 60D.17, 60D.18, and 60D.20, and must comply with the provisions of chapter
2720 applicable to insurers, unless the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end adopts rules to
implement this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 25.
Minnesota Statutes 2024, section 62D.221, subdivision 2, is amended to read:
Subd. 2.
Statement.
In addition to the conditions in section 60D.17, subdivision 1,
subjecting a health maintenance organization to filing requirements, no person other than
the issuer shall acquire all or substantially all of the assets of a domestic nonprofit health
maintenance organization through any means unless at the time the offer, request, or
invitation is made or the agreement is entered into the person has filed with the commissioner
and has sent to the health maintenance organization a statement containing the information
required in section 60D.17 and the offer, request, invitation, agreement, or acquisition has
been approved by the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end in the manner prescribed in section
60D.17.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 26.
Minnesota Statutes 2024, section 62E.11, subdivision 9, is amended to read:
Subd. 9.
Special assessment upon termination of individual health coverage.
new text begin (a)
new text end Each contributing member that terminates individual health coverage for reasons other than
deleted text begin (a)deleted text end new text begin (1)new text end nonpayment of premium; deleted text begin (b)deleted text end new text begin (2)new text end failure to make co-payments; deleted text begin (c)deleted text end new text begin (3)new text end enrollee moving
out of the area served; or deleted text begin (d)deleted text end new text begin (4)new text end a materially false statement or misrepresentation by the
enrollee in the application for membership; and does not provide or arrange for replacement
coverage that meets the requirements of section 62D.121; shall pay a special assessment to
the state plan based upon the number of terminated individuals who join the comprehensive
health insurance plan as authorized under section 62E.14, subdivisions 1, paragraph (d),
and 6. Such a contributing member shall pay the association an amount equal to the average
cost of an enrollee in the state plan in the year in which the member terminated enrollees
multiplied by the total number of terminated enrollees who enroll in the state plan.
new text begin (b) new text end The average cost of an enrollee in the state comprehensive health insurance plan
shall be determined by dividing the state plan's total annual losses by the total number of
enrollees from that year. This cost will be assessed to the contributing member who has
terminated health coverage before the association makes the annual determination of each
contributing member's liability as required under this section.
new text begin (c) new text end In the event that the contributing member is terminating health coverage because of
a loss of health care providers, the commissioner may review whether or not the special
assessment established under this subdivision will have an adverse impact on the contributing
member or its enrollees or insureds, including but not limited to causing the contributing
member to fall below statutory net worth requirements. If the commissioner determines that
the special assessment would have an adverse impact on the contributing member or its
enrollees or insureds, the commissioner may adjust the amount of the special assessment,
or establish alternative payment arrangements to the state plan. For health maintenance
organizations regulated under chapter 62D, the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end shall
make the determination regarding any adjustment in the special assessment deleted text begin and shall transmit
that determination to the commissioner of commercedeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 27.
Minnesota Statutes 2024, section 62E.11, subdivision 13, is amended to read:
Subd. 13.
State funding; effect on premium rates of members.
In approving the
premium rates as required in sections 62A.65, subdivision 3; and 62L.08, subdivision 8,
the deleted text begin commissionersdeleted text end new text begin commissionernew text end of deleted text begin health anddeleted text end commerce shall ensure that any appropriation
to reduce the annual assessment made on the contributing members to cover the costs of
the Minnesota comprehensive health insurance plan as required under this section is reflected
in the premium rates charged by each contributing member.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 28.
Minnesota Statutes 2024, section 62J.60, subdivision 5, is amended to read:
Subd. 5.
Annual reporting.
As part of an annual filing made with the commissioner of
deleted text begin health ordeleted text end commerce deleted text begin on or after January 1, 2003deleted text end , a group purchaser shall certify compliance
with this section and shall submit to the commissioner of deleted text begin health ordeleted text end commerce a copy of the
Minnesota uniform health care identification card used by the group purchaser.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 29.
Minnesota Statutes 2024, section 62L.02, subdivision 8, is amended to read:
Subd. 8.
Commissioner.
"Commissioner" means the commissioner of commerce deleted text begin for
health carriers subject to the jurisdiction of the Department of Commerce or the commissioner
of health for health carriers subject to the jurisdiction of the Department of Health, or the
relevant commissioner's designated representative. For purposes of sections 62L.13 to
62L.22, "commissioner" means the commissioner of commerce or that commissioner's
designated representativedeleted text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 30.
Minnesota Statutes 2024, section 62L.08, subdivision 11, is amended to read:
Subd. 11.
Loss ratio standards.
Notwithstanding section 62A.02, subdivision 3, relating
to loss ratios, each policy or contract form used with respect to a health benefit plan offered,
or issued in the small employer market, is subject, beginning July 1, 1993, to section 62A.021.
deleted text begin The commissioner of health has, with respect to carriers under that commissioner's
jurisdiction, all of the powers of the commissioner of commerce under that section.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 31.
Minnesota Statutes 2024, section 62L.09, subdivision 3, is amended to read:
Subd. 3.
Reentry prohibition.
(a) Except as otherwise provided in paragraph (b), a
health carrier that ceases to do business in the small employer market after July 1, 1993, is
prohibited from writing new business in the small employer market in this state for a period
of five years from the date of notice to the commissioner. This subdivision applies to any
health maintenance organization that ceases to do business in the small employer market
in one service area with respect to that service area only. Nothing in this subdivision prohibits
an affiliated health maintenance organization from continuing to do business in the small
employer market in that same service area.
(b) The commissioner of commerce deleted text begin or the commissioner of healthdeleted text end may permit a health
carrier that ceases to do business in the small employer market in this state after July 1,
1993, to begin writing new business in the small employer market if:
(1) since the carrier ceased doing business in the small employer market, legislative
action has occurred that has significantly changed the effect on the carrier of its decision to
cease doing business in the small employer market; and
(2) the commissioner deems it appropriate.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 32.
Minnesota Statutes 2024, section 62L.10, subdivision 4, is amended to read:
Subd. 4.
Review of premium rates.
The commissioner shall regulate premium rates
charged or proposed to be charged by all health carriers in the small employer market under
section 62A.02. deleted text begin The commissioner of health has, with respect to carriers under that
commissioner's jurisdiction, all of the powers of the commissioner of commerce under that
section.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 33.
Minnesota Statutes 2024, section 62L.11, subdivision 2, is amended to read:
Subd. 2.
Enforcement powers.
The deleted text begin commissionersdeleted text end new text begin commissionernew text end of deleted text begin health anddeleted text end
commerce deleted text begin eachdeleted text end hasnew text begin ,new text end for purposes of this chapternew text begin ,new text end all of deleted text begin eachdeleted text end new text begin thenew text end commissioner's deleted text begin respectivedeleted text end
powers under other chapters that are applicable to deleted text begin their respectivedeleted text end new text begin the commissioner'snew text end duties
under this chapter.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 34.
Minnesota Statutes 2024, section 62M.11, is amended to read:
62M.11 COMPLAINTS TO COMMERCE deleted text begin OR HEALTHdeleted text end .
Notwithstanding the provisions of this chapter, an enrollee may file a complaint regarding
an adverse determination directly to the commissioner deleted text begin responsible for regulating the
utilization review organizationdeleted text end new text begin of commercenew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 35.
Minnesota Statutes 2024, section 62Q.01, subdivision 2, is amended to read:
Subd. 2.
Commissioner.
"Commissioner" means deleted text begin the commissioner of health for purposes
of regulating health maintenance organizations, and community integrated service networks,
ordeleted text end the commissioner of commerce for purposes of regulating deleted text begin all otherdeleted text end health plan companies.
For all other purposes, "commissioner" means the commissioner of health.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 36.
Minnesota Statutes 2024, section 62Q.106, is amended to read:
62Q.106 DISPUTE RESOLUTION BY COMMISSIONER.
(a) A complainant may at any time submit a complaint to the deleted text begin appropriatedeleted text end commissioner
to investigate. After investigating a complaint, or reviewing a company's decision, the
deleted text begin appropriatedeleted text end commissioner may order a remedy as authorized under chapter 45, 60A, or 62D.
(b) In investigating a complaint filed against a health maintenance organization regarding
a vulnerable adult, upon request, the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end must interview at
least one family member of the complainant or the subject of the complaint. If the
complainant or the subject of the complaint does not want any family members to be
interviewed, this information will be included in the investigative file.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 37.
Minnesota Statutes 2024, section 62Q.188, subdivision 2, is amended to read:
Subd. 2.
Flexible benefits plan.
Notwithstanding any provision of this chapter, chapter
363A, or any other law to the contrary, a health plan company may offer, sell, issue, and
renew a health plan that is a flexible benefits plan under this section if the following
requirements are satisfied:
(1) the health plan must be offered in compliance with the laws of this state, except as
otherwise permitted in this section;
(2) the health plan must be designed to enable covered persons to better manage costs
and coverage options through the use of co-pays, deductibles, and other cost-sharing
arrangements;
(3) the health plan may modify or exclude any or all coverages of benefits that would
otherwise be required by law, except for maternity benefits and other benefits required under
federal law;
(4) each health plan and plan's premiums must be approved by the commissioner of
deleted text begin health ordeleted text end commerce, deleted text begin whichever is appropriate under section 62Q.01, subdivision 2,deleted text end but
deleted text begin neitherdeleted text end new text begin thenew text end commissioner maynew text begin notnew text end disapprove a plan on the grounds of a modification or
exclusion permitted under clause (3); and
(5) prior to the sale of the health plan, the purchaser must be given a written list of the
coverages otherwise required by law that are modified or excluded in the health plan. The
list must include a description of each coverage in the list and indicate whether the coverage
is modified or excluded. If coverage is modified, the list must describe the modification.
The list may, but is not required to, also list any or all coverages otherwise required by law
that are included in the health plan and indicate that they are included. The health plan
company must require that a copy of this written list be provided, prior to the effective date
of the health plan, to each enrollee or employee who is eligible for health coverage under
the plan.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 38.
Minnesota Statutes 2024, section 62Q.37, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For purposes of this section, the following terms have the
meanings given them.
(b) "Commissioner" means the commissioner of deleted text begin health for purposes of regulating health
maintenance organizations and community integrated service networks, the commissioner
ofdeleted text end commerce for purposes of regulatingnew text begin health maintenance organizations andnew text end nonprofit
health service plan corporations, or the commissioner of human services for the purpose of
contracting with managed care organizations serving persons enrolled in programs under
chapter 256B or 256L.
(c) "Health plan company" means (1) a nonprofit health service plan corporation operating
under chapter 62C; (2) a health maintenance organization operating under chapter 62D; (3)
a community integrated service network operating under chapter 62N; or (4) a managed
care organization operating under chapter 256B or 256L.
(d) "Nationally recognized independent organization" means (1) an organization that
sets specific national standards governing health care quality assurance processes, utilization
review, provider credentialing, marketing, and other topics covered by this chapter and
other chapters and audits and provides accreditation to those health plan companies that
meet those standards. The American Accreditation Health Care Commission (URAC), the
National Committee for Quality Assurance (NCQA), the Joint Commission on Accreditation
of Healthcare Organizations (JCAHO), and the Accreditation Association for Ambulatory
Health Care (AAAHC) are, at a minimum, defined as nationally recognized independent
organizations; and (2) the Centers for Medicare and Medicaid Services for purposes of
reviews or audits conducted of health plan companies under Part C of Title XVIII of the
Social Security Act or under section 1876 of the Social Security Act.
(e) "Performance standard" means those standards relating to quality management and
improvement, access and availability of service, utilization review, provider selection,
provider credentialing, marketing, member rights and responsibilities, complaints, appeals,
grievance systems, enrollee information and materials, enrollment and disenrollment,
subcontractual relationships and delegation, confidentiality, continuity and coordination of
care, assurance of adequate capacity and services, coverage and authorization of services,
practice guidelines, health information systems, and financial solvency.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 39.
Minnesota Statutes 2024, section 62Q.47, is amended to read:
62Q.47 ALCOHOLISM, MENTAL HEALTH, AND CHEMICAL DEPENDENCY
SERVICES.
(a) All health plans, as defined in section 62Q.01, that provide coverage for alcoholism,
mental health, or chemical dependency services, must comply with the requirements of this
section.
(b) Cost-sharing requirements and benefit or service limitations for outpatient mental
health and outpatient chemical dependency and alcoholism services, except for persons
seeking chemical dependency services under section 245G.05, must not place a greater
financial burden on the insured or enrollee, or be more restrictive than those requirements
and limitations for outpatient medical services.
(c) Cost-sharing requirements and benefit or service limitations for inpatient hospital
mental health services, psychiatric residential treatment facility services, and inpatient
hospital and residential chemical dependency and alcoholism services, except for persons
seeking chemical dependency services under section 245G.05, must not place a greater
financial burden on the insured or enrollee, or be more restrictive than those requirements
and limitations for inpatient hospital medical services.
(d) A health plan company must not impose an NQTL with respect to mental health and
substance use disorders in any classification of benefits unless, under the terms of the health
plan as written and in operation, any processes, strategies, evidentiary standards, or other
factors used in applying the NQTL to mental health and substance use disorders in the
classification are comparable to, and are applied no more stringently than, the processes,
strategies, evidentiary standards, or other factors used in applying the NQTL with respect
to medical and surgical benefits in the same classification.
(e) All health plans must meet the requirements of the federal Mental Health Parity Act
of 1996, Public Law 104-204; Paul Wellstone and Pete Domenici Mental Health Parity and
Addiction Equity Act of 2008; the Affordable Care Act; and any amendments to, and federal
guidance or regulations issued under, those acts.
(f) The commissioner may require information from health plan companies to confirm
that mental health parity is being implemented by the health plan company. Information
required may include comparisons between mental health and substance use disorder
treatment and other medical conditions, including a comparison of prior authorization
requirements, drug formulary design, claim denials, rehabilitation services, and other
information the commissioner deems appropriate.
(g) Regardless of the health care provider's professional license, if the service provided
is consistent with the provider's scope of practice and the health plan company's credentialing
and contracting provisions, mental health therapy visits and medication maintenance visits
shall be considered primary care visits for the purpose of applying any enrollee cost-sharing
requirements imposed under the enrollee's health plan.
(h) All health plan companies offering health plans that provide coverage for alcoholism,
mental health, or chemical dependency benefits shall provide reimbursement for the benefits
delivered through the psychiatric Collaborative Care Model, which must include the following
Current Procedural Terminology or Healthcare Common Procedure Coding System billing
codes:
(1) 99492;
(2) 99493;
(3) 99494;
(4) G2214; and
(5) G0512.
This paragraph does not apply to managed care plans or county-based purchasing plans
when the plan provides coverage to public health care program enrollees under chapter
256B or 256L.
(i) The commissioner of commerce shall update the list of codes in paragraph (h) if any
alterations or additions to the billing codes for the psychiatric Collaborative Care Model
are made.
(j) "Psychiatric Collaborative Care Model" means the evidence-based, integrated
behavioral health service delivery method described at Federal Register, volume 81, page
80230, which includes a formal collaborative arrangement among a primary care team
consisting of a primary care provider, a care manager, and a psychiatric consultant, and
includes but is not limited to the following elements:
(1) care directed by the primary care team;
(2) structured care management;
(3) regular assessments of clinical status using validated tools; and
(4) modification of treatment as appropriate.
(k) By June 1 of each yeardeleted text begin , beginning June 1, 2021deleted text end , the commissioner of commercedeleted text begin , in
consultation with the commissioner of health,deleted text end shall submit a report on compliance and
oversight to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and commerce. The report must:
(1) describe the commissioner's process for reviewing health plan company compliance
with United States Code, title 42, section 18031(j), any federal regulations or guidance
relating to compliance and oversight, and compliance with this section and section 62Q.53;
(2) identify any enforcement actions taken by either commissioner during the preceding
12-month period regarding compliance with parity for mental health and substance use
disorders benefits under state and federal law, summarizing the results of any market conduct
examinations. The summary must include: (i) the number of formal enforcement actions
taken; (ii) the benefit classifications examined in each enforcement action; and (iii) the
subject matter of each enforcement action, including quantitative and nonquantitative
treatment limitations;
(3) detail any corrective action taken by either commissioner to ensure health plan
company compliance with this section, section 62Q.53, and United States Code, title 42,
section 18031(j); and
(4) describe the information provided by either commissioner to the public about
alcoholism, mental health, or chemical dependency parity protections under state and federal
law.
The report must be written in nontechnical, readily understandable language and must be
made available to the public by, among other means as the commissioners find appropriate,
posting the report on department websites. Individually identifiable information must be
excluded from the report, consistent with state and federal privacy protections.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 40.
Minnesota Statutes 2024, section 62Q.51, subdivision 3, is amended to read:
Subd. 3.
Rate approval.
The premium rates and cost sharing requirements for each
option must be submitted to deleted text begin the commissioner of health ordeleted text end the commissioner of commerce
as required by law. A health plan that includes lower enrollee cost sharing for services
provided by network providers than for services provided by out-of-network providers, or
lower enrollee cost sharing for services provided with prior authorization or second opinion
than for services provided without prior authorization or second opinion, qualifies as a
point-of-service option.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 41.
Minnesota Statutes 2024, section 62Q.556, subdivision 3, is amended to read:
Subd. 3.
Annual data reporting.
(a) Beginning April 1, 2024, a health plan company
must report annually to the commissioner of deleted text begin healthdeleted text end new text begin commercenew text end :
(1) the total number of claims and total billed and paid amounts for nonparticipating
provider services, by service and provider type, submitted to the health plan in the prior
calendar year; and
(2) the total number of enrollee complaints received regarding the rights and protections
established by the No Surprises Act in the prior calendar year.
(b) The deleted text begin commissionersdeleted text end new text begin commissionernew text end of commerce deleted text begin and healthdeleted text end shall develop the form
and manner for health plan companies to comply with paragraph (a).
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 42.
Minnesota Statutes 2024, section 62Q.556, subdivision 4, is amended to read:
Subd. 4.
Enforcement.
(a) Any provider or facility, including a health care provider or
facility pursuant to section 62A.63, subdivision 2, or 62J.03, subdivision 8, that is subject
to the relevant provisions of the No Surprises Act is subject to the requirements of this
section and section 62J.811.
(b) The commissioner of commerce deleted text begin or healthdeleted text end shall enforce this section.
(c) If a health-related licensing board has cause to believe that a provider has violated
this section, it may further investigate and enforce the provisions of this section pursuant
to chapter 214.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 43.
Minnesota Statutes 2024, section 62Q.69, subdivision 2, is amended to read:
Subd. 2.
Procedures for filing a complaint.
(a) A complainant may submit a complaint
to a health plan company either by telephone or in writing. If a complaint is submitted orally
and the resolution of the complaint, as determined by the complainant, is partially or wholly
adverse to the complainant, or the oral complaint is not resolved to the satisfaction of the
complainant, by the health plan company within ten days of receiving the complaint, the
health plan company must inform the complainant that the complaint may be submitted in
writing. The health plan company must also offer to provide the complainant with any
assistance needed to submit a written complaint, including an offer to complete the complaint
form for a complaint that was previously submitted orally and promptly mail the completed
form to the complainant for the complainant's signature. At the complainant's request, the
health plan company must provide the assistance requested by the complainant. The
complaint form must include the following information:
(1) the telephone number of the health plan company member services or other
departments or persons equipped to advise complainants on complaint resolution;
(2) the address to which the form must be sent;
(3) a description of the health plan company's internal complaint procedure and the
applicable time limits; and
(4) the toll-free telephone number of deleted text begin eitherdeleted text end the commissioner of deleted text begin health ordeleted text end commerce
and notification that the complainant has the right to submit the complaint at any time to
the deleted text begin appropriatedeleted text end commissioner for investigation.
(b) Upon receipt of a written complaint, the health plan company must notify the
complainant within ten business days that the complaint was received, unless the complaint
is resolved to the satisfaction of the complainant within the ten business days.
(c) Each health plan company must provide, in the member handbook, subscriber contract,
or certification of coverage, a clear and concise description of how to submit a complaint
and a statement that, upon request, assistance in submitting a written complaint is available
from the health plan company.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 44.
Minnesota Statutes 2024, section 62Q.69, subdivision 3, is amended to read:
Subd. 3.
Notification of complaint decisions.
(a) The health plan company must notify
the complainant in writing of its decision and the reasons for it as soon as practical but in
no case later than 30 days after receipt of a written complaint. If the health plan company
cannot make a decision within 30 days due to circumstances outside the control of the health
plan company, the health plan company may take up to 14 additional days to notify the
complainant of its decision. If the health plan company takes any additional days beyond
the initial 30-day period to make its decision, it must inform the complainant, in advance,
of the extension and the reasons for the extension.
(b) For group health plans, if the decision is partially or wholly adverse to the
complainant, the notification must inform the complainant of the right to appeal the decision
to the health plan company's internal appeal process described in section 62Q.70 and the
procedure for initiating an appeal.
(c) For individual health plans, if the decision is partially or wholly adverse to the
complainant, the notification must inform the complainant of the right to submit the complaint
decision to the external review process described in section 62Q.73 and the procedure for
initiating the external review process. Notwithstanding the provisions in this subdivision,
a health plan company offering individual coverage may instead follow the process for
group health plans outlined in paragraph (b).
(d) The notification must also inform the complainant of the right to submit the complaint
at any time to deleted text begin eitherdeleted text end the commissioner of deleted text begin health ordeleted text end commerce for investigation and the
toll-free telephone number of the deleted text begin appropriatedeleted text end commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 45.
Minnesota Statutes 2024, section 62Q.71, is amended to read:
62Q.71 NOTICE TO ENROLLEES.
Each health plan company shall provide to enrollees a clear and concise description of
its complaint resolution procedure, if applicable under section 62Q.68, subdivision 1, and
the procedure used for utilization review as defined under chapter 62M as part of the member
handbook, subscriber contract, or certificate of coverage. If the health plan company does
not issue a member handbook, the health plan company may provide the description in
another written document. The description must specifically inform enrollees:
(1) how to submit a complaint to the health plan company;
(2) if the health plan includes utilization review requirements, how to notify the utilization
review organization in a timely manner and how to obtain authorization for health care
services;
(3) how to request an appeal either through the procedures described in section 62Q.70,
if applicable, or through the procedures described in chapter 62M;
(4) of the right to file a complaint with deleted text begin eitherdeleted text end the commissioner of deleted text begin health ordeleted text end commerce
at any time during the complaint and appeal process;
(5) of the toll-free telephone number of the deleted text begin appropriatedeleted text end commissioner; and
(6) of the right, for individual and group coverage, to obtain an external review under
section 62Q.73 and a description of when and how that right may be exercised, including
that under most circumstances an enrollee must exhaust the internal complaint or appeal
process prior to external review. However, an enrollee may proceed to external review
without exhausting the internal complaint or appeal process under the following
circumstances:
(i) the health plan company waives the exhaustion requirement;
(ii) the health plan company is considered to have waived the exhaustion requirement
by failing to substantially comply with any requirements including, but not limited to, time
limits for internal complaints or appeals; or
(iii) the enrollee has applied for an expedited external review at the same time the enrollee
has applied for internal review under chapter 62M.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 46.
Minnesota Statutes 2024, section 62Q.73, subdivision 3, is amended to read:
Subd. 3.
Right to external review.
(a) Any enrollee or anyone acting on behalf of an
enrollee who has received an adverse determination may submit a written request for an
external review of the adverse determination, if applicable under section 62Q.68, subdivision
1, or 62M.06, deleted text begin to the commissioner of health if the request involves a health plan company
regulated by that commissioner ordeleted text end to the commissioner of commerce deleted text begin if the request involves
a health plan company regulated by that commissionerdeleted text end . Notification of the enrollee's right
to external review must accompany the denial issued by the insurer.
(b) Nothing in this section requires the commissioner of deleted text begin health ordeleted text end commerce to
independently investigate an adverse determination referred for independent external review.
(c) If an enrollee requests an external review, the health plan company must participate
in the external review. The cost of the external review must be borne by the health plan
company.
(d) The enrollee must request external review within six months from the date of the
adverse determination.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 47.
Minnesota Statutes 2024, section 62Q.73, subdivision 10, is amended to read:
Subd. 10.
Data reporting.
The deleted text begin commissionersdeleted text end new text begin commissioner of commercenew text end shall make
available to the public, upon request, summary data on the decisions rendered under this
section, including the number of reviews heard and decided and the final outcomes. Any
data released to the public must not individually identify the enrollee initiating the request
for external review.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 48.
Minnesota Statutes 2024, section 62Q.81, subdivision 7, is amended to read:
Subd. 7.
Standard plans.
(a) A health plan company that offers individual health plans
must ensure that no less than one individual health plan at each level of coverage described
in subdivision 1, paragraph (b), clause (3), that the health plan company offers in each
geographic rating area the health plan company serves conforms to the standard plan
parameters determined by the commissioner under paragraph (e).
(b) An individual health plan offered under this subdivision must be:
(1) clearly and appropriately labeled as standard plans to aid the purchaser in the selection
process;
(2) marketed as standard plans and in the same manner as other individual health plans
offered by the health plan company; and
(3) offered for purchase to any individual.
(c) This subdivision does not apply to catastrophic plans, grandfathered plans, small
group health plans, large group health plans, health savings accounts, qualified high
deductible health benefit plans, limited health benefit plans, or short-term limited-duration
health insurance policies.
(d) Health plan companies must meet the requirements in this subdivision separately for
plans offered through MNsure under chapter 62V and plans offered outside of MNsure.
(e) The commissioner of commercedeleted text begin , in consultation with the commissioner of health,deleted text end
must annually determine standard plan parameters, including but not limited to cost-sharing
structure and covered benefits, that comprise a standard plan in Minnesota.
(f) Notwithstanding section 62A.65, subdivision 2, a health plan company may
discontinue offering a health plan under this subdivision if, three years after the date the
plan is initially offered, the plan has fewer than 75 enrollees. A health plan company
discontinuing a health plan under this paragraph may discontinue a health plan that has
fewer than 75 enrollees if it:
(1) provides notice of the plan's discontinuation in writing, in a form prescribed by the
commissioner, to each enrollee of the plan at least 90 calendar days before the date the
coverage is discontinued;
(2) offers on a guaranteed issue basis to each enrollee the option to purchase an individual
health plan currently being offered by the health plan company for individuals in that
geographic rating area. An enrollee who does not select an option shall be automatically
enrolled in the individual health plan closest in actuarial value to the enrollee's current plan;
and
(3) acts uniformly without regard to any health status-related factor of an enrollee or an
enrollee's dependents who may become eligible for coverage.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
Sec. 49. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) Except as otherwise provided in this act, the revisor of statutes shall substitute the
term "commissioner of commerce" for the term "commissioner of health" wherever the
term appears in (1) Minnesota Statutes, chapters 62D, except section 62D.02, subdivision
12; 62L; and 62Q, except sections 62Q.19 and 62Q.33; (2) Minnesota Statutes, sections
60B.15, 60B.191, 60B.20, 62K.09, 62K.10, 62K.105, 62K.12, 62K.13, 62K.14, 62W.05,
256B.69, and 256B.692; (3) Minnesota Rules, chapters 4685, 2740, 4688; and (4) Minnesota
Rules, part 9510.2020, subparts 3 and 8, item C. The revisor shall also make any necessary
grammatical changes to verbs or other words to conform with this substitution.
new text end
new text begin
(b) The revisor of statutes shall remove the term "commissioner of health" wherever the
term appears in Minnesota Rules, chapter 2730.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2027.
new text end
ARTICLE 11
GAS RESOURCE DEVELOPMENT
Section 1.
Minnesota Statutes 2024, section 103I.001, is amended to read:
103I.001 LEGISLATIVE INTENT.
This chapter is intended to protect the health and general welfare by providing a means
for the deleted text begin development anddeleted text end protection of the natural resource of groundwater in an orderly,
healthful, and reasonable manner.
Sec. 2.
Minnesota Statutes 2024, section 103I.005, subdivision 9, is amended to read:
Subd. 9.
Exploratory boring.
"Exploratory boring" means a surface drilling done to
explore or prospect for deleted text begin oil, naturaldeleted text end gas, apatite, diamonds, graphite, gemstones, kaolin clay,
and metallic minerals, including iron, copper, zinc, lead, gold, silver, titanium, vanadium,
nickel, cadmium, molybdenum, chromium, manganese, cobalt, zirconium, beryllium,
thorium, uranium, aluminum, platinum, palladium, radium, tantalum, tin, and niobiumdeleted text begin , and
a drilling or boring for petroleumdeleted text end .
Sec. 3.
Minnesota Statutes 2024, section 103I.005, is amended by adding a subdivision
to read:
new text begin Subd. 10a. new text end
new text begin Gas. new text end
new text begin
"Gas" includes both hydrocarbon and nonhydrocarbon gases.
new text end
Sec. 4.
Minnesota Statutes 2024, section 103I.005, is amended by adding a subdivision
to read:
new text begin Subd. 10b. new text end
new text begin Gas well. new text end
new text begin
"Gas well" means an excavation that is constructed to locate,
extract, or produce gas.
new text end
Sec. 5.
Minnesota Statutes 2024, section 103I.005, is amended by adding a subdivision
to read:
new text begin Subd. 10c. new text end
new text begin Gas well contractor. new text end
new text begin
"Gas well contractor" means a person with a gas well
contractor's license issued by the commissioner.
new text end
Sec. 6.
Minnesota Statutes 2024, section 103I.005, subdivision 21, is amended to read:
Subd. 21.
Well.
"Well" means an excavation that is drilled, cored, bored, washed, driven,
dug, jetted, or otherwise constructed if the excavation is intended for the location, diversion,
artificial recharge, monitoring, testing, remediation, or acquisition of groundwater. Well
includes environmental wells, drive point wells, and dewatering wells. "Well" does not
include:
(1) an excavation by backhoe, or otherwise for temporary dewatering of groundwater
for nonpotable use during construction, if the depth of the excavation is 25 feet or less;
(2) an excavation made to obtain or prospect for oil, deleted text begin naturaldeleted text end gas, minerals, or products
of mining or quarrying;
(3) an excavation to insert media to repressure oil or deleted text begin naturaldeleted text end gas bearing formations or
to store petroleum, deleted text begin naturaldeleted text end gas, or other products;
(4) an excavation for nonpotable use for wildfire suppression activities; deleted text begin or
deleted text end
(5) boringsnew text begin ; or
new text end
new text begin (6) gas and oil wellsnew text end .
Sec. 7.
Minnesota Statutes 2024, section 103I.601, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For the purposes of this section, the following words
have the meanings given them.
(b) "Data" includes samples and factual noninterpreted data obtained from exploratory
borings and samples including analytical results.
(c) "Parcel" means a government section, fractional section, or government lot.
(d) "Samples" means at least a one-quarter portion of all samples from exploratory
borings that are customarily collected by the explorer. When the exploratory borings are
being done to explore or prospect for kaolin clay, "samples" means a representative sample
of at least two cubic inches of material per foot from exploratory borings of the material
that is customarily collected by the explorer.
new text begin
(e) "Encounter gas" means a sustained presence of gas in an exploratory boring for at
least 24 hours and in which gas has not dissipated prior to sealing.
new text end
Sec. 8.
Minnesota Statutes 2024, section 103I.601, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Exploratory borings encountering gas. new text end
new text begin
(a) Requirements in this subdivision
apply only for exploratory borings encountering gas.
new text end
new text begin
(b) An explorer must notify the commissioners of health and natural resources:
new text end
new text begin
(1) within 24 hours of drilling an exploratory boring encountering gas; and
new text end
new text begin
(2) prior to beginning a permanent sealing of an exploratory boring encountering gas.
new text end
new text begin
(c) An explorer must submit a permanent sealing notification and fee of $125 to the
commissioner prior to permanently sealing an exploratory boring encountering gas.
new text end
new text begin
(d) An explorer must begin permanently sealing an exploratory boring encountering gas
within ten days of encountering gas.
new text end
new text begin
(e) An exploratory boring encountering gas is exempt from paragraph (d) if the boring
is constructed to prevent movement of gas and water within and from one geological
formation to another. The boring must be permanently sealed within 90 days after the
completion of drilling unless gas is no longer present in the boring.
new text end
new text begin
(f) An exploratory boring encountering gas must be permanently sealed from the bottom
of the boring to within two feet of the established ground surface.
new text end
new text begin
(g) A permanent sealing report as required by subdivision 9 must also contain information
indicating gas was encountered during construction and at what depth it was encountered.
new text end
new text begin
(h) A person must not use an exploratory boring to extract gas for production.
new text end
Sec. 9.
Minnesota Statutes 2024, section 103I.601, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Conversion of a gas well prohibited. new text end
new text begin
A person must not convert a gas well
to any other type of well or boring.
new text end
Sec. 10.
Minnesota Statutes 2024, section 103I.601, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Conversion of a well or boring to a gas well. new text end
new text begin
A person must not convert a
well or boring to a gas well, except that an exploratory boring constructed before enactment
of section 103I.707 may be converted to a gas well if constructed in accordance with
provisions of section 103I.707, except that the outermost casing may be:
new text end
new text begin
(1) ASTM Standard A53;
new text end
new text begin
(2) ASTM Standard A589, Types I, II, and III;
new text end
new text begin
(3) API Specification 5L; or
new text end
new text begin
(4) API Specification 5CT.
new text end
Sec. 11.
new text begin
[103I.706] GAS WELLS.
new text end
new text begin Subdivision 1. new text end
new text begin Rulemaking authority. new text end
new text begin
The commissioner of health must adopt rules
for gas wells including requirements for drilling, construction, sealing, use, reporting, and
rig registration; and for licensing and certifying persons constructing, repairing, and sealing
gas wells. In adopting rules under this section, the commissioner must use the expedited
procedure in section 14.389. Rules adopted or amended under this authority are exempt
from the 18-month time limit under section 14.125. The commissioner must publish notice
of intent to adopt expedited rules within 24 months after May 22, 2026.
new text end
new text begin Subd. 2. new text end
new text begin Fees. new text end
new text begin
(a) License, certification, and registration renewals are not prorated and
expire on December 31 of each year.
new text end
new text begin
(b) An applicant must meet the gas well contractor license requirements and fee
requirements to construct, repair, or seal a gas well. The fee for a gas well contractor license
is $300. The annual renewal fee for a gas well contractor license is $300.
new text end
new text begin
(c) A gas well contractor must designate a certified representative. The certified
representative must meet the application and fee requirements. The application fee for a
certified representative is $100. The annual renewal fee for a certified representative is
$100.
new text end
new text begin
(d) A gas well contractor must meet the registration and fee requirements for rigs used
to construct, repair, service, or seal a gas well. The fee to register gas well rigs is $125. The
annual renewal fee for gas well rig registration is $125.
new text end
new text begin
(e) If a gas well contractor or certified representative under paragraphs (b) and (c) fails
to submit all information required for renewal or submits the application and information
after the required renewal date:
new text end
new text begin
(1) the gas well contractor or certified representative must include a late fee of $75; and
new text end
new text begin
(2) the gas well contractor or certified representative may not conduct activities authorized
by the gas well contractor's license or certified representative's certification until the renewal
application, renewal application fee, and all other information required is submitted.
new text end
new text begin
(f) A gas well contractor must submit a notification for construction of a proposed gas
well on a form prescribed by the commissioner, with a fee of $10,000.
new text end
new text begin
(g) A gas well contractor must submit a notification for sealing a gas well on a form
prescribed by the commissioner, with a fee of $7,500.
new text end
new text begin Subd. 3. new text end
new text begin Rig registration. new text end
new text begin
(a) Rigs used to drill, maintain, repair, or seal a gas well,
including drilling rigs and workover rigs, must be registered with the commissioner.
new text end
new text begin
(b) A person must file an application to register a rig on a form provided by the
commissioner with the fee under subdivision 2, paragraph (d), with the commissioner.
new text end
new text begin
(c) A registration is valid until the date prescribed by the commissioner in the registration.
new text end
new text begin
(d) A person must file an application with the fee under subdivision 2, paragraph (d), to
renew the registration by the date prescribed by the commissioner in the registration.
new text end
new text begin Subd. 4. new text end
new text begin Gas well contractor's license. new text end
new text begin
(a) A person must not construct, repair, or seal
a gas well without a gas well contractor's license issued by the commissioner.
new text end
new text begin
(b) A person must file a complete application for a gas well contractor's license on a
form provided by the commissioner with the fee under subdivision 2, paragraph (b), with
the commissioner. The person applying must meet the qualifications for a gas well contractor
license.
new text end
new text begin
(c) A gas well contractor's license is valid until the date prescribed by the commissioner
in the license.
new text end
new text begin
(d) A gas well contractor must file a complete application with the fee under subdivision
2, paragraph (b), to renew the license by the date prescribed by the commissioner in the
license. A person must not construct, repair, or seal a gas well until a gas well contractor's
license is renewed. The commissioner may not renew a license until the renewal fee is paid.
new text end
new text begin
(e) A gas well contractor must include information at the time of renewal that the
applicant has met the continuing education requirements established by the commissioner
for gas wells.
new text end
new text begin
(f) A gas well contractor must designate a certified representative to supervise and
oversee regulated work on gas wells.
new text end
new text begin
(g) A person must file a complete application on a form provided by the commissioner
with the fee under subdivision 2, paragraph (c), to qualify as a certified representative.
new text end
new text begin
(h) A certified representative must file an application with the fee under subdivision 2,
paragraph (c), to renew the certification by the expiration date prescribed by the commissioner
on the certification. A certified representative may not supervise or oversee regulated work
on a gas well until the renewal application and application fee are submitted. The
commissioner may not review a certification until the renewal fee is paid.
new text end
new text begin
(i) A certified representative must include information at the time of renewal that the
applicant has met the continuing education requirements established by the commissioner
for gas wells.
new text end
new text begin
(j) The commissioner of natural resources may require a bond, security, or other assurance
from a gas well contractor if the commissioner of natural resources has reasonable doubts
about the person's financial ability to comply with the requirements of law relating to
reclamation of a gas well and the process to restore the land disturbed by a gas well drilling
and production operations back to the condition of original state.
new text end
new text begin
(k) The commissioner may suspend or revoke a licensee's license according to section
144.99.
new text end
new text begin Subd. 5. new text end
new text begin Construction notification. new text end
new text begin
(a) A gas well contractor must not begin drilling
or constructing a gas well unless it is included in a valid gas resource development permit
issued by the commissioner of natural resources.
new text end
new text begin
(b) The contractor must submit a notification to the commissioner to construct a gas
well after receiving permit approval from the commissioner of natural resources and prior
to drilling or constructing a gas well. A gas well contractor must file the gas well notification
with the fee under subdivision 2, paragraph (f), with the commissioner.
new text end
new text begin Subd. 6. new text end
new text begin Access to drill sites. new text end
new text begin
(a) The commissioner of health shall have access to gas
well sites to inspect gas wells, including the drilling, construction, and sealing of gas wells.
new text end
new text begin
(b) The commissioner of health has enforcement authority according to section 144.99.
new text end
new text begin Subd. 7. new text end
new text begin Emergency notification. new text end
new text begin
In the event of an occurrence during construction,
repair, or sealing of a gas well that has a potential for significant adverse public health or
environmental effects, the person drilling or constructing a gas or well must promptly:
new text end
new text begin
(1) take reasonable action to minimize the adverse effects; and
new text end
new text begin
(2) notify the commissioners of health, natural resources, and the Pollution Control
Agency immediately by informing the Minnesota Duty Officer.
new text end
new text begin Subd. 8. new text end
new text begin Sealing notification. new text end
new text begin
(a) A gas well, including an unsuccessful gas well, that
is not in use must be sealed by a gas well contractor.
new text end
new text begin
(b) A gas well contractor must file a notification and fee with the commissioner prior
to sealing a gas well.
new text end
new text begin Subd. 9. new text end
new text begin Report of work. new text end
new text begin
Within 60 days after completion or sealing of a gas well, the
gas well contractor must submit a verified report to the commissioner on a form prescribed
by the commissioner or in a format approved by the commissioner.
new text end
Sec. 12.
new text begin
[103I.707] MORATORIUM ON GAS WELL CONSTRUCTION UNTIL
ADOPTION OF RULES.
new text end
new text begin
Until rules are adopted under section 103I.706, a person shall not drill or construct a gas
well or an exploratory boring in this state.
new text end
Sec. 13.
new text begin
[103I.708] OIL WELLS.
new text end
new text begin
Notwithstanding any provision of chapter 93, or the rules adopted thereunder, to the
contrary, a person shall not explore, prospect, or construct an oil well.
new text end
Sec. 14. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective the day following final enactment.
new text end
ARTICLE 12
MISCELLANEOUS
Section 1.
Minnesota Statutes 2024, section 62Q.096, is amended to read:
62Q.096 CREDENTIALING OF PROVIDERS.
(a) If a health plan company has initially credentialed, as providers in its provider network,
individual providers employed by or under contract with an entity that:
(1) is authorized to bill under section 256B.0625, subdivision 5;
(2) is a mental health clinic certified under section 245I.20;
(3) is designated an essential community provider under section 62Q.19; and
(4) is under contract with the health plan company to provide mental health services,
the health plan company must continue to credential at least the same number of providers
from that entity, as long as those providers meet the health plan company's credentialing
standards.
(b) In order to ensure timely access by patients to mental health services, deleted text begin between July
1, 2023, and June 30, 2025,deleted text end a health plan company must credential and enter into a contract
for mental health services with any provider of mental health services that:
(1) meets the health plan company's credential requirements. For purposes of credentialing
under this paragraph, a health plan company may waive credentialing requirements that are
not directly related to quality of care in order to ensure patient access to providers from
underserved communities or to providers in rural areas;
(2) seeks to receive a credential from the health plan company;
(3) agrees to the health plan company's contract terms. The contract shall include payment
rates that are usual and customary for the services provided;
(4) is accepting new patients; and
(5) is not already under a contract with the health plan company under a separate tax
identification number or, if already under a contract with the health plan company, has
provided notice to the health plan company of termination of the existing contract.
(c) A health plan company shall not refuse to credential these providers on the grounds
that their provider network has:
(1) a sufficient number of providers of that type, including but not limited to the provider
types identified in paragraph (a); or
(2) a sufficient number of providers of mental health services in the aggregate.
Sec. 2.
new text begin
[62Q.60] COVERAGE OF INFERTILITY TREATMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
This section applies, and only applies, to all large group health
plans that provide maternity benefits to Minnesota residents.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms have the
meanings given.
new text end
new text begin
(b) "Diagnosis of and treatment for infertility" means procedures and medications:
new text end
new text begin
(1) to diagnose or treat infertility; and
new text end
new text begin
(2) consistent with established, published, or approved medical practices or professional
guidelines from the American College of Obstetricians and Gynecologists or the American
Society for Reproductive Medicine.
new text end
new text begin
(c) "Infertility" means a disease, condition, or status characterized by:
new text end
new text begin
(1) the failure of a person with a uterus to establish a pregnancy or to carry a pregnancy
to live birth after the following duration of unprotected sexual intercourse, regardless of
whether a pregnancy resulted in miscarriage during such time:
new text end
new text begin
(i) for a person under the age of 35, 12 months duration; or
new text end
new text begin
(ii) for a person 35 years of age or older, six months duration;
new text end
new text begin
(2) a person's inability to reproduce without medical intervention, either as a single
individual or with the person's partner; or
new text end
new text begin
(3) a licensed health care provider's determination that a patient is infertile based on the
patient's medical, sexual, and reproductive history; age; physical findings; or diagnostic
testing.
new text end
new text begin
(d) "Standard fertility preservation services" means procedures that are consistent with
the established medical practices or professional guidelines published by the American
Society for Reproductive Medicine or the American Society of Clinical Oncology for a
person who has a medical condition or is expected to undergo medication therapy, surgery,
radiation, chemotherapy, or other medical treatment that is recognized by medical
professionals to cause a risk of impairment to fertility.
new text end
new text begin Subd. 3. new text end
new text begin Required coverage. new text end
new text begin
(a) Health plans must provide comprehensive coverage
for:
new text end
new text begin
(1) diagnosis of and treatment for infertility; and
new text end
new text begin
(2) standard fertility preservation services.
new text end
new text begin
(b) Coverage under this section must include unlimited embryo transfers but may impose
a limit of four completed oocyte retrievals. Single embryo transfer must be used when
medically appropriate and recommended by the treating health care provider.
new text end
new text begin
(c) Coverage for surgical reversal of elective sterilization is not required under this
section.
new text end
new text begin Subd. 4. new text end
new text begin Cost-sharing requirements. new text end
new text begin
A health plan must not impose on the coverage
under this section any cost-sharing requirement that is greater than the cost-sharing
requirement imposed on maternity coverage under the plan, including but not limited to the
following requirements:
new text end
new text begin
(1) co-payment;
new text end
new text begin
(2) deductible; or
new text end
new text begin
(3) coinsurance.
new text end
new text begin Subd. 5. new text end
new text begin Exclusions and limitations. new text end
new text begin
(a) A health plan must not impose any benefit
maximum, waiting period, utilization review, referral requirement, or any other limitation
on the coverage under this section, except as provided in subdivision 3, paragraphs (b) and
(c), that is not generally applicable to maternity coverage under the health plan.
new text end
new text begin
(b) The prohibition under this subdivision includes but is not limited to any exclusion,
limitation, or other restriction on:
new text end
new text begin
(1) fertility medications that are different from those imposed on other prescription
medications; and
new text end
new text begin
(2) any fertility services based on an enrollee's participation in fertility services provided
by or to a third party.
new text end
new text begin Subd. 6. new text end
new text begin Exception. new text end
new text begin
Notwithstanding subdivision 1, this section does not apply to the
State Employees Group Insurance Program.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, and applies to all large
group health plans issued or renewed on or after that date that provide maternity benefits
to Minnesota residents.
new text end
Sec. 3.
Minnesota Statutes 2024, section 62Q.679, is amended to read:
62Q.679 RELIGIOUS OBJECTIONS.
Subdivision 1.
Definitions.
(a) The definitions in this subdivision apply to this section.
(b) "Closely held for-profit entity" means an entity that is not a nonprofit entity, has
more than 50 percent of the value of its ownership interest owned directly or indirectly by
five or fewer owners, and has no publicly traded ownership interest. For purposes of this
paragraph:
(1) ownership interests owned by a corporation, partnership, limited liability company,
estate, trust, or similar entity are considered owned by that entity's shareholders, partners,
members, or beneficiaries in proportion to their interest held in the corporation, partnership,
limited liability company, estate, trust, or similar entity;
(2) ownership interests owned by a nonprofit entity are considered owned by a single
owner;
(3) ownership interests owned by all individuals in a family are considered held by a
single owner. For purposes of this clause, "family" means brothers and sisters, including
half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
(4) if an individual or entity holds an option, warrant, or similar right to purchase an
ownership interest, the individual or entity is considered to be the owner of those ownership
interests.
(c) "Eligible organization" means an organization that opposes covering some or all
health benefits under section 62Q.522, 62Q.524, deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end on account of
religious objections and that is:
(1) organized as a nonprofit entity and holds itself out to be religious; or
(2) organized and operates as a closely held for-profit entity, and the organization's
owners or highest governing body has adopted, under the organization's applicable rules of
governance and consistent with state law, a resolution or similar action establishing that the
organization objects to covering some or all health benefits under section 62Q.522, 62Q.524,
deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end on account of the owners' sincerely held religious beliefs.
(d) "Exempt organization" means an organization that is organized and operates as a
nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal
Revenue Code of 1986, as amended.
Subd. 2.
Exemption.
(a) An exempt organization is not required to provide coverage
under section 62Q.522, 62Q.524, deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end if the exempt organization has
religious objections to the coverage. An exempt organization that chooses to not provide
coverage pursuant to this paragraph must notify employees as part of the hiring process and
must notify all employees at least 30 days before:
(1) an employee enrolls in the health plan; or
(2) the effective date of the health plan, whichever occurs first.
(b) If the exempt organization provides partial coverage under section 62Q.522, 62Q.524,
deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end , the notice required under paragraph (a) must provide a list of the
portions of such coverage which the organization refuses to cover.
Subd. 3.
Accommodation for eligible organizations.
(a) A health plan established or
maintained by an eligible organization complies with the coverage requirements of section
62Q.522, 62Q.524, deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end , with respect to the health benefits identified in
the notice under this paragraph, if the eligible organization provides notice to any health
plan company with which the eligible organization contracts that it is an eligible organization
and that the eligible organization has a religious objection to coverage for all or a subset of
the health benefits under section 62Q.522, 62Q.524, deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end .
(b) The notice from an eligible organization to a health plan company under paragraph
(a) must include: (1) the name of the eligible organization; (2) a statement that it objects to
coverage for some or all of the health benefits under section 62Q.522, 62Q.524, deleted text begin ordeleted text end 62Q.585new text begin ,
or 62Q.60new text end , including a list of the health benefits to which the eligible organization objects,
if applicable; and (3) the health plan name. The notice must be executed by a person
authorized to provide notice on behalf of the eligible organization.
(c) An eligible organization must provide a copy of the notice under paragraph (a) to
prospective employees as part of the hiring process and to all employees at least 30 days
before:
(1) an employee enrolls in the health plan; or
(2) the effective date of the health plan, whichever occurs first.
(d) A health plan company that receives a copy of the notice under paragraph (a) with
respect to a health plan established or maintained by an eligible organization must, for all
future enrollments in the health plan:
(1) expressly exclude coverage for those health benefits identified in the notice under
paragraph (a) from the health plan; and
(2) provide separate payments for any health benefits required to be covered under
section 62Q.522, 62Q.524, deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end for enrollees as long as the enrollee
remains enrolled in the health plan.
(e) The health plan company must not impose any cost-sharing requirements, including
co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or
other charge for the health benefits under section 62Q.522 on the enrollee. The health plan
company must not directly or indirectly impose any premium, fee, or other charge for the
health benefits under section 62Q.522, 62Q.524, deleted text begin ordeleted text end 62Q.585new text begin , or 62Q.60new text end on the eligible
organization or health plan.
(f) On January 1, 2025, and every year thereafter a health plan company must notify the
commissioner, in a manner determined by the commissioner, of the number of eligible
organizations granted an accommodation under this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027.
new text end
Sec. 4.
Minnesota Statutes 2024, section 151.741, subdivision 4, is amended to read:
Subd. 4.
Insulin safety net program account.
new text begin (a) new text end The insulin safety net program account
is established in the special revenue fund in the state treasury. Money in the account is
appropriated each fiscal year to:
(1) the MNsure board in an amount sufficient to carry out assigned duties under section
151.74, subdivision 7; and
(2) the Board of Pharmacy in an amount sufficient to cover costs incurred by the board
deleted text begin in assessing and collecting the registration fee under this section anddeleted text end in administering the
insulin safety net program under section 151.74.
new text begin
(b) The commissioner of management and budget shall annually transfer from the health
care access fund to the insulin safety net program account an amount sufficient to implement
paragraph (a).
new text end
Sec. 5.
Minnesota Statutes 2025 Supplement, section 151.741, subdivision 5, is amended
to read:
Subd. 5.
Insulin repayment account; annual transfer from health care access fund.
(a)
The insulin repayment account is established in the special revenue fund in the state treasury.
Money in the account is appropriated each fiscal year to the commissioner of administration
to reimburse manufacturers for insulin dispensed under the insulin safety net program in
section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6,
paragraph (h), and to cover costs incurred by the commissioner in providing these
reimbursement payments.
(b) deleted text begin By June 30, 2025, anddeleted text end Each June 30 deleted text begin thereafterdeleted text end , the commissioner of administration
shall certify to the commissioner of management and budget the total amount expended in
the prior fiscal year for:
(1) reimbursement to manufacturers for insulin dispensed under the insulin safety net
program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph
(h), and 6, paragraph (h); and
(2) costs incurred by the commissioner of administration in providing the reimbursement
payments described in clause (1).
(c) new text begin Each July 1, new text end the commissioner of management and budget shall transfer from the
health care access fund to the insulin repayment accountdeleted text begin , beginning July 1, 2025, and each
July 1 thereafter,deleted text end an amount equal to the amount to which the commissioner of administration
certified pursuant to paragraph (b).
Sec. 6.
new text begin
[256.0141] HUMAN SERVICES SYSTEMS STEERING COMMITTEE.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The Human Services Systems Steering Committee is
established to provide recommendations to the commissioners of human services; information
technology services; and children, youth, and families on the development, administration,
and business operations of human services information technology systems. For purposes
of this section, "human services systems" means any information technology system used
by counties or the commissioners of human services and children, youth, and families.
new text end
new text begin Subd. 2. new text end
new text begin Membership; costs. new text end
new text begin
(a) The steering committee must be composed of the
following members:
new text end
new text begin
(1) two members appointed by the commissioner of human services;
new text end
new text begin
(2) two members appointed by the commissioner of children, youth, and families;
new text end
new text begin
(3) six members appointed jointly by the Association of Minnesota Counties, the
Minnesota Inter-County Association, and the Minnesota Association of County Social
Service Administrators; and
new text end
new text begin
(4) two nonvoting members appointed by the commissioner of information technology
services.
new text end
new text begin
(b) One member appointed under paragraph (a), clause (3), and one member appointed
under paragraph (a), clause (4), must serve as cochairpersons for the steering committee.
new text end
new text begin
(c) Steering committee costs must be paid and reimbursed for expenses as provided in
section 15.0575 from the budgets of the Department of Human Services, the Department
of Information Technology Services, and the Department of Children, Youth, and Families.
new text end
new text begin
(d) The commissioner of information technology services must organize and administer
the steering committee.
new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin
(a) The steering committee must provide recommendations on the
administration and business operations of current human services systems and the
development of any new human services systems.
new text end
new text begin
(b) For each human services system, the steering committee must make recommendations
on setting system goals and priorities, allocating system resources, making major system
decisions, and tracking total system funding and expenditures from all sources.
new text end
new text begin
(c) The steering committee must provide monthly updates on the committee's duties
under this subdivision to the Legislative Commission on Human Services Systems under
section 256.0142.
new text end
new text begin Subd. 4. new text end
new text begin Meetings. new text end
new text begin
(a) The steering committee must meet at least quarterly.
new text end
new text begin
(b) As part of every steering committee meeting, the steering committee must provide
the opportunity for oral and written public testimony and comments on steering committee
recommendations.
new text end
new text begin
(c) All votes of the steering committee must be recorded and each member's vote must
be identified.
new text end
new text begin Subd. 5. new text end
new text begin Implementation of changes; new systems. new text end
new text begin
(a) The commissioners of human
services and children, youth, and families must not implement new major changes to current
human services systems, or implement a new human services system, prior to receiving
recommendations from the steering committee and consulting with counties on the changes
or development.
new text end
new text begin
(b) The commissioners of human services and children, youth, and families must
implement changes to human services systems recommended and passed by at least seven
members of the steering committee.
new text end
new text begin Subd. 6. new text end
new text begin Report. new text end
new text begin
(a) Beginning January 30, 2027, and each January 30 thereafter, the
steering committee must report to the Legislative Commission on Human Services Systems
under section 256.0142 and to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services systems. The report must include:
new text end
new text begin
(1) for each human services system, system funding and expenditures, including amounts
received in the previous calendar year by funding source and expenditures made in the
previous calendar year by funding source;
new text end
new text begin
(2) recommendations made by the steering committee under subdivision 3, including
any draft legislation to implement the recommendations; and
new text end
new text begin
(3) a list of projects needed to improve human services systems.
new text end
new text begin
(b) The legislative committees with jurisdiction over human services systems must hold
a public hearing on the report during the regular legislative session in the year in which the
report was submitted.
new text end
Sec. 7.
new text begin
[256.0142] LEGISLATIVE COMMISSION ON HUMAN SERVICES
SYSTEMS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; duties. new text end
new text begin
(a) The Legislative Commission on Human
Services Systems is created to:
new text end
new text begin
(1) provide oversight and monitoring of the efforts by the counties and the Departments
of Human Services; Information Technology Services; and Children, Youth, and Families
to manage, develop, update, and modernize information technology systems across human
services programs, including but not limited to: MAXIS, METS, MMIS, SSIS, PRISM, and
MEC2;
new text end
new text begin
(2) evaluate Minnesota's state-supervised, county-administered human services system
and provide recommendations for changes, if applicable. This must include evaluating
changes to roles and responsibilities for the administration and delivery of human services
programs and services, including program eligibility, case management functions, and use
of third-party and nongovernmental entities;
new text end
new text begin
(3) review how other states procure, administer, and deliver human services programs
and services and the information technology infrastructure used;
new text end
new text begin
(4) identify areas within the governance, procurement, and technology structures of the
human services system that need to be addressed by the legislature;
new text end
new text begin
(5) review reports provided to the legislature from state agencies on information
technology projects and human services system transformation; and
new text end
new text begin
(6) review reports and updates provided to the commission by the Human Services
Systems Steering Committee under section 256.0141.
new text end
new text begin
(b) The commission must work with Minnesota's Tribal Nations, counties, and the
Departments of Human Services; Information Technology Services; and Children, Youth,
and Families to:
new text end
new text begin
(1) evaluate proposals for modifications to information technology systems used by
Minnesota's Tribal Nations, counties, or the Departments of Human Services and Children,
Youth, and Families; and
new text end
new text begin
(2) consider overall costs to the state, counties, and Tribal Nations for the implementation
of any systems changes and assess whether proposed solutions deliver improved services
to Minnesotans and administrative responsibilities are efficiently delegated across
stakeholders.
new text end
new text begin Subd. 2. new text end
new text begin Members; meetings. new text end
new text begin
(a) Members of the legislative commission must include:
new text end
new text begin
(1) six members from the house of representatives, including three members appointed
by the speaker of the house and three members appointed by the minority leader; and
new text end
new text begin
(2) six members from the senate, including three members appointed by the senate
majority leader and three members appointed by the senate minority leader.
new text end
new text begin
(b) Members of the commission serve a term that expires on December 31 of the
even-numbered year following the year the members are appointed. The speaker of the
house and the majority leader of the senate must each designate a chair and vice-chair from
the membership of the commission. The chair and vice-chair must rotate after each meeting.
new text end
new text begin
(c) The commission must meet at least quarterly.
new text end
new text begin Subd. 3. new text end
new text begin Administrative support. new text end
new text begin
The Legislative Coordinating Commission must
provide administrative support to the commission and arrange meeting space for commission
meetings.
new text end
new text begin Subd. 4. new text end
new text begin Report. new text end
new text begin
By February 15, 2027, and annually thereafter, the commission, in
cooperation with the commissioners of human services; information technology services;
and children, youth, and families, must provide a report to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services and children,
youth, and families. The report must contain information on the results of the commission's
evaluations, identifications, and review under subdivision 1; recommendations for any
legislative changes, including any draft legislation to implement the recommendations; and
funding needs to implement any recommended changes.
new text end
new text begin Subd. 5. new text end
new text begin Expiration. new text end
new text begin
This commission expires December 31, 2033.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 8. new text begin HUMAN SERVICES SYSTEMS STEERING COMMITTEE; FIRST
APPOINTMENTS AND FIRST MEETING.
new text end
new text begin
Appointing authorities for the Human Services Systems Steering Committee under
Minnesota Statutes, section 256.0141, must make first appointments to the steering committee
by August 15, 2026. The commissioner of information technology services must convene
the first meeting of the committee by September 15, 2026.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 9. new text begin LEGISLATIVE COMMISSION ON HUMAN SERVICES SYSTEMS; FIRST
APPOINTMENTS AND FIRST MEETING.
new text end
new text begin
Appointing authorities for the Legislative Commission on Human Services Systems
under Minnesota Statutes, section 256.0142, must make first appointments to, and designate
the chairs and vice-chairs of, the Legislative Commission on Human Services Systems by
August 15, 2026. The member designated as chair by the majority leader of the senate must
convene the first meeting of the commission by September 15, 2026.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 10. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 151.741, subdivisions 2, 3, and 6,
new text end
new text begin
are repealed.
new text end
ARTICLE 13
HUMAN SERVICES APPROPRIATIONS
Section 1. new text begin HUMAN SERVICES APPROPRIATIONS.
|
new text begin
The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special
Session chapter 3, article 20, from the general fund or any fund named for the purposes
specified in this article, to be available for the fiscal year indicated for each purpose. The
figures "2026" and "2027" used in this article mean that the appropriations listed under them
are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The
first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is
fiscal years 2026 and 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
new text begin
$ new text end |
new text begin
(798,000) new text end |
new text begin
$ new text end |
new text begin
25,588,000 new text end |
||
new text begin
The amounts that may be spent for each
purpose are specified in this article.
new text end
Sec. 3. new text begin CENTRAL OFFICE; OPERATIONS
|
new text begin
$ new text end |
new text begin
34,000 new text end |
new text begin
$ new text end |
new text begin
1,473,000 new text end |
||
new text begin
The general fund base is increased by
$6,969,000 in fiscal year 2028 and $7,805,000
in fiscal year 2029.
new text end
Sec. 4. new text begin CENTRAL OFFICE; HEALTH CARE
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
19,403,000 new text end |
||
new text begin
The general fund base is increased by
$59,838,000 in fiscal year 2028 and
$60,350,000 in fiscal year 2029.
new text end
Sec. 5. new text begin CENTRAL OFFICE; OFFICE OF
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
26,000 new text end |
||
Sec. 6. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
5,143,000 new text end |
||
Sec. 7. new text begin GRANT PROGRAMS; CHILD AND
|
new text begin
$ new text end |
new text begin
(407,000) new text end |
new text begin
$ new text end |
new text begin
(407,000) new text end |
||
Sec. 8. new text begin GRANT PROGRAMS; FRAUD
|
new text begin
$ new text end |
new text begin
(425,000) new text end |
new text begin
$ new text end |
new text begin
(425,000) new text end |
||
Sec. 9. new text begin GRANT PROGRAMS; HEALTH CARE
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
1,500,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Health Care Navigator Incentive
|
||||||
new text begin
$250,000 in fiscal year 2027 is for application
assistance bonuses to organizations and
licensed insurance producers for applicants
successfully enrolled in medical assistance
under Minnesota Statutes, section 256.962,
subdivision 5. The base for this appropriation
is $500,000 in fiscal year 2028 and $500,000
in fiscal year 2029.
new text end
new text begin Subd. 2. new text end
new text begin
Community Minigrant Program
|
||||||
new text begin
$1,250,000 in fiscal year 2027 is for the
community minigrant program under
Minnesota Statutes, section 256.01,
subdivision 2, paragraph (a), clause (6). Grants
under this subdivision are subject to the grant
requirements under Minnesota Statutes,
chapter 16B. The base for this appropriation
is $1,250,000 in fiscal year 2028 and $625,000
in fiscal year 2029.
new text end
new text begin Subd. 3. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base is increased by
$1,750,000 in fiscal year 2028 and $1,125,000
in fiscal year 2029.
new text end
Sec. 10. new text begin GRANT PROGRAMS; HOUSING AND
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
192,000 new text end |
||
Sec. 11. new text begin GRANT PROGRAMS; ADULT
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
(1,317,000) new text end |
||
Sec. 12. new text begin GRANT PROGRAMS; CHILD
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
361,000 new text end |
||
Sec. 13. new text begin GRANT PROGRAMS; CHEMICAL
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
(361,000) new text end |
||
Sec. 14. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
This article appropriates necessary administrative costs. The administrative costs retention
requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to
any appropriation in this article for a grant.
new text end
Sec. 15. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit or an appropriation is made available beyond June 30,
2027.
new text end
Sec. 16. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation, transfer, or cancellation in this article is enacted more than once
during the 2026 legislative session, the appropriation, transfer, or cancellation must be given
effect once.
new text end
ARTICLE 14
DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS
Section 1. new text begin CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS.
|
new text begin
The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special
Session chapter 3, article 22, from the general fund or any fund named for the purposes
specified in this article, to be available for the fiscal year indicated for each purpose. The
figures "2026" and "2027" used in this article mean that the appropriations listed under them
are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The
first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium" is
fiscal years 2026 and 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF CHILDREN,
|
new text begin
$ new text end |
new text begin
1,113,000 new text end |
new text begin
$ new text end |
new text begin
74,017,000 new text end |
||
new text begin
The amounts that may be spent for each
purpose are specified in the following sections.
new text end
Sec. 3. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
11,119,000 new text end |
||
new text begin
The base is increased by $12,182,000 in fiscal
year 2028 and $10,985,000 in fiscal year 2029.
new text end
Sec. 4. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
1,346,000 new text end |
||
new text begin
The base is increased by $1,582,000 in fiscal
year 2028 and $1,582,000 in fiscal year 2029.
new text end
Sec. 5. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
281,000 new text end |
new text begin
$ new text end |
new text begin
281,000 new text end |
||
Sec. 6. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
441,000 new text end |
||
new text begin
This is a onetime appropriation.
new text end
Sec. 7. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
3,577,000 new text end |
||
new text begin
The general fund base is increased by
$4,202,000 in fiscal year 2028 and $4,202,000
in fiscal year 2029.
new text end
Sec. 8. new text begin FORECAST PROGRAMS;
|
||||||
new text begin
The estimated base for this section is
$71,239,000 in fiscal year 2028 and
$96,735,000 in fiscal year 2029.
new text end
Sec. 9. new text begin FORECASTED PROGRAMS; SNAP
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
24,286,000 new text end |
||
Sec. 10. new text begin GRANT PROGRAMS; CHILD CARE
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
450,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Child Care Licensing Basics
|
||||||
new text begin
$450,000 in fiscal year 2027 is for a contract
with a vendor to provide child care licensing
basics training, including course content
creation, translation, marketing, promotion,
and underwriting. The base for this
appropriation is $338,000 in fiscal year 2028
and $338,000 in fiscal year 2029.
new text end
new text begin Subd. 2. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base is increased by
$338,000 in fiscal year 2028 and $338,000 in
fiscal year 2029.
new text end
Sec. 11. new text begin GRANT PROGRAMS; CHILD AND
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
14,085,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Minnesota African American
|
||||||
new text begin
$14,085,000 in fiscal year 2027 is for counties
for child protection grants under Minnesota
Statutes, section 256M.41.
new text end
new text begin Subd. 2. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base for this section is
$13,924,000 in fiscal year 2028 and
$13,924,000 in fiscal year 2029.
new text end
Sec. 12. new text begin GRANT PROGRAMS; CHILD AND
|
new text begin
$ new text end |
new text begin
832,000 new text end |
new text begin
$ new text end |
new text begin
18,432,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Prepared Meals Food Relief
|
||||||
new text begin
$2,300,000 in fiscal year 2027 is for prepared
meals food relief grants. This is a onetime
appropriation and is available until June 30,
2028.
new text end
new text begin Subd. 2. new text end
new text begin
Regional Food Bank Grants
|
||||||
new text begin
$9,900,000 in fiscal year 2027 is for regional
food bank grants. This is a onetime
appropriation.
new text end
new text begin Subd. 3. new text end
new text begin
Minnesota Food Shelf Program
|
||||||
new text begin
$5,400,000 in fiscal year 2027 is for food shelf
programs under Minnesota Statutes, section
142F.14. This is a onetime appropriation.
new text end
new text begin Subd. 4. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base is increased by
$832,000 in fiscal year 2028 and $832,000 in
fiscal year 2029.
new text end
Sec. 13.
Minnesota Statutes 2025 Supplement, section 256.043, subdivision 3, is amended
to read:
Subd. 3.
Appropriations from registration and license fee account.
(a) The
appropriations in paragraphs (b) to (n) shall be made from the registration and license fee
account on a fiscal year basis in the order specified.
(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs
(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be
made accordingly.
(c) $100,000 is appropriated to the commissioner of human services for grants for opiate
antagonist distribution. Grantees may utilize funds for opioid overdose prevention,
community asset mapping, education, and opiate antagonist distribution.
(d) $2,000,000 is appropriated to the commissioner of human services for direct payments
to Tribal nations and five urban Indian communities for traditional healing practices for
American Indians and to increase the capacity of culturally specific providers in the
behavioral health workforce. Any evaluations of practices under this paragraph must be
designed cooperatively by the commissioner and Tribal nations or urban Indian communities.
The commissioner must not require recipients to provide the details of specific ceremonies
or identities of healers.
(e) $400,000 is appropriated to the commissioner of human services for competitive
grants for opioid-focused Project ECHO programs.
(f) deleted text begin $277,000deleted text end new text begin $321,000new text end in fiscal year deleted text begin 2024deleted text end new text begin 2027new text end and deleted text begin $321,000deleted text end each year thereafter is
appropriated to the commissioner of deleted text begin human servicesdeleted text end new text begin children, youth, and familiesnew text end to
administer the funding distribution and reporting requirements in paragraph deleted text begin (o)deleted text end new text begin (m)new text end .
(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated
to the commissioner of human services for safe recovery sites start-up and capacity building
grants under section 254B.18.
(h) $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated to
the commissioner of human services for the opioid overdose surge alert system under section
245.891.
(i) $300,000 is appropriated to the commissioner of management and budget for
evaluation activities under section 256.042, subdivision 1, paragraph (c).
(j) $261,000 is appropriated to the commissioner of human services for the provision of
administrative services to the Opiate Epidemic Response Advisory Council and for the
administration of the grants awarded under paragraph (n).
(k) $126,000 is appropriated to the Board of Pharmacy for the collection of the registration
fees under section 151.066.
(l) $672,000 is appropriated to the commissioner of public safety for the Bureau of
Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies
and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
(m) After the appropriations in paragraphs (b) to (l) are made, 50 percent of the remaining
amount is appropriated to the commissioner of children, youth, and families for distribution
to county social service agencies and Tribal social service agency initiative projects
authorized under section 256.01, subdivision 14b, to provide prevention and child protection
services to children and families who are affected by addiction. The commissioner shall
distribute this money proportionally to county social service agencies and Tribal social
service agency initiative projects through a formula based on intake data from the previous
three calendar years related to substance use and out-of-home placement episodes where
parental drug abuse is a reason for the out-of-home placement. County social service agencies
and Tribal social service agency initiative projects receiving funds from the opiate epidemic
response fund must annually report to the commissioner on how the funds were used to
provide prevention and child protection services, including measurable outcomes, as
determined by the commissioner. County social service agencies and Tribal social service
agency initiative projects must not use funds received under this paragraph to supplant
current state or local funding received for child protection services for children and families
who are affected by addiction.
(n) After the appropriations in paragraphs (b) to (m) are made, the remaining amount in
the account is appropriated to the commissioner of human services to award grants as
specified by the Opiate Epidemic Response Advisory Council in accordance with section
256.042, unless otherwise appropriated by the legislature.
(o) Beginning in fiscal year 2022 and each year thereafter, funds for county social service
agencies and Tribal social service agency initiative projects under paragraph (m) and grant
funds specified by the Opiate Epidemic Response Advisory Council under paragraph (n)
may be distributed on a calendar year basis.
(p) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
(c), (d), (e), (g), (m), and (n) are available for three years after the funds are appropriated.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026.
new text end
Sec. 14.
Laws 2024, chapter 117, section 22, is amended to read:
Sec. 22. APPROPRIATIONS; MINNESOTA AFRICAN AMERICAN FAMILY
PRESERVATION AND CHILD WELFARE DISPROPORTIONALITY ACT.
(a) $5,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for grants to Hennepin and Ramsey Counties to implement
the Minnesota African American Family Preservation and Child Welfare Disproportionality
Act phase-in program. Of this amount, $2,500,000 must be provided to Hennepin County
and $2,500,000 must be provided to Ramsey County. This is a onetime appropriation and
is available until deleted text begin June 30deleted text end new text begin December 31new text end , 2026.
(b) $1,000,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services for the African American and disproportionately represented
family preservation grant program under Minnesota Statutes, section 260.693.
Notwithstanding Minnesota Statutes, section 16B.98, subdivision 14, the amount for
administrative costs under this paragraph is $0.
(c) $2,367,000 in fiscal year 2025 is appropriated from the general fund to the
commissioner of human services to implement the African American Family Preservation
and Child Welfare Disproportionality Act. The base for this appropriation is $3,251,000 in
fiscal year 2026 and $3,110,000 in fiscal year 2027.
Sec. 15. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
This article appropriates necessary administrative costs. The administrative costs retention
requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to
any appropriation in this article for a grant.
new text end
Sec. 16. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit or an appropriation is made available beyond June 30,
2027.
new text end
Sec. 17. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation, transfer, or cancellation in this article is enacted more than once
during the 2026 legislative session, the appropriation, transfer, or cancellation must be given
effect once.
new text end
Sec. 18. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective the day following final enactment unless otherwise indicated.
new text end
ARTICLE 15
DEPARTMENT OF HEALTH APPROPRIATIONS
Section 1. new text begin HEALTH APPROPRIATIONS.
|
new text begin
The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special
Session chapter 3, article 21, from the general fund or any named fund and are available
for the fiscal years indicated for each purpose. The figures "2026" and "2027" used in this
article mean that the addition to or subtraction from the appropriations listed under them
are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively. "The
first year" is fiscal year 2026. "The second year" is fiscal year 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF HEALTH
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
50,440,000 new text end |
new text begin
$ new text end |
new text begin
237,605,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
50,000,000 new text end |
new text begin
236,978,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
440,000 new text end |
new text begin
627,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivision.
new text end
new text begin Subd. 2. new text end
new text begin
Health Improvement
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
50,000,000 new text end |
new text begin
234,925,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
440,000 new text end |
new text begin
627,000 new text end |
new text begin
(a) Helping Paws Grant. $200,000 in fiscal
year 2027 is from the general fund for a grant
to Helping Paws, Inc., to breed, train, and
place service or facility dogs with individuals
who have physical disabilities; veterans and
first responders living with service-related
post-traumatic stress disorder; and
professionals in courthouse, educational, and
mental health settings. This is a onetime
appropriation in memory of Speaker Emerita
Melissa Hortman.
new text end
new text begin
(b) Helping Paws; Private Donations. The
commissioner of health may accept private
donations to supplement the state money
appropriated under paragraph (a). All
donations accepted by the commissioner under
this paragraph must be deposited in the gift
fund and are appropriated to the commissioner
for the purposes of paragraph (a).
new text end
new text begin
(c) Crisis Telephone Services. $1,125,000 in
fiscal year 2027 is from the general fund for
regional coordination and 24-hour-a-day,
seven-day-a-week statewide crisis telephone
services.
new text end
new text begin
(d) Hospital Stabilization Program.
$114,800,000 in fiscal year 2027 is from the
general fund for the hospital stabilization
program under Minnesota Statutes, section
144.5911. This is a onetime appropriation.
Notwithstanding Minnesota Statutes, section
16B.98, subdivision 14, $700,000 in fiscal
year 2027 is for the commissioner to
administer the program.
new text end
new text begin
(e) Community-Based Safety Net Provider
Stabilization Program. $17,600,000 in fiscal
year 2027 is from the general fund for the
community-based safety net provider
stabilization program under Minnesota
Statutes, section 144.5912. This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16B.98, subdivision 14,
$100,000 in fiscal year 2027 is for the
commissioner to administer the program.
new text end
new text begin
(f) Hennepin Healthcare Stabilization
Grant. $49,950,000 in fiscal year 2026 and
$99,650,000 in fiscal year 2027 are from the
general fund for the Hennepin Healthcare
stabilization grant. This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16B.98, subdivision 14,
$50,000 in fiscal year 2026 and $350,000 in
fiscal year 2027 are for the commissioner to
administer this grant.
new text end
new text begin
(g) Report on Financial Stability of
Hospitals. $400,000 in fiscal year 2027 is
from the general fund to prepare the report on
the financial stability of hospitals under
Minnesota Statutes, section 16A.103,
subdivision 1k.
new text end
new text begin
(h) Hennepin Healthcare Future Structure
and Governance Advisory Task Force.
$500,000 in fiscal year 2027 is from the
general fund for administration of the
Hennepin Healthcare Future Structure and
Governance Advisory Task Force. This is a
onetime appropriation.
new text end
new text begin
(i) HMO Regulation. $440,000 in fiscal year
2026 and $440,000 in fiscal year 2027 are
from the state government special revenue
fund to administer the licensing and regulation
of health maintenance organizations under
Minnesota Statutes, chapter 62D.
new text end
new text begin
(j) All-Payer Claims Data Administration.
$187,000 in fiscal year 2027 is from the state
government special revenue fund to administer
all-payer claims data under Minnesota
Statutes, chapter 62U. The base for this
appropriation is $233,000 in fiscal year 2028
and $291,000 in fiscal year 2029.
new text end
new text begin
(k) Base Adjustment. The general fund base
is reduced by $225,000 in fiscal year 2028 and
$225,000 in fiscal year 2029.
new text end
new text begin Subd. 3. new text end
new text begin
Health Protection
|
new text begin
-0- new text end |
new text begin
2,053,000 new text end |
||||
new text begin Rulemaking for Gas Wells.new text end new text begin $2,053,000 in
fiscal year 2027 is for rulemaking activities
under Minnesota Statutes, section 103I.706.
This is a onetime appropriation and is
available until December 31, 2029.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Subdivision 2, paragraphs (f) and (i), are effective the day
following final enactment.
new text end
Sec. 3. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
This article appropriates necessary administrative costs. The administrative costs retention
requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to
any appropriation in this article for a grant.
new text end
Sec. 4. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit or an appropriation is made available beyond June 30,
2027.
new text end
Sec. 5. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation, transfer, or cancellation in this article is enacted more than once
during the 2026 legislative session, the appropriation, transfer, or cancellation must be given
effect once.
new text end
ARTICLE 16
OTHER AGENCY APPROPRIATIONS
Section 1. new text begin OTHER AGENCY APPROPRIATIONS.
|
new text begin
The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2025, First Special
Session chapter 3, articles 23 and 24, from the general fund or any fund named for the
purposes specified in this article, to be available for the fiscal year indicated for each purpose.
The figures "2026" and "2027" used in this article mean that the appropriations listed under
them are available for the fiscal years ending June 30, 2026, or June 30, 2027, respectively.
"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium"
is fiscal years 2026 and 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2. new text begin OFFICE OF EMERGENCY MEDICAL
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
15,000,000 new text end |
||
new text begin
$14,900,000 in fiscal year 2027 is for the rural
EMS uncompensated care pool payment
program under Minnesota Statutes, section
144E.55. This is a onetime appropriation.
Notwithstanding Minnesota Statutes, section
16B.98, subdivision 14, $100,000 in fiscal
year 2027 is for the director to administer the
program.
new text end
Sec. 3. new text begin COMMISSIONER OF INFORMATION
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
45,000,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Information Technology Changes;
|
||||||
new text begin
(a) $32,500,000 in fiscal year 2027 is
appropriated to update information technology
systems. This appropriation must be used, in
collaboration with counties, to fund the
following projects:
new text end
new text begin
(1) expand Data Depot to all interested
Minnesota counties and Tribal Nations;
new text end
new text begin
(2) expand BlueZone Scripting Collaborative
to all interested Minnesota counties and Tribal
Nations;
new text end
new text begin
(3) expand piloted artificial intelligence tools
for human services to all interested Minnesota
counties and Tribal Nations;
new text end
new text begin
(4) develop new user interfaces to replace
character-based green screens for the MAXIS
and PRISM computer systems;
new text end
new text begin
(5) complete the renewal self-service portal
in the Minnesota Eligibility Technology
System (METS);
new text end
new text begin
(6) copy all state human services systems
policies and procedures into the data
warehouse and keep the policies and
procedures regularly updated;
new text end
new text begin
(7) develop the ability for METS to note when
a recipient has a second pregnancy;
new text end
new text begin
(8) determine, in collaboration with Minnesota
Management and Budget, the dollar amount
needed to fund the integration layer tool and
the amount needed to allow full
implementation for both the MAXIS and
PRISM computer systems; and
new text end
new text begin
(9) other projects decided by the Human
Services Systems Steering Committee under
Minnesota Statutes, section 256.0141.
new text end
new text begin
(b) Of the amount appropriated under
paragraph (a), $2,500,000 is for fully funding
the work verification vendor system for child
support, health care, and public assistance
programs.
new text end
new text begin
(c) The base for this appropriation is
$10,000,000 in fiscal year 2028 and
$10,000,000 in fiscal year 2029.
new text end
new text begin Subd. 2. new text end
new text begin
Information Technology Changes;
|
||||||
new text begin
(a) $12,500,000 in fiscal year 2027 is
appropriated to update information technology
systems to conform with legislative changes.
This appropriation must be used, in
collaboration with counties, to fund the
following projects:
new text end
new text begin
(1) develop an automated process in the
MAXIS computer system to confirm the
eligibility for health care program enrollees;
new text end
new text begin
(2) eliminate the duplicative data entry by
county eligibility workers, including
integrating MNBenefits with the MAXIS
computer system and developing a solution to
allow recipients to provide updated
information through electronic means;
new text end
new text begin
(3) update the MAXIS computer system to
require a county eligibility worker to update
the shelter and utility panels in MAXIS every
time the address panel is updated for
Supplemental Nutrition Assistance Program
(SNAP) applications;
new text end
new text begin
(4) update the MAXIS computer system to
allow the state to move to a simplified
reporting method for SNAP so that all
recipients will report changes on a six-month
timeline;
new text end
new text begin
(5) update the MAXIS computer system with
correct coding for time-limited recipients
receiving SNAP benefits and integrate the
coding with other panels in MAXIS;
new text end
new text begin
(6) update the MAXIS computer system
eligibility results to reflect the most recent
noncitizen eligibility policy for health care
programs and SNAP;
new text end
new text begin
(7) update the MAXIS computer system to
eliminate the need for county eligibility
workers to enter and approve general
assistance and SNAP applications separately
within the same system, including the ability
for MAXIS to translate information between
general assistance and SNAP;
new text end
new text begin
(8) initiate a review and modernization of
client notices generated by the MAXIS
computer system and METS to ensure the
notices are clear, accurate, and compliant with
all current federal and state requirements and
enhance system functionality so the notices
automatically populate correct and complete
information based on case actions;
new text end
new text begin
(9) update the MAXIS computer system to
allow automatic case noting; and
new text end
new text begin
(10) other projects decided by the Human
Services Systems Steering Committee under
Minnesota Statutes, section 256.0141.
new text end
new text begin
(b) The base for this appropriation is
$2,500,000 in fiscal year 2028 and $2,500,000
in fiscal year 2029.
new text end
new text begin Subd. 3. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base is increased by
$12,500,000 in fiscal year 2028 and
$12,500,000 in fiscal year 2029.
new text end
Sec. 4. new text begin LEGISLATIVE COORDINATING
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
194,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Legislative Commission on Human
|
||||||
new text begin
$194,000 in fiscal year 2027 is to administer
the Legislative Commission on Human
Services Systems under Minnesota Statutes,
section 256.0142. The base for this
appropriation is $191,000 in fiscal year 2028
and $174,000 in fiscal year 2029.
new text end
new text begin Subd. 2. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base is increased by
$191,000 in fiscal year 2028 and $174,000 in
fiscal year 2029.
new text end
Sec. 5. new text begin COMMISSIONER OF PUBLIC
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
549,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Child Care Licensing
|
||||||
new text begin
$549,000 in fiscal year 2027 is for child care
licensing modernization under Minnesota
Statutes, chapters 142H and 142I. The base
for this appropriation is $544,000 in fiscal year
2028 and $544,000 in fiscal year 2029.
new text end
new text begin Subd. 2. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base is increased by
$544,000 in fiscal year 2028 and $544,000 in
fiscal year 2029.
new text end
Sec. 6. new text begin COMMISSIONER OF EDUCATION
|
new text begin
$ new text end |
new text begin
(281,000) new text end |
new text begin
$ new text end |
new text begin
(281,000) new text end |
||
new text begin
This reduction is for preschool assessment
funding.
new text end
Sec. 7. new text begin COMMISSIONER OF MANAGEMENT
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
450,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Financial Stability of Safety Net
|
||||||
new text begin
$250,000 in fiscal year 2027 is for a study to
evaluate strategies to promote the long-term
financial stability of safety net health care
providers across Minnesota. This is a onetime
appropriation.
new text end
new text begin Subd. 2. new text end
new text begin
Report on Financial Stability of
|
||||||
new text begin
$200,000 in fiscal year 2027 is to prepare the
report on the financial stability of hospitals
under Minnesota Statutes, section 16A.103,
subdivision 1k.
new text end
new text begin Subd. 3. new text end
new text begin
Base Adjustment
|
||||||
new text begin
The general fund base is increased by
$200,000 in fiscal year 2028 and $200,000 in
fiscal year 2029.
new text end
Sec. 8. new text begin COMMISSIONER OF COMMERCE
|
new text begin
$ new text end |
new text begin
-0- new text end |
new text begin
$ new text end |
new text begin
-0- new text end |
||
new text begin
The general fund base is increased by
$1,750,000 in fiscal year 2028 and $1,750,000
in fiscal year 2029 for health maintenance
organization regulatory activities.
new text end
Sec. 9.
Laws 2024, chapter 127, article 67, section 7, is amended to read:
Sec. 7. BOARD OF DIRECTORS OF MNSURE
|
$ |
-0- |
$ |
2,330,000 |
||
(a) Information Technology deleted text begin to Implement
Federal Deferred Action for Childhood
Arrivals Regulatory Requirementsdeleted text end .
$2,330,000 in fiscal year 2025 is deleted text begin for
information technology to implement federal
Deferred Action for Childhood Arrivals
regulatory requirementsdeleted text end new text begin for technology and
operational needs. This appropriation is for
information technology enhancements, system
readiness, consumer communications, and
operational changes to maintain service
continuity and improve the consumer
experiencenew text end . This is a onetime appropriation
and is available until June 30, 2027.
(b) Transfer to Enterprise Account. The
Board of Directors of MNsure must transfer
$2,330,000 in fiscal year 2025 from the
general fund to the enterprise account under
Minnesota Statutes, section 62V.07. This is a
onetime transfer.
Sec. 10. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
This article appropriates necessary administrative costs. The administrative costs retention
requirement under Minnesota Statutes, section 16B.98, subdivision 14, is inapplicable to
any appropriation in this article for a grant.
new text end
Sec. 11. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit or an appropriation is made available beyond June 30,
2027.
new text end
Sec. 12. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation, transfer, or cancellation in this article is enacted more than once
during the 2026 legislative session, the appropriation, transfer, or cancellation must be given
effect once.
new text end
APPENDIX
Repealed Minnesota Statutes: S4612-2
142B.01 DEFINITIONS.
Subd. 11.
Drop-in child care program.
"Drop-in child care program" means a nonresidential program of child care in which children participate on a onetime only or occasional basis up to a maximum of 90 hours per child, per month. A drop-in child care program must be licensed under Minnesota Rules governing child care centers. A drop-in child care program must meet one of the following requirements to qualify for the rule exemptions specified in section 142B.41, subdivision 6:
(1) the drop-in child care program operates in a child care center which houses no child care program except the drop-in child care program;
(2) the drop-in child care program operates in the same child care center but not during the same hours as a regularly scheduled ongoing child care program with a stable enrollment; or
(3) the drop-in child care program operates in a child care center at the same time as a regularly scheduled ongoing child care program with a stable enrollment but the program's activities, except for bathroom use and outdoor play, are conducted separately from each other.
Subd. 12.
Experience.
For purposes of child care centers, "experience" means paid or unpaid employment:
(1) caring for children as a teacher, assistant teacher, aide, or student intern:
(i) in a licensed child care center, a licensed family day care or group family day care, or a Tribally licensed child care program in any United States state or territory; or
(ii) in a public or nonpublic school;
(2) caring for children as a staff person or unsupervised volunteer in a certified, license-exempt child care center under chapter 142C; or
(3) providing direct contact services in a home or residential facility serving children with disabilities that requires a background study under section 245C.03.
Subd. 13.
Family day care and group family day care child age classifications.
(a) For the purposes of family day care and group family day care licensing under this chapter, the following terms have the meanings given them in this subdivision.
(b) "Newborn" means a child between birth and six weeks old.
(c) "Infant" means a child who is at least six weeks old but less than 12 months old.
(d) "Toddler" means a child who is at least 12 months old but less than 24 months old, except that for purposes of specialized infant and toddler family and group family day care, "toddler" means a child who is at least 12 months old but less than 30 months old.
(e) "Preschooler" means a child who is at least 24 months old up to school age.
(f) "School age" means a child who is at least five years of age, but is younger than 11 years of age.
Subd. 25.
School-age child.
"School-age child," for programs licensed or required to be licensed as a child care center, means a child who is at least of sufficient age to have attended the first day of kindergarten, or is eligible to enter kindergarten within the next four months, but is younger than 13 years of age.
Subd. 26.
School-age child care program.
"School-age child care program" means a program licensed or required to be licensed as a child care center, serving more than ten children with the primary purpose of providing child care for school age children.
Subd. 27.
Supervision.
(a) For purposes of licensed child care centers, "supervision" means when a program staff person:
(1) is accountable for the child's care;
(2) can intervene to protect the health and safety of the child; and
(3) is within sight and hearing of the child at all times except as described in paragraphs (b) to (e).
(b) When an infant is placed in a crib room to sleep, supervision occurs when a program staff person is within sight or hearing of the infant. When supervision of a crib room is provided by sight or hearing, the center must have a plan to address the other supervision components.
(c) When a single school-age child uses the restroom within the licensed space, supervision occurs when a program staff person has knowledge of the child's activity and location and checks on the child at least every five minutes. When a school-age child uses the restroom outside the licensed space, including but not limited to field trips, supervision occurs when staff accompany children to the restroom.
(d) When a school-age child leaves the classroom but remains within the licensed space to deliver or retrieve items from the child's personal storage space, supervision occurs when a program staff person has knowledge of the child's activity and location and checks on the child at least every five minutes.
(e) When a single preschooler uses an individual, private restroom within the classroom with the door closed, supervision occurs when a program staff person has knowledge of the child's activity and location, can hear the child, and checks on the child at least every five minutes.
142B.41 SPECIAL CONDITIONS FOR NONRESIDENTIAL PROGRAMS.
Subd. 4.
Special family child care homes.
(a) Nonresidential child care programs serving 14 or fewer children that are conducted at a location other than the license holder's own residence shall be licensed under this section and the rules governing family child care or group family child care if:
(1) the license holder is the primary provider of care and the nonresidential child care program is conducted in a dwelling that is located on a residential lot;
(2) the license holder is an employer who may or may not be the primary provider of care, and the purpose for the child care program is to provide child care services to children of the license holder's employees;
(3) the license holder is a church or religious organization;
(4) the license holder is a community collaborative child care provider. For purposes of this subdivision, a community collaborative child care provider is a provider participating in a cooperative agreement with a community action agency as defined in section 142F.301;
(5) the license holder is a not-for-profit agency that provides child care in a dwelling located on a residential lot and the license holder maintains two or more contracts with community employers or other community organizations to provide child care services. The county licensing agency may grant a capacity variance to a license holder licensed under this clause to exceed the licensed capacity of 14 children by no more than five children during transition periods related to the work schedules of parents, if the license holder meets the following requirements:
(i) the program does not exceed a capacity of 14 children more than a cumulative total of four hours per day;
(ii) the program meets a one to seven staff-to-child ratio during the variance period;
(iii) all employees receive at least an extra four hours of training per year than required in the rules governing family child care each year;
(iv) the facility has square footage required per child under Minnesota Rules, part 9502.0425;
(v) the program is in compliance with local zoning regulations;
(vi) the program is in compliance with the applicable fire code as follows:
(A) if the program serves more than five children older than 2-1/2 years of age, but no more than five children 2-1/2 years of age or less, the applicable fire code is educational occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2020, Section 202; or
(B) if the program serves more than five children 2-1/2 years of age or less, the applicable fire code is Group I-4 Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202, unless the rooms in which the children 2-1/2 years of age or younger are cared for are located on a level of exit discharge and each of these child care rooms has an exit door directly to the exterior, then the applicable fire code is Group E Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202; and
(vii) any age and capacity limitations required by the fire code inspection and square footage determinations shall be printed on the license; or
(6) the license holder is the primary provider of care and has located the licensed child care program in a commercial space, if the license holder meets the following requirements:
(i) the program is in compliance with local zoning regulations;
(ii) the program is in compliance with the applicable fire code as follows:
(A) if the program serves more than five children older than 2-1/2 years of age, but no more than five children 2-1/2 years of age or less, the applicable fire code is educational occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2020, Section 202; or
(B) if the program serves more than five children 2-1/2 years of age or less, the applicable fire code is Group I-4 Occupancy, as provided under the Minnesota State Fire Code 2020, Section 202, unless the rooms in which the children 2-1/2 years of age or younger are cared for are located on a level of exit discharge and each of these child care rooms has an exit door directly to the exterior, then the applicable fire code is Group E Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202;
(iii) any age and capacity limitations required by the fire code inspection and square footage determinations are printed on the license; and
(iv) the license holder prominently displays the license issued by the commissioner which contains the statement "This special family child care provider is not licensed as a child care center."
(b) Notwithstanding Minnesota Rules, part 9502.0335, subpart 12, the commissioner may issue up to four licenses to an organization licensed under paragraph (a), clause (2), (3), or (5). Each license must have its own primary provider of care as required under paragraph (d). Each license must operate as a distinct and separate program in compliance with all applicable laws and regulations.
(c) For licenses issued under paragraph (a), clause (2), (3), (4), (5), or (6), the commissioner may approve up to four licenses at the same location or under one contiguous roof if each license holder is able to demonstrate compliance with all applicable rules and laws. Each licensed program must operate as a distinct program and within the capacity, age, and ratio distributions of each license.
(d) For a license issued under paragraph (a), clause (2), (3), or (5), the license holder must designate a person to be the primary provider of care at the licensed location on a form and in a manner prescribed by the commissioner. The license holder shall notify the commissioner in writing before there is a change of the person designated to be the primary provider of care. The primary provider of care:
(1) must be the person who will be the provider of care at the program and present during the hours of operation;
(2) must operate the program in compliance with applicable laws and regulations under this chapter and Minnesota Rules, chapter 9502;
(3) is considered a child care background study subject as defined in section 245C.02, subdivision 6a, and must comply with background study requirements in chapter 245C;
(4) must complete the training that is required of license holders in section 142B.70; and
(5) is authorized to communicate with the county licensing agency and the department on matters related to licensing.
(e) For any license issued under this subdivision, the license holder must ensure that any other caregiver, substitute, or helper who assists in the care of children meets the training requirements in section 142B.70 and background study requirements under chapter 245C.
Subd. 6.
Drop-in and school age child care programs.
(a) Except as expressly set forth in this subdivision, drop-in and school age child care programs must be licensed as a drop-in or school age program under the rules governing child care programs operated in a center.
(b) Drop-in and school age child care programs are exempt from the following Minnesota Rules:
(1) part 9503.0040;
(2) part 9503.0045, subpart 1, items F and G;
(3) part 9503.0050, subpart 6, except for children less than 2-1/2 years old;
(4) one-half the requirements of part 9503.0060, subpart 4, item A, subitems (2), (5), and (8), subpart 5, item A, subitems (2), (3), and (7), and subpart 6, item A, subitems (3) and (6);
(5) part 9503.0070; and
(6) part 9503.0090, subpart 2.
(c) A drop-in and school age child care program must be operated under the supervision of a person qualified as a director and a teacher.
(d) A drop-in and school age child care program must have at least two persons on staff whenever the program is operating, except that the commissioner may permit variances from this requirement under specified circumstances for parent cooperative programs, as long as all other staff-to-child ratios are met.
(e) Whenever the total number of children present to be cared for at a drop-in child care center is more than 20, children that are younger than age 2-1/2 must be in a separate group. This group may contain children up to 60 months old. This group must be cared for in an area that is physically separated from older children.
(f) A drop-in child care program must maintain a minimum staff ratio for children age 2-1/2 or greater of one staff person for each ten children. A school age child care program must maintain a minimum staff ratio of one staff person for every 15 children.
(g) If the drop-in child care program has additional staff who are on call as a mandatory condition of their employment, the minimum child-to-staff ratio may be exceeded only for children age 2-1/2 or greater, by a maximum of four children, for no more than 20 minutes while additional staff are in transit.
(h) In a drop-in child care program, the minimum staff-to-child ratio for infants up to 16 months of age is one staff person for every four infants. The minimum staff-to-child ratio for children age 17 months to 30 months is one staff for every seven children.
(i) In drop-in care programs that serve both infants and older children, children up to age 2-1/2 may be supervised by assistant teachers, as long as other staff are present in appropriate ratios.
(j) The minimum staff distribution pattern for a drop-in child care program serving children age 2-1/2 or greater and a school age child care program serving school age children is: the first staff member must be a teacher; the second, third, and fourth staff members must have at least the qualifications of a child care aide; the fifth staff member must have at least the qualifications of an assistant teacher; the sixth, seventh, and eighth staff members must have at least the qualifications of a child care aide; and the ninth staff person must have at least the qualifications of an assistant teacher.
(k) A drop-in child care program may care for siblings 16 months or older together in any group. For purposes of this subdivision, sibling is defined as sister or brother, half sister or half brother, or stepsister or stepbrother.
(l) The commissioner may grant a variance to any of the requirements in paragraphs (a) to (k), as long as the health and safety of the persons served by the program are not affected. The request for a variance shall comply with the provisions in section 142B.10, subdivision 16.
Subd. 7.
Experienced aides; child care centers.
(a) An individual employed as an aide at a child care center may work with children without being directly supervised for an amount of time that does not exceed 25 percent of the child care center's daily hours if:
(1) a teacher is in the facility;
(2) the individual is at least 20 years old; and
(3) the individual has at least 4,160 hours of child care experience as a staff member in a licensed child care center or as the license holder of a family day care home, 120 days of which must be in the employment of the current company.
(b) A child care center that uses experienced aides under this subdivision must notify parents or guardians by posting the notification in each classroom that uses experienced aides, identifying which staff member is the experienced aide. Records of experienced aide usage must be kept on site and given to the commissioner upon request.
(c) A child care center may not use the experienced aide provision for one year following two determined experienced aide violations within a one-year period.
(d) A child care center may use one experienced aide per every four full-time child care classroom staff.
Subd. 8.
Portable wading pools; family day care and group family day care providers.
A portable wading pool as defined in section 144.1222 may not be used by a child at a family day care or group family day care home or at a home at which child care services are provided under section 142B.05, subdivision 2, paragraph (a), clause (2), unless the parent or legal guardian of the child has provided written consent. The written consent shall include a statement that the parent or legal guardian has received and read material provided by the Department of Health to the Department of Children, Youth, and Families for distribution to all family day care or group family day care homes and the general public on the human services Internet website related to the risk of disease transmission as well as other health risks associated with the use of portable wading pools.
Subd. 9.
Swimming pools; family day care and group family day care providers.
(a) This subdivision governs swimming pools located at family day care or group family day care homes licensed under Minnesota Rules, chapter 9502. This subdivision does not apply to portable wading pools or whirlpools located at family day care or group family day care homes licensed under Minnesota Rules, chapter 9502. For a provider to be eligible to allow a child cared for at the family day care or group family day care home to use the swimming pool located at the home, the provider must not have had a licensing sanction under section 142B.18 or 245A.07 or a correction order or conditional license under section 142B.16 or 245A.06 relating to the supervision or health and safety of children during the prior 24 months, and must satisfy the following requirements:
(1) notify the county agency before initial use of the swimming pool and annually, thereafter;
(2) obtain written consent from a child's parent or legal guardian allowing the child to use the swimming pool and renew the parent or legal guardian's written consent at least annually. The written consent must include a statement that the parent or legal guardian has received and read materials provided by the Department of Health to the Department of Children, Youth, and Families for distribution to all family day care or group family day care homes and the general public on the human services Internet website related to the risk of disease transmission as well as other health risks associated with swimming pools. The written consent must also include a statement that the Department of Health, Department of Children, Youth, and Families, and county agency will not monitor or inspect the provider's swimming pool to ensure compliance with the requirements in this subdivision;
(3) enter into a written contract with a child's parent or legal guardian and renew the written contract annually. The terms of the written contract must specify that the provider agrees to perform all of the requirements in this subdivision;
(4) attend and successfully complete a swimming pool operator training course once every five years. Acceptable training courses are:
(i) the National Swimming Pool Foundation Certified Pool Operator course;
(ii) the National Spa and Pool Institute Tech I and Tech II courses (both required); or
(iii) the National Recreation and Park Association Aquatic Facility Operator course;
(5) require a caregiver trained in first aid and adult and child cardiopulmonary resuscitation to supervise and be present at the swimming pool with any children in the pool;
(6) toilet all potty-trained children before they enter the swimming pool;
(7) require all children who are not potty-trained to wear swim diapers while in the swimming pool;
(8) if fecal material enters the swimming pool water, add three times the normal shock treatment to the pool water to raise the chlorine level to at least 20 parts per million, and close the pool to swimming for the 24 hours following the entrance of fecal material into the water or until the water pH and disinfectant concentration levels have returned to the standards specified in clause (10), whichever is later;
(9) prevent any person from entering the swimming pool who has an open wound or any person who has or is suspected of having a communicable disease;
(10) maintain the swimming pool water at a pH of not less than 7.2 and not more than 8.0, maintain the disinfectant concentration between two and five parts per million for chlorine or between 2.3 and 4.5 parts per million for bromine, and maintain a daily record of the swimming pool's operation with pH and disinfectant concentration readings on days when children cared for at the family day care or group family day care home are present;
(11) have a disinfectant feeder or feeders;
(12) have a recirculation system that will clarify and disinfect the swimming pool volume of water in ten hours or less;
(13) maintain the swimming pool's water clarity so that an object on the pool floor at the pool's deepest point is easily visible;
(14) comply with the provisions of the Abigail Taylor Pool Safety Act in section 144.1222, subdivisions 1c and 1d;
(15) have in place and enforce written safety rules and swimming pool policies;
(16) have in place at all times a safety rope that divides the shallow and deep portions of the swimming pool;
(17) satisfy any existing local ordinances regarding swimming pool installation, decks, and fencing;
(18) maintain a water temperature of not more than 104 degrees Fahrenheit and not less than 70 degrees Fahrenheit; and
(19) for lifesaving equipment, have a United States Coast Guard-approved life ring attached to a rope, an exit ladder, and a shepherd's hook available at all times to the caregiver supervising the swimming pool.
The requirements of clauses (5), (16), and (18) only apply at times when children cared for at the family day care or group family day care home are present.
(b) A violation of paragraph (a), clauses (1) to (3), is grounds for a sanction under section 142B.18 or a correction order or conditional license under section 142B.16.
(c) If a provider under this subdivision receives a licensing sanction under section 142B.18 or 245A.07 or a correction order or a conditional license under section 142B.16 or 245A.06 relating to the supervision or health and safety of children, the provider is prohibited from allowing a child cared for at the family day care or group family day care home to continue to use the swimming pool located at the home.
Subd. 10.
Attendance records for publicly funded services.
(a) A child care center licensed under this chapter and according to Minnesota Rules, chapter 9503, must maintain documentation of actual attendance for each child receiving care for which the license holder is reimbursed by a governmental program. The records must be accessible to the commissioner during the program's hours of operation, they must be completed on the actual day of attendance, and they must include:
(1) the first and last name of the child;
(2) the time of day that the child was dropped off; and
(3) the time of day that the child was picked up.
(b) A family child care provider licensed under this chapter and according to Minnesota Rules, chapter 9502, must maintain documentation of actual attendance for each child receiving care for which the license holder is reimbursed for the care of that child by a governmental program. The records must be accessible to the commissioner during the program's hours of operation, they must be completed on the actual day of attendance, and they must include:
(1) the first and last name of the child;
(2) the time of day that the child was dropped off; and
(3) the time of day that the child was picked up.
Subd. 11.
Parental access in child care programs.
An enrolled child's parent or legal guardian must be allowed access to the parent's or legal guardian's child at any time while the child is in care.
Subd. 12.
Valid driver's license.
Notwithstanding any law to the contrary, when a licensed child care center provides transportation for children or contracts to provide transportation for children, a person who has a current, valid driver's license appropriate to the vehicle driven may transport the child.
Subd. 13.
Reusable water bottles or cups.
Notwithstanding any law to the contrary, a licensed child care center may provide drinking water to a child in a reusable water bottle or reusable cup if the center develops and ensures implementation of a written policy that at a minimum includes the following procedures:
(1) each day the water bottle or cup is used, the child care center cleans and sanitizes the water bottle or cup using procedures that comply with the Food Code under Minnesota Rules, chapter 4626, or allows the child's parent or legal guardian to bring the water bottle or cup home to be cleaned and sanitized each day the water bottle or cup is used;
(2) a water bottle or cup is assigned to a specific child and labeled with the child's first and last name;
(3) water bottles and cups are stored in a manner that reduces the risk of a child using the wrong water bottle or cup; and
(4) a water bottle or cup is used only for water.
142B.54 REQUIREMENTS; MALTREATMENT OF MINORS OR VULNERABLE ADULTS.
Subdivision 1.
Maltreatment of minors internal review.
Except for family child care settings and foster care for children in the license holder's residence, license holders serving children shall:
(1) establish and maintain policies and procedures to ensure that an internal review is completed within 30 calendar days and that corrective action is taken if necessary to protect the health and safety of children in care when the facility has reason to know that an internal or external report of alleged or suspected maltreatment has been made. The review must include an evaluation of whether:
(i) related policies and procedures were followed;
(ii) the policies and procedures were adequate;
(iii) there is a need for additional staff training;
(iv) the reported event is similar to past events with the children or the services involved; and
(v) there is a need for corrective action by the license holder to protect the health and safety of children in care.
Based on the results of this review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by individuals or the license holder, if any;
(2) identify the primary and secondary person or position who will ensure that, when required, internal reviews are completed. The secondary person shall be involved when there is reason to believe that the primary person was involved in the alleged or suspected maltreatment; and
(3) document and make internal reviews accessible to the commissioner immediately upon the commissioner's request. For the purposes of this section, the documentation provided to the commissioner by the license holder may consist of a completed checklist that verifies completion of each of the requirements of the review.
Subd. 2.
Child care centers; risk reduction plan.
(a) Child care centers licensed under this chapter and Minnesota Rules, chapter 9503, must develop a risk reduction plan that identifies the general risks to children served by the child care center. The license holder must establish procedures to minimize identified risks, train staff on the procedures, and annually review the procedures.
(b) The risk reduction plan must include an assessment of risk to children the center serves or intends to serve and identify specific risks based on the outcome of the assessment. The assessment of risk must be based on the following:
(1) an assessment of the risks presented by the physical plant where the licensed services are provided, including an evaluation of the following factors: the condition and design of the facility and its outdoor space, bathrooms, storage areas, and accessibility of medications and cleaning products that are harmful to children when children are not supervised and the existence of areas that are difficult to supervise; and
(2) an assessment of the risks presented by the environment for each facility and for each site, including an evaluation of the following factors: the type of grounds and terrain surrounding the building and the proximity to hazards, busy roads, and publicly accessed businesses.
(c) The risk reduction plan must include a statement of measures that will be taken to minimize the risk of harm presented to children for each risk identified in the assessment required under paragraph (b) related to the physical plant and environment. At a minimum, the stated measures must include the development and implementation of specific policies and procedures or reference to existing policies and procedures that minimize the risks identified.
(d) In addition to any program-specific risks identified in paragraph (b), the plan must include development and implementation of specific policies and procedures or refer to existing policies and procedures that minimize the risk of harm or injury to children, including:
(1) closing children's fingers in doors, including cabinet doors;
(2) leaving children in the community without supervision;
(3) children leaving the facility without supervision;
(4) caregiver dislocation of children's elbows;
(5) burns from hot food or beverages, whether served to children or being consumed by caregivers, and the devices used to warm food and beverages;
(6) injuries from equipment, such as scissors and glue guns;
(7) sunburn;
(8) feeding children foods to which they are allergic;
(9) children falling from changing tables; and
(10) children accessing dangerous items or chemicals or coming into contact with residue from harmful cleaning products.
(e) The plan shall prohibit the accessibility of hazardous items to children.
(f) The plan must include specific policies and procedures to ensure adequate supervision of children at all times as defined under section 142B.01, subdivision 27, with particular emphasis on:
(1) times when children are transitioned from one area within the facility to another;
(2) nap-time supervision, including infant crib rooms as specified under section 142B.01, subdivision 27, which requires that when an infant is placed in a crib to sleep, supervision occurs when a staff person is within sight or hearing of the infant. When supervision of a crib room is provided by sight or hearing, the center must have a plan to address the other supervision components;
(3) child drop-off and pick-up times;
(4) supervision during outdoor play and on community activities, including but not limited to field trips and neighborhood walks;
(5) supervision of children in hallways;
(6) supervision of school-age children when using the restroom and visiting the child's personal storage space; and
(7) supervision of preschool children when using an individual, private restroom within the classroom.
Subd. 3.
Yearly review of risk reduction plan.
The license holder must review the risk reduction plan each calendar year and document the review. When conducting the review, the license holder must consider incidents that have occurred in the center since the last review, including:
(1) the assessment factors in the plan;
(2) the internal reviews conducted under this section, if any;
(3) substantiated maltreatment findings, if any; and
(4) incidents that caused injury or harm to a child, if any, that occurred since the last review.
Following any change to the risk reduction plan, the license holder must inform staff persons, under the control of the license holder, of the changes in the risk reduction plan, and document that the staff were informed of the changes.
142B.62 CHILD CARE LICENSE HOLDER INSURANCE.
(a) A license holder must provide a written notice to all parents or guardians of all children to be accepted for care prior to admission stating whether the license holder has liability insurance. This notice may be incorporated into and provided on the admission form used by the license holder.
(b) If the license holder has liability insurance:
(1) the license holder shall inform parents in writing that a current certificate of coverage for insurance is available for inspection to all parents or guardians of children receiving services and to all parents seeking services from the family child care program;
(2) the notice must provide the parent or guardian with the date of expiration or next renewal of the policy; and
(3) upon the expiration of the policy or a change in coverage, the license holder must provide a new written notice informing all parents or guardians of children receiving services of the change and indicating whether the insurance policy has lapsed.
If a license holder has a continuous insurance policy that renews each year, the license holder may indicate the policy's renewal date in the initial written notice to parents and guardians. This initial written notice shall remain valid and no further notices are required until the insurance coverage changes or the policy lapses.
(c) If the license holder does not have liability insurance, the license holder must provide an annual notice, on a form developed and made available by the commissioner, to the parents or guardians of children in care indicating that the license holder does not carry liability insurance.
(d) The license holder must notify all parents and guardians in writing immediately of any change in insurance status.
(e) The license holder must make available upon request the certificate of liability insurance to the parents of children in care, to the commissioner, and to county licensing agents.
(f) The license holder must document, with the signature of the parent or guardian, that the parent or guardian received the notices required by this section.
142B.65 CHILD CARE CENTER TRAINING REQUIREMENTS.
Subdivision 1.
Orientation.
(a) The child care center license holder must ensure that the director, staff persons, substitutes, and unsupervised volunteers are given orientation training and successfully complete the training before starting assigned duties. The orientation training must include information about:
(1) the center's philosophy, child care program, and procedures for maintaining health and safety according to section 142B.66 and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according to Minnesota Rules, part 9503.0110;
(2) specific job responsibilities;
(3) the behavior guidance standards in Minnesota Rules, part 9503.0055;
(4) the reporting responsibilities in chapter 260E and Minnesota Rules, part 9503.0130;
(5) the center's drug and alcohol policy under section 142B.10, subdivision 1, paragraph (c);
(6) the center's risk reduction plan as required under section 142B.54, subdivision 2;
(7) at least one-half hour of training on the standards under section 142B.46 and on reducing the risk of sudden unexpected infant death as required in subdivision 6, if applicable;
(8) at least one-half hour of training on the risk of abusive head trauma as required for the director and staff under subdivision 7, if applicable; and
(9) training required by a child's individual child care program plan as required under Minnesota Rules, part 9503.0065, subpart 3, if applicable.
(b) In addition to paragraph (a), before having unsupervised direct contact with a child, the director and staff persons within the first 90 days of employment, and substitutes and unsupervised volunteers within 90 days after the first date of direct contact with a child, must complete:
(1) pediatric first aid, in accordance with subdivision 4; and
(2) pediatric cardiopulmonary resuscitation, in accordance with subdivision 5.
(c) In addition to paragraph (b), the director and staff persons within the first 90 days of employment, and substitutes and unsupervised volunteers within 90 days from the first date of direct contact with a child, must complete training in child development, in accordance with subdivision 3.
(d) The license holder must ensure that documentation, as required in subdivision 10, identifies the number of hours completed for each topic with a minimum training time identified, if applicable, and that all required content is included.
(e) Training in this subdivision must not be used to meet in-service training requirements in subdivision 9.
(f) Training completed within the previous 12 months under paragraphs (a), clauses (7) and (8), and (c) are transferable to another child care center.
Subd. 2.
Definitions.
(a) For the purposes of this section, the following terms have the meanings given.
(b) "Substitute" means an adult who is temporarily filling a position as a director, teacher, assistant teacher, or aide in a licensed child care center for less than 240 hours total in a calendar year due to the absence of a regularly employed staff person.
(c) "Staff person" means an employee of a child care center who provides direct contact services to children.
(d) "Unsupervised volunteer" means an individual who:
(1) assists in the care of a child in care;
(2) is not under the continuous direct supervision of a staff person; and
(3) is not employed by the child care center.
Subd. 3.
Child development and learning training.
(a) The director and all staff persons, substitutes, and unsupervised volunteers shall complete child development and learning training within the first 90 days of employment. The director and staff persons, not including substitutes, must complete at least two hours of training on child development and learning. The training for substitutes and unsupervised volunteers is not required to be of a minimum length. For purposes of this subdivision, "child development and learning training" means any training in Knowledge and Competency Area I: Child Development and Learning, which is training in understanding how children develop physically, cognitively, emotionally, and socially and learn as part of the children's family, culture, and community.
(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:
(1) have taken a three-credit college course on early childhood development within the past five years;
(2) have received a baccalaureate or master's degree in early childhood education or school-age child care within the past five years;
(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood special education teacher, or an elementary teacher with a kindergarten endorsement; or
(4) have received a baccalaureate degree with a Montessori certificate within the past five years.
(c) The director and staff persons, not including substitutes, must complete at least two hours of child development and learning training every second calendar year.
(d) Substitutes and unsupervised volunteers must complete child development and learning training every second calendar year. There is no minimum number of training hours required.
(e) Except for training required under paragraph (a), training completed under this subdivision may be used to meet the in-service training requirements under subdivision 9.
Subd. 4.
First aid.
(a) Unless training has been completed within the previous two years, the director, staff persons, substitutes, and unsupervised volunteers must satisfactorily complete pediatric first aid training prior to having unsupervised direct contact with a child, but not to exceed the first 90 days of employment.
(b) Pediatric first aid training must be repeated at least every second calendar year. First aid training under this subdivision must be provided by an individual approved as a first aid instructor and must not be used to meet in-service training requirements under subdivision 9.
Subd. 5.
Cardiopulmonary resuscitation.
(a) Unless training has been completed within the previous two years, the director, staff persons, substitutes, and unsupervised volunteers must satisfactorily complete pediatric cardiopulmonary resuscitation (CPR) training that meets the requirements of this subdivision. Pediatric CPR training must be completed prior to having unsupervised direct contact with a child, but not to exceed the first 90 days of employment.
(b) Pediatric CPR training must be provided by an individual approved to provide pediatric CPR instruction.
(c) The pediatric CPR training must:
(1) cover CPR techniques for infants and children and the treatment of obstructed airways;
(2) include instruction, hands-on practice, and an in-person, observed skills assessment under the direct supervision of a CPR instructor; and
(3) be developed by the American Heart Association, the American Red Cross, or another organization that uses nationally recognized, evidence-based guidelines for CPR.
(d) Pediatric CPR training must be repeated at least once every second calendar year.
(e) Pediatric CPR training in this subdivision must not be used to meet in-service training requirements under subdivision 9.
Subd. 6.
Sudden unexpected infant death training.
(a) Before caring for infants, the director, staff persons, substitutes, unsupervised volunteers, and any other volunteers must receive training on the standards under section 142B.46 and on reducing the risk of sudden unexpected infant death during orientation and each calendar year thereafter.
(b) Sudden unexpected infant death reduction training required under this subdivision must be at least one-half hour in length. At a minimum, the training must address the risk factors related to sudden unexpected infant death, means of reducing the risk of sudden unexpected infant death in child care, and license holder communication with parents regarding reducing the risk of sudden unexpected infant death.
(c) Except if completed during orientation, training taken under this subdivision may be used to meet the in-service training requirements under subdivision 9.
Subd. 7.
Abusive head trauma training.
(a) Before caring for children under school age, the director, staff persons, substitutes, and unsupervised volunteers must receive training on the risk of abusive head trauma during orientation and each calendar year thereafter.
(b) Abusive head trauma training under this subdivision must be at least one-half hour in length. At a minimum, the training must address the risk factors related to shaking infants and young children, means to reduce the risk of abusive head trauma in child care, and license holder communication with parents regarding reducing the risk of abusive head trauma.
(c) Except if completed during orientation, training taken under this subdivision may be used to meet the in-service training requirements under subdivision 9.
(d) The commissioner shall make available for viewing a video presentation on the dangers associated with shaking infants and young children, which may be used in conjunction with the annual training required under paragraph (b).
Subd. 8.
Child passenger restraint systems; training requirement.
(a) Before a license holder transports a child or children under age nine in a motor vehicle, the person placing the child or children in a passenger restraint must satisfactorily complete training on the proper use and installation of child restraint systems in motor vehicles.
(b) Training required under this subdivision must be repeated at least once every five years. At a minimum, the training must address the proper use of child restraint systems based on the child's size, weight, and age, and the proper installation of a car seat or booster seat in the motor vehicle used by the license holder to transport the child or children.
(c) Training required under this subdivision must be provided by individuals who are certified and approved by the Department of Public Safety, Office of Traffic Safety. License holders may obtain a list of certified and approved trainers through the Department of Public Safety website or by contacting the agency.
(d) Child care providers that only transport school-age children as defined in section 142B.01, subdivision 25, in child care buses as defined in section 169.448, subdivision 1, paragraph (e), are exempt from this subdivision.
(e) Training completed under this subdivision may be used to meet in-service training requirements under subdivision 9. Training completed within the previous five years is transferable upon a staff person's change in employment to another child care center.
Subd. 9.
In-service training.
(a) A license holder must ensure that the center director, staff persons, substitutes, and unsupervised volunteers complete in-service training each calendar year.
(b) The center director and staff persons who work more than 20 hours per week must complete 24 hours of in-service training each calendar year. Staff persons who work 20 hours or less per week must complete 12 hours of in-service training each calendar year. Substitutes and unsupervised volunteers must complete at least two hours of training each year, and the training must include the requirements of paragraphs (d) to (g).
(c) The number of in-service training hours may be prorated for center directors and staff persons not employed for an entire year.
(d) Each year, in-service training must include:
(1) the center's procedures for maintaining health and safety according to section 142B.66 and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according to Minnesota Rules, part 9503.0110;
(2) the reporting responsibilities under chapter 260E and Minnesota Rules, part 9503.0130;
(3) at least one-half hour of training on the standards under section 142B.46 and on reducing the risk of sudden unexpected infant death as required under subdivision 6, if applicable; and
(4) at least one-half hour of training on the risk of abusive head trauma from shaking infants and young children as required under subdivision 7, if applicable.
(e) Each year, or when a change is made, whichever is more frequent, in-service training must be provided on: (1) the center's risk reduction plan under section 142B.54, subdivision 2; and (2) a child's individual child care program plan as required under Minnesota Rules, part 9503.0065, subpart 3.
(f) At least once every two calendar years, the in-service training must include:
(1) child development and learning training under subdivision 3;
(2) pediatric first aid that meets the requirements of subdivision 4;
(3) pediatric cardiopulmonary resuscitation training that meets the requirements of subdivision 5;
(4) cultural dynamics training to increase awareness of cultural differences; and
(5) disabilities training to increase awareness of differing abilities of children.
(g) At least once every five years, in-service training must include child passenger restraint training that meets the requirements of subdivision 8, if applicable.
(h) The remaining hours of the in-service training requirement must be met by completing training in the following content areas of the Minnesota Knowledge and Competency Framework:
(1) Content area I: child development and learning;
(2) Content area II: developmentally appropriate learning experiences;
(3) Content area III: relationships with families;
(4) Content area IV: assessment, evaluation, and individualization;
(5) Content area V: historical and contemporary development of early childhood education;
(6) Content area VI: professionalism;
(7) Content area VII: health, safety, and nutrition; and
(8) Content area VIII: application through clinical experiences.
(i) For purposes of this subdivision, the following terms have the meanings given them.
(1) "Child development and learning training" means training in understanding how children develop physically, cognitively, emotionally, and socially and learn as part of the children's family, culture, and community.
(2) "Developmentally appropriate learning experiences" means creating positive learning experiences, promoting cognitive development, promoting social and emotional development, promoting physical development, and promoting creative development.
(3) "Relationships with families" means training on building a positive, respectful relationship with the child's family.
(4) "Assessment, evaluation, and individualization" means training in observing, recording, and assessing development; assessing and using information to plan; and assessing and using information to enhance and maintain program quality.
(5) "Historical and contemporary development of early childhood education" means training in past and current practices in early childhood education and how current events and issues affect children, families, and programs.
(6) "Professionalism" means training in knowledge, skills, and abilities that promote ongoing professional development.
(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring safety, and providing healthy nutrition.
(8) "Application through clinical experiences" means clinical experiences in which a person applies effective teaching practices using a range of educational programming models.
(j) The license holder must ensure that documentation, as required in subdivision 10, includes the number of total training hours required to be completed, name of the training, the Minnesota Knowledge and Competency Framework content area, number of hours completed, and the director's approval of the training.
(k) In-service training completed by a staff person that is not specific to that child care center is transferable upon a staff person's change in employment to another child care program.
Subd. 10.
Documentation.
All training must be documented and maintained on site in each personnel record. In addition to any requirements for each training provided in this section, documentation for each staff person must include the staff person's first date of direct contact and first date of unsupervised contact with a child in care.
142B.66 CHILD CARE CENTER HEALTH AND SAFETY REQUIREMENTS.
Subdivision 1.
Allergy prevention and response.
(a) Before admitting a child for care, the license holder must obtain documentation of any known allergy from the child's parent or legal guardian or the child's source of medical care. If a child has a known allergy, the license holder must maintain current information about the allergy in the child's record and develop an individual child care program plan as specified in Minnesota Rules, part 9503.0065, subpart 3. The individual child care program plan must include but not be limited to a description of the allergy, specific triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for responding to an allergic reaction, including medication, dosages, and a doctor's contact information.
(b) The license holder must ensure that each staff person who is responsible for carrying out the individual child care program plan review and follow the plan. Documentation of a staff person's review must be kept on site.
(c) At least once each calendar year or following any changes made to allergy-related information in the child's record, the license holder must update the child's individual child care program plan and inform each staff person who is responsible for carrying out the individual child care program plan of the change. The license holder must keep on site documentation that a staff person was informed of a change.
(d) A child's allergy information must be available at all times including on site, when on field trips, or during transportation. A child's food allergy information must be readily available to a staff person in the area where food is prepared and served to the child.
(e) The license holder must contact the child's parent or legal guardian as soon as possible in any instance of exposure or allergic reaction that requires medication or medical intervention. The license holder must call emergency medical services when epinephrine is administered to a child in the license holder's care.
Subd. 2.
Handling and disposal of bodily fluids.
The licensed child care center must comply with the following procedures for safely handling and disposing of bodily fluids:
(1) surfaces that come in contact with potentially infectious bodily fluids, including blood and vomit, must be cleaned and disinfected according to Minnesota Rules, part 9503.0005, subpart 11;
(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
(3) sharp items used for a child with special care needs must be disposed of in a "sharps container." The sharps container must be stored out of reach of a child;
(4) the license holder must have the following bodily fluid disposal supplies in the center: disposable gloves, disposal bags, and eye protection; and
(5) the license holder must ensure that each staff person follows universal precautions to reduce the risk of spreading infectious disease.
Subd. 3.
Emergency preparedness.
(a) A licensed child care center must have a written emergency plan for emergencies that require evacuation, sheltering, or other protection of a child, such as fire, natural disaster, intruder, or other threatening situation that may pose a health or safety hazard to a child. The plan must be written on a form developed by the commissioner and must include:
(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
(2) a designated relocation site and evacuation route;
(3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation, shelter-in-place, or lockdown, including procedures for reunification with families;
(4) accommodations for a child with a disability or a chronic medical condition;
(5) procedures for storing a child's medically necessary medicine that facilitates easy removal during an evacuation or relocation;
(6) procedures for continuing operations in the period during and after a crisis;
(7) procedures for communicating with local emergency management officials, law enforcement officials, or other appropriate state or local authorities; and
(8) accommodations for infants and toddlers.
(b) The license holder must train staff persons on the emergency plan at orientation, when changes are made to the plan, and at least once each calendar year. Training must be documented in each staff person's personnel file.
(c) The license holder must conduct drills according to the requirements in Minnesota Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented.
(d) The license holder must review and update the emergency plan each calendar year. Documentation of the yearly emergency plan review shall be maintained in the program's administrative records.
(e) The license holder must include the emergency plan in the program's policies and procedures as specified under section 142B.10, subdivision 21. The license holder must provide a physical or electronic copy of the emergency plan to the child's parent or legal guardian upon enrollment.
(f) The relocation site and evacuation route must be posted in a visible place as part of the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140, subpart 21.
Subd. 4.
Child passenger restraint requirements.
A license holder must comply with all seat belt and child passenger restraint system requirements under section 169.685.
Subd. 5.
Telephone requirement in licensed child care centers.
(a) A working telephone which is capable of making outgoing calls and receiving incoming calls must be located within the licensed child care center at all times. Staff must have access to a working telephone while providing care and supervision to children in care, even if the care occurs outside of the child care facility. A license holder may use a cellular telephone to meet the requirements of this subdivision.
(b) If a cellular telephone is used to satisfy the requirements of this subdivision, the cellular telephone must be accessible to staff, be stored in a centrally located area when not in use, and be sufficiently charged for use at all times.
142B.70 FAMILY CHILD CARE TRAINING REQUIREMENTS.
Subdivision 1.
Initial training.
(a) License holders, second adult caregivers, and substitutes must comply with the training requirements in this section.
(b) Helpers who assist with care on a regular basis must complete six hours of training within one year after the date of initial employment.
(c) Training requirements established under this section that must be completed prior to initial licensure must be satisfied only by a newly licensed child care provider or by a child care provider who has not held an active child care license in Minnesota in the previous 12 months. A child care provider who voluntarily cancels a license or allows the license to lapse for a period of less than 12 months and who seeks reinstatement of the lapsed or canceled license within 12 months of the lapse or cancellation must satisfy the annual, ongoing training requirements, and is not required to satisfy the training requirements that must be completed prior to initial licensure. A child care provider who relocates within the state must (1) satisfy the annual, ongoing training requirements according to the schedules established in this section and (2) not be required to satisfy the training requirements under this section that the child care provider completed prior to initial licensure. If a licensed provider moves to a new county, the new county is prohibited from requiring the provider to complete any orientation class or training for new providers.
(d) Before a second adult caregiver or substitute cares for a child or assists in the care of a child, the license holder must train the second adult caregiver or substitute on:
(1) the emergency preparedness plan required under section 142B.71, subdivision 3; and
(2) allergy prevention and response required under section 142B.71, subdivision 1.
Subd. 2.
Definitions and general provisions.
For the purposes of this section, the following terms have the meanings given:
(1) "second adult caregiver" means an adult who cares for children in the licensed program along with the license holder for a cumulative total of more than 500 hours annually;
(2) "helper" means a minor, ages 13 to 17, who assists in caring for children; and
(3) "substitute" means an adult who assumes responsibility for a license holder for a cumulative total of not more than 500 hours annually.
An adult who cares for children in the licensed program along with the license holder for a cumulative total of not more than 500 hours annually has the same training requirements as a substitute.
Subd. 3.
Child development and learning and behavior guidance training.
(a) For purposes of family and group family child care, the license holder and each second adult caregiver shall complete and document at least four hours of child development and learning and behavior guidance training prior to initial licensure, and before caring for children. For purposes of this subdivision, "child development and learning training" means training in understanding how children develop physically, cognitively, emotionally, and socially and learn as part of the children's family, culture, and community. "Behavior guidance training" means training in the understanding of the functions of child behavior and strategies for managing challenging situations. The training shall be developed or approved by the commissioner of children, youth, and families.
(b) Notwithstanding initial child development and learning and behavior guidance training requirements in paragraph (a), individuals are exempt from this requirement if they:
(1) have taken a three-credit course on early childhood development within the past five years;
(2) have received a baccalaureate or master's degree in early childhood education or school-age child care within the past five years;
(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early childhood special education teacher, or an elementary teacher with a kindergarten endorsement; or
(4) have received a baccalaureate degree with a Montessori certificate within the past five years.
(c) The license holder and each second adult caregiver must annually take at least two hours of child development and learning or behavior guidance training. A three-credit course about early childhood development meets the requirements of this paragraph.
Subd. 4.
First aid.
(a) Before initial licensure and before caring for a child, license holders, second adult caregivers, and substitutes must be trained in pediatric first aid. The first aid training must have been provided by an individual approved to provide first aid instruction. First aid training may be less than eight hours and persons qualified to provide first aid training include individuals approved as first aid instructors. License holders, second adult caregivers, and substitutes must repeat pediatric first aid training every two years within 90 days of the date the training was previously taken.
(b) Video training reviewed and approved by the county licensing agency satisfies the training requirement of this subdivision.
Subd. 5.
Cardiopulmonary resuscitation.
(a) Before initial licensure and before caring for a child, license holders, second adult caregivers, and substitutes must be trained in pediatric cardiopulmonary resuscitation (CPR), including CPR techniques for infants and children, and in the treatment of obstructed airways. The CPR training must have been provided by an individual approved to provide CPR instruction. License holders, second adult caregivers, and substitutes must repeat pediatric CPR training at least once every two years within 90 days of the date the training was previously taken, and the training must be documented in the license holder's records.
(b) Persons providing CPR training must use CPR training that has been developed:
(1) by the American Heart Association or the American Red Cross and incorporates psychomotor skills to support the instruction; or
(2) using nationally recognized, evidence-based guidelines for CPR training and incorporates psychomotor skills to support the instruction.
Subd. 6.
Sudden unexpected infant death and abusive head trauma training.
(a) License holders must ensure and document that before the license holder, second adult caregivers, substitutes, and helpers assist in the care of infants, they are instructed on the standards in section 142B.46 and receive training on reducing the risk of sudden unexpected infant death. In addition, license holders must ensure and document that before the license holder, second adult caregivers, substitutes, and helpers assist in the care of infants and children under school age, they receive training on reducing the risk of abusive head trauma from shaking infants and young children. The training in this subdivision may be provided as initial training under subdivision 1 or ongoing annual training under subdivision 8.
(b) Sudden unexpected infant death reduction training required under this subdivision must, at a minimum, address the risk factors related to sudden unexpected infant death, means of reducing the risk of sudden unexpected infant death in child care, and license holder communication with parents regarding reducing the risk of sudden unexpected infant death.
(c) Abusive head trauma training required under this subdivision must, at a minimum, address the risk factors related to shaking infants and young children, means of reducing the risk of abusive head trauma in child care, and license holder communication with parents regarding reducing the risk of abusive head trauma.
(d) Training for family and group family child care providers must be developed by the commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved by the Minnesota Center for Professional Development. Sudden unexpected infant death reduction training and abusive head trauma training may be provided in a single course of no more than two hours in length.
(e) Sudden unexpected infant death reduction training and abusive head trauma training required under this subdivision must be completed in person or as allowed under subdivision 11, clause (1) or (2), at least once every two years. On the years when the individual receiving training is not receiving training in person or as allowed under subdivision 11, clause (1) or (2), the individual receiving training in accordance with this subdivision must receive sudden unexpected infant death reduction training and abusive head trauma training through a video of no more than one hour in length. The video must be developed or approved by the commissioner.
(f) An individual who is related to the license holder as defined in section 142B.01, subdivision 15, and who is involved only in the care of the license holder's own infant or child under school age and who is not designated to be a second adult caregiver, helper, or substitute for the licensed program, is exempt from the sudden unexpected infant death and abusive head trauma training.
Subd. 7.
Child passenger restraint systems; training requirement.
(a) A license holder must comply with all seat belt and child passenger restraint system requirements under section 169.685.
(b) Family and group family child care programs licensed by the Department of Children, Youth, and Families that serve a child or children under nine years of age must document training that fulfills the requirements in this subdivision.
(1) Before a license holder, second adult caregiver, substitute, or helper transports a child or children under age nine in a motor vehicle, the person placing the child or children in a passenger restraint must satisfactorily complete training on the proper use and installation of child restraint systems in motor vehicles. Training completed under this subdivision may be used to meet initial training under subdivision 1 or ongoing training under subdivision 8.
(2) Training required under this subdivision must be at least one hour in length, completed at initial training, and repeated at least once every five years. At a minimum, the training must address the proper use of child restraint systems based on the child's size, weight, and age, and the proper installation of a car seat or booster seat in the motor vehicle used by the license holder to transport the child or children.
(3) Training under this subdivision must be provided by individuals who are certified and approved by the Department of Public Safety, Office of Traffic Safety. License holders may obtain a list of certified and approved trainers through the Department of Public Safety website or by contacting the agency.
(c) Child care providers that only transport school-age children as defined in section 142B.01, subdivision 13, paragraph (f), in child care buses as defined in section 169.448, subdivision 1, paragraph (e), are exempt from this subdivision.
Subd. 8.
Training requirements for family and group family child care.
(a) For purposes of family and group family child care, the license holder and each second adult caregiver must complete 16 hours of ongoing training each year. Repeat of topical training requirements in subdivisions 3 to 9 shall count toward the annual 16-hour training requirement. Additional ongoing training subjects to meet the annual 16-hour training requirement must be selected from the following areas:
(1) child development and learning training in understanding how a child develops physically, cognitively, emotionally, and socially, and how a child learns as part of the child's family, culture, and community;
(2) developmentally appropriate learning experiences, including training in creating positive learning experiences, promoting cognitive development, promoting social and emotional development, promoting physical development, promoting creative development; and behavior guidance;
(3) relationships with families, including training in building a positive, respectful relationship with the child's family;
(4) assessment, evaluation, and individualization, including training in observing, recording, and assessing development; assessing and using information to plan; and assessing and using information to enhance and maintain program quality;
(5) historical and contemporary development of early childhood education, including training in past and current practices in early childhood education and how current events and issues affect children, families, and programs;
(6) professionalism, including training in knowledge, skills, and abilities that promote ongoing professional development; and
(7) health, safety, and nutrition, including training in establishing healthy practices; ensuring safety; and providing healthy nutrition.
(b) A provider who is approved as a trainer through the Develop data system may count up to two hours of training instruction toward the annual 16-hour training requirement in paragraph (a). The provider may only count training instruction hours for the first instance in which they deliver a particular content-specific training during each licensing year. Hours counted as training instruction must be approved through the Develop data system with attendance verified on the trainer's individual learning record and must be in Knowledge and Competency Framework content area VII A (Establishing Healthy Practices) or B (Ensuring Safety).
(c) Substitutes and adult caregivers who provide care for 500 or fewer hours per year must complete a minimum of one hour of training each calendar year, and the training must include the requirements in subdivisions 3, 4, 5, 6, and 9.
Subd. 9.
Other required training requirements.
(a) The training required of family and group family child care providers and staff must include training in the cultural dynamics of early childhood development and child care. The cultural dynamics and disabilities training and skills development of child care providers must be designed to achieve outcomes for providers of child care that include, but are not limited to:
(1) an understanding and support of the importance of culture and differences in ability in children's identity development;
(2) understanding the importance of awareness of cultural differences and similarities in working with children and their families;
(3) understanding and support of the needs of families and children with differences in ability;
(4) developing skills to help children develop unbiased attitudes about cultural differences and differences in ability;
(5) developing skills in culturally appropriate caregiving; and
(6) developing skills in appropriate caregiving for children of different abilities.
The commissioner shall approve the curriculum for cultural dynamics and disability training.
(b) The provider must meet the training requirement in section 142B.41, subdivision 9, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child care or group family child care home to use the swimming pool located at the home.
Subd. 10.
Supervising for safety; training requirement.
(a) Courses required by this subdivision must include the following health and safety topics:
(1) preventing and controlling infectious diseases;
(2) administering medication;
(3) preventing and responding to allergies;
(4) ensuring building and physical premises safety;
(5) handling and storing biological contaminants;
(6) preventing and reporting child abuse and maltreatment; and
(7) emergency preparedness.
(b) Before initial licensure and before caring for a child, all family child care license holders and each second adult caregiver shall complete and document the completion of the six-hour Supervising for Safety for Family Child Care course developed by the commissioner.
(c) The license holder must ensure and document that, before caring for a child, all substitutes have completed the four-hour Basics of Licensed Family Child Care for Substitutes course developed by the commissioner, which must include health and safety topics as well as child development and learning.
(d) The family child care license holder and each second adult caregiver shall complete and document:
(1) the annual completion of either:
(i) a two-hour active supervision course developed by the commissioner; or
(ii) any courses in the ensuring safety competency area under the health, safety, and nutrition standard of the Knowledge and Competency Framework that the commissioner has identified as an active supervision training course; and
(2) the completion at least once every five years of the two-hour courses Health and Safety I and Health and Safety II. A license holder's or second adult caregiver's completion of either training in a given year meets the annual active supervision training requirement in clause (1).
(e) At least once every three years, license holders must ensure and document that substitutes have completed the four-hour Basics of Licensed Family Child Care for Substitutes course.
Subd. 11.
Approved training.
(a) The commissioner of children, youth, and families must post information on the department's website indicating the specific category within the Knowledge and Competency Framework that will satisfy training requirements for child development and learning, behavior guidance, and active supervision. County licensing staff must accept trainings designated as satisfying training requirements by the commissioner under this paragraph.
(b) Unless specifically authorized in this section, one training does not fulfill two different training requirements. Courses within the identified knowledge and competency areas that are specific to child care centers or legal nonlicensed providers do not fulfill the requirements of this section.
(c) County licensing staff must accept training approved by the Minnesota Center for Professional Development, including:
(1) face-to-face or classroom training;
(2) online training; and
(3) relationship-based professional development, such as mentoring, coaching, and consulting.
Subd. 12.
Provider training.
New and increased training requirements under this section must not be imposed on providers until the commissioner establishes statewide accessibility to the required provider training.
142B.71 FAMILY CHILD CARE HEALTH AND SAFETY REQUIREMENTS.
Subdivision 1.
Allergy prevention and response.
(a) Before admitting a child for care, the license holder must obtain information about any known allergy from the child's parent or legal guardian. The license holder must maintain current allergy information in each child's record. The allergy information must include a description of the allergy, specific triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for responding to an allergic reaction, including medication, dosages, and a doctor's contact information.
(b) The child's allergy information must be documented on a form approved by the commissioner, readily available to all caregivers, and reviewed annually by the license holder and each caregiver.
Subd. 2.
Handling and disposal of bodily fluids.
The licensed family child care provider must comply with the following procedures for safely handling and disposing of bodily fluids:
(1) surfaces that come in contact with potentially infectious bodily fluids, including blood and vomit, must be cleaned and disinfected as described in section 142B.76;
(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
(3) sharp items used for a child with special care needs must be disposed of in a "sharps container." The sharps container must be stored out of reach of a child; and
(4) the license holder must have the following bodily fluid disposal supplies available: disposable gloves, disposal bags, and eye protection.
Subd. 3.
Emergency preparedness plan.
(a) A licensed family child care provider must have a written emergency preparedness plan for emergencies that require evacuation, sheltering, or other protection of children, such as fire, natural disaster, intruder, or other threatening situation that may pose a health or safety hazard to children. The plan must be written on a form developed by the commissioner and updated at least annually. The plan must include:
(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
(2) a designated relocation site and evacuation route;
(3) procedures for notifying a child's parent or legal guardian of the evacuation, shelter-in-place, or lockdown, including procedures for reunification with families;
(4) accommodations for a child with a disability or a chronic medical condition;
(5) procedures for storing a child's medically necessary medicine that facilitate easy removal during an evacuation or relocation;
(6) procedures for continuing operations in the period during and after a crisis;
(7) procedures for communicating with local emergency management officials, law enforcement officials, or other appropriate state or local authorities; and
(8) accommodations for infants and toddlers.
(b) The license holder must train caregivers before the caregiver provides care and at least annually on the emergency preparedness plan and document completion of this training.
(c) The license holder must conduct drills according to the requirements in Minnesota Rules, part 9502.0435, subpart 8. The date and time of the drills must be documented.
(d) The license holder must have the emergency preparedness plan available for review.
Subd. 4.
Transporting children.
A license holder must ensure compliance with all seat belt and child passenger restraint system requirements under section 169.685.
Subd. 5.
Telephone requirement.
Notwithstanding Minnesota Rules, part 9502.0435, subpart 8, item B, a license holder is not required to post a list of emergency numbers. A license holder may use a cellular telephone to meet the requirements of Minnesota Rules, part 9502.0435, subpart 8, if the cellular telephone is sufficiently charged for use at all times.
142B.72 FAMILY CHILD CARE PHYSICAL SPACE REQUIREMENTS.
Subdivision 1.
Means of escape.
(a) At least one emergency escape route separate from the main exit from the space must be available in: (1) each room used for sleeping by anyone receiving licensed care; and (2) a basement used for child care. One means of escape must be a stairway or door leading to the floor of exit discharge. The other must be a door or window leading directly outside. A window used as an emergency escape route must be openable without special knowledge.
(b) In homes with construction that began before March 31, 2020, the interior of the window leading directly outside must have a net clear opening area of not less than 4.5 square feet or 648 square inches and have minimum clear opening dimensions of 20 inches wide and 20 inches high. The net clear opening dimensions shall be the result of normal operation of the opening. The opening must be no higher than 48 inches from the floor. The height to the window may be measured from a platform if a platform is located below the window.
(c) In homes with construction that began on or after March 31, 2020, the interior of the window leading directly outside must have minimum clear opening dimensions of 20 inches wide and 24 inches high. The net clear opening dimensions shall be the result of normal operation of the opening. The opening must be no higher than 44 inches from the floor.
Additional requirements are dependent on the distance of the openings from the ground outside the window: (1) windows or other openings with a sill height not more than 44 inches above or below the finished ground level adjacent to the opening (grade-floor emergency escape and rescue openings) must have a minimum opening of five square feet; and (2) non-grade-floor emergency escape and rescue openings must have a minimum opening of 5.7 square feet.
Subd. 2.
Door to attached garage.
(a) If there is an opening between an attached garage and a day care residence, there must be a door that is:
(1) a solid wood bonded-core door at least 1-3/8 inches thick;
(2) a steel insulated door at least 1-3/8 inches thick; or
(3) a door with a fire protection rating of 20 minutes.
(b) The separation wall on the garage side between the residence and garage must consist of 1/2-inch-thick gypsum wallboard or its equivalent.
Subd. 3.
Heating and venting systems.
(a) Notwithstanding Minnesota Rules, part 9502.0425, subpart 7, item C, items that can be ignited and support combustion, including but not limited to plastic, fabric, and wood products must not be located within:
(1) 18 inches of a gas or fuel-oil heater or furnace; or
(2) 36 inches of a solid-fuel-burning appliance.
(b) If a license holder produces manufacturer instructions listing a smaller distance, then the manufacturer instructions control the distance combustible items must be from gas, fuel-oil, or solid-fuel burning heaters or furnaces.
Subd. 4.
Fire extinguisher.
A portable, operational, multipurpose, dry chemical fire extinguisher with a minimum 2 A 10 BC rating must be located in or near the kitchen and cooking areas of the residence at all times. The fire extinguisher must be serviced annually by a qualified inspector. All caregivers must know how to properly use the fire extinguisher.
Subd. 5.
Carbon monoxide and smoke alarms.
(a) All homes must have an approved and operational carbon monoxide alarm installed within ten feet of each room used for sleeping children in care.
(b) Smoke alarms that have been listed by the Underwriter Laboratory must be properly installed and maintained in hallways outside of rooms used for sleeping children and on all levels, including basements but not including crawl spaces and uninhabitable attics.
(c) In homes with construction that began on or after March 31, 2020, smoke alarms must be installed and maintained in each room used for sleeping children in care.
Subd. 6.
Updates.
After readoption of the Minnesota State Fire Code, the fire marshal must notify the commissioner of any changes that conflict with this section and Minnesota Rules, chapter 9502. The state fire marshal must identify necessary statutory changes to align statutes with the revised code. The commissioner must recommend updates to sections of this chapter that are derived from the Minnesota State Fire Code in the legislative session following readoption of the code.
Subd. 7.
Fire code variances.
When a variance is requested of the standards contained in subdivision 1, 2, 3, 4, or 5, an applicant or provider must submit written approval from the state fire marshal of the variance requested and the alternative measures identified to ensure the safety of children in care.
Subd. 8.
Stairways.
(a) All stairways must meet the requirements in this subdivision.
(b) Stairways of four or more steps must have handrails on at least one side.
(c) Any open area between the handrail and stair tread must be enclosed with a protective guardrail as specified in the State Building Code. At open risers, openings located more than 30 inches or 762 millimeters as measured vertically to the floor or grade below must not permit the passage of a sphere four inches or 102 millimeters in diameter.
(d) Gates or barriers must be used when children aged six to 18 months are in care.
(e) Stairways must be well lit, in good repair, and free of clutter and obstructions.
142B.74 SUBSTITUTE CAREGIVERS AND REPLACEMENTS IN FAMILY CHILD CARE.
Subdivision 1.
Total hours allowed.
Notwithstanding Minnesota Rules, part 9502.0365, subpart 5, the use of a substitute caregiver in a licensed family child care program must be limited to a cumulative total of not more than 500 hours annually. The license holder must document the name, dates, and number of hours of the substitute who provided care.
Subd. 2.
Emergency replacement supervision.
(a) A license holder may allow an adult who has not completed the training requirements under this chapter or the background study requirements under chapter 245C to supervise children in a family child care program in an emergency. For purposes of this subdivision, an emergency is a situation in which:
(1) the license holder has begun operating the family child care program for the day and for reasons beyond the license holder's control, including, but not limited to a serious illness or injury, accident, or situation requiring the license holder's immediate attention, the license holder needs to leave the licensed space and close the program for the day; and
(2) the parents or guardians of the children attending the program are contacted to pick up their children as soon as is practicable.
(b) The license holder must make reasonable efforts to minimize the time the emergency replacement has unsupervised contact with the children in care, not to exceed 24 hours per emergency incident.
(c) The license holder shall not knowingly use a person as an emergency replacement who has committed an action or has been convicted of a crime that would cause the person to be disqualified from providing care to children, if a background study was conducted under chapter 245C.
(d) To the extent practicable, the license holder must attempt to arrange for emergency care by a substitute caregiver before using an emergency replacement.
(e) To the extent practicable, the license holder must notify the county licensing agency within seven days that an emergency replacement was used, and specify the circumstances that led to the use of the emergency replacement. The county licensing agency must notify the commissioner within three business days after receiving the license holder's notice that an emergency replacement was used, and specify the circumstances that led to the use of the emergency replacement.
(f) Notwithstanding the requirements in Minnesota Rules, part 9502.0405, a license holder is not required to provide the names of persons who may be used as replacements in emergencies to parents or the county licensing agency.
142B.75 FAMILY CHILD CARE INFANT SLEEP SUPERVISION REQUIREMENTS.
Subdivision 1.
In-person checks on infants.
(a) License holders of family child care programs that serve infants are encouraged to monitor sleeping infants by conducting in-person checks on each infant in their care every 30 minutes.
(b) Upon enrollment of an infant in a family child care program, the license holder is encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during the first four months of care.
(c) When an infant has an upper respiratory infection, the license holder is encouraged to conduct in-person checks on the sleeping infant every 15 minutes throughout the hours of sleep.
Subd. 2.
Use of audio or visual monitoring devices.
In addition to conducting the in-person checks encouraged under subdivision 1, license holders serving infants are encouraged to use and maintain an audio or visual monitoring device to monitor each sleeping infant in care during all hours of sleep.
142B.76 FAMILY CHILD CARE DIAPERING AREA DISINFECTION.
Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may disinfect the diaper changing surface with chlorine bleach in a manner consistent with label directions for disinfection or with a surface disinfectant that meets the following criteria:
(1) the manufacturer's label or instructions state that the product is registered with the United States Environmental Protection Agency;
(2) the manufacturer's label or instructions state that the disinfectant is effective against Staphylococcus aureus, Salmonella enterica, and Pseudomonas aeruginosa;
(3) the manufacturer's label or instructions state that the disinfectant is effective with a ten minute or less contact time;
(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing and use;
(5) the disinfectant is used only in accordance with the manufacturer's directions; and
(6) the product does not include triclosan or derivatives of triclosan.
142B.77 SUPERVISION OF FAMILY CHILD CARE LICENSE HOLDER'S OWN CHILD.
(a) Notwithstanding Minnesota Rules, part 9502.0365, subpart 5, and with the license holder's consent, an individual may be present in the licensed space, may supervise the family child care license holder's own child both inside and outside of the licensed space, and is exempt from the training and supervision requirements of this chapter and Minnesota Rules, chapter 9502, if the individual:
(1) is related to the license holder or to the license holder's child, as defined in section 142B.01, subdivision 15, or is a household member who the license holder has reported to the county agency;
(2) is not a designated caregiver, helper, or substitute for the licensed program;
(3) is involved only in the care of the license holder's own child; and
(4) does not have direct, unsupervised contact with any nonrelative children receiving services.
(b) If the individual in paragraph (a) is not a household member, the individual is also exempt from background study requirements under chapter 245C.
151.741 INSULIN MANUFACTURER REGISTRATION FEE.
Subd. 2.
Assessment of registration fee.
(a) The board shall assess each manufacturer an annual registration fee of $100,000, except as provided in paragraph (b). The board shall notify each manufacturer of this requirement beginning November 1, 2024, and each November 1 thereafter.
(b) A manufacturer may request an exemption from the annual registration fee. The board shall exempt a manufacturer from the annual registration fee if the manufacturer can demonstrate to the board, in the form and manner specified by the board, that gross revenue from sales of prescription insulin produced by that manufacturer and sold or delivered within or into Minnesota was less than five percent of the total gross revenue from sales of prescription insulin produced by all manufacturers and sold or delivered within or into Minnesota in the previous calendar year.
Subd. 3.
Payment of the registration fee; deposit of fee.
(a) Each manufacturer must pay the registration fee by March 1, 2025, and by each March 1 thereafter. In the event of a change in ownership of the manufacturer, the new owner must pay the registration fee that the original owner would have been assessed had the original owner retained ownership. The board may assess a late fee of ten percent per month or any portion of a month that the registration fee is paid after the due date.
(b) The registration fee, including any late fees, must be deposited in the insulin safety net program account.
Subd. 6.
Contingent transfer by commissioner.
If subdivisions 2 and 3, or the application of subdivisions 2 and 3 to any person or circumstance, are held invalid for any reason in a court of competent jurisdiction, the invalidity of subdivisions 2 and 3 does not affect other provisions of this act, and the commissioner of management and budget shall annually transfer from the health care access fund to the insulin safety net program account an amount sufficient to implement subdivision 4.
256B.0625 COVERED SERVICES.
Subd. 38.
Payments for mental health services.
Payments for mental health services covered under the medical assistance program that are provided by masters-prepared mental health professionals shall be 80 percent of the rate paid to doctoral-prepared professionals. Payments for mental health services covered under the medical assistance program that are provided by masters-prepared mental health professionals employed by community mental health centers shall be 100 percent of the rate paid to doctoral-prepared professionals. Payments for mental health services covered under the medical assistance program that are provided by physician assistants shall be 80.4 percent of the base rate paid to psychiatrists.
256B.198 PAYMENTS FOR NON-HOSPITAL-BASED GOVERNMENTAL HEALTH CENTERS.
(a) The commissioner may make payments to non-hospital-based health centers operated by a governmental entity for the difference between the expenditures incurred by the health center for patients eligible for medical assistance, and the payments to the health center for medical assistance permitted elsewhere under this chapter.
(b) The nonfederal share of payments authorized under paragraph (a) shall be provided through certified public expenditures authorized under section 256B.199, paragraph (b).
(c) Effective July 1, 2013, or no earlier than 12 months after implementation of a total cost of care demonstration project, Hennepin County may receive federal matching funds for certified public expenditures under paragraph (a), if the county participates in a total cost of care demonstration project under sections 256B.0755 and 256B.0756, or another total cost of care demonstration project approved by the commissioner, and the county exceeds the minimum performance threshold established by the commissioner for the demonstration project. The value of the federal matching funds for the certified public expenditures allocated to Hennepin County shall be equal to the value of savings achieved above the minimum performance threshold. The same proportion of federal matching funds for certified public expenditure allocated to Hennepin County based on savings achieved under the demonstration project shall continue after the demonstration project and must continue to be paid to Hennepin County each year thereafter.
(d) Beginning July 1, 2014, or no earlier than 12 months after the initial allocation under paragraph (c) if a portion of the federal matching funds for certified public expenditure remains with the state, the commissioner shall annually determine if the savings from county's total cost of care demonstration project exceeded the savings from the previous year and allocate federal matching funds for certified public expenditures to Hennepin County equal to the amount of savings achieved above the amount achieved in the previous year. The proportion of federal matching funds for certified public expenditure allocated to Hennepin County shall be paid to Hennepin County each year thereafter, until no federal matching funds for certified public expenditures under paragraph (a) remain with the state.
(e) Nothing under this section precludes Hennepin County from receiving an additional gain-sharing payment or relieves the county from paying a downside risk-sharing payment to the state under the demonstration project under section 256B.0755.
256B.69 PREPAID HEALTH PLANS.
Subd. 6i.
Directed pharmacy dispensing payment.
(a) The commissioner shall provide a directed pharmacy dispensing payment of $4.50 per filled prescription to eligible outpatient retail pharmacies in Minnesota to improve and maintain access to pharmaceutical services in rural and underserved areas of Minnesota. Managed care and county-based purchasing plans delivering services under section 256B.69 or 256B.692, and any pharmacy benefit managers under contract with these entities, must pay the directed pharmacy dispensing payment to eligible outpatient retail pharmacies for drugs dispensed to medical assistance enrollees. The directed pharmacy dispensing payment is in addition to, and must not supplant or reduce, any other dispensing fee paid by these entities to the pharmacy. Entities paying the directed pharmacy dispensing payment must not reduce other payments to the pharmacy as a result of payment of the directed pharmacy dispensing payment.
(b) For purposes of this subdivision, "eligible outpatient retail pharmacy" means an outpatient retail pharmacy licensed under chapter 151 that is not owned, either directly or indirectly or through an affiliate or subsidiary, by a pharmacy benefit manager licensed under chapter 62W or a health carrier, as defined in section 62A.011, subdivision 2, and that:
(1) is located in a medically underserved area or primarily serves a medically underserved population, as defined by the United States Department of Health and Human Services Health Resources and Services Administration under United States Code, title 42, section 254; or
(2) shares common ownership with 13 or fewer Minnesota pharmacies.
(c) In order to receive the directed pharmacy dispensing payment, a pharmacy must submit to the commissioner a form, developed by the commissioner, attesting that the pharmacy meets the requirements of paragraph (b).
(d) Managed care and county-based purchasing plans, and any pharmacy benefit managers under contract with these entities, shall pay the directed pharmacy dispensing payment to eligible outpatient retail pharmacies. The commissioner shall monitor the effect of this requirement on access to pharmaceutical services in rural and underserved areas of Minnesota. If, for any contract year, federal approval is not received for this subdivision, the commissioner must adjust the capitation rates paid to managed care plans and county-based purchasing plans for that contract year to reflect removal of this subdivision. Contracts between managed care plans and county-based purchasing plans, and any pharmacy benefit managers under contract with these entities, and providers to whom this subdivision applies must allow recovery of payments from those providers if capitation rates are adjusted in accordance with this paragraph. Payment recoveries must not exceed the amount equal to any increase in rates that results from this subdivision. This subdivision expires if federal approval is not received for this subdivision at any time.
(e) This subdivision expires on December 31, 2026.
260.63 DEFINITIONS.
Subd. 9.
Disproportionality.
"Disproportionality" means the overrepresentation of African American children and other disproportionately represented children in Minnesota's child welfare system population as compared to the representation of those children in Minnesota's total child population.
Repealed Minnesota Rule: S4612-2
9502.0300 REPEALER AND EFFECTIVE DATE.
Subpart 1.
Repealer.
Minnesota Rules, parts 9545.0310, 9545.0320, 9545.0330, 9545.0340, 9545.0350, 9545.0360, 9545.0370, 9545.0380, 9545.0390, 9545.0400, 9545.0410, 9545.0420, 9545.0430, 9545.0440, and 9545.0450, are repealed, except for providers who are licensed under those parts. As to those providers, parts 9545.0310, 9545.0320, 9545.0330, 9545.0340, 9545.0350, 9545.0360, 9545.0370, 9545.0380, 9545.0390, 9545.0400, 9545.0410, 9545.0420, 9545.0430, 9545.0440, and 9545.0450 are repealed March 25, 1986.
Subp. 2.
Effective date.
Parts 9502.0315 to 9502.0445 take effect April 1, 1985, except for providers who are licensed on April 1, 1985 under parts 9545.0310 to 9545.0440. As to those providers, parts 9502.0315 to 9502.0445 take effect October 1, 1985, or on the first date the provider's license is renewed after March 25, 1985, whichever is later, except that parts 9502.0365 and 9502.0367 shall be construed not to require the exclusion from the day care facility of any child who is receiving care on March 25, 1985.
Any provider who is licensed under parts 9545.0310 to 9545.0440 April 1, 1985, and who is not providing care in a residence as defined by part 9502.0315, subpart 27, may be licensed under parts 9502.0315 to 9502.0445 until the provider ceases to give care in that facility or obtains a license to operate a day care center.
9502.0315 DEFINITIONS.
Subpart 1.
Applicability.
As used in parts 9502.0315 to 9502.0445, the following terms have the meanings given them.
Subp. 3.
Agency.
"Agency" means the county or multicounty social or human service agency governed by the county board or multicounty human services board.
Subp. 4.
Applicant.
"Applicant" means the person seeking a license to be the primary provider of day care in the residence.
Subp. 5.
Building official.
"Building official" means the person appointed in accordance with Minnesota Statutes, section 326B.133, to administer the State Building Code, or the building official's authorized representative.
Subp. 6.
Caregiver.
"Caregiver" means the provider, substitute, helper, or another adult giving care in the residence.
Subp. 8.
Commissioner.
"Commissioner" means the Minnesota commissioner of the Department of Human Services or the commissioner's authorized representative.
Subp. 9.
Day care.
"Day care" means the care of a child in a residence outside the child's own home for gain or otherwise, on a regular basis, for any part of a 24 hour day.
Subp. 11.
Family day care.
"Family day care" means day care for no more than ten children at one time of which no more than six are under school age. The licensed capacity must include all children of any caregiver when the children are present in the residence.
Subp. 12.
Fire marshal.
"Fire marshal" means the person designated by Minnesota Statutes, section 299F.011 to administer and enforce the State Fire Code, or the fire marshal's authorized representative.
Subp. 13.
Group family day care.
"Group family day care" means day care for no more than 14 children at any one time. The total number of children includes all children of any caregiver when the children are present in the residence.
Subp. 14.
Helper.
"Helper" means a person at least 13 years of age and less than 18 years of age who assists the provider with the care of children.
Subp. 15.
Agent of a community health board.
"Agent of a community health board" as authorized under Minnesota Statutes, section 145A.04, means the designated representative of the state or community health board authorized to enforce state and local health codes.
Subp. 16.
Infant.
"Infant" means a child who is at least six weeks of age but less than 12 months of age.
Subp. 17.
License.
"License" means a certificate issued by the commissioner authorizing the provider to give specified services for a specified period of time in accordance with the terms in parts 9502.0315 to 9502.0445; Minnesota Statutes, chapter 245A; and the rules of the department.
Subp. 18.
Licensed capacity.
"Licensed capacity" means the total number of children ten years of age or younger permitted at any one time in the residence. The licensed capacity includes all children of any caregiver when the children are present in the residence.
Subp. 19.
Medicine.
"Medicine" means a prescription or nonprescription substance taken internally or applied externally to prevent or cure disease, heal, or relieve pain.
Subp. 19a.
Mental illness.
"Mental illness" means the inability to interpret reality realistically and the impaired functioning in primary aspects of daily living, such as personal relations, living arrangements, work, and recreation; which is listed in the International Classification of Diseases (ICD-9-CM) Ninth Revision (1980), code range 290.0-299.9, or the corresponding code in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) Third Edition (1980), Axes I, II, or III. These publications are incorporated by reference and are not subject to frequent change. They are available in the State Law Library.
Subp. 19b.
State Fire Code.
"State Fire Code" means those codes and regulations adopted by the state fire marshal in accordance with Minnesota Statutes, section 299F.011 and contained in chapter 7511.
Subp. 21.
Parent.
"Parent" means a person who has the legal responsibility for a child such as the child's mother, father, or legally appointed guardian.
Subp. 22.
Preschooler.
"Preschooler" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 19, paragraph (e).
Subp. 25.
Related.
"Related" means any of the following relationships by marriage, blood, or adoption: parent, grandparent, brother, sister, stepparent, stepsister, stepbrother, uncle, aunt, child, niece, nephew. Related also includes a legally appointed guardian.
Subp. 26.
Regularly or regular basis.
"Regularly" or "regular basis" means a cumulative total of more than 30 days within any 12 month period.
Subp. 27.
Residence.
"Residence" means the dwelling unit, as defined by section 405 of the State Building Code, in which day care is provided and which is occupied as a home.
Subp. 28.
School age.
"School age" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 19, paragraph (f).
Subp. 28a.
State Building Code.
"State Building Code" means those codes and regulations adopted by the commissioner of administration in accordance with Minnesota Statutes, section 326B.101 and contained in chapter 1300.
Subp. 29.
Substitute.
"Substitute" means an adult at least 18 years of age who assumes the responsibility of the provider as specified in part 9502.0365, subpart 5.
Subp. 29a.
Supervision.
"Supervision" means a caregiver being within sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver is capable of intervening to protect the health and safety of the child. For the school age child, it means a caregiver being available for assistance and care so that the child's health and safety is protected.
9502.0325 LICENSING OF FACILITIES FOR CHILDREN FAMILY DAY CARE AND GROUP FAMILY DAY CARE HOMES.
Subpart 1.
Purpose.
The purpose of parts 9502.0315 to 9502.0445 is to establish procedures and standards for licensing family day care and group family day care homes to ensure that minimum levels of care and service are given and the protection, proper care, health, safety, and development of the children are assured.
Subp. 2.
Applicability.
Parts 9502.0315 to 9502.0445 as authorized by Minnesota Statutes, chapter 245A, govern the licensing of family day care homes and group family day care homes.
9502.0335 LICENSING PROCESS.
Subpart 1.
License application.
A license to operate a family or group family day care residence must be obtained from the department.
A.
Application for a license must be made on the application form issued by the department. The application must be made in the county where the applicant resides.
B.
The applicant shall be the person who will be the provider of care in the residence, present during the hours of operation, and who shall be legally responsible for the operation of the residence.
C.
An application for licensure is complete when the applicant completes, signs, and submits all department forms and documentation needed for licensure to the agency and the agency receives all inspection, zoning, evaluation, and investigative reports, documentation, and information required to verify compliance with parts 9502.0315 to 9502.0445 and Minnesota Statutes.
Subp. 2.
Licensing study.
The applicant shall give the agency access to the residence for a licensing study to determine compliance with parts 9502.0315 to 9502.0445.
A.
If, in the judgment of the agency representative, a potentially hazardous condition may be present, due to a violation of parts 9502.0315 to 9502.0445, the applicant shall obtain an inspection from a fire marshal, building official, or agent of a community health board as authorized under Minnesota Statutes, section 145A.04 to verify the absence of hazard and report to the agency.
B.
The residence must comply with any applicable local ordinances. If the commissioner or the agency has reasonable cause to believe a hazardous condition may be present and requests an inspection by a fire marshal, building official, or authorized agent, then any condition cited by a fire marshal, building official, or authorized agent as hazardous and creating an immediate danger of fire, or threat to human life and safety, must be corrected or a variance approved in accordance with subparts 8, 8a, and 8b prior to issuance of a license.
C.
An initial inspection of the residence by a fire marshal to determine compliance with the State Fire Code and compliance with orders issued are conditions of licensure for all residences with freestanding solid fuel heating appliances; manufactured (mobile) homes; new applicants for licensure with a licensed capacity of more than ten; day care residences which use the basement for child care; and residences in mixed or multiple occupancy buildings. "Multiple occupancy building" means a structure with two or more residential dwelling units such as a duplex, apartment building, or townhome. "Mixed occupancy building" means a residence in a structure that contains nonresidential occupancies or an attached garage.
D.
The commissioner or agency may require, prior to licensure, or anytime during the licensed term of day care, a physical, mental illness, or chemical dependency or abuse evaluation of any caregiver or person living in the residence or present during the hours children are in care if the agency has reasonable cause to believe that any of the disqualification factors in subpart 6, item A, exist, or that the provider is not physically able to care for the children. These evaluations, conducted by a licensed physician, psychiatrist, psychologist, consulting psychologist, or certified chemical dependency practitioner or counselor may be used to verify physical or mental illness, chemical dependency or chemical abuse, or behavior that would reflect on the ability of the provider to give day care.
Subp. 4.
Period of licensure; nontransfer.
A license must be issued by the department when the provider fully complies with parts 9502.0315 to 9502.0445. The period of licensure may be up to two years. The license must not be transferred to another provider.
Subp. 5.
Initial license.
An applicant for initial licensure may be granted a license by the department for up to two years if all laws and rules cannot be met immediately, the deviations from parts 9502.0315 to 9502.0445 do not threaten the health, rights, or safety of the children, and which will be corrected within the time specified by the commissioner but not to exceed two years. Failure to correct deviations within the stated time shall be cause for revocation, suspension, or nonrenewal.
Subp. 6.
Disqualification factors.
An applicant or provider shall not be issued a license or the license shall be revoked, not renewed, or suspended if the applicant, provider, or any other person living in the day care residence or present during the hours children are in care, or working with children:
A.
Abuses prescription drugs or uses controlled substances as specified in Minnesota Statutes, chapter 152, or alcohol, to the extent that the use or abuse has or may have a negative effect on the ability of the provider to give care or is apparent during the hours children are in care. Caregivers who have abused prescription drugs or have been dependent on controlled substances as specified in Minnesota Statutes, chapter 152, or alcohol, such that the use, abuse, or dependency has had a negative effect on the ability to give care, was apparent during the hours children are in care, or required treatment or therapy, must have 12 months of verified abstinence before licensure.
C.
Refuses to give written consent for the disclosure of criminal history records as specified in Minnesota Statutes, section 245C.09.
D.
Has a disqualification under Minnesota Statutes, section 245C.15, that is not set aside under Minnesota Statutes, section 245C.22, or for which a variance has not been granted under Minnesota Statutes, section 245C.30.
E.
Has had a child placed in foster care within the past 12 months and the agency determines the reasons for placement reflect on the ability of the provider to give care. A license may not be denied if the primary reason for the placement was due to a physical illness of the parent, developmental disability of the child, a disability of the child, or for the temporary care of an infant being relinquished for adoption.
F.
Has had a child placed in residential treatment within the past 12 months for emotional disturbance or antisocial behavior and the agency determines that the reasons for the placement reflect on the ability of the provider to give care.
Subp. 8.
Variance standard.
An applicant or provider may request a variance from compliance with parts 9502.0315 to 9502.0445. When reviewing a variance request of parts 9502.0315 and 9502.0445, the department shall assess whether alternative methods are identified by the applicant or provider to ensure the health, safety, and protection of children in care. A variance may be granted only if:
B.
specific equivalent measures are identified by the applicant or provider to ensure the health, safety, and protection of the children in care;
C.
any variance to the safety provisions in part 9502.0425, subparts 4, 5, 6, 7, 12, 15, 16, 17, and 18 which relate to the State Fire Code is approved by a fire marshal and alternative measures are identified to ensure the safety of children in care;
D.
any variance of the provisions in part 9502.0435 relating to sanitation and health and part 9502.0445 on water, food, and nutrition are approved by an authorized agent and alternative measures are identified to ensure the health of children in care;
E.
any variance of the provisions in part 9502.0425 relating to subparts 10, stairways; 11, decks; and 13, sewage disposal which relate to the State Building Code, are approved by a building official and alternative measures are identified to ensure the health and safety of children in care; and
F.
any variance to subpart 6, item F must have clear and convincing evidence presented by the applicant or provider that no threat or harm whatsoever will result to the children in care due to the granting of the variance. The department shall consider the nature of the crime committed and the amount of time which has elapsed without a repeat of the crime.
Subp. 8a.
Variance procedure.
Request for a variance must comply with and be handled according to the following procedures.
A.
An applicant or provider must submit to the agency a written request for a variance. The request must include the following information:
(1)
the sections of parts 9502.0315 to 9502.0445 with which the applicant or provider cannot comply;
(4)
the specific equivalent alternative measures which the applicant or provider will provide so the health, safety, and protection of children in care are ensured if the variance is granted.
B.
An applicant or provider must submit to the agency written approval from a fire marshal of a variance request and the alternative measures identified to ensure the safety of children in care when a variance of the fire safety provisions in part 9502.0425 on physical environment is requested. These are part 9502.0425, subpart 4, means of escape; subpart 5, occupancy separations; subpart 6, vertical separations; subpart 7, heating and venting systems; subpart 12, locks and latches; subpart 15, interior walls and ceilings; subpart 16, extinguishers; subpart 17, smoke detection systems; and subpart 18, electrical services.
C.
An applicant or provider must submit to the agency written approval from an authorized agent of a variance request and the alternative measures identified to ensure the safety of children in care when a variance of the health provisions in parts 9502.0435 on sanitation and health, and 9502.0445 on water, food, and nutrition is requested.
D.
An applicant or provider must submit to the agency written approval from a building official of a variance request and alternative measures identified to ensure the health and safety of children in care when a variance is requested of the standards contained in part 9502.0425 relating to subparts 10, stairways; 11, decks; and 13, sewage disposal.
Subp. 10.
Posting license.
The provider shall post the license in the residence in a prominent place.
Subp. 11.
Change in license terms.
The following shall apply to changes in the terms of a license.
A.
A new department application form must be submitted by the provider and a full licensing study as specified in part 9502.0335, subpart 2, must be completed when the provider wants to move the day care operation to a new residence or the provider wants to change to group family day care from family day care.
B.
A new department application form indicating the changes in the ages and numbers of children in care must be completed when the provider wants to change to family day care from group family day care.
C.
A background study must be initiated and completed as required under Minnesota Statutes, chapter 245C.
Subp. 12.
Number of licenses.
No provider shall be issued a license to operate more than one day care residence.
Subp. 13.
Access to residence.
The provider shall give authorized representatives of the commissioner or agency access to the residence during the hours of operation to determine whether the residence complies with the standards of parts 9502.0315 to 9502.0445. Access shall include:
B.
any adjoining land or buildings owned or operated by the applicant or provider in conjunction with the provision of day care and designed for use by the children in care;
C.
noninterference in interviewing all caregivers and household members present in the residence on a regular basis and present during the hours of operation; and
Subp. 15.
Return of license to commissioner.
When a provider stops giving care, or if a license is revoked, suspended, or not renewed, the provider shall return the license to the commissioner, stop all advertising and refrain from providing care to children in excess of the exclusions specified in part 9502.0325, subpart 3.
9502.0341 NEGATIVE LICENSING ACTIONS.
Subp. 2.
Definitions.
For the purposes of this subpart, negative licensing actions shall mean denial of application for licensure, issuance of a fine, revocation, suspension, or temporary immediate suspension of an existing license.
Subp. 3.
Procedures.
In accordance with Minnesota Statutes, section 245A.06 or 245A.07, failure to comply with parts 9502.0315 to 9502.0445 or the terms of licensure is grounds for a negative licensing action. If the agency recommends a negative licensing action, the agency shall notify the department and the department shall determine if the standards in parts 9502.0315 to 9502.0445 or the terms of licensure have been violated. If the grounds are sufficient, the commissioner shall notify the applicant or provider by certified mail unless personal service is required by subpart 9. The notice must be addressed to the name and location shown on the application or license and contain a statement of, and the reasons for, the proposed action. The notice must inform the applicant or provider of the right to appeal the decision within the specified time period. The applicant or provider shall be notified of the specific appeal rights provided under chapter 245A.
Subp. 3a.
Fine.
If the commissioner issues a fine, the provider must be informed of the reason for the fine and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivision 3.
Subp. 4.
Denial.
If the commissioner denies an application for licensure, the applicant must be informed of the reason the application was denied and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.05.
Subp. 5.
Revocation.
If the commissioner revokes a license, the provider must be informed of the reason for the revocation and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivision 3.
Subp. 8.
Suspension.
If the commissioner suspends a license, the provider must be informed of the reason for the suspension and the right to a contested case hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivision 3.
Subp. 9.
Temporary immediate suspension.
If the provider's actions or failure to comply with applicable law or rule poses an imminent risk of harm to the health, safety, or rights of the children in care, the commissioner shall act immediately to temporarily suspend the license. The provider shall be informed by personal service and informed of the right to an expedited hearing under Minnesota Statutes, chapter 14, and parts 1400.8505 to 1400.8612 as provided in Minnesota Statutes, section 245A.07, subdivisions 2 and 2a.
Subp. 10.
Notice to parents of recommended action.
As soon as the county recommends revocation, suspension, a conditional license, or temporary immediate suspension action, a notice of the circumstances for the action, but not the identity of a child, other than the parent's own, shall be sent by the agency to the parents of children in care. If the provider remains in operation and exercises a right to a hearing, the provider must give a copy of the Notice of and Order for Hearing on the appeal to the parents of any child currently enrolled or seeking admission to the residence.
Subp. 11.
Reapplication after revocation or denial.
A provider whose license has been revoked because of noncompliance with applicable laws or rules, shall not be granted a new license for five years following revocation. When the commissioner initiates an action to revoke a license, the provider may not voluntarily withdraw his or her license without written assurance from the provider that he or she is voluntarily accepting revocation and will not reapply for five years. An applicant whose application was denied shall not be granted a new license for two years following a denial, unless the applicant's subsequent application contains new information which constitutes a substantial change in the condition that caused the previous denial.
9502.0345 AGENCY RECORDS.
Subpart 1.
Agency records.
The agency shall maintain the following records for each provider:
C.
Any written reports from the fire marshal, agent of a community health board as authorized under Minnesota Statutes, section 145A.04, or building official.
E.
If the applicant has been licensed through another jurisdiction, the agency shall request and keep a reference from the licensing authority in that jurisdiction.
F.
The annual relicensing evaluation by the agency of the provider. Any comments of the provider about the evaluation by the agency shall also be noted in the agency record.
H.
Arrest, conviction, or criminal history information and substantiated maltreatment information used to disqualify an individual required to have a background study under Minnesota Statutes, chapter 245C.
Subp. 2.
Data privacy.
The agency, department, and the authorized agent shall have access to provider records on children in care to determine compliance with parts 9502.0315 to 9502.0445. The provider shall not disclose any records on children in care to any persons other than the parents of the child, the agency, the department, the persons required by part 9502.0375, subpart 1, and medical or public safety persons if information is necessary to protect the health and safety of the child.
9502.0355 CAREGIVER QUALIFICATIONS.
Subpart 1.
Age.
An applicant for family day care or group family day care shall be an adult at the time of licensure.
Subp. 2.
Health.
An adult caregiver shall be physically able to care for children.
A.
The applicant shall supply documentation to the agency with the license application that the applicant has had a physical examination from a licensed physician within 12 months prior to initial licensure and is physically able to care for children.
B.
The applicant shall supply documentation to the agency with the license application that all adult caregivers who are assisting with care on a regular basis have had a physical examination from a licensed physician within 12 months prior to employment within the residence and are physically able to care for children.
Subp. 3.
Group family day care.
A group family day care applicant shall meet all the requirements listed in subparts 1 and 2 for family day care. A group family day care applicant shall also meet the qualifications in item A, B, or C.
A.
A minimum of one years' substantial compliance with parts 9502.0315 to 9502.0445 as a licensed family day care provider; or
B.
A minimum of six months' substantial compliance with parts 9502.0315 to 9502.0445 as a licensed family day care provider; and
(1)
completion of an accredited competency based family day care training and assessment program offered by an accredited institute; or
(2)
thirty hours of child care, health, and nutrition training as specified in part 9502.0385, and a minimum of 520 hours of experience as an assistant teacher, student teacher, or intern in an elementary school or licensed child care center, or as an assistant adult caregiver in a licensed group family day care home; or
C.
Certification or licensure indicating:
(1)
completion of a two year child development or early childhood education associate or certificate program at an accredited college or university;
(2)
completion of a nine month child development assistant program at an accredited technical college;
(4)
a kindergarten through sixth grade teaching degree from an accredited university or college that includes a minimum of 30 hours of child development training; or
(5)
documentation of a minimum of six months satisfactory experience as a full-time teacher at a state licensed group day care center.
Subp. 3a.
Accredited.
For the purposes of this part, "accredited" means a postsecondary institution or technical college recognized and listed by a regional, state, or national group approved by the department. To be approved, a group must meet the following criteria:
C.
it must have standards which ensure that persons who complete the program have the knowledge and training to work as group family day care providers; and
D.
it must not be affiliated with any individual program, postsecondary institution, or technical college.
Subp. 4.
Day care insurance coverage.
A provider shall have:
A.
a certificate of insurance for the residence for general liability coverage for bodily injury in the amount of at least $100,000 per person and $250,000 per occurrence; or
B.
if the provider has liability coverage of lesser limits or no liability coverage, the provider shall give a written notice of the level of liability coverage to parents of all children in care prior to admission or when there is a change in the amount of insurance coverage; and
9502.0365 LICENSED CAPACITY, CHILD/ADULT RATIOS, AGE DISTRIBUTION RESTRICTIONS.
Subpart 1.
Capacity limits.
Family day care and group family day care providers shall comply with part 9502.0367, which limits the total number of children and the number of preschoolers, toddlers, and infants who may be in care at any one time, and provides for the number of adults who are required to be present.
A.
Providers shall be licensed for the total number of children, ten years of age or younger, who are present in the residence at any one time. The licensed capacity must include all children of any caregiver when the children are present in the residence.
B.
Within the licensed capacity, the age distribution restrictions specify the maximum number of children under school age, infants, and toddlers who are in care at any one time.
Subp. 2.
Specialized infant and toddler group family day care.
In specialized infant and toddler group family day care, the caregivers must be adults.
Subp. 3.
Newborn care.
When a newborn is in care and only one adult caregiver is present, the newborn shall be the only child under 12 months of age and the provider shall not care for more than two other children at the same time unless another adult caregiver is also present or the newborn is the provider's own.
Subp. 4.
Helpers.
A helper may be used in place of a second adult caregiver when there is no more than one infant or toddler present.
Subp. 5.
Supervision and use of substitutes.
A licensed provider must be the primary provider of care in the residence. Children in care must be supervised by a caregiver. The use of a substitute caregiver must be limited to a cumulative total of not more than 30 days in any 12-month period.
9502.0367 CHILD/ADULT RATIOS; AGE DISTRIBUTION RESTRICTIONS.
A.
Family Day Care:
| Child/Adult Ratio | Age Restrictions | ||
| Licensed Capacity | Adults | Total children under school age | Total infants and toddlers |
| 10 | 1 | 6 | Of the total children under school age, a combined total of no more than 3 shall be infants and toddlers. Of this total, no more than 2 shall be infants. |
B.
Specialized Infant and Toddler Family Day Care:
| (1) 5 | 1 | 3 | No more than 3 shall be infants. |
| (2) 6 | 1 | 4 | No more than 2 shall be infants. |
C.
Group Family Day Care:
| (1) 10 | 1 | 8 | Of the total children under school age, a combined total of no more than 3 shall be infants and toddlers. Of this total, no more than 2 shall be infants. |
| (2) 12 | 1 | 10 | Of the total children under school age, a combined total of no more than 2 shall be infants and toddlers. Of this total, no more than 1 shall be an infant. |
| (3) 14 | 2 | 10 | Of the total children under school age, a combined total of no more than 4 shall be infants and toddlers. Of this total, no more than 3 shall be infants. |
| A helper may be used in place of a second adult caregiver when there is no more than 1 infant or toddler present. | |||
D.
Specialized Infant and Toddler Group Family Day Care:
| 9 | 2 | 7 | Of the total children, no more than 4 shall be infants. |
| Both caregivers shall be adults. | |||
9502.0375 REPORTING TO AGENCY.
Subpart 1.
Abuse, neglect reporting.
All caregivers shall report any suspected physical abuse, sexual abuse, or neglect of a child to the agency or police as required by Minnesota Statutes, chapter 260E. If a caregiver has reasonable cause to believe a child has died as a result of physical or sexual abuse or neglect, the caregiver shall report this information to the county medical examiner or coroner.
Subp. 2.
Other reporting.
The provider shall inform the agency:
A.
within 30 days of any change in the regular membership of the household within the day care residence or the addition of an employee who will regularly be providing care;
C.
within 48 hours after the occurrence of a fire that requires the service of a fire department so the agency may determine continued substantial compliance with parts 9502.0315 to 9502.0445; and
D.
immediately after the occurrence of any serious injury or death of a child within the day care residence. A serious injury is one that is treated by a physician.
9502.0395 BEHAVIOR GUIDANCE.
Subpart 1.
Methods.
Caregivers shall give each child guidance which helps the child acquire a positive self-concept, self-control, and teaches acceptable behavior.
A.
The provider shall discuss methods of behavior guidance with parents at the time of admission and the parent's standards shall be considered by the provider within the context of this part when guiding the behavior of a child.
B.
Behavior guidance used by caregivers must be constructive, positive, and suited to the age of the child. Methods of intervention, guidance, and redirection must be used.
Subp. 2.
Standards.
The following shall apply to all caregivers when guiding behavior in children.
A.
No child shall be subject to corporal punishment or emotional abuse. "Corporal punishment" means the nonaccidental infliction of physical pain on a child by a caregiver. Corporal punishment includes, but is not limited to, rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking. "Emotional abuse" means the infliction of verbal or psychological abuse on a child by a caregiver. Emotional abuse includes, but is not limited to, name calling, ostracism, shaming, derogatory remarks about the child or child's family, and threats which threaten, humiliate, or frighten the child.
D.
The separation of a child from a group to guide behavior must be appropriate to the age of the child and circumstances requiring the separation.
G.
A child separated from the group must be placed in an area or separate room that is well-lighted, free from hazards, ventilated, and open to the view of caregivers.
9502.0405 ADMISSIONS; PROVIDER RECORDS; REPORTING.
Subpart 1.
Cooperating with parents.
When admitting a child to day care, the provider and parents shall discuss child rearing, sleeping, feeding, and behavior guidance practices essential for the care of the child.
Subp. 2.
Rule summary for parents.
A descriptive summary of parts 9502.0315 to 9502.0445 shall be distributed to the parent by the provider at the time a child is admitted to care. The summary shall be provided by the department to the agency for distribution to the provider. The summary shall be written in language that is understandable to the general public and:
C.
state that a complete copy of parts 9502.0315 to 9502.0445 may be seen at the day care residence, the agency, department, or State Law Library, or purchased from the Print Communications Division, Department of Administration, State of Minnesota, 117 University Avenue, Saint Paul, Minnesota 55155.
Subp. 3.
Provider policies.
The provider shall have the following written information available for discussion with parents or the agency:
G.
policies for the care of ill children, disease notification procedures, immunizations, and medicine permission policies;
Subp. 4.
Records for each child.
The provider shall obtain the information required by items A to C from parents prior to admission of a child. The provider shall keep this information up-to-date and on file for each child.
A.
The signed and completed admission and arrangements form of the department must be on file in the provider's home and contain the following information:
(4)
Name, address, and telephone number of physician, dentist, and hospital to be used for emergencies when parents cannot be reached.
(5)
Name, address, and telephone number of persons to be notified in case of emergency, when parents cannot be reached.
B.
Special instructions from the parent shall be obtained in writing and followed about toilet training, eating, sleeping or napping, allergies, and any health problems.
C.
Immunization records must be kept in accordance with Minnesota Statutes, section 121A.15. The provider shall request, update, and keep on file the dates of immunizations received by a child in regular attendance at the residence as follows:
D.
Signed written consent must be obtained in advance from the parent so the provider can obtain emergency medical care or treatment. The consent may be used if the parent cannot be reached or is delayed in arriving.
E.
Written permission to transport children must be obtained from parents if the provider will be transporting a child.
F.
A provider shall release a child from care only to a parent or a person authorized by the parent.
Subp. 5.
Children with disabilities.
For children with disabilities requiring special therapy, program, or behavior guidance, the parents, physician, or therapist shall provide and the provider shall follow written instructions for any special needs. "Child with a disability" means a child who has been determined by a physician, a school district multidisciplinary team, or other person licensed to identify disabling conditions, to have a hearing, mental, neurological, developmental, serious emotional, social, learning, speech or language, physical, or visual impairment.
Subp. 6.
Nondiscrimination.
No caregiver shall discriminate in relation to admissions on the basis of race, creed, color, national origin, religion, or sex.
9502.0415 ACTIVITIES AND EQUIPMENT.
Subpart 1.
General activities.
Day care activities must provide for the physical, intellectual, emotional, and social development of the child. The environment must facilitate the implementation of the activities. Activities must:
Subp. 3.
Equipment.
The provider must have the equipment specified in this part in adequate quantities for the number and ages of children in care and to carry out the activities specified in this part. Equipment may be new, used, commercial, or homemade, as long as it is appropriate for the ages of the children and activities for which it will be used, safe, and in good repair.
Subp. 4.
Newborn or infant activities.
The provider shall:
A.
Hold the infant or newborn during bottle feedings until the child can hold its own bottle. Bottles must not be propped.
C.
Provide freedom of movement to the infant or newborn during a large part of the waking day to the extent that safety and weather permits. The noncreeping child shall spend part of each day out of a crib or infant seat. The creeping infant or newborn shall have freedom to explore outside of the crib or infant seat.
D.
Give the infant or newborn opportunity to stimulate the senses by providing a variety of activities and objects to see, touch, feel, smell, hear, and taste.
E.
Provide activities for the infant or newborn that develop the child's manipulative and fine motor skills, self-awareness, and social responsiveness.
Subp. 5.
Newborn or infant equipment.
The following minimum equipment is required for each infant or newborn:
Subp. 6.
Toddler activities.
The provider shall:
A.
Provide the toddler with freedom of movement and freedom to explore outside the crib or playpen.
C.
Provide the toddler with large muscle activities and activities which develop the child's small muscles and manipulative skills.
D.
Develop and stimulate learning by reading stories to the child or looking at picture books together.
E.
Give the toddler opportunities to stimulate the senses by providing a variety of age-appropriate activities and objects to see, touch, feel, smell, hear, and taste.
Subp. 7.
Toddler equipment.
Each toddler shall be provided with a mat, crib, cot, bed, sofa, or sleeping bag.
Subp. 8.
Preschooler activities.
The provider shall:
B.
Provide opportunity to play near and with other children; provide time and space for individual and group play; allow for quiet times to talk or rest; allow for unplanned time and individual play time.
C.
Foster understanding of personal and peer feelings and actions and allow for the constructive release of feelings and anger through discussion or play.
D.
Give assistance in toileting and provide time to carry out self-help skills and provide opportunity to be responsible for activities like putting away play equipment and helping around the house.
E.
Provide opportunity for each child to make decisions about daily activities and to take credit for the consequences of decisions.
Subp. 9.
Preschooler equipment.
Each preschooler shall be provided with a mat, bed, cot, sofa, or sleeping bag.
Subp. 10.
School-age activities.
The provider shall:
A.
provide opportunities for individual discussion about the happenings of the day and planning for activities;
B.
provide space and opportunity for games, activities, or sports using the whole body, outdoors, weather permitting;
Subp. 12.
Written permission.
Written permission must be obtained from the parent to allow a school-age child in care to participate in activities away from the residence.
9502.0425 PHYSICAL ENVIRONMENT.
Subpart 1.
Indoor space.
The licensed capacity of the day care residence must be limited by the amount of usable indoor space available to children. A minimum of 35 square feet of usable indoor space is required per child.
A.
Bathrooms, closets, space occupied by major appliances, and other space not used by children may not be counted as usable space. Space occupied by adult furniture, if it is used by children, may be counted as usable indoor space.
B.
Usable indoor space may include a basement if it has been inspected by a fire marshal, is free of hazard, and meets the minimum exiting standards specified in subpart 4.
Subp. 2.
Outdoor play space.
There must be an outdoor play space of at least 50 square feet per child in attendance, adjacent to the residence, for regular use, or a park, playground, or play space within 1,500 feet of the residence. On-site supervision must be provided by a caregiver for children of less than school age when play space is not adjacent to the residence. Enclosure may be required by the agency to provide protection from rail, traffic, water, or machinery hazard. The area must be free of litter, rubbish, toxic materials, water hazards, machinery, unlocked vehicles, human or animal wastes, and sewage contaminants.
Subp. 3.
Water hazards.
Swimming and wading pools, beaches, or other bodies of water on or adjacent to the site of the residence must be inaccessible to children except during periods of supervised use. Wading pools, as defined in chapter 4717, must be kept clean. When children use a swimming pool, as defined in chapter 4717, or beach, an attendant trained in first aid and resuscitation shall be present. Any public swimming pool, as defined in chapter 4717, used by children must meet the requirements of chapter 4717.
Subp. 6.
Vertical separations.
For group family day care homes with a licensed capacity of more than ten children, a 1-3/4 inch solid wood core door or a door and frame with at least a 20-minute fire protection rating, must be provided whenever more than two floors of the residence are connected. These doors must be equipped with self-closing devices.
Subp. 7.
Heating and venting systems.
The following heating and venting guidelines must be met:
B.
Gas, coal, wood, kerosene, or oil heaters must be vented to the outside in accordance with the State Building Code.
C.
Combustible items must not be located within 36 inches of the furnace or other heating sources.
D.
Whenever in use, fireplaces, wood-burning stoves, solid fuel appliances, space heaters, steam radiators, and other potentially hot surfaces, such as steam pipes, must be protected by guards to prevent burns. All fireplaces, wood-burning stoves, space heaters, steam radiators, and furnaces must be installed according to the State Building Code.
E.
The furnace, hot water heater, and workshop area must be inaccessible to children. Separation may be by a door, partition, or gate. There must be allowance for air circulation to the furnace.
F.
Ventilation of usable space must meet the requirements of the State Building Code. Outside doors and windows used for ventilation in summer months must be screened when biting insects are prevalent.
Subp. 8.
Temperature.
A minimum temperature of 62 degrees Fahrenheit must be maintained in indoor areas used by children.
Subp. 9.
Infant and newborn sleeping space.
There must be a safe, comfortable sleeping space for each infant and newborn. A crib, portable crib, or playpen with waterproof mattress or pad must be provided for each infant or newborn in care. The equipment must be of safe and sturdy construction that conforms to volume 16, parts 1508 to 1508.7 and parts 1509 to 1509.9 of the Code of Federal Regulations, its successor, or have a bar or rail pattern such that a 2-3/8 inch diameter sphere cannot pass through. Playpens with mesh sidings must not be used for the care or sleeping of infants or newborns.
Subp. 11.
Decks.
Decks, balconies, or lofts used by children more than 30 inches above the ground or floor must be surrounded by a protective guardrail and be constructed in accordance with the State Building Code. Wooden decks must be free of splinters and coated with wood preservative, paint, or constructed with treated wood.
Subp. 12.
Locks and latches.
Door locks and latches must meet the following guidelines:
B.
every bathroom door lock must permit opening of the locked door from the outside and the opening device must be readily accessible to all caregivers; and
Subp. 13.
Sewage disposal.
Day care residences must have toilet facilities and sewage disposal systems that conform to the State Building Code or local septic system ordinances. The toilets must flush thoroughly. Outdoor toilets are permissible when local ordinances allow.
Subp. 14.
Construction, remodeling.
During construction or remodeling, children shall not have access to dangerous construction or remodeling areas within or around the residence.
Subp. 15.
Interior walls and ceilings.
The interior walls and ceilings within the residence, as well as corridors, stairways, and lobbies must have a flame spread rating of 200 or less.
Subp. 18.
Electrical services.
The following electrical guidelines must be met:
A.
all electric receptacles accessible to children under first grade must be tamper-proof or shielded when not in use;
B.
all major electrical appliances must be properly installed, grounded in accordance with the state electric code, and in good working order;
C.
extension cords shall not be used as a substitute for permanent wiring; extension cords and flexible cords shall not be affixed to structures, extended through walls, ceilings, floors, under doors or floor coverings, nor be subject to environmental damage or physical impact; and
9502.0435 SANITATION AND HEALTH.
Subpart 1.
Sanitation and cleanliness.
The residence must be free from accumulations of dirt, rubbish, or peeling paint.
Subp. 2.
Pest control.
Effective measures must be taken to protect the home against vermin and insects. Chemicals for insect and rodent control must not be applied in areas accessible to children when children are present.
Subp. 3.
Rubbish.
Indoor and outdoor garbage and rubbish containers must not be accessible to infants and toddlers.
Subp. 4.
Toxic substances.
All medicines, chemicals, detergents, poisonous plants, alcoholic beverages, and other toxic substances must be inaccessible to children. They must be stored away from food products. Equipment or toys which are mouthed or may be chewed must be free of lead-based paint. Toys and equipment with chipped, cracked, or peeling paint must be tested to verify the absence of lead or be replaced.
Subp. 5.
Firearms.
All firearms must be unloaded and inaccessible to children. Ammunition and firearms must be stored in separate locked areas.
Subp. 6.
Hazardous activity materials.
Knives, matches, plastic bags, and other potential hazards must be kept out of the reach of infants, toddlers, and preschoolers. The use of potentially hazardous materials and tools must be supervised.
Subp. 7.
First aid kit.
The provider shall have a first aid kit that contains bandages, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, and adhesive tape. A first aid manual must be included. The kit and manual must be accessible and taken on field trips.
Subp. 8.
Emergencies.
The provider shall be prepared for emergencies.
B.
Emergency phone numbers must be posted by the telephone. The numbers must be those of the local fire department, police department, emergency transportation, and poison control center.
C.
The emergency phone numbers of the parents and child's physician and dentist must be readily available within the residence and taken on field trips.
E.
For severe storms and tornadoes, the provider shall have a designated area within the residence that children shall go to for cover, and an operable battery flashlight, and portable radio or TV available.
F.
The provider shall have a written fire escape plan and a log of monthly fire and storm drills on file in the residence. The plan must be approved by the agency and specify:
(5)
escape routes to the outside from all levels used by children. In buildings with three or more dwelling units, enclosed exit stairs must be indicated.
Subp. 9.
Transportation of children.
When transportation is given to children in a motor vehicle other than a bus or school bus operated by a common carrier, the following provisions for their safety must be made.
A.
A child may be transported only if the child is fastened in a safety seat, seat belt, or harness appropriate to the child's weight and the restraint is installed and used in accordance with the manufacturer's instructions.
B.
A child under the age of four may be transported only if the child is securely fastened in a child passenger restraint system which meets the federal motor vehicle safety standards contained in Code of Federal Regulations, title 49, section 571.213 or its successor.
C.
Any vehicle operated by the provider for the transportation of children must be licensed in accordance with the laws of the state and the driver shall hold a current, valid driver's license.
Subp. 10.
Separation of personal articles.
Separate towels, wash cloths, drinking cups, combs, and other personal articles must be used for each child.
Subp. 12.
Pets.
All pets housed within the residence shall be maintained in good health and limited to dogs, cats, fish, guinea pigs, gerbils, rabbits, hamsters, rats, mice, and birds if the birds are clear of chlamydia psittaci. The provider shall ensure that:
F.
parents of a child whose skin is broken by an animal bite or scratch, are notified of the injury on the day the injury occurs; and
G.
the agent of a community health board as authorized under Minnesota Statutes, section 145A.04 is immediately notified whenever a child in care is bitten by an animal, the notification shall be given before any steps are taken to destroy the animal, and the provider shall take reasonable steps to confine the animal.
Subp. 13.
Diapers.
Children in diapers shall be kept clean and dry. The following sanitary procedures must be used to reduce the spread of communicable disease.
A.
An adequate supply of clean diapers must be available for each child and stored in a clean place inaccessible to children. If cloth diapers are used, parents must provide a change of the outer plastic pants for each fecally soiled diaper change. Cloth diapers, except those supplied by a commercial diaper service, and plastic pants, if supplied by parents, must be labeled with the child's name.
C.
For disposable diapers, a covered diaper disposal container must be located in the diaper changing area and lined with a disposable plastic bag. The container must be emptied when full, and at least daily.
D.
Diapering must not take place in a food preparation area. The diaper changing area must be covered with a smooth, nonabsorbent surface. If the surface is not disposable and is wet or soiled, it must be washed with soap and water to remove debris and then disinfected with a solution of at least two teaspoons of chlorine bleach to one quart of water. If the surface is not soiled with feces or urine, then it must be disinfected with the solution of chlorine bleach and water after each diapering.
E.
Single service disposable wipes or freshly laundered cloths must be used for washing a soiled child. A child who has soiled or wet must be washed with a disposable wipe or a freshly laundered cloth before rediapering.
F.
Cloth diapers, except those supplied by a commercial diaper service, plastic pants, and soiled clothing must be placed in the plastic bag after removal and sent home with the parent daily.
Subp. 14.
Toilet training chairs.
Toilet training chairs, chairs, stools, and seats must be washed with soap and water when soiled, and at least daily.
Subp. 15.
Hand washing.
A child's hands must be washed with soap and water when soiled, after the use of a toilet or toilet training chair, and before eating a meal or snack. The provider shall monitor and assist the child who needs help.
A.
In sinks and tubs accessible to children, the water temperature must not exceed 120 degrees Fahrenheit to prevent children from scalding themselves while washing.
B.
Caregivers shall wash their hands with soap and water after each diaper change, after assisting a child on the toilet, after washing the diapering surface, and before food preparation. Hands must be dried on a single use towel.
Subp. 16.
Care of ill children, medicine administration.
The following provisions must be followed for the care of ill children and the administration of medicine.
A.
The provider shall notify the parent immediately when a child in care develops any of the following symptoms:
(1)
underarm temperature of 100 degrees Fahrenheit or over, or an oral temperature of 101 degrees Fahrenheit or over;
B.
The provider shall follow written instructions from an authorized agent or the physician of an ill child placed in the provider's care if the child has any of the illnesses specified in item E.
C.
The provider shall require that a child's parent notify the provider within 24 hours of the diagnosis of a serious contagious illness or parasitic infestation listed in item E so the provider may notify the parents of other children in care.
D.
The provider shall inform a parent of each exposed child the same day the provider is notified a positive diagnosis has been made for any of the illnesses or parasitic infestations in item E.
E.
The provider shall notify the authorized agent or Minnesota Department of Health of any suspected case of reportable disease as specified in part 4605.7040. The agency shall provide the provider with a copy of part 4605.7040 at the time of initial licensure.
F.
The following govern the administration of medicine by the provider to children in care:
(1)
The provider shall obtain written permission from the child's parent prior to administering medicine, diapering products, sunscreen lotions, and insect repellents. Nonprescription medicines, diapering products, sunscreen lotions, and insect repellents must be administered according to the manufacturer's instructions unless there are written instructions for their use provided by a licensed physician or dentist.
(2)
The provider shall obtain and follow written instructions from a licensed physician or dentist prior to administering each prescription medicine. Medicine with the child's name and current prescription information on the label constitutes instructions.
9502.0445 WATER, FOOD, AND NUTRITION.
Subpart 1.
Water.
There must be a safe water supply in the residence.
A.
Water from privately owned wells, must be tested annually by a Minnesota Health Department certified laboratory for coliform bacteria and nitrate nitrogens to verify safety. The provider shall file a record of the test results with the agency. Retesting and corrective measures may be required by the agency if results exceed state drinking water standards or where the supply may be subject to off-site contamination.
B.
Drinking water must be available to the children and offered at frequent intervals in separate or single service drinking cups or bottles.
Subp. 3.
Meals and snacks.
Well-balanced meals and snacks must be offered daily.
A.
Food served during the day must include servings from each of the basic food groups as defined by the United States Department of Agriculture's Code of Federal Regulations, title 7, section 226.20.
B.
The provider shall follow written instructions obtained from the parents, at the time of enrollment, on each child's special diet or food needs. Parents shall be consulted about special food preferences.
C.
Flexible feeding schedules must be provided for infants and toddlers, and the infant or toddler's usual diet and feeding schedule must be followed.
D.
Food, lunches, and bottles brought from home must be labeled with the child's name and refrigerated when necessary. Bottles must be washed after use.
Subp. 4.
Food safety.
Food must be handled and stored properly to prevent contamination and spoilage.
A.
All food and cooking utensils must be stored to protect them from dust, vermin, pipe leakage, or other contamination.
B.
Food requiring refrigeration must be maintained at no more than 40 degrees Fahrenheit. Food requiring heating must be maintained at no less than 150 degrees Fahrenheit until ready to serve. Frozen food must be maintained in a solid state until used.
D.
No hermetically sealed (canned), nonacid or low-acid food which has been processed in a place other than a commercial food-processing establishment shall be served to children in care. Low-acid food includes meats, fish, and poultry and most vegetables and is required to be steam-pressure canned by the United States Department of Agriculture in Bulletin number 8, "Home Canning of Fruits and Vegetables," 1983 Edition. Fresh and frozen foods, properly canned tomatoes, pickled foods, and canned fruits such as apples, berries, peaches, apricots, jams, and jellies may be served to children in care. The USDA "Home Canning of Fruits and Vegetables," Home and Garden Bulletin number 8, 1983 Edition, is incorporated by reference. It is not subject to frequent change and is available through Minitex interlibrary loan system, or by writing the Superintendent of Documents, U.S. Government Printing Office, Washington D.C., 20402.
9503.0005 DEFINITIONS.
Subp. 2.
Age category.
"Age category" means the designation given a child according to the child's age. The age categories are as follows:
C.
"Preschooler" means a child who is at least 33 months old but who has not yet attended the first day of kindergarten.
Subp. 3.
Applicant.
"Applicant" means a person, corporation, partnership, voluntary association, or other organization that has applied for licensure under Minnesota Statutes, chapter 245A, and parts 9503.0005 to 9503.0170. The term includes license holders that have applied for a new license to continue operating a child care program after the expiration date of their current license.
Subp. 4.
Building official.
"Building official" means a person appointed according to Minnesota Statutes, section 326B.133, to administer the State Building Code. The term includes the appointee's authorized representative.
Subp. 5.
Center.
"Center" means a facility in which a child care program is operated when the facility is not excluded by Minnesota Statutes, section 245A.03, subdivision 2, and is not required to be licensed under parts 9502.0315 to 9502.0445 as a family or group family day care home.
Subp. 7.
Child care program.
"Child care program" means the systematic organization or arrangement of activities, personnel, materials, and equipment in a facility to promote the physical, intellectual, social, and emotional development of a child in the absence of the parent for a period of less than 24 hours a day.
Subp. 8.
Child care program plan.
"Child care program plan" means the written document that states the specific activities that will be provided by the license holder to promote the physical, intellectual, social, and emotional development of the children enrolled in the center.
Subp. 9.
Clean.
"Clean" means free from dirt or other contaminants that can be detected by sight, smell, or touch.
Subp. 10.
Commissioner.
"Commissioner" means the commissioner of the Department of Human Services or the commissioner's designated representative.
Subp. 11.
Disinfected.
"Disinfected" means treated to reduce microorganism contamination after an object has been cleaned. Disinfection must be done by rinsing or wiping with a solution of one-fourth cup chlorine bleach plus water to equal one gallon, or an equivalent product or process approved by the community health board as defined in Minnesota Statutes, section 145A.02, or its designee.
Subp. 12.
Facility.
"Facility" means the indoor and outdoor space in which the child care program is provided.
Subp. 13.
Fire marshal.
"Fire marshal" means the person designated by Minnesota Statutes, section 299F.011, to administer and enforce the Minnesota Uniform Fire Code. The term includes the fire marshal's authorized representative.
Subp. 14.
Health consultant.
"Health consultant" means a physician licensed to practice medicine under Minnesota Statutes, chapter 147; a public health nurse or registered nurse licensed under Minnesota Statutes, section 148.171; or the community health board as defined in Minnesota Statutes, section 145A.02, or its designee.
Subp. 15.
License.
"License" means a certificate issued by the commissioner authorizing the license holder to operate a child care program in a center for a specified period of time in accordance with the terms of the license, rules of the commissioner, and provisions of Minnesota Statutes, chapter 245A.
Subp. 16.
License holder.
"License holder" means the individual, corporation, partnership, voluntary association, or other organization legally responsible for the operation of the child care program in a center that has been granted a license by the commissioner under Minnesota Statutes, chapter 245A, and parts 9503.0005 to 9503.0170.
Subp. 17.
Licensed capacity.
"Licensed capacity" means the maximum number of children for which the license holder is licensed to operate a child care program in a center at any one time.
Subp. 18.
Medicine.
"Medicine" means a substance used to treat disease or injuries, maintain health, heal, or relieve pain. The term applies to prescription and nonprescription substances taken internally or applied externally.
Subp. 19.
Minnesota Uniform Fire Code.
"Minnesota Uniform Fire Code" means those codes and regulations adopted by the state fire marshal according to Minnesota Statutes, section 299F.011.
Subp. 21.
Program staff person.
"Program staff person" means a teacher, assistant teacher, or aide, whether paid or unpaid, who carries out the child care program plan in the center and has direct contact with children.
Subp. 21a.
School-age child care program.
"School-age child care program" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 17.
Subp. 22.
Sick child.
"Sick child" means a child with a condition or illness as specified in part 9503.0080.
Subp. 23.
Staff person.
"Staff person" means a person, whether paid or unpaid, who works in the center.
Subp. 24.
State Building Code.
"State Building Code" means those codes and regulations adopted by the commissioner of the Department of Administration according to Minnesota Statutes, section 326B.101, and contained in chapter 1300.
9503.0010 APPLICABILITY.
Parts 9503.0005 to 9503.0170 govern the licensure of the applicants for and license holders operating a child care program in a center.
9503.0015 OPTIONS FOR CHILD CARE PROGRAMS.
A license holder must provide one or more of the following child care programs:
A.
A "day program" means a child care program operated during normal waking hours (approximately 6 a.m. to 6 p.m.). The program:
(1)
operates for more than 30 days in any 12 month period and is not excluded by Minnesota Statutes, section 245A.03, subdivision 2; and
(2)
provides care to any child for more than 30 days in any 12 month period and 45 hours in any calendar month.
B.
A "drop-in child care program" has the meaning given in Minnesota Statutes, section 245A.02, subdivision 6a.
C.
A "night care program" means a child care program operated during normal sleeping hours (approximately 6 p.m. to 6 a.m.).
9503.0030 QUALIFICATIONS OF APPLICANT AND STAFF.
Subpart 1.
Definitions.
In parts 9503.0030 to 9503.0034:
A.
"Accredited course" means a course that is offered for credit by or through an accredited postsecondary institution.
C.
"Experience" means paid or unpaid employment serving children as a teacher, assistant teacher, or aide, in a licensed child care center, or work as a student intern in a licensed center, a school operated by the commissioner of education or by a legally constituted local school board, or a private school approved under rules administered by the commissioner of education.
D.
"Student intern" means a student of a postsecondary institution assigned by that institution for a supervised experience with children. The experience must be in a licensed center, an elementary school operated by the commissioner of education or a legally constituted local school board, or a private school approved under rules administered by the commissioner of education. The term includes a person who is practice teaching, student teaching, or carrying out a practicum or internship.
E.
"Staff supervision" means responsibility to hire, train, assign duties, and direct staff in day to day activities and evaluate staff performance. A "supervisor" is a person with staff supervision responsibility.
9503.0031 DIRECTORS.
Subpart 1.
General requirements for a director.
A director must:
B.
be a graduate of a high school or hold an equivalent diploma attained through successful completion of the commissioner of education-selected high school equivalency test;
D.
have at least nine quarter credits or 90 hours earned in any combination of accredited courses in staff supervision, human relations, and child development.
9503.0032 TEACHERS.
Subpart 1.
Teacher qualifications, general.
A teacher must be at least 18 years old and meet the qualifications in subpart 2 with the following exceptions:
B.
A registered nurse may be used to meet the staff-to-child ratios for a teacher for sick care in a center licensed to operate a sick care program.
Subp. 2.
Teacher education and experience requirements.
A teacher with the credential listed in column A must have the education and experience listed in column B.
| Column A | Column B |
| (1) A high school diploma or commissioner of education-selected high school equivalency certification | Experience: 4,160 hours as assistant teacherEducation: 24 quarter credits |
| . | |
| (2) Diploma from Association Montessori Internationale; preprimary credential, primary diploma, or provisional certificate from the American Montessori Society, without a baccalaureate degree | Experience: 2,080 hours as assistant teacher, aide, or student internEducation: 12 quarter credits |
| . | |
| (3) Preprimary credential, primary diploma, or provisional certificate from the American Montessori Society; or diploma from the Association Montessori Internationale with a baccalaureate degree | Experience: 1,040 hours as assistant teacher, aide, or student internEducation: no additional required |
| . | |
| (4) Minnesota technical institute certificate as a Child Development Assistant | Experience: 2,080 hours as an assistant teacherEducation: six quarter credits |
| . | |
| (5) Child Development Associate credential (center based or family day care) for preschool or for infants and toddlers from the Council for Early Childhood Professional Recognition | Experience: 1,560 hours as assistant teacher, aide, or student internEducation: no additional required |
| . | |
| (6) License from the Minnesota Department of Education for Prekindergarten Associate; or a certificate or credential for a two-year program from an accredited community college or technical college in child development or early childhood education | Experience: 1,040 hours as assistant teacher, aide, or student internEducation: six quarter credits |
| . | |
| (7) Baccalaureate degree from an accredited college or university in any field | Experience: 1,040 hours as assistant teacher, aide, or student internEducation: 18 quarter credits |
| . | |
| (8) License from the Minnesota Department of Education for elementary education without kindergarten endorsement | Experience: 520 hours as assistant teacher, aide, or student intern if teaching children under school ageEducation: six quarter credits within one year of initial employment if teaching children under school age |
| . | |
| (9) License from the Minnesota Department of Education for prekindergarten/nursery, or a license from the Minnesota Department of Education for elementary education with a kindergarten endorsement | Experience: no additional requiredEducation: no additional required |
9503.0033 ASSISTANT TEACHERS.
Subpart 1.
Assistant teacher qualifications, general.
An assistant teacher must work under the supervision of a teacher. An assistant teacher must be at least 18 years old and meet the qualifications in subpart 2 with the following exceptions:
A.
A registered nurse or licensed practical nurse is qualified as an assistant teacher for infants only.
B.
A registered nurse may be used to meet the staff-to-child ratios for an assistant teacher for sick care in a center licensed to operate a sick care program.
Subp. 2.
Assistant teacher education and experience requirements.
An assistant teacher with the credential listed in column A must have the education and experience listed in column B.
| Column A | Column B |
| (1) High school diploma or commissioner of education-selected high school equivalency certification | Experience: 2,080 hours as an aide or student internEducation: 12 quarter credits |
| . | |
| (2) Minnesota license as a family day care or group family day care provider | Experience: 2,080 hours as a licensed family day care or group family day care providerEducation: 12 quarter credits |
| . | |
| (3) Diploma from Association Montessori Internationale or preprimary credential, primary diploma, or provisional certificate from the American Montessori Society | Experience: 520 hours as an aide or student internEducation: three quarter credits |
| . | |
| (4) Minnesota technical institute certificate as a Child Development Assistant | Experience: 520 hours as an aide or student internEducation: no additional required |
| . | |
| (5) Two years full-time postsecondary education from a college or university | Experience: 1,040 hours as an aide or student internEducation: nine quarter credits |
| . | |
| (6) Child Development Associate credential, center based or for family day care, from the Council for Early Childhood Professional Recognition | Experience: no additional requiredEducation: no additional required |
| . | |
| (7) Baccalaureate degree in any field from an accredited college or university | Experience: no additional requiredEducation: nine quarter credits |
| . | |
| (8) Certificate or credential for a two year program in child development or early childhood education at a Minnesota community college or technical college | Experience: no additional requiredEducation: no additional required |
| . | |
| (9) License from the Minnesota Department of Children, Families, and Learning for Prekindergarten Associate | Experience: no additional requiredEducation: no additional required |
9503.0034 AIDES, VOLUNTEERS, SUBSTITUTES.
Subpart 1.
Aide qualifications.
In this part, "aide" means a staff person who carries out child care program activities under the supervision of a teacher or assistant teacher. An aide who is under 18 years old must be directly supervised by a teacher or assistant teacher at all times except when the aide is assisting with the supervision of sleeping children or assisting children with washing, toileting, and diapering. An aide must be at least 16 years old.
Subp. 2.
Volunteers used as staff.
A volunteer who is included in the staff-to-child ratio must meet the requirements for the assigned staff position as specified in parts 9503.0030 to 9503.0034. Volunteers who have direct contact with or access to children must be supervised by a staff person who meets the qualifications for director, teacher, or assistant teacher.
Subp. 3.
Substitute staff.
A person designated as a substitute must meet the qualifications for the assigned staff position as specified in parts 9503.0030 to 9503.0034, except that the license holder may use substitutes who do not meet the qualifications for teacher in part 9503.0032, subpart 2, or assistant teacher in part 9503.0033, subpart 2, only if:
A.
the amount of unqualified substitute hours per center per calendar year does not exceed 40 hours multiplied by the number of the center's full-time teacher and assistant teacher positions;
B.
unqualified substitutes are not used as teachers or assistant teachers for more than ten consecutive working days for the same group of children per calendar year; and
9503.0040 STAFF RATIOS AND GROUP SIZE.
Subpart 1.
Staff-to-child ratios and maximum group size.
Except as provided in subpart 2, the minimally acceptable staff-to-child ratios and the maximum group size within each age category are:
| Age Category | Minimum Staff:Child Ratio | Maximum Group Size |
| Infant | 1:4 | 8 |
| Toddler | 1:7 | 14 |
| Preschooler | 1:10 | 20 |
| School-age child | 1:15 | 30 |
Subp. 2.
Staff distribution.
The license holder must ensure that the following requirements for staff distribution are met and a written staff distribution record is kept in the administrative record.
A.
Only a staff person who is qualified as a teacher, assistant teacher, or aide and who works directly with children can be counted in meeting the staff-to-child ratios.
B.
An assistant teacher may be substituted for a teacher during morning arrival and afternoon departure times if the total arrival and departure time does not exceed 25 percent of the center's daily hours of operation.
C.
The maximum group size applies at all times except during meals, outdoor activities, field trips, naps and rest, and special activities such as films, guest speakers, and holiday programs.
D.
Except as provided in item B, staff distribution within each age category must follow the pattern in subitems (1) to (4).
(4)
The fourth staff member must have at least the qualifications of a child care aide.
The pattern in subitems (1) to (4) must be repeated until the number of staff needed to meet the staff-to-child ratio for each age category has been achieved.
Subp. 3.
Age category grouping.
Children in different age categories may be grouped as follows:
A.
During morning arrival and afternoon departure times, children in different age categories may be grouped together if:
(1)
the total arrival and departure time does not exceed 25 percent of the daily hours of operation;
(2)
the staff-to-child ratio, group size, and staff distribution applied are for the age category of the youngest child present; and
(3)
the group is divided when the number of children present reaches the maximum group size of the youngest child present.
B.
During the center's regular hours of operation, children in different age categories may be mixed within a group if:
(3)
the staff-to-child ratios, group size, and staff distribution applied are for the youngest child present; and
(4)
program staff are qualified to teach the ages of all children present within the group.
The restriction in subitem (2) may be waived if all children in the group are school age.
Subp. 4.
Age designation.
A child must be designated as a member of the age category that is consistent with the child's date of birth with the following exceptions:
A.
A child may be designated as an "infant" up to the age of 18 months for purposes of staff ratios, group size, and child care programming, if the parent, teacher, and center director determine that such a designation is in the best interests of the child. A child may be designated as a "toddler" up to the age of 35 months, or as a "preschooler" at the age of 31 months for purposes of staff ratios, group size, and child care programming, if the parent, teacher, and center director determine that the designation is in the best interests of the child.
9503.0045 CHILD CARE PROGRAM PLAN.
Subpart 1.
General requirement.
The applicant must develop a written child care program plan, and the license holder must see that it is carried out. The child care program plan must:
D.
describe the general educational methods to be used by the program and the religious, political, or philosophical basis, if any;
E.
be developed and evaluated in writing annually by a staff person qualified as a teacher under part 9503.0032;
F.
have stated goals and objectives to promote the physical, intellectual, social, and emotional development of the children in each age category in part 9503.0005, subpart 2, for which care is provided;
G.
specify activities designed to promote the intellectual, physical, social, and emotional development of a child in a manner consistent with the child's cultural background;
H.
specify that the intellectual, physical, social, and emotional progress of each child be documented in the child's record and conveyed to the parent during the conferences specified in part 9503.0090, subpart 2;
K.
provide for a variety of activities that require the use of varied equipment and materials; and
Subp. 2.
Interest areas.
A child care program that operates for more than three hours a day must provide daily access to interest areas of the center that are supplied with the equipment and materials needed to carry out the activities specified in items A to H, except that a child care program serving only school-age children and operating for less than 90 consecutive calendar days or any program operating for less than three hours a day must provide each child with daily access to indoor or outdoor large muscle activities specified in item G and at least five of the following interest areas:
9503.0050 NAPS AND REST.
Subpart 1.
Naps and rest policy.
The applicant must develop a policy for naps and rest that is consistent with the developmental level of the children enrolled in the center.
Subp. 2.
Parent consultation.
The parent of each child must be informed at the time the child is enrolled of the center's policy on naps and rest.
Subp. 3.
Confinement limitation.
A child who has completed a nap or rested quietly for 30 minutes must not be required to remain on a cot or mat or in a crib or bed.
Subp. 4.
Placement of equipment.
Naps and rest must be provided in a quiet area that is physically separated from children who are engaged in activity that will disrupt a napping or resting child. Cribs, cots, beds, and mats must be placed so there are clear aisles and unimpeded access for both adults and children on at least one side of each piece of napping and resting equipment. Cribs, cots, beds, and mats must be placed directly on the floor and must not be stacked when in use.
Subp. 5.
Crib standard.
A crib or portable crib must be provided for each infant for which the center is licensed to provide care. The equipment must be of safe and sturdy construction that conforms to Code of Federal Regulations, title 16, sections 1508 to 1508.7 and 1509 to 1509.9, as amended through October 27, 1982, or have a bar, mesh, or rail pattern such that a 2-3/8 inch diameter sphere cannot pass through.
Subp. 6.
Bedding.
Separate bedding must be provided for each child in care. Bedding must be washed weekly and when soiled or wet. Blankets must be washed or dry cleaned weekly and when soiled or wet.
9503.0055 BEHAVIOR GUIDANCE.
Subpart 1.
General requirements.
The applicant must develop written behavior guidance policies and procedures, and the license holder must see that the policies and procedures are carried out. The policies and procedures must:
C.
redirect children and groups away from problems toward constructive activity in order to reduce conflict;
D.
teach children how to use acceptable alternatives to problem behavior in order to reduce conflict;
Subp. 2.
Persistent unacceptable behavior.
The license holder must have written procedures for dealing with persistent unacceptable behavior that requires an increased amount of staff guidance and time. The procedures must specify that staff:
B.
develop a plan to address the behavior documented in item A in consultation with the child's parent and with other staff persons and professionals when appropriate.
Subp. 3.
Prohibited actions.
The license holder must have and enforce a policy that prohibits the following actions by or at the direction of a staff person:
A.
Subjection of a child to corporal punishment. Corporal punishment includes, but is not limited to, rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking.
B.
Subjection of a child to emotional abuse. Emotional abuse includes, but is not limited to, name calling, ostracism, shaming, making derogatory remarks about the child or the child's family, and using language that threatens, humiliates, or frightens the child.
E.
Withholding food, light, warmth, clothing, or medical care as a punishment for unacceptable behavior.
F.
The use of physical restraint other than to physically hold a child when containment is necessary to protect a child or others from harm.
G.
The use of mechanical restraints, such as tying.
For children with developmental disabilities or children under the age of five, as specified in parts 9525.0004 to 9525.0036, physical and mechanical restraints may be permitted if they are implemented in accordance with the aversive and deprivation procedures governed by parts 9525.2700 to 9525.2810.
Subp. 4.
Separation from the group.
No child may be separated from the group unless the license holder has tried less intrusive methods of guiding the child's behavior which have been ineffective and the child's behavior threatens the well being of the child or other children in the center. A child who requires separation from the group must remain within an unenclosed part of the classroom where the child can be continuously seen and heard by a program staff person. When separation from the group is used as a behavior guidance technique, the child's return to the group must be contingent on the child's stopping or bringing under control the behavior that precipitated the separation, and the child must be returned to the group as soon as the behavior that precipitated the separation abates or stops. A child between the ages of six weeks and 16 months must not be separated from the group as a means of behavior guidance.
Subp. 5.
Separation report.
All separations from the group must be noted on a daily log. The license holder must ensure that notation in the log includes the child's name, staff person's name, time, date, and information indicating what less intrusive methods were used to guide the child's behavior and how the child's behavior continued to threaten the well being of the child or other children in care. If a child is separated from the group three times or more in one day, the child's parent shall be notified and notation of the parent notification shall be indicated on the daily log. If a child is separated five times or more in one week or eight times or more in two weeks, the procedure in subpart 2 must be followed.
9503.0060 FURNISHINGS, EQUIPMENT, MATERIALS, AND SUPPLIES.
Subpart 1.
General requirements.
Each child care program must have the quantity and type of equipment specified in subparts 3 to 6 for the age categories of children served. Equipment must be appropriate to the age categories and any special needs of the children served. A center must have enough equipment for the number of children for which the center is licensed unless the use of equipment is rotated among groups of children. If the equipment is rotated among groups of children, the center must have enough for the maximum group size of the age category scheduled to use the equipment at times shown on the child care program plan. When the term "group" is used in this part it means the maximum group size for the age category specified in part 9503.0040, subpart 1. The minimum equipment specified for an age category in subparts 3 to 6 must be accessible every day to the children of that age category and arranged as specified in the child care program plan. Centers operating for less than three hours a day do not have to provide the outdoor equipment required in subpart 4, item B, subitem (9); subpart 5, item B, subitem (9); and subpart 6, item B, subitem (7).
Subp. 2.
Definitions.
For the purpose of this part, the following terms have the meanings given them.
A.
"Cognitive development equipment and materials" means equipment and materials designed to enhance components of intellectual development, such as problem solving abilities, observation skills, group skills, and symbol recognition.
B.
"Dramatic play equipment" or "practical life activity equipment" means equipment, such as dress up clothes, large or miniature play sets, figures, and small and large building blocks that can be used to design a setting or space that stimulates the child's imagination and encourages role playing and the learning of practical life skills.
C.
"Large muscle equipment" means equipment that is designed to enhance large muscle development and coordination, such as playground equipment, large boxes and pillows, large wheel toys, pull toys, balls, jump ropes, climbers, and rocking boats.
D.
"Manipulative equipment" means equipment that is designed to enhance fine motor development and coordination, such as pegs and peg boards, puzzles, beads and strings, interlocking plastic forms, and carpentry materials.
E.
"Sensory stimulation materials" means equipment, other than pictures, that has different shapes, colors, and textures that stimulate the child's visual and tactile senses. Examples of sensory stimulation materials include mobiles, crib attached activity boxes, sand and water activity materials, swatches of different textures of cloth, and wooden or plastic items of different shapes and colors.
Subp. 3.
Equipment and materials for infants.
The minimum equipment and materials required for a center serving infants are as follows:
A.
Furnishings:
(2)
a variety of nonfolding child size chairs including infant seats and high chairs, one per child, or a minimum of four per group;
B.
Program equipment and materials:
(5)
one mirror at least 12 inches by 36 inches in size made of Plexiglas or a similar plastic or of safety glass per group;
(6)
one music source such as a tape player or record player per group and music selections appropriate for the music source;
(8)
visual and tactile sensory stimulation materials as needed to provide visual and tactile stimulation; and
Subp. 4.
Equipment and materials for toddlers.
The minimum equipment required for a center serving toddlers is as follows:
A.
Furnishings:
(3)
one changing table for every group of 14 toddlers and succeeding group of 14 or fewer toddlers;
(5)
one cot per child (mats are acceptable for programs operating during the day for less than five hours);
B.
Program equipment and materials:
(1)
arts and crafts supplies, such as clay or playdough, tempera or finger paints, colored and white paper, paste, collage materials, paint brushes, washable felt type markers, crayons, blunt scissors, and smocks;
(5)
three pieces of dramatic play equipment or sets of Montessori Practical Life equipment per group;
(6)
materials and accessories required for subitem (5) as needed to carry out the theme of the activity, or six Montessori Practical Life exercises;
(10)
one mirror, at least 12 inches by 36 inches, made of Plexiglas or a similar plastic or safety glass, per group;
(11)
one music source such as a tape recorder or record player per group and music selections appropriate for the source;
(12)
one set of cognitive developmental equipment and materials, such as puzzles and matching games, per child;
(13)
two sets of manipulative equipment, such as interlocking plastic forms or beads and string, per child;
Subp. 5.
Equipment and materials for preschoolers.
The minimum equipment required for a center serving preschoolers is as follows:
A.
Furnishings:
(3)
one cot or bed and waterproof mattress per child (mats are acceptable for programs operating during the day for less than five hours). This subitem is not required for preschoolers in programs operating for less than five hours per day if rest is not indicated as part of the center's child care program;
(4)
two square feet of wall or bulletin board display space per child, one-half at child's eye level;
B.
Program equipment and materials:
(1)
arts and crafts supplies, such as clay or playdough, tempera or fingerpaints, white or colored paper, paste, collage materials, paint brushes, washable felt type markers, crayons, scissors, and smocks;
(5)
five pieces of dramatic play equipment or sets of Montessori Practical Life equipment per group;
(10)
one mirror, at least 12 inches by 36 inches, made of Plexiglas or a similar plastic or safety glass, per group;
(11)
one music source such as a tape recorder or record player per group and music selections appropriate for the source;
(12)
one set of cognitive developmental equipment and materials, such as puzzles and number and letter games, per child;
(14)
pictures at child's eye level, mobiles, and other items as needed to create a pleasant environment and provide sensory stimulation; and
Subp. 6.
Equipment and materials for school-age children.
The minimum equipment and materials required for a program serving school-age children are as follows:
B.
Program equipment and materials:
(1)
arts and crafts supplies, such as clay or playdough, tempera or fingerpaints, white or colored paper, paste, collage materials, paint brushes, felt type markers, crayons, and scissors;
(5)
one music source such as a tape recorder or record player per group and music selections appropriate for the source;
(8)
pictures at child's level, mobiles, and other items as needed to create a pleasant environment and provide sensory stimulation;
(9)
one set of cognitive developmental equipment and materials, such as puzzles and games, per child;
(11)
ten pieces of sports or recreational equipment, such as bats, balls, hoops, and jump ropes, per group.
9503.0065 CHILD CARE FOR CHILDREN WITH SPECIAL NEEDS.
Subpart 1.
Definition.
"Child with special needs" for purposes of this part means a child at least six weeks old but younger than 13 years old who:
A.
has developmental disabilities or is otherwise eligible for case management as specified in parts 9525.0004 to 9525.0036 and has an individual service plan specifying child care to be provided by the center;
B.
has been identified by the local school district as a child with a disability as specified in Minnesota Statutes, section 125A.02, subdivision 1, and has an individualized education program specifying child care to be provided by the center according to Minnesota Statutes, section 125A.05; or
C.
has been determined by a licensed physician, psychiatrist, licensed psychologist, or licensed consulting psychologist as having a special need relating to physical, social, or emotional development.
Subp. 2.
Report to parent.
The license holder must inform the parent of any diagnosed or identified special need of a child that was not reported by the parent at the time of admission.
Subp. 3.
Individual child care program plan.
When a license holder admits a child with special needs, the license holder must ensure that an individual child care program plan is developed to meet the child's individual needs. The individual child care program plan must be in writing and specify methods of implementation and be reviewed and followed by all staff who interact with the child.
If the child has developmental disabilities or is otherwise eligible for case management as specified in subpart 1, item A, then the individual child care plan must be coordinated with the child's individual service plan developed under parts 9525.0004 to 9525.0036.
If the child has a disability as specified in subpart 1, item B, then the individual child care plan must be coordinated with the child's individualized education program developed under Minnesota Statutes, chapter 125A.
If the child has a special need determined under subpart 1, item C, the individual child care plan must be coordinated with reports from the licensed physician, licensed psychiatrist, licensed psychologist, or licensed consulting psychologist. The individual child care plan must be evaluated at least annually by the licensed physician, licensed psychiatrist, licensed psychologist, or licensed consulting psychologist and with the child's parent to determine if the needs of the child are being met.
Subp. 4.
Service contracts.
The license holder must have copies of all service contracts with the center for care or services provided under parts 9525.0004 to 9525.0036 and Minnesota Statutes, chapter 125A, when the care or service is provided to a child while at the center.
Subp. 5.
Additional staff, staff qualifications, or training.
The license holder must ensure that any additional staff, staff qualifications, or training required by the child's individual child care plan in subpart 3 are provided.
9503.0070 NIGHT CARE PROGRAM.
Subpart 1.
Applicability.
A license holder operating a night care program must comply with this part as well as with all other requirements of parts 9503.0005 to 9503.0170.
Subp. 2.
Furnishings.
Each child enrolled in a night care program must be provided with a crib, a bed, or a cot with a mattress. A crib and two sets of clean linens must be provided for each infant and meet the standards specified in part 9503.0050. A bed or a cot with a mattress, two sets of sheets, a blanket or quilt, and personal towels and washcloths must be provided for each child in all other age categories.
Subp. 3.
Garments for sleeping.
The license holder must ensure that all children are put to bed in garments for sleeping as designated by the child's parent.
Subp. 4.
Personal effects.
The license holder must ensure that all children have the personal effects needed to clean up and prepare for sleep. The effects must include an individual wash cloth, towel, toothbrush, toothpaste, and liquid hand soap.
Subp. 5.
Meals and snacks.
The license holder must ensure that a child who will be present in the center between 6:00 p.m. and 7:00 p.m. has had or will be provided with an evening meal. A bedtime snack must be available for all children in attendance. Eating times and schedules for the individual child must be consistent with patterns established in consultation with the child's parents.
Subp. 6.
Staffing.
At least two staff persons, one of whom must qualify as a teacher under part 9503.0032, must be present in the center at all times during the hours the night program is in operation. When more than 80 percent of the children present are asleep, the remaining staff persons needed to meet the required staff-to-child ratio must have at least the qualifications of a child care aide. Program staff must be awake and dressed and provide supervision to children who are sleeping.
Subp. 7.
Wash-up assistance.
The license holder must ensure that children have the opportunity to wash up and cleanse their teeth before bedtime and be assisted by program staff when necessary.
Subp. 8.
Privacy.
To ensure privacy, school-age boys and girls must be separated during bedtime washing and changing activities.
Subp. 9.
Infants.
Infants must have a sleep area separate from the center's play and activity areas.
Subp. 11.
Light.
In rooms used for sleep during children's bedtime, light must be reduced to no less than one footcandle.
9503.0075 DROP-IN AND SCHOOL-AGE CHILD CARE PROGRAMS.
Subpart 1.
Exemptions for drop-in and school-age child care programs.
A license holder operating a drop-in or school-age child care program as defined in part 9503.0015 must comply with parts 9503.0005 to 9503.0170 with the following exceptions:
A.
The staff ratios and group size restrictions in part 9503.0040 do not apply and are replaced by the requirements in subparts 2 to 6.
C.
The requirement in part 9503.0050, subpart 6, that separate bedding be provided for each child in care applies only to those children in care who are less than 30 months old. The provisions in part 9503.0050, subpart 6, requiring washing and cleaning of bedding and blankets remain in effect and apply to all bedding or blankets used by the drop-in child care program.
Subp. 2.
Supervision.
A drop-in and school-age child care program must:
A.
be operated under the supervision of a person who qualifies both as a director under part 9503.0031 and as a teacher under part 9503.0032; and
B.
have at least two staff persons present at the center whenever the program is operating even when the ages and numbers of children present are such that the staff-to-child ratio requirements established in subpart 3 could be met by having only one staff person.
Subp. 3.
Staff ratios; drop-in programs.
The minimum ratio of staff persons to children that a license holder may maintain in a drop-in program is:
Subp. 3a.
Staff ratios; school-age programs.
A school age program must maintain a minimum staff ratio as provided in Minnesota Statutes, section 245A.14, subdivision 6, paragraph (f).
Subp. 4.
Exception to staff ratio for ages 30 months through 12 years in a drop-in program.
The number of children per staff person specified in subpart 3 for a drop-in program may be increased only with children ages 30 months through 12 years, only by a maximum of four children, and only for a time period, not to exceed 20 minutes, required for additional staff to arrive at the center. A center that exceeds the ratio in subpart 3, item C, must be able to document having staff persons who, as a condition of their employment, are on call to come to the center as needed and arrive at the center within 20 minutes after receiving notification to report.
Subp. 5.
Age category grouping; drop-in programs.
Whenever the total number of children present to be cared for at a drop-in child care center is more than 20, the center shall comply with Minnesota Statutes, section 245A.14, subdivision 6, paragraph (e).
Subp. 5a.
Care provided to siblings.
A drop-in child care program may group siblings together as provided in Minnesota Statutes, section 245A.14, subdivision 6, paragraph (k).
Subp. 6.
Staff distribution.
Staff distributions for drop-in child care programs must meet the requirements in items A and B.
A.
If a drop-in child care program serves both infants and older children, the following minimum staff distribution pattern applies for the supervision of infants ages six weeks through 16 months and children ages 17 months through 29 months:
(1)
The first staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an assistant teacher as specified in part 9503.0033.
(2)
The second staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1.
(3)
The third staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an assistant teacher as specified in part 9503.0033.
(4)
The fourth staff person needed to meet the staff-to-child ratios required in subpart 3, items A and B, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1.
B.
The following minimum staff distribution pattern applies for the supervision of children 30 months and older.
(1)
The first staff person needed to meet the required staff-to-child ratio specified in subpart 3, item C, must meet the qualifications for teachers specified in part 9503.0032.
(2)
The second, third, and fourth staff persons needed to meet the required staff-to-child ratio specified in subpart 3, item C, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1.
(3)
The fifth staff person needed to meet the staff-to-child ratio required in subpart 3, item C, must have at least the qualifications of an assistant teacher as specified in part 9503.0033.
(4)
The sixth, seventh, and eighth staff persons needed to meet the staff-to-child ratio required in subpart 3, item C, must have at least the qualifications of an aide as specified in part 9503.0034, subpart 1.
(5)
For any additional staff persons needed after the eighth staff person to meet ratio requirements, the pattern of required staff qualifications established in subitems (3) and (4) applies.
9503.0080 EXCLUSION OF SICK CHILDREN.
A child with any of the following conditions or behaviors is a sick child and must be excluded from a center not licensed to operate a sick care program. If the child becomes sick while at the center, the child must be isolated from other children in care and the parent called immediately. A sick child must be supervised at all times. The license holder must exclude a child:
A.
with a reportable illness or condition as specified in part 4605.7040 that the commissioner of health determines to be contagious and a physician determines has not had sufficient treatment to reduce the health risk to others;
B.
with chicken pox until the child is no longer infectious or until the lesions are crusted over;
F.
who has a bacterial infection such as streptococcal pharyngitis or impetigo and has not completed 24 hours of antimicrobial therapy;
I.
who has a 100 degree Fahrenheit axillary or higher temperature of undiagnosed origin before fever reducing medication is given;
M.
who requires more care than the program staff can provide without compromising the health and safety of other children in care.
9503.0085 SICK CARE PROGRAM.
Subpart 1.
Licensure of sick care programs.
If a license holder chooses to care for a sick child, then the license holder must operate a sick care program that complies with the standards specified by this part and with all other applicable provisions of parts 9503.0005 to 9503.0170, and any standards of the commissioner of health governing the group care of children.
Subp. 2.
Review of admission and health policies and practices.
At the time of initial license application, after the first six months of initial operation, and annually after that time, a sick care program's admission policies must be reviewed and approved by a licensed physician with a specialization in pediatric care. The physician's review must include consultation with the licensed registered nurse or physician responsible for admissions. A report of the physician's findings must be sent to the commissioner with the initial application for licensure, and subsequent reports must be placed in the center's administrative record.
The license holder operating a sick care program must ensure that the program's health policies and practices are reviewed quarterly by a health consultant.
Subp. 3.
Evaluation of a sick child.
A license holder who operates a sick care program must provide for the evaluation of the condition of a sick child before admitting the child to the center. The evaluation must be based on the physical symptoms of the child each day of admission, the probable contagion and risk to the health of others present, and the ability of the program to provide the care the child requires. A physician or registered nurse affiliated with the center must perform the evaluations specified in items A to C.
A.
A preliminary evaluation must be made before the parent brings the child to the center. The preliminary evaluation must consist of the parent's reporting the child's symptoms to the center's physician or registered nurse by phone. The physician or registered nurse must tell the parent whether the parent may bring the child to the center for further evaluation. Children with a communicable reportable illness or condition as specified in part 4605.7040 must be evaluated by a physician prior to admission to the center.
B.
The physician or registered nurse must do a physical assessment of the child and obtain a health history from the parent when the child is brought to the center.
Subp. 3a.
Illness separation.
Children recovering from a noncontagious condition must be cared for in a room separate from children with contagious conditions.
Subp. 4.
Chicken pox.
Children with chicken pox must be excluded from any child care program, including a sick care program, unless care is provided in a room that is separate from other parts of the facility and has its own air circulation system and street entrance.
Subp. 5.
Gastrointestinal illness.
Children with gastrointestinal illness must be at least two years old to be in a sick care program and must be cared for in a separate room used exclusively for the care of gastrointestinal illness.
Subp. 6.
Information to parents.
A summary of the sick care program's health care policies and practices and the center's procedures for notification of parents in the event of an emergency must be given to the parent at the time a child is admitted.
Subp. 7.
Parent conference exception.
Centers licensed to provide child care exclusively to sick children need not provide parent conferences as specified in part 9503.0090, subpart 2, item B.
Subp. 8.
Child care program emphasis.
A sick care program must meet the child care program plan standards in part 9503.0045. However, the child care program plan for the care of sick children must emphasize quiet activities.
Subp. 9.
Group size and age category grouping exceptions.
The maximum group sizes specified in part 9503.0040, subpart 1, and the age category grouping restrictions in part 9503.0040, subpart 3, are not required except that there must be no more than 16 children in care in a room at the same time and the provisions in subparts 5 and 14 apply.
Subp. 10.
Additional staff-to-child ratios and staff distribution requirements.
A one to four staff to child ratio must be maintained at all times in a room used to care for sick children. At least two staff persons must be present in a center operating a sick care program whenever sick children are in care. The first staff person must be a nurse registered by the Board of Nursing to practice professional nursing. The second staff person must meet the qualifications for a teacher in part 9503.0032. The remaining staff persons must at least meet the qualifications and follow the staff distribution pattern specified in part 9503.0040.
Subp. 11.
Limitation on staff assignment.
Staff must not care for well children or prepare food for well children on the same day they care for sick children. Staff caring for sick children must not enter the kitchen used to prepare food for well children.
Subp. 12.
Food preparation.
Food provided by the license holder and prepared at the center must be prepared in a room separate from rooms where sick care is provided and must be delivered to each sick care room in individual servings and in covered containers. Procedures for preparing, handling, and serving food and washing food, utensils, and equipment must comply with the requirements in chapter 4626.
Subp. 13.
Menus.
Menus for sick children must be modified to meet the individual needs of the child.
Subp. 14.
Additional facility requirements.
A license holder operating a sick care program must provide:
A.
a room or rooms that are exclusively used to care for sick children and that are not used at any time for any other child care purpose; and
B.
toilets and hand sinks that are within or immediately adjacent to the room or rooms used for sick care and are not used by well children in care.
Subp. 15.
Outdoor activity area, activities and equipment exception.
A license holder operating a sick care program that provides care exclusively to sick children need not provide the outdoor activity area required in part 9503.0155, subpart 7; outdoor activities as specified in part 9503.0045, subpart 1, item I; and the outdoor equipment required in part 9503.0060, subpart 4, item B, subitem (9); subpart 5, item B, subitem (9); and subpart 6, item B, subitems (7) and (11).
Subp. 16.
Disinfection.
Walls and floors in rooms where sick care is provided and all linens, furnishings, objects, and equipment used by sick children must be cleaned and disinfected at least daily and as needed.
Subp. 17.
Linens and changes of clothing.
All linens used by a sick child must be washed after each use, and each child must be in clean clothing at all times.
Subp. 18.
Additional equipment.
Each sick child must be provided with a crib, bed, or cot, two sheets, a pillow, a pillowcase, and a blanket or quilt.
9503.0090 INFORMATION FOR PARENTS.
Subpart 1.
Policies given to parents.
At the time of a child's enrollment, the parent must be provided with written notification of the:
C.
child care program options the center is licensed to operate, including a description of the program's educational methods and religious, political, or philosophical basis, if any, and how parents may review the center's child care program plan;
D.
center's policy on parent conferences and notification to a parent of a child's intellectual, physical, social, and emotional development;
F.
policies and procedures for the care of children who become sick at the center and parent notification practices for the onset of or exposure to a contagious illness or condition or when there is an emergency or injury requiring medical attention;
G.
center's policies and procedures for administering first aid and sources of care to be used in case of emergencies;
J.
procedures for obtaining written parental permission before each occasion of research, experimental procedure, or public relations activity involving a child;
N.
center's policy that parents of enrolled children may visit the center any time during the hours of operation; and
Subp. 2.
Parent conferences and daily reports.
The license holder must ensure that the parent of a child is informed of the child's progress. The license holder must ensure that:
B.
documentation is made in the child's record that individual parent conferences were planned and offered;
C.
the status of the child's intellectual, physical, social, and emotional development is reported to the parent during the conference; and
D.
daily written reports are made to the parent of an infant or toddler about the child's food intake, elimination, sleeping patterns, and general behavior.
9503.0095 PARENT VISITATION.
Parents of enrolled children may visit the center any time during the hours of operation.
9503.0100 PARTICIPATION IN FIELD TRIPS.
The license holder must ensure that written permission is obtained from each child's parent before taking a child on a field trip. A written permission form must be obtained before each field trip or on a form that annually summarizes all field trips that will be taken. The parent's written permission must state that the parent has been informed of the purpose and destination of the field trip.
On field trips, staff must take emergency phone numbers for the child's parent and the persons to be called if a parent cannot be reached, the phone number of the child's physician, and a first aid kit.
9503.0105 RESEARCH AND PUBLIC RELATIONS PERMISSION.
The license holder must ensure that written permission is obtained from a parent before a child is involved in experimental research or public relations activity involving a child while at the center. A separate written permission form must be obtained before each occasion of experimental research or public relations activity or on a form that annually summarizes all research and public relations activities that will be undertaken. The permission form must be maintained in the child's record.
9503.0110 EMERGENCY AND ACCIDENT POLICIES AND RECORDS.
Subpart 1.
Policies and records.
The applicant must develop written policies governing emergencies, accidents, and injuries. The license holder must ensure that written records are kept about incidents, emergencies, accidents, and injuries that have occurred.
Subp. 2.
Instruction record.
The license holder must keep a record of instruction to all staff persons and, when appropriate, to children and parents, about how to carry out the policies.
Subp. 3.
Policy content.
The policies must contain:
B.
Safety rules to follow in avoiding injuries, burns, poisoning, choking, suffocation, and traffic and pedestrian accidents.
D.
Procedures for fire prevention and procedures to follow in the event of a fire. Fire procedures must:
(2)
identify primary and secondary exits, building evacuation routes, the phone number of the fire department, persons responsible for the evacuation of children, and areas for which they are responsible;
E.
Procedures to follow in the event of a blizzard, tornado, or other natural disaster that include the location of emergency shelter, procedures for monthly tornado drills from April to September, and a log of times and dates showing that the drills were held.
G.
Procedures to follow if an unauthorized person or a person who is incapacitated or suspected of abuse attempts to pick up a child or if no one comes to pick up a child.
I.
Procedures for recording accidents, injuries, and incidents involving a child enrolled in the center. The written record must contain the name and age of the persons involved; date and place of the accident, injury, or incident; type of injury; action taken by staff; and to whom the accident, injury, or incident was reported.
J.
Procedures mandating an annual analysis of the record in item I and any modification of the center's policies based on the analysis.
9503.0115 CENTER ADMINISTRATIVE RECORDS.
The records required by this part must be maintained within the center and be available for inspection at the request of the commissioner. The license holder must ensure that the following are maintained:
9503.0120 PERSONNEL RECORDS.
The license holder must ensure that a personnel record for each staff person is maintained at the center. The personnel record for each staff person must contain:
B.
the staff person's documentation indicating that the staff person meets the requirements of the staff person's job position and the education and experience requirements specified in parts 9503.0031 to 9503.0034;
C.
documentation that the staff person has completed the orientation to the center required in part 9503.0035, subpart 1;
9503.0125 CHILDREN'S RECORDS.
At the time of enrollment in the center, the license holder must ensure that a record is maintained on each child. The record must contain:
E.
the names, addresses, and telephone numbers of the child's source of regular medical and dental care and the source of medical and dental care to be used in case of an emergency;
F.
the names, addresses, and telephone numbers of two persons to be contacted if a parent cannot be reached in an emergency or when there is an injury requiring medical attention;
H.
written authorization for the license holder to act in an emergency, or when a parent cannot be reached or is delayed;
J.
for children age six weeks to 36 months, a description of the child's eating, sleeping, toileting, and communication habits, and effective methods for comforting the child;
M.
the date of parent conferences and a summary of the information provided to the parent at the conference.
The license holder shall not disclose a child's record to any person other than the child, the child's parent or guardian, the child's legal representative, employees of the license holder, and the commissioner unless the child's parent or guardian has given written consent or as otherwise required by law.
9503.0130 REPORTING.
Subpart 1.
Abuse; neglect.
The license holder must comply with the reporting requirements for abuse and neglect specified in Minnesota Statutes, chapter 260E.
Subp. 2.
Other reporting.
The license holder must inform the commissioner within:
B.
24 hours of any injury to a child in care in the center that required treatment by a physician;
C.
48 hours of the occurrence of a fire during the hours of operation that requires the service of a fire department; and
9503.0140 HEALTH.
Subpart 1.
Health policies.
The license holder must develop written health policies approved by the commissioner and must ensure that they are carried out.
Subp. 2.
Health consultation.
The center must have a health consultant who must review the center's health policies and practices specified in items A to C and certify that they are adequate to protect the health of children in care.
The review must be done before initial licensure, submitted with the application for initial licensure and repeated every year after the date of initial licensure. For programs serving infants, this review must be done initially and monthly thereafter. Additionally, the license holder must request a review by the health consultant of the center's health policies and practices if there is a proposed change in the center's health policies or practices or an outbreak of contagious reportable illness as specified in part 4605.7040. A copy of the consultant's findings must be placed in the center's administrative record.
The consultant must review:
Subp. 3.
Health information at admission.
Before a child is admitted to a center or within 30 days of admission, the license holder must obtain a report on a current physical examination of the child signed by the child's source of medical care.
Subp. 4.
Reexamination.
For children already admitted to the center, the license holder shall obtain an updated report of physical examination signed by the child's source of medical care at least annually for children under 24 months of age, and whenever a child 24 months or older advances to an older age category.
Subp. 5.
Immunizations.
When a child is enrolled in the center, the license holder must obtain documentation of current immunization according to Minnesota Statutes, section 121A.15, a signed notarized statement of parental objection to the immunization, or a medical exemption.
Subp. 6.
Notice about a sick child.
Notices about the illness or condition of a child must be given as required in items A to D:
A.
The license holder must ensure that a parent is notified immediately when the parent's child becomes sick at the center.
B.
The license holder must require a parent to inform the center within 24 hours, exclusive of weekends and holidays, when a child is diagnosed by a child's source of medical or dental care as having a contagious reportable disease specified in part 4605.7040, or lice, scabies, impetigo, ringworm, or chicken pox.
C.
The license holder must post or give a notice to the parents of exposed children the same day a parent notifies the center of a child's illness or condition listed in item B.
Subp. 7.
Administration of medicine.
A license holder who chooses to administer medicine must ensure that the procedures in items A to E are followed.
A.
The license holder must get written permission from the child's parent before administering medicine, diapering products, sunscreen lotions, and insect repellents. Nonprescription medicines, diapering products, sunscreen lotions, and insect repellents must be administered according to the manufacturer's instructions unless there are written instructions for their use provided by a licensed physician or dentist.
B.
The license holder must get and follow written instructions from a licensed physician or dentist before administering each prescription medicine. Medicine with the child's name and current prescription information on the label constitutes instructions.
C.
All medicine must be kept in its original container and have a legible label stating the child's name. The medicine must be given only to the child whose name is on the label. The medicine must not be given after an expiration date on the label, and any unused portion must be returned to the child's parent or destroyed. The license holder must ensure that the administration of medicine is recorded and give the name of the child, name of the medication or prescription number, date, time, dosage, and the name and signature of the person who dispensed the medicine. The record must be available to the parent and maintained in the child's record.
D.
Sunscreen lotions and insect repellents supplied by the license holder may be used on more than one child. A product to control or prevent diaper rash, including premoistened commercial wipes that cannot be dispensed in a manner that prevents cross contamination of the product and container as determined by the health consultant, must be labeled with the child's name and used only for the individual child whose name is written on the label.
E.
Medicines, insect repellents, sunscreen lotions, and diaper rash control products must be stored according to directions on the original container and so that they are inaccessible to children.
Subp. 10.
Toilet facilities.
The toilet rooms of the center must be cleaned daily. Toilet training chairs must be emptied, washed with soap and water, and disinfected after each use. Toilets and seats must be washed with soap and water and disinfected when soiled or at least daily.
Subp. 11.
Diaper changing area.
A diaper must be changed only in the diaper changing area. The diaper changing area must be separate from areas used for food storage, food preparation, and eating. The area must have a hand sink equipped with hot and cold running water within three feet of the diaper changing surface, a smooth nonabsorbent diaper changing surface and floor covering, and a sanitary container for soiled and wet diapers.
Subp. 12.
Diaper changing procedures.
The center must have and follow diaper changing procedures that have been developed in consultation with a health consultant. The license holder must post the diaper changing procedures in the diaper changing area.
Subp. 13.
Hand washing: child.
A child's hands must be washed with soap and water after a diaper change, after use of a toilet or toilet training chair, and before eating a meal or snack. Staff must monitor hand washing and assist a child who needs help. The use of a common basin or a hand sink filled with standing water is prohibited.
Subp. 14.
Hand washing: staff person.
A staff person must wash his or her hands with soap and water after changing a child's diaper, after using toilet facilities, and before handling food or eating.
Subp. 15.
Toilet articles.
The license holder shall provide the following supplies and make them accessible to children: toilet paper, liquid hand soap, facial tissues, and single use paper towels or warm air hand dryers.
Subp. 16.
First aid kit.
The license holder must ensure that a first aid kit is available within the center. The kit must contain sterile bandages and band-aids, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer, and adhesive tape. A current first aid manual must be included. The first aid kit and manual must be accessible to the staff in the center and taken on field trips.
Subp. 17.
Hazardous objects.
Sharp objects, medicines, plastic bags, and poisonous plants and chemicals, including household supplies, must be stored out of reach of children.
Subp. 18.
Emergency equipment.
The center must have a battery operated flashlight and battery operated portable radio.
Subp. 19.
Condition of equipment and furniture.
Equipment and furniture must be durable, in good repair, structurally sound and stable following assembly and installation. Equipment must be free of sharp edges, dangerous protrusions, points where a child's extremities could be pinched or crushed, and openings or angles that could trap part of a child's body. Tables, chairs, and other furniture must be appropriate to the age and size of children who use them. Toys and equipment that are likely to be mouthed by infants and toddlers must be made of a material that can be disinfected. These must be cleaned and disinfected when mouthed or soiled and at least daily.
Infant rattles must meet the United States consumer product safety standards contained in the Code of Federal Regulations, title 16, sections 1510.1 to 1510.4, as adopted on May 23, 1978. All toys and other articles intended for use by children under three years of age that present choking, aspiration, or ingestion hazards because of small parts must meet the size standards in Code of Federal Regulations, title 16, sections 1501.1 to 1501.5, as adopted on June 15, 1979.
Subp. 20.
Maintenance of areas used by children.
The areas used by children must be free from debris, loose flaking, peeling, or chipped paint, loose wallpaper, or crumbling plaster, litter, and holes in the walls, floors, and ceilings. Rugs must have a nonskid backing or be firmly fastened to the floor and be free from tears, curled or frayed edges, and hazardous wrinkles.
Subp. 21.
Emergencies.
The license holder must ensure that written procedures for emergencies and accidents are posted in a visible place. The procedures must:
F.
list the phone numbers and sources of emergency medical and dental care, poison control center, fire department, health authority, and licensing division of the Department of Human Services.
Subp. 22.
Pets.
If pets are permitted at the center, parents must be informed at the time of admission that a pet is present.
9503.0145 FOOD AND WATER.
Subpart 1.
Food.
The license holder must see that meals and supplemental snacks are available. Bag lunches provided by the parent are acceptable as specified in subpart 4.
Subp. 2.
Menus.
When food is provided by the license holder, menus must comply with the nutritional requirements of the United States Department of Agriculture, Food and Nutrition Service, Code of Federal Regulations, title 7, section 226.20.
Subp. 3.
Sanitation.
Procedures for preparing, handling, and serving food, and washing food, utensils, and equipment must comply with the requirements for food and beverage establishments in chapter 4626. If the food is prepared off site by another facility or if food service is provided according to a contract with a food service provider, the facility or license holder must ensure that food is prepared in compliance with chapter 4626. The license holder must provide refrigeration for dairy products and other perishable foods, whether supplied by the license holder or supplied by the parent. The refrigeration must have a temperature of 40 degrees Fahrenheit or less. Tables and highchair trays used for meals must be washed with soap and water before and after each use.
Subp. 4.
Meals and snacks.
Each meal must provide one-third of the child's daily nutritional needs as specified by the United States Department of Agriculture, Food and Nutrition Service, in Code of Federal Regulations, title 7, section 226.20. The license holder must provide or ensure the availability of:
B.
one meal and two snacks or two meals and one snack for a child in attendance five to ten hours unless four or more of these hours are spent in sleep;
C.
a minimum of two meals and two snacks for a child in attendance more than ten hours unless four or more of these hours are spent in sleep; and
Subp. 5.
Prescribed diet needs.
The license holder must provide for a child's dietary needs prescribed by the child's source of medical care or require the parent to provide the prescribed diet items that are not part of the menu plan approved in subpart 2. A license holder serving a child who has a prescribed diet must keep the diet order and its duration specified in the child's record. All staff designated to provide care to the child must be informed of the diet order.
Subp. 6.
Food allergy information.
Information about food allergies of the children in the center must be available in the area where food is prepared or served to children with allergies. All staff providing care to the child must be informed of the allergy.
Subp. 7.
Infant diets.
The diet of an infant must be determined by the infant's parent. The license holder must ensure that sanitary procedures and practices are used to prepare, handle, and store formula, milk, breast milk, solid foods, and supplements. Procedures must be reviewed and certified by a health consultant. A center serving infants must:
C.
offer the child formula or milk and nutritionally adequate solid foods in prescribed quantities at specified time intervals; and
Subp. 8.
Water.
The center must have a safe water supply. A center that uses water from a privately owned well that is not governed by chapter 4720 must be tested annually by a Minnesota Health Department certified laboratory for coliform bacteria and nitrate nitrogens to verify safety. The license holder must ensure that a record of the test results is in the center's administrative record. The commissioner of health may issue an advisory order for retesting and corrective measures.
Drinking water must be available to children throughout the hours of operation and offered at frequent intervals. Drinking water for children must be provided in single service drinking cups or from drinking fountains accessible to children.
9503.0150 TRANSPORTATION.
A license holder who provides transportation for children or contracts to provide transportation must comply with the following transportation policies:
A.
The vehicle must be driven by a person who holds a current Minnesota driver's license appropriate to the vehicle driven.
C.
When children are driven in a private car or van, a second adult must be present when more than four children under the age of five are being transported.
D.
When the license holder provides transportation to and from the center, a second adult must be present in the vehicle and children must not be transported more than one hour per one-way trip. A two-way communication system can be used in lieu of a second adult when ten or fewer children are being transported.
E.
When children are transported, they must be restrained in accordance with Minnesota Statutes, section 169.686, and a child under the age of four may be transported only if the child is properly fastened in a child passenger restraint system that meets the federal motor vehicle safety standards contained in Code of Federal Regulations, title 49, section 571.213.
9503.0155 FACILITY.
Subpart 1.
Occupancy designation.
In areas of the state that have adopted the Minnesota State Building Code, the applicant must comply with the standards specified by the code if the application is an initial one. In those areas of the state that have not adopted the Minnesota State Building Code, an applicant for licensure must comply with any applicable local building ordinances if the application is an initial one. The commissioner must not grant an initial license until written verification of compliance with the State Building Code or local building ordinance, when applicable, has been received by the commissioner from the building official with jurisdiction.
Subp. 2.
Fire inspection.
The center must be inspected by a fire marshal within 12 months before initial licensure. The commissioner must not grant an initial license until the commissioner has received written approval of compliance with the Minnesota Uniform Fire Code from the fire marshal with jurisdiction.
Subp. 3.
Reinspection for cause.
If the commissioner has reasonable cause to believe that a potential hazard exists, the commissioner may request another inspection and written report by a fire marshal, building official, or health authority to verify the absence of hazard.
Subp. 4.
Facility floor plan and designated areas.
Indoor and outdoor space to be used for child care must be designated on a facility floor plan. This space must be exclusively used for child care by the center during the hours of operation. The initial application for licensure and the center's administrative record must contain a floor plan of the center. Precise scale drawings are not required. The plan must indicate the:
Subp. 5.
Child's personal storage space.
A center must have storage space for each child's clothing and personal belongings. The space must be at a height appropriate to the age of the child.
Subp. 6.
Space for children who become sick.
Space must be provided in the center for a child who becomes sick at a center not licensed to operate a sick care program under part 9503.0085. The space must be separate from activity areas used by other children. A cot and blanket must be provided. The space must be within sight and hearing of a staff person and supervised by a staff person when occupied by a sick child.
Subp. 7.
Outdoor activity area.
An outdoor activity area that complies with the following items must be provided or available for all child care programs except those licensed to exclusively provide sick care as specified in part 9503.0085, drop in care as specified in part 9503.0075, and those operating for less than three hours a day.
A.
A center must have an outdoor activity area of at least 1,500 square feet, and there must be at least 75 square feet of space per child within the area at any given time during use.
B.
An outdoor activity area used daily by children under school age must be within 2,000 feet of the center or transportation must be provided by the license holder. In no case, however, shall the outdoor activity area be farther than one-half mile from the center.
C.
The area must be enclosed if it is located adjacent to a traffic, rail, water, machinery, or other environmental hazard, unless the area is a public park or playground.
D.
The area must be free of litter, rubbish, toxic materials, water hazard, machinery, animal waste, and sewage contaminants.
Subp. 9.
Indoor space.
The licensed capacity of the center must be limited by the amount of indoor space. A minimum of 35 square feet of indoor space must be available for each child in attendance. Hallways, stairways, closets, utility rooms, lavatories, water closets, kitchens, and space occupied by cribs may not be counted as indoor space. Twenty-five percent of the space occupied by furniture or equipment used by staff or children may be counted as indoor space.
Subp. 10.
Shielding of hot surfaces.
Radiators, fireplaces, hot pipes, and other hot surfaces in areas used by children must be shielded or insulated to prevent burns.
Subp. 11.
Electrical outlets.
Except in a center that serves only school-age children, electrical outlets must be tamper proof or shielded when not in use.
Subp. 12.
Water hazards.
Bodies of water within or adjacent to the center must be inaccessible to children. When using a pool or beach, children must be supervised at all times.
Subp. 13.
Room temperature.
A minimum temperature of 68 degrees Fahrenheit must be maintained in indoor areas used by children.
Subp. 15.
Hazardous areas.
Kitchens, stairs, and other hazardous areas must be inaccessible to children except during periods of supervised use.
Subp. 16.
Fire extinguisher inspection.
Fire extinguishers must be serviced annually by a qualified inspector. The name of the inspector and date of the inspection must be written on a tag attached to the extinguisher.
Subp. 17.
Screens.
Outside doors and windows used for ventilation must be screened to provide protection from insects.
Subp. 18.
Toilets and hand sinks.
Toilets and hand sinks must be provided as specified in items A to G:
A.
The center must have at least one hand sink and one toilet for each 15 children or portion of 15 children specified in the licensed capacity. One toilet training seat or training chair must be provided for every 15 toddlers specified in the licensed capacity. Any hand sink required for children, other than infants, must be in the toilet area.
B.
In newly constructed centers or those undergoing major remodeling to the plumbing system, foot or wrist operated sinks must be provided in the diaper changing area.
D.
The temperature of hot water in the hand sinks used by children must not exceed 120 degrees Fahrenheit.
E.
Single service towels or air dryers must be available to dry hands and designed for easy use by the children.
F.
Toilets, sinks, faucets, and hand drying devices in the toilet area used by children under school age other than infants must be placed at a height appropriate to the ages of the children.
G.
Portable steps may be used to meet the requirement in item F for toddlers and preschoolers, if the steps are sturdy and washable.
9503.0170 LICENSING PROCESS.
Subpart 1.
License required.
A person, corporation, partnership, voluntary association, or other organization may not operate a child care program in a center unless licensed by the commissioner under parts 9503.0005 to 9503.0170 and Minnesota Statutes, chapter 245A.
Subp. 3.
Posting license.
A license holder must post the license in a conspicuous place within the child care center.