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Capital IconMinnesota Legislature

HF 2128

Conference Committee Report - 92nd Legislature (2021 - 2022) Posted on 05/16/2021 08:54pm

KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 1.39 1.40 1.41 1.42 1.43 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 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 2.43 2.44 2.45 2.46 2.47 2.48 2.49 2.50 2.51 2.52 2.53 2.54 2.55 2.56 2.57 2.58 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 3.34 3.35 3.36 3.37 3.38 3.39 3.40 3.41 3.42 3.43 3.44 3.45 3.46 3.47 3.48
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 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 5.32 5.33 5.34 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 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 7.34 7.35 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 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 9.32 9.33 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 10.32 10.33 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 12.31 12.32 12.33 12.34 12.35 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 13.33 13.34 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 14.33 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 15.32 15.33 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
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 17.31 17.32 17.33 17.34 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 18.30 18.31 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 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 22.31 22.32 22.33 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 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 24.31 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
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 26.33 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 27.33 27.34 27.35 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 28.35 28.36 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 29.32 29.33 29.34 29.35 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 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 32.31 32.32 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
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 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 35.32 35.33 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
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 37.30 37.31 37.32 37.33 37.34 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
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 39.32 39.33 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
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 41.31 41.32 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 46.29 46.30 46.31 46.32 46.33 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 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 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 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 53.30 53.31 53.32 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 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 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 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 57.31 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 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 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 60.17 60.16 60.19 60.18 60.20 60.21 60.22 60.23 60.25 60.24 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 60.35 60.36 60.37 60.38 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.9 61.8 61.11 61.10 61.12 61.13 61.15 61.14 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 61.32 61.33 61.34 61.35 61.36 61.37 61.38 61.39 61.40 61.41 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.14 62.13 62.15 62.16 62.17 62.18 62.19 62.20 62.22 62.21 62.23 62.24 62.26 62.25 62.27 62.28 62.29 62.30 62.31 62.32 62.34 62.33 62.35 62.36 62.37 62.38 62.39 62.40 62.41 62.42 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 63.15 63.14 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 63.34 63.35 63.36 63.37 63.38 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 64.17 64.16 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 64.32 64.33 64.34 64.35 64.36 64.37 64.38 64.39 64.40 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 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 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 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 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 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 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 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
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 77.31 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 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 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 82.31 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 83.31 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 84.30 84.31 84.32 84.33 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 85.31 85.32 85.33 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 86.31 86.32 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 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 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 91.31 91.32 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 93.31 93.32 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 94.28 94.27 94.29 94.30 94.32 94.31 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.11 95.10 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 95.31 95.32 95.33 95.34 95.35 95.36 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 96.32 96.33 96.34 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 97.31 97.32 97.33 97.34 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 98.33 98.34 98.35 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 99.32 99.33
100.1 100.2
100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8
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
101.25 101.26 101.27 101.28 101.29 102.1 102.2 102.3 102.4 102.5
102.6 102.7 102.8 102.9 102.10
102.11 102.12 102.13 102.14 102.15
102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 104.34 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18
105.19 105.20
105.21 105.22
105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20
106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 108.1 108.2
108.3
108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 108.33 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12
109.13
109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 110.1 110.2
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
110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13
111.14 111.15
111.16 111.17
111.18 111.19 111.20 111.21
111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9
113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21
113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 114.1 114.2 114.3 114.4 114.5 114.6
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
114.28 114.29 114.30 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27
115.28
115.29 115.30 115.31 115.32 116.1 116.2 116.3 116.4 116.5 116.6 116.7
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
117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18
118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30
120.31 120.32 120.33 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18
121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 122.1 122.2
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
122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8
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
123.29 123.30 123.31 123.32 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 125.1 125.2
125.3
125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 125.34 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16
126.17
126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 127.1 127.2 127.3
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
127.28 127.29 127.30 127.31 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 128.34 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28
129.29
129.30 129.31 129.32 129.33 130.1 130.2
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
130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30
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
131.25 131.26 131.27 131.28 131.29 131.30 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29
141.30
142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23
144.24
144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32
145.33
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
146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 147.1 147.2 147.3 147.4 147.5 147.6
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
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
148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 149.1 149.2
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
149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 150.1 150.2 150.3 150.4
150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16
150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 150.33
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
151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 152.34 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29
153.30
153.31 153.32 153.33 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 158.33 159.1 159.2
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
160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24
161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18
162.19
162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8
163.9 163.10 163.11 163.12 163.13 163.14
163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14
164.15 164.16
164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29
167.30
168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8
169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15
170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16
172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33
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
174.26 174.27 174.28 174.29 174.30 174.31 174.32 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16
175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 176.33 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27
177.28
177.29 177.30 177.31 177.32 177.33 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24
179.25
179.26 179.27 179.28 179.29 179.30 179.31 179.32 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10
181.11
181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30
183.31
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
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
185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 187.33 187.34 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12
188.13
188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22
188.23
188.24 188.25 188.26 188.27 188.28 188.29 188.30 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9
191.10
191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 194.1 194.2 194.3 194.4 194.5 194.6 194.7
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
195.26 195.27 195.28 195.29 195.30 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20
196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 196.33 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15
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
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
199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20
203.21
203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 205.1 205.2
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
205.28 205.29 205.30 205.31 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21
206.22
206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 206.34 206.35 207.1 207.2 207.3 207.4 207.5 207.7 207.6 207.9 207.8 207.11 207.10 207.13 207.12 207.15 207.14 207.17 207.16 207.19 207.18 207.21 207.20 207.23 207.22 207.25 207.24 207.27 207.26 207.29 207.28 207.31 207.30 207.33 207.32 207.35 207.34 207.37 207.36 207.39 207.38 207.41 207.40 207.43 207.42 207.45 207.44 208.2 208.1 208.4 208.3 208.6 208.5 208.8 208.7 208.10 208.9 208.12 208.11 208.14 208.13 208.16 208.15 208.18 208.17 208.20 208.19 208.22 208.21 208.24 208.23 208.26 208.25 208.28 208.27 208.30 208.29 208.32 208.31 208.34 208.33 208.36 208.35 208.38 208.37 208.40 208.39 208.42 208.41 208.44 208.43 208.46 208.45 209.2 209.1 209.4 209.3 209.6 209.5 209.8 209.7 209.10 209.9 209.12 209.11 209.14 209.13 209.16 209.15 209.18 209.17 209.20 209.19 209.22 209.21 209.24 209.23 209.26 209.25 209.28 209.27 209.30 209.29 209.32 209.31 209.34 209.33 209.36 209.35 209.38 209.37 209.40 209.39 209.42 209.41 209.44 209.43 209.46 209.45 210.2 210.1 210.4 210.3 210.6 210.5 210.8 210.7 210.10 210.9 210.12 210.11 210.14 210.13 210.16 210.15 210.18 210.17 210.20 210.19 210.22 210.21 210.24 210.23 210.26 210.25 210.28 210.27 210.30 210.29 210.32 210.31 210.34 210.33 210.36 210.35 210.38 210.37 210.40 210.39 210.42 210.41 210.44 210.43 210.46 210.45 211.2 211.1 211.4 211.3 211.6 211.5 211.8 211.7 211.10 211.9 211.12 211.11 211.14 211.13 211.16 211.15 211.18 211.17 211.20 211.19 211.22 211.21 211.24 211.23 211.26 211.25 211.28 211.27 211.30 211.29 211.32 211.31 211.34 211.33 211.36 211.35 211.38 211.37 211.40 211.39 211.42 211.41 211.44 211.43 211.46 211.45 212.2 212.1 212.4 212.3 212.6 212.5 212.8 212.7 212.10 212.9 212.12 212.11 212.14 212.13 212.16 212.15 212.18 212.17 212.20 212.19 212.22 212.21 212.24 212.23 212.26 212.25 212.28 212.27 212.30 212.29 212.32 212.31 212.34 212.33 212.36 212.35 212.38 212.37 212.40 212.39 212.42 212.41 212.44 212.43 212.46 212.45 213.2 213.1 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 213.32 213.33 213.34 213.35 213.36 213.37 213.38 213.39 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20
214.21
214.22 214.23 214.24 214.25 214.26 214.27 214.28
214.29 214.30 214.31 214.32 214.33 214.34 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13
215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 215.32 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11
216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 216.32 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23
217.24
217.25 217.26 217.27 217.28 217.29 217.30 218.1 218.2 218.3
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
219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 220.32 220.33 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26
221.27
221.28 221.29 221.30 221.31 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33
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
224.29 224.30 224.31 224.32 225.1 225.2 225.3 225.4 225.5 225.6
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
225.25 225.26 225.27 225.28 225.29 225.30 225.31 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 226.34 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 227.33 227.34 228.1 228.2 228.3 228.4 228.5
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
228.27 228.28 228.29 228.30 228.31 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 231.34 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8
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
232.26 232.27 232.28 232.29 232.30 232.31 232.32 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 234.34 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 235.33 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10
236.11 236.12 236.13
236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14
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
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
238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33 239.34 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 241.33 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 242.33 242.34 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13
243.14 243.15
243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 243.33 243.34 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16
244.17
244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 244.33 244.34 245.1 245.2
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
245.26 245.27 245.28 245.29 245.30 245.31 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11
248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15
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
250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20
250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30
251.1 251.2 251.3 251.4
251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22
251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16
252.17 252.18 252.19 252.20 252.21
252.22 252.23 252.24 252.25
252.26 252.27 252.28 252.29 252.30 253.1 253.2
253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14
253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29
254.1 254.2 254.3 254.4 254.5
254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17
254.18 254.19 254.20 254.21 254.22
254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30
255.1 255.2 255.3 255.4 255.5 255.6 255.7
255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27
255.28 255.29 255.30 255.31 256.1 256.2 256.3 256.4 256.5 256.6
256.7 256.8 256.9 256.10 256.11
256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21
256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29
257.1 257.2 257.3 257.4
257.5 257.6 257.7 257.8 257.9 257.10
257.11 257.12 257.13 257.14
257.15 257.16 257.17 257.18 257.19 257.20
257.21 257.22 257.23 257.24
257.25 257.26 257.27 257.28 257.29
258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17
258.18 258.19 258.20 258.21 258.22 258.23
258.24 258.25 258.26 258.27 258.28 258.29 258.30 259.1 259.2 259.3
259.4 259.5 259.6 259.7 259.8 259.9 259.10
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
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
260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10
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
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
262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16
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
263.30 263.31 263.32 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 264.31 264.32 264.33 264.34 264.35 265.1 265.2 265.3 265.4 265.5
265.6 265.7 265.8 265.9 265.10 265.11
265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28
266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28
267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12
267.13 267.14 267.15 267.16 267.17 267.18
267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 268.1 268.2 268.3 268.4 268.5 268.6
268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8
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
270.25 270.26 270.27 270.28 270.29 270.30 270.31 270.32 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34 271.35 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34 272.35 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 273.33 273.34 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29
274.30 274.31 274.32 274.33 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18
275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 278.33 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 280.33 281.1 281.2 281.3 281.4 281.5 281.6
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
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
282.27 282.28 282.29 282.30 282.31 282.32 282.33 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21
284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23
285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19
287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22
288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16
291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28
293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 293.32 293.33
294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 295.1
295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11
297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31
298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30
299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 300.32
301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10
303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16
304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19
305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30
307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25
307.26 307.27 307.28 307.29 307.30 307.31 307.32 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17
308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33 308.34 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22
309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 309.32 309.33 310.1 310.2 310.3 310.4 310.5
310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21
310.22 310.23 310.24 310.25
310.26 310.27
311.1 311.2
311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 312.1 312.2
312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18
314.19 314.20
314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29
315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 315.32 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25
316.26 316.27 316.28 316.29 316.30 316.31 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 317.32 317.33 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 318.32 318.33 318.34 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19 319.20 319.21 319.22 319.23 319.24 319.25 319.26 319.27 319.28 319.29 319.30 319.31 319.32 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 320.31 320.32 321.1 321.2 321.3 321.4 321.5
321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24
323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 326.32 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19 327.20 327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15
329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 331.1 331.2 331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24
332.25 332.26 332.27 332.28 332.29 332.30 333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18
334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9
335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26 336.27 336.28
336.29 336.30 336.31 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11 337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 337.32 338.1 338.2 338.3 338.4
338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 344.32 344.33 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20
345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29 347.30 347.31 348.1 348.2 348.3
348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 350.1 350.2 350.3 350.4 350.5
350.6 350.7 350.8 350.9 350.10 350.11
350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 352.1 352.2 352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 356.32 357.1 357.2 357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 357.32 357.33
358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 361.32 361.33 361.34 361.35 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 364.32 364.33 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16
370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 371.32 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 376.32 376.33 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16 378.17 378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 378.29 378.30 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29 379.30 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 380.34 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29 381.30 381.31 381.32 381.33 381.34 382.1 382.2 382.3
382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13
382.14 382.15 382.16 382.17
382.18 382.19
382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11 383.12
383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24 383.25 383.26 383.27 383.28 383.29 383.30 383.31 383.32 384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18
384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31 384.32 385.1 385.2 385.3 385.4 385.5 385.6
385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29 386.30 386.31 386.32 387.1 387.2 387.3 387.4 387.5 387.6 387.7 387.8 387.9 387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21 387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 387.32 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9 389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18 389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 389.31 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14 390.15 390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 391.31 391.32 391.33 392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14 392.15 392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 392.31 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14 393.15 393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28 393.29 393.30 393.31 393.32 393.33 393.34 394.1 394.2 394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 394.32 394.33 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28 395.29 395.30 395.31 395.32 395.33 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29 396.30 396.31 396.32 397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8 397.9 397.10 397.11 397.12 397.13 397.14 397.15 397.16 397.17 397.18 397.19 397.20 397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29 397.30 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16 398.17 398.18 398.19 398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27 398.28 398.29 398.30 398.31 399.1 399.2 399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 399.30 399.31
400.1 400.2 400.3 400.4
400.5 400.6 400.7
400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18
400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 401.1 401.2
401.3 401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16
401.17 401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 401.29 401.30 401.31 401.32 402.1 402.2 402.3
402.4 402.5 402.6 402.7 402.8 402.9 402.10 402.11 402.12 402.13 402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25 402.26 402.27 402.28 402.29 402.30 403.1 403.2 403.3 403.4 403.5
403.6 403.7 403.8 403.9 403.10 403.11 403.12 403.13 403.14 403.15 403.16 403.17 403.18 403.19 403.20 403.21 403.22 403.23 403.24 403.25 403.26 403.27 403.28 403.29 403.30 404.1 404.2 404.3 404.4 404.5 404.6 404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14 404.15 404.16
404.17 404.18 404.19 404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 404.32 404.33 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8
405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21 405.22 405.23 405.24 405.25 405.26 405.27 405.28 405.29 405.30 405.31 406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12
406.13 406.14 406.15 406.16 406.17 406.18 406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29 406.30 406.31 406.32 407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8
407.9 407.10 407.11
407.12 407.13 407.14 407.15 407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27
407.28 407.29 407.30 408.1 408.2 408.3 408.4 408.5 408.6 408.7 408.8 408.9 408.10 408.11 408.12 408.13 408.14 408.15 408.16 408.17
408.18 408.19 408.20 408.21 408.22 408.23 408.24 408.25 408.26 408.27 408.28 408.29 408.30 408.31 408.32 408.33 409.1 409.2 409.3 409.4 409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16 409.17
409.18 409.19 409.20 409.21 409.22 409.23 409.24 409.25 409.26
409.27 409.28 409.29 409.30 409.31
410.1 410.2 410.3 410.4 410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14 410.15 410.16 410.17 410.18 410.19 410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27 410.28 410.29 410.30 410.31 410.32 411.1 411.2 411.3 411.4 411.5 411.6 411.7 411.8 411.9 411.10 411.11 411.12 411.13 411.14 411.15 411.16 411.17 411.18 411.19 411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28 411.29 411.30 411.31 411.32 412.1 412.2 412.3 412.4 412.5 412.6 412.7 412.8 412.9 412.10 412.11 412.12
412.13 412.14 412.15 412.16 412.17 412.18 412.19 412.20 412.21 412.22 412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 412.31 413.1 413.2 413.3 413.4 413.5 413.6 413.7 413.8 413.9 413.10 413.11 413.12 413.13 413.14 413.15
413.16 413.17 413.18 413.19 413.20 413.21 413.22
413.23 413.24 413.25 413.26 413.27 413.28 413.29
414.1 414.2 414.3 414.4
414.5 414.6 414.7 414.8 414.9 414.10 414.11 414.12 414.13 414.14 414.15 414.16 414.17 414.18 414.19
414.20 414.21 414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29 414.30 414.31
415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8 415.9 415.10 415.11 415.12 415.13 415.14 415.15
415.16 415.17 415.18 415.19 415.20 415.21 415.22 415.23 415.24 415.25 415.26 415.27 415.28 415.29 415.30 415.31 415.32 415.33 415.34
416.1 416.2 416.3 416.4 416.5 416.6 416.7 416.8 416.9 416.10 416.11 416.12 416.13 416.14 416.15 416.16 416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24
416.25 416.26 416.27 416.28 416.29 416.30 416.31 417.1 417.2 417.3 417.4 417.5 417.6 417.7 417.8 417.9 417.10 417.11 417.12 417.13 417.14 417.15 417.16 417.17 417.18 417.19 417.20 417.21 417.22
417.23 417.24 417.25 417.26 417.27 417.28 417.29 417.30 417.31
418.1 418.2 418.3 418.4 418.5 418.6 418.7 418.8 418.9 418.10 418.11 418.12 418.13 418.14 418.15 418.16 418.17 418.18 418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26 418.27 418.28 418.29
418.30 418.31 418.32 419.1 419.2 419.3 419.4 419.5 419.6 419.7 419.8 419.9 419.10 419.11 419.12 419.13 419.14 419.15
419.16 419.17 419.18 419.19 419.20 419.21 419.22 419.23 419.24 419.25 419.26 419.27 419.28 419.29 419.30 419.31 419.32 419.33 420.1 420.2 420.3 420.4 420.5 420.6 420.7 420.8
420.9 420.10 420.11 420.12 420.13 420.14 420.15 420.16 420.17 420.18 420.19 420.20 420.21 420.22 420.23 420.24 420.25 420.26 420.27 420.28 420.29 420.30 421.1 421.2 421.3 421.4 421.5 421.6 421.7 421.8
421.9 421.10 421.11 421.12 421.13 421.14 421.15 421.16 421.17 421.18 421.19 421.20 421.21 421.22 421.23 421.24 421.25 421.26 421.27 421.28
422.1 422.2 422.3 422.4 422.5 422.6 422.7 422.8 422.9 422.10 422.11
422.12 422.13 422.14 422.15
422.16 422.17 422.18 422.19 422.20 422.21 422.22 422.23 422.24 422.25 422.26 422.27 422.28 422.29 422.30 422.31 422.32 423.1 423.2 423.3 423.4 423.5 423.6 423.7 423.8 423.9 423.10 423.11 423.12 423.13 423.14 423.15 423.16 423.17 423.18 423.19 423.20 423.21 423.22
423.23 423.24 423.25 423.26 423.27 423.28 423.29
423.30 423.31 423.32 424.1 424.2 424.3 424.4 424.5 424.6 424.7 424.8 424.9 424.10 424.11 424.12 424.13
424.14 424.15 424.16 424.17 424.18 424.19 424.20
424.21 424.22 424.23 424.24 424.25 424.26 424.27
424.28 424.29 424.30 424.31
425.1 425.2 425.3 425.4 425.5 425.6 425.7 425.8 425.9 425.10 425.11 425.12 425.13 425.14 425.15
425.16 425.17 425.18 425.19 425.20 425.21 425.22 425.23 425.24 425.25 425.26 425.27 425.28 425.29 425.30 425.31 425.32 425.33 425.34 425.35 426.1 426.2 426.3
426.4 426.5 426.6 426.7 426.8 426.9 426.10 426.11 426.12 426.13 426.14 426.15 426.16 426.17 426.18 426.19 426.20 426.21 426.22 426.23 426.24 426.25 426.26 426.27 426.28
426.29 426.30 426.31 427.1 427.2 427.3 427.4 427.5 427.6 427.7 427.8 427.9 427.10 427.11 427.12
427.13 427.14 427.15 427.16
427.17 427.18 427.19 427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 428.1 428.2 428.3 428.4 428.5 428.6 428.7 428.8 428.9 428.10
428.11 428.12 428.13 428.15 428.14 428.16 428.17 428.18 428.19 428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 428.30 428.31 428.32 428.33 428.34 428.35 429.1 429.2 429.3 429.4 429.5 429.6 429.7 429.8 429.9 429.10 429.11 429.12 429.13 429.14 429.15 429.16 429.17 429.18 429.19 429.20 429.21 429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30 429.31 429.32 429.33 429.34 429.35 429.36 429.37 429.38 429.39 429.40 429.41 429.42 429.43 429.44 429.45 429.46 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16 430.17 430.18 430.19 430.20 430.21 430.22 430.23 430.24 430.25 430.26 430.27 430.28 430.29 430.30 430.31 430.32 430.33 430.34 430.35 430.36 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17 431.18 431.19 431.20 431.21 431.22 431.23 431.24 431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 431.33 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11 432.12 432.13 432.14 432.15 432.16 432.17 432.18 432.19 432.20
432.21 432.22 432.23 432.24 432.25 432.26 432.27 432.28 432.29 432.30 432.31 432.32 432.33 433.1 433.2 433.3 433.4 433.5 433.6 433.7 433.8 433.9 433.10 433.11 433.12 433.13 433.14 433.15 433.16 433.17 433.18 433.19 433.20 433.21 433.22 433.23 433.24 433.25 433.26 433.27 433.28 433.29 433.30 433.31 433.32 433.33 433.34 434.1 434.2 434.3 434.4 434.5 434.6 434.7 434.8 434.9 434.10
434.11 434.12 434.13 434.14 434.15
434.16 434.17 434.18 434.19 434.20 434.21
434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29 434.30 434.31
435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8
435.9 435.10 435.11 435.12
435.13 435.14 435.15 435.16 435.17 435.18 435.19 435.20 435.21 435.22 435.23
435.24 435.25 435.26 435.27 435.28 435.29 435.30 435.31 436.1 436.2 436.3
436.4 436.5 436.6 436.7 436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 436.31 436.32 436.33 437.1 437.2 437.3 437.4 437.5 437.6 437.7 437.8 437.9 437.10 437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19 437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27 437.28 437.29 437.30 437.31 437.32 437.33 437.34 437.35 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16 438.17 438.18 438.19 438.20 438.21 438.22 438.23 438.24 438.25 438.26 438.27 438.28 438.29 438.30 438.31 438.32 439.1 439.2 439.3 439.4 439.5 439.6 439.7 439.8 439.9 439.10 439.11 439.12 439.13 439.14 439.15 439.16 439.17 439.18 439.19 439.20 439.21 439.22 439.23 439.24 439.25 439.26
439.27 439.28 439.29 439.30 439.31 440.1 440.2 440.3 440.4 440.5 440.6 440.7 440.8 440.9 440.10 440.11 440.12 440.13 440.14 440.15 440.16 440.17 440.18 440.19 440.20 440.21 440.22 440.23 440.24 440.25 440.26 440.27 440.28 440.29 440.30 440.31
441.1 441.2 441.3 441.4 441.5 441.6 441.7 441.8 441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19 441.20 441.21 441.22
441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 441.31 441.32 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9 442.10 442.11 442.12 442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24 442.25 442.26 442.27 442.28 442.29 442.30 442.31 442.32 442.33 443.1 443.2 443.3 443.4 443.5 443.6 443.7 443.8 443.9 443.10 443.11 443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19 443.20 443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28
443.29 443.30 443.31 443.32 444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12 444.13 444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26 444.27 444.28 444.29 444.30 444.31 444.32 444.33 445.1 445.2 445.3 445.4 445.5 445.6 445.7 445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16 445.17 445.18 445.19 445.20 445.21 445.22 445.23 445.24 445.25 445.26 445.27 445.28 445.29 445.30 445.31 445.32 445.33 446.1 446.2 446.3 446.4 446.5 446.6 446.7 446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 446.32 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16 447.17 447.18 447.19 447.20 447.21 447.22 447.23 447.24 447.25 447.26 447.27 447.28
447.29 447.30 447.31 447.32 448.1 448.2 448.3 448.4 448.5 448.6 448.7 448.8 448.9 448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21 448.22 448.23 448.24 448.25 448.26 448.27 448.28 448.29 448.30 448.31 448.32 448.33 449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14 449.15 449.16 449.17 449.18 449.19 449.20 449.21 449.22 449.23 449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 449.32 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16 450.17 450.18 450.19
450.20 450.21 450.22 450.23 450.24 450.25 450.26 450.27 450.28 450.29 450.30 451.1 451.2 451.3 451.4 451.5 451.6 451.7 451.8 451.9 451.10 451.11 451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30 451.31 451.32 451.33 452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13 452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28
452.29 452.30 452.31 452.32 452.33 453.1 453.2 453.3 453.4 453.5 453.6
453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 453.31 453.32 454.1 454.2 454.3 454.4 454.5
454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17
454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8 456.9 456.10
456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19 456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 456.31 457.1 457.2 457.3 457.4 457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26 457.27 457.28 457.29 457.30 458.1 458.2 458.3 458.4 458.5 458.6 458.7 458.8 458.9 458.10 458.11 458.12 458.13 458.14 458.15 458.16 458.17 458.18 458.19
458.20 458.21 458.22 458.23 458.24 458.25 458.26 458.27 458.28 458.29 458.30 458.31 458.32 459.1 459.2 459.3 459.4 459.5 459.6 459.7 459.8 459.9 459.10 459.11 459.12 459.13 459.14 459.15 459.16 459.17 459.18 459.19 459.20 459.21 459.22 459.23 459.24 459.25 459.26 459.27 459.28 459.29 459.30 459.31 459.32 459.33 460.1 460.2 460.3 460.4 460.5 460.6 460.7 460.8 460.9 460.10 460.11 460.12 460.13 460.14 460.15 460.16 460.17 460.18 460.19 460.20 460.21 460.22 460.23 460.24 460.25
460.26 460.27 460.28 460.29 460.30 460.31 460.32 461.1 461.2 461.3 461.4 461.5 461.6 461.7
461.8 461.9 461.10 461.11 461.12 461.13 461.14 461.15 461.16 461.17 461.18 461.19 461.20 461.21 461.22 461.23 461.24 461.25 461.26 461.27 461.28 461.29 461.30 461.31 461.32 461.33 462.1 462.2 462.3 462.4 462.5 462.6 462.7
462.8 462.9 462.10 462.11 462.12 462.13 462.14 462.15 462.16 462.17 462.18 462.19 462.20 462.21 462.22 462.23 462.24 462.25 462.26 462.27 462.28 462.29 462.30 462.31 462.32 463.1 463.2 463.3 463.4 463.5 463.6 463.7 463.8 463.9 463.10 463.11 463.12 463.13 463.14 463.15 463.16 463.17 463.18 463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27 463.28 463.29 463.30 463.31 463.32 463.33 464.1 464.2 464.3
464.4 464.5 464.6 464.7 464.8 464.9 464.10 464.11 464.12 464.13 464.14 464.15 464.16 464.17 464.18 464.19 464.20 464.21 464.22 464.23 464.24 464.25 464.26 464.27 464.28 464.29 464.30 464.31 464.32 465.1 465.2 465.3 465.4 465.5 465.6 465.7 465.8 465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23 465.24 465.25
465.26 465.27
465.28 465.29 465.30 465.31 465.32 465.33 466.1 466.2 466.3 466.4 466.5 466.6
466.7 466.8 466.9 466.10 466.11 466.12 466.13 466.14 466.15 466.16 466.17 466.18 466.19 466.20
466.21 466.22 466.23 466.24 466.25 466.26
466.27 466.28 466.29 466.30 466.31 466.32 467.1 467.2 467.3 467.4 467.5 467.6 467.7
467.8 467.9 467.10 467.11 467.12 467.13 467.14 467.15 467.16 467.17 467.18 467.19 467.20 467.21 467.22 467.23 467.24 467.25 467.26 467.27 467.28
468.1 468.2 468.3 468.4 468.5 468.6 468.7 468.8 468.9 468.10 468.11 468.12 468.13 468.14 468.15 468.16 468.17 468.18 468.19 468.20 468.21 468.22 468.23 468.24 468.25 468.26 468.27 468.28 468.29 468.30 469.1 469.2 469.3 469.4 469.5 469.6 469.7 469.8 469.9 469.10 469.11 469.12 469.13 469.14 469.15 469.16 469.17 469.18 469.19 469.20
469.21 469.22 469.23 469.24 469.25 469.26 469.27 469.28 469.29 469.30 469.31 470.1 470.2 470.3 470.4 470.5 470.6 470.7 470.8 470.9 470.10 470.11 470.12 470.13 470.14 470.15 470.16 470.17 470.18
470.19 470.20 470.21 470.22 470.23 470.24 470.25 470.26 470.27 470.28 470.29 470.30 470.31 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18
471.19 471.20 471.21 471.22 471.23 471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 471.32 472.1 472.2 472.3 472.4 472.5 472.6 472.7 472.8 472.9 472.10 472.11 472.12 472.13 472.14 472.15 472.16 472.17 472.18 472.19 472.20 472.21 472.22 472.23 472.24 472.25 472.26 472.27 472.28 472.29 472.30 472.31 472.32 472.33 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11 473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19 473.20 473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29 473.30 473.31 473.32 473.33 473.34 474.1 474.2 474.3 474.4 474.5 474.6 474.7 474.8 474.9 474.10 474.11 474.12 474.13 474.14 474.15 474.16 474.17 474.18 474.19 474.20 474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29 474.30 474.31 474.32 474.33 474.34 475.1 475.2 475.3 475.4 475.5 475.6 475.7 475.8 475.9 475.10 475.11 475.12 475.13 475.14 475.15
475.16 475.17 475.18 475.19 475.20 475.21 475.22 475.23 475.24 475.25 475.26 475.27 475.28 475.29 475.30 475.31 475.32 476.1
476.2 476.3 476.4 476.5 476.6 476.7 476.8 476.9 476.10 476.11 476.12 476.13 476.14 476.15 476.16 476.17 476.18 476.19 476.20 476.21 476.22 476.23 476.24 476.25 476.26 476.27 476.28 476.29
476.30 476.31 476.32 477.1 477.2 477.3 477.4 477.5 477.6 477.7 477.8 477.9 477.10 477.11 477.12 477.13 477.14 477.15
477.16 477.17 477.18 477.19 477.20 477.21 477.22 477.23 477.24 477.25 477.26 477.27 477.28 477.29 477.30 477.31 477.32 477.33 478.1 478.2 478.3 478.4 478.5 478.6 478.7 478.8 478.9 478.10 478.11 478.12 478.13 478.14 478.15 478.16 478.17 478.18 478.19 478.20 478.21 478.22 478.23 478.24
478.25 478.26 478.27 478.28 478.29
479.1 479.2 479.3 479.4 479.5 479.6 479.7 479.8 479.9 479.10 479.11 479.12 479.13 479.14 479.15 479.16 479.17 479.18 479.19 479.20 479.21 479.22 479.23 479.24 479.25 479.26 479.27 479.28 479.29 479.30 479.31 479.32 479.33 480.1 480.2 480.3 480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20 480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 480.32 480.33 481.1 481.2 481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10 481.11 481.12 481.13 481.14 481.15 481.16 481.17 481.18 481.19 481.20 481.21 481.22 481.23 481.24 481.25 481.26 481.27 481.28 481.29 481.30 481.31 481.32 481.33 481.34 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10 482.11 482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21 482.22 482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31 482.32 482.33
483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10 483.11 483.12 483.13 483.14 483.15 483.16 483.17 483.18 483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28 483.29
484.1 484.2 484.3 484.4 484.5 484.6 484.7 484.8 484.9 484.10 484.11 484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21 484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 484.30 484.31 484.32 484.33 484.34 485.1 485.2 485.3 485.4 485.5 485.6 485.7 485.8 485.9 485.10 485.11 485.12 485.13 485.14 485.15 485.16 485.17 485.18 485.19 485.20 485.21 485.22 485.23 485.24 485.25 485.26 485.27 485.28 485.29 485.30 485.31 485.32 485.33 486.1 486.2 486.3 486.4 486.5 486.6 486.7 486.8 486.9 486.10 486.11 486.12 486.13 486.14 486.15 486.16 486.17 486.18 486.19 486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29 486.30 486.31 486.32 486.33 486.34 487.1 487.2 487.3 487.4 487.5 487.6 487.7 487.8 487.9 487.10 487.11 487.12 487.13 487.14 487.15 487.16 487.17 487.18 487.19 487.20 487.21 487.22 487.23 487.24 487.25 487.26 487.27 487.28 487.29 487.30 487.31 487.32 487.33 488.1 488.2 488.3 488.4 488.5 488.6
488.7 488.8 488.9 488.10 488.11 488.12 488.13 488.14 488.15 488.16 488.17 488.18 488.19 488.20 488.21 488.22 488.23 488.24 488.25 488.26 488.27 488.28
488.29 488.30 488.31 489.1 489.2 489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14 489.15 489.16 489.17 489.18 489.19 489.20
489.21 489.22 489.23 489.24 489.25 489.26 489.27 489.28 489.29 489.30 489.31 489.32 490.1 490.2 490.3 490.4 490.5 490.6 490.7 490.8 490.9 490.10 490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27 490.28 490.29 490.30 490.31 490.32 491.1 491.2 491.3 491.4 491.5 491.6 491.7 491.8 491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20 491.21 491.22 491.23 491.24 491.25 491.26 491.27
491.28 491.29 491.30 491.31 491.32 492.1 492.2 492.3 492.4 492.5 492.6 492.7 492.8 492.9 492.10 492.11 492.12 492.13 492.14 492.15 492.16 492.17 492.18 492.19 492.20 492.21 492.22 492.23 492.24 492.25 492.26 492.27
492.28 492.29 492.30 492.31 492.32 492.33 493.1 493.2 493.3 493.4 493.5 493.6 493.7 493.8 493.9 493.10
493.11 493.12 493.13 493.14 493.15 493.16 493.17 493.18 493.19 493.20 493.21 493.22 493.23 493.24 493.25 493.26 493.27 493.28 493.29 493.30 494.1 494.2 494.3 494.4 494.5 494.6 494.7 494.8 494.9 494.10 494.11 494.12 494.13 494.14 494.15 494.16 494.17 494.18 494.19 494.20 494.21 494.22 494.23 494.24 494.25 494.26 494.27 494.28 494.29 494.30
495.1 495.2 495.3 495.4 495.5 495.6 495.7 495.8 495.9 495.10 495.11 495.12 495.13 495.14 495.15 495.16 495.17 495.18 495.19 495.20 495.21 495.22
495.23 495.24 495.25 495.26 495.27 495.28 495.29
496.1 496.2 496.3 496.4 496.5 496.6 496.7 496.8 496.9 496.10 496.11 496.12 496.13 496.14 496.15 496.16 496.17 496.18 496.19 496.20 496.21 496.22 496.23 496.24 496.25 496.26 496.27 496.28 496.29 496.30 496.31 496.32 496.33 497.1 497.2 497.3 497.4 497.5 497.6 497.7 497.8 497.9 497.10 497.11 497.12 497.13 497.14 497.15 497.16 497.17 497.18 497.19 497.20 497.21 497.22 497.23 497.24 497.25 497.26 497.27 497.28 497.29 497.30 498.1 498.2 498.3 498.4 498.5 498.6 498.7 498.8 498.9 498.10 498.11 498.12 498.13 498.14 498.15 498.16 498.17 498.18 498.19 498.20 498.21 498.22 498.23 498.24
498.25 498.26 498.27 498.28 498.29 498.30 499.1 499.2 499.3 499.4 499.5 499.6 499.7 499.8 499.9 499.10 499.11 499.12 499.13
499.14 499.15 499.16 499.17 499.18 499.19 499.20 499.21 499.22 499.23 499.24 499.25 499.26 499.27 499.28 499.29 499.30 499.31 499.32 500.1 500.2 500.3 500.4 500.5 500.6 500.7 500.8 500.9 500.10 500.11 500.12 500.13 500.14 500.15 500.16 500.17 500.18 500.19 500.20 500.21 500.22 500.23 500.24 500.25 500.26 500.27 500.28 500.29 500.30
501.1 501.2 501.3 501.4 501.5 501.6 501.7 501.8 501.9 501.10 501.11 501.12 501.13 501.14 501.15 501.16 501.17 501.18 501.19 501.20 501.21 501.22 501.23 501.24 501.25 501.26 501.27 501.28 501.29 501.30 501.31 501.32 502.1 502.2 502.3 502.4 502.5 502.6 502.7 502.8 502.9 502.10 502.11 502.12 502.13 502.14 502.15 502.16 502.17 502.18 502.19 502.20 502.21 502.22 502.23 502.24 502.25 502.26 502.27 502.28 502.29 502.30 502.31 502.32 503.1 503.2 503.3 503.4 503.5 503.6 503.7 503.8 503.9 503.10 503.11 503.12
503.13 503.14 503.15 503.16 503.17 503.18 503.19 503.20 503.21 503.22 503.23 503.24 503.25 503.26 503.27 503.28 503.29 503.30 503.31 504.1 504.2 504.3 504.4 504.5 504.6 504.7 504.8 504.9 504.10 504.11 504.12 504.13 504.14 504.15 504.16 504.17 504.18 504.19 504.20 504.21 504.22 504.23 504.24 504.25 504.26 504.27 504.28 504.29 504.30 504.31 505.1 505.2 505.3 505.4 505.5 505.6 505.7 505.8 505.9 505.10 505.11 505.12 505.13 505.14 505.15 505.16 505.17 505.18 505.19 505.20 505.21
505.22 505.23 505.24 505.25 505.26 505.27 505.28 505.29 505.30 505.31 505.32 505.33 505.34 506.1 506.2 506.3 506.4 506.5 506.6 506.7 506.8
506.9 506.10 506.11 506.12 506.13 506.14 506.15 506.16 506.17 506.18 506.19 506.20 506.21 506.22 506.23 506.24 506.25 506.26 506.27 506.28 506.29 506.30 506.31 507.1 507.2 507.3 507.4 507.5 507.6 507.7 507.8 507.9 507.10 507.11 507.12 507.13 507.14 507.15 507.16 507.17 507.18 507.19 507.20 507.21 507.22 507.23 507.24 507.25 507.26 507.27 507.28 507.29 507.30 507.31 508.1 508.2 508.3 508.4 508.5 508.6 508.7 508.8 508.9 508.10 508.11 508.12 508.13 508.14 508.15 508.16
508.17 508.18 508.19 508.20 508.21 508.22 508.23 508.24 508.25 508.26 508.27 508.28 508.29
509.1 509.2 509.3 509.4 509.5 509.6 509.7 509.8 509.9 509.10 509.11 509.12 509.13 509.14
509.15 509.16 509.17 509.18 509.19 509.20 509.21 509.22 509.23 509.24 509.25 509.26
509.27 509.28 509.29 509.30 509.31 510.1 510.2 510.3 510.4 510.5 510.6 510.7 510.8 510.9 510.10 510.11 510.12 510.13 510.14 510.15 510.16 510.17 510.18 510.19 510.20 510.21 510.22 510.23 510.24 510.25
510.26 510.27 510.28 510.29 510.30 510.31 511.1 511.2 511.3 511.4 511.5 511.6 511.7 511.8 511.9 511.10 511.11 511.12 511.13 511.14 511.15 511.16 511.17 511.18 511.19 511.20 511.21 511.22 511.23 511.24 511.25 511.26 511.27 511.28 511.29 511.30 511.31 511.32 511.33 512.1 512.2 512.3 512.4 512.5 512.6
512.7 512.8 512.9 512.10 512.11 512.12 512.13 512.14 512.15 512.16 512.17 512.18 512.19 512.20 512.21 512.22
512.23 512.24 512.25 512.26 512.27 512.28 512.29 512.30 513.1 513.2 513.3 513.4 513.5 513.6 513.7 513.8 513.9 513.10 513.11 513.12 513.13 513.14 513.15 513.16 513.17 513.18 513.19 513.20 513.21 513.22 513.23 513.24 513.25 513.26 513.27 513.28 513.29 513.30 513.31 514.1 514.2 514.3 514.4 514.5 514.6 514.7 514.8 514.9
514.10 514.11 514.12 514.13 514.14 514.15 514.16 514.17 514.18 514.19 514.20 514.21 514.22 514.23 514.24 514.25 514.26 514.27 514.28 514.29 514.30 514.31 514.32 515.1 515.2 515.3 515.4 515.5 515.6 515.7 515.8 515.9 515.10 515.11 515.12 515.13 515.14 515.15 515.16 515.17 515.18 515.19 515.20 515.21 515.22 515.23 515.24 515.25 515.26 515.27 515.28 515.29 515.30 515.31
516.1 516.2 516.3 516.4 516.5 516.6 516.7 516.8 516.9 516.10 516.11 516.12
516.13 516.14 516.15 516.16
516.17 516.18
516.19 516.20 516.21 516.22 516.23 516.24 516.25 516.26 516.27 516.28 516.29
516.30 516.31 516.32 517.1 517.2 517.3 517.4 517.5 517.6 517.7 517.8 517.9 517.10 517.11 517.12 517.13 517.14 517.15 517.16 517.17 517.18 517.19 517.20 517.21 517.22 517.23 517.24 517.25 517.26 517.27 517.28 517.29 517.30 517.31 517.32 517.33
518.1 518.2
518.3 518.4
518.5 518.6 518.7 518.8 518.9 518.10 518.11 518.12 518.13 518.14 518.15 518.16 518.17 518.18 518.19 518.20 518.21 518.22 518.23 518.24 518.25 518.26 518.27 518.28 518.29 518.30 518.31 518.32 518.33 518.34 518.35 518.36 518.37 518.38 518.39 518.40 518.41 518.42 518.43 518.44 518.45 518.46 518.47 518.48 518.49 519.1 519.2 519.3 519.4 519.5 519.6 519.7 519.8 519.9 519.10 519.11 519.12 519.13 519.14 519.15 519.16 519.17 519.18 519.19 519.20 519.21 519.22 519.23 519.24 519.25 519.26 519.27 519.28 519.29 519.30 519.31 519.32 519.33 519.34 519.35 519.36 519.37 519.38 519.39 519.40 519.41 519.42 519.43 519.44 519.45 519.46 519.47 519.48 519.49 520.1 520.2 520.3 520.4 520.5 520.6 520.7 520.8 520.9 520.10 520.11 520.12 520.13 520.14 520.15

CONFERENCE COMMITTEE REPORT ON H. F. No. 2128

A bill for an act
relating to state government; modifying provisions governing health, health care,
human services, human services licensing and background studies, health-related
licensing boards, prescription drugs, health insurance, telehealth, children and
family services, behavioral health, direct care and treatment, disability services
and continuing care for older adults, community supports, and chemical and mental
health services; establishing a budget for health and human services; making
forecast adjustments; making technical and conforming changes; requiring reports;
transferring money; appropriating money; amending Minnesota Statutes 2020,
sections 16A.151, subdivision 2; 62A.04, subdivision 2; 62A.10, by adding a
subdivision; 62A.15, subdivision 4, by adding a subdivision; 62A.152, subdivision
3; 62A.3094, subdivision 1; 62A.65, subdivision 1, by adding a subdivision;
62C.01, by adding a subdivision; 62D.01, by adding a subdivision; 62D.095,
subdivisions 2, 3, 4, 5; 62J.495, subdivisions 1, 2, 3, 4; 62J.497, subdivisions 1,
3; 62J.498; 62J.4981; 62J.4982; 62J.63, subdivisions 1, 2; 62Q.01, subdivision
2a; 62Q.02; 62Q.096; 62Q.46; 62Q.677, by adding a subdivision; 62Q.81; 62U.04,
subdivisions 4, 5, 11; 62V.05, by adding a subdivision; 62W.11; 103H.201,
subdivision 1; 119B.011, subdivision 15; 119B.025, subdivision 4; 119B.03,
subdivisions 4, 6; 119B.09, subdivision 4; 119B.11, subdivision 2a; 119B.125,
subdivision 1; 119B.13, subdivisions 1, 1a, 6, 7; 119B.25, subdivision 3; 122A.18,
subdivision 8; 136A.128, subdivisions 2, 4; 144.0724, subdivisions 1, 2, 3a, 4, 5,
7, 8, 9, 12; 144.1205, subdivisions 2, 4, 8, 9, by adding a subdivision; 144.125,
subdivision 1; 144.1481, subdivision 1; 144.1501, subdivisions 1, 2, 3; 144.1911,
subdivision 6; 144.212, by adding a subdivision; 144.225, subdivisions 2, 7;
144.226, by adding subdivisions; 144.55, subdivisions 4, 6; 144.551, subdivision
1, by adding a subdivision; 144.555; 144.651, subdivision 2; 144.9501, subdivision
17; 144.9502, subdivision 3; 144.9504, subdivisions 2, 5; 144D.01, subdivision
4; 144G.08, subdivision 7, as amended; 144G.54, subdivision 3; 144G.84; 145.893,
subdivision 1; 145.894; 145.897; 145.899; 145.901, subdivisions 2, 4; 147.033;
148.90, subdivision 2; 148.911; 148B.30, subdivision 1; 148B.31; 148B.51;
148B.5301, subdivision 2; 148B.54, subdivision 2; 148E.010, by adding a
subdivision; 148E.120, subdivision 2; 148E.130, subdivision 1, by adding a
subdivision; 148F.11, subdivision 1; 151.01, by adding subdivisions; 151.071,
subdivisions 1, 2; 151.37, subdivision 2; 151.555, subdivisions 1, 7, 11, by adding
a subdivision; 152.01, subdivision 23; 152.02, subdivisions 2, 3; 152.11, subdivision
1a, by adding a subdivision; 152.12, by adding a subdivision; 152.125, subdivision
3; 152.22, subdivisions 6, 11, by adding subdivisions; 152.23; 152.25, by adding
a subdivision; 152.26; 152.27, subdivisions 3, 4, 6; 152.28, subdivision 1; 152.29,
subdivisions 1, 3, by adding subdivisions; 152.31; 152.32, subdivision 3; 156.12,
subdivision 2; 171.07, by adding a subdivision; 174.30, subdivision 3; 245.462,
subdivisions 1, 6, 8, 9, 14, 16, 17, 18, 21, 23, by adding a subdivision; 245.4661,
subdivision 5; 245.4662, subdivision 1; 245.467, subdivisions 2, 3; 245.469,
subdivisions 1, 2; 245.470, subdivision 1; 245.4712, subdivision 2; 245.472,
subdivision 2; 245.4863; 245.4871, subdivisions 9a, 10, 11a, 17, 21, 26, 27, 29,
31, 32, 34, by adding a subdivision; 245.4876, subdivisions 2, 3; 245.4879,
subdivision 1; 245.488, subdivision 1; 245.4882, subdivisions 1, 3; 245.4885,
subdivision 1; 245.4889, subdivision 1; 245.4901, subdivision 2; 245.62,
subdivision 2; 245.735, subdivisions 3, 5, by adding a subdivision; 245A.02, by
adding subdivisions; 245A.03, subdivision 7; 245A.04, subdivision 5; 245A.041,
by adding a subdivision; 245A.043, subdivision 3; 245A.05; 245A.07, subdivision
1; 245A.10, subdivision 4; 245A.14, subdivision 4; 245A.16, by adding a
subdivision; 245A.50, subdivisions 7, 9; 245A.65, subdivision 2; 245C.02,
subdivisions 4a, 5, by adding subdivisions; 245C.03; 245C.05, subdivisions 1, 2,
2a, 2b, 2c, 2d, 4; 245C.08, subdivision 3, by adding a subdivision; 245C.10,
subdivision 15, by adding subdivisions; 245C.13, subdivision 2; 245C.14,
subdivision 1, by adding a subdivision; 245C.15, by adding a subdivision; 245C.16,
subdivisions 1, 2; 245C.17, subdivision 1, by adding a subdivision; 245C.18;
245C.24, subdivisions 2, 3, 4, by adding a subdivision; 245C.32, subdivision 1a;
245D.02, subdivision 20; 245F.04, subdivision 2; 245G.01, subdivisions 13, 26;
245G.03, subdivision 2; 245G.06, subdivision 1; 246.54, subdivision 1b; 254A.19,
subdivision 5; 254B.01, subdivision 4a, by adding a subdivision; 254B.05,
subdivision 5; 254B.12, by adding a subdivision; 256.01, subdivisions 14b, 28;
256.0112, subdivision 6; 256.041; 256.042, subdivisions 2, 4; 256.043, subdivision
3; 256.969, subdivisions 2b, 9, by adding a subdivision; 256.9695, subdivision 1;
256.9741, subdivision 1; 256.98, subdivision 1; 256.983; 256B.04, subdivisions
12, 14; 256B.055, subdivision 6; 256B.056, subdivision 10; 256B.057, subdivision
3; 256B.06, subdivision 4; 256B.0615, subdivisions 1, 5; 256B.0616, subdivisions
1, 3, 5; 256B.0621, subdivision 10; 256B.0622, subdivisions 1, 2, 3a, 4, 7, 7a, 7b,
7d; 256B.0623, subdivisions 1, 2, 3, 4, 5, 6, 9, 12; 256B.0624; 256B.0625,
subdivisions 3b, 3c, 3d, 3e, 5, 5m, 9, 10, 13, 13c, 13d, 13e, 13h, 17, 17b, 18, 18b,
19c, 20, 20b, 28a, 30, 31, 42, 46, 48, 49, 52, 56a, 58, by adding subdivisions;
256B.0631, subdivision 1; 256B.0638, subdivisions 3, 5, 6; 256B.0659, subdivisions
13, 21, 24, by adding subdivisions; 256B.0757, subdivision 4c; 256B.0759,
subdivisions 2, 4, by adding subdivisions; 256B.0911, subdivisions 1a, 3a, 3f, 4d;
256B.092, subdivisions 4, 5, 12; 256B.0924, subdivision 6; 256B.094, subdivision
6; 256B.0941, subdivision 1; 256B.0943, subdivisions 1, 2, 3, 4, 5, 5a, 6, 7, 9, 11;
256B.0946, subdivisions 1, 1a, 2, 3, 4, 6; 256B.0947, subdivisions 1, 2, 3, 3a, 5,
6, 7; 256B.0949, subdivisions 2, 4, 5a, by adding a subdivision; 256B.097, by
adding subdivisions; 256B.196, subdivision 2; 256B.25, subdivision 3; 256B.439,
by adding subdivisions; 256B.49, subdivisions 11, 11a, 14, 17, by adding a
subdivision; 256B.4914, subdivisions 5, 6, 7, 8, 9, by adding a subdivision;
256B.69, subdivisions 5a, 6, 6d, by adding subdivisions; 256B.6928, subdivision
5; 256B.75; 256B.76, subdivisions 2, 4; 256B.761; 256B.763; 256B.79,
subdivisions 1, 3; 256B.85, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12,
12b, 13, 13a, 15, 17a, 18a, 20b, 23, 23a, by adding subdivisions; 256D.03, by
adding a subdivision; 256D.051, by adding subdivisions; 256D.0515; 256D.0516,
subdivision 2; 256E.34, subdivision 1; 256I.03, subdivision 13; 256I.04, subdivision
3; 256I.05, subdivisions 1a, 1c, 11; 256I.06, subdivisions 6, 8; 256J.08, subdivisions
15, 71, 79; 256J.09, subdivision 3; 256J.10; 256J.21, subdivisions 3, 4, 5; 256J.24,
subdivision 5; 256J.30, subdivision 8; 256J.33, subdivisions 1, 2, 4; 256J.37,
subdivisions 1, 1b, 3, 3a; 256J.45, subdivision 1; 256J.626, subdivision 1; 256J.95,
subdivision 9; 256L.01, subdivision 5; 256L.03, subdivision 5; 256L.04, subdivision
7b; 256L.05, subdivision 3a; 256L.07, subdivision 2; 256L.11, subdivisions 6a,
7; 256L.15, subdivision 2; 256N.25, subdivisions 2, 3; 256N.26, subdivisions 11,
13; 256P.01, subdivisions 3, 6a, by adding a subdivision; 256P.04, subdivisions
4, 8; 256P.06, subdivisions 2, 3; 256P.07; 256S.05, subdivision 2; 256S.18,
subdivision 7; 256S.20, subdivision 1; 257.0755, subdivision 1; 257.076,
subdivisions 3, 5; 257.0768, subdivisions 1, 6; 257.0769; 260.761, subdivision 2;
260C.007, subdivisions 6, 14, 26c, 31; 260C.157, subdivision 3; 260C.212,
subdivisions 1a, 13; 260C.215, subdivision 4; 260C.4412; 260C.452; 260C.704;
260C.706; 260C.708; 260C.71; 260C.712; 260C.714; 260D.01; 260D.05; 260D.06,
subdivision 2; 260D.07; 260D.08; 260D.14; 260E.01; 260E.02, subdivision 1;
260E.03, subdivision 22, by adding subdivisions; 260E.06, subdivision 1; 260E.14,
subdivisions 2, 5; 260E.17, subdivision 1; 260E.18; 260E.20, subdivision 2;
260E.24, subdivisions 2, 7; 260E.31, subdivision 1; 260E.33, subdivision 1, by
adding a subdivision; 260E.35, subdivision 6; 260E.36, by adding a subdivision;
295.50, subdivision 9b; 295.53, subdivision 1; 325F.721, subdivision 1; 326.71,
subdivision 4; 326.75, subdivisions 1, 2, 3; Laws 2019, First Special Session
chapter 9, article 14, section 3, as amended; Laws 2020, First Special Session
chapter 7, section 1, subdivision 2, as amended; Laws 2020, Seventh Special
Session chapter 1, article 6, section 12, subdivision 4; proposing coding for new
law in Minnesota Statutes, chapters 3; 62A; 62J; 62Q; 62W; 119B; 144; 145; 151;
245; 245A; 245C; 254B; 256; 256B; 256P; 256S; proposing coding for new law
as Minnesota Statutes, chapter 245I; repealing Minnesota Statutes 2020, sections
16A.724, subdivision 2; 62A.67; 62A.671; 62A.672; 62J.63, subdivision 3;
119B.125, subdivision 5; 144.0721, subdivision 1; 144.0722; 144.0724, subdivision
10; 144.693; 245.462, subdivision 4a; 245.4871, subdivision 32a; 245.4879,
subdivision 2; 245.62, subdivisions 3, 4; 245.69, subdivision 2; 245.735,
subdivisions 1, 2, 4; 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10, 11, 12,
13, 14, 16; 256B.0596; 256B.0615, subdivision 2; 256B.0616, subdivision 2;
256B.0622, subdivisions 3, 5a; 256B.0623, subdivisions 7, 8, 10, 11; 256B.0625,
subdivisions 5l, 18c, 18d, 18e, 18h, 35a, 35b, 61, 62, 65; 256B.0916, subdivisions
2, 3, 4, 5, 8, 11, 12; 256B.0924, subdivision 4a; 256B.0943, subdivisions 8, 10;
256B.0944; 256B.0946, subdivision 5; 256B.097, subdivisions 1, 2, 3, 4, 5, 6;
256B.49, subdivisions 26, 27; 256D.051, subdivisions 1, 1a, 2, 2a, 3, 3a, 3b, 6b,
6c, 7, 8, 9, 18; 256D.052, subdivision 3; 256J.08, subdivisions 10, 53, 61, 62, 81,
83; 256J.21, subdivisions 1, 2; 256J.30, subdivisions 5, 7, 8; 256J.33, subdivisions
3, 4, 5; 256J.34, subdivisions 1, 2, 3, 4; 256J.37, subdivision 10; 256S.20,
subdivision 2; Minnesota Rules, parts 9505.0275; 9505.0370; 9505.0371;
9505.0372; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14,
15, 16, 17, 18, 19, 20, 21, 22; 9505.1699; 9505.1701; 9505.1703; 9505.1706;
9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730; 9505.1733;
9505.1736; 9505.1739; 9505.1742; 9505.1745; 9505.1748; 9520.0010; 9520.0020;
9520.0030; 9520.0040; 9520.0050; 9520.0060; 9520.0070; 9520.0080; 9520.0090;
9520.0100; 9520.0110; 9520.0120; 9520.0130; 9520.0140; 9520.0150; 9520.0160;
9520.0170; 9520.0180; 9520.0190; 9520.0200; 9520.0210; 9520.0230; 9520.0750;
9520.0760; 9520.0770; 9520.0780; 9520.0790; 9520.0800; 9520.0810; 9520.0820;
9520.0830; 9520.0840; 9520.0850; 9520.0860; 9520.0870; 9530.6800; 9530.6810.

May 16, 2021
The Honorable Melissa Hortman
Speaker of the House of Representatives

The Honorable Jeremy R. Miller
President of the Senate

We, the undersigned conferees for H. F. No. 2128 report that we have agreed upon the
items in dispute and recommend as follows:

That the Senate recede from its amendments and that H. F. No. 2128 be further amended
as follows:

Delete everything after the enacting clause and insert:

"ARTICLE 1

DEPARTMENT OF HUMAN SERVICES HEALTH CARE PROGRAMS

Section 1.

Minnesota Statutes 2020, section 256.01, is amended by adding a subdivision
to read:


new text begin Subd. 42.new text end

new text beginExpiration of report mandates.new text end

new text begin(a) If the submission of a report by the
commissioner of human services to the legislature is mandated by statute and the enabling
legislation does not include a date for the submission of a final report, the mandate to submit
the report shall expire in accordance with this section.
new text end

new text begin (b) If the mandate requires the submission of an annual report and the mandate was
enacted before January 1, 2021, the mandate shall expire on January 1, 2023. If the mandate
requires the submission of a biennial or less frequent report and the mandate was enacted
before January 1, 2021, the mandate shall expire on January 1, 2024.
new text end

new text begin (c) Any reporting mandate enacted on or after January 1, 2021, shall expire three years
after the date of enactment if the mandate requires the submission of an annual report and
shall expire five years after the date of enactment if the mandate requires the submission
of a biennial or less frequent report unless the enacting legislation provides for a different
expiration date.
new text end

new text begin (d) The commissioner shall submit a list to the chairs and ranking minority members of
the legislative committee with jurisdiction over human services by February 15 of each
year, beginning February 15, 2022, of all reports set to expire during the following calendar
year in accordance with this section.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256.969, subdivision 2b, is amended to read:


Subd. 2b.

Hospital payment rates.

(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:

(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;

(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;

(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and

(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.

(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.

(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base yearnew text begin or yearsnew text end for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.

(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).

(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:

(1) pediatric services;

(2) behavioral health services;

(3) trauma services as defined by the National Uniform Billing Committee;

(4) transplant services;

(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;

(6) outlier admissions;

(7) low-volume providers; and

(8) services provided by small rural hospitals that are not critical access hospitals.

(f) Hospital payment rates established under paragraph (c) must incorporate the following:

(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;

(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;

(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and

(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.

(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.

(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base yearnew text begin or yearsnew text end and the next base yearnew text begin or yearsnew text end.new text begin In
any year that inpatient claims volume falls below the threshold required to ensure a statically
valid sample of claims, the commissioner may combine claims data from two consecutive
years to serve as the base year. Years in which inpatient claims volume is reduced or altered
due to a pandemic or other public health emergency shall not be used as a base year or part
of a base year if the base year includes more than one year.
new text end Changes in costs between base
years shall be measured using the lower of the hospital cost index defined in subdivision 1,
paragraph (a), or the percentage change in the case mix adjusted cost per claim. The
commissioner shall establish the base year for each rebasing period considering the most
recent yearnew text begin or yearsnew text end for which filed Medicare cost reports are available. The estimated
change in the average payment per hospital discharge resulting from a scheduled rebasing
must be calculated and made available to the legislature by January 15 of each year in which
rebasing is scheduled to occur, and must include by hospital the differential in payment
rates compared to the individual hospital's costs.

(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:

(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;

(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and

(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.

(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:

(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;

(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);

(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and

(6) geographic location.

Sec. 3.

Minnesota Statutes 2020, section 256.969, is amended by adding a subdivision to
read:


new text begin Subd. 2f.new text end

new text beginAlternate inpatient payment rate.new text end

new text beginEffective 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 99 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).
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2022.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256.969, subdivision 9, is amended to read:


Subd. 9.

Disproportionate numbers of low-income patients served.

(a) For admissions
occurring on or after July 1, 1993, the medical assistance disproportionate population
adjustment shall comply with federal law and shall be paid to a hospital, excluding regional
treatment centers and facilities of the federal Indian Health Service, with a medical assistance
inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined
as follows:

(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic
mean for all hospitals excluding regional treatment centers and facilities of the federal Indian
Health Service but less than or equal to one standard deviation above the mean, the
adjustment must be determined by multiplying the total of the operating and property
payment rates by the difference between the hospital's actual medical assistance inpatient
utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers
and facilities of the federal Indian Health Service; and

(2) for a hospital with a medical assistance inpatient utilization rate above one standard
deviation above the mean, the adjustment must be determined by multiplying the adjustment
that would be determined under clause (1) for that hospital by 1.1. The commissioner shall
report annually on the number of hospitals likely to receive the adjustment authorized by
this paragraph. The commissioner shall specifically report on the adjustments received by
public hospitals and public hospital corporations located in cities of the first class.

(b) Certified public expenditures made by Hennepin County Medical Center shall be
considered Medicaid disproportionate share hospital payments. Hennepin County and
Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning
July 1, 2005, or another date specified by the commissioner, that may qualify for
reimbursement under federal law. Based on these reports, the commissioner shall apply for
federal matching funds.

(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective
retroactively from July 1, 2005, or the earliest effective date approved by the Centers for
Medicare and Medicaid Services.

(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid
in accordance with a new methodology using 2012 as the base year. Annual payments made
under this paragraph shall equal the total amount of payments made for 2012. A licensed
children's hospital shall receive only a single DSH factor for children's hospitals. Other
DSH factors may be combined to arrive at a single factor for each hospital that is eligible
for DSH payments. The new methodology shall make payments only to hospitals located
in Minnesota and include the following factors:

(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the
base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000
fee-for-service discharges in the base year shall receive a factor of 0.7880;

(2) a hospital that has in effect for the initial rate year a contract with the commissioner
to provide extended psychiatric inpatient services under section 256.9693 shall receive a
factor of 0.0160;

(3) a hospital that has receivednew text begin medical assistancenew text end payment deleted text beginfrom the fee-for-service
program
deleted text end for at least 20 transplant services in the base year shall receive a factor of 0.0435;

(4) a hospital that has a medical assistance utilization rate in the base year between 20
percent up to one standard deviation above the statewide mean utilization rate shall receive
a factor of 0.0468;

(5) a hospital that has a medical assistance utilization rate in the base year that is at least
one standard deviation above the statewide mean utilization rate but is less than two and
one-half standard deviations above the mean shall receive a factor of 0.2300; and

(6) a hospitalnew text begin that is a level one trauma center andnew text end that has a medical assistance utilization
rate in the base year that is at least two and one-half standard deviations above the statewide
mean utilization rate shall receive a factor of 0.3711.

new text begin (e) For the purposes of determining eligibility for the disproportionate share hospital
factors in paragraph (d), clauses (1) to (6), the medical assistance utilization rate and
discharge thresholds shall be measured using only one year when a two-year base period
is used.
new text end

deleted text begin (e)deleted text endnew text begin (f)new text end Any payments or portion of payments made to a hospital under this subdivision
that are subsequently returned to the commissioner because the payments are found to
exceed the hospital-specific DSH limit for that hospital shall be redistributed, proportionate
to the number of fee-for-service discharges, to other DSH-eligible non-children's hospitals
that have a medical assistance utilization rate that is at least one standard deviation above
the mean.

deleted text begin (f)deleted text endnew text begin (g)new text end An additional payment adjustment shall be established by the commissioner under
this subdivision for a hospital that provides high levels of administering high-cost drugs to
enrollees in fee-for-service medical assistance. The commissioner shall consider factors
including fee-for-service medical assistance utilization rates and payments made for drugs
purchased through the 340B drug purchasing program and administered to fee-for-service
enrollees. If any part of this adjustment exceeds a hospital's hospital-specific disproportionate
share hospital limit, the commissioner shall make a payment to the hospital that equals the
nonfederal share of the amount that exceeds the limit. The total nonfederal share of the
amount of the payment adjustment under this paragraph shall not exceed $1,500,000.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

Sec. 5.

Minnesota Statutes 2020, section 256.9695, subdivision 1, is amended to read:


Subdivision 1.

Appeals.

A hospital may appeal a decision arising from the application
of standards or methods under section 256.9685, 256.9686, or 256.969, if an appeal would
result in a change to the hospital's payment rate or payments. Both overpayments and
underpayments that result from the submission of appeals shall be implemented. Regardless
of any appeal outcome, relative values, Medicare wage indexes, Medicare cost-to-charge
ratios, and policy adjusters shall not be changed. The appeal shall be heard by an
administrative law judge according to sections 14.57 to 14.62, or upon agreement by both
parties, according to a modified appeals procedure established by the commissioner and the
Office of Administrative Hearings. In any proceeding under this section, the appealing party
must demonstrate by a preponderance of the evidence that the commissioner's determination
is incorrect or not according to law.

To appeal a payment rate or payment determination or a determination made from base
year information, the hospital shall file a written appeal request to the commissioner within
60 days of the date the preliminary payment rate determination was mailed. The appeal
request shall specify: (i) the disputed items; (ii) the authority in federal or state statute or
rule upon which the hospital relies for each disputed item; and (iii) the name and address
of the person to contact regarding the appeal. Facts to be considered in any appeal of base
year information are limited to those in existence deleted text begin12deleted text endnew text begin 18new text end months after the last day of the
calendar year that is the base year for the payment rates in dispute.

Sec. 6.

Minnesota Statutes 2020, section 256.983, is amended to read:


256.983 FRAUD PREVENTION INVESTIGATIONS.

Subdivision 1.

Programs established.

Within the limits of available appropriations, the
commissioner of human services shall require the maintenance of budget neutral fraud
prevention investigation programs in the counties new text beginor tribal agencies new text endparticipating in the
fraud prevention investigation project established under this section. If funds are sufficient,
the commissioner may also extend fraud prevention investigation programs to other counties
new text begin or tribal agencies new text endprovided the expansion is budget neutral to the state. Under any expansion,
the commissioner has the final authority in decisions regarding the creation and realignment
of individual countynew text begin, tribal agency,new text end or regional operations.

Subd. 2.

County new text beginand tribal agency new text endproposals.

Each participating county new text beginand tribal
new text end agency shall develop and submit an annual staffing and funding proposal to the commissioner
no later than April 30 of each year. Each proposal shall include, but not be limited to, the
staffing and funding of the fraud prevention investigation program, a job description for
investigators involved in the fraud prevention investigation program, and the organizational
structure of the county new text beginor tribal new text endagency unit, training programs for case workers, and the
operational requirements which may be directed by the commissioner. The proposal shall
be approved, to include any changes directed or negotiated by the commissioner, no later
than June 30 of each year.

Subd. 3.

Department responsibilities.

The commissioner shall establish training
programs which shall be attended by all investigative and supervisory staff of the involved
county new text beginand tribal new text endagencies. The commissioner shall also develop the necessary operational
guidelines, forms, and reporting mechanisms, which shall be used by the involved countynew text begin
or tribal
new text end agencies. An individual's application or redetermination form for public assistance
benefits, including child care assistance programs and medical care programs, must include
an authorization for release by the individual to obtain documentation for any information
on that form which is involved in a fraud prevention investigation. The authorization for
release is effective for six months after public assistance benefits have ceased.

Subd. 4.

Funding.

(a) County new text beginand tribal new text endagency reimbursement shall be made through
the settlement provisions applicable to the Supplemental Nutrition Assistance Program
(SNAP), MFIP, child care assistance programs, the medical assistance program, and other
federal and state-funded programs.

(b) The commissioner will maintain program compliance if for any three consecutive
month period, a county new text beginor tribal new text endagency fails to comply with fraud prevention investigation
program guidelines, or fails to meet the cost-effectiveness standards developed by the
commissioner. This result is contingent on the commissioner providing written notice,
including an offer of technical assistance, within 30 days of the end of the third or subsequent
month of noncompliance. The county new text beginor tribal new text endagency shall be required to submit a corrective
action plan to the commissioner within 30 days of receipt of a notice of noncompliance.
Failure to submit a corrective action plan or, continued deviation from standards of more
than ten percent after submission of a corrective action plan, will result in denial of funding
for each subsequent month, or billing the county new text beginor tribal new text endagency for fraud prevention
investigation (FPI) service provided by the commissioner, or reallocation of program grant
funds, or investigative resources, or both, to other countiesnew text begin or tribal agenciesnew text end. The denial of
funding shall apply to the general settlement received by the county new text beginor tribal new text endagency on a
quarterly basis and shall not reduce the grant amount applicable to the FPI project.

Subd. 5.

Child care providers; financial misconduct.

(a) A county or tribal agency
may conduct investigations of financial misconduct by child care providers as described in
chapter 245E. Prior to opening an investigation, a county or tribal agency must contact the
commissioner to determine whether an investigation under this chapter may compromise
an ongoing investigation.

(b) If, upon investigation, a preponderance of evidence shows a provider committed an
intentional program violation, intentionally gave the county or tribe materially false
information on the provider's billing forms, provided false attendance records to a county,
tribe, or the commissioner, or committed financial misconduct as described in section
245E.01, subdivision 8, the county or tribal agency may suspend a provider's payment
pursuant to chapter 245E, or deny or revoke a provider's authorization pursuant to section
119B.13, subdivision 6, paragraph (d), clause (2), prior to pursuing other available remedies.
The countynew text begin or tribenew text end must send notice in accordance with the requirements of section
119B.161, subdivision 2. If a provider's payment is suspended under this section, the payment
suspension shall remain in effect until: (1) the commissioner, county,new text begin tribe,new text end or a law
enforcement authority determines that there is insufficient evidence warranting the action
and a county, tribe, or the commissioner does not pursue an additional administrative remedy
under chapter 119B or 245E, or section 256.046 or 256.98; or (2) all criminal, civil, and
administrative proceedings related to the provider's alleged misconduct conclude and any
appeal rights are exhausted.

(c) For the purposes of this section, an intentional program violation includes intentionally
making false or misleading statements; intentionally misrepresenting, concealing, or
withholding facts; and repeatedly and intentionally violating program regulations under
chapters 119B and 245E.

(d) A provider has the right to administrative review under section 119B.161 if: (1)
payment is suspended under chapter 245E; or (2) the provider's authorization was denied
or revoked under section 119B.13, subdivision 6, paragraph (d), clause (2).

Sec. 7.

Minnesota Statutes 2020, section 256B.057, subdivision 3, is amended to read:


Subd. 3.

Qualified Medicare beneficiaries.

new text begin(a) new text endA person deleted text beginwho is entitled to Part A
Medicare benefits, whose income is equal to or less than 100 percent of the federal poverty
guidelines, and whose assets are no more than $10,000 for a single individual and $18,000
for a married couple or family of two or more,
deleted text end is eligible for medical assistance
reimbursement of new text beginMedicare new text endPart A and Part B premiums, Part A and Part B coinsurance
and deductibles, and cost-effective premiums for enrollment with a health maintenance
organization or a competitive medical plan under section 1876 of the Social Security Actdeleted text begin.deleted text endnew text begin
if:
new text end

new text begin (1) the person is entitled to Medicare Part A benefits;
new text end

new text begin (2) the person's income is equal to or less than 100 percent of the federal poverty
guidelines; and
new text end

new text begin (3) the person's assets are no more than (i) $10,000 for a single individual, or (ii) $18,000
for a married couple or family of two or more; or, when the resource limits for eligibility
for the Medicare Part D extra help low income subsidy (LIS) exceed either amount in item
(i) or (ii), the person's assets are no more than the LIS resource limit in United States Code,
title 42, section 1396d, subsection (p).
new text end

new text begin (b)new text end Reimbursement of the Medicare coinsurance and deductibles, when added to the
amount paid by Medicare, must not exceed the total rate the provider would have received
for the same service or services if the person were a medical assistance recipient with
Medicare coverage. Increases in benefits under Title II of the Social Security Act shall not
be counted as income for purposes of this subdivision until July 1 of each year.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 8.

Minnesota Statutes 2020, section 256B.0625, subdivision 3c, is amended to read:


Subd. 3c.

Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end.

(a) The commissioner,
after receiving recommendations from professional physician associations, professional
associations representing licensed nonphysician health care professionals, and consumer
groups, shall establish a deleted text begin13-memberdeleted text endnew text begin 14-membernew text end Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory
Council
new text end, which consists of deleted text begin12deleted text endnew text begin 13new text end voting members and one nonvoting member. The Health
Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end shall advise the commissioner regardingnew text begin (1)new text end
health services pertaining to the administration of health care benefits covered under deleted text beginthe
medical assistance and MinnesotaCare programs
deleted text endnew text begin Minnesota health care programs (MHCP);
and (2) evidence-based decision-making and health care benefit and coverage policies for
MHCP. The Health Services Advisory Council shall consider available evidence regarding
quality, safety, and cost-effectiveness when advising the commissioner
new text end. The Health Services
deleted text begin Policy Committeedeleted text endnew text begin Advisory Councilnew text end shall meet at least quarterly. The Health Services deleted text beginPolicy
Committee
deleted text endnew text begin Advisory Councilnew text end shall annually deleted text beginelectdeleted text endnew text begin selectnew text end a deleted text beginphysiciandeleted text end chair from among its
membersdeleted text begin,deleted text end who shall work directly with the commissioner's medical directordeleted text begin,deleted text end to establish
the agenda for each meeting. The Health Services deleted text beginPolicy Committee shall alsodeleted text endnew text begin Advisory
Council may
new text end recommend criteria for verifying centers of excellence for specific aspects of
medical care where a specific set of combined services, a volume of patients necessary to
maintain a high level of competency, or a specific level of technical capacity is associated
with improved health outcomes.

(b) The commissioner shall establish a dental deleted text beginsubcommitteedeleted text endnew text begin subcouncilnew text end to operate under
the Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end. The dental deleted text beginsubcommitteedeleted text endnew text begin
subcouncil
new text end consists of general dentists, dental specialists, safety net providers, dental
hygienists, health plan company and county and public health representatives, health
researchers, consumers, and a designee of the commissioner of health. The dental
deleted text begin subcommitteedeleted text endnew text begin subcouncilnew text end shall advise the commissioner regarding:

(1) the critical access dental program under section 256B.76, subdivision 4, including
but not limited to criteria for designating and terminating critical access dental providers;

(2) any changes to the critical access dental provider program necessary to comply with
program expenditure limits;

(3) dental coverage policy based on evidence, quality, continuity of care, and best
practices;

(4) the development of dental delivery models; and

(5) dental services to be added or eliminated from subdivision 9, paragraph (b).

deleted text begin (c) The Health Services Policy Committee shall study approaches to making provider
reimbursement under the medical assistance and MinnesotaCare programs contingent on
patient participation in a patient-centered decision-making process, and shall evaluate the
impact of these approaches on health care quality, patient satisfaction, and health care costs.
The committee shall present findings and recommendations to the commissioner and the
legislative committees with jurisdiction over health care by January 15, 2010.
deleted text end

deleted text begin (d)deleted text endnew text begin (c)new text end The Health Services deleted text beginPolicy Committee shalldeleted text endnew text begin Advisory Council maynew text end monitor and
track the practice patterns of deleted text beginphysicians providing services to medical assistance and
MinnesotaCare enrollees
deleted text endnew text begin health care providers who serve MHCP recipientsnew text end under
fee-for-service, managed care, and county-based purchasing. The deleted text begincommitteedeleted text endnew text begin monitoring
and tracking
new text end shall focus on services or specialties for which there is a high variation in
utilization new text beginor quality new text endacross deleted text beginphysiciansdeleted text endnew text begin providersnew text end, or which are associated with high medical
costs. The commissioner, based upon the findings of the deleted text begincommitteedeleted text endnew text begin Health Services Advisory
Council
new text end, deleted text beginshall regularlydeleted text endnew text begin maynew text end notify deleted text beginphysiciansdeleted text endnew text begin providersnew text end whose practice patterns indicate
new text begin below average quality or new text endhigher than average utilization or costs. Managed care and
county-based purchasing plans shall provide the commissioner with utilization and cost
data necessary to implement this paragraph, and the commissioner shall make deleted text beginthisdeleted text endnew text begin thesenew text end
data available to the deleted text begincommitteedeleted text endnew text begin Health Services Advisory Councilnew text end.

deleted text begin (e) The Health Services Policy Committee shall review caesarean section rates for the
fee-for-service medical assistance population. The committee may develop best practices
policies related to the minimization of caesarean sections, including but not limited to
standards and guidelines for health care providers and health care facilities.
deleted text end

Sec. 9.

Minnesota Statutes 2020, section 256B.0625, subdivision 3d, is amended to read:


Subd. 3d.

Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end members.

(a) The
Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end consists of:

(1) deleted text beginsevendeleted text endnew text begin sixnew text end voting members who are licensed physicians actively engaged in the practice
of medicine in Minnesota, deleted text beginone of whom must be actively engaged in the treatment of persons
with mental illness, and
deleted text end three of whom must represent health plans currently under contract
to serve deleted text beginmedical assistancedeleted text endnew text begin MHCPnew text end recipients;

(2) two voting members who are new text beginlicensed new text endphysician specialists actively practicing their
specialty in Minnesota;

(3) two voting members who are nonphysician health care professionals licensed or
registered in their profession and actively engaged in their practice of their profession in
Minnesota;

new text begin (4) one voting member who is a health care or mental health professional licensed or
registered in the member's profession, actively engaged in the practice of the member's
profession in Minnesota, and actively engaged in the treatment of persons with mental
illness;
new text end

deleted text begin (4) one consumerdeleted text endnew text begin (5) two consumersnew text end who shall serve as deleted text beginadeleted text end voting deleted text beginmemberdeleted text endnew text begin membersnew text end; and

deleted text begin (5)deleted text endnew text begin (6)new text end the commissioner's medical director who shall serve as a nonvoting member.

(b) Members of the Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end shall not be
employed by the deleted text beginDepartment of Human Servicesdeleted text endnew text begin state of Minnesotanew text end, except for the medical
director.new text begin A quorum shall comprise a simple majority of the voting members. Vacant seats
shall not count toward a quorum.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256B.0625, subdivision 3e, is amended to read:


Subd. 3e.

Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory Councilnew text end terms and
compensation.

deleted text beginCommitteedeleted text end Members shall serve staggered three-year terms, with one-third
of the voting members' terms expiring annually. Members may be reappointed by the
commissioner. The commissioner may require more frequent Health Services deleted text beginPolicy
Committee
deleted text endnew text begin Advisory Councilnew text end meetings as needed. An honorarium of $200 per meeting and
reimbursement for mileage and parking shall be paid to each deleted text begincommitteedeleted text endnew text begin councilnew text end member
in attendance except the medical director. The Health Services deleted text beginPolicy Committeedeleted text endnew text begin Advisory
Council
new text end does not expire as provided in section 15.059, subdivision 6.

Sec. 11.

Minnesota Statutes 2020, section 256B.0625, subdivision 30, is amended to read:


Subd. 30.

Other clinic services.

(a) Medical assistance covers rural health clinic services,
federally qualified health center services, nonprofit community health clinic services, and
public health clinic services. Rural health clinic services and federally qualified health center
services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and
(C). Payment for rural health clinic and federally qualified health center services shall be
made according to applicable federal law and regulation.

(b) A federally qualified health center (FQHC) that is beginning initial operation shall
submit an estimate of budgeted costs and visits for the initial reporting period in the form
and detail required by the commissioner. An FQHC that is already in operation shall submit
an initial report using actual costs and visits for the initial reporting period. Within 90 days
of the end of its reporting period, an FQHC shall submit, in the form and detail required by
the commissioner, a report of its operations, including allowable costs actually incurred for
the period and the actual number of visits for services furnished during the period, and other
information required by the commissioner. FQHCs that file Medicare cost reports shall
provide the commissioner with a copy of the most recent Medicare cost report filed with
the Medicare program intermediary for the reporting year which support the costs claimed
on their cost report to the state.

(c) In order to continue cost-based payment under the medical assistance program
according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation
as an essential community provider within six months of final adoption of rules by the
Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and
rural health clinics that have applied for essential community provider status within the
six-month time prescribed, medical assistance payments will continue to be made according
to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural
health clinics that either do not apply within the time specified above or who have had
essential community provider status for three years, medical assistance payments for health
services provided by these entities shall be according to the same rates and conditions
applicable to the same service provided by health care providers that are not FQHCs or rural
health clinics.

(d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural
health clinic to make application for an essential community provider designation in order
to have cost-based payments made according to paragraphs (a) and (b) no longer apply.

(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall
be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.

(f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health
clinic may elect to be paid either under the prospective payment system established in United
States Code, title 42, section 1396a(aa), or under an alternative payment methodology
consistent with the requirements of United States Code, title 42, section 1396a(aa), and
approved by the Centers for Medicare and Medicaid Services. The alternative payment
methodology shall be 100 percent of cost as determined according to Medicare cost
principles.

(g) Effective for services provided on or after January 1, 2021, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner, according to an annual election by the FQHC or rural health clinic, under
the current prospective payment system described in paragraph (f) or the alternative payment
methodology described in paragraph (l).

(h) For purposes of this section, "nonprofit community clinic" is a clinic that:

(1) has nonprofit status as specified in chapter 317A;

(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);

(3) is established to provide health services to low-income population groups, uninsured,
high-risk and special needs populations, underserved and other special needs populations;

(4) employs professional staff at least one-half of which are familiar with the cultural
background of their clients;

(5) charges for services on a sliding fee scale designed to provide assistance to
low-income clients based on current poverty income guidelines and family size; and

(6) does not restrict access or services because of a client's financial limitations or public
assistance status and provides no-cost care as needed.

(i) Effective for services provided on or after January 1, 2015, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner. the commissioner shall determine the most feasible method for paying claims
from the following options:

(1) FQHCs and rural health clinics submit claims directly to the commissioner for
payment, and the commissioner provides claims information for recipients enrolled in a
managed care or county-based purchasing plan to the plan, on a regular basis; or

(2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed
care or county-based purchasing plan to the plan, and those claims are submitted by the
plan to the commissioner for payment to the clinic.

(j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate
and pay monthly the proposed managed care supplemental payments to clinics, and clinics
shall conduct a timely review of the payment calculation data in order to finalize all
supplemental payments in accordance with federal law. Any issues arising from a clinic's
review must be reported to the commissioner by January 1, 2017. Upon final agreement
between the commissioner and a clinic on issues identified under this subdivision, and in
accordance with United States Code, title 42, section 1396a(bb), no supplemental payments
for managed care plan or county-based purchasing plan claims for services provided prior
to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are
unable to resolve issues under this subdivision, the parties shall submit the dispute to the
arbitration process under section 14.57.

(k) The commissioner shall seek a federal waiver, authorized under section 1115 of the
Social Security Act, to obtain federal financial participation at the 100 percent federal
matching percentage available to facilities of the Indian Health Service or tribal organization
in accordance with section 1905(b) of the Social Security Act for expenditures made to
organizations dually certified under Title V of the Indian Health Care Improvement Act,
Public Law 94-437, and as a federally qualified health center under paragraph (a) that
provides services to American Indian and Alaskan Native individuals eligible for services
under this subdivision.

(l) All claims for payment of clinic services provided by FQHCs and rural health clinics,
that have elected to be paid under this paragraph, shall be paid by the commissioner according
to the following requirements:

(1) the commissioner shall establish a single medical and single dental organization
encounter rate for each FQHC and rural health clinic when applicable;

(2) each FQHC and rural health clinic is eligible for same day reimbursement of one
medical and one dental organization encounter rate if eligible medical and dental visits are
provided on the same day;

(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance
with current applicable Medicare cost principles, their allowable costs, including direct
patient care costs and patient-related support services. Nonallowable costs include, but are
not limited to:

(i) general social services and administrative costs;

(ii) retail pharmacy;

(iii) patient incentives, food, housing assistance, and utility assistance;

(iv) external lab and x-ray;

(v) navigation services;

(vi) health care taxes;

(vii) advertising, public relations, and marketing;

(viii) office entertainment costs, food, alcohol, and gifts;

(ix) contributions and donations;

(x) bad debts or losses on awards or contracts;

(xi) fines, penalties, damages, or other settlements;

(xii) fund-raising, investment management, and associated administrative costs;

(xiii) research and associated administrative costs;

(xiv) nonpaid workers;

(xv) lobbying;

(xvi) scholarships and student aid; and

(xvii) nonmedical assistance covered services;

(4) the commissioner shall review the list of nonallowable costs in the years between
the rebasing process established in clause (5), in consultation with the Minnesota Association
of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall
publish the list and any updates in the Minnesota health care programs provider manual;

(5) the initial applicable base year organization encounter rates for FQHCs and rural
health clinics shall be computed for services delivered on or after January 1, 2021, and:

(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports
from 2017 and 2018;

(ii) must be according to current applicable Medicare cost principles as applicable to
FQHCs and rural health clinics without the application of productivity screens and upper
payment limits or the Medicare prospective payment system FQHC aggregate mean upper
payment limit;

(iii) must be subsequently rebased every two years thereafter using the Medicare cost
reports that are three and four years prior to the rebasing yearnew text begin. Years in which organizational
cost or claims volume is reduced or altered due to a pandemic, disease, or other public health
emergency shall not be used as part of a base year when the base year includes more than
one year. The commissioner may use the Medicare cost reports of a year unaffected by a
pandemic, disease, or other public health emergency, or previous two consecutive years,
inflated to the base year as established under item (iv)
new text end;

(iv) must be inflated to the base year using the inflation factor described in clause (6);
and

(v) the commissioner must provide for a 60-day appeals process under section 14.57;

(6) the commissioner shall annually inflate the applicable organization encounter rates
for FQHCs and rural health clinics from the base year payment rate to the effective date by
using the CMS FQHC Market Basket inflator established under United States Code, title
42, section 1395m(o), less productivity;

(7) FQHCs and rural health clinics that have elected the alternative payment methodology
under this paragraph shall submit all necessary documentation required by the commissioner
to compute the rebased organization encounter rates no later than six months following the
date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid
Services;

(8) the commissioner shall reimburse FQHCs and rural health clinics an additional
amount relative to their medical and dental organization encounter rates that is attributable
to the tax required to be paid according to section 295.52, if applicable;

(9) FQHCs and rural health clinics may submit change of scope requests to the
commissioner if the change of scope would result in an increase or decrease of 2.5 percent
or higher in the medical or dental organization encounter rate currently received by the
FQHC or rural health clinic;

(10) for FQHCs and rural health clinics seeking a change in scope with the commissioner
under clause (9) that requires the approval of the scope change by the federal Health
Resources Services Administration:

(i) FQHCs and rural health clinics shall submit the change of scope request, including
the start date of services, to the commissioner within seven business days of submission of
the scope change to the federal Health Resources Services Administration;

(ii) the commissioner shall establish the effective date of the payment change as the
federal Health Resources Services Administration date of approval of the FQHC's or rural
health clinic's scope change request, or the effective start date of services, whichever is
later; and

(iii) within 45 days of one year after the effective date established in item (ii), the
commissioner shall conduct a retroactive review to determine if the actual costs established
under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in
the medical or dental organization encounter rate, and if this is the case, the commissioner
shall revise the rate accordingly and shall adjust payments retrospectively to the effective
date established in item (ii);

(11) for change of scope requests that do not require federal Health Resources Services
Administration approval, the FQHC and rural health clinic shall submit the request to the
commissioner before implementing the change, and the effective date of the change is the
date the commissioner received the FQHC's or rural health clinic's request, or the effective
start date of the service, whichever is later. The commissioner shall provide a response to
the FQHC's or rural health clinic's request within 45 days of submission and provide a final
approval within 120 days of submission. This timeline may be waived at the mutual
agreement of the commissioner and the FQHC or rural health clinic if more information is
needed to evaluate the request;

(12) the commissioner, when establishing organization encounter rates for new FQHCs
and rural health clinics, shall consider the patient caseload of existing FQHCs and rural
health clinics in a 60-mile radius for organizations established outside of the seven-county
metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan
area. If this information is not available, the commissioner may use Medicare cost reports
or audited financial statements to establish base rate;

(13) the commissioner shall establish a quality measures workgroup that includes
representatives from the Minnesota Association of Community Health Centers, FQHCs,
and rural health clinics, to evaluate clinical and nonclinical measures; and

(14) the commissioner shall not disallow or reduce costs that are related to an FQHC's
or rural health clinic's participation in health care educational programs to the extent that
the costs are not accounted for in the alternative payment methodology encounter rate
established in this paragraph.

Sec. 12.

Minnesota Statutes 2020, section 256B.0638, subdivision 3, is amended to read:


Subd. 3.

Opioid prescribing work group.

(a) The commissioner of human services, in
consultation with the commissioner of health, shall appoint the following voting members
to an opioid prescribing work group:

(1) two consumer members who have been impacted by an opioid abuse disorder or
opioid dependence disorder, either personally or with family members;

(2) one member who is a licensed physician actively practicing in Minnesota and
registered as a practitioner with the DEA;

(3) one member who is a licensed pharmacist actively practicing in Minnesota and
registered as a practitioner with the DEA;

(4) one member who is a licensed nurse practitioner actively practicing in Minnesota
and registered as a practitioner with the DEA;

(5) one member who is a licensed dentist actively practicing in Minnesota and registered
as a practitioner with the DEA;

(6) two members who are nonphysician licensed health care professionals actively
engaged in the practice of their profession in Minnesota, and their practice includes treating
pain;

(7) one member who is a mental health professional who is licensed or registered in a
mental health profession, who is actively engaged in the practice of that profession in
Minnesota, and whose practice includes treating patients with chemical dependency or
substance abuse;

(8) one member who is a medical examiner for a Minnesota county;

(9) one member of the Health Services Policy Committee established under section
256B.0625, subdivisions 3c to 3e;

(10) one member who is a medical director of a health plan company doing business in
Minnesota;

(11) one member who is a pharmacy director of a health plan company doing business
in Minnesota; deleted text beginand
deleted text end

(12) one member representing Minnesota law enforcementdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (13) two consumer members who are Minnesota residents and who have used or are
using opioids to manage chronic pain.
new text end

(b) In addition, the work group shall include the following nonvoting members:

(1) the medical director for the medical assistance program;

(2) a member representing the Department of Human Services pharmacy unit; deleted text beginand
deleted text end

(3) the medical director for the Department of Labor and Industrydeleted text begin.deleted text endnew text begin; and
new text end

new text begin (4) a member representing the Minnesota Department of Health.
new text end

(c) An honorarium of $200 per meeting and reimbursement for mileage and parking
shall be paid to each voting member in attendance.

Sec. 13.

Minnesota Statutes 2020, section 256B.0638, subdivision 5, is amended to read:


Subd. 5.

Program implementation.

(a) The commissioner shall implement the programs
within the Minnesota health care program to improve the health of and quality of care
provided to Minnesota health care program enrollees. The commissioner shall annually
collect and report tonew text begin provider groups the sentinel measures of data showing individualnew text end opioid
deleted text begin prescribers data showing the sentinel measures of theirdeleted text endnew text begin prescribers'new text end opioid prescribing
patterns compared to their anonymized peers.new text begin Provider groups shall distribute data to their
affiliated, contracted, or employed opioid prescribers.
new text end

(b) The commissioner shall notify an opioid prescriber and all provider groups with
which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing
pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber
and any provider group that receives a notice under this paragraph shall submit to the
commissioner a quality improvement plan for review and approval by the commissioner
with the goal of bringing the opioid prescriber's prescribing practices into alignment with
community standards. A quality improvement plan must include:

(1) components of the program described in subdivision 4, paragraph (a);

(2) internal practice-based measures to review the prescribing practice of the opioid
prescriber and, where appropriate, any other opioid prescribers employed by or affiliated
with any of the provider groups with which the opioid prescriber is employed or affiliated;
and

(3) appropriate use of the prescription monitoring program under section 152.126.

(c) If, after a year from the commissioner's notice under paragraph (b), the opioid
prescriber's prescribing practices do not improve so that they are consistent with community
standards, the commissioner shall take one or more of the following steps:

(1) monitor prescribing practices more frequently than annually;

(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel
measures; or

(3) require the opioid prescriber to participate in additional quality improvement efforts,
including but not limited to mandatory use of the prescription monitoring program established
under section 152.126.

(d) The commissioner shall terminate from Minnesota health care programs all opioid
prescribers and provider groups whose prescribing practices fall within the applicable opioid
disenrollment standards.

Sec. 14.

Minnesota Statutes 2020, section 256B.0638, subdivision 6, is amended to read:


Subd. 6.

Data practices.

(a) Reports and data identifying an opioid prescriber are private
data on individuals as defined under section 13.02, subdivision 12, until an opioid prescriber
is subject to termination as a medical assistance provider under this section. Notwithstanding
this data classification, the commissioner shall share with all of the provider groups with
which an opioid prescriber is employednew text begin, contracted,new text end or affiliated, deleted text begina report identifying an
opioid prescriber who is subject to quality improvement activities
deleted text endnew text begin the datanew text end under subdivision
5, paragraphnew text begin (a),new text end (b)new text begin,new text end or (c).

(b) Reports and data identifying a provider group are nonpublic data as defined under
section 13.02, subdivision 9, until the provider group is subject to termination as a medical
assistance provider under this section.

(c) Upon termination under this section, reports and data identifying an opioid prescriber
or provider group are public, except that any identifying information of Minnesota health
care program enrollees must be redacted by the commissioner.

Sec. 15.

Minnesota Statutes 2020, section 256B.0659, subdivision 13, is amended to read:


Subd. 13.

Qualified professional; qualifications.

(a) The qualified professional must
work for a personal care assistance provider agency, meet the definition of qualified
professional under section 256B.0625, subdivision 19c, deleted text beginand enroll with the department as
a qualified professional after clearing
deleted text endnew text begin clearnew text end a background studynew text begin, and meet provider training
requirements
new text end. Before a qualified professional provides services, the personal care assistance
provider agency must initiate a background study on the qualified professional under chapter
245C, and the personal care assistance provider agency must have received a notice from
the commissioner that the qualified professional:

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

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

(b) The qualified professional shall perform the duties of training, supervision, and
evaluation of the personal care assistance staff and evaluation of the effectiveness of personal
care assistance services. The qualified professional shall:

(1) develop and monitor with the recipient a personal care assistance care plan based on
the service plan and individualized needs of the recipient;

(2) develop and monitor with the recipient a monthly plan for the use of personal care
assistance services;

(3) review documentation of personal care assistance services provided;

(4) provide training and ensure competency for the personal care assistant in the individual
needs of the recipient; and

(5) document all training, communication, evaluations, and needed actions to improve
performance of the personal care assistants.

(c) deleted text beginEffective July 1, 2011,deleted text end The qualified professional shall complete the provider training
with basic information about the personal care assistance program approved by the
commissioner. Newly hired qualified professionals must complete the training within six
months of the date hired by a personal care assistance provider agency. Qualified
professionals who have completed the required training as a worker from a personal care
assistance provider agency do not need to repeat the required training if they are hired by
another agency, if they have completed the training within the last three years. The required
training must be available with meaningful access according to title VI of the Civil Rights
Act and federal regulations adopted under that law or any guidance from the United States
Health and Human Services Department. The required training must be available online or
by electronic remote connection. The required training must provide for competency testing
to demonstrate an understanding of the content without attending in-person training. A
qualified professional is allowed to be employed and is not subject to the training requirement
until the training is offered online or through remote electronic connection. A qualified
professional employed by a personal care assistance provider agency certified for
participation in Medicare as a home health agency is exempt from the training required in
this subdivision. When available, the qualified professional working for a Medicare-certified
home health agency must successfully complete the competency test. The commissioner
shall ensure there is a mechanism in place to verify the identity of persons completing the
competency testing electronically.

Sec. 16.

Minnesota Statutes 2020, section 256B.196, subdivision 2, is amended to read:


Subd. 2.

Commissioner's duties.

(a) For the purposes of this subdivision and subdivision
3, the commissioner shall determine the fee-for-service outpatient hospital services upper
payment limit for nonstate government hospitals. The commissioner shall then determine
the amount of a supplemental payment to Hennepin County Medical Center and Regions
Hospital for these services that would increase medical assistance spending in this category
to the aggregate upper payment limit for all nonstate government hospitals in Minnesota.
In making this determination, the commissioner shall allot the available increases between
Hennepin County Medical Center and Regions Hospital based on the ratio of medical
assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner
shall adjust this allotment as necessary based on federal approvals, the amount of
intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors,
in order to maximize the additional total payments. The commissioner shall inform Hennepin
County and Ramsey County of the periodic intergovernmental transfers necessary to match
federal Medicaid payments available under this subdivision in order to make supplementary
medical assistance payments to Hennepin County Medical Center and Regions Hospital
equal to an amount that when combined with existing medical assistance payments to
nonstate governmental hospitals would increase total payments to hospitals in this category
for outpatient services to the aggregate upper payment limit for all hospitals in this category
in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make
supplementary payments to Hennepin County Medical Center and Regions Hospital.

(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians and other billing professionals affiliated
with Hennepin County Medical Center and with Regions Hospital. The upper payment limit
shall be based on the average commercial rate or be determined using another method
acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
necessary to match the federal Medicaid payments available under this subdivision in order
to make supplementary payments to physicians and other billing professionals affiliated
with Hennepin County Medical Center and to make supplementary payments to physicians
and other billing professionals affiliated with Regions Hospital through HealthPartners
Medical Group equal to the difference between the established medical assistance payment
for physician and other billing professional services and the upper payment limit. Upon
receipt of these periodic transfers, the commissioner shall make supplementary payments
to physicians and other billing professionals affiliated with Hennepin County Medical Center
and shall make supplementary payments to physicians and other billing professionals
affiliated with Regions Hospital through HealthPartners Medical Group.

(c) Beginning January 1, 2010, deleted text beginHennepin County anddeleted text end Ramsey County may make monthly
voluntary intergovernmental transfers to the commissioner in amounts not to exceed
deleted text begin $12,000,000 per year from Hennepin County anddeleted text end $6,000,000 per year deleted text beginfrom Ramsey Countydeleted text end.
The commissioner shall increase the medical assistance capitation payments to any licensed
health plan under contract with the medical assistance program that agrees to make enhanced
payments to deleted text beginHennepin County Medical Center ordeleted text end Regions Hospital. The increase shall be
in an amount equal to the annual value of the monthly transfers plus federal financial
participation, with each health plan receiving its pro rata share of the increase based on the
pro rata share of medical assistance admissions to deleted text beginHennepin County Medical Center anddeleted text end
Regions Hospital by those plans. For the purposes of this paragraph, "the base amount"
means the total annual value of increased medical assistance capitation payments, including
the voluntary intergovernmental transfers, under this paragraph in calendar year 2017. For
managed care contracts beginning on or after January 1, 2018, the commissioner shall reduce
the total annual value of increased medical assistance capitation payments under this
paragraph by an amount equal to ten percent of the base amount, and by an additional ten
percent of the base amount for each subsequent contract year until December 31, 2025.
Upon the request of the commissioner, health plans shall submit individual-level cost data
for verification purposes. The commissioner may ratably reduce these payments on a pro
rata basis in order to satisfy federal requirements for actuarial soundness. If payments are
reduced, transfers shall be reduced accordingly. Any licensed health plan that receives
increased medical assistance capitation payments under the intergovernmental transfer
described in this paragraph shall increase its medical assistance payments to deleted text beginHennepin
County Medical Center and
deleted text end Regions Hospital by the same amount as the increased payments
received in the capitation payment described in this paragraph. This paragraph expires
January 1, 2026.

(d) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for ambulance services affiliated with Hennepin County
Medical Center and the city of St. Paul, and ambulance services owned and operated by
another governmental entity that chooses to participate by requesting the commissioner to
determine an upper payment limit. The upper payment limit shall be based on the average
commercial rate or be determined using another method acceptable to the Centers for
Medicare and Medicaid Services. The commissioner shall inform Hennepin County, the
city of St. Paul, and other participating governmental entities of the periodic
intergovernmental transfers necessary to match the federal Medicaid payments available
under this subdivision in order to make supplementary payments to Hennepin County
Medical Center, the city of St. Paul, and other participating governmental entities equal to
the difference between the established medical assistance payment for ambulance services
and the upper payment limit. Upon receipt of these periodic transfers, the commissioner
shall make supplementary payments to Hennepin County Medical Center, the city of St.
Paul, and other participating governmental entities. A tribal government that owns and
operates an ambulance service is not eligible to participate under this subdivision.

(e) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians, dentists, and other billing professionals
affiliated with the University of Minnesota and University of Minnesota Physicians. The
upper payment limit shall be based on the average commercial rate or be determined using
another method acceptable to the Centers for Medicare and Medicaid Services. The
commissioner shall inform the University of Minnesota Medical School and University of
Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to
match the federal Medicaid payments available under this subdivision in order to make
supplementary payments to physicians, dentists, and other billing professionals affiliated
with the University of Minnesota and the University of Minnesota Physicians equal to the
difference between the established medical assistance payment for physician, dentist, and
other billing professional services and the upper payment limit. Upon receipt of these periodic
transfers, the commissioner shall make supplementary payments to physicians, dentists,
and other billing professionals affiliated with the University of Minnesota and the University
of Minnesota Physicians.

(f) The commissioner shall inform the transferring governmental entities on an ongoing
basis of the need for any changes needed in the intergovernmental transfers in order to
continue the payments under paragraphs (a) to (e), at their maximum level, including
increases in upper payment limits, changes in the federal Medicaid match, and other factors.

(g) The payments in paragraphs (a) to (e) shall be implemented independently of each
other, subject to federal approval and to the receipt of transfers under subdivision 3.

(h) All of the data and funding transactions related to the payments in paragraphs (a) to
(e) shall be between the commissioner and the governmental entities.

(i) For purposes of this subdivision, billing professionals are limited to physicians, nurse
practitioners, nurse midwives, clinical nurse specialists, physician assistants,
anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and
dental therapists.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2022, or upon federal approval
of both this section and Minnesota Statutes, section 256B.1973, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 17.

new text begin[256B.1973] DIRECTED PAYMENT ARRANGEMENTS.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) For the purposes of this section, the following terms have
the meanings given them.
new text end

new text begin (b) "Billing professionals" means physicians, nurse practitioners, nurse midwives, clinical
nurse specialists, physician assistants, anesthesiologists, and certified registered anesthetists,
and may include dentists, individually enrolled dental hygienists, and dental therapists.
new text end

new text begin (c) "Health plan" means a managed care or county-based purchasing plan that is under
contract with the commissioner to deliver services to medical assistance enrollees under
section 256B.69.
new text end

new text begin (d) "High medical assistance utilization" means a medical assistance utilization rate
equal to the standard established in section 256.969, subdivision 9, paragraph (d), clause
(6).
new text end

new text begin Subd. 2.new text end

new text beginFederal approval required.new text end

new text beginEach directed payment arrangement under this
section is contingent on federal approval and must conform with the requirements for
permissible directed managed care organization expenditures under section 256B.6928,
subdivision 5.
new text end

new text begin Subd. 3.new text end

new text beginEligible providers.new text end

new text beginEligible providers under this section are nonstate government
teaching hospitals with high medical assistance utilization and a level 1 trauma center and
all of the hospital's owned or affiliated billing professionals, ambulance services, sites, and
clinics.
new text end

new text begin Subd. 4.new text end

new text beginVoluntary intergovernmental transfers.new text end

new text beginA nonstate governmental entity that
is eligible to perform intergovernmental transfers may make voluntary intergovernmental
transfers to the commissioner. The commissioner shall inform the nonstate governmental
entity of the intergovernmental transfers necessary to maximize the allowable directed
payments.
new text end

new text begin Subd. 5.new text end

new text beginCommissioner's duties; state-directed fee schedule requirement.new text end

new text begin(a) For
each federally approved directed payment arrangement that is a state-directed fee schedule
requirement, the commissioner shall determine a uniform adjustment factor to be applied
to each claim submitted by an eligible provider to a health plan. The uniform adjustment
factor shall be determined using the average commercial payer rate or using another method
acceptable to the Centers for Medicare and Medicaid Services if the average commercial
payer rate is not approved, minus the amount necessary for the plan to satisfy tax liabilities
under sections 256.9657 and 297I.05 attributable to the directed payment arrangement. The
commissioner shall ensure that the application of the uniform adjustment factor maximizes
the allowable directed payments and does not result in payments exceeding federal limits,
and may use an annual settle-up process. The directed payment shall be specific to each
health plan and prospectively incorporated into capitation payments for that plan.
new text end

new text begin (b) For each federally approved directed payment arrangement that is a state-directed
fee schedule requirement, the commissioner shall develop a plan for the initial
implementation of the state-directed fee schedule requirement to ensure that the eligible
provider receives the entire permissible value of the federally approved directed payment
arrangement. If federal approval of a directed payment arrangement under this subdivision
is retroactive, the commissioner shall make a onetime pro rata increase to the uniform
adjustment factor and the initial payments in order to include claims submitted between the
retroactive federal approval date and the period captured by the initial payments.
new text end

new text begin Subd. 6.new text end

new text beginHealth plan duties; submission of claims.new text end

new text beginIn accordance with its contract,
each health plan shall submit to the commissioner payment information for each claim paid
to an eligible provider for services provided to a medical assistance enrollee.
new text end

new text begin Subd. 7.new text end

new text beginHealth plan duties; directed payments.new text end

new text beginIn accordance with its contract, each
health plan shall make directed payments to the eligible provider in an amount equal to the
payment amounts the plan received from the commissioner.
new text end

new text begin Subd. 8.new text end

new text beginState quality goals.new text end

new text beginThe directed payment arrangement and state-directed fee
schedule requirement must align the state quality goals to Hennepin Healthcare medical
assistance patients, including unstably housed individuals, those with higher levels of social
and clinical risk, limited English proficiency (LEP) patients, adults with serious chronic
conditions, and individuals of color. The directed payment arrangement must maintain
quality and access to a full range of health care delivery mechanisms for these patients that
may include behavioral health, emergent care, preventive care, hospitalization, transportation,
interpreter services, and pharmaceutical services. The commissioner, in consultation with
Hennepin Healthcare, shall submit to the Centers for Medicare and Medicaid Services a
methodology to measure access to care and the achievement of state quality goals.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2022, or upon federal approval,
whichever is later, unless the federal approval provides for an effective date after July 1,
2021, but before the date of federal approval, in which case the federally approved effective
date applies.
new text end

Sec. 18.

Minnesota Statutes 2020, section 256B.6928, subdivision 5, is amended to read:


Subd. 5.

Direction of managed care organization expenditures.

(a) The commissioner
shall not direct managed care organizations expenditures under the managed care contract,
except deleted text beginindeleted text endnew text begin as permitted under Code of Federal Regulations, part 42, section 438.6(c). The
exception under this paragraph includes
new text end the following situations:

(1) implementation of a value-based purchasing model for provider reimbursement,
including pay-for-performance arrangements, bundled payments, or other service payments
intended to recognize value or outcomes over volume of services;

(2) participation in a multipayer or medical assistance-specific delivery system reform
or performance improvement initiative; or

(3) implementation of a minimum or maximum fee schedule, or a uniform dollar or
percentage increase for network providers that provide a particular service. The maximum
fee schedule must allow the managed care organization the ability to reasonably manage
risk and provide discretion in accomplishing the goals of the contract.

(b) Any managed care contract that directs managed care organization expenditures as
permitted under paragraph (a), clauses (1) to (3), must be developed in accordance with
Code of Federal Regulations, part 42, sections 438.4 and 438.5; comply with actuarial
soundness and generally accepted actuarial principles and practices; and have written
approval from the Centers for Medicare and Medicaid Services before implementation. To
obtain approval, the commissioner shall demonstrate in writing that the contract arrangement:

(1) is based on the utilization and delivery of services;

(2) directs expenditures equally, using the same terms of performance for a class of
providers providing service under the contract;

(3) is intended to advance at least one of the goals and objectives in the commissioner's
quality strategy;

(4) has an evaluation plan that measures the degree to which the arrangement advances
at least one of the goals in the commissioner's quality strategy;

(5) does not condition network provider participation on the network provider entering
into or adhering to an intergovernmental transfer agreement; and

(6) is not renewed automatically.

(c) For contract arrangements identified in paragraph (a), clauses (1) and (2), the
commissioner shall:

(1) make participation in the value-based purchasing model, special delivery system
reform, or performance improvement initiative available, using the same terms of
performance, to a class of providers providing services under the contract related to the
model, reform, or initiative; and

(2) use a common set of performance measures across all payers and providers.

(d) The commissioner shall not set the amount or frequency of the expenditures or recoup
from the managed care organization any unspent funds allocated for these arrangements.

Sec. 19.

Minnesota Statutes 2020, section 256L.01, subdivision 5, is amended to read:


Subd. 5.

Income.

"Income" has the meaning given for modified adjusted gross income,
as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's
deleted text begin current income, or if income fluctuates month to month, the income for the 12-month
eligibility period
deleted text endnew text begin projected annual income for the applicable tax yearnew text end.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 20.

Minnesota Statutes 2020, section 256L.04, subdivision 7b, is amended to read:


Subd. 7b.

Annual income limits adjustment.

The commissioner shall adjust the income
limits under this section annually deleted text begineach July 1deleted text endnew text begin on January 1new text end as deleted text begindescribed in section 256B.056,
subdivision 1c
deleted text endnew text begin provided in Code of Federal Regulations, title 26, section 1.36B-1(h)new text end.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 21.

Minnesota Statutes 2020, section 256L.05, subdivision 3a, is amended to read:


Subd. 3a.

Redetermination of eligibility.

(a) An enrollee's eligibility must be
redetermined on an annual basisdeleted text begin, in accordance with Code of Federal Regulations, title 42,
section 435.916 (a). The 12-month eligibility period begins the month of application.
Beginning July 1, 2017, the commissioner shall adjust the eligibility period for enrollees to
implement renewals throughout the year according to guidance from the Centers for Medicare
and Medicaid Services
deleted text end.new text begin The period of eligibility is the entire calendar year following the
year in which eligibility is redetermined. Eligibility redeterminations shall occur during the
open enrollment period for qualified health plans as specified in Code of Federal Regulations,
title 45, section 155.410(e)(3).
new text end

(b) Each new period of eligibility must take into account any changes in circumstances
that impact eligibility and premium amount. Coverage begins as provided in section 256L.06.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 22.

Minnesota Statutes 2020, section 295.53, subdivision 1, is amended to read:


Subdivision 1.

Exclusions and exemptions.

(a) The following payments are excluded
from the gross revenues subject to the hospital, surgical center, or health care provider taxes
under sections 295.50 to 295.59:

(1) payments received by a health care provider or the wholly owned subsidiary of a
health care provider for care provided outside Minnesota;

(2) government payments received by the commissioner of human services for
state-operated services;

(3) payments received by a health care provider for hearing aids and related equipment
or prescription eyewear delivered outside of Minnesota; and

(4) payments received by an educational institution from student tuition, student activity
fees, health care service fees, government appropriations, donations, or grants, and for
services identified in and provided under an individualized education program as defined
in section 256B.0625 or Code of Federal Regulations, chapter 34, section 300.340(a). Fee
for service payments and payments for extended coverage are taxable.

(b) The following payments are exempted from the gross revenues subject to hospital,
surgical center, or health care provider taxes under sections 295.50 to 295.59:

(1) payments received for services provided under the Medicare program, including
payments received from the government and organizations governed by sections 1833,
1853, and 1876 of title XVIII of the federal Social Security Act, United States Code, title
42, section 1395; and enrollee deductibles, co-insurance, and co-payments, whether paid
by the Medicare enrollee, by Medicare supplemental coverage as described in section
62A.011, subdivision 3, clause (10), or by Medicaid payments under title XIX of the federal
Social Security Act. Payments for services not covered by Medicare are taxable;

(2) payments received for home health care services;

(3) payments received from hospitals or surgical centers for goods and services on which
liability for tax is imposed under section 295.52 or the source of funds for the payment is
exempt under clause (1), (6), (9), (10), or (11);

(4) payments received from the health care providers for goods and services on which
liability for tax is imposed under this chapter or the source of funds for the payment is
exempt under clause (1), (6), (9), (10), or (11);

(5) amounts paid for legend drugs to a wholesale drug distributor who is subject to tax
under section 295.52, subdivision 3, reduced by reimbursement received for legend drugs
otherwise exempt under this chapter;

(6) payments received from the chemical dependency fund under chapter 254B;

(7) payments received in the nature of charitable donations that are not designated for
providing patient services to a specific individual or group;

(8) payments received for providing patient services incurred through a formal program
of health care research conducted in conformity with federal regulations governing research
on human subjects. Payments received from patients or from other persons paying on behalf
of the patients are subject to tax;

(9) payments received from any governmental agency for services benefiting the public,
not including payments made by the government in its capacity as an employer or insurer
or payments made by the government for services provided under the MinnesotaCare
program or the medical assistance program governed by title XIX of the federal Social
Security Act, United States Code, title 42, sections 1396 to 1396v;

(10) payments received under the federal Employees Health Benefits Act, United States
Code, title 5, section 8909(f), as amended by the Omnibus Reconciliation Act of 1990.
Enrollee deductibles, co-insurance, and co-payments are subject to tax;

(11) payments received under the federal Tricare program, Code of Federal Regulations,
title 32, section 199.17(a)(7). Enrollee deductibles, co-insurance, and co-payments are
subject to tax; and

(12) supplemental deleted text beginordeleted text endnew text begin,new text end enhancednew text begin, or uniform adjustment factornew text end payments authorized under
section 256B.196 deleted text beginordeleted text endnew text begin,new text end 256B.197new text begin, or 256B.1973new text end.

(c) Payments received by wholesale drug distributors for legend drugs sold directly to
veterinarians or veterinary bulk purchasing organizations are excluded from the gross
revenues subject to the wholesale drug distributor tax under sections 295.50 to 295.59.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective for taxable years beginning after December
31, 2021.
new text end

Sec. 23. new text beginDIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
FUNDING FOR RECUPERATIVE CARE.
new text end

new text begin The commissioner of human services shall develop a medical assistance reimbursable
recuperative care service, not limited to a health home model, designed to serve individuals
with chronic conditions, as defined in United States Code, title 42, section 1396w-4(h), who
also lack a permanent place of residence at the time of discharge from an emergency
department or hospital in order to prevent a return to the emergency department, readmittance
to the hospital, or hospitalization. This section is contingent on the receipt of nonstate
funding to the commissioner of human services for this purpose as permitted by Minnesota
Statutes, section 256.01, subdivision 25.
new text end

Sec. 24. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes must change the term "Health Services Policy Committee" to
"Health Services Advisory Council" wherever the term appears in Minnesota Statutes and
may make any necessary changes to grammar or sentence structure to preserve the meaning
of the text.
new text end

ARTICLE 2

DEPARTMENT OF HUMAN SERVICES
LICENSING AND BACKGROUND STUDIES

Section 1.

Minnesota Statutes 2020, section 245A.043, subdivision 3, is amended to read:


Subd. 3.

Change of ownership process.

(a) When a change in ownership is proposed
and the party intends to assume operation without an interruption in service longer than 60
days after acquiring the program or service, the license holder must provide the commissioner
with written notice of the proposed change on a form provided by the commissioner at least
60 days before the anticipated date of the change in ownership. For purposes of this
subdivision and subdivision 4, "party" means the party that intends to operate the service
or program.

(b) The party must submit a license application under this chapter on the form and in
the manner prescribed by the commissioner at least 30 days before the change in ownership
is complete, and must include documentation to support the upcoming change. The party
must comply with background study requirements under chapter 245C and shall pay the
application fee required under section 245A.10. A party that intends to assume operation
without an interruption in service longer than 60 days after acquiring the program or service
is exempt from the requirements of deleted text beginMinnesota Rules, part 9530.6800deleted text endnew text begin sections 245G.03,
subdivision 2, paragraph (b), and 254B.03, subdivision 2, paragraphs (d) and (e)
new text end.

(c) The commissioner may streamline application procedures when the party is an existing
license holder under this chapter and is acquiring a program licensed under this chapter or
service in the same service class as one or more licensed programs or services the party
operates and those licenses are in substantial compliance. For purposes of this subdivision,
"substantial compliance" means within the previous 12 months the commissioner did not
(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make
a license held by the party conditional according to section 245A.06.

(d) Except when a temporary change in ownership license is issued pursuant to
subdivision 4, the existing license holder is solely responsible for operating the program
according to applicable laws and rules until a license under this chapter is issued to the
party.

(e) If a licensing inspection of the program or service was conducted within the previous
12 months and the existing license holder's license record demonstrates substantial
compliance with the applicable licensing requirements, the commissioner may waive the
party's inspection required by section 245A.04, subdivision 4. The party must submit to the
commissioner (1) proof that the premises was inspected by a fire marshal or that the fire
marshal deemed that an inspection was not warranted, and (2) proof that the premises was
inspected for compliance with the building code or that no inspection was deemed warranted.

(f) If the party is seeking a license for a program or service that has an outstanding action
under section 245A.06 or 245A.07, the party must submit a letter as part of the application
process identifying how the party has or will come into full compliance with the licensing
requirements.

(g) The commissioner shall evaluate the party's application according to section 245A.04,
subdivision 6. If the commissioner determines that the party has remedied or demonstrates
the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has
determined that the program otherwise complies with all applicable laws and rules, the
commissioner shall issue a license or conditional license under this chapter. The conditional
license remains in effect until the commissioner determines that the grounds for the action
are corrected or no longer exist.

(h) The commissioner may deny an application as provided in section 245A.05. An
applicant whose application was denied by the commissioner may appeal the denial according
to section 245A.05.

(i) This subdivision does not apply to a licensed program or service located in a home
where the license holder resides.

Sec. 2.

Minnesota Statutes 2020, section 245F.04, subdivision 2, is amended to read:


Subd. 2.

Contents of application.

Prior to the issuance of a license, an applicant must
submit, on forms provided by the commissioner, documentation demonstrating the following:

(1) compliance with this section;

(2) compliance with applicable building, fire, and safety codes; health rules; zoning
ordinances; and other applicable rules and regulations or documentation that a waiver has
been granted. The granting of a waiver does not constitute modification of any requirement
of this section;new text begin and
new text end

deleted text begin (3) completion of an assessment of need for a new or expanded program as required by
Minnesota Rules, part 9530.6800; and
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end insurance coverage, including bonding, sufficient to cover all patient funds,
property, and interests.

Sec. 3.

Minnesota Statutes 2020, section 245G.03, subdivision 2, is amended to read:


Subd. 2.

Application.

new text begin(a) new text endBefore the commissioner issues a license, an applicant must
submit, on forms provided by the commissioner, any documents the commissioner requires.

new text begin (b) The applicant must submit documentation that the applicant has notified the county
as required under section 254B.03, subdivision 2.
new text end

Sec. 4.

Minnesota Statutes 2020, section 254B.03, subdivision 2, is amended to read:


Subd. 2.

Chemical dependency fund payment.

(a) Payment from the chemical
dependency fund is limited to payments for services other than detoxification licensed under
Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally
recognized tribal lands, would be required to be licensed by the commissioner as a chemical
dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and
services other than detoxification provided in another state that would be required to be
licensed as a chemical dependency program if the program were in the state. Out of state
vendors must also provide the commissioner with assurances that the program complies
substantially with state licensing requirements and possesses all licenses and certifications
required by the host state to provide chemical dependency treatment. Vendors receiving
payments from the chemical dependency fund must not require co-payment from a recipient
of benefits for services provided under this subdivision. The vendor is prohibited from using
the client's public benefits to offset the cost of services paid under this section. The vendor
shall not require the client to use public benefits for room or board costs. This includes but
is not limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP
benefits. Retention of SNAP benefits is a right of a client receiving services through the
consolidated chemical dependency treatment fund or through state contracted managed care
entities. Payment from the chemical dependency fund shall be made for necessary room
and board costs provided by vendors meeting the criteria under section 254B.05, subdivision
1a, or in a community hospital licensed by the commissioner of health according to sections
144.50 to 144.56 to a client who is:

(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and

(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.

(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.

(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment services.

new text begin (d) At least 60 days prior to submitting an application for new licensure under chapter
245G, the applicant must notify the county human services director in writing of the
applicant's intent to open a new treatment program. The written notification must include,
at a minimum:
new text end

new text begin (1) a description of the proposed treatment program; and
new text end

new text begin (2) a description of the target population to be served by the treatment program.
new text end

new text begin (e) The county human services director may submit a written statement to the
commissioner, within 60 days of receiving notice from the applicant, regarding the county's
support of or opposition to the opening of the new treatment program. The written statement
must include documentation of the rationale for the county's determination. The commissioner
shall consider the county's written statement when determining whether there is a need for
the treatment program as required by paragraph (c).
new text end

Sec. 5. new text beginREPEALER.
new text end

new text begin Minnesota Rules, parts 9530.6800; and 9530.6810,new text endnew text begin are repealed.
new text end

ARTICLE 3

HEALTH DEPARTMENT

Section 1.

Minnesota Statutes 2020, section 62J.495, subdivision 3, is amended to read:


Subd. 3.

Interoperable electronic health record requirements.

(a) Hospitals and health
care providers must meet the following criteria when implementing an interoperable
electronic health records system within their hospital system or clinical practice setting.

(b) The electronic health record must be a qualified electronic health record.

(c) The electronic health record must be certified by the Office of the National
Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health
care providers if a certified electronic health record product for the provider's particular
practice setting is available. This criterion shall be considered met if a hospital or health
care provider is using an electronic health records system that has been certified within the
last three years, even if a more current version of the system has been certified within the
three-year period.

(d) The electronic health record must meet the standards established according to section
3004 of the HITECH Act as applicable.

(e) The electronic health record must have the ability to generate information on clinical
quality measures and other measures reported under sections 4101, 4102, and 4201 of the
HITECH Act.

(f) The electronic health record system must be connected to a state-certified health
information organization either directly or through a connection facilitated by a deleted text beginstate-certifieddeleted text end
health data intermediary as defined in section 62J.498.

(g) A health care provider who is a prescriber or dispenser of legend drugs must have
an electronic health record system that meets the requirements of section 62J.497.

Sec. 2.

Minnesota Statutes 2020, section 62J.498, is amended to read:


62J.498 HEALTH INFORMATION EXCHANGE.

Subdivision 1.

Definitions.

(a) The following definitions apply to sections 62J.498 to
62J.4982:

(b) "Clinical data repository" means a real time database that consolidates data from a
variety of clinical sources to present a unified view of a single patient and is used by a
deleted text begin state-certifieddeleted text end health information exchange service provider to enable health information
exchange among health care providers that are not related health care entities as defined in
section 144.291, subdivision 2, paragraph (k). This does not include clinical data that are
submitted to the commissioner for public health purposes required or permitted by law,
including any rules adopted by the commissioner.

(c) "Clinical transaction" means any meaningful use transaction or other health
information exchange transaction that is not covered by section 62J.536.

(d) "Commissioner" means the commissioner of health.

(e) "Health care provider" or "provider" means a health care provider or provider as
defined in section 62J.03, subdivision 8.

(f) "Health data intermediary" means an entity that provides the technical capabilities
or related products and services to enable health information exchange among health care
providers that are not related health care entities as defined in section 144.291, subdivision
2, paragraph (k). This includes but is not limited to health information service providers
(HISP), electronic health record vendors, and pharmaceutical electronic data intermediaries
as defined in section 62J.495.

(g) "Health information exchange" means the electronic transmission of health-related
information between organizations according to nationally recognized standards.

(h) "Health information exchange service provider" means a health data intermediary
or health information organization.

(i) "Health information organization" means an organization that oversees, governs, and
facilitates health information exchange among health care providers that are not related
health care entities as defined in section 144.291, subdivision 2, paragraph (k), to improve
coordination of patient care and the efficiency of health care delivery.

deleted text begin (j) "HITECH Act" means the Health Information Technology for Economic and Clinical
Health Act as defined in section 62J.495.
deleted text end

deleted text begin (k)deleted text endnew text begin (j)new text end "Major participating entity" means:

(1) a participating entity that receives compensation for services that is greater than 30
percent of the health information organization's gross annual revenues from the health
information exchange service provider;

(2) a participating entity providing administrative, financial, or management services to
the health information organization, if the total payment for all services provided by the
participating entity exceeds three percent of the gross revenue of the health information
organization; and

(3) a participating entity that nominates or appoints 30 percent or more of the board of
directors or equivalent governing body of the health information organization.

deleted text begin (l)deleted text endnew text begin (k)new text end "Master patient index" means an electronic database that holds unique identifiers
of patients registered at a care facility and is used by a deleted text beginstate-certifieddeleted text end health information
exchange service provider to enable health information exchange among health care providers
that are not related health care entities as defined in section 144.291, subdivision 2, paragraph
(k). This does not include data that are submitted to the commissioner for public health
purposes required or permitted by law, including any rules adopted by the commissioner.

deleted text begin (m) "Meaningful use" means use of certified electronic health record technology to
improve quality, safety, and efficiency and reduce health disparities; engage patients and
families; improve care coordination and population and public health; and maintain privacy
and security of patient health information as established by the Centers for Medicare and
Medicaid Services and the Minnesota Department of Human Services pursuant to sections
4101, 4102, and 4201 of the HITECH Act.
deleted text end

deleted text begin (n) "Meaningful use transaction" means an electronic transaction that a health care
provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare
penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
deleted text end

deleted text begin (o)deleted text endnew text begin (l)new text end "Participating entity" means any of the following persons, health care providers,
companies, or other organizations with which a health information organization deleted text beginor health
data intermediary
deleted text end has contracts or other agreements for the provision of health information
exchange services:

(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home
licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise
licensed under the laws of this state or registered with the commissioner;

(2) a health care provider, and any other health care professional otherwise licensed
under the laws of this state or registered with the commissioner;

(3) a group, professional corporation, or other organization that provides the services of
individuals or entities identified in clause (2), including but not limited to a medical clinic,
a medical group, a home health care agency, an urgent care center, and an emergent care
center;

(4) a health plan as defined in section 62A.011, subdivision 3; and

(5) a state agency as defined in section 13.02, subdivision 17.

deleted text begin (p)deleted text endnew text begin (m)new text end "Reciprocal agreement" means an arrangement in which two or more health
information exchange service providers agree to share in-kind services and resources to
allow for the pass-through of clinical transactions.

deleted text begin (q) "State-certified health data intermediary" means a health data intermediary that has
been issued a certificate of authority to operate in Minnesota.
deleted text end

deleted text begin (r)deleted text endnew text begin (n)new text end "State-certified health information organization" means a health information
organization that has been issued a certificate of authority to operate in Minnesota.

Subd. 2.

Health information exchange oversight.

(a) The commissioner shall protect
the public interest on matters pertaining to health information exchange. The commissioner
shall:

(1) review and act on applications from deleted text beginhealth data intermediaries anddeleted text end health information
organizations for certificates of authority to operate in Minnesota;

new text begin (2) require information to be provided as needed from health information exchange
service providers in order to meet requirements established under sections 62J.498 to
62J.4982;
new text end

deleted text begin (2)deleted text endnew text begin (3)new text end provide ongoing monitoring to ensure compliance with criteria established under
sections 62J.498 to 62J.4982;

deleted text begin (3)deleted text endnew text begin (4)new text end respond to public complaints related to health information exchange services;

deleted text begin (4)deleted text endnew text begin (5)new text end take enforcement actions as necessary, including the imposition of fines,
suspension, or revocation of certificates of authority as outlined in section 62J.4982;

deleted text begin (5)deleted text endnew text begin (6)new text end provide a biennial report on the status of health information exchange services
that includes but is not limited to:

(i) recommendations on actions necessary to ensure that health information exchange
services are adequate to meet the needs of Minnesota citizens and providers statewide;

(ii) recommendations on enforcement actions to ensure that health information exchange
service providers act in the public interest without causing disruption in health information
exchange services;

(iii) recommendations on updates to criteria for obtaining certificates of authority under
this section; and

(iv) recommendations on standard operating procedures for health information exchange,
including but not limited to the management of consumer preferences; and

deleted text begin (6)deleted text endnew text begin (7)new text end other duties necessary to protect the public interest.

(b) As part of the application review process for certification under paragraph (a), prior
to issuing a certificate of authority, the commissioner shall:

(1) make all portions of the application classified as public data available to the public
for at least ten days while an application is under consideration. At the request of the
commissioner, the applicant shall participate in a public hearing by presenting an overview
of their application and responding to questions from interested parties; and

(2) consult with hospitals, physicians, and other providers prior to issuing a certificate
of authority.

(c) When the commissioner is actively considering a suspension or revocation of a
certificate of authority as described in section 62J.4982, subdivision 3, all investigatory data
that are collected, created, or maintained related to the suspension or revocation are classified
as confidential data on individuals and as protected nonpublic data in the case of data not
on individuals.

(d) The commissioner may disclose data classified as protected nonpublic or confidential
under paragraph (c) if disclosing the data will protect the health or safety of patients.

(e) After the commissioner makes a final determination regarding a suspension or
revocation of a certificate of authority, all minutes, orders for hearing, findings of fact,
conclusions of law, and the specification of the final disciplinary action, are classified as
public data.

Sec. 3.

Minnesota Statutes 2020, section 62J.4981, is amended to read:


62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH
INFORMATION EXCHANGE SERVICES.

Subdivision 1.

Authority to require organizations to apply.

The commissioner shall
require deleted text begina health data intermediary ordeleted text end a health information organization to apply for a
certificate of authority under this section. An applicant may continue to operate until the
commissioner acts on the application. If the application is denied, the applicant is considered
a health information exchange service provider whose certificate of authority has been
revoked under section 62J.4982, subdivision 2, paragraph (d).

deleted text begin Subd. 2.deleted text end

deleted text beginCertificate of authority for health data intermediaries.deleted text end

deleted text begin(a) A health data
intermediary must be certified by the state and comply with requirements established in this
section.
deleted text end

deleted text begin (b) Notwithstanding any law to the contrary, any corporation organized to do so may
apply to the commissioner for a certificate of authority to establish and operate as a health
data intermediary in compliance with this section. No person shall establish or operate a
health data intermediary in this state, nor sell or offer to sell, or solicit offers to purchase
or receive advance or periodic consideration in conjunction with a health data intermediary
contract unless the organization has a certificate of authority or has an application under
active consideration under this section.
deleted text end

deleted text begin (c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:
deleted text end

deleted text begin (1) hold reciprocal agreements with at least one state-certified health information
organization to access patient data, and for the transmission and receipt of clinical
transactions. Reciprocal agreements must meet the requirements established in subdivision
5; and
deleted text end

deleted text begin (2) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability between state-certified health information
organizations and state-certified health data intermediaries.
deleted text end

Subd. 3.

Certificate of authority for health information organizations.

(a) A health
information organization must obtain a certificate of authority from the commissioner and
demonstrate compliance with the criteria in paragraph (c).

(b) Notwithstanding any law to the contrary, an organization may apply for a certificate
of authority to establish and operate a health information organization under this section.
No person shall establish or operate a health information organization in this state, nor sell
or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in
conjunction with a health information organization or health information contract unless
the organization has a certificate of authority under this section.

(c) In issuing the certificate of authority, the commissioner shall determine whether the
applicant for the certificate of authority has demonstrated that the applicant meets the
following minimum criteria:

(1) the entity is a legally established organization;

(2) appropriate insurance, including liability insurance, for the operation of the health
information organization is in place and sufficient to protect the interest of the public and
participating entities;

(3) strategic and operational plans address governance, technical infrastructure, legal
and policy issues, finance, and business operations in regard to how the organization will
expand to support providers in achieving health information exchange goals over time;

(4) the entity addresses the parameters to be used with participating entities and other
health information exchange service providers for clinical transactions, compliance with
Minnesota law, and interstate health information exchange trust agreements;

(5) the entity's board of directors or equivalent governing body is composed of members
that broadly represent the health information organization's participating entities and
consumers;

(6) the entity maintains a professional staff responsible to the board of directors or
equivalent governing body with the capacity to ensure accountability to the organization's
mission;

(7) the organization is compliant with national certification and accreditation programs
designated by the commissioner;

(8) the entity maintains the capability to query for patient information based on national
standards. The query capability may utilize a master patient index, clinical data repository,
or record locator service as defined in section 144.291, subdivision 2, paragraph (j). The
entity must be compliant with the requirements of section 144.293, subdivision 8, when
conducting clinical transactions;

(9) the organization demonstrates interoperability with all other state-certified health
information organizations using nationally recognized standards;

(10) the organization demonstrates compliance with all privacy and security requirements
required by state and federal law; and

(11) the organization uses financial policies and procedures consistent with generally
accepted accounting principles and has an independent audit of the organization's financials
on an annual basis.

(d) Health information organizations that have obtained a certificate of authority must:

(1) meet the requirements established for connecting to the National eHealth Exchange;

(2) annually submit strategic and operational plans for review by the commissioner that
address:

(i) progress in achieving objectives included in previously submitted strategic and
operational plans across the following domains: business and technical operations, technical
infrastructure, legal and policy issues, finance, and organizational governance;

(ii) plans for ensuring the necessary capacity to support clinical transactions;

(iii) approach for attaining financial sustainability, including public and private financing
strategies, and rate structures;

(iv) rates of adoption, utilization, and transaction volume, and mechanisms to support
health information exchange; and

(v) an explanation of methods employed to address the needs of community clinics,
critical access hospitals, and free clinics in accessing health information exchange services;

(3) enter into reciprocal agreements with all other state-certified health information
organizations deleted text beginand state-certified health data intermediariesdeleted text end to enable access to patient data,
and for the transmission and receipt of clinical transactions. Reciprocal agreements must
meet the requirements in subdivision 5;

(4) participate in statewide shared health information exchange services as defined by
the commissioner to support interoperability deleted text beginbetween state-certified health information
organizations and state-certified health data intermediaries
deleted text end; and

(5) comply with additional requirements for the certification or recertification of health
information organizations that may be established by the commissioner.

Subd. 4.

Application for certificate of authority for health information deleted text beginexchange
service providers
deleted text endnew text begin organizationsnew text end.

(a) Each application for a certificate of authority shall
be in a form prescribed by the commissioner and verified by an officer or authorized
representative of the applicant. Each application shall include the following in addition to
information described in the criteria in deleted text beginsubdivisions 2 anddeleted text endnew text begin subdivisionnew text end 3:

(1) deleted text beginfor health information organizations only,deleted text end a copy of the basic organizational document,
if any, of the applicant and of each major participating entity, such as the articles of
incorporation, or other applicable documents, and all amendments to it;

(2) deleted text beginfor health information organizations only,deleted text end a list of the names, addresses, and official
positions of the following:

(i) all members of the board of directors or equivalent governing body, and the principal
officers and, if applicable, shareholders of the applicant organization; and

(ii) all members of the board of directors or equivalent governing body, and the principal
officers of each major participating entity and, if applicable, each shareholder beneficially
owning more than ten percent of any voting stock of the major participating entity;

(3) deleted text beginfor health information organizations only,deleted text end the name and address of each participating
entity and the agreed-upon duration of each contract or agreement if applicable;

(4) a copy of each standard agreement or contract intended to bind the participating
entities and the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end. Contractual
provisions shall be consistent with the purposes of this section, in regard to the services to
be performed under the standard agreement or contract, the manner in which payment for
services is determined, the nature and extent of responsibilities to be retained by the health
information organization, and contractual termination provisions;

(5) a statement generally describing the health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end, its health information exchange contracts, facilities, and personnel, including
a statement describing the manner in which the applicant proposes to provide participants
with comprehensive health information exchange services;

(6) a statement reasonably describing the geographic area or areas to be served and the
type or types of participants to be served;

(7) a description of the complaint procedures to be used as required under this section;

(8) a description of the mechanism by which participating entities will have an opportunity
to participate in matters of policy and operation;

(9) a copy of any pertinent agreements between the health information organization and
insurers, including liability insurers, demonstrating coverage is in place;

(10) a copy of the conflict of interest policy that applies to all members of the board of
directors or equivalent governing body and the principal officers of the health information
organization; and

(11) other information as the commissioner may reasonably require to be provided.

(b) Within 45 days after the receipt of the application for a certificate of authority, the
commissioner shall determine whether or not the application submitted meets the
requirements for completion in paragraph (a), and notify the applicant of any further
information required for the application to be processed.

(c) Within 90 days after the receipt of a complete application for a certificate of authority,
the commissioner shall issue a certificate of authority to the applicant if the commissioner
determines that the applicant meets the minimum criteria requirements of deleted text beginsubdivision 2 for
health data intermediaries or
deleted text end subdivision 3 deleted text beginfor health information organizationsdeleted text end. If the
commissioner determines that the applicant is not qualified, the commissioner shall notify
the applicant and specify the reasons for disqualification.

(d) Upon being granted a certificate of authority to operate as a state-certified health
information organization deleted text beginor state-certified health data intermediarydeleted text end, the organization must
operate in compliance with the provisions of this section. Noncompliance may result in the
imposition of a fine or the suspension or revocation of the certificate of authority according
to section 62J.4982.

Subd. 5.

Reciprocal agreements between health information deleted text beginexchange entitiesdeleted text endnew text begin
organizations
new text end.

(a) Reciprocal agreements between two health information organizations
deleted text begin or between a health information organization and a health data intermediarydeleted text end must include
a fair and equitable model for charges between the entities that:

(1) does not impede the secure transmission of clinical transactions;

(2) does not charge a fee for the exchange of deleted text beginmeaningful usedeleted text end transactions transmitted
according to nationally recognized standards where no additional value-added service is
rendered to the sending or receiving health information organization deleted text beginor health data
intermediary
deleted text end either directly or on behalf of the client;

(3) is consistent with fair market value and proportionately reflects the value-added
services accessed as a result of the agreement; and

(4) prevents health care stakeholders from being charged multiple times for the same
service.

(b) Reciprocal agreements must include comparable quality of service standards that
ensure equitable levels of services.

(c) Reciprocal agreements are subject to review and approval by the commissioner.

(d) Nothing in this section precludes a state-certified health information organization deleted text beginor
state-certified health data intermediary
deleted text end from entering into contractual agreements for the
provision of value-added services deleted text beginbeyond meaningful use transactionsdeleted text end.

Sec. 4.

Minnesota Statutes 2020, section 62J.4982, is amended to read:


62J.4982 ENFORCEMENT AUTHORITY; COMPLIANCE.

Subdivision 1.

Penalties and enforcement.

(a) The commissioner may, for any violation
of statute or rule applicable to a health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end,
levy an administrative penalty in an amount up to $25,000 for each violation. In determining
the level of an administrative penalty, the commissioner shall consider the following factors:

(1) the number of participating entities affected by the violation;

(2) the effect of the violation on participating entities' access to health information
exchange services;

(3) if only one participating entity is affected, the effect of the violation on the patients
of that entity;

(4) whether the violation is an isolated incident or part of a pattern of violations;

(5) the economic benefits derived by the health information organization deleted text beginor a health data
intermediary
deleted text end by virtue of the violation;

(6) whether the violation hindered or facilitated an individual's ability to obtain health
care;

(7) whether the violation was intentional;

(8) whether the violation was beyond the direct control of the health information deleted text beginexchange
service provider
deleted text endnew text begin organizationnew text end;

(9) any history of prior compliance with the provisions of this section, including
violations;

(10) whether and to what extent the health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end attempted to correct previous violations;

(11) how the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end responded to
technical assistance from the commissioner provided in the context of a compliance effort;
and

(12) the financial condition of the health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end includingdeleted text begin,deleted text end but not limited todeleted text begin,deleted text end whether the health information deleted text beginexchange service
provider
deleted text endnew text begin organizationnew text end had financial difficulties that affected its ability to comply or whether
the imposition of an administrative monetary penalty would jeopardize the ability of the
health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end to continue to deliver health
information exchange services.

The commissioner shall give reasonable notice in writing to the health information
deleted text begin exchange service providerdeleted text endnew text begin organizationnew text end of the intent to levy the penalty and the reasons for
it. A health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end may have 15 days within
which to contest whether the facts found constitute a violation of sections 62J.4981 and
62J.4982, according to the contested case and judicial review provisions of sections 14.57
to 14.69.

(b) If the commissioner has reason to believe that a violation of section 62J.4981 or
62J.4982 has occurred or is likely, the commissioner may confer with the persons involved
before commencing action under subdivision 2. The commissioner may notify the health
information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end and the representatives, or other persons
who appear to be involved in the suspected violation, to arrange a voluntary conference
with the alleged violators or their authorized representatives. The purpose of the conference
is to attempt to learn the facts about the suspected violation and, if it appears that a violation
has occurred or is threatened, to find a way to correct or prevent it. The conference is not
governed by any formal procedural requirements, and may be conducted as the commissioner
considers appropriate.

(c) The commissioner may issue an order directing a health information deleted text beginexchange service
provider
deleted text endnew text begin organizationnew text end or a representative of a health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end to cease and desist from engaging in any act or practice in violation of sections
62J.4981 and 62J.4982.

(d) Within 20 days after service of the order to cease and desist, a health information
deleted text begin exchange service providerdeleted text endnew text begin organizationnew text end may contest whether the facts found constitute a
violation of sections 62J.4981 and 62J.4982 according to the contested case and judicial
review provisions of sections 14.57 to 14.69.

(e) In the event of noncompliance with a cease and desist order issued under this
subdivision, the commissioner may institute a proceeding to obtain injunctive relief or other
appropriate relief in Ramsey County District Court.

Subd. 2.

Suspension or revocation of certificates of authority.

(a) The commissioner
may suspend or revoke a certificate of authority issued to a deleted text beginhealth data intermediary ordeleted text end
health information organization under section 62J.4981 if the commissioner finds that:

(1) the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end is operating
significantly in contravention of its basic organizational document, or in a manner contrary
to that described in and reasonably inferred from any other information submitted under
section 62J.4981, unless amendments to the submissions have been filed with and approved
by the commissioner;

(2) the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end is unable to fulfill its
obligations to furnish comprehensive health information exchange services as required
under its health information exchange contract;

(3) the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end is no longer financially
solvent or may not reasonably be expected to meet its obligations to participating entities;

(4) the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end has failed to implement
the complaint system in a manner designed to reasonably resolve valid complaints;

(5) the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end, or any person acting
with its sanction, has advertised or merchandised its services in an untrue, misleading,
deceptive, or unfair manner;

(6) the continued operation of the health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end would be hazardous to its participating entities or the patients served by the
participating entities; or

(7) the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end has otherwise failed
to substantially comply with section 62J.4981 or with any other statute or administrative
rule applicable to health information exchange service providers, or has submitted false
information in any report required under sections 62J.498 to 62J.4982.

(b) A certificate of authority shall be suspended or revoked only after meeting the
requirements of subdivision 3.

(c) If the certificate of authority of a health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end is suspended, the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end
shall not, during the period of suspension, enroll any additional participating entities, and
shall not engage in any advertising or solicitation.

(d) If the certificate of authority of a health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end is revoked, the organization shall proceed, immediately following the effective
date of the order of revocation, to wind up its affairs, and shall conduct no further business
except as necessary to the orderly conclusion of the affairs of the organization. The
organization shall engage in no further advertising or solicitation. The commissioner may,
by written order, permit further operation of the organization as the commissioner finds to
be in the best interest of participating entities, to the end that participating entities will be
given the greatest practical opportunity to access continuing health information exchange
services.

Subd. 3.

Denial, suspension, and revocation; administrative procedures.

(a) When
the commissioner has cause to believe that grounds for the denial, suspension, or revocation
of a certificate of authority exist, the commissioner shall notify the health information
deleted text begin exchange service providerdeleted text endnew text begin organizationnew text end in writing stating the grounds for denial, suspension,
or revocation and setting a time within 20 days for a hearing on the matter.

(b) After a hearing before the commissioner at which the health information deleted text beginexchange
service provider
deleted text endnew text begin organizationnew text end may respond to the grounds for denial, suspension, or
revocation, or upon the failure of the health information deleted text beginexchange service providerdeleted text endnew text begin
organization
new text end to appear at the hearing, the commissioner shall take action as deemed necessary
and shall issue written findings and mail them to the health information deleted text beginexchange service
provider
deleted text endnew text begin organizationnew text end.

(c) If suspension, revocation, or administrative penalty is proposed according to this
section, the commissioner must deliver, or send by certified mail with return receipt
requested, to the health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end written notice
of the commissioner's intent to impose a penalty. This notice of proposed determination
must include:

(1) a reference to the statutory basis for the penalty;

(2) a description of the findings of fact regarding the violations with respect to which
the penalty is proposed;

(3) the nature and amount of the proposed penalty;

(4) any circumstances described in subdivision 1, paragraph (a), that were considered
in determining the amount of the proposed penalty;

(5) instructions for responding to the notice, including a statement of the health
information deleted text beginexchange service provider'sdeleted text endnew text begin organization'snew text end right to a contested case proceeding
and a statement that failure to request a contested case proceeding within 30 calendar days
permits the imposition of the proposed penalty; and

(6) the address to which the contested case proceeding request must be sent.

Subd. 4.

Coordination.

The commissioner shall, to the extent possible, seek the advice
of the Minnesota e-Health Advisory Committee, in the review and update of criteria for the
certification and recertification of health information deleted text beginexchange service providersdeleted text endnew text begin
organizations
new text end when implementing sections 62J.498 to 62J.4982.

Subd. 5.

Fees and monetary penalties.

(a) The commissioner shall assess fees on every
health information deleted text beginexchange service providerdeleted text endnew text begin organizationnew text end subject to sections 62J.4981 and
62J.4982 as follows:

(1) filing an application for certificate of authority to operate as a health information
organization, $7,000;new text begin and
new text end

(2) deleted text beginfiling an application for certificate of authority to operate as a health data intermediary,
$7,000;
deleted text end

deleted text begin (3)deleted text end annual health information organization certificate fee, $7,000deleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (4) annual health data intermediary certificate fee, $7,000.
deleted text end

(b) Fees collected under this section shall be deposited in the state treasury and credited
to the state government special revenue fund.

(c) Administrative monetary penalties imposed under this subdivision shall be credited
to an account in the special revenue fund and are appropriated to the commissioner for the
purposes of sections 62J.498 to 62J.4982.

Sec. 5.

Minnesota Statutes 2020, section 62J.84, subdivision 3, is amended to read:


Subd. 3.

Prescription drug price increases reporting.

(a) Beginning deleted text beginOctober 1, 2021deleted text endnew text begin
January 1, 2022
new text end, a drug manufacturer must submit to the commissioner the information
described in paragraph (b) for each prescription drug for which the price was $100 or greater
for a 30-day supply or for a course of treatment lasting less than 30 days and:

(1) for brand name drugs where there is an increase of ten percent or greater in the price
over the previous 12-month period or an increase of 16 percent or greater in the price over
the previous 24-month period; and

(2) for generic drugs where there is an increase of 50 percent or greater in the price over
the previous 12-month period.

(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
the commissioner no later than 60 days after the price increase goes into effect, in the form
and manner prescribed by the commissioner, the following information, if applicable:

(1) the name and price of the drug and the net increase, expressed as a percentage;

(2) the factors that contributed to the price increase;

(3) the name of any generic version of the prescription drug available on the market;

(4) the introductory price of the prescription drug when it was approved for marketing
by the Food and Drug Administration and the net yearly increase, by calendar year, in the
price of the prescription drug during the previous five years;

(5) the direct costs incurred by the manufacturer that are associated with the prescription
drug, listed separately:

(i) to manufacture the prescription drug;

(ii) to market the prescription drug, including advertising costs; and

(iii) to distribute the prescription drug;

(6) the total sales revenue for the prescription drug during the previous 12-month period;

(7) the manufacturer's net profit attributable to the prescription drug during the previous
12-month period;

(8) the total amount of financial assistance the manufacturer has provided through patient
prescription assistance programs, if applicable;

(9) any agreement between a manufacturer and another entity contingent upon any delay
in offering to market a generic version of the prescription drug;

(10) the patent expiration date of the prescription drug if it is under patent;

(11) the name and location of the company that manufactured the drug; and

(12) if a brand name prescription drug, the ten highest prices paid for the prescription
drug during the previous calendar year in any country other than the United States.

(c) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.

Sec. 6.

Minnesota Statutes 2020, section 62J.84, subdivision 4, is amended to read:


Subd. 4.

New prescription drug price reporting.

(a) Beginning deleted text beginOctober 1, 2021deleted text endnew text begin January
1, 2022
new text end, no later than 60 days after a manufacturer introduces a new prescription drug for
sale in the United States that is a new brand name drug with a price that is greater than the
tier threshold established by the Centers for Medicare and Medicaid Services for specialty
drugs in the Medicare Part D program for a 30-day supply or a new generic or biosimilar
drug with a price that is greater than the tier threshold established by the Centers for Medicare
and Medicaid Services for specialty drugs in the Medicare Part D program for a 30-day
supply and is not at least 15 percent lower than the referenced brand name drug when the
generic or biosimilar drug is launched, the manufacturer must submit to the commissioner,
in the form and manner prescribed by the commissioner, the following information, if
applicable:

(1) the price of the prescription drug;

(2) whether the Food and Drug Administration granted the new prescription drug a
breakthrough therapy designation or a priority review;

(3) the direct costs incurred by the manufacturer that are associated with the prescription
drug, listed separately:

(i) to manufacture the prescription drug;

(ii) to market the prescription drug, including advertising costs; and

(iii) to distribute the prescription drug; and

(4) the patent expiration date of the drug if it is under patent.

(b) The manufacturer may submit documentation necessary to support the information
reported under this subdivision.

Sec. 7.

Minnesota Statutes 2020, section 62J.84, subdivision 5, is amended to read:


Subd. 5.

Newly acquired prescription drug price reporting.

(a) Beginning deleted text beginOctober
1, 2021
deleted text endnew text begin January 1, 2022new text end, the acquiring drug manufacturer must submit to the commissioner
the information described in paragraph (b) for each newly acquired prescription drug for
which the price was $100 or greater for a 30-day supply or for a course of treatment lasting
less than 30 days and:

(1) for a newly acquired brand name drug where there is an increase of ten percent or
greater in the price over the previous 12-month period or an increase of 16 percent or greater
in price over the previous 24-month period; and

(2) for a newly acquired generic drug where there is an increase of 50 percent or greater
in the price over the previous 12-month period.

(b) For each of the drugs described in paragraph (a), the acquiring manufacturer shall
submit to the commissioner no later than 60 days after the acquiring manufacturer begins
to sell the newly acquired drug, in the form and manner prescribed by the commissioner,
the following information, if applicable:

(1) the price of the prescription drug at the time of acquisition and in the calendar year
prior to acquisition;

(2) the name of the company from which the prescription drug was acquired, the date
acquired, and the purchase price;

(3) the year the prescription drug was introduced to market and the price of the
prescription drug at the time of introduction;

(4) the price of the prescription drug for the previous five years;

(5) any agreement between a manufacturer and another entity contingent upon any delay
in offering to market a generic version of the manufacturer's drug; and

(6) the patent expiration date of the drug if it is under patent.

(c) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.

Sec. 8.

Minnesota Statutes 2020, section 62J.84, subdivision 6, is amended to read:


Subd. 6.

Public posting of prescription drug price information.

(a) The commissioner
shall post on the department's website, or may contract with a private entity or consortium
that satisfies the standards of section 62U.04, subdivision 6, to meet this requirement, the
following information:

(1) a list of the prescription drugs reported under subdivisions 3, 4, and 5, and the
manufacturers of those prescription drugs; and

(2) information reported to the commissioner under subdivisions 3, 4, and 5.

(b) The information must be published in an easy-to-read format and in a manner that
identifies the information that is disclosed on a per-drug basis and must not be aggregated
in a manner that prevents the identification of the prescription drug.

(c) The commissioner shall not post to the department's website or a private entity
contracting with the commissioner shall not post any information described in this section
if the information is not public data under section 13.02, subdivision 8a; or is trade secret
information under section 13.37, subdivision 1, paragraph (b); or is trade secret information
pursuant to the Defend Trade Secrets Act of 2016, United States Code, title 18, section
1836, as amended. If a manufacturer believes information should be withheld from public
disclosure pursuant to this paragraph, the manufacturer must clearly and specifically identify
that information and describe the legal basis in writing when the manufacturer submits the
information under this section. If the commissioner disagrees with the manufacturer's request
to withhold information from public disclosure, the commissioner shall provide the
manufacturer written notice that the information will be publicly posted 30 days after the
date of the notice.

(d) If the commissioner withholds any information from public disclosure pursuant to
this subdivision, the commissioner shall post to the department's website a report describing
the nature of the information and the commissioner's basis for withholding the information
from disclosure.

new text begin (e) To the extent the information required to be posted under this subdivision is collected
and made available to the public by another state, by the University of Minnesota, or through
an online drug pricing reference and analytical tool, the commissioner may reference the
availability of this drug price data from another source including, within existing
appropriations, creating the ability of the public to access the data from the source for
purposes of meeting the reporting requirements of this subdivision.
new text end

Sec. 9.

Minnesota Statutes 2020, section 62J.84, subdivision 9, is amended to read:


Subd. 9.

Legislative report.

(a) No later than deleted text beginJanuary 15 of each year, beginning January
15, 2022
deleted text endnew text begin May 15, 2022, and by January 15 of each year thereafternew text end, the commissioner shall
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over commerce and health and human services policy and finance on the
implementation of this section, including but not limited to the effectiveness in addressing
the following goals:

(1) promoting transparency in pharmaceutical pricing for the state and other payers;

(2) enhancing the understanding on pharmaceutical spending trends; and

(3) assisting the state and other payers in the management of pharmaceutical costs.

(b) The report must include a summary of the information submitted to the commissioner
under subdivisions 3, 4, and 5.

Sec. 10.

Minnesota Statutes 2020, section 144.05, is amended by adding a subdivision to
read:


new text begin Subd. 7.new text end

new text beginExpiration of report mandates.new text end

new text begin(a) If the submission of a report by the
commissioner of health to the legislature is mandated by statute and the enabling legislation
does not include a date for the submission of a final report, the mandate to submit the report
shall expire in accordance with this section.
new text end

new text begin (b) If the mandate requires the submission of an annual report and the mandate was
enacted before January 1, 2021, the mandate shall expire on January 1,2023. If the mandate
requires the submission of a biennial or less frequent report and the mandate was enacted
before January 1, 2021, the mandate shall expire on January 1, 2024.
new text end

new text begin (c) Any reporting mandate enacted on or after January 1, 2021 shall expire three years
after the date of enactment if the mandate requires the submission of an annual report and
shall expire five years after the date of enactment if the mandate requires the submission
of a biennial or less frequent report, unless the enacting legislation provides for a different
expiration date.
new text end

new text begin (d) The commissioner shall submit a list to the chairs and ranking minority members of
the legislative committee with jurisdiction over health by February 15 of each year, beginning
February 15, 2022, of all reports set to expire during the following calendar year in
accordance with this section.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 11.

Minnesota Statutes 2020, section 144.1205, subdivision 2, is amended to read:


Subd. 2.

new text beginInitial and new text endannual fee.

new text begin(a) A licensee must pay an initial fee that is equivalent
to the annual fee upon issuance of the initial license.
new text end

new text begin (b) new text endA licensee must pay an annual fee at least 60 days before the anniversary date of the
issuance of the license. The annual fee is as follows:

TYPE
deleted text begin ANNUALdeleted text endnew text begin
LICENSE
new text end FEE
Academic broad scope - type Anew text begin, B, or C
new text end
deleted text begin $19,920deleted text endnew text begin
$25,896
new text end
deleted text begin Academic broad scope - type B
deleted text end
deleted text begin19,920
deleted text end
deleted text begin Academic broad scope - type C
deleted text end
deleted text begin19,920
deleted text end
new text begin Academic broad scope - type A, B, or C (4-8 locations)
new text end
new text begin$31,075
new text end
new text begin Academic broad scope - type A, B, or C (9 or more locations)
new text end
new text begin$36,254
new text end
Medical broad scope - type A
deleted text begin 19,920deleted text endnew text begin
$25,896
new text end
new text begin Medical broad scope- type A (4-8 locations)
new text end
new text begin$31,075
new text end
new text begin Medical broad scope- type A (9 or more locations)
new text end
new text begin$36,254
new text end
deleted text begin Medical institution - diagnostic and therapeutic
deleted text end
deleted text begin3,680
deleted text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
medicine, eye applicators, high dose rate afterloaders, and
medical therapy emerging technologies
new text end
new text begin$4,784
new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
medicine, eye applicators, high dose rate afterloaders, and
medical therapy emerging technologies (4-8 locations)
new text end
new text begin$5,740
new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
medicine, eye applicators, high dose rate afterloaders, and
medical therapy emerging technologies (9 or more locations)
new text end
new text begin$6,697
new text end
deleted text begin Medical institution - diagnostic (no written directives)
deleted text end
deleted text begin3,680
deleted text end
deleted text begin Medical private practice - diagnostic and therapeutic
deleted text end
deleted text begin3,680
deleted text end
deleted text begin Medical private practice - diagnostic (no written directives)
deleted text end
deleted text begin3,680
deleted text end
deleted text begin Eye applicators
deleted text end
deleted text begin3,680
deleted text end
deleted text begin Nuclear medical vans
deleted text end
deleted text begin3,680
deleted text end
deleted text begin High dose rate afterloader
deleted text end
deleted text begin3,680
deleted text end
deleted text begin Mobile high dose rate afterloader
deleted text end
deleted text begin3,680
deleted text end
deleted text begin Medical therapy - other emerging technology
deleted text end
deleted text begin3,680
deleted text end
Teletherapy
deleted text begin 8,960deleted text endnew text begin
$11,648
new text end
Gamma knife
deleted text begin 8,960deleted text endnew text begin
$11,648
new text end
Veterinary medicine
deleted text begin2,000deleted text endnew text begin $2,600
new text end
In vitro testing lab
deleted text begin2,000deleted text endnew text begin $2,600
new text end
Nuclear pharmacy
deleted text begin 8,800deleted text endnew text begin
$11,440
new text end
new text begin Nuclear pharmacy (5 or more locations)
new text end
new text begin$13,728
new text end
Radiopharmaceutical distribution (10 CFR 32.72)
deleted text begin3,840deleted text endnew text begin $4,992
new text end
Radiopharmaceutical processing and distribution (10 CFR
32.72)
deleted text begin8,800deleted text endnew text begin
$11,440
new text end
new text begin Radiopharmaceutical processing and distribution (10 CFR
32.72) (5 or more locations)
new text end
new text begin$13,728
new text end
Medical sealed sources - distribution (10 CFR 32.74)
deleted text begin3,840deleted text endnew text begin $4,992
new text end
Medical sealed sources - processing and distribution (10 CFR
32.74)
deleted text begin8,800deleted text endnew text begin
$11,440
new text end
new text begin Medical sealed sources - processing and distribution (10 CFR
32.74) (5 or more locations)
new text end
new text begin$13,728
new text end
Well logging - sealed sources
deleted text begin3,760deleted text endnew text begin $4,888
new text end
Measuring systems - new text begin(new text endfixed gaugenew text begin, portable gauge, gas
chromatograph, other)
new text end
deleted text begin2,000deleted text endnew text begin $2,600
new text end
deleted text begin Measuring systems - portable gauge
deleted text end
deleted text begin2,000
deleted text end
new text begin Measuring systems - (fixed gauge, portable gauge, gas
chromatograph, other) (4-8 locations)
new text end
new text begin$3,120
new text end
new text begin Measuring systems - (fixed gauge, portable gauge, gas
chromatograph, other) (9 or more locations)
new text end
new text begin$3,640
new text end
X-ray fluorescent analyzer
deleted text begin1,520deleted text endnew text begin $1,976
new text end
deleted text begin Measuring systems - gas chromatograph
deleted text end
deleted text begin2,000
deleted text end
deleted text begin Measuring systems - other
deleted text end
deleted text begin2,000
deleted text end
deleted text begin Broad scopedeleted text end Manufacturing and distribution - type Anew text begin broad
scope
new text end
deleted text begin19,920deleted text endnew text begin
$25,896
new text end
new text begin Manufacturing and distribution - type A broad scope (4-8
locations)
new text end
new text begin$31,075
new text end
new text begin Manufacturing and distribution - type A broad scope (9 or more
locations)
new text end
new text begin$36,254
new text end
deleted text begin Broad scopedeleted text end Manufacturing and distribution - type Bnew text begin or C broad
scope
new text end
deleted text begin17,600deleted text endnew text begin
$22,880
new text end
deleted text begin Broad scope Manufacturing and distribution - type C
deleted text end
deleted text begin17,600
deleted text end
new text begin Manufacturing and distribution - type B or C broad scope (4-8
locations)
new text end
new text begin$27,456
new text end
new text begin Manufacturing and distribution - type B or C broad scope (9
or more locations)
new text end
new text begin$32,032
new text end
Manufacturing and distribution - other
deleted text begin5,280deleted text endnew text begin $6,864
new text end
new text begin Manufacturing and distribution - other (4-8 locations)
new text end
new text begin$8,236
new text end
new text begin Manufacturing and distribution - other (9 or more locations)
new text end
new text begin$9,609
new text end
Nuclear laundry
deleted text begin 18,640deleted text endnew text begin
$24,232
new text end
Decontamination services
deleted text begin4,960deleted text endnew text begin $6,448
new text end
Leak test services only
deleted text begin2,000deleted text endnew text begin $2,600
new text end
Instrument calibration service onlydeleted text begin, less than 100 curies
deleted text end
deleted text begin2,000deleted text endnew text begin $2,600
new text end
deleted text begin Instrument calibration service only, 100 curies or more
deleted text end
deleted text begin2,000
deleted text end
Service, maintenance, installation, source changes, etc.
deleted text begin4,960deleted text endnew text begin $6,448
new text end
Waste disposal service, prepackaged only
deleted text begin6,000deleted text endnew text begin $7,800
new text end
Waste disposal
deleted text begin 8,320deleted text endnew text begin
$10,816
new text end
Distribution - general licensed devices (sealed sources)
deleted text begin1,760deleted text endnew text begin $2,288
new text end
Distribution - general licensed material (unsealed sources)
deleted text begin1,120deleted text endnew text begin $1,456
new text end
Industrial radiography - fixednew text begin or temporarynew text end location
deleted text begin 9,840deleted text endnew text begin
$12,792
new text end
deleted text begin Industrial radiography - temporary job sites
deleted text end
deleted text begin9,840
deleted text end
new text begin Industrial radiography - fixed or temporary location (5 or more
locations)
new text end
new text begin$16,629
new text end
Irradiators, self-shieldingdeleted text begin, less than 10,000 curies
deleted text end
deleted text begin2,880deleted text endnew text begin $3,744
new text end
Irradiators, other, less than 10,000 curies
deleted text begin5,360deleted text endnew text begin $6,968
new text end
deleted text begin Irradiators, self-shielding, 10,000 curies or more
deleted text end
deleted text begin2,880
deleted text end
Research and development - type Anew text begin, B, or Cnew text end broad scope
deleted text begin 9,520deleted text endnew text begin
$12,376
new text end
deleted text begin Research and development - type B broad scope
deleted text end
deleted text begin9,520
deleted text end
deleted text begin Research and development - type C broad scope
deleted text end
deleted text begin9,520
deleted text end
new text begin Research and development - type A, B, or C broad scope (4-8
locations)
new text end
new text begin$14,851
new text end
new text begin Research and development - type A, B, or C broad scope (9 or
more locations)
new text end
new text begin$17,326
new text end
Research and development - other
deleted text begin4,480deleted text endnew text begin $5,824
new text end
Storage - no operations
deleted text begin2,000deleted text endnew text begin $2,600
new text end
Source material - shielding
deleted text begin584deleted text endnew text begin $759
new text end
Special nuclear material plutonium - neutron source in device
deleted text begin3,680deleted text endnew text begin $4,784
new text end
Pacemaker by-product and/or special nuclear material - medical
(institution)
deleted text begin3,680deleted text endnew text begin $4,784
new text end
Pacemaker by-product and/or special nuclear material -
manufacturing and distribution
deleted text begin5,280deleted text endnew text begin $6,864
new text end
Accelerator-produced radioactive material
deleted text begin3,840deleted text endnew text begin $4,992
new text end
Nonprofit educational institutions
deleted text begin300deleted text endnew text begin $500
new text end
deleted text begin General license registration
deleted text end
deleted text begin150
deleted text end

Sec. 12.

Minnesota Statutes 2020, section 144.1205, subdivision 4, is amended to read:


Subd. 4.

new text beginInitial and renewal new text endapplication fee.

A licensee must pay an new text begininitial and a
renewal
new text endapplication fee deleted text beginas follows:deleted text endnew text begin according to this subdivision.
new text end

TYPE
APPLICATION FEE
Academic broad scope - type Anew text begin, B, or C
new text end
deleted text begin $ 5,920deleted text endnew text begin
$6,808
new text end
deleted text begin Academic broad scope - type B
deleted text end
deleted text begin5,920
deleted text end
deleted text begin Academic broad scope - type C
deleted text end
deleted text begin5,920
deleted text end
Medical broad scope - type A
deleted text begin3,920deleted text endnew text begin $4,508
new text end
new text begin Medical - diagnostic, diagnostic and therapeutic, mobile nuclear
medicine, eye applicators, high dose rate afterloaders, and
medical therapy emerging technologies
new text end
new text begin$1,748
new text end
deleted text begin Medical institution - diagnostic and therapeutic
deleted text end
deleted text begin1,520
deleted text end
deleted text begin Medical institution - diagnostic (no written directives)
deleted text end
deleted text begin1,520
deleted text end
deleted text begin Medical private practice - diagnostic and therapeutic
deleted text end
deleted text begin1,520
deleted text end
deleted text begin Medical private practice - diagnostic (no written directives)
deleted text end
deleted text begin1,520
deleted text end
deleted text begin Eye applicators
deleted text end
deleted text begin1,520
deleted text end
deleted text begin Nuclear medical vans
deleted text end
deleted text begin1,520
deleted text end
deleted text begin High dose rate afterloader
deleted text end
deleted text begin1,520
deleted text end
deleted text begin Mobile high dose rate afterloader
deleted text end
deleted text begin1,520
deleted text end
deleted text begin Medical therapy - other emerging technology
deleted text end
deleted text begin1,520
deleted text end
Teletherapy
deleted text begin5,520deleted text endnew text begin $6,348
new text end
Gamma knife
deleted text begin5,520deleted text endnew text begin $6,348
new text end
Veterinary medicine
deleted text begin960deleted text endnew text begin $1,104
new text end
In vitro testing lab
deleted text begin960deleted text endnew text begin $1,104
new text end
Nuclear pharmacy
deleted text begin4,880deleted text endnew text begin $5,612
new text end
Radiopharmaceutical distribution (10 CFR 32.72)
deleted text begin2,160deleted text endnew text begin $2,484
new text end
Radiopharmaceutical processing and distribution (10 CFR
32.72)
deleted text begin4,880deleted text endnew text begin $5,612
new text end
Medical sealed sources - distribution (10 CFR 32.74)
deleted text begin2,160deleted text endnew text begin $2,484
new text end
Medical sealed sources - processing and distribution (10 CFR
32.74)
deleted text begin4,880deleted text endnew text begin $5,612
new text end
Well logging - sealed sources
deleted text begin1,600deleted text endnew text begin $1,840
new text end
Measuring systems - new text begin(new text endfixed gaugenew text begin, portable gauge, gas
chromatograph, other)
new text end
deleted text begin960deleted text endnew text begin $1,104
new text end
deleted text begin Measuring systems - portable gauge
deleted text end
deleted text begin960
deleted text end
X-ray fluorescent analyzer
deleted text begin584deleted text endnew text begin $671
new text end
deleted text begin Measuring systems - gas chromatograph
deleted text end
deleted text begin960
deleted text end
deleted text begin Measuring systems - other
deleted text end
deleted text begin960
deleted text end
deleted text begin Broad scopedeleted text end Manufacturing and distribution - type Anew text begin, B, and
C broad scope
new text end
deleted text begin5,920deleted text endnew text begin $6,854
new text end
deleted text begin Broad scope manufacturing and distribution - type B
deleted text end
deleted text begin5,920
deleted text end
deleted text begin Broad scope manufacturing and distribution - type C
deleted text end
deleted text begin5,920
deleted text end
Manufacturing and distribution - other
deleted text begin2,320deleted text endnew text begin $2,668
new text end
Nuclear laundry
deleted text begin 10,080deleted text endnew text begin
$11,592
new text end
Decontamination services
deleted text begin2,640deleted text endnew text begin $3,036
new text end
Leak test services only
deleted text begin960deleted text endnew text begin $1,104
new text end
Instrument calibration service onlydeleted text begin, less than 100 curies
deleted text end
deleted text begin960deleted text endnew text begin $1,104
new text end
deleted text begin Instrument calibration service only, 100 curies or more
deleted text end
deleted text begin960
deleted text end
Service, maintenance, installation, source changes, etc.
deleted text begin2,640deleted text endnew text begin $3,036
new text end
Waste disposal service, prepackaged only
deleted text begin2,240deleted text endnew text begin $2,576
new text end
Waste disposal
deleted text begin1,520deleted text endnew text begin $1,748
new text end
Distribution - general licensed devices (sealed sources)
deleted text begin880deleted text endnew text begin $1,012
new text end
Distribution - general licensed material (unsealed sources)
deleted text begin520deleted text endnew text begin $598
new text end
Industrial radiography - fixed new text beginor temporary new text endlocation
deleted text begin2,640deleted text endnew text begin $3,036
new text end
deleted text begin Industrial radiography - temporary job sites
deleted text end
deleted text begin2,640
deleted text end
Irradiators, self-shieldingdeleted text begin, less than 10,000 curies
deleted text end
deleted text begin1,440deleted text endnew text begin $1,656
new text end
Irradiators, other, less than 10,000 curies
deleted text begin2,960deleted text endnew text begin $3,404
new text end
deleted text begin Irradiators, self-shielding, 10,000 curies or more
deleted text end
deleted text begin1,440
deleted text end
Research and development - type Anew text begin, B, or Cnew text end broad scope
deleted text begin4,960deleted text endnew text begin $5,704
new text end
deleted text begin Research and development - type B broad scope
deleted text end
deleted text begin4,960
deleted text end
deleted text begin Research and development - type C broad scope
deleted text end
deleted text begin4,960
deleted text end
Research and development - other
deleted text begin2,400deleted text endnew text begin $2,760
new text end
Storage - no operations
deleted text begin960deleted text endnew text begin $1,104
new text end
Source material - shielding
deleted text begin136deleted text endnew text begin $156
new text end
Special nuclear material plutonium - neutron source in device
deleted text begin1,200deleted text endnew text begin $1,380
new text end
Pacemaker by-product and/or special nuclear material - medical
(institution)
deleted text begin1,200deleted text endnew text begin $1,380
new text end
Pacemaker by-product and/or special nuclear material -
manufacturing and distribution
deleted text begin2,320deleted text endnew text begin $2,668
new text end
Accelerator-produced radioactive material
deleted text begin4,100deleted text endnew text begin $4,715
new text end
Nonprofit educational institutions
deleted text begin300deleted text endnew text begin $345
new text end
deleted text begin General license registration
deleted text end
deleted text begin0
deleted text end
deleted text begin Industrial radiographer certification
deleted text end
deleted text begin150
deleted text end

Sec. 13.

Minnesota Statutes 2020, section 144.1205, subdivision 8, is amended to read:


Subd. 8.

Reciprocity fee.

A licensee submitting an application for reciprocal recognition
of a materials license issued by another agreement state or the United States Nuclear
Regulatory Commission for a period of 180 days or less during a calendar year must pay
deleted text begin $1,200deleted text endnew text begin $2,400new text end. For a period of 181 days or more, the licensee must obtain a license under
subdivision 4.

Sec. 14.

Minnesota Statutes 2020, section 144.1205, subdivision 9, is amended to read:


Subd. 9.

Fees for license amendments.

A licensee must pay a fee of deleted text begin$300deleted text endnew text begin $600new text end to
amend a license as follows:

(1) to amend a license requiring review including, but not limited to, addition of isotopes,
procedure changes, new authorized users, or a new radiation safety officer; deleted text beginanddeleted text end new text beginor
new text end

(2) to amend a license requiring review and a site visit including, but not limited to,
facility move or addition of processes.

Sec. 15.

Minnesota Statutes 2020, section 144.1205, is amended by adding a subdivision
to read:


new text begin Subd. 10.new text end

new text beginFees for general license registrations.new text end

new text beginA person required to register generally
licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual
registration fee of $450.
new text end

Sec. 16.

Minnesota Statutes 2020, section 144.1481, subdivision 1, is amended to read:


Subdivision 1.

Establishment; membership.

The commissioner of health shall establish
a deleted text begin15-memberdeleted text endnew text begin 16-membernew text end Rural Health Advisory Committee. The committee shall consist
of the following members, all of whom must reside outside the seven-county metropolitan
area, as defined in section 473.121, subdivision 2:

(1) two members from the house of representatives of the state of Minnesota, one from
the majority party and one from the minority party;

(2) two members from the senate of the state of Minnesota, one from the majority party
and one from the minority party;

(3) a volunteer member of an ambulance service based outside the seven-county
metropolitan area;

(4) a representative of a hospital located outside the seven-county metropolitan area;

(5) a representative of a nursing home located outside the seven-county metropolitan
area;

(6) a medical doctor or doctor of osteopathic medicine licensed under chapter 147;

(7) new text begina dentist licensed under chapter 150A;
new text end

new text begin (8) new text enda midlevel practitioner;

deleted text begin (8)deleted text endnew text begin (9)new text end a registered nurse or licensed practical nurse;

deleted text begin (9)deleted text endnew text begin (10)new text end a licensed health care professional from an occupation not otherwise represented
on the committee;

deleted text begin (10)deleted text endnew text begin (11)new text end a representative of an institution of higher education located outside the
seven-county metropolitan area that provides training for rural health care providers; and

deleted text begin (11)deleted text endnew text begin (12)new text end three consumers, at least one of whom must be an advocate for persons who
are mentally ill or developmentally disabled.

The commissioner will make recommendations for committee membership. Committee
members will be appointed by the governor. In making appointments, the governor shall
ensure that appointments provide geographic balance among those areas of the state outside
the seven-county metropolitan area. The chair of the committee shall be elected by the
members. The advisory committee is governed by section 15.059, except that the members
do not receive per diem compensation.

Sec. 17.

Minnesota Statutes 2020, 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, new text begingeneral surgery, new text endinternal 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. Notwithstanding any law to the contrary, funds awarded to
grantees in a grant agreement do not lapse until the grant agreement expires. 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. 18.

Minnesota Statutes 2020, section 144.223, is amended to read:


144.223 REPORT OF MARRIAGE.

Data relating to certificates of marriage registered shall be reported to the state registrar
by the local registrar or designee of the county board in each of the 87 registration districts
pursuant to the rules of the commissioner. The information in clause (1) necessary to compile
the report shall be furnished by the applicant prior to the issuance of the marriage license.
The report shall contain the following:

(1) personal information on bride and groom:

(i) name;

(ii) residence;

(iii) date and place of birth;

deleted text begin (iv) race;
deleted text end

deleted text begin (v)deleted text endnew text begin (iv)new text end if previously married, how terminated; and

deleted text begin (vi)deleted text endnew text begin (v)new text end signature of applicant, date signed, and Social Security number; and

(2) information concerning the marriage:

(i) date of marriage;

(ii) place of marriage; and

(iii) civil or religious ceremony.

Sec. 19.

Minnesota Statutes 2020, section 144.225, subdivision 7, is amended to read:


Subd. 7.

Certified birth or death record.

(a) The state registrar or local issuance office
shall issue a certified birth or death record or a statement of no vital record found to an
individual upon the individual's proper completion of an attestation provided by the
commissioner and payment of the required fee:

(1) to a person who deleted text beginhas a tangible interest in the requested vital record. A person who
has a tangible interest
deleted text end is:

(i) the subject of the vital record;

(ii) a child of the subject;

(iii) the spouse of the subject;

(iv) a parent of the subject;

(v) the grandparent or grandchild of the subject;

(vi) if the requested record is a death record, a sibling of the subject;

deleted text begin (vii) the party responsible for filing the vital record;
deleted text end

deleted text begin (viii)deleted text endnew text begin (vii)new text end the legal custodian, guardian or conservator, or health care agent of the subject;

deleted text begin (ix)deleted text endnew text begin (viii)new text end a personal representative, by sworn affidavit of the fact that the certified copy
is required for administration of the estate;

deleted text begin (x)deleted text endnew text begin (ix)new text end a successor of the subject, as defined in section 524.1-201, if the subject is
deceased, by sworn affidavit of the fact that the certified copy is required for administration
of the estate;

deleted text begin (xi)deleted text endnew text begin (x)new text end if the requested record is a death record, a trustee of a trust by sworn affidavit
of the fact that the certified copy is needed for the proper administration of the trust;

deleted text begin (xii)deleted text endnew text begin (xi)new text end a person or entity who demonstrates that a certified vital record is necessary
for the determination or protection of a personal or property right, pursuant to rules adopted
by the commissioner; or

deleted text begin (xiii)deleted text endnew text begin (xii)new text end an adoption agency in order to complete confidential postadoption searches
as required by section 259.83;

(2) to any local, state, tribal, or federal governmental agency upon request if the certified
vital record is necessary for the governmental agency to perform its authorized duties;

(3) to an attorney new text beginrepresenting the subject of the vital record or another person listed in
clause (1),
new text endupon evidence of the attorney's license;

(4) pursuant to a court order issued by a court of competent jurisdiction. For purposes
of this section, a subpoena does not constitute a court order; or

(5) to a representative authorized by a person under clauses (1) to (4).

(b) The state registrar or local issuance office shall also issue a certified death record to
an individual described in paragraph (a), clause (1), items (ii) to deleted text begin(viii)deleted text endnew text begin (xi)new text end, if, on behalf of
the individual, a licensed mortician furnishes the registrar with a properly completed
attestation in the form provided by the commissioner within 180 days of the time of death
of the subject of the death record. This paragraph is not subject to the requirements specified
in Minnesota Rules, part 4601.2600, subpart 5, item B.

Sec. 20.

Minnesota Statutes 2020, section 144G.84, is amended to read:


144G.84 SERVICES FOR RESIDENTS WITH DEMENTIA.

(a) In addition to the minimum services required in section 144G.41, an assisted living
facility with dementia care must also provide the following services:

(1) assistance with activities of daily living that address the needs of each resident with
dementia due to cognitive or physical limitations. These services must meet or be in addition
to the requirements in the licensing rules for the facility. Services must be provided in a
person-centered manner that promotes resident choice, dignity, and sustains the resident's
abilities;

(2) nonpharmacological practices that are person-centered and evidence-informed;

(3) services to prepare and educate persons living with dementia and their legal and
designated representatives about transitions in care and ensuring complete, timely
communication between, across, and within settings; and

(4) services that provide residents with choices for meaningful engagement with other
facility residents and the broader community.

(b) Each resident must be evaluated for activities according to the licensing rules of the
facility. In addition, the evaluation must address the following:

(1) past and current interests;

(2) current abilities and skills;

(3) emotional and social needs and patterns;

(4) physical abilities and limitations;

(5) adaptations necessary for the resident to participate; and

(6) identification of activities for behavioral interventions.

(c) An individualized activity plan must be developed for each resident based on their
activity evaluation. The plan must reflect the resident's activity preferences and needs.

(d) A selection of daily structured and non-structured activities must be provided and
included on the resident's activity service or care plan as appropriate. Daily activity options
based on resident evaluation may include but are not limited to:

(1) occupation or chore related tasks;

(2) scheduled and planned events such as entertainment or outings;

(3) spontaneous activities for enjoyment or those that may help defuse a behavior;

(4) one-to-one activities that encourage positive relationships between residents and
staff such as telling a life story, reminiscing, or playing music;

(5) spiritual, creative, and intellectual activities;

(6) sensory stimulation activities;

(7) physical activities that enhance or maintain a resident's ability to ambulate or move;
and

(8) new text begina resident's individualized activity plan for regular new text endoutdoor deleted text beginactivitiesdeleted text endnew text begin activitynew text end.

(e) Behavioral symptoms that negatively impact the resident and others in the assisted
living facility with dementia care must be evaluated and included on the service or care
plan. The staff must initiate and coordinate outside consultation or acute care when indicated.

(f) Support must be offered to family and other significant relationships on a regularly
scheduled basis but not less than quarterly.

(g) deleted text beginAccess to secured outdoor space and walkways that allow residents to enter and
return without staff assistance must be provided.
deleted text endnew text begin Existing housing with services
establishments registered under chapter 144D prior to August 1, 2021, that obtain an assisted
living facility license must provide residents with regular access to outdoor space. A licensee
with new construction on or after August 1, 2021, or a new licensee that was not previously
registered under chapter 144D prior to August 1, 2021, must provide regular access to
secured outdoor space on the premises of the facility. A resident's access to outdoor space
must be in accordance with the resident's documented care plan.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2021.
new text end

Sec. 21.

new text begin[145.87] HOME VISITING FOR PREGNANT WOMEN AND FAMILIES
WITH YOUNG CHILDREN.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) The terms defined in this subdivision apply to this section
and have the meanings given them.
new text end

new text begin (b) "Evidence-based home visiting program" means a program that:
new text end

new text begin (1) is based on a clear, consistent program or model that is research-based and grounded
in relevant, empirically based knowledge;
new text end

new text begin (2) is linked to program-determined outcomes and is associated with a national
organization, institution of higher education, or national or state public health institute;
new text end

new text begin (3) has comprehensive home visitation standards that ensure high-quality service delivery
and continuous quality improvement;
new text end

new text begin (4) has demonstrated significant, sustained positive outcomes; and
new text end

new text begin (5) either:
new text end

new text begin (i) has been evaluated using rigorous randomized controlled research designs and the
evaluation results have been published in a peer-reviewed journal; or
new text end

new text begin (ii) is based on quasi-experimental research using two or more separate, comparable
client samples.
new text end

new text begin (c) "Evidence-informed home visiting program" means a program that:
new text end

new text begin (1) has data or evidence demonstrating effectiveness at achieving positive outcomes for
pregnant women or young children; and
new text end

new text begin (2) either:
new text end

new text begin (i) has an active evaluation of the program; or
new text end

new text begin (ii) has a plan and timeline for an active evaluation of the program to be conducted.
new text end

new text begin (d) "Health equity" means every individual has a fair opportunity to attain the individual's
full health potential and no individual is disadvantaged from achieving this potential.
new text end

new text begin (e) "Promising practice home visiting program" means a program that has shown
improvement toward achieving positive outcomes for pregnant women or young children.
new text end

new text begin Subd. 2.new text end

new text beginGrants for home visiting programs.new text end

new text begin(a) The commissioner of health shall
award grants to community health boards, nonprofit organizations, and Tribal nations to
start up, sustain, or expand voluntary home visiting programs serving pregnant women or
families with young children. Home visiting programs supported under this section shall
provide voluntary home visits by early childhood professionals or health professionals,
including but not limited to nurses, social workers, early childhood educators, and trained
paraprofessionals. Grant money shall be used to:
new text end

new text begin (1) establish, sustain, or expand evidence-based, evidence-informed, or promising practice
home visiting programs that address health equity and utilize community-driven health
strategies;
new text end

new text begin (2) serve families with young children or pregnant women who have high needs or are
high-risk, including but not limited to a family with low income, a parent or pregnant woman
with a mental illness or a substance use disorder, or a parent or pregnant woman experiencing
housing instability or domestic abuse; and
new text end

new text begin (3) improve program outcomes in two or more of the following areas:
new text end

new text begin (i) maternal and newborn health;
new text end

new text begin (ii) school readiness and achievement;
new text end

new text begin (iii) family economic self-sufficiency;
new text end

new text begin (iv) coordination and referral for other community resources and supports;
new text end

new text begin (v) reduction in child injuries, abuse, or neglect; or
new text end

new text begin (vi) reduction in crime or domestic violence.
new text end

new text begin (b) Grants awarded to evidence-informed and promising practice home visiting programs
must include money to evaluate program outcomes for up to four of the areas listed in
paragraph (a), clause (3).
new text end

new text begin Subd. 3.new text end

new text beginGrant prioritization.new text end

new text begin(a) In awarding grants, the commissioner shall give
priority to community health boards, nonprofit organizations, and Tribal nations seeking to
expand home visiting services with community or regional partnerships.
new text end

new text begin (b) The commissioner shall allocate at least 75 percent of the grant money awarded each
grant cycle to evidence-based home visiting programs that address health equity and up to
25 percent of the grant money awarded each grant cycle to evidence-informed or promising
practice home visiting programs that address health equity and utilize community-driven
health strategies.
new text end

new text begin Subd. 4.new text end

new text beginAdministrative costs.new text end

new text beginThe commissioner may use up to seven percent of the
annual appropriation under this section to provide training and technical assistance and to
administer and evaluate the program. The commissioner may contract for training,
capacity-building support for grantees or potential grantees, technical assistance, and
evaluation support.
new text end

new text begin Subd. 5.new text end

new text beginUse of state general fund appropriations.new text end

new text beginAppropriations dedicated to
establishing, sustaining, or expanding evidence-based home visiting programs shall, for
grants awarded on or after July 1, 2021, be awarded according to this section. This section
shall not govern grant awards of federal funds for home visiting programs and shall not
govern grant awards using state general fund appropriations dedicated to establishing or
expanding nurse-family partnership home visiting programs.
new text end

Sec. 22.

Minnesota Statutes 2020, section 145.893, subdivision 1, is amended to read:


Subdivision 1.

deleted text beginVouchersdeleted text endnew text begin Food benefitsnew text end.

An eligible individual shall receive deleted text beginvouchersdeleted text endnew text begin
food benefits
new text end for the purchase of specified nutritional supplements in type and quantity
approved by the commissioner. Alternate forms of delivery may be developed by the
commissioner in appropriate cases.

Sec. 23.

Minnesota Statutes 2020, section 145.894, is amended to read:


145.894 STATE COMMISSIONER OF HEALTH; DUTIES, RESPONSIBILITIES.

The commissioner of health shall:

(1) develop a comprehensive state plan for the delivery of nutritional supplements to
pregnant and lactating women, infants, and children;

(2) contract with existing local public or private nonprofit organizations for the
administration of the nutritional supplement program;

(3) develop and implement a public education program promoting the provisions of
sections 145.891 to 145.897, and provide for the delivery of individual and family nutrition
education and counseling at project sites. The education programs must include a campaign
to promote breast feeding;

(4) develop in cooperation with other agencies and vendors a uniform state deleted text beginvoucherdeleted text end new text beginfood
benefit
new text end system for the delivery of nutritional supplements;

(5) authorize local health agencies to issue deleted text beginvouchers bimonthlydeleted text endnew text begin food benefits trimonthlynew text end
to some or all eligible individuals served by the agency, provided the agency demonstrates
that the federal minimum requirements for providing nutrition education will continue to
be met and that the quality of nutrition education and health services provided by the agency
will not be adversely impacted;

(6) investigate and implement a system to reduce the cost of nutritional supplements
and maintain ongoing negotiations with nonparticipating manufacturers and suppliers to
maximize cost savings;

(7) develop, analyze, and evaluate the health aspects of the nutritional supplement
program and establish nutritional guidelines for the program;

(8) apply for, administer, and annually expend at least 99 percent of available federal
or private funds;

(9) aggressively market services to eligible individuals by conducting ongoing outreach
activities and by coordinating with and providing marketing materials and technical assistance
to local human services and community service agencies and nonprofit service providers;

(10) determine, on July 1 of each year, the number of pregnant women participating in
each special supplemental food program for women, infants, and children (WIC) deleted text beginand, in
1986, 1987, and 1988, at the commissioner's discretion, designate a different food program
deliverer if the current deliverer fails to increase the participation of pregnant women in the
program by at least ten percent over the previous year's participation rate
deleted text end;

(11) promulgate all rules necessary to carry out the provisions of sections 145.891 to
145.897; and

(12) ensure that any state appropriation to supplement the federal program is spent
consistent with federal requirements.

Sec. 24.

Minnesota Statutes 2020, section 145.897, is amended to read:


145.897 deleted text beginVOUCHERSdeleted text endnew text begin FOOD BENEFITSnew text end.

deleted text begin Vouchersdeleted text endnew text begin Food benefitsnew text end issued pursuant to sections 145.891 to 145.897 shall be only
for the purchase of those foods determined by the deleted text begincommissionerdeleted text endnew text begin United States Department
of Agriculture
new text end to be desirable nutritional supplements for pregnant and lactating women,
infants and children. deleted text beginThese foods shall include, but not be limited to, iron fortified infant
formula, vegetable or fruit juices, cereal, milk, cheese, and eggs.
deleted text end

Sec. 25.

Minnesota Statutes 2020, section 145.899, is amended to read:


145.899 WIC deleted text beginVOUCHERSdeleted text endnew text begin FOOD BENEFITSnew text end FOR ORGANICS.

deleted text begin Vouchersdeleted text endnew text begin Food benefitsnew text end for the special supplemental nutrition program for women,
infants, and children (WIC) may be used to purchase cost-neutral organic WIC allowable
food. The commissioner of health shall regularly evaluate the list of WIC allowable food
in accordance with federal requirements and shall add to the list any organic WIC allowable
foods determined to be cost-neutral.

Sec. 26.

new text begin[145A.145] NURSE-FAMILY PARTNERSHIP PROGRAMS.
new text end

new text begin (a) The commissioner of health shall award expansion grants to community health boards
and tribal nations to expand existing nurse-family partnership programs. Grant funds must
be used to start up, expand, or sustain nurse-family partnership programs in the county,
reservation, or region to serve families in accordance with the Nurse-Family Partnership
Service Office nurse-family partnership model. The commissioner shall award grants to
community health boards, nonprofit organizations, or tribal nations in metropolitan and
rural areas of the state.
new text end

new text begin (b) Priority for all grants shall be given to nurse-family partnership programs that provide
services through a Minnesota health care program-enrolled provider that accepts medical
assistance. Priority for grants to rural areas shall be given to community health boards,
nonprofit organizations, and tribal nations that start up, expand, or sustain services within
regional partnerships that provide the nurse-family partnership program.
new text end

new text begin (c) Funding available under this section may only be used to supplement, not to replace,
funds being used for nurse-family partnership home visiting services as of June 30, 2015.
new text end

Sec. 27.

Minnesota Statutes 2020, section 151.72, subdivision 5, is amended to read:


Subd. 5.

Labeling requirements.

(a) A product regulated under this section must bear
a label that contains, at a minimum:

(1) the name, location, contact phone number, and website of the manufacturer of the
product;

(2) the name and address of the independent, accredited laboratory used by the
manufacturer to test the product;new text begin and
new text end

(3) an accurate statement of the amount or percentage of cannabinoids found in each
unit of the product meant to be consumed; deleted text beginanddeleted text endnew text begin or
new text end

(4) new text begininstead of the information required in clauses (1) to (3), a scannable bar code or QR
code that links to the manufacturer's website.
new text end

new text begin The label must also include new text enda statement stating that this product does not claim to diagnose,
treat, cure, or prevent any disease and has not been evaluated or approved by the United
States Food and Drug Administration (FDA) unless the product has been so approved.

(b) The information required to be on the label must be prominently and conspicuously
placed and in terms that can be easily read and understood by the consumer.

(c) The label must not contain any claim that the product may be used or is effective for
the prevention, treatment, or cure of a disease or that it may be used to alter the structure
or function of human or animal bodies, unless the claim has been approved by the FDA.

Sec. 28.

Minnesota Statutes 2020, section 152.22, is amended by adding a subdivision to
read:


new text begin Subd. 5c.new text end

new text beginHemp processor.new text end

new text begin"Hemp processor" means a person or business licensed by
the commissioner of agriculture under chapter 18K to convert raw hemp into a product.
new text end

Sec. 29.

Minnesota Statutes 2020, section 152.22, subdivision 6, is amended to read:


Subd. 6.

Medical cannabis.

(a) "Medical cannabis" means any species of the genus
cannabis plant, or any mixture or preparation of them, including whole plant extracts and
resins, and is delivered in the form of:

(1) liquid, including, but not limited to, oil;

(2) pill;

(3) vaporized delivery method with use of liquid or oil deleted text beginbut which does not require the
use of dried leaves or plant form; or
deleted text endnew text begin;
new text end

new text begin (4) combustion with use of dried raw cannabis; or
new text end

deleted text begin (4)deleted text endnew text begin (5)new text end any other methoddeleted text begin, excluding smoking,deleted text end approved by the commissioner.

(b) This definition includes any part of the genus cannabis plant prior to being processed
into a form allowed under paragraph (a), that is possessed by a person while that person is
engaged in employment duties necessary to carry out a requirement under sections 152.22
to 152.37 for a registered manufacturer or a laboratory under contract with a registered
manufacturer. This definition also includes any hemp acquired by a manufacturer by a hemp
grower as permitted under section 152.29, subdivision 1, paragraph (b).

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the earlier of (1) March 1, 2022, or (2)
a date, as determined by the commissioner of health, by which (i) the rules adopted or
amended under Minnesota Statutes, section 152.26, paragraph (b), are in effect and (ii) the
independent laboratories under contract with the manufacturers have the necessary procedures
and equipment in place to perform the required testing of dried raw cannabis. If this section
is effective before March 1, 2022, the commissioner shall provide notice of that effective
date to the public.
new text end

Sec. 30.

Minnesota Statutes 2020, section 152.22, subdivision 11, is amended to read:


Subd. 11.

Registered designated caregiver.

"Registered designated caregiver" means
a person who:

(1) is at least 18 years old;

(2) does not have a conviction for a disqualifying felony offense;

(3) has been approved by the commissioner to assist a patient who deleted text beginhas been identified
by a health care practitioner as developmentally or physically disabled and therefore
deleted text end requires
assistance in administering medical cannabis or obtaining medical cannabis from a
distribution facility deleted text begindue to the disabilitydeleted text end; and

(4) is authorized by the commissioner to assist the patient with the use of medical
cannabis.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 31.

Minnesota Statutes 2020, section 152.23, is amended to read:


152.23 LIMITATIONS.

(a) Nothing in sections 152.22 to 152.37 permits any person to engage in and does not
prevent the imposition of any civil, criminal, or other penalties for:

(1) undertaking any task under the influence of medical cannabis that would constitute
negligence or professional malpractice;

(2) possessing or engaging in the use of medical cannabis:

(i) on a school bus or van;

(ii) on the grounds of any preschool or primary or secondary school;

(iii) in any correctional facility; or

(iv) on the grounds of any child care facility or home day care;

(3) vaporizing new text beginor combusting new text endmedical cannabis pursuant to section 152.22, subdivision
6
:

(i) on any form of public transportation;

(ii) where the vapor would be inhaled by a nonpatient minor childnew text begin or where the smoke
would be inhaled by a minor child
new text end; or

(iii) in any public place, including any indoor or outdoor area used by or open to the
general public or a place of employment as defined under section 144.413, subdivision 1b;
and

(4) operating, navigating, or being in actual physical control of any motor vehicle,
aircraft, train, or motorboat, or working on transportation property, equipment, or facilities
while under the influence of medical cannabis.

(b) Nothing in sections 152.22 to 152.37 require the medical assistance and
MinnesotaCare programs to reimburse an enrollee or a provider for costs associated with
the medical use of cannabis. Medical assistance and MinnesotaCare shall continue to provide
coverage for all services related to treatment of an enrollee's qualifying medical condition
if the service is covered under chapter 256B or 256L.

Sec. 32.

Minnesota Statutes 2020, section 152.26, is amended to read:


152.26 RULEMAKING.

new text begin (a) new text endThe commissioner may adopt rules to implement sections 152.22 to 152.37. Rules
for which notice is published in the State Register before January 1, 2015, may be adopted
using the process in section 14.389.

new text begin (b) The commissioner may adopt or amend rules, using the procedure in section 14.386,
paragraph (a), to implement the addition of dried raw cannabis as an allowable form of
medical cannabis under section 152.22, subdivision 6, paragraph (a), clause (4). Section
14.386, paragraph (b), does not apply to these rules.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 33.

Minnesota Statutes 2020, section 152.27, subdivision 2, is amended to read:


Subd. 2.

Commissioner duties.

(a) The commissioner shall:

(1) give notice of the program to health care practitioners in the state who are eligible
to serve as health care practitioners and explain the purposes and requirements of the
program;

(2) allow each health care practitioner who meets or agrees to meet the program's
requirements and who requests to participate, to be included in the registry program to
collect data for the patient registry;

(3) provide explanatory information and assistance to each health care practitioner in
understanding the nature of therapeutic use of medical cannabis within program requirements;

(4) create and provide a certification to be used by a health care practitioner for the
practitioner to certify whether a patient has been diagnosed with a qualifying medical
condition and include in the certification an option for the practitioner to certify whether
the patient, in the health care practitioner's medical opinion, is developmentally or physically
disabled and, as a result of that disability, the patient requires assistance in administering
medical cannabis or obtaining medical cannabis from a distribution facility;

(5) supervise the participation of the health care practitioner in conducting patient
treatment and health records reporting in a manner that ensures stringent security and
record-keeping requirements and that prevents the unauthorized release of private data on
individuals as defined by section 13.02;

(6) develop safety criteria for patients with a qualifying medical condition as a
requirement of the patient's participation in the program, to prevent the patient from
undertaking any task under the influence of medical cannabis that would constitute negligence
or professional malpractice on the part of the patient; and

(7) conduct research and studies based on data from health records submitted to the
registry program and submit reports on intermediate or final research results to the legislature
and major scientific journals. The commissioner may contract with a third party to complete
the requirements of this clause. Any reports submitted must comply with section 152.28,
subdivision 2
.

(b) The commissioner may add a delivery method under section 152.22, subdivision 6,
or addnew text begin, remove,new text end or modify a qualifying medical condition under section 152.22, subdivision
14
, upon a petition from a member of the public or the task force on medical cannabis
therapeutic research or as directed by law. The commissioner shall evaluate all petitions to
add a qualifying medical condition new text beginor to remove new text endor modify an existing qualifying medical
condition submitted by the task force on medical cannabis therapeutic research or as directed
by law and deleted text beginshalldeleted text endnew text begin maynew text end make the additionnew text begin, removal,new text end or modification if the commissioner
determines the additionnew text begin, removal,new text end or modification is warranted based on the best available
evidence and research. If the commissioner wishes to add a delivery method under section
152.22, subdivision 6, or new text beginadd or remove new text enda qualifying medical condition under section 152.22,
subdivision 14
, the commissioner must notify the chairs and ranking minority members of
the legislative policy committees having jurisdiction over health and public safety of the
additionnew text begin or removalnew text end and the reasons for its additionnew text begin or removalnew text end, including any written
comments received by the commissioner from the public and any guidance received from
the task force on medical cannabis research, by January 15 of the year in which the
commissioner wishes to make the change. The change shall be effective on August 1 of that
year, unless the legislature by law provides otherwise.

Sec. 34.

Minnesota Statutes 2020, section 152.27, subdivision 3, is amended to read:


Subd. 3.

Patient application.

(a) The commissioner shall develop a patient application
for enrollment into the registry program. The application shall be available to the patient
and given to health care practitioners in the state who are eligible to serve as health care
practitioners. The application must include:

(1) the name, mailing address, and date of birth of the patient;

(2) the name, mailing address, and telephone number of the patient's health care
practitioner;

(3) the name, mailing address, and date of birth of the patient's designated caregiver, if
any, or the patient's parent, legal guardian, or spouse if the parent, legal guardian, or spouse
will be acting as a caregiver;

(4) a copy of the certification from the patient's health care practitioner that is dated
within 90 days prior to submitting the application deleted text beginwhichdeleted text endnew text begin thatnew text end certifies that the patient has
been diagnosed with a qualifying medical condition deleted text beginand, if applicable, that, in the health
care practitioner's medical opinion, the patient is developmentally or physically disabled
and, as a result of that disability, the patient requires assistance in administering medical
cannabis or obtaining medical cannabis from a distribution facility
deleted text end; and

(5) all other signed affidavits and enrollment forms required by the commissioner under
sections 152.22 to 152.37, including, but not limited to, the disclosure form required under
paragraph (c).

(b) The commissioner shall require a patient to resubmit a copy of the certification from
the patient's health care practitioner on a yearly basis and shall require that the recertification
be dated within 90 days of submission.

(c) The commissioner shall develop a disclosure form and require, as a condition of
enrollment, all patients to sign a copy of the disclosure. The disclosure must include:

(1) a statement that, notwithstanding any law to the contrary, the commissioner, or an
employee of any state agency, may not be held civilly or criminally liable for any injury,
loss of property, personal injury, or death caused by any act or omission while acting within
the scope of office or employment under sections 152.22 to 152.37; and

(2) the patient's acknowledgment that enrollment in the patient registry program is
conditional on the patient's agreement to meet all of the requirements of sections 152.22 to
152.37.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 35.

Minnesota Statutes 2020, section 152.27, subdivision 4, is amended to read:


Subd. 4.

Registered designated caregiver.

(a) The commissioner shall register a
designated caregiver for a patient if deleted text beginthe patient's health care practitioner has certified that
the patient, in the health care practitioner's medical opinion, is developmentally or physically
disabled and, as a result of that disability,
deleted text end the patient requires assistance in administering
medical cannabis or obtaining medical cannabis from a distribution facility and the caregiver
has agreed, in writing, to be the patient's designated caregiver. As a condition of registration
as a designated caregiver, the commissioner shall require the person to:

(1) be at least 18 years of age;

(2) agree to only possess the patient's medical cannabis for purposes of assisting the
patient; and

(3) agree that if the application is approved, the person will not be a registered designated
caregiver for more than deleted text beginone patient, unless thedeleted text endnew text begin six registered patients at one time.new text end Patients
new text begin who new text endreside in the same residencenew text begin shall count as one patientnew text end.

(b) The commissioner shall conduct a criminal background check on the designated
caregiver prior to registration to ensure that the person does not have a conviction for a
disqualifying felony offense. Any cost of the background check shall be paid by the person
seeking registration as a designated caregiver. A designated caregiver must have the criminal
background check renewed every two years.

(c) Nothing in sections 152.22 to 152.37 shall be construed to prevent a person registered
as a designated caregiver from also being enrolled in the registry program as a patient and
possessing and using medical cannabis as a patient.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 36.

Minnesota Statutes 2020, section 152.28, subdivision 1, is amended to read:


Subdivision 1.

Health care practitioner duties.

(a) Prior to a patient's enrollment in
the registry program, a health care practitioner shall:

(1) determine, in the health care practitioner's medical judgment, whether a patient suffers
from a qualifying medical condition, and, if so determined, provide the patient with a
certification of that diagnosis;

(2) deleted text begindetermine whether a patient is developmentally or physically disabled and, as a result
of that disability, the patient requires assistance in administering medical cannabis or
obtaining medical cannabis from a distribution facility, and, if so determined, include that
determination on the patient's certification of diagnosis;
deleted text end

deleted text begin (3)deleted text end advise patients, registered designated caregivers, and parents, legal guardians, or
spouses who are acting as caregivers of the existence of any nonprofit patient support groups
or organizations;

deleted text begin (4)deleted text endnew text begin (3)new text end provide explanatory information from the commissioner to patients with qualifying
medical conditions, including disclosure to all patients about the experimental nature of
therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the
proposed treatment; the application and other materials from the commissioner; and provide
patients with the Tennessen warning as required by section 13.04, subdivision 2; and

deleted text begin (5)deleted text endnew text begin (4)new text end agree to continue treatment of the patient's qualifying medical condition and
report medical findings to the commissioner.

(b) Upon notification from the commissioner of the patient's enrollment in the registry
program, the health care practitioner shall:

(1) participate in the patient registry reporting system under the guidance and supervision
of the commissioner;

(2) report health records of the patient throughout the ongoing treatment of the patient
to the commissioner in a manner determined by the commissioner and in accordance with
subdivision 2;

(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying
medical condition and, if so, issue the patient a new certification of that diagnosis; and

(4) otherwise comply with all requirements developed by the commissioner.

(c) A health care practitioner may conduct a patient assessment to issue a recertification
as required under paragraph (b), clause (3), via telemedicine as defined under section
62A.671, subdivision 9.

(d) Nothing in this section requires a health care practitioner to participate in the registry
program.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 37.

Minnesota Statutes 2020, section 152.29, subdivision 1, is amended to read:


Subdivision 1.

Manufacturer; requirements.

(a) A manufacturer may operate eight
distribution facilities, which may include the manufacturer's single location for cultivation,
harvesting, manufacturing, packaging, and processing but is not required to include that
location. The commissioner shall designate the geographical service areas to be served by
each manufacturer based on geographical need throughout the state to improve patient
access. A manufacturer shall not have more than two distribution facilities in each
geographical service area assigned to the manufacturer by the commissioner. A manufacturer
shall operate only one location where all cultivation, harvesting, manufacturing, packaging,
and processing of medical cannabis shall be conducted. This location may be one of the
manufacturer's distribution facility sites. The additional distribution facilities may dispense
medical cannabis and medical cannabis products but may not contain any medical cannabis
in a form other than those forms allowed under section 152.22, subdivision 6, and the
manufacturer shall not conduct any cultivation, harvesting, manufacturing, packaging, or
processing at the other distribution facility sites. Any distribution facility operated by the
manufacturer is subject to all of the requirements applying to the manufacturer under sections
152.22 to 152.37, including, but not limited to, security and distribution requirements.

(b) A manufacturer may acquire hemp grown in this state from a hemp growernew text begin, and may
acquire hemp products produced by a hemp processor
new text end. A manufacturer may manufacture
or process hemp new text beginand hemp products new text endinto an allowable form of medical cannabis under
section 152.22, subdivision 6. Hemp new text beginand hemp products new text endacquired by a manufacturer under
this paragraph deleted text beginisdeleted text endnew text begin arenew text end subject to the same quality control program, security and testing
requirements, and other requirements that apply to medical cannabis under sections 152.22
to 152.37 and Minnesota Rules, chapter 4770.

(c) A medical cannabis manufacturer shall contract with a laboratory approved by the
commissioner, subject to any additional requirements set by the commissioner, for purposes
of testing medical cannabis manufactured or hemp new text beginor hemp products new text endacquired by the medical
cannabis manufacturer as to content, contamination, and consistency to verify the medical
cannabis meets the requirements of section 152.22, subdivision 6. The cost of laboratory
testing shall be paid by the manufacturer.

(d) The operating documents of a manufacturer must include:

(1) procedures for the oversight of the manufacturer and procedures to ensure accurate
record keeping;

(2) procedures for the implementation of appropriate security measures to deter and
prevent the theft of medical cannabis and unauthorized entrance into areas containing medical
cannabis; and

(3) procedures for the delivery and transportation of hemp between hemp growers and
manufacturersnew text begin and for the delivery and transportation of hemp products between hemp
processors and manufacturers
new text end.

(e) A manufacturer shall implement security requirements, including requirements for
the delivery and transportation of hempnew text begin and hemp productsnew text end, protection of each location by
a fully operational security alarm system, facility access controls, perimeter intrusion
detection systems, and a personnel identification system.

(f) A manufacturer shall not share office space with, refer patients to a health care
practitioner, or have any financial relationship with a health care practitioner.

(g) A manufacturer shall not permit any person to consume medical cannabis on the
property of the manufacturer.

(h) A manufacturer is subject to reasonable inspection by the commissioner.

(i) For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is not
subject to the Board of Pharmacy licensure or regulatory requirements under chapter 151.

(j) A medical cannabis manufacturer may not employ any person who is under 21 years
of age or who has been convicted of a disqualifying felony offense. An employee of a
medical cannabis manufacturer must submit a completed criminal history records check
consent form, a full set of classifiable fingerprints, and the required fees for submission to
the Bureau of Criminal Apprehension before an employee may begin working with the
manufacturer. The bureau must conduct a Minnesota criminal history records check and
the superintendent is authorized to exchange the fingerprints with the Federal Bureau of
Investigation to obtain the applicant's national criminal history record information. The
bureau shall return the results of the Minnesota and federal criminal history records checks
to the commissioner.

(k) A manufacturer may not operate in any location, whether for distribution or
cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a
public or private school existing before the date of the manufacturer's registration with the
commissioner.

(l) A manufacturer shall comply with reasonable restrictions set by the commissioner
relating to signage, marketing, display, and advertising of medical cannabis.

(m) Before a manufacturer acquires hemp from a hemp growernew text begin or hemp products from
a hemp processor
new text end, the manufacturer must verify that the hemp grower new text beginor hemp processor
new text end has a valid license issued by the commissioner of agriculture under chapter 18K.

(n) Until a state-centralized, seed-to-sale system is implemented that can track a specific
medical cannabis plant from cultivation through testing and point of sale, the commissioner
shall conduct at least one unannounced inspection per year of each manufacturer that includes
inspection of:

(1) business operations;

(2) physical locations of the manufacturer's manufacturing facility and distribution
facilities;

(3) financial information and inventory documentation, including laboratory testing
results; and

(4) physical and electronic security alarm systems.

Sec. 38.

Minnesota Statutes 2020, section 152.29, subdivision 3, is amended to read:


Subd. 3.

Manufacturer; distribution.

(a) A manufacturer shall require that employees
licensed as pharmacists pursuant to chapter 151 be the only employees to give final approval
for the distribution of medical cannabis to a patient. A manufacturer may transport medical
cannabis or medical cannabis products that have been cultivated, harvested, manufactured,
packaged, and processed by that manufacturer to another registered manufacturer for the
other manufacturer to distribute.

(b) A manufacturer may distribute medical cannabis products, whether or not the products
have been manufactured by that manufacturer.

(c) Prior to distribution of any medical cannabis, the manufacturer shall:

(1) verify that the manufacturer has received the registry verification from the
commissioner for that individual patient;

(2) verify that the person requesting the distribution of medical cannabis is the patient,
the patient's registered designated caregiver, or the patient's parent, legal guardian, or spouse
listed in the registry verification using the procedures described in section 152.11, subdivision
2d
;

(3) assign a tracking number to any medical cannabis distributed from the manufacturer;

(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to
chapter 151 has consulted with the patient to determine the proper dosage for the individual
patient after reviewing the ranges of chemical compositions of the medical cannabis and
the ranges of proper dosages reported by the commissioner. For purposes of this clause, a
consultation may be conducted remotely deleted text beginusing adeleted text endnew text begin by securenew text end videoconferencenew text begin, telephone, or
other remote means
new text end, so long as the employee providing the consultation is able to confirm
the identity of the patientdeleted text begin, the consultation occurs while the patient is at a distribution facility,deleted text end
and the consultation adheres to patient privacy requirements that apply to health care services
delivered through telemedicinenew text begin. A pharmacist consultation under this clause is not required
when a manufacturer is distributing medical cannabis to a patient according to a
patient-specific dosage plan established with that manufacturer and is not modifying the
dosage or product being distributed under that plan and the medical cannabis is distributed
by a pharmacy technician
new text end;

(5) properly package medical cannabis in compliance with the United States Poison
Prevention Packing Act regarding child-resistant packaging and exemptions for packaging
for elderly patients, and label distributed medical cannabis with a list of all active ingredients
and individually identifying information, including:

(i) the patient's name and date of birth;

(ii) the name and date of birth of the patient's registered designated caregiver or, if listed
on the registry verification, the name of the patient's parent or legal guardian, if applicable;

(iii) the patient's registry identification number;

(iv) the chemical composition of the medical cannabis; and

(v) the dosage; and

(6) ensure that the medical cannabis distributed contains a maximum of a 90-day supply
of the dosage determined for that patient.

(d) A manufacturer shall require any employee of the manufacturer who is transporting
medical cannabis or medical cannabis products to a distribution facility or to another
registered manufacturer to carry identification showing that the person is an employee of
the manufacturer.

new text begin (e) A manufacturer shall distribute medical cannabis in dried raw cannabis form only
to a patient age 21 or older, or to the registered designated caregiver, parent, legal guardian,
or spouse of a patient age 21 or older.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginParagraph (c) is effective the day following final enactment.
Paragraph (e) is effective the earlier of (1) March 1, 2022, or (2) a date, as determined by
the commissioner of health, by which (i) the rules adopted or amended under Minnesota
Statutes, section 152.26, paragraph (b), are in effect and (ii) the independent laboratories
under contract with the manufacturers have the necessary procedures and equipment in
place to perform the required testing of dried raw cannabis. If paragraph (e) is effective
before March 1, 2022, the commissioner shall provide notice of that effective date to the
public.
new text end

Sec. 39.

Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to
read:


new text begin Subd. 3b.new text end

new text beginDistribution to recipient in a motor vehicle.new text end

new text beginA manufacturer may distribute
medical cannabis to a patient, registered designated caregiver, or parent, legal guardian, or
spouse of a patient who is at the distribution facility but remains in a motor vehicle, provided:
new text end

new text begin (1) distribution facility staff receive payment and distribute medical cannabis in a
designated zone that is as close as feasible to the front door of the distribution facility;
new text end

new text begin (2) the manufacturer ensures that the receipt of payment and distribution of medical
cannabis are visually recorded by a closed-circuit television surveillance camera at the
distribution facility and provides any other necessary security safeguards;
new text end

new text begin (3) the manufacturer does not store medical cannabis outside a restricted access area at
the distribution facility, and distribution facility staff transport medical cannabis from a
restricted access area at the distribution facility to the designated zone for distribution only
after confirming that the patient, designated caregiver, or parent, guardian, or spouse has
arrived in the designated zone;
new text end

new text begin (4) the payment and distribution of medical cannabis take place only after a pharmacist
consultation takes place, if required under subdivision 3, paragraph (c), clause (4);
new text end

new text begin (5) immediately following distribution of medical cannabis, distribution facility staff
enter the transaction in the state medical cannabis registry information technology database;
and
new text end

new text begin (6) immediately following distribution of medical cannabis, distribution facility staff
take the payment received into the distribution facility.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 40.

Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to
read:


new text begin Subd. 3c.new text end

new text beginDisposal of medical cannabis plant root balls.new text end

new text beginNotwithstanding Minnesota
Rules, part 4770.1200, subpart 2, item C, a manufacturer is not required to grind root balls
of medical cannabis plants or incorporate them with a greater quantity of nonconsumable
solid waste before transporting root balls to another location for disposal. For purposes of
this subdivision, "root ball" means a compact mass of roots formed by a plant and any
attached growing medium.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 41.

Minnesota Statutes 2020, section 152.31, is amended to read:


152.31 DATA PRACTICES.

(a) Government data in patient files maintained by the commissioner and the health care
practitioner, and data submitted to or by a medical cannabis manufacturer, are private data
on individuals, as defined in section 13.02, subdivision 12, or nonpublic data, as defined in
section 13.02, subdivision 9, but may be used for purposes of complying with chapter 13
and complying with a request from the legislative auditor or the state auditor in the
performance of official duties. The provisions of section 13.05, subdivision 11, apply to a
registration agreement entered between the commissioner and a medical cannabis
manufacturer under section 152.25.

(b) Not public data maintained by the commissioner may not be used for any purpose
not provided for in sections 152.22 to 152.37, and may not be combined or linked in any
manner with any other list, dataset, or database.

(c) The commissioner may execute data sharing arrangements with the commissioner
of agriculture to verify licensing, inspection, and compliance information related to hemp
growers new text beginand hemp processors new text endunder chapter 18K.

Sec. 42.

Minnesota Statutes 2020, section 157.22, is amended to read:


157.22 EXEMPTIONS.

This chapter does not apply to:

(1) interstate carriers under the supervision of the United States Department of Health
and Human Services;

(2) weddings, fellowship meals, or funerals conducted by a faith-based organization
using any building constructed and primarily used for religious worship or education;

(3) any building owned, operated, and used by a college or university in accordance
with health regulations promulgated by the college or university under chapter 14;

(4) any person, firm, or corporation whose principal mode of business is licensed under
sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food or beverage
establishment; provided that the holding of any license pursuant to sections 28A.04 and
28A.05 shall not exempt any person, firm, or corporation from the applicable provisions of
this chapter or the rules of the state commissioner of health relating to food and beverage
service establishments;

(5) family day care homes and group family day care homes governed by sections
245A.01 to 245A.16;

(6) nonprofit senior citizen centers for the sale of home-baked goods;

(7) fraternal, sportsman, or patriotic organizations that are tax exempt under section
501(c)(3), 501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue
Code of 1986, or organizations related to, affiliated with, or supported by such fraternal,
sportsman, or patriotic organizations for events held in the building or on the grounds of
the organization and at which home-prepared food is donated by organization members for
sale at the events, provided:

(i) the event is not a circus, carnival, or fair;

(ii) the organization controls the admission of persons to the event, the event agenda, or
both; and

(iii) the organization's licensed kitchen is not used in any manner for the event;

(8) food not prepared at an establishment and brought in by individuals attending a
potluck event for consumption at the potluck event. An organization sponsoring a potluck
event under this clause may advertise the potluck event to the public through any means.
Individuals who are not members of an organization sponsoring a potluck event under this
clause may attend the potluck event and consume the food at the event. Licensed food
establishments other than schools cannot be sponsors of potluck events. A school may
sponsor and hold potluck events in areas of the school other than the school's kitchen,
provided that the school's kitchen is not used in any manner for the potluck event. For
purposes of this clause, "school" means a public school as defined in section 120A.05,
subdivisions 9, 11, 13, and 17
, or a nonpublic school, church, or religious organization at
which a child is provided with instruction in compliance with sections 120A.22 and 120A.24.
Potluck event food shall not be brought into a licensed food establishment kitchen;

(9) a home school in which a child is provided instruction at home;

(10) school concession stands serving commercially prepared, nonpotentially hazardous
foods, as defined in Minnesota Rules, chapter 4626;

(11) group residential facilities of ten or fewer beds licensed by the commissioner of
human services under Minnesota Rules, chapter 2960, provided the facility employs or
contracts with a certified food manager under Minnesota Rules, part 4626.2015;

deleted text begin (12) food served at fund-raisers or community events conducted in the building or on
the grounds of a faith-based organization, provided that a certified food manager, or a
volunteer trained in a food safety course, trains the food preparation workers in safe food
handling practices. This exemption does not apply to faith-based organizations at the state
agricultural society or county fairs or to faith-based organizations that choose to apply for
a license;
deleted text end

new text begin (12) food served at fund-raisers, community events or fellowship meals conducted in
the building or on the grounds of a faith-based organization, provided that a certified food
manager or volunteer trained in a food safety course, trains the food preparation workers
in safe food handling practices. Food prepared during these events is allowed to be made
available for curbside pickup or delivered to members of the faith-based organization or
the community in which the faith-based organization serves. This exemption does not apply
to faith-based organizations at the state agricultural society or county fairs or to faith-based
organizations that choose to apply for a license;
new text end

(13) food service events conducted following a disaster for purposes of feeding disaster
relief staff and volunteers serving commercially prepared, nonpotentially hazardous foods,
as defined in Minnesota Rules, chapter 4626;

(14) chili or soup served at a chili or soup cook-off fund-raiser conducted by a
community-based nonprofit organization, provided:

(i) the municipality where the event is located approves the event;

(ii) the sponsoring organization must develop food safety rules and ensure that participants
follow these rules; and

(iii) if the food is not prepared in a kitchen that is licensed or inspected, a visible sign
or placard must be posted that states: "These products are homemade and not subject to
state inspection."

Foods exempt under this clause must be labeled to accurately reflect the name and
address of the person preparing the foods; and

(15) a special event food stand or a seasonal temporary food stand provided:

(i) the stand is located on private property with the permission of the property owner;

(ii) the stand has gross receipts or contributions of $1,000 or less in a calendar year; and

(iii) the operator of the stand posts a sign or placard at the site that states "The products
sold at this stand are not subject to state inspection or regulation." if the stand offers for sale
potentially hazardous food as defined in Minnesota Rules, part 4626.0020, subpart 62.

Sec. 43.

Minnesota Statutes 2020, section 256.98, subdivision 1, is amended to read:


Subdivision 1.

Wrongfully obtaining assistance.

new text begin(a) new text endA person who commits any of the
following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897,
the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program
formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, 256I, 256J, 256K, or
256L, child care assistance programs, and emergency assistance programs under section
256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses
(1) to (5):

(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willfully false statement or representation, by intentional concealment of any material fact,
or by impersonation or other fraudulent device, assistance or the continued receipt of
assistance, to include child care assistance or deleted text beginvouchersdeleted text endnew text begin food benefitsnew text end produced according
to sections 145.891 to 145.897 and MinnesotaCare services according to sections 256.9365,
256.94, and 256L.01 to 256L.15, to which the person is not entitled or assistance greater
than that to which the person is entitled;

(2) knowingly aids or abets in buying or in any way disposing of the property of a
recipient or applicant of assistance without the consent of the county agency; or

(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments
to which the individual is not entitled as a provider of subsidized child care, or by furnishing
or concurring in a willfully false claim for child care assistance.

new text begin (b) new text endThe continued receipt of assistance to which the person is not entitled or greater than
that to which the person is entitled as a result of any of the acts, failure to act, or concealment
described in this subdivision shall be deemed to be continuing offenses from the date that
the first act or failure to act occurred.

Sec. 44.

Minnesota Statutes 2020, section 326.71, subdivision 4, is amended to read:


Subd. 4.

Asbestos-related work.

"Asbestos-related work" means the enclosure, removal,
or encapsulation of asbestos-containing material in a quantity that meets or exceeds 260
linear feet of friable asbestos-containing material on pipes, 160 square feet of friable
asbestos-containing material on other facility components, or, if linear feet or square feet
cannot be measured, a total of 35 cubic feet of friable asbestos-containing material on or
off all facility components in one facility. In the case of single or multifamily residences,
"asbestos-related work" also means the enclosure, removal, or encapsulation of greater than
ten but less than 260 linear feet of friable asbestos-containing material on pipes, greater
than six but less than 160 square feet of friable asbestos-containing material on other facility
components, or, if linear feet or square feet cannot be measured, greater than one cubic foot
but less than 35 cubic feet of friable asbestos-containing material on or off all facility
components in one facility. deleted text beginThis provision excludes asbestos-containing floor tiles and
sheeting, roofing materials, siding, and all ceilings with asbestos-containing material in
single family residences and buildings with no more than four dwelling units.
deleted text end
Asbestos-related work includes asbestos abatement area preparation; enclosure, removal,
or encapsulation operations; and an air quality monitoring specified in rule to assure that
the abatement and adjacent areas are not contaminated with asbestos fibers during the project
and after completion.

For purposes of this subdivision, the quantity of deleted text beginasbestos containingdeleted text end new text beginasbestos-containingnew text end
material applies separately for every project.

Sec. 45.

Minnesota Statutes 2020, section 326.75, subdivision 1, is amended to read:


Subdivision 1.

Licensing fee.

A person required to be licensed under section 326.72
shall, before receipt of the license and before causing asbestos-related work to be performed,
pay the commissioner an annual license fee of deleted text begin$100deleted text endnew text begin $105new text end.

Sec. 46.

Minnesota Statutes 2020, section 326.75, subdivision 2, is amended to read:


Subd. 2.

Certification fee.

An individual required to be certified new text beginas an asbestos worker
or asbestos site supervisor
new text endunder section 326.73, subdivision 1, shall pay the commissioner
a certification fee of deleted text begin$50deleted text endnew text begin $52.50new text end before the issuance of the certificate. deleted text beginThe commissioner
may establish by rule fees required before the issuance of
deleted text endnew text begin An individual required to be
certified as an
new text end asbestos inspector, asbestos management planner, deleted text beginanddeleted text end new text beginornew text end asbestos project
designer deleted text begincertificates requireddeleted text end under section 326.73, subdivisions 2, 3, and 4new text begin, shall pay the
commissioner a certification fee of $105 before the issuance of the certificate
new text end.

Sec. 47.

Minnesota Statutes 2020, section 326.75, subdivision 3, is amended to read:


Subd. 3.

Permit fee.

Five calendar days before beginning asbestos-related work, a person
shall pay a project permit fee to the commissioner equal to deleted text beginonedeleted text endnew text begin twonew text end percent of the total costs
of the asbestos-related work. For asbestos-related work performed in single or multifamily
residences, of greater than ten but less than 260 linear feet of asbestos-containing material
on pipes, or greater than six but less than 160 square feet of asbestos-containing material
on other facility components, a person shall pay a project permit fee of $35 to the
commissioner.

Sec. 48.

Laws 2008, chapter 364, section 17, is amended to read:


Sec. 17. APPROPRIATIONS.

deleted text begin (a) $261,000 is appropriated from the state government special revenue fund to the
commissioner of health for the purposes of this act for fiscal year 2009. Base level funding
for this appropriation shall be $77,000 for fiscal years beginning on or after July 1, 2009.
deleted text end

deleted text begin (b) Of the appropriation in paragraph (a), $116,000 in fiscal year 2009 is for the study
and report required in section 12, $145,000 in fiscal year 2009 shall be transferred to the
general fund, and $77,000 shall be transferred for each fiscal year beginning on or after July
1, 2009.
deleted text end

deleted text begin (c)deleted text endnew text begin (a)new text end $145,000 is appropriated from the general fund to the commissioner of human
services for fiscal year 2009 for the actuarial and other department costs associated with
additional reporting requirements for health plans and county-based purchasing plans. Base
level funding for this appropriation for fiscal years beginning on or after July 1, 2009, shall
be $135,000 each year.

deleted text begin (d)deleted text endnew text begin (b)new text end $96,000 is appropriated from the general fund to the commissioner of human
services for fiscal year 2009 for the study authorized in section 11, clause (3). This
appropriation is onetime.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

Sec. 49.

Laws 2019, First Special Session chapter 9, article 14, section 3, as amended by
Laws 2019, First Special Session chapter 12, section 6, is amended to read:


Sec. 3. COMMISSIONER OF HEALTH

Subdivision 1.

Total Appropriation

$
231,829,000
$
deleted text begin 236,188,000deleted text endnew text begin
233,584,000
new text end
Appropriations by Fund
2020
2021
General
124,381,000
deleted text begin 126,276,000deleted text endnew text begin
125,881,000
new text end
State Government
Special Revenue
58,450,000
deleted text begin61,367,000deleted text endnew text begin
59,158,000
new text end
Health Care Access
37,285,000
36,832,000
Federal TANF
11,713,000
11,713,000

The amounts that may be spent for each
purpose are specified in the following
subdivisions.

Subd. 2.

Health Improvement

Appropriations by Fund
General
94,980,000
deleted text begin 96,117,000deleted text endnew text begin
95,722,000
new text end
State Government
Special Revenue
7,614,000
deleted text begin7,558,000deleted text endnew text begin
6,924,000
new text end
Health Care Access
37,285,000
36,832,000
Federal TANF
11,713,000
11,713,000

(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2020 and $3,579,000 in fiscal year
2021 are from the TANF fund for home
visiting and nutritional services under
Minnesota Statutes, section 145.882,
subdivision 7
, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;

(2) $2,000,000 in fiscal year 2020 and
$2,000,000 in fiscal year 2021 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7
;

(3) $4,978,000 in fiscal year 2020 and
$4,978,000 in fiscal year 2021 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in each
fiscal year must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1. $978,000 of
the funding in each fiscal year must be
distributed to tribal governments according to
Minnesota Statutes, section 145A.14,
subdivision 2a
;

(4) $1,156,000 in fiscal year 2020 and
$1,156,000 in fiscal year 2021 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and

(5) The commissioner may use up to 6.23
percent of the amounts appropriated from the
TANF fund each year to conduct the ongoing
evaluations required under Minnesota Statutes,
section 145A.17, subdivision 7, and training
and technical assistance as required under
Minnesota Statutes, section 145A.17,
subdivisions 4
and 5.

(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.

(c) Comprehensive Suicide Prevention.
$2,730,000 in fiscal year 2020 and $2,730,000
in fiscal year 2021 are from the general fund
for a comprehensive, community-based suicide
prevention strategy. The funds are allocated
as follows:

(1) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are for community-based
suicide prevention grants authorized in
Minnesota Statutes, section 145.56,
subdivision 2
. Specific emphasis must be
placed on those communities with the greatest
disparities. The base for this appropriation is
$1,291,000 in fiscal year 2022 and $1,291,000
in fiscal year 2023;

(2) $683,000 in fiscal year 2020 and $683,000
in fiscal year 2021 are to support
evidence-based training for educators and
school staff and purchase suicide prevention
curriculum for student use statewide, as
authorized in Minnesota Statutes, section
145.56, subdivision 2. The base for this
appropriation is $913,000 in fiscal year 2022
and $913,000 in fiscal year 2023;

(3) $137,000 in fiscal year 2020 and $137,000
in fiscal year 2021 are to implement the Zero
Suicide framework with up to 20 behavioral
and health care organizations each year to treat
individuals at risk for suicide and support
those individuals across systems of care upon
discharge. The base for this appropriation is
$205,000 in fiscal year 2022 and $205,000 in
fiscal year 2023;

(4) $955,000 in fiscal year 2020 and $955,000
in fiscal year 2021 are to develop and fund a
Minnesota-based network of National Suicide
Prevention Lifeline, providing statewide
coverage. The base for this appropriation is
$1,321,000 in fiscal year 2022 and $1,321,000
in fiscal year 2023; and

(5) the commissioner may retain up to 18.23
percent of the appropriation under this
paragraph to administer the comprehensive
suicide prevention strategy.

(d) Statewide Tobacco Cessation. $1,598,000
in fiscal year 2020 and $2,748,000 in fiscal
year 2021 are from the general fund for
statewide tobacco cessation services under
Minnesota Statutes, section 144.397. The base
for this appropriation is $2,878,000 in fiscal
year 2022 and $2,878,000 in fiscal year 2023.

(e) Health Care Access Survey. $225,000 in
fiscal year 2020 and $225,000 in fiscal year
2021 are from the health care access fund to
continue and improve the Minnesota Health
Care Access Survey. These appropriations
may be used in either year of the biennium.

(f) Community Solutions for Healthy Child
Development Grant Program.
$1,000,000
in fiscal year 2020 and $1,000,000 in fiscal
year 2021 are for the community solutions for
healthy child development grant program to
promote health and racial equity for young
children and their families under article 11,
section 107. The commissioner may use up to
23.5 percent of the total appropriation for
administration. The base for this appropriation
is $1,000,000 in fiscal year 2022, $1,000,000
in fiscal year 2023, and $0 in fiscal year 2024.

(g) Domestic Violence and Sexual Assault
Prevention Program.
$375,000 in fiscal year
2020 and $375,000 in fiscal year 2021 are
from the general fund for the domestic
violence and sexual assault prevention
program under article 11, section 108. This is
a onetime appropriation.

(h) Skin Lightening Products Public
Awareness Grant Program.
$100,000 in
fiscal year 2020 and $100,000 in fiscal year
2021 are from the general fund for a skin
lightening products public awareness and
education grant program. This is a onetime
appropriation.

(i) Cannabinoid Products Workgroup.
$8,000 in fiscal year 2020 is from the state
government special revenue fund for the
cannabinoid products workgroup. This is a
onetime appropriation.

(j) Base Level Adjustments. The general fund
base is $96,742,000 in fiscal year 2022 and
$96,742,000 in fiscal year 2023. The health
care access fund base is $37,432,000 in fiscal
year 2022 and $36,832,000 in fiscal year 2023.

Subd. 3.

Health Protection

Appropriations by Fund
General
18,803,000
19,774,000
State Government
Special Revenue
50,836,000
deleted text begin53,809,000deleted text endnew text begin
52,234,000
new text end

(a) Public Health Laboratory Equipment.
$840,000 in fiscal year 2020 and $655,000 in
fiscal year 2021 are from the general fund for
equipment for the public health laboratory.
This is a onetime appropriation and is
available until June 30, 2023.

(b) Base Level Adjustment. The general fund
base is $19,119,000 in fiscal year 2022 and
$19,119,000 in fiscal year 2023. The state
government special revenue fund base is
$53,782,000 in fiscal year 2022 and
$53,782,000 in fiscal year 2023.

Subd. 4.

Health Operations

10,598,000
10,385,000

Base Level Adjustment. The general fund
base is $10,912,000 in fiscal year 2022 and
$10,912,000 in fiscal year 2023.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment and
the reductions in subdivisions 1 to 3 are onetime reductions.
new text end

Sec. 50.

Laws 2020, Seventh Special Session chapter 1, article 6, section 12, subdivision
4, is amended to read:


Subd. 4.

Housing with services establishment registration; conversion to an assisted
living facility license.

(a) Housing with services establishments registered under chapter
144D, providing home care services according to chapter 144A to at least one resident, and
intending to provide assisted living services on or after August 1, 2021, must submit an
application for an assisted living facility license in accordance with section 144G.12 no
later than June 1, 2021. The commissioner shall consider the application in accordance with
section deleted text begin144G.16deleted text endnew text begin 144G.15new text end.

(b) Notwithstanding the housing with services contract requirements identified in section
144D.04, any existing housing with services establishment registered under chapter 144D
that does not intend to convert its registration to an assisted living facility license under this
chapter must provide written notice to its residents at least 60 days before the expiration of
its registration, or no later than May 31, 2021, whichever is earlier. The notice must:

(1) state that the housing with services establishment does not intend to convert to an
assisted living facility;

(2) include the date when the housing with services establishment will no longer provide
housing with services;

(3) include the name, e-mail address, and phone number of the individual associated
with the housing with services establishment that the recipient of home care services may
contact to discuss the notice;

(4) include the contact information consisting of the phone number, e-mail address,
mailing address, and website for the Office of Ombudsman for Long-Term Care and the
Office of Ombudsman for Mental Health and Developmental Disabilities; and

(5) for residents who receive home and community-based waiver services under section
256B.49 and chapter 256S, also be provided to the resident's case manager at the same time
that it is provided to the resident.

(c) A housing with services registrant that obtains an assisted living facility license, but
does so under a different business name as a result of reincorporation, and continues to
provide services to the recipient, is not subject to the 60-day notice required under paragraph
(b). However, the provider must otherwise provide notice to the recipient as required under
sections 144D.04 and 144D.045, as applicable, and section 144D.09.

(d) All registered housing with services establishments providing assisted living under
sections 144G.01 to 144G.07 prior to August 1, 2021, must have an assisted living facility
license under this chapter.

(e) Effective August 1, 2021, any housing with services establishment registered under
chapter 144D that has not converted its registration to an assisted living facility license
under this chapter is prohibited from providing assisted living services.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective retroactively from December 17, 2020.
new text end

Sec. 51. new text beginDIRECTION TO MODIFY MARRIAGE LICENSE APPLICATIONS.
new text end

new text begin A local registrar or a designee of the county board shall delete from the county's marriage
license application any space or other manner in which the applicant is required to specify
the applicant's race.
new text end

ARTICLE 4

HEALTH-RELATED LICENSING BOARDS

Section 1.

Minnesota Statutes 2020, section 151.01, subdivision 29, is amended to read:


Subd. 29.

deleted text beginLegenddeleted text end Medical gas.

"deleted text beginLegenddeleted text end Medical gas" means deleted text begina liquid or gaseous
substance used for medical purposes and that is required by federal law to be dispensed
only pursuant to the prescription of a licensed practitioner
deleted text endnew text begin any gas or liquid manufactured
or stored in a liquefied, nonliquefied, or cryogenic state that:
new text end

new text begin (1) has a chemical or physical action in or on the human body or animals or is used in
conjunction with medical gas equipment; and
new text end

new text begin (2) is intended to be used for the diagnosis, cure, mitigation, treatment, or prevention of
disease
new text end.

Sec. 2.

Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to
read:


new text begin Subd. 29a.new text end

new text beginMedical gas manufacturer.new text end

new text begin"Medical gas manufacturer" means any person:
new text end

new text begin (1) originally manufacturing a medical gas by chemical reaction, physical separation,
compression of atmospheric air, purification, or other means;
new text end

new text begin (2) filling a medical gas into a dispensing container via gas to gas, liquid to gas, or liquid
to liquid processes;
new text end

new text begin (3) combining two or more medical gases into a container to form a medically appropriate
mixture; or
new text end

new text begin (4) filling a medical gas via liquid to liquid into a final use container at the point of use.
new text end

Sec. 3.

Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to
read:


new text begin Subd. 29b.new text end

new text beginMedical gas wholesaler.new text end

new text begin"Medical gas wholesaler" means any person who
sells a medical gas to another business or entity for the purpose of reselling or providing
that medical gas to the ultimate consumer or patient.
new text end

Sec. 4.

Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to
read:


new text begin Subd. 29c.new text end

new text beginMedical gas dispenser.new text end

new text begin"Medical gas dispenser" means any person, other
than a licensed practitioner or pharmacy, who sells or provides a medical gas directly to the
ultimate consumer or patient via a valid prescription.
new text end

Sec. 5.

new text begin[151.191] LICENSING MEDICAL GAS FACILITIES; FEES;
PROHIBITIONS.
new text end

new text begin Subdivision 1.new text end

new text beginMedical gas manufacturers; requirements.new text end

new text begin(a) No person shall act as
a medical gas manufacturer without first obtaining a license from the board and paying any
applicable fee specified in section 151.065.
new text end

new text begin (b) Application for a medical gas manufacturer license under this section must be made
in a manner specified by the board.
new text end

new text begin (c) A license must not be issued or renewed for a medical gas manufacturer unless the
applicant agrees to operate in a manner prescribed by federal and state law and according
to Minnesota Rules.
new text end

new text begin (d) A license must not be issued or renewed for a medical gas manufacturer that is
required to be licensed or registered by the state in which it is physically located unless the
applicant supplies the board with proof of licensure or registration. The board may establish
standards for the licensure of a medical gas manufacturer that is not required to be licensed
or registered by the state in which it is physically located.
new text end

new text begin (e) The board must require a separate license for each facility located within the state at
which medical gas manufacturing occurs and for each facility located outside of the state
at which medical gases that are shipped into the state are manufactured.
new text end

new text begin (f) Prior to the issuance of an initial or renewed license for a medical gas manufacturing
facility, the board may require the facility to pass an inspection conducted by an authorized
representative of the board. In the case of a medical gas manufacturing facility located
outside of the state, the board may require the applicant to pay the cost of the inspection,
in addition to the license fee in section 151.065, unless the applicant furnishes the board
with a report, issued by the appropriate regulatory agency of the state in which the facility
is located, of an inspection that has occurred within the 24 months immediately preceding
receipt of the license application by the board. The board may deny licensure unless the
applicant submits documentation satisfactory to the board that any deficiencies noted in an
inspection report have been corrected.
new text end

new text begin (g) A duly licensed medical gas manufacturing facility may also wholesale or dispense
any medical gas that is manufactured by the licensed facility, or manufactured or wholesaled
by another properly licensed medical gas facility, without also obtaining a medical gas
wholesaler license or medical gas dispenser registration.
new text end

new text begin (h) The filling of a medical gas into a final use container, at the point of use and by liquid
to liquid transfer, is permitted as long as the facility used as the base of operations is duly
licensed as a medical gas manufacturer.
new text end

new text begin Subd. 2.new text end

new text beginMedical gas wholesalers; requirements.new text end

new text begin(a) No person shall act as a medical
gas wholesaler without first obtaining a license from the board and paying any applicable
fee specified in section 151.065.
new text end

new text begin (b) Application for a medical gas wholesaler license under this section must be made in
a manner specified by the board.
new text end

new text begin (c) A license must not be issued or renewed for a medical gas wholesaler unless the
applicant agrees to operate in a manner prescribed by federal and state law and according
to Minnesota Rules.
new text end

new text begin (d) A license must not be issued or renewed for a medical gas wholesaler that is required
to be licensed or registered by the state in which it is physically located unless the applicant
supplies the board with proof of licensure or registration. The board may establish standards
for the licensure of a medical gas wholesaler that is not required to be licensed or registered
by the state in which it is physically located.
new text end

new text begin (e) The board must require a separate license for each facility located within the state at
which medical gas wholesaling occurs and for each facility located outside of the state from
which medical gases that are shipped into the state are wholesaled.
new text end

new text begin (f) Prior to the issuance of an initial or renewed license for a medical gas wholesaling
facility, the board may require the facility to pass an inspection conducted by an authorized
representative of the board. In the case of a medical gas wholesaling facility located outside
of the state, the board may require the applicant to pay the cost of the inspection, in addition
to the license fee in section 151.065, unless the applicant furnishes the board with a report,
issued by the appropriate regulatory agency of the state in which the facility is located, of
an inspection that has occurred within the 24 months immediately preceding receipt of the
license application by the board. The board may deny licensure unless the applicant submits
documentation satisfactory to the board that any deficiencies noted in an inspection report
have been corrected.
new text end

new text begin (g) A duly licensed medical gas wholesaling facility may also dispense any medical gas
that is manufactured or wholesaled by another properly licensed medical gas facility.
new text end

new text begin Subd. 3.new text end

new text beginMedical gas dispensers; requirements.new text end

new text begin(a) A person or establishment not
licensed as a pharmacy, practitioner, medical gas manufacturer, or medical gas dispenser
must not engage in the dispensing of medical gases without first obtaining a registration
from the board and paying the applicable fee specified in section 151.065. The registration
must be displayed in a conspicuous place in the business for which it is issued and expires
on the date set by the board.
new text end

new text begin (b) Application for a medical gas dispenser registration under this section must be made
in a manner specified by the board.
new text end

new text begin (c) A registration must not be issued or renewed for a medical gas dispenser located
within the state unless the applicant agrees to operate in a manner prescribed by federal and
state law and according to the rules adopted by the board. A license must not be issued for
a medical gas dispenser located outside of the state unless the applicant agrees to operate
in a manner prescribed by federal law and, when dispensing medical gases for residents of
this state, the laws of this state and Minnesota Rules.
new text end

new text begin (d) A registration must not be issued or renewed for a medical gas dispenser that is
required to be licensed or registered by the state in which it is physically located unless the
applicant supplies the board with proof of the licensure or registration. The board may
establish standards for the registration of a medical gas dispenser that is not required to be
licensed or registered by the state in which it is physically located.
new text end

new text begin (e) The board must require a separate registration for each medical gas dispenser located
within the state and for each facility located outside of the state from which medical gases
are dispensed to residents of this state.
new text end

new text begin (f) Prior to the issuance of an initial or renewed registration for a medical gas dispenser,
the board may require the medical gas dispenser to pass an inspection conducted by an
authorized representative of the board. In the case of a medical gas dispenser located outside
of the state, the board may require the applicant to pay the cost of the inspection, in addition
to the license fee in section 151.065, unless the applicant furnishes the board with a report,
issued by the appropriate regulatory agency of the state in which the facility is located, of
an inspection that has occurred within the 24 months immediately preceding receipt of the
license application by the board. The board may deny licensure unless the applicant submits
documentation satisfactory to the board that any deficiencies noted in an inspection report
have been corrected.
new text end

new text begin (g) A facility holding a medical gas dispenser registration must not engage in the
manufacturing or wholesaling of medical gases, except that a medical gas dispenser may
transfer medical gases from one of its duly registered facilities to other duly registered
medical gas manufacturing, wholesaling, or dispensing facilities owned or operated by that
same company, without requiring a medical gas wholesaler license.
new text end

Sec. 6. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 151.19, subdivision 3,new text endnew text begin is repealed.
new text end

ARTICLE 5

PRESCRIPTION DRUGS

Section 1.

Minnesota Statutes 2020, section 62W.11, is amended to read:


62W.11 GAG CLAUSE PROHIBITION.

(a) No contract between a pharmacy benefit manager or health carrier and a pharmacy
or pharmacist shall prohibit, restrict, or penalize a pharmacy or pharmacist from disclosing
to an enrollee any health care information that the pharmacy or pharmacist deems appropriate
regarding the nature of treatment; the risks or alternatives; the availability of alternative
therapies, consultations, or tests; the decision of utilization reviewers or similar persons to
authorize or deny services; the process that is used to authorize or deny health care services
or benefits; or information on financial incentives and structures used by the health carrier
or pharmacy benefit manager.

(b) A pharmacy or pharmacist must provide to an enrollee information regarding the
enrollee's total cost for each prescription drug dispensed where part or all of the cost of the
prescription is being paid or reimbursed by the employer-sponsored plan or by a health
carrier or pharmacy benefit manager, in accordance with section 151.214, subdivision 1.

(c) A pharmacy benefit manager or health carrier must not prohibit a pharmacist or
pharmacy from discussing information regarding the total cost for pharmacy services for a
prescription drug, including the patient's co-payment amount deleted text beginanddeleted text endnew text begin,new text end the pharmacy's own usual
and customary price deleted text beginofdeleted text endnew text begin fornew text end the prescriptionnew text begin drug, the pharmacy's acquisition cost for the
prescription drug, and the amount the pharmacy is being reimbursed by the pharmacy benefit
manager or health carrier for the prescription drug
new text end.

new text begin (d) A pharmacy benefit manager must not prohibit a pharmacist or pharmacy from
discussing with a health carrier the amount the pharmacy is being paid or reimbursed for a
prescription drug by the pharmacy benefit manager or the pharmacy's acquisition cost for
a prescription drug.
new text end

deleted text begin (d)deleted text endnew text begin (e)new text end A pharmacy benefit manager or health carrier must not prohibit a pharmacist or
pharmacy from discussing the availability of any therapeutically equivalent alternative
prescription drugs or alternative methods for purchasing the prescription drug, including
but not limited to paying out-of-pocket the pharmacy's usual and customary price when that
amount is less expensive to the enrollee than the amount the enrollee is required to pay for
the prescription drug under the enrollee's health plan.

Sec. 2.

Minnesota Statutes 2020, section 151.555, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.

(b) "Central repository" means a wholesale distributor that meets the requirements under
subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this
section.

(c) "Distribute" means to deliver, other than by administering or dispensing.

(d) "Donor" means:

(1) a health care facility as defined in this subdivision;

(2) a skilled nursing facility licensed under chapter 144A;

(3) an assisted living facility registered under chapter 144D where there is centralized
storage of drugs and 24-hour on-site licensed nursing coverage provided seven days a week;

(4) a pharmacy licensed under section 151.19, and located either in the state or outside
the state;

(5) a drug wholesaler licensed under section 151.47;

(6) a drug manufacturer licensed under section 151.252; or

(7) an individual at least 18 years of age, provided that the drug or medical supply that
is donated was obtained legally and meets the requirements of this section for donation.

(e) "Drug" means any prescription drug that has been approved for medical use in the
United States, is listed in the United States Pharmacopoeia or National Formulary, and
meets the criteria established under this section for donationnew text begin; or any over-the-counter
medication that meets the criteria established under this section for donation
new text end. This definition
includes cancer drugs and antirejection drugs, but does not include controlled substances,
as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed
to a patient registered with the drug's manufacturer in accordance with federal Food and
Drug Administration requirements.

(f) "Health care facility" means:

(1) a physician's office or health care clinic where licensed practitioners provide health
care to patients;

(2) a hospital licensed under section 144.50;

(3) a pharmacy licensed under section 151.19 and located in Minnesota; or

(4) a nonprofit community clinic, including a federally qualified health center; a rural
health clinic; public health clinic; or other community clinic that provides health care utilizing
a sliding fee scale to patients who are low-income, uninsured, or underinsured.

(g) "Local repository" means a health care facility that elects to accept donated drugs
and medical supplies and meets the requirements of subdivision 4.

(h) "Medical supplies" or "supplies" means any prescription and nonprescription medical
supplies needed to administer a prescription drug.

(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is
sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or
unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose
packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules,
part 6800.3750.

(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that
it does not include a veterinarian.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2020, section 151.555, subdivision 7, is amended to read:


Subd. 7.

Standards and procedures for inspecting and storing donated prescription
drugs and supplies.

(a) A pharmacist or authorized practitioner who is employed by or
under contract with the central repository or a local repository shall inspect all donated
prescription drugs and supplies before the drug or supply is dispensed to determine, to the
extent reasonably possible in the professional judgment of the pharmacist or practitioner,
that the drug or supply is not adulterated or misbranded, has not been tampered with, is safe
and suitable for dispensing, has not been subject to a recall, and meets the requirements for
donation. The pharmacist or practitioner who inspects the drugs or supplies shall sign an
inspection record stating that the requirements for donation have been met. If a local
repository receives drugs and supplies from the central repository, the local repository does
not need to reinspect the drugs and supplies.

(b) The central repository and local repositories shall store donated drugs and supplies
in a secure storage area under environmental conditions appropriate for the drug or supply
being stored. Donated drugs and supplies may not be stored with nondonated inventory. deleted text beginIf
donated drugs or supplies are not inspected immediately upon receipt, a repository must
quarantine the donated drugs or supplies separately from all dispensing stock until the
donated drugs or supplies have been inspected and (1) approved for dispensing under the
program; (2) disposed of pursuant to paragraph (c); or (3) returned to the donor pursuant to
paragraph (d).
deleted text end

(c) The central repository and local repositories shall dispose of all prescription drugs
and medical supplies that are not suitable for donation in compliance with applicable federal
and state statutes, regulations, and rules concerning hazardous waste.

(d) In the event that controlled substances or prescription drugs that can only be dispensed
to a patient registered with the drug's manufacturer are shipped or delivered to a central or
local repository for donation, the shipment delivery must be documented by the repository
and returned immediately to the donor or the donor's representative that provided the drugs.

(e) Each repository must develop drug and medical supply recall policies and procedures.
If a repository receives a recall notification, the repository shall destroy all of the drug or
medical supply in its inventory that is the subject of the recall and complete a record of
destruction form in accordance with paragraph (f). If a drug or medical supply that is the
subject of a Class I or Class II recall has been dispensed, the repository shall immediately
notify the recipient of the recalled drug or medical supply. A drug that potentially is subject
to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug
is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.

(f) A record of destruction of donated drugs and supplies that are not dispensed under
subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation
shall be maintained by the repository for at least deleted text beginfivedeleted text endnew text begin twonew text end years. For each drug or supply
destroyed, the record shall include the following information:

(1) the date of destruction;

(2) the name, strength, and quantity of the drug destroyed; and

(3) the name of the person or firm that destroyed the drug.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2020, section 151.555, subdivision 11, is amended to read:


Subd. 11.

Forms and record-keeping requirements.

(a) The following forms developed
for the administration of this program shall be utilized by the participants of the program
and shall be available on the board's website:

(1) intake application form described under subdivision 5;

(2) local repository participation form described under subdivision 4;

(3) local repository withdrawal form described under subdivision 4;

(4) drug repository donor form described under subdivision 6;

(5) record of destruction form described under subdivision 7; and

(6) drug repository recipient form described under subdivision 8.

(b) All records, including drug inventory, inspection, and disposal of donated prescription
drugs and medical supplies, must be maintained by a repository for a minimum of deleted text beginfivedeleted text endnew text begin twonew text end
years. Records required as part of this program must be maintained pursuant to all applicable
practice acts.

(c) Data collected by the drug repository program from all local repositories shall be
submitted quarterly or upon request to the central repository. Data collected may consist of
the information, records, and forms required to be collected under this section.

(d) The central repository shall submit reports to the board as required by the contract
or upon request of the board.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 5.

Minnesota Statutes 2020, section 151.555, is amended by adding a subdivision to
read:


new text begin Subd. 14.new text end

new text beginCooperation.new text end

new text beginThe central repository, as approved by the Board of Pharmacy,
may enter into an agreement with another state that has an established drug repository or
drug donation program if the other state's program includes regulations to ensure the purity,
integrity, and safety of the drugs and supplies donated, to permit the central repository to
offer to another state program inventory that is not needed by a Minnesota resident and to
accept inventory from another state program to be distributed to local repositories and
dispensed to Minnesota residents in accordance with this program.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

ARTICLE 6

HEALTH INSURANCE

Section 1.

new text begin[62Q.097] REQUIREMENTS FOR TIMELY PROVIDER
CREDENTIALING.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "Clean application for provider credentialing" or "clean application" means an
application for provider credentialing submitted by a health care provider to a health plan
company that is complete, is in the format required by the health plan company, and includes
all information and substantiation required by the health plan company and does not require
evaluation of any identified potential quality or safety concern.
new text end

new text begin (c) "Provider credentialing" means the process undertaken by a health plan company to
evaluate and approve a health care provider's education, training, residency, licenses,
certifications, and history of significant quality or safety concerns in order to approve the
health care provider to provide health care services to patients at a clinic or facility.
new text end

new text begin Subd. 2.new text end

new text beginTime limit for credentialing determination.new text end

new text beginA health plan company that
receives an application for provider credentialing must:
new text end

new text begin (1) if the application is determined to be a clean application for provider credentialing
and if the health care provider submitting the application or the clinic or facility at which
the health care provider provides services requests the information, affirm that the health
care provider's application is a clean application and notify the health care provider or clinic
or facility of the date by which the health plan company will make a determination on the
health care provider's application;
new text end

new text begin (2) if the application is determined not to be a clean application, inform the health care
provider of the application's deficiencies or missing information or substantiation within
three business days after the health plan company determines the application is not a clean
application; and
new text end

new text begin (3) make a determination on the health care provider's clean application within 45 days
after receiving the clean application unless the health plan company identifies a substantive
quality or safety concern in the course of provider credentialing that requires further
investigation. Upon notice to the health care provider, clinic, or facility, the health plan
company is allowed 30 additional days to investigate any quality or safety concerns.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section applies to applications for provider credentialing
submitted to a health plan company on or after January 1, 2022.
new text end

ARTICLE 7

TELEHEALTH

Section 1.

Minnesota Statutes 2020, section 256J.08, subdivision 21, is amended to read:


Subd. 21.

Date of application.

"Date of application" means the date on which the county
agency receives an applicant's deleted text beginsigneddeleted text end applicationnew text begin as a signed written application, an
application submitted by telephone, or an application submitted through Internet telepresence
new text end.

Sec. 2.

Minnesota Statutes 2020, section 256J.09, subdivision 3, is amended to read:


Subd. 3.

Submitting application form.

(a) A county agency must offer, in person or
by mail, the application forms prescribed by the commissioner as soon as a person makes
a written or oral inquiry. At that time, the county agency must:

(1) inform the person that assistance begins deleted text beginwithdeleted text endnew text begin onnew text end the datenew text begin thatnew text end the deleted text beginsigneddeleted text end application
is received by the county agency new text begineither as a signed written application; an application
submitted by telephone; or an application submitted through Internet telepresence;
new text endor new text beginon
new text end the datenew text begin thatnew text end all eligibility criteria are met, whichever is later;

new text begin (2) inform a person that the person may submit the application by telephone or through
Internet telepresence;
new text end

new text begin (3) inform a person that when the person submits the application by telephone or through
Internet telepresence, the county agency must receive a signed written application within
30 days of the date that the person submitted the application by telephone or through Internet
telepresence;
new text end

deleted text begin (2)deleted text endnew text begin (4)new text end inform the person that any delay in submitting the application will reduce the
amount of assistance paid for the month of application;

deleted text begin (3)deleted text endnew text begin (5)new text end inform a person that the person may submit the application before an interview;

deleted text begin (4)deleted text endnew text begin (6)new text end explain the information that will be verified during the application process by
the county agency as provided in section 256J.32;

deleted text begin (5)deleted text endnew text begin (7)new text end inform a person about the county agency's average application processing time
and explain how the application will be processed under subdivision 5;

deleted text begin (6)deleted text endnew text begin (8)new text end explain how to contact the county agency if a person's application information
changes and how to withdraw the application;

deleted text begin (7)deleted text endnew text begin (9)new text end inform a person that the next step in the application process is an interview and
what a person must do if the application is approved including, but not limited to, attending
orientation under section 256J.45 and complying with employment and training services
requirements in sections 256J.515 to 256J.57;

deleted text begin (8)deleted text endnew text begin (10)new text end inform the person that deleted text beginthedeleted text endnew text begin annew text end interview must be conductednew text begin. The interview may
be conducted
new text end face-to-face in the county officenew text begin or at a location mutually agreed uponnew text end, through
Internet telepresence, or deleted text beginat a location mutually agreed upondeleted text endnew text begin by telephonenew text end;

deleted text begin (9) inform a person who has received MFIP or DWP in the past 12 months of the option
to have a face-to-face, Internet telepresence, or telephone interview;
deleted text end

deleted text begin (10)deleted text endnew text begin (11)new text end explain the child care and transportation services that are available under
paragraph (c) to enable caregivers to attend the interview, screening, and orientation; and

deleted text begin (11)deleted text endnew text begin (12)new text end identify any language barriers and arrange for translation assistance during
appointments, including, but not limited to, screening under subdivision 3a, orientation
under section 256J.45, and assessment under section 256J.521.

(b) Upon receipt of a signed application, the county agency must stamp the date of receipt
on the face of the application. The county agency must process the application within the
time period required under subdivision 5. An applicant may withdraw the application at
any time by giving written or oral notice to the county agency. The county agency must
issue a written notice confirming the withdrawal. The notice must inform the applicant of
the county agency's understanding that the applicant has withdrawn the application and no
longer wants to pursue it. When, within ten days of the date of the agency's notice, an
applicant informs a county agency, in writing, that the applicant does not wish to withdraw
the application, the county agency must reinstate the application and finish processing the
application.

(c) Upon a participant's request, the county agency must arrange for transportation and
child care or reimburse the participant for transportation and child care expenses necessary
to enable participants to attend the screening under subdivision 3a and orientation under
section 256J.45.

Sec. 3.

Minnesota Statutes 2020, section 256J.45, subdivision 1, is amended to read:


Subdivision 1.

County agency to provide orientation.

A county agency must provide
deleted text begin a face-to-facedeleted text endnew text begin annew text end orientation to each MFIP caregiver unless the caregiver is:

(1) a single parent, or one parent in a two-parent family, employed at least 35 hours per
week; or

(2) a second parent in a two-parent family who is employed for 20 or more hours per
week provided the first parent is employed at least 35 hours per week.

The county agency must inform caregivers who are not exempt under clause (1) or (2) that
failure to attend the orientation is considered an occurrence of noncompliance with program
requirements, and will result in the imposition of a sanction under section 256J.46. If the
client complies with the orientation requirement prior to the first day of the month in which
the grant reduction is proposed to occur, the orientation sanction shall be lifted.

Sec. 4.

Minnesota Statutes 2020, section 256J.95, subdivision 5, is amended to read:


Subd. 5.

Submitting application form.

The eligibility date for the diversionary work
program begins deleted text beginwithdeleted text endnew text begin onnew text end the date new text beginthat new text endthe deleted text beginsigneddeleted text end combined application form (CAF) is received
by the county agency new text begineither as a signed written application; an application submitted by
telephone; or an application submitted through Internet telepresence;
new text endor new text beginon new text endthe date new text beginthat
new text end diversionary work program eligibility criteria are met, whichever is later. new text beginThe county agency
must inform an applicant that when the applicant submits the application by telephone or
through Internet telepresence, the county agency must receive a signed written application
within 30 days of the date that the applicant submitted the application by telephone or
through Internet telepresence.
new text endThe county agency must inform the applicant that any delay
in submitting the application will reduce the benefits paid for the month of application. The
county agency must inform a person that an application may be submitted before the person
has an interview appointment. Upon receipt of a signed application, the county agency must
stamp the date of receipt on the face of the application. The applicant may withdraw the
application at any time prior to approval by giving written or oral notice to the county
agency. The county agency must follow the notice requirements in section 256J.09,
subdivision 3
, when issuing a notice confirming the withdrawal.

ARTICLE 8

ECONOMIC SUPPORTS

Section 1.

Minnesota Statutes 2020, section 256E.34, subdivision 1, is amended to read:


Subdivision 1.

Distribution of appropriation.

The commissioner must distribute funds
appropriated to the commissioner by law for that purpose to Hunger Solutions, a statewide
association of food shelves organized as a nonprofit corporation as defined under section
501(c)(3) of the Internal Revenue Code of 1986, to distribute to qualifying food shelves. A
food shelf qualifies under this section if:

(1) it is a nonprofit corporation, or is affiliated with a nonprofit corporation, as defined
in section 501(c)(3) of the Internal Revenue Code of 1986new text begin or a federally recognized Tribal
nation
new text end;

(2) it distributes standard food orders without charge to needy individuals. The standard
food order must consist of at least a two-day supply or six pounds per person of nutritionally
balanced food items;

(3) it does not limit food distributions to individuals of a particular religious affiliation,
race, or other criteria unrelated to need or to requirements necessary to administration of a
fair and orderly distribution system;

(4) it does not use the money received or the food distribution program to foster or
advance religious or political views; and

(5) it has a stable address and directly serves individuals.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256J.30, subdivision 8, is amended to read:


Subd. 8.

Late MFIP household report forms.

(a) Paragraphs (b) to (e) apply to the
reporting requirements in subdivision 7.

(b) When the county agency receives an incomplete MFIP household report form, the
county agency must immediately deleted text beginreturn the incomplete form and clearly state what the
caregiver must do for the form to be complete
deleted text endnew text begin contact the caregiver by phone or in writing
to acquire the necessary information to complete the form
new text end.

(c) The automated eligibility system must send a notice of proposed termination of
assistance to the assistance unit if a complete MFIP household report form is not received
by a county agency. The automated notice must be mailed to the caregiver by approximately
the 16th of the month. When a caregiver submits an incomplete form on or after the date a
notice of proposed termination has been sent, the termination is valid unless the caregiver
submits a complete form before the end of the month.

(d) An assistance unit required to submit an MFIP household report form is considered
to have continued its application for assistance if a complete MFIP household report form
is received within a calendar month after the month in which the form was due and assistance
shall be paid for the period beginning with the first day of that calendar month.

(e) A county agency must allow good cause exemptions from the reporting requirements
under subdivision 5 when any of the following factors cause a caregiver to fail to provide
the county agency with a completed MFIP household report form before the end of the
month in which the form is due:

(1) an employer delays completion of employment verification;

(2) a county agency does not help a caregiver complete the MFIP household report form
when the caregiver asks for help;

(3) a caregiver does not receive an MFIP household report form due to mistake on the
part of the department or the county agency or due to a reported change in address;

(4) a caregiver is ill, or physically or mentally incapacitated; or

(5) some other circumstance occurs that a caregiver could not avoid with reasonable
care which prevents the caregiver from providing a completed MFIP household report form
before the end of the month in which the form is due.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256J.626, subdivision 1, is amended to read:


Subdivision 1.

Consolidated fund.

The consolidated fund is established to support
counties and tribes in meeting their duties under this chapter. Counties and tribes must use
funds from the consolidated fund to develop programs and services that are designed to
improve participant outcomes as measured in section 256J.751, subdivision 2. Counties new text beginand
tribes that administer MFIP eligibility
new text endmay use the funds for any allowable expenditures
under subdivision 2, including case management. Tribes new text beginthat do not administer MFIP
eligibility
new text endmay use the funds for any allowable expenditures under subdivision 2, including
case management, except those in subdivision 2, paragraph (a), clauses (1) and (6). new text beginAll
payments made through the MFIP consolidated fund to support a caregiver's pursuit of
greater economic stability does not count when determining a family's available income.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

ARTICLE 9

CHILD PROTECTION

Section 1.

Minnesota Statutes 2020, section 256N.02, subdivision 16, is amended to read:


Subd. 16.

Permanent legal and physical custody.

"Permanent legal and physical
custody" meansnew text begin: (1)new text end a new text beginfull new text endtransfer of permanent legal and physical custody new text beginof a child ordered
by a Minnesota juvenile court under section 260C.515, subdivision 4,
new text endto a relative deleted text beginordered
by a Minnesota juvenile court under section 260C.515, subdivision 4,
deleted text endnew text begin who is not the child's
parent as defined in section 260C.007, subdivision 25;
new text end or new text begin(2) new text endfor a child under jurisdiction
of a tribal court, a judicial determination under a similar provision in tribal code which
means that a relative will assume the duty and authority to provide care, control, and
protection of a child who is residing in foster care, and to make decisions regarding the
child's education, health care, and general welfare until adulthood.new text begin To establish eligibility
for Northstar kinship assistance, permanent legal and physical custody does not include
joint legal custody, joint physical custody, or joint legal and joint physical custody of a child
shared by the child's parent and relative custodian.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256N.02, subdivision 17, is amended to read:


Subd. 17.

Reassessment.

"Reassessment" means an update of a previous assessment
through the process under section 256N.24 for a child who has been continuously eligible
for Northstar Care for Children, or when a child identified as an at-risk child (Level A)
under deleted text beginguardianship ordeleted text end adoption assistance has manifested the disability upon which eligibility
for the agreement was based according to section 256N.25, subdivision 3, paragraph (b).
A reassessment may be used to update an initial assessment, a special assessment, or a
previous reassessment.

Sec. 3.

Minnesota Statutes 2020, section 256N.22, subdivision 1, is amended to read:


Subdivision 1.

General eligibility requirements.

(a) To be eligible for Northstar kinship
assistance under this section, there must be a judicial determination under section 260C.515,
subdivision 4
, that a transfer of permanent legal and physical custody to a relative new text beginwho is
not the child's parent
new text endis in the child's best interest. For a child under jurisdiction of a tribal
court, a judicial determination under a similar provision in tribal code indicating that a
relative will assume the duty and authority to provide care, control, and protection of a child
who is residing in foster care, and to make decisions regarding the child's education, health
care, and general welfare until adulthood, and that this is in the child's best interest is
considered equivalent. new text beginA child whose parent shares legal, physical, or legal and physical
custody of the child with a relative custodian is not eligible for Northstar kinship assistance.
new text end Additionally, a child must:

(1) have been removed from the child's home pursuant to a voluntary placement
agreement or court order;

(2)(i) have resided with the prospective relative custodian who has been a licensed child
foster parent for at least six consecutive months; or

(ii) have received from the commissioner an exemption from the requirement in item
(i) that the prospective relative custodian has been a licensed child foster parent for at least
six consecutive months, based on a determination that:

(A) an expedited move to permanency is in the child's best interest;

(B) expedited permanency cannot be completed without provision of Northstar kinship
assistance;

(C) the prospective relative custodian is uniquely qualified to meet the child's needs, as
defined in section 260C.212, subdivision 2, on a permanent basis;

(D) the child and prospective relative custodian meet the eligibility requirements of this
section; and

(E) efforts were made by the legally responsible agency to place the child with the
prospective relative custodian as a licensed child foster parent for six consecutive months
before permanency, or an explanation why these efforts were not in the child's best interests;

(3) meet the agency determinations regarding permanency requirements in subdivision
2;

(4) meet the applicable citizenship and immigration requirements in subdivision 3;

(5) have been consulted regarding the proposed transfer of permanent legal and physical
custody to a relative, if the child is at least 14 years of age or is expected to attain 14 years
of age prior to the transfer of permanent legal and physical custody; and

(6) have a written, binding agreement under section 256N.25 among the caregiver or
caregivers, the financially responsible agency, and the commissioner established prior to
transfer of permanent legal and physical custody.

(b) In addition to the requirements in paragraph (a), the child's prospective relative
custodian or custodians must meet the applicable background study requirements in
subdivision 4.

(c) To be eligible for title IV-E Northstar kinship assistance, a child must also meet any
additional criteria in section 473(d) of the Social Security Act. The sibling of a child who
meets the criteria for title IV-E Northstar kinship assistance in section 473(d) of the Social
Security Act is eligible for title IV-E Northstar kinship assistance if the child and sibling
are placed with the same prospective relative custodian or custodians, and the legally
responsible agency, relatives, and commissioner agree on the appropriateness of the
arrangement for the sibling. A child who meets all eligibility criteria except those specific
to title IV-E Northstar kinship assistance is entitled to Northstar kinship assistance paid
through funds other than title IV-E.

Sec. 4.

Minnesota Statutes 2020, section 256N.23, subdivision 2, is amended to read:


Subd. 2.

Special needs determination.

(a) A child is considered a child with special
needs under this section if the requirements in paragraphs (b) to (g) are met.

(b) There must be a determination that the child must not or should not be returned to
the home of the child's parents as evidenced by:

(1) a court-ordered termination of parental rights;

(2) a petition to terminate parental rights;

(3) consent of new text beginthe child's new text endparent to adoption accepted by the court under chapter 260Cnew text begin
or, in the case of a child receiving Northstar kinship assistance payments under section
256N.22, consent of the child's parent to the child's adoption executed under chapter 259
new text end;

(4) in circumstances when tribal law permits the child to be adopted without a termination
of parental rights, a judicial determination by a tribal court indicating the valid reason why
the child cannot or should not return home;

(5) a voluntary relinquishment under section 259.25 deleted text beginor 259.47deleted text end or, if relinquishment
occurred in another state, the applicable laws in that state; or

(6) the death of the legal parent or parents if the child has two legal parents.

(c) There exists a specific factor or condition of which it is reasonable to conclude that
the child cannot be placed with adoptive parents without providing adoption assistance as
evidenced by:

(1) a determination by the Social Security Administration that the child meets all medical
or disability requirements of title XVI of the Social Security Act with respect to eligibility
for Supplemental Security Income benefits;

(2) a documented physical, mental, emotional, or behavioral disability not covered under
clause (1);

(3) a member of a sibling group being adopted at the same time by the same parent;

(4) an adoptive placement in the home of a parent who previously adopted a sibling for
whom they receive adoption assistance; or

(5) documentation that the child is an at-risk child.

(d) A reasonable but unsuccessful effort must have been made to place the child with
adoptive parents without providing adoption assistance as evidenced by:

(1) a documented search for an appropriate adoptive placement; or

(2) a determination by the commissioner that a search under clause (1) is not in the best
interests of the child.

(e) The requirement for a documented search for an appropriate adoptive placement
under paragraph (d), including the registration of the child with the state adoption exchange
and other recruitment methods under paragraph (f), must be waived if:

(1) the child is being adopted by a relative and it is determined by the child-placing
agency that adoption by the relative is in the best interests of the child;

(2) the child is being adopted by a foster parent with whom the child has developed
significant emotional ties while in the foster parent's care as a foster child and it is determined
by the child-placing agency that adoption by the foster parent is in the best interests of the
child; or

(3) the child is being adopted by a parent that previously adopted a sibling of the child,
and it is determined by the child-placing agency that adoption by this parent is in the best
interests of the child.

For an Indian child covered by the Indian Child Welfare Act, a waiver must not be
granted unless the child-placing agency has complied with the placement preferences required
by the Indian Child Welfare Act, United States Code, title 25, section 1915(a).

(f) To meet the requirement of a documented search for an appropriate adoptive placement
under paragraph (d), clause (1), the child-placing agency minimally must:

(1) conduct a relative search as required by section 260C.221 and give consideration to
placement with a relative, as required by section 260C.212, subdivision 2;

(2) comply with the placement preferences required by the Indian Child Welfare Act
when the Indian Child Welfare Act, United States Code, title 25, section 1915(a), applies;

(3) locate prospective adoptive families by registering the child on the state adoption
exchange, as required under section 259.75; and

(4) if registration with the state adoption exchange does not result in the identification
of an appropriate adoptive placement, the agency must employ additional recruitment
methods prescribed by the commissioner.

(g) Once the legally responsible agency has determined that placement with an identified
parent is in the child's best interests and made full written disclosure about the child's social
and medical history, the agency must ask the prospective adoptive parent if the prospective
adoptive parent is willing to adopt the child without receiving adoption assistance under
this section. If the identified parent is either unwilling or unable to adopt the child without
adoption assistance, the legally responsible agency must provide documentation as prescribed
by the commissioner to fulfill the requirement to make a reasonable effort to place the child
without adoption assistance. If the identified parent is willing to adopt the child without
adoption assistance, the parent must provide a written statement to this effect to the legally
responsible agency and the statement must be maintained in the permanent adoption record
of the legally responsible agency. For children under guardianship of the commissioner,
the legally responsible agency shall submit a copy of this statement to the commissioner to
be maintained in the permanent adoption record.

Sec. 5.

Minnesota Statutes 2020, section 256N.23, subdivision 6, is amended to read:


Subd. 6.

Exclusions.

The commissioner must not enter into an adoption assistance
agreement with the following individuals:

(1) a child's biological parent or stepparent;

(2) a child's relative under section 260C.007, subdivision 26b or 27, with whom the
child resided immediately prior to child welfare involvement unless:

(i) the child was in the custody of a Minnesota county or tribal agency pursuant to an
order under chapter 260C or equivalent provisions of tribal code and the agency had
placement and care responsibility for permanency planning for the child; and

(ii) the child is under guardianship of the commissioner of human services according to
the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota tribal
court after termination of parental rights, suspension of parental rights, or a finding by the
tribal court that the child cannot safely return to the care of the parent;

(3) an individual adopting a child who is the subject of a direct adoptive placement under
section 259.47 or the equivalent in tribal code;

(4) a child's legal custodian or guardian who is now adopting the childnew text begin, except for a
relative custodian as defined in section 256N.02, subdivision 19, who is currently receiving
Northstar kinship assistance benefits on behalf of the child
new text end; or

(5) an individual who is adopting a child who is not a citizen or resident of the United
States and was either adopted in another country or brought to the United States for the
purposes of adoption.

Sec. 6.

Minnesota Statutes 2020, section 256N.24, subdivision 1, is amended to read:


Subdivision 1.

Assessment.

(a) Each child eligible under sections 256N.21, 256N.22,
and 256N.23, must be assessed to determine the benefits the child may receive under section
256N.26, in accordance with the assessment tool, process, and requirements specified in
subdivision 2.

(b) If an agency applies the emergency foster care rate for initial placement under section
256N.26, the agency may wait up to 30 days to complete the initial assessment.

(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic
level, level B, or one of ten supplemental difficulty of care levels, levels C to L.

(d) An assessment must not be completed for:

(1) a child eligible for Northstar deleted text beginkinship assistance under section 256N.22 ordeleted text end adoption
assistance under section 256N.23 who is determined to be an at-risk child. A child under
this clause must be assigned level A under section 256N.26, subdivision 1; and

(2) a child transitioning into Northstar Care for Children under section 256N.28,
subdivision 7, unless the commissioner determines an assessment is appropriate.

Sec. 7.

Minnesota Statutes 2020, section 256N.24, subdivision 8, is amended to read:


Subd. 8.

Completing the special assessment.

(a) The special assessment must be
completed in consultation with the child's caregiver. Face-to-face contact with the caregiver
is not required to complete the special assessment.

(b) If a new special assessment is required prior to the effective date of the Northstar
kinship assistance agreement, it must be completed by the financially responsible agency,
in consultation with the legally responsible agency if different. If the prospective relative
custodian is unable or unwilling to cooperate with the special assessment process, the child
shall be assigned the basic level, level B under section 256N.26, subdivision 3deleted text begin, unless the
child is known to be an at-risk child, in which case, the child shall be assigned level A under
section 256N.26, subdivision 1
deleted text end.

(c) If a special assessment is required prior to the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency, in consultation with
the legally responsible agency if different. If there is no financially responsible agency, the
special assessment must be completed by the agency designated by the commissioner. If
the prospective adoptive parent is unable or unwilling to cooperate with the special
assessment process, the child must be assigned the basic level, level B under section 256N.26,
subdivision 3
, unless the child is known to be an at-risk child, in which case, the child shall
be assigned level A under section 256N.26, subdivision 1.

(d) Notice to the prospective relative custodians or prospective adoptive parents must
be provided as specified in subdivision 13.

Sec. 8.

Minnesota Statutes 2020, section 256N.24, subdivision 11, is amended to read:


Subd. 11.

Completion of reassessment.

(a) The reassessment must be completed in
consultation with the child's caregiver. Face-to-face contact with the caregiver is not required
to complete the reassessment.

(b) For foster children eligible under section 256N.21, reassessments must be completed
by the financially responsible agency, in consultation with the legally responsible agency
if different.

(c) If reassessment is required after the effective date of the Northstar kinship assistance
agreement, the reassessment must be completed by the financially responsible agency.

(d) If a reassessment is required after the effective date of the adoption assistance
agreement, it must be completed by the financially responsible agency or, if there is no
financially responsible agency, the agency designated by the commissioner.

(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment, the
child must be assessed at level B under section 256N.26, subdivision 3, unless the child has
deleted text begin andeleted text endnew text begin a Northstarnew text end adoption assistance deleted text beginor Northstar kinship assistancedeleted text end agreement deleted text beginin placedeleted text end and
is known to be an at-risk child, in which case the child must be assessed at level A under
section 256N.26, subdivision 1.

Sec. 9.

Minnesota Statutes 2020, section 256N.24, subdivision 12, is amended to read:


Subd. 12.

Approval of initial assessments, special assessments, and reassessments.

(a)
Any agency completing initial assessments, special assessments, or reassessments must
designate one or more supervisors or other staff to examine and approve assessments
completed by others in the agency under subdivision 2. The person approving an assessment
must not be the case manager or staff member completing that assessment.

(b) In cases where a special assessment or reassessment for deleted text beginguardiandeleted text endnew text begin Northstar kinshipnew text end
assistance and adoption assistance is required under subdivision 8 or 11, the commissioner
shall review and approve the assessment as part of the eligibility determination process
outlined in section 256N.22, subdivision 7, for Northstar kinship assistance, or section
256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum
deleted text begin fordeleted text endnew text begin ofnew text end the negotiated agreement amount under section 256N.25.

(c) The new rate is effective the calendar month that the assessment is approved, or the
effective date of the agreement, whichever is later.

Sec. 10.

Minnesota Statutes 2020, section 256N.24, subdivision 14, is amended to read:


Subd. 14.

Assessment tool determines rate of benefits.

The assessment tool established
by the commissioner in subdivision 2 determines the monthly benefit level for children in
foster care. The monthly payment for deleted text beginguardiandeleted text endnew text begin Northstar kinshipnew text end assistance or adoption
assistance may be negotiated up to the monthly benefit level under foster care for those
children eligible for a payment under section 256N.26, subdivision 1.

Sec. 11.

Minnesota Statutes 2020, section 256N.25, subdivision 1, is amended to read:


Subdivision 1.

Agreement; Northstar kinship assistance; adoption assistance.

(a) In
order to receive Northstar kinship assistance or adoption assistance benefits on behalf of
an eligible child, a written, binding agreement between the caregiver or caregivers, the
financially responsible agency, or, if there is no financially responsible agency, the agency
designated by the commissioner, and the commissioner must be established prior to
finalization of the adoption or a transfer of permanent legal and physical custody. The
agreement must be negotiated with the caregiver or caregivers under subdivision 2 and
renegotiated under subdivision 3, if applicable.

(b) The agreement must be on a form approved by the commissioner and must specify
the following:

(1) duration of the agreement;

(2) the nature and amount of any payment, services, and assistance to be provided under
such agreement;

(3) the child's eligibility for Medicaid services;

(4) the terms of the payment, including any child care portion as specified in section
256N.24, subdivision 3;

(5) eligibility for reimbursement of nonrecurring expenses associated with adopting or
obtaining permanent legal and physical custody of the child, to the extent that the total cost
does not exceed $2,000 per childnew text begin pursuant to subdivision 1anew text end;

(6) that the agreement must remain in effect regardless of the state of which the adoptive
parents or relative custodians are residents at any given time;

(7) provisions for modification of the terms of the agreement, including renegotiation
of the agreement;

(8) the effective date of the agreement; and

(9) the successor relative custodian or custodians for Northstar kinship assistance, when
applicable. The successor relative custodian or custodians may be added or changed by
mutual agreement under subdivision 3.

(c) The caregivers, the commissioner, and the financially responsible agency, or, if there
is no financially responsible agency, the agency designated by the commissioner, must sign
the agreement. A copy of the signed agreement must be given to each party. Once signed
by all parties, the commissioner shall maintain the official record of the agreement.

(d) The effective date of the Northstar kinship assistance agreement must be the date of
the court order that transfers permanent legal and physical custody to the relative. The
effective date of the adoption assistance agreement is the date of the finalized adoption
decree.

(e) Termination or disruption of the preadoptive placement or the foster care placement
prior to assignment of custody makes the agreement with that caregiver void.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2021.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256N.25, is amended by adding a subdivision
to read:


new text begin Subd. 1a.new text end

new text beginReimbursement of nonrecurring expenses.new text end

new text begin(a) The commissioner of human
services must reimburse a relative custodian with a fully executed Northstar kinship assistance
benefit agreement for costs that the relative custodian incurs while seeking permanent legal
and physical custody of a child who is the subject of a Northstar kinship assistance benefit
agreement. The commissioner must reimburse a relative custodian for expenses that are
reasonable and necessary that the relative incurs during the transfer of permanent legal and
physical custody of a child to the relative custodian, subject to a maximum of $2,000. To
be eligible for reimbursement, the expenses must directly relate to the legal transfer of
permanent legal and physical custody of the child to the relative custodian, must not have
been incurred by the relative custodian in violation of state or federal law, and must not
have been reimbursed from other sources or funds. The relative custodian must submit
reimbursement requests to the commissioner within 21 months of the date of the child's
finalized transfer of permanent legal and physical custody, and the relative custodian must
follow all requirements and procedures that the commissioner prescribes.
new text end

new text begin (b) The commissioner of human services must reimburse an adoptive parent for costs
that the adoptive parent incurs in an adoption of a child with special needs according to
section 256N.23, subdivision 2. The commissioner must reimburse an adoptive parent for
expenses that are reasonable and necessary for the adoption of the child to occur, subject
to a maximum of $2,000. To be eligible for reimbursement, the expenses must directly relate
to the legal adoption of the child, must not have been incurred by the adoptive parent in
violation of state or federal law, and must not have been reimbursed from other sources or
funds.
new text end

new text begin (1) Children who have special needs but who are not citizens or residents of the United
States and were either adopted in another country or brought to this country for the purposes
of adoption are categorically ineligible for the reimbursement program in this section, except
when the child meets the eligibility criteria in this section after the dissolution of the child's
international adoption.
new text end

new text begin (2) An adoptive parent, in consultation with the responsible child-placing agency, may
request reimbursement of nonrecurring adoption expenses by submitting a complete
application to the commissioner that follows the commissioner's requirements and procedures
on forms that the commissioner prescribes.
new text end

new text begin (3) The commissioner must determine a child's eligibility for adoption expense
reimbursement under title IV-E of the Social Security Act, United States Code, title 42,
sections 670 to 679c. If the commissioner determines that a child is eligible, the commissioner
of human services must fully execute the agreement for nonrecurring adoption expense
reimbursement by signing the agreement. For a child to be eligible, the commissioner must
have fully executed the agreement for nonrecurring adoption expense reimbursement prior
to finalizing a child's adoption.
new text end

new text begin (4) An adoptive parent who has a fully executed Northstar adoption assistance agreement
is not required to submit a separate application for reimbursement of nonrecurring adoption
expenses for the child who is the subject of the Northstar adoption assistance agreement.
new text end

new text begin (5) If the commissioner has determined the child to be eligible, the adoptive parent must
submit reimbursement requests to the commissioner within 21 months of the date of the
child's adoption decree, and the adoptive parent must follow requirements and procedures
that the commissioner prescribes.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2021.
new text end

Sec. 13.

Minnesota Statutes 2020, section 259.22, subdivision 4, is amended to read:


Subd. 4.

Time for filing petition.

A petition shall be filed not later than 12 months after
a child is placed in a prospective adoptive home. If a petition is not filed by that time, the
agency that placed the child, or, in a direct adoptive placement, the agency that is supervising
the placement shall file with the district court in the county where the prospective adoptive
parent resides a motion for an order and a report recommending one of the following:

(1) that the time for filing a petition be extended because of the child's special needs as
defined under title IV-E of the Social Security Act, United States Code, title 42, section
673;

(2) that, based on a written plan for completing filing of the petition, including a specific
timeline, to which the prospective adoptive parents have agreed, the time for filing a petition
be extended long enough to complete the plan because such an extension is in the best
interests of the child and additional time is needed for the child to adjust to the adoptive
home; or

(3) that the child be removed from the prospective adoptive home.

The prospective adoptive parent must reimburse an agency for the cost of preparing and
filing the motion and report under this section, unless the costs are reimbursed by the
commissioner under section 259.73 or deleted text begin259A.70deleted text endnew text begin 256N.25, subdivision 1anew text end.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2021.
new text end

Sec. 14.

Minnesota Statutes 2020, section 259.35, subdivision 1, is amended to read:


Subdivision 1.

Parental responsibilities.

Prior to commencing an investigation of the
suitability of proposed adoptive parents, a child-placing agency shall give the individuals
the following written notice in all capital letters at least one-eighth inch high:

"Minnesota Statutes, section 259.59, provides that upon legally adopting a child, adoptive
parents assume all the rights and responsibilities of birth parents. The responsibilities include
providing for the child's financial support and caring for health, emotional, and behavioral
problems. Except for subsidized adoptions under Minnesota Statutes, chapter deleted text begin259Adeleted text endnew text begin 256Nnew text end,
or any other provisions of law that expressly apply to adoptive parents and children, adoptive
parents are not eligible for state or federal financial subsidies besides those that a birth
parent would be eligible to receive for a child. Adoptive parents may not terminate their
parental rights to a legally adopted child for a reason that would not apply to a birth parent
seeking to terminate rights to a child. An individual who takes guardianship of a child for
the purpose of adopting the child shall, upon taking guardianship from the child's country
of origin, assume all the rights and responsibilities of birth and adoptive parents as stated
in this paragraph."

Sec. 15.

Minnesota Statutes 2020, section 259.73, is amended to read:


259.73 REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.

An individual may apply for reimbursement for costs incurred in an adoption of a child
with special needs under section deleted text begin259A.70deleted text endnew text begin 256N.25, subdivision 1anew text end.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2021.
new text end

ARTICLE 10

CHILD PROTECTION POLICY

Section 1.

Minnesota Statutes 2020, section 245.4885, subdivision 1, is amended to read:


Subdivision 1.

Admission criteria.

(a) Prior to admission or placement, except in the
case of an emergency, all children referred for treatment of severe emotional disturbance
in a treatment foster care setting, residential treatment facility, or informally admitted to a
regional treatment center shall undergo an assessment to determine the appropriate level of
care if public funds are used to pay for the new text beginchild's new text endservices.

(b) The responsible social services agency shall determine the appropriate level of care
for a child when county-controlled funds are used to pay for the child's services or placement
in a qualified residential treatment facility under chapter 260C and licensed by the
commissioner under chapter 245A. In accordance with section 260C.157, a juvenile treatment
screening team shall conduct a screeningnew text begin of a childnew text end before the team may recommend whether
to place a child in a qualified residential treatment program as defined in section 260C.007,
subdivision 26d. When a social services agency does not have responsibility for a child's
placement and the child is enrolled in a prepaid health program under section 256B.69, the
enrolled child's contracted health plan must determine the appropriate level of carenew text begin for the
child
new text end. When Indian Health Services funds or funds of a tribally owned facility funded under
the Indian Self-Determination and Education Assistance Act, Public Law 93-638, are to be
usednew text begin for a childnew text end, the Indian Health Services or 638 tribal health facility must determine the
appropriate level of carenew text begin for the childnew text end. When more than one entity bears responsibility fornew text begin
a child's
new text end coverage, the entities shall coordinate level of care determination activitiesnew text begin for the
child
new text end to the extent possible.

(c) The responsible social services agency must make thenew text begin child'snew text end level of care
determination available to thenew text begin child'snew text end juvenile treatment screening team, as permitted under
chapter 13. The level of care determination shall inform the juvenile treatment screening
team process and the assessment in section 260C.704 when considering whether to place
the child in a qualified residential treatment program. When the responsible social services
agency is not involved in determining a child's placement, the child's level of care
determination shall determine whether the proposed treatment:

(1) is necessary;

(2) is appropriate to the child's individual treatment needs;

(3) cannot be effectively provided in the child's home; and

(4) provides a length of stay as short as possible consistent with the individual child's
deleted text begin needdeleted text endnew text begin needsnew text end.

(d) When a level of care determination is conducted, the responsible social services
agency or other entity may not determine that a screeningnew text begin of a childnew text end under section 260C.157
or referral or admission to a treatment foster care setting or residential treatment facility is
not appropriate solely because services were not first provided to the child in a less restrictive
setting and the child failed to make progress toward or meet treatment goals in the less
restrictive setting. The level of care determination must be based on a diagnostic assessmentnew text begin
of a child
new text end that includes a functional assessment which evaluatesnew text begin the child'snew text end family, school,
and community living situations; and an assessment of the child's need for care out of the
home using a validated tool which assesses a child's functional status and assigns an
appropriate level of carenew text begin to the childnew text end. The validated tool must be approved by the
commissioner of human servicesnew text begin and may be the validated tool approved for the child's
assessment under section 260C.704 if the juvenile treatment screening team recommended
placement of the child in a qualified residential treatment program
new text end. If a diagnostic assessment
including a functional assessment has been completed by a mental health professional within
the past 180 days, a new diagnostic assessment need not be completed unless in the opinion
of the current treating mental health professional the child's mental health status has changed
markedly since the assessment was completed. The child's parent shall be notified if an
assessment will not be completed and of the reasons. A copy of the notice shall be placed
in the child's file. Recommendations developed as part of the level of care determination
process shall include specific community services needed by the child and, if appropriate,
the child's family, and shall indicate whether deleted text beginor notdeleted text end these services are available and accessible
to the child andnew text begin the child'snew text end family.

(e) During the level of care determination process, the child, child's family, or child's
legal representative, as appropriate, must be informed of the child's eligibility for case
management services and family community support services and that an individual family
community support plan is being developed by the case manager, if assigned.

(f) When the responsible social services agency has authority, the agency must engage
the child's parents in case planning under sections 260C.212 and 260C.708 new text beginand chapter
260D
new text end
unless a court terminates the parent's rights or court orders restrict the parent from
participating in case planning, visitation, or parental responsibilities.

(g) The level of care determination, deleted text beginanddeleted text end placement decision, and recommendations for
mental health services must be documented in the child's record, as required in deleted text beginchapterdeleted text end
new text begin chaptersnew text end 260Cnew text begin and 260Dnew text end.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 2.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 3c.new text end

new text beginAt risk of becoming a victim of sex trafficking or commercial sexual
exploitation.
new text end

new text beginFor the purposes of section 245A.25, a youth who is "at risk of becoming a
victim of sex trafficking or commercial sexual exploitation" means a youth who meets the
criteria established by the commissioner of human services for this purpose.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 3.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 4a.new text end

new text beginChildren's residential facility.new text end

new text begin"Children's residential facility" means a
residential program licensed under this chapter or chapter 241 according to the applicable
standards in Minnesota Rules, parts 2960.0010 to 2960.0710.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 6d.new text end

new text beginFoster family setting.new text end

new text begin"Foster family setting" has the meaning given in
Minnesota Rules, part 2960.3010, subpart 23, and includes settings licensed by the
commissioner of human services or the commissioner of corrections.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 5.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 6e.new text end

new text beginFoster residence setting.new text end

new text begin"Foster residence setting" has the meaning given
in Minnesota Rules, part 2960.3010, subpart 26, and includes settings licensed by the
commissioner of human services or the commissioner of corrections.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 6.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 18a.new text end

new text beginTrauma.new text end

new text beginFor the purposes of section 245A.25, "trauma" means an event,
series of events, or set of circumstances experienced by an individual as physically or
emotionally harmful or life-threatening and has lasting adverse effects on the individual's
functioning and mental, physical, social, emotional, or spiritual well-being. Trauma includes
the cumulative emotional or psychological harm of group traumatic experiences transmitted
across generations within a community that are often associated with racial and ethnic
population groups that have suffered major intergenerational losses.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 7.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 23.new text end

new text beginVictim of sex trafficking or commercial sexual exploitation.new text end

new text beginFor the purposes
of section 245A.25, "victim of sex trafficking or commercial sexual exploitation" means a
person who meets the definitions in section 260C.007, subdivision 31, clauses (4) and (5).
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 8.

Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to
read:


new text begin Subd. 24.new text end

new text beginYouth.new text end

new text beginFor the purposes of section 245A.25, "youth" means a child as defined
in section 260C.007, subdivision 4, and includes individuals under 21 years of age who are
in foster care pursuant to section 260C.451.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 9.

Minnesota Statutes 2020, section 245A.041, is amended by adding a subdivision
to read:


new text begin Subd. 5.new text end

new text beginFirst date of working in a facility or setting; documentation
requirements.
new text end

new text beginChildren's residential facility and foster residence setting license holders
must document the first date that a person who is a background study subject begins working
in the license holder's facility or setting. If the license holder does not maintain documentation
of each background study subject's first date of working in the facility or setting in the
license holder's personnel files, the license holder must provide documentation to the
commissioner that contains the first date that each background study subject began working
in the license holder's program upon the commissioner's request.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2021.
new text end

Sec. 10.

new text begin[245A.25] RESIDENTIAL PROGRAM CERTIFICATIONS FOR
COMPLIANCE WITH THE FAMILY FIRST PREVENTION SERVICES ACT.
new text end

new text begin Subdivision 1.new text end

new text beginCertification scope and applicability.new text end

new text begin(a) This section establishes the
requirements that a children's residential facility or child foster residence setting must meet
to be certified for the purposes of Title IV-E funding requirements as:
new text end

new text begin (1) a qualified residential treatment program;
new text end

new text begin (2) a residential setting specializing in providing care and supportive services for youth
who have been or are at risk of becoming victims of sex trafficking or commercial sexual
exploitation;
new text end

new text begin (3) a residential setting specializing in providing prenatal, postpartum, or parenting
support for youth; or
new text end

new text begin (4) a supervised independent living setting for youth who are 18 years of age or older.
new text end

new text begin (b) This section does not apply to a foster family setting in which the license holder
resides in the foster home.
new text end

new text begin (c) Children's residential facilities licensed as detention settings according to Minnesota
Rules, parts 2960.0230 to 2960.0290, or secure programs according to Minnesota Rules,
parts 2960.0300 to 2960.0420, may not be certified under this section.
new text end

new text begin (d) For purposes of this section, "license holder" means an individual, organization, or
government entity that was issued a children's residential facility or foster residence setting
license by the commissioner of human services under this chapter or by the commissioner
of corrections under chapter 241.
new text end

new text begin (e) Certifications issued under this section for foster residence settings may only be
issued by the commissioner of human services and are not delegated to county or private
licensing agencies under section 245A.16.
new text end

new text begin Subd. 2.new text end

new text beginProgram certification types and requests for certification.new text end

new text begin(a) By July 1,
2021, the commissioner of human services must offer certifications to license holders for
the following types of programs:
new text end

new text begin (1) qualified residential treatment programs;
new text end

new text begin (2) residential settings specializing in providing care and supportive services for youth
who have been or are at risk of becoming victims of sex trafficking or commercial sexual
exploitation;
new text end

new text begin (3) residential settings specializing in providing prenatal, postpartum, or parenting
support for youth; and
new text end

new text begin (4) supervised independent living settings for youth who are 18 years of age or older.
new text end

new text begin (b) An applicant or license holder must submit a request for certification under this
section on a form and in a manner prescribed by the commissioner of human services. The
decision of the commissioner of human services to grant or deny a certification request is
final and not subject to appeal under chapter 14.
new text end

new text begin Subd. 3.new text end

new text beginTrauma-informed care.new text end

new text begin(a) Programs certified under subdivision 4 or 5 must
provide services to a person according to a trauma-informed model of care that meets the
requirements of this subdivision, except that programs certified under subdivision 5 are not
required to meet the requirements of paragraph (e).
new text end

new text begin (b) For the purposes of this section, "trauma-informed care" means care that:
new text end

new text begin (1) acknowledges the effects of trauma on a person receiving services and on the person's
family;
new text end

new text begin (2) modifies services to respond to the effects of trauma on the person receiving services;
new text end

new text begin (3) emphasizes skill and strength-building rather than symptom management; and
new text end

new text begin (4) focuses on the physical and psychological safety of the person receiving services
and the person's family.
new text end

new text begin (c) The license holder must have a process for identifying the signs and symptoms of
trauma in a youth and must address the youth's needs related to trauma. This process must
include:
new text end

new text begin (1) screening for trauma by completing a trauma-specific screening tool with each youth
upon the youth's admission or obtaining the results of a trauma-specific screening tool that
was completed with the youth within 30 days prior to the youth's admission to the program;
and
new text end

new text begin (2) ensuring that trauma-based interventions targeting specific trauma-related symptoms
are available to each youth when needed to assist the youth in obtaining services. For
qualified residential treatment programs, this must include the provision of services in
paragraph (e).
new text end

new text begin (d) The license holder must develop and provide services to each youth according to the
principles of trauma-informed care including:
new text end

new text begin (1) recognizing the impact of trauma on a youth when determining the youth's service
needs and providing services to the youth;
new text end

new text begin (2) allowing each youth to participate in reviewing and developing the youth's
individualized treatment or service plan;
new text end

new text begin (3) providing services to each youth that are person-centered and culturally responsive;
and
new text end

new text begin (4) adjusting services for each youth to address additional needs of the youth.
new text end

new text begin (e) In addition to the other requirements of this subdivision, qualified residential treatment
programs must use a trauma-based treatment model that includes:
new text end

new text begin (1) assessing each youth to determine if the youth needs trauma-specific treatment
interventions;
new text end

new text begin (2) identifying in each youth's treatment plan how the program will provide
trauma-specific treatment interventions to the youth;
new text end

new text begin (3) providing trauma-specific treatment interventions to a youth that target the youth's
specific trauma-related symptoms; and
new text end

new text begin (4) training all clinical staff of the program on trauma-specific treatment interventions.
new text end

new text begin (f) At the license holder's program, the license holder must provide a physical, social,
and emotional environment that:
new text end

new text begin (1) promotes the physical and psychological safety of each youth;
new text end

new text begin (2) avoids aspects that may be retraumatizing;
new text end

new text begin (3) responds to trauma experienced by each youth and the youth's other needs; and
new text end

new text begin (4) includes designated spaces that are available to each youth for engaging in sensory
and self-soothing activities.
new text end

new text begin (g) The license holder must base the program's policies and procedures on
trauma-informed principles. In the program's policies and procedures, the license holder
must:
new text end

new text begin (1) describe how the program provides services according to a trauma-informed model
of care;
new text end

new text begin (2) describe how the program's environment fulfills the requirements of paragraph (f);
new text end

new text begin (3) prohibit the use of aversive consequences for a youth's violation of program rules
or any other reason;
new text end

new text begin (4) describe the process for how the license holder incorporates trauma-informed
principles and practices into the organizational culture of the license holder's program; and
new text end

new text begin (5) if the program is certified to use restrictive procedures under Minnesota Rules, part
2960.0710, describe how the program uses restrictive procedures only when necessary for
a youth in a manner that addresses the youth's history of trauma and avoids causing the
youth additional trauma.
new text end

new text begin (h) Prior to allowing a staff person to have direct contact, as defined in section 245C.02,
subdivision 11, with a youth and annually thereafter, the license holder must train each staff
person about:
new text end

new text begin (1) concepts of trauma-informed care and how to provide services to each youth according
to these concepts; and
new text end

new text begin (2) impacts of each youth's culture, race, gender, and sexual orientation on the youth's
behavioral health and traumatic experiences.
new text end

new text begin Subd. 4.new text end

new text beginQualified residential treatment programs; certification requirements.new text end

new text begin(a)
To be certified as a qualified residential treatment program, a license holder must meet:
new text end

new text begin (1) the definition of a qualified residential treatment program in section 260C.007,
subdivision 26d;
new text end

new text begin (2) the requirements for providing trauma-informed care and using a trauma-based
treatment model in subdivision 3; and
new text end

new text begin (3) the requirements of this subdivision.
new text end

new text begin (b) For each youth placed in the license holder's program, the license holder must
collaborate with the responsible social services agency and other appropriate parties to
implement the youth's out-of-home placement plan and the youth's short-term and long-term
mental health and behavioral health goals in the assessment required by sections 260C.212,
subdivision 1; 260C.704; and 260C.708.
new text end

new text begin (c) A qualified residential treatment program must use a trauma-based treatment model
that meets all of the requirements of subdivision 3 that is designed to address the needs,
including clinical needs, of youth with serious emotional or behavioral disorders or
disturbances. The license holder must develop, document, and review a treatment plan for
each youth according to the requirements of Minnesota Rules, parts 2960.0180, subpart 2,
item B; and 2960.0190, subpart 2.
new text end

new text begin (d) The following types of staff must be on-site according to the program's treatment
model and must be available 24 hours a day and seven days a week to provide care within
the scope of their practice:
new text end

new text begin (1) a registered nurse or licensed practical nurse licensed by the Minnesota Board of
Nursing to practice professional nursing or practical nursing as defined in section 148.171,
subdivisions 14 and 15; and
new text end

new text begin (2) other licensed clinical staff to meet each youth's clinical needs.
new text end

new text begin (e) A qualified residential treatment program must be accredited by one of the following
independent, not-for-profit organizations:
new text end

new text begin (1) the Commission on Accreditation of Rehabilitation Facilities (CARF);
new text end

new text begin (2) the Joint Commission;
new text end

new text begin (3) the Council on Accreditation (COA); or
new text end

new text begin (4) another independent, not-for-profit accrediting organization approved by the Secretary
of the United States Department of Health and Human Services.
new text end

new text begin (f) The license holder must facilitate participation of a youth's family members in the
youth's treatment program, consistent with the youth's best interests and according to the
youth's out-of-home placement plan required by sections 260C.212, subdivision 1; and
260C.708.
new text end

new text begin (g) The license holder must contact and facilitate outreach to each youth's family
members, including the youth's siblings, and must document outreach to the youth's family
members in the youth's file, including the contact method and each family member's contact
information. In the youth's file, the license holder must record and maintain the contact
information for all known biological family members and fictive kin of the youth.
new text end

new text begin (h) The license holder must document in the youth's file how the program integrates
family members into the treatment process for the youth, including after the youth's discharge
from the program, and how the program maintains the youth's connections to the youth's
siblings.
new text end

new text begin (i) The program must provide discharge planning and family-based aftercare support to
each youth for at least six months after the youth's discharge from the program. When
providing aftercare to a youth, the program must have monthly contact with the youth and
the youth's caregivers to promote the youth's engagement in aftercare services and to regularly
evaluate the family's needs. The program's monthly contact with the youth may be
face-to-face, by telephone, or virtual.
new text end

new text begin (j) The license holder must maintain a service delivery plan that describes how the
program provides services according to the requirements in paragraphs (b) to (i).
new text end

new text begin Subd. 5.new text end

new text beginResidential settings specializing in providing care and supportive services
for youth who have been or are at risk of becoming victims of sex trafficking or
commercial sexual exploitation; certification requirements.
new text end

new text begin(a) To be certified as a
residential setting specializing in providing care and supportive services for youth who have
been or are at risk of becoming victims of sex trafficking or commercial sexual exploitation,
a license holder must meet the requirements of this subdivision.
new text end

new text begin (b) Settings certified according to this subdivision are exempt from the requirements of
section 245A.04, subdivision 11, paragraph (b).
new text end

new text begin (c) The program must use a trauma-informed model of care that meets all of the applicable
requirements of subdivision 3, and that is designed to address the needs, including emotional
and mental health needs, of youth who have been or are at risk of becoming victims of sex
trafficking or commercial sexual exploitation.
new text end

new text begin (d) The program must provide high-quality care and supportive services for youth who
have been or are at risk of becoming victims of sex trafficking or commercial sexual
exploitation and must:
new text end

new text begin (1) offer a safe setting to each youth designed to prevent ongoing and future trafficking
of the youth;
new text end

new text begin (2) provide equitable, culturally responsive, and individualized services to each youth;
new text end

new text begin (3) assist each youth with accessing medical, mental health, legal, advocacy, and family
services based on the youth's individual needs;
new text end

new text begin (4) provide each youth with relevant educational, life skills, and employment supports
based on the youth's individual needs;
new text end

new text begin (5) offer a trafficking prevention education curriculum and provide support for each
youth at risk of future sex trafficking or commercial sexual exploitation; and
new text end

new text begin (6) engage with the discharge planning process for each youth and the youth's family.
new text end

new text begin (e) The license holder must maintain a service delivery plan that describes how the
program provides services according to the requirements in paragraphs (c) and (d).
new text end

new text begin (f) The license holder must ensure that each staff person who has direct contact, as
defined in section 245C.02, subdivision 11, with a youth served by the license holder's
program completes a human trafficking training approved by the Department of Human
Services' Children and Family Services Administration before the staff person has direct
contact with a youth served by the program and annually thereafter. For programs certified
prior to January 1, 2022, the license holder must ensure that each staff person at the license
holder's program completes the initial training by January 1, 2022.
new text end

new text begin Subd. 6.new text end

new text beginResidential settings specializing in providing prenatal, postpartum, or
parenting supports for youth; certification requirements.
new text end

new text begin(a) To be certified as a
residential setting specializing in providing prenatal, postpartum, or parenting supports for
youth, a license holder must meet the requirements of this subdivision.
new text end

new text begin (b) The license holder must collaborate with the responsible social services agency and
other appropriate parties to implement each youth's out-of-home placement plan required
by section 260C.212, subdivision 1.
new text end

new text begin (c) The license holder must specialize in providing prenatal, postpartum, or parenting
supports for youth and must:
new text end

new text begin (1) provide equitable, culturally responsive, and individualized services to each youth;
new text end

new text begin (2) assist each youth with accessing postpartum services during the same period of time
that a woman is considered pregnant for the purposes of medical assistance eligibility under
section 256B.055, subdivision 6, including providing each youth with:
new text end

new text begin (i) sexual and reproductive health services and education; and
new text end

new text begin (ii) a postpartum mental health assessment and follow-up services; and
new text end

new text begin (3) discharge planning that includes the youth and the youth's family.
new text end

new text begin (d) On or before the date of a child's initial physical presence at the facility, the license
holder must provide education to the child's parent related to safe bathing and reducing the
risk of sudden unexpected infant death and abusive head trauma from shaking infants and
young children. The license holder must use the educational material developed by the
commissioner of human services to comply with this requirement. At a minimum, the
education must address:
new text end

new text begin (1) instruction that: (i) a child or infant should never be left unattended around water;
(ii) a tub should be filled with only two to four inches of water for infants; and (iii) an infant
should never be put into a tub when the water is running; and
new text end

new text begin (2) the risk factors related to sudden unexpected infant death and abusive head trauma
from shaking infants and young children and means of reducing the risks, including the
safety precautions identified in section 245A.1435 and the risks of co-sleeping.
new text end

new text begin The license holder must document the parent's receipt of the education and keep the
documentation in the parent's file. The documentation must indicate whether the parent
agrees to comply with the safeguards described in this paragraph. If the parent refuses to
comply, program staff must provide additional education to the parent as described in the
parental supervision plan. The parental supervision plan must include the intervention,
frequency, and staff responsible for the duration of the parent's participation in the program
or until the parent agrees to comply with the safeguards described in this paragraph.
new text end

new text begin (e) On or before the date of a child's initial physical presence at the facility, the license
holder must document the parent's capacity to meet the health and safety needs of the child
while on the facility premises considering the following factors:
new text end

new text begin (1) the parent's physical and mental health;
new text end

new text begin (2) the parent being under the influence of drugs, alcohol, medications, or other chemicals;
new text end

new text begin (3) the child's physical and mental health; and
new text end

new text begin (4) any other information available to the license holder indicating that the parent may
not be able to adequately care for the child.
new text end

new text begin (f) The license holder must have written procedures specifying the actions that staff shall
take if a parent is or becomes unable to adequately care for the parent's child.
new text end

new text begin (g) If the parent refuses to comply with the safeguards described in paragraph (d) or is
unable to adequately care for the child, the license holder must develop a parental supervision
plan in conjunction with the parent. The plan must account for any factors in paragraph (e)
that contribute to the parent's inability to adequately care for the child. The plan must be
dated and signed by the staff person who completed the plan.
new text end

new text begin (h) The license holder must have written procedures addressing whether the program
permits a parent to arrange for supervision of the parent's child by another youth in the
program. If permitted, the facility must have a procedure that requires staff approval of the
supervision arrangement before the supervision by the nonparental youth occurs. The
procedure for approval must include an assessment of the nonparental youth's capacity to
assume the supervisory responsibilities using the criteria in paragraph (e). The license holder
must document the license holder's approval of the supervisory arrangement and the
assessment of the nonparental youth's capacity to supervise the child and must keep this
documentation in the file of the parent whose child is being supervised by the nonparental
youth.
new text end

new text begin (i) The license holder must maintain a service delivery plan that describes how the
program provides services according to paragraphs (b) to (h).
new text end

new text begin Subd. 7.new text end

new text beginSupervised independent living settings for youth 18 years of age or older;
certification requirements.
new text end

new text begin(a) To be certified as a supervised independent living setting
for youth who are 18 years of age or older, a license holder must meet the requirements of
this subdivision.
new text end

new text begin (b) A license holder must provide training, counseling, instruction, supervision, and
assistance for independent living, according to the needs of the youth being served.
new text end

new text begin (c) A license holder may provide services to assist the youth with locating housing,
money management, meal preparation, shopping, health care, transportation, and any other
support services necessary to meet the youth's needs and improve the youth's ability to
conduct such tasks independently.
new text end

new text begin (d) The service plan for the youth must contain an objective of independent living skills.
new text end

new text begin (e) The license holder must maintain a service delivery plan that describes how the
program provides services according to paragraphs (b) to (d).
new text end

new text begin Subd. 8.new text end

new text beginMonitoring and inspections.new text end

new text begin(a) For a program licensed by the commissioner
of human services, the commissioner of human services may review a program's compliance
with certification requirements by conducting an inspection, a licensing review, or an
investigation of the program. The commissioner may issue a correction order to the license
holder for a program's noncompliance with the certification requirements of this section.
For a program licensed by the commissioner of human services, a license holder must make
a request for reconsideration of a correction order according to section 245A.06, subdivision
2.
new text end

new text begin (b) For a program licensed by the commissioner of corrections, the commissioner of
human services may review the program's compliance with the requirements for a certification
issued under this section biennially and may issue a correction order identifying the program's
noncompliance with the requirements of this section. The correction order must state the
following:
new text end

new text begin (1) the conditions that constitute a violation of a law or rule;
new text end

new text begin (2) the specific law or rule violated; and
new text end

new text begin (3) the time allowed for the program to correct each violation.
new text end

new text begin (c) For a program licensed by the commissioner of corrections, if a license holder believes
that there are errors in the correction order of the commissioner of human services, the
license holder may ask the Department of Human Services to reconsider the parts of the
correction order that the license holder alleges are in error. To submit a request for
reconsideration, the license holder must send a written request for reconsideration by United
States mail to the commissioner of human services. The request for reconsideration must
be postmarked within 20 calendar days of the date that the correction order was received
by the license holder and must:
new text end

new text begin (1) specify the parts of the correction order that are alleged to be in error;
new text end

new text begin (2) explain why the parts of the correction order are in error; and
new text end

new text begin (3) include documentation to support the allegation of error.
new text end

new text begin A request for reconsideration does not stay any provisions or requirements of the correction
order. The commissioner of human services' disposition of a request for reconsideration is
final and not subject to appeal under chapter 14.
new text end

new text begin (d) Nothing in this subdivision prohibits the commissioner of human services from
decertifying a license holder according to subdivision 9 prior to issuing a correction order.
new text end

new text begin Subd. 9.new text end

new text beginDecertification.new text end

new text begin(a) The commissioner of human services may rescind a
certification issued under this section if a license holder fails to comply with the certification
requirements in this section.
new text end

new text begin (b) The license holder may request reconsideration of a decertification by notifying the
commissioner of human services by certified mail or personal service. The license holder
must request reconsideration of a decertification in writing. If the license holder sends the
request for reconsideration of a decertification by certified mail, the license holder must
send the request by United States mail to the commissioner of human services and the
request must be postmarked within 20 calendar days after the license holder received the
notice of decertification. If the license holder requests reconsideration of a decertification
by personal service, the request for reconsideration must be received by the commissioner
of human services within 20 calendar days after the license holder received the notice of
decertification. When submitting a request for reconsideration of a decertification, the license
holder must submit a written argument or evidence in support of the request for
reconsideration.
new text end

new text begin (c) The commissioner of human services' disposition of a request for reconsideration is
final and not subject to appeal under chapter 14.
new text end

new text begin Subd. 10.new text end

new text beginVariances.new text end

new text beginThe commissioner of human services may grant variances to the
requirements in this section that do not affect a youth's health or safety or compliance with
federal requirements for Title IV-E funding if the conditions in section 245A.04, subdivision
9, are met.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 11.

Minnesota Statutes 2020, section 256.01, subdivision 14b, is amended to read:


Subd. 14b.

American Indian child welfare projects.

(a) The commissioner of human
services may authorize projects to initiate tribal delivery of child welfare services to American
Indian children and their parents and custodians living on the reservation. The commissioner
has authority to solicit and determine which tribes may participate in a project. Grants may
be issued to Minnesota Indian tribes to support the projects. The commissioner may waive
existing state rules as needed to accomplish the projects. The commissioner may authorize
projects to use alternative methods of (1) screening, investigating, and assessing reports of
child maltreatment, and (2) administrative reconsideration, administrative appeal, and
judicial appeal of maltreatment determinations, provided the alternative methods used by
the projects comply with the provisions of section 256.045 and chapter 260E that deal with
the rights of individuals who are the subjects of reports or investigations, including notice
and appeal rights and data practices requirements. The commissioner shall only authorize
alternative methods that comply with the public policy under section 260E.01. The
commissioner may seek any federal approval necessary to carry out the projects as well as
seek and use any funds available to the commissioner, including use of federal funds,
foundation funds, existing grant funds, and other funds. The commissioner is authorized to
advance state funds as necessary to operate the projects. Federal reimbursement applicable
to the projects is appropriated to the commissioner for the purposes of the projects. The
projects must be required to address responsibility for safety, permanency, and well-being
of children.

(b) For the purposes of this section, "American Indian child" means a person under 21
years old and who is a tribal member or eligible for membership in one of the tribes chosen
for a project under this subdivision and who is residing on the reservation of that tribe.

(c) In order to qualify for an American Indian child welfare project, a tribe must:

(1) be one of the existing tribes with reservation land in Minnesota;

(2) have a tribal court with jurisdiction over child custody proceedings;

(3) have a substantial number of children for whom determinations of maltreatment have
occurred;

(4)(i) have capacity to respond to reports of abuse and neglect under chapter 260E; or
(ii) have codified the tribe's screening, investigation, and assessment of reports of child
maltreatment procedures, if authorized to use an alternative method by the commissioner
under paragraph (a);

(5) provide a wide range of services to families in need of child welfare services; deleted text beginand
deleted text end

(6) have a tribal-state title IV-E agreement in effectnew text begin; and
new text end

new text begin (7) enter into host Tribal contracts pursuant to section 256.0112, subdivision 6new text end.

(d) Grants awarded under this section may be used for the nonfederal costs of providing
child welfare services to American Indian children on the tribe's reservation, including costs
associated with:

(1) assessment and prevention of child abuse and neglect;

(2) family preservation;

(3) facilitative, supportive, and reunification services;

(4) out-of-home placement for children removed from the home for child protective
purposes; and

(5) other activities and services approved by the commissioner that further the goals of
providing safety, permanency, and well-being of American Indian children.

(e) When a tribe has initiated a project and has been approved by the commissioner to
assume child welfare responsibilities for American Indian children of that tribe under this
section, the affected county social service agency is relieved of responsibility for responding
to reports of abuse and neglect under chapter 260E for those children during the time within
which the tribal project is in effect and funded. The commissioner shall work with tribes
and affected counties to develop procedures for data collection, evaluation, and clarification
of ongoing role and financial responsibilities of the county and tribe for child welfare services
prior to initiation of the project. Children who have not been identified by the tribe as
participating in the project shall remain the responsibility of the county. Nothing in this
section shall alter responsibilities of the county for law enforcement or court services.

(f) Participating tribes may conduct children's mental health screenings under section
245.4874, subdivision 1, paragraph (a), clause (12), for children who are eligible for the
initiative and living on the reservation and who meet one of the following criteria:

(1) the child must be receiving child protective services;

(2) the child must be in foster care; or

(3) the child's parents must have had parental rights suspended or terminated.

Tribes may access reimbursement from available state funds for conducting the screenings.
Nothing in this section shall alter responsibilities of the county for providing services under
section 245.487.

(g) Participating tribes may establish a local child mortality review panel. In establishing
a local child mortality review panel, the tribe agrees to conduct local child mortality reviews
for child deaths or near-fatalities occurring on the reservation under subdivision 12. Tribes
with established child mortality review panels shall have access to nonpublic data and shall
protect nonpublic data under subdivision 12, paragraphs (c) to (e). The tribe shall provide
written notice to the commissioner and affected counties when a local child mortality review
panel has been established and shall provide data upon request of the commissioner for
purposes of sharing nonpublic data with members of the state child mortality review panel
in connection to an individual case.

(h) The commissioner shall collect information on outcomes relating to child safety,
permanency, and well-being of American Indian children who are served in the projects.
Participating tribes must provide information to the state in a format and completeness
deemed acceptable by the state to meet state and federal reporting requirements.

(i) In consultation with the White Earth Band, the commissioner shall develop and submit
to the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services a plan to transfer legal responsibility for providing child
protective services to White Earth Band member children residing in Hennepin County to
the White Earth Band. The plan shall include a financing proposal, definitions of key terms,
statutory amendments required, and other provisions required to implement the plan. The
commissioner shall submit the plan by January 15, 2012.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256.0112, subdivision 6, is amended to read:


Subd. 6.

Contracting within and across county lines; lead county contractsnew text begin; lead
Tribal contracts
new text end.

Paragraphs (a) to (e) govern contracting within and across county lines
and lead county contracts.new text begin Paragraphs (a) to (e) govern contracting within and across
reservation boundaries and lead Tribal contracts for initiative tribes under section 256.01,
subdivision 14b. For purposes of this subdivision, "local agency" includes a tribe or a county
agency.
new text end

(a) Once a local agency and an approved vendor execute a contract that meets the
requirements of this subdivision, the contract governs all other purchases of service from
the vendor by all other local agencies for the term of the contract. The local agency that
negotiated and entered into the contract becomes the leadnew text begin tribe ornew text end county for the contract.

(b) When the local agency in the countynew text begin or reservationnew text end where a vendor is located wants
to purchase services from that vendor and the vendor has no contract with the local agency
or any othernew text begin tribe ornew text end county, the local agency must negotiate and execute a contract with
the vendor.

(c) When a local agency deleted text beginin one countydeleted text end wants to purchase services from a vendor located
in another countynew text begin or reservationnew text end, it must notify the local agency in the countynew text begin or reservationnew text end
where the vendor is located. Within 30 days of being notified, the local agency in the vendor's
countynew text begin or reservationnew text end must:

(1) if it has a contract with the vendor, send a copy to the inquiring new text beginlocal new text endagency;

(2) if there is a contract with the vendor for which another local agency is the lead new text begintribe
or
new text endcounty, identify the lead new text begintribe or new text endcounty to the inquiring agency; or

(3) if no local agency has a contract with the vendor, inform the inquiring agency whether
it will negotiate a contract and become the lead new text begintribe or new text endcounty. If the agency where the
vendor is located will not negotiate a contract with the vendor because of concerns related
to clients' health and safety, the agency must share those concerns with the inquiringnew text begin localnew text end
agency.

(d) If the local agency in the county where the vendor is located declines to negotiate a
contract with the vendor or fails to respond within 30 days of receiving the notification
under paragraph (c), the inquiring agency is authorized to negotiate a contract and must
notify the local agency that declined or failed to respond.

(e) When the inquiring deleted text begincountydeleted text endnew text begin local agencynew text end under paragraph (d) becomes the lead new text begintribe
or
new text endcounty for a contract and the contract expires and needs to be renegotiated, that new text begintribe or
new text end county must again follow the requirements under paragraph (c) and notify the local agency
where the vendor is located. The local agency where the vendor is located has the option
of becoming the lead new text begintribe or new text endcounty for the new contract. If the local agency does not
exercise the option, paragraph (d) applies.

(f) This subdivision does not affect the requirement to seek county concurrence under
section 256B.092, subdivision 8a, when the services are to be purchased for a person with
a developmental disability or under section 245.4711, subdivision 3, when the services to
be purchased are for an adult with serious and persistent mental illness.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 13.

Minnesota Statutes 2020, section 256.741, is amended by adding a subdivision
to read:


new text begin Subd. 12a.new text end

new text beginAppeals of good cause determinations.new text end

new text beginAccording to section 256.045, an
individual may appeal the determination or redetermination of good cause under this section.
To initiate an appeal of a good cause determination or redetermination, the individual must
make a request for a state agency hearing in writing within 30 calendar days after the date
that a notice of denial for good cause is mailed or otherwise transmitted to the individual.
Until a human services judge issues a decision under section 256.0451, subdivision 22, the
child support agency shall cease all child support enforcement efforts and shall not report
the individual's noncooperation to public assistance agencies.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256.741, is amended by adding a subdivision
to read:


new text begin Subd. 12b.new text end

new text beginReporting noncooperation.new text end

new text beginThe public authority may issue a notice of the
individual's noncooperation to each public assistance agency providing public assistance
to the individual if:
new text end

new text begin (1) 30 calendar days have passed since the later of the initial county denial or the date
of the denial following the state agency hearing; or
new text end

new text begin (2) the individual has not cooperated with the child support agency as required in
subdivision 5.
new text end

Sec. 15.

Minnesota Statutes 2020, section 259.241, is amended to read:


259.241 ADULT ADOPTION.

(a) Any adult person may be adopted, regardless of the adult person's residence. A
resident of Minnesota may petition the court of record having jurisdiction of adoption
proceedings to adopt an individual who has reached the age of 18 years or older.

(b) The consent of the person to be adopted shall be the only consent necessary, according
to section 259.24. The consent of an adult in the adult person's own adoption is invalid if
the adult is considered to be a vulnerable adult under section 626.5572, subdivision 21, or
if the person consenting to the adoption is determined not competent to give consent.

new text begin (c) Notwithstanding paragraph (b), a person in extended foster care under section
260C.451 may consent to the person's own adoption as long as the court with jurisdiction
finds the person competent to give consent.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end The decree of adoption establishes a parent-child relationship between the adopting
parent or parents and the person adopted, including the right to inherit, and also terminates
the parental rights deleted text beginand sibling relationshipdeleted text end between the adopted person and the adopted
person's birth parents deleted text beginand siblingsdeleted text end according to section 259.59.

deleted text begin (d)deleted text endnew text begin (e)new text end If the adopted person requests a change of name, the adoption decree shall order
the name change.

Sec. 16.

Minnesota Statutes 2020, section 259.53, subdivision 4, is amended to read:


Subd. 4.

Preadoption residence.

No petition shall be grantednew text begin under this chapternew text end until
the child deleted text beginshall havedeleted text endnew text begin hasnew text end livednew text begin fornew text end three months in the proposed new text beginadoptive new text endhome, subject to a
right of visitation by the commissioner or an agency or their authorized representatives.

Sec. 17.

Minnesota Statutes 2020, section 259.75, subdivision 5, is amended to read:


Subd. 5.

Withdrawal of registration.

A child's registration shall be withdrawn when
the exchange service has been notified in writing by the local social service agency or the
licensed child-placing agency that the child has been placed in an adoptive home deleted text beginordeleted text endnew text begin,new text end has
diednew text begin, or is no longer under the guardianship of the commissioner and is no longer seeking
an adoptive home
new text end.

Sec. 18.

Minnesota Statutes 2020, section 259.75, subdivision 6, is amended to read:


Subd. 6.

Periodic review of status.

new text begin(a) new text endThe deleted text beginexchange servicedeleted text endnew text begin commissionernew text end shall
deleted text begin semiannually checkdeleted text endnew text begin reviewnew text end thenew text begin state adoption exchangenew text end status of deleted text beginlisteddeleted text end children deleted text beginfor whom
inquiries have been received
deleted text endnew text begin identified under subdivision 2, including a child whose
registration was withdrawn pursuant to subdivision 5. The commissioner may determine
that a child who is unregistered, or whose registration has been deferred, must be registered
and require the authorized child-placing agency to register the child with the state adoption
exchange within ten working days of the commissioner's determination
new text end.

new text begin (b)new text end Periodic deleted text beginchecksdeleted text endnew text begin reviewsnew text end shall be made by the deleted text beginservicedeleted text endnew text begin commissionernew text end to determine the
progress toward adoption of deleted text beginthose children and the status ofdeleted text end children registered deleted text beginbut never
listed
deleted text end in the deleted text beginexchange book because of placement in an adoptive home prior to or at the
time of registration
deleted text endnew text begin state adoption exchangenew text end.

Sec. 19.

Minnesota Statutes 2020, section 259.75, subdivision 9, is amended to read:


Subd. 9.

Rules; staff.

The commissioner of human services shall make rules as necessary
to administer this section and shall employ necessary staff to carry out the purposes of this
section.new text begin The commissioner may contract for services to carry out the purposes of this section.
new text end

Sec. 20.

Minnesota Statutes 2020, section 259.83, subdivision 1a, is amended to read:


Subd. 1a.

Social and medical history.

(a) If a person aged 19 years and over who was
adopted on or after August 1, 1994, or the adoptive parent requests the detailed nonidentifying
social and medical history of the adopted person's birth family that was provided at the time
of the adoption, agencies must provide the information to the adopted person or adoptive
parent on thenew text begin applicablenew text end form required under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 259.43new text begin and 260C.212,
subdivision 15
new text end.

(b) If an adopted person aged 19 years and over or the adoptive parent requests the
agency to contact the adopted person's birth parents to request current nonidentifying social
and medical history of the adopted person's birth family, agencies must use thenew text begin applicablenew text end
form required under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 259.43new text begin and 260C.212, subdivision 15,new text end when obtaining
the information for the adopted person or adoptive parent.

Sec. 21.

Minnesota Statutes 2020, section 259A.75, subdivision 1, is amended to read:


Subdivision 1.

General information.

(a) Subject to the procedures required by the
commissioner and the provisions of this section, a Minnesota countynew text begin or Tribal agencynew text end shall
receive a reimbursement from the commissioner equal to 100 percent of the reasonable and
appropriate cost for contracted adoption placement services identified for a specific child
that are not reimbursed under other federal or state funding sources.

(b) The commissioner may spend up to $16,000 for each purchase of service contract.
Only one contract per child per adoptive placement is permitted. Funds encumbered and
obligated under the contract for the child remain available until the terms of the contract
are fulfilled or the contract is terminated.

(c) The commissioner shall set aside an amount not to exceed five percent of the total
amount of the fiscal year appropriation from the state for the adoption assistance program
to reimburse a Minnesota county or tribal social services placing agency for child-specific
adoption placement services. When adoption assistance payments for children's needs exceed
95 percent of the total amount of the fiscal year appropriation from the state for the adoption
assistance program, the amount of reimbursement available to placing agencies for adoption
services is reduced correspondingly.

Sec. 22.

Minnesota Statutes 2020, section 259A.75, subdivision 2, is amended to read:


Subd. 2.

Purchase of service contract child eligibility criteria.

deleted text begin(a)deleted text end A child who is the
subject of a purchase of service contract must:

(1) have the goal of adoption, which may include an adoption in accordance with tribal
law;

(2) be under the guardianship of the commissioner of human services or be a ward of
tribal court pursuant to section 260.755, subdivision 20; and

(3) meet all of the special needs criteria according to section deleted text begin259A.10, subdivision 2deleted text endnew text begin
256N.23, subdivision 2
new text end.

deleted text begin (b) A child under the guardianship of the commissioner must have an identified adoptive
parent and a fully executed adoption placement agreement according to section 260C.613,
subdivision 1
, paragraph (a).
deleted text end

Sec. 23.

Minnesota Statutes 2020, section 259A.75, subdivision 3, is amended to read:


Subd. 3.

Agency eligibility criteria.

(a) A Minnesota countynew text begin or Tribalnew text end social services
agency shall receive reimbursement for child-specific adoption placement services for an
eligible child that it purchases from a private adoption agency licensed in Minnesota or any
other state or tribal social services agency.

(b) Reimbursement for adoption services is available only for services provided prior
to the date of the adoption decree.

Sec. 24.

Minnesota Statutes 2020, section 259A.75, subdivision 4, is amended to read:


Subd. 4.

Application and eligibility determination.

(a) Anew text begin Minnesotanew text end countynew text begin or Tribalnew text end
social services agency may request reimbursement of costs for adoption placement services
by submitting a complete purchase of service application, according to the requirements
and procedures and on forms prescribed by the commissioner.

(b) The commissioner shall determine eligibility for reimbursement of adoption placement
services. If determined eligible, the commissioner of human services shall sign the purchase
of service agreement, making this a fully executed contract. No reimbursement under this
section shall be made to an agency for services provided prior to the fully executed contract.

(c) Separate purchase of service agreements shall be made, and separate records
maintained, on each child. Only one agreement per child per adoptive placement is permitted.
For siblings who are placed together, services shall be planned and provided to best maximize
efficiency of the contracted hours.

Sec. 25.

Minnesota Statutes 2020, section 260C.007, subdivision 22a, is amended to read:


Subd. 22a.

Licensed residential family-based substance use disorder treatment
program.

"Licensed residential family-based substance use disorder treatment program"
means a residential treatment facility that provides the parent or guardian with parenting
skills training, parent education, or individual and family counseling, under an organizational
structure and treatment framework that involves understanding, recognizing, and responding
to the effects of all types of trauma according to recognized principles of a trauma-informed
approach and trauma-specific interventions to address the consequences of trauma and
facilitate healing. The residential program must be licensed by the Department of Human
Services under deleted text beginchapterdeleted text endnew text begin chaptersnew text end 245A and deleted text beginsections 245G.01 to 245G.16, 245G.19, and
245G.21
deleted text endnew text begin 245G or Tribally licensed or approvednew text end as a residential substance use disorder
treatment program specializing in the treatment of clients with children.

Sec. 26.

Minnesota Statutes 2020, section 260C.007, subdivision 26c, is amended to read:


Subd. 26c.

Qualified individual.

new text begin(a) new text end"Qualified individual" means a trained culturally
competent professional or licensed clinician, including a mental health professional under
section 245.4871, subdivision 27, who is deleted text beginnotdeleted text end new text beginqualified to conduct the assessment approved
by the commissioner. The qualified individual must not be
new text end an employee of the responsible
social services agency deleted text beginand who is notdeleted text end new text beginor an individualnew text end connected to or affiliated with any
placement setting in which a responsible social services agency has placed children.

new text begin (b) When the Indian Child Welfare Act of 1978, United States Code, title 25, sections
1901 to 1963, applies to a child, the county must contact the child's tribe without delay to
give the tribe the option to designate a qualified individual who is a trained culturally
competent professional or licensed clinician, including a mental health professional under
section 245.4871, subdivision 27, who is not employed by the responsible social services
agency and who is not connected to or affiliated with any placement setting in which a
responsible social services agency has placed children. Only a federal waiver that
demonstrates maintained objectivity may allow a responsible social services agency employee
or Tribal employee affiliated with any placement setting in which the responsible social
services agency has placed children to be designated the qualified individual.
new text end

Sec. 27.

Minnesota Statutes 2020, section 260C.007, subdivision 31, is amended to read:


Subd. 31.

Sexually exploited youth.

"Sexually exploited youth" means an individual
who:

(1) is alleged to have engaged in conduct which would, if committed by an adult, violate
any federal, state, or local law relating to being hired, offering to be hired, or agreeing to
be hired by another individual to engage in sexual penetration or sexual conduct;

(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
609.3451, 609.3453, 609.352, 617.246, or 617.247;

(3) is a victim of a crime described in United States Code, title 18, section 2260; 2421;
2422; 2423; 2425; 2425A; or 2256; deleted text beginor
deleted text end

(4) is a sex trafficking victim as defined in section 609.321, subdivision 7bdeleted text begin.deleted text endnew text begin; or
new text end

new text begin (5) is a victim of commercial sexual exploitation as defined in United States Code, title
22, section 7102(11)(A) and (12).
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 28.

Minnesota Statutes 2020, section 260C.157, subdivision 3, is amended to read:


Subd. 3.

Juvenile treatment screening team.

(a) The responsible social services agency
shall establish a juvenile treatment screening team to conduct screenings under this chapternew text begin
and chapter 260D,
new text end deleted text beginand section 245.487, subdivision 3,deleted text end for a child to receive treatment for
an emotional disturbance, a developmental disability, or related condition in a residential
treatment facility licensed by the commissioner of human services under chapter 245A, or
licensed or approved by a tribe. A screening team is not required for a child to be in: (1) a
residential facility specializing in prenatal, postpartum, or parenting support; (2) a facility
specializing in high-quality residential care and supportive services to children and youth
who deleted text beginaredeleted text endnew text begin have been or are at risk of becoming victims ofnew text end deleted text beginsex-traffickingdeleted text end new text beginsex trafficking
new text enddeleted text begin victims or are at risk of becoming sex-trafficking victimsdeleted text endnew text begin or commercial sexual exploitationnew text end;
(3) supervised settings for youthnew text begin who arenew text end 18 years deleted text beginolddeleted text endnew text begin of agenew text end or oldernew text begin andnew text end living
independently; or (4) a licensed residential family-based treatment facility for substance
abuse consistent with section 260C.190. Screenings are also not required when a child must
be placed in a facility due to an emotional crisis or other mental health emergency.

(b) The responsible social services agency shall conduct screenings within 15 days of a
request for a screening, unless the screening is for the purpose of residential treatment and
the child is enrolled in a prepaid health program under section 256B.69, in which case the
agency shall conduct the screening within ten working days of a request. The responsible
social services agency shall convene the new text beginjuvenile treatment screening new text endteam, which may be
constituted under section 245.4885 or 256B.092 or Minnesota Rules, parts 9530.6600 to
9530.6655. The team shall consist of social workers; persons with expertise in the treatment
of juveniles who are emotionally deleted text begindisableddeleted text end new text begindisturbednew text end, chemically dependent, or have a
developmental disability; and the child's parent, guardian, or permanent legal custodian.
The team may include the child's relatives as defined in section 260C.007, subdivisions 26b
and 27, the child's foster care provider, and professionals who are a resource to the child's
family such as teachers, medical or mental health providers, and clergy, as appropriate,
consistent with the family and permanency team as defined in section 260C.007, subdivision
16a
. Prior to forming the team, the responsible social services agency must consult with new text beginthe
child's parents,
new text end the child if the child is age 14 or older, deleted text beginthe child's parents,deleted text end and, if applicable,
the child's tribe new text beginto obtain recommendations regarding which individuals to include on the
team and
new text end to ensure that the team is family-centered and will act in the child's best deleted text begininterestdeleted text end
new text begin interestsnew text end. If the child, child's parents, or legal guardians raise concerns about specific relatives
or professionals, the team should not include those individuals. This provision does not
apply to paragraph (c).

(c) If the agency provides notice to tribes under section 260.761, and the child screened
is an Indian child, the responsible social services agency must make a rigorous and concerted
effort to include a designated representative of the Indian child's tribe on the juvenile
treatment screening team, unless the child's tribal authority declines to appoint a
representative. The Indian child's tribe may delegate its authority to represent the child to
any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12.
The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections
1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to
260.835, apply to this section.

(d) If the court, prior to, or as part of, a final disposition or other court order, proposes
to place a child with an emotional disturbance or developmental disability or related condition
in residential treatment, the responsible social services agency must conduct a screening.
If the team recommends treating the child in a qualified residential treatment program, the
agency must follow the requirements of sections 260C.70 to 260C.714.

The court shall ascertain whether the child is an Indian child and shall notify the
responsible social services agency and, if the child is an Indian child, shall notify the Indian
child's tribe as paragraph (c) requires.

(e) When the responsible social services agency is responsible for placing and caring
for the child and the screening team recommends placing a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1)
begin the assessment and processes required in section 260C.704 without delay; and (2)
conduct a relative search according to section 260C.221 to assemble the child's family and
permanency team under section 260C.706. Prior to notifying relatives regarding the family
and permanency team, the responsible social services agency must consult with new text beginthe child's
parent or legal guardian,
new text end the child if the child is age 14 or older, deleted text beginthe child's parentsdeleted text end and, if
applicable, the child's tribe to ensure that the agency is providing notice to individuals who
will act in the child's best deleted text begininterestdeleted text end new text begininterestsnew text end. The child and the child's parents may identify
a culturally competent qualified individual to complete the child's assessment. The agency
shall make efforts to refer the assessment to the identified qualified individual. The
assessment may not be delayed for the purpose of having the assessment completed by a
specific qualified individual.

(f) When a screening team determines that a child does not need treatment in a qualified
residential treatment program, the screening team must:

(1) document the services and supports that will prevent the child's foster care placement
and will support the child remaining at home;

(2) document the services and supports that the agency will arrange to place the child
in a family foster home; or

(3) document the services and supports that the agency has provided in any other setting.

(g) When the Indian child's tribe or tribal health care services provider or Indian Health
Services provider proposes to place a child for the primary purpose of treatment for an
emotional disturbance, a developmental disability, or co-occurring emotional disturbance
and chemical dependency, the Indian child's tribe or the tribe delegated by the child's tribe
shall submit necessary documentation to the county juvenile treatment screening team,
which must invite the Indian child's tribe to designate a representative to the screening team.

(h) The responsible social services agency must conduct and document the screening in
a format approved by the commissioner of human services.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 29.

Minnesota Statutes 2020, section 260C.212, subdivision 1, is amended to read:


Subdivision 1.

Out-of-home placement; plan.

(a) An out-of-home placement plan shall
be prepared within 30 days after any child is placed in foster care by court order or a
voluntary placement agreement between the responsible social services agency and the
child's parent pursuant to section 260C.227 or chapter 260D.

(b) An out-of-home placement plan means a written document which is prepared by the
responsible social services agency jointly with the parent or parents or guardian of the child
and in consultation with the child's guardian ad litem, the child's tribe, if the child is an
Indian child, the child's foster parent or representative of the foster care facility, and, where
appropriate, the child. When a child is age 14 or older, the child may include two other
individuals on the team preparing the child's out-of-home placement plan. The child may
select one member of the case planning team to be designated as the child's advisor and to
advocate with respect to the application of the reasonable and prudent parenting standards.
The responsible social services agency may reject an individual selected by the child if the
agency has good cause to believe that the individual would not act in the best interest of the
child. For a child in voluntary foster care for treatment under chapter 260D, preparation of
the out-of-home placement plan shall additionally include the child's mental health treatment
provider. For a child 18 years of age or older, the responsible social services agency shall
involve the child and the child's parents as appropriate. As appropriate, the plan shall be:

(1) submitted to the court for approval under section 260C.178, subdivision 7;

(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and

(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem,
a representative of the child's tribe, the responsible social services agency, and, if possible,
the child.

(c) The out-of-home placement plan shall be explained to all persons involved in its
implementation, including the child who has signed the plan, and shall set forth:

(1) a description of the foster care home or facility selected, including how the
out-of-home placement plan is designed to achieve a safe placement for the child in the
least restrictive, most family-like, setting available which is in close proximity to the home
of the parent or parents or guardian of the child when the case plan goal is reunification,
and how the placement is consistent with the best interests and special needs of the child
according to the factors under subdivision 2, paragraph (b);

(2) the specific reasons for the placement of the child in foster care, and when
reunification is the plan, a description of the problems or conditions in the home of the
parent or parents which necessitated removal of the child from home and the changes the
parent or parents must make for the child to safely return home;

(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:

(i) the specific actions to be taken by the parent or parents of the child to eliminate or
correct the problems or conditions identified in clause (2), and the time period during which
the actions are to be taken; and

(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to
achieve a safe and stable home for the child including social and other supportive services
to be provided or offered to the parent or parents or guardian of the child, the child, and the
residential facility during the period the child is in the residential facility;

(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if not,
the basis for the denial of the services or resources;

(5) the visitation plan for the parent or parents or guardian, other relatives as defined in
section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not
placed together in foster care, and whether visitation is consistent with the best interest of
the child, during the period the child is in foster care;

(6) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize adoption as the permanency plan for the child through reasonable efforts
to place the child for adoption. At a minimum, the documentation must include consideration
of whether adoption is in the best interests of the child, child-specific recruitment efforts
such as relative search and the use of state, regional, and national adoption exchanges to
facilitate orderly and timely placements in and outside of the state. A copy of this
documentation shall be provided to the court in the review required under section 260C.317,
subdivision 3, paragraph (b);

(7) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize the transfer of permanent legal and physical custody to a relative as the
permanency plan for the child. This documentation must support the requirements of the
kinship placement agreement under section 256N.22 and must include the reasonable efforts
used to determine that it is not appropriate for the child to return home or be adopted, and
reasons why permanent placement with a relative through a Northstar kinship assistance
arrangement is in the child's best interest; how the child meets the eligibility requirements
for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's
relative foster parent and reasons why the relative foster parent chose not to pursue adoption,
if applicable; and agency efforts to discuss with the child's parent or parents the permanent
transfer of permanent legal and physical custody or the reasons why these efforts were not
made;

(8) efforts to ensure the child's educational stability while in foster care for a child who
attained the minimum age for compulsory school attendance under state law and is enrolled
full time in elementary or secondary school, or instructed in elementary or secondary
education at home, or instructed in an independent study elementary or secondary program,
or incapable of attending school on a full-time basis due to a medical condition that is
documented and supported by regularly updated information in the child's case plan.
Educational stability efforts include:

(i) efforts to ensure that the child remains in the same school in which the child was
enrolled prior to placement or upon the child's move from one placement to another, including
efforts to work with the local education authorities to ensure the child's educational stability
and attendance; or

(ii) if it is not in the child's best interest to remain in the same school that the child was
enrolled in prior to placement or move from one placement to another, efforts to ensure
immediate and appropriate enrollment for the child in a new school;

(9) the educational records of the child including the most recent information available
regarding:

(i) the names and addresses of the child's educational providers;

(ii) the child's grade level performance;

(iii) the child's school record;

(iv) a statement about how the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of placement; and

(v) any other relevant educational information;

(10) the efforts by the responsible social services agency to ensure the oversight and
continuity of health care services for the foster child, including:

(i) the plan to schedule the child's initial health screens;

(ii) how the child's known medical problems and identified needs from the screens,
including any known communicable diseases, as defined in section 144.4172, subdivision
2, shall be monitored and treated while the child is in foster care;

(iii) how the child's medical information shall be updated and shared, including the
child's immunizations;

(iv) who is responsible to coordinate and respond to the child's health care needs,
including the role of the parent, the agency, and the foster parent;

(v) who is responsible for oversight of the child's prescription medications;

(vi) how physicians or other appropriate medical and nonmedical professionals shall be
consulted and involved in assessing the health and well-being of the child and determine
the appropriate medical treatment for the child; and

(vii) the responsibility to ensure that the child has access to medical care through either
medical insurance or medical assistance;

(11) the health records of the child including information available regarding:

(i) the names and addresses of the child's health care and dental care providers;

(ii) a record of the child's immunizations;

(iii) the child's known medical problems, including any known communicable diseases
as defined in section 144.4172, subdivision 2;

(iv) the child's medications; and

(v) any other relevant health care information such as the child's eligibility for medical
insurance or medical assistance;

(12) an independent living plan for a child 14 years of age or older, developed in
consultation with the child. The child may select one member of the case planning team to
be designated as the child's advisor and to advocate with respect to the application of the
reasonable and prudent parenting standards in subdivision 14. The plan should include, but
not be limited to, the following objectives:

(i) educational, vocational, or employment planning;

(ii) health care planning and medical coverage;

(iii) transportation including, where appropriate, assisting the child in obtaining a driver's
license;

(iv) money management, including the responsibility of the responsible social services
agency to ensure that the child annually receives, at no cost to the child, a consumer report
as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies
in the report;

(v) planning for housing;

(vi) social and recreational skills;

(vii) establishing and maintaining connections with the child's family and community;
and

(viii) regular opportunities to engage in age-appropriate or developmentally appropriate
activities typical for the child's age group, taking into consideration the capacities of the
individual child;

(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic
and assessment information, specific services relating to meeting the mental health care
needs of the child, and treatment outcomes;

(14) for a child 14 years of age or older, a signed acknowledgment that describes the
child's rights regarding education, health care, visitation, safety and protection from
exploitation, and court participation; receipt of the documents identified in section 260C.452;
and receipt of an annual credit report. The acknowledgment shall state that the rights were
explained in an age-appropriate manner to the child; and

(15) for a child placed in a qualified residential treatment program, the plan must include
the requirements in section 260C.708.

(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time of
placement of the child. The child shall also have the right to a guardian ad litem. If unable
to employ counsel from their own resources, the court shall appoint counsel upon the request
of the parent or parents or the child or the child's legal guardian. The parent or parents may
also receive assistance from any person or social services agency in preparation of the case
plan.

After the plan has been agreed upon by the parties involved or approved or ordered by
the court, the foster parents shall be fully informed of the provisions of the case plan and
shall be provided a copy of the plan.

Uponnew text begin the child'snew text end discharge from foster care, thenew text begin responsible social services agency must
provide the child's
new text end parent, adoptive parent, or permanent legal and physical custodian, deleted text beginas
appropriate,
deleted text end and the child, if deleted text beginappropriate, must be provideddeleted text endnew text begin the child is 14 years of age or
older,
new text end with a current copy of the child's health and education record.new text begin If a child meets the
conditions in subdivision 15, paragraph (b), the agency must also provide the child with the
child's social and medical history. The responsible social services agency may give a copy
of the child's health and education record and social and medical history to a child who is
younger than 14 years of age, if it is appropriate and if subdivision 15, paragraph (b), applies.
new text end

Sec. 30.

Minnesota Statutes 2020, section 260C.212, subdivision 1a, is amended to read:


Subd. 1a.

Out-of-home placement plan update.

(a) Within 30 days of placing the child
in foster care, the agency must file thenew text begin child'snew text end initial out-of-home placement plan with the
court. After filing thenew text begin child'snew text end initial out-of-home placement plan, the agency shall update
and file thenew text begin child'snew text end out-of-home placement plan with the court as follows:

(1) when the agency moves a child to a different foster care setting, the agency shall
inform the court within 30 days of the new text beginchild's new text endplacement change or court-ordered trial home
visit. The agency must file the new text beginchild's new text endupdated out-of-home placement plan with the court
at the next required review hearing;

(2) when the agency places a child in a qualified residential treatment program as defined
in section 260C.007, subdivision 26d, or moves a child from one qualified residential
treatment program to a different qualified residential treatment program, the agency must
update thenew text begin child'snew text end out-of-home placement plan within 60 days. To meet the requirements
of section 260C.708, the agency must file thenew text begin child'snew text end out-of-home placement plan deleted text beginwith the
court as part of the 60-day hearing and
deleted text endnew text begin along with the agency's report seeking the court's
approval of the child's placement at a qualified residential treatment program under section
260C.71. After the court issues an order, the agency
new text end must update thenew text begin child's out-of-home
placement
new text end plan deleted text beginafter the court hearingdeleted text end to document the court's approval or disapproval of
the child's placement in a qualified residential treatment program;

(3) when the agency places a child with the child's parent in a licensed residential
family-based substance use disorder treatment program under section 260C.190, the agency
must identify the treatment programnew text begin where the child will be placednew text end in the child's out-of-home
placement plan prior to the child's placement. The agency must file thenew text begin child'snew text end out-of-home
placement plan with the court at the next required review hearing; and

(4) under sections 260C.227 and 260C.521, the agency must update thenew text begin child'snew text end
out-of-home placement plan and file thenew text begin child's out-of-home placementnew text end plan with the court.

(b) When none of the items in paragraph (a) apply, the agency must update thenew text begin child'snew text end
out-of-home placement plan no later than 180 days after the child's initial placement and
every six months thereafter, consistent with section 260C.203, paragraph (a).

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 31.

Minnesota Statutes 2020, section 260C.212, subdivision 2, is amended to read:


Subd. 2.

Placement decisions based on best interests of the child.

(a) The policy of
the state of Minnesota is to ensure that the child's best interests are met by requiring an
individualized determination of the needs of the child and of how the selected placement
will serve the needs of the child being placed. The authorized child-placing agency shall
place a child, released by court order or by voluntary release by the parent or parents, in a
family foster home selected by considering placement with relatives and important friends
in the following order:

(1) with an individual who is related to the child by blood, marriage, or adoptionnew text begin,
including the legal parent, guardian, or custodian of the child's siblings
new text end; or

(2) with an individual who is an important friend with whom the child has resided or
had significant contact.

For an Indian child, the agency shall follow the order of placement preferences in the Indian
Child Welfare Act of 1978, United States Code, title 25, section 1915.

(b) Among the factors the agency shall consider in determining the needs of the child
are the following:

(1) the child's current functioning and behaviors;

(2) the medical needs of the child;

(3) the educational needs of the child;

(4) the developmental needs of the child;

(5) the child's history and past experience;

(6) the child's religious and cultural needs;

(7) the child's connection with a community, school, and faith community;

(8) the child's interests and talents;

(9) the child's relationship to current caretakers, parents, siblings, and relatives;

(10) the reasonable preference of the child, if the court, or the child-placing agency in
the case of a voluntary placement, deems the child to be of sufficient age to express
preferences; and

(11) for an Indian child, the best interests of an Indian child as defined in section 260.755,
subdivision 2a
.

(c) Placement of a child cannot be delayed or denied based on race, color, or national
origin of the foster parent or the child.

(d) Siblings should be placed together for foster care and adoption at the earliest possible
time unless it is documented that a joint placement would be contrary to the safety or
well-being of any of the siblings or unless it is not possible after reasonable efforts by the
responsible social services agency. In cases where siblings cannot be placed together, the
agency is required to provide frequent visitation or other ongoing interaction between
siblings unless the agency documents that the interaction would be contrary to the safety
or well-being of any of the siblings.

(e) Except for emergency placement as provided for in section 245A.035, the following
requirements must be satisfied before the approval of a foster or adoptive placement in a
related or unrelated home: (1) a completed background study under section 245C.08; and
(2) a completed review of the written home study required under section 260C.215,
subdivision 4
, clause (5), or 260C.611, to assess the capacity of the prospective foster or
adoptive parent to ensure the placement will meet the needs of the individual child.

(f) The agency must determine whether colocation with a parent who is receiving services
in a licensed residential family-based substance use disorder treatment program is in the
child's best interests according to paragraph (b) and include that determination in the child's
case plan under subdivision 1. The agency may consider additional factors not identified
in paragraph (b). The agency's determination must be documented in the child's case plan
before the child is colocated with a parent.

(g) The agency must establish a juvenile treatment screening team under section 260C.157
to determine whether it is necessary and appropriate to recommend placing a child in a
qualified residential treatment program, as defined in section 260C.007, subdivision 26d.

Sec. 32.

Minnesota Statutes 2020, section 260C.212, subdivision 13, is amended to read:


Subd. 13.

Protecting missing and runaway children and youth at risk of sex
traffickingnew text begin or commercial sexual exploitationnew text end.

(a) The local social services agency shall
expeditiously locate any child missing from foster care.

(b) The local social services agency shall report immediately, but no later than 24 hours,
after receiving information on a missing or abducted child to the local law enforcement
agency for entry into the National Crime Information Center (NCIC) database of the Federal
Bureau of Investigation, and to the National Center for Missing and Exploited Children.

(c) The local social services agency shall not discharge a child from foster care or close
the social services case until diligent efforts have been exhausted to locate the child and the
court terminates the agency's jurisdiction.

(d) The local social services agency shall determine the primary factors that contributed
to the child's running away or otherwise being absent from care and, to the extent possible
and appropriate, respond to those factors in current and subsequent placements.

(e) The local social services agency shall determine what the child experienced while
absent from care, including screening the child to determine if the child is a possible sex
traffickingnew text begin or commercial sexual exploitationnew text end victim as defined in section deleted text begin609.321,
subdivision 7b
deleted text endnew text begin 260C.007, subdivision 31new text end.

(f) The local social services agency shall report immediately, but no later than 24 hours,
to the local law enforcement agency any reasonable cause to believe a child is, or is at risk
of being, a sex traffickingnew text begin or commercial sexual exploitationnew text end victim.

(g) The local social services agency shall determine appropriate services as described
in section 145.4717 with respect to any child for whom the local social services agency has
responsibility for placement, care, or supervision when the local social services agency has
reasonable cause to believenew text begin thatnew text end the child is, or is at risk of being, a sex traffickingnew text begin or
commercial sexual exploitation
new text end victim.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 33.

Minnesota Statutes 2020, section 260C.212, is amended by adding a subdivision
to read:


new text begin Subd. 15.new text end

new text beginSocial and medical history.new text end

new text begin(a) The responsible social services agency must
complete each child's social and medical history using forms developed by the commissioner.
The responsible social services agency must work with each child's birth family, foster
family, medical and treatment providers, and school to ensure that there is a detailed and
up-to-date social and medical history of the child on forms provided by the commissioner.
new text end

new text begin (b) If the child continues to be in placement out of the home of the parent or guardian
from whom the child was removed, reasonable efforts by the responsible social services
agency to complete the child's social and medical history must begin no later than the child's
permanency progress review hearing required under section 260C.204 or six months after
the child's placement in foster care, whichever occurs earlier.
new text end

new text begin (c) In a child's social and medical history, the responsible social services agency must
include background information and health history specific to the child, the child's birth
parents, and the child's other birth relatives. Applicable background and health information
about the child includes the child's current health condition, behavior, and demeanor;
placement history; education history; sibling information; and birth, medical, dental, and
immunization information. Redacted copies of pertinent records, assessments, and evaluations
must be attached to the child's social and medical history. Applicable background information
about the child's birth parents and other birth relatives includes general background
information; education and employment history; physical health and mental health history;
and reasons for the child's placement.
new text end

Sec. 34.

Minnesota Statutes 2020, section 260C.219, subdivision 5, is amended to read:


Subd. 5.

Children reaching age of majority; copies of records.

new text beginRegardless of new text endwhethernew text begin
a child is
new text end under state guardianship deleted text beginor notdeleted text end, if a child leaves foster care by reason of having
attained the age of majority under state law, the child must be given at no cost a copy of
the child's social and medical history, as deleted text begindefineddeleted text endnew text begin describednew text end in section deleted text begin259.43,deleted text endnew text begin 260C.212,
subdivision 15, including the child's health
new text end and education report.

Sec. 35.

Minnesota Statutes 2020, section 260C.4412, is amended to read:


260C.4412 PAYMENT FOR RESIDENTIAL PLACEMENTS.

(a) When a child is placed in a foster care group residential setting under Minnesota
Rules, parts 2960.0020 to 2960.0710, a foster residence licensed under chapter 245A that
meets the standards of Minnesota Rules, parts 2960.3200 to 2960.3230, or a children's
residential facility licensed or approved by a tribe, foster care maintenance payments must
be made on behalf of the child to cover the cost of providing food, clothing, shelter, daily
supervision, school supplies, child's personal incidentals and supports, reasonable travel for
visitation, or other transportation needs associated with the items listed. Daily supervision
in the group residential setting includes routine day-to-day direction and arrangements to
ensure the well-being and safety of the child. It may also include reasonable costs of
administration and operation of the facility.

(b) The commissioner of human services shall specify the title IV-E administrative
procedures under section 256.82 for each of the following residential program settings:

(1) residential programs licensed under chapter 245A or licensed by a tribe, including:

(i) qualified residential treatment programs as defined in section 260C.007, subdivision
26d
;

(ii) program settings specializing in providing prenatal, postpartum, or parenting supports
for youth; and

(iii) program settings providing high-quality residential care and supportive services to
children and youth who are, or are at risk of becoming, sex trafficking victims;

(2) licensed residential family-based substance use disorder treatment programs as
defined in section 260C.007, subdivision 22a; and

(3) supervised settings in which a foster child age 18 or older may live independently,
consistent with section 260C.451.

new text begin (c) A lead contract under section 256.0112, subdivision 6, is not required to establish
the foster care maintenance payment in paragraph (a) for foster residence settings licensed
under chapter 245A that meet the standards of Minnesota Rules, parts 2960.3200 to
2960.3230. The foster care maintenance payment for these settings must be consistent with
section 256N.26, subdivision 3, and subject to the annual revision as specified in section
256N.26, subdivision 9.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective for placements made in licensed residential
settings after September 30, 2021.
new text end

Sec. 36.

Minnesota Statutes 2020, section 260C.452, is amended to read:


260C.452 SUCCESSFUL TRANSITION TO ADULTHOOD.

Subdivision 1.

Scopenew text begin; purposenew text end.

new text begin(a) For purposes of this section, "youth" means a person
who is at least 14 years of age and under 23 years of age.
new text end

new text begin (b) new text endThis section pertains to a deleted text beginchilddeleted text endnew text begin youthnew text end whonew text begin:
new text end

new text begin (1)new text end isnew text begin in foster care and is 14 years of age or older, including a youth who isnew text end under the
guardianship of the commissioner of human servicesdeleted text begin, or whodeleted text endnew text begin;
new text end

new text begin (2)new text end has a permanency disposition of permanent custody to the agencydeleted text begin, or whodeleted text endnew text begin;
new text end

new text begin (3)new text end will leave foster care deleted text beginat 18 to 21 years of age.deleted text endnew text begin when the youth is 18 years of age or
older and under 21 years of age;
new text end

new text begin (4) has left foster care due to adoption when the youth was 16 years of age or older;
new text end

new text begin (5) has left foster care due to a transfer of permanent legal and physical custody to a
relative, or Tribal equivalent, when the youth was 16 years of age or older; or
new text end

new text begin (6) was reunified with the youth's primary caretaker when the youth was 14 years of age
or older and under 18 years of age.
new text end

new text begin (c) The purpose of this section is to provide support to each youth who is transitioning
to adulthood by providing services to the youth in the areas of:
new text end

new text begin (1) education;
new text end

new text begin (2) employment;
new text end

new text begin (3) daily living skills such as financial literacy training and driving instruction, preventive
health activities including promoting abstinence from substance use and smoking, and
nutrition education and pregnancy prevention;
new text end

new text begin (4) forming meaningful, permanent connections with caring adults;
new text end

new text begin (5) engaging in age-appropriate and developmentally appropriate activities under section
260C.212, subdivision 14, and positive youth development;
new text end

new text begin (6) financial, housing, counseling, and other services to assist a youth over 18 years of
age in achieving self-sufficiency and accepting personal responsibility for the transition
from adolescence to adulthood; and
new text end

new text begin (7) making vouchers available for education and training.
new text end

new text begin (d) The responsible social services agency may provide support and case management
services to a youth as defined in paragraph (a) until the youth reaches 23 years of age.
According to section 260C.451, a youth's placement in a foster care setting will end when
the youth reaches 21 years of age.
new text end

new text begin Subd. 1a.new text end

new text beginCase management services.new text end

new text beginCase management services include the
responsibility for planning, coordinating, authorizing, monitoring, and evaluating services
for a youth and shall be provided to a youth by the responsible social services agency or
the contracted agency. Case management services include the out-of-home placement plan
under section 260C.212, subdivision 1, when the youth is in out-of-home placement.
new text end

Subd. 2.

Independent living plan.

When the deleted text beginchilddeleted text endnew text begin youthnew text end is 14 years of age or oldernew text begin and
is receiving support from the responsible social services agency under this section
new text end, the
responsible social services agency, in consultation with the deleted text beginchilddeleted text endnew text begin youthnew text end, shall complete thenew text begin
youth's
new text end independent living plan according to section 260C.212, subdivision 1, paragraph
(c), clause (12)new text begin, regardless of the youth's current placement statusnew text end.

deleted text begin Subd. 3.deleted text end

deleted text beginNotification.deleted text end

deleted text beginSix months before the child is expected to be discharged from
foster care, the responsible social services agency shall provide written notice to the child
regarding the right to continued access to services for certain children in foster care past 18
years of age and of the right to appeal a denial of social services under section 256.045.
deleted text end

Subd. 4.

Administrative or court review of placements.

(a) When the deleted text beginchilddeleted text endnew text begin youthnew text end is
14 years of age or older, the court, in consultation with the deleted text beginchilddeleted text endnew text begin youthnew text end, shall review thenew text begin
youth's
new text end independent living plan according to section 260C.203, paragraph (d).

(b) The responsible social services agency shall file a copy of the notification deleted text beginrequired
in subdivision 3
deleted text endnew text begin of foster care benefits for a youth who is 18 years of age or older according
to section 260C.451, subdivision 1,
new text end with the court. If the responsible social services agency
does not file the notice by the time the deleted text beginchilddeleted text endnew text begin youthnew text end is 17-1/2 years of age, the court shall
require the responsible social services agency to file the notice.

(c) new text beginWhen a youth is 18 years of age or older, new text endthe court shall ensure that the responsible
social services agency assists the deleted text beginchilddeleted text endnew text begin youthnew text end in obtaining the following documents before
the deleted text beginchilddeleted text endnew text begin youthnew text end leaves foster care: a Social Security card; an official or certified copy of the
deleted text begin child'sdeleted text endnew text begin youth'snew text end birth certificate; a state identification card or driver's license, tribal enrollment
identification card, green card, or school visa; health insurance information; the deleted text beginchild'sdeleted text endnew text begin
youth's
new text end school, medical, and dental records; a contact list of the deleted text beginchild'sdeleted text endnew text begin youth'snew text end medical,
dental, and mental health providers; and contact information for the deleted text beginchild'sdeleted text endnew text begin youth'snew text end siblings,
if the siblings are in foster care.

(d) For a deleted text beginchilddeleted text endnew text begin youthnew text end who will be discharged from foster care at 18 years of age or older
new text begin because the youth is not eligible for extended foster care benefits or chooses to leave foster
care
new text end, the responsible social services agency must develop a personalized transition plan as
directed by the deleted text beginchilddeleted text endnew text begin youthnew text end during the deleted text begin90-daydeleted text end new text begin180-daynew text end period immediately prior to the
expected date of discharge. The transition plan must be as detailed as the deleted text beginchilddeleted text endnew text begin youthnew text end elects
and include specific options, including but not limited to:

(1) affordable housing with necessary supports that does not include a homeless shelter;

(2) health insurance, including eligibility for medical assistance as defined in section
256B.055, subdivision 17;

(3) education, including application to the Education and Training Voucher Program;

(4) local opportunities for mentors and continuing support servicesdeleted text begin, including the Healthy
Transitions and Homeless Prevention program, if available
deleted text end;

(5) workforce supports and employment services;

(6) a copy of the deleted text beginchild'sdeleted text endnew text begin youth'snew text end consumer credit report as defined in section 13C.001
and assistance in interpreting and resolving any inaccuracies in the report, at no cost to the
deleted text begin childdeleted text endnew text begin youthnew text end;

(7) information on executing a health care directive under chapter 145C and on the
importance of designating another individual to make health care decisions on behalf of the
deleted text begin childdeleted text endnew text begin youthnew text end if the deleted text beginchilddeleted text endnew text begin youthnew text end becomes unable to participate in decisions;

(8) appropriate contact information through 21 years of age if the deleted text beginchilddeleted text endnew text begin youthnew text end needs
information or help dealing with a crisis situation; and

(9) official documentation that the youth was previously in foster care.

Subd. 5.

Notice of termination of deleted text beginfoster caredeleted text endnew text begin social servicesnew text end.

(a) deleted text beginWhendeleted text endnew text begin Beforenew text end a deleted text beginchilddeleted text endnew text begin
youth who is 18 years of age or older
new text end leaves foster care deleted text beginat 18 years of age or olderdeleted text end, the
responsible social services agency shall give the deleted text beginchilddeleted text endnew text begin youthnew text end written notice that foster care
shall terminate 30 days from the datenew text begin thatnew text end the notice is sentnew text begin by the agency according to
section 260C.451, subdivision 8
new text end.

deleted text begin (b) The child or the child's guardian ad litem may file a motion asking the court to review
the responsible social services agency's determination within 15 days of receiving the notice.
The child shall not be discharged from foster care until the motion is heard. The responsible
social services agency shall work with the child to transition out of foster care.
deleted text end

deleted text begin (c) The written notice of termination of benefits shall be on a form prescribed by the
commissioner and shall give notice of the right to have the responsible social services
agency's determination reviewed by the court under this section or sections 260C.203,
260C.317, and 260C.515, subdivision 5 or 6. A copy of the termination notice shall be sent
to the child and the child's attorney, if any, the foster care provider, the child's guardian ad
litem, and the court. The responsible social services agency is not responsible for paying
foster care benefits for any period of time after the child leaves foster care.
deleted text end

new text begin (b) Before case management services will end for a youth who is at least 18 years of
age and under 23 years of age, the responsible social services agency shall give the youth:
(1) written notice that case management services for the youth shall terminate; and (2)
written notice that the youth has the right to appeal the termination of case management
services under section 256.045, subdivision 3, by responding in writing within ten days of
the date that the agency mailed the notice. The termination notice must include information
about services for which the youth is eligible and how to access the services.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

Sec. 37.

Minnesota Statutes 2020, section 260C.503, subdivision 2, is amended to read:


Subd. 2.

Termination of parental rights.

(a) The responsible social services agency
must ask the county attorney to immediately file a termination of parental rights petition
when:

(1) the child has been subjected to egregious harm as defined in section 260C.007,
subdivision 14;

(2) the child is determined to be the sibling of a child who was subjected to egregious
harm;

(3) the child is an abandoned infant as defined in section 260C.301, subdivision 2,
paragraph (a), clause (2);

(4) the child's parent has lost parental rights to another child through an order involuntarily
terminating the parent's rights;

(5) the parent has committed sexual abuse as defined in section 260E.03, against the
child or another child of the parent;

(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or

(7) another child of the parent is the subject of an order involuntarily transferring
permanent legal and physical custody of the child to a relative under this chapter or a similar
law of another jurisdiction;

The county attorney shall file a termination of parental rights petition unless the conditions
of paragraph (d) are met.

(b) When the termination of parental rights petition is filed under this subdivision, the
responsible social services agency shall identify, recruit, and approve an adoptive family
for the child. If a termination of parental rights petition has been filed by another party, the
responsible social services agency shall be joined as a party to the petition.

(c) If criminal charges have been filed against a parent arising out of the conduct alleged
to constitute egregious harm, the county attorney shall determine which matter should
proceed to trial first, consistent with the best interests of the child and subject to the
defendant's right to a speedy trial.

(d) The requirement of paragraph (a) does not apply if the responsible social services
agency and the county attorney determine and file with the court:

(1) a petition for transfer of permanent legal and physical custody to a relative under
sections 260C.505 and 260C.515, subdivision deleted text begin3deleted text endnew text begin 4new text end, including a determination that adoption
is not in the child's best interests and that transfer of permanent legal and physical custody
is in the child's best interests; or

(2) a petition under section 260C.141 alleging the child, and where appropriate, the
child's siblings, to be in need of protection or services accompanied by a case plan prepared
by the responsible social services agency documenting a compelling reason why filing a
termination of parental rights petition would not be in the best interests of the child.

Sec. 38.

Minnesota Statutes 2020, section 260C.515, subdivision 3, is amended to read:


Subd. 3.

Guardianship; commissioner.

The court may new text beginissue an new text endorder new text beginthat the child is
under the
new text endguardianship deleted text begintodeleted text endnew text begin ofnew text end the commissioner of human services under the following
procedures and conditions:

(1) there is an identified prospective adoptive parent agreed to by the responsible social
services agency deleted text beginhavingdeleted text endnew text begin that hasnew text end legal custody of the child pursuant to court order under this
chapter and that prospective adoptive parent has agreed to adopt the child;

(2) the court accepts the parent's voluntary consent to adopt in writing on a form
prescribed by the commissioner, executed before two competent witnesses and confirmed
by the consenting parent before the court or executed before the court. The consent shall
contain notice that consent given under this chapter:

(i) is irrevocable upon acceptance by the court unless fraud is established and an order
is issued permitting revocation as stated in clause (9) unless the matter is governed by the
Indian Child Welfare Act, United States Code, title 25, section 1913(c); and

(ii) will result in an order that the child is under the guardianship of the commissioner
of human services;

(3) a consent executed and acknowledged outside of this state, either in accordance with
the law of this state or in accordance with the law of the place where executed, is valid;

(4) the court must review the matter at least every 90 days under section 260C.317;

(5) a consent to adopt under this subdivision vests guardianship of the child with the
commissioner of human services and makes the child a ward of the commissioner of human
services under section 260C.325;

(6) the court must forward to the commissioner a copy of the consent to adopt, together
with a certified copy of the order transferring guardianship to the commissioner;

(7) if an adoption is not finalized by the identified prospective adoptive parent within
six months of the execution of the consent to adopt under this clause, the responsible social
services agency shall pursue adoptive placement in another home unless the court finds in
a hearing under section 260C.317 that the failure to finalize is not due to either an action
or a failure to act by the prospective adoptive parent;

(8) notwithstanding clause (7), the responsible social services agency must pursue
adoptive placement in another home as soon as the agency determines that finalization of
the adoption with the identified prospective adoptive parent is not possible, that the identified
prospective adoptive parent is not willing to adopt the child, or that the identified prospective
adoptive parent is not cooperative in completing the steps necessary to finalize the adoptionnew text begin.
The court may order a termination of parental rights under subdivision 2
new text end; and

(9) unless otherwise required by the Indian Child Welfare Act, United States Code, title
25, section 1913(c), a consent to adopt executed under this section shall be irrevocable upon
acceptance by the court except upon order permitting revocation issued by the same court
after written findings that consent was obtained by fraud.

Sec. 39.

Minnesota Statutes 2020, section 260C.605, subdivision 1, is amended to read:


Subdivision 1.

Requirements.

(a) Reasonable efforts to finalize the adoption of a child
under the guardianship of the commissioner shall be made by the responsible social services
agency responsible for permanency planning for the child.

(b) Reasonable efforts to make a placement in a home according to the placement
considerations under section 260C.212, subdivision 2, with a relative or foster parent who
will commit to being the permanent resource for the child in the event the child cannot be
reunified with a parent are required under section 260.012 and may be made concurrently
with reasonable, or if the child is an Indian child, active efforts to reunify the child with the
parent.

(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the
child is in foster care under this chapter, but not later than the hearing required under section
260C.204.

(d) Reasonable efforts to finalize the adoption of the child include:

(1) using age-appropriate engagement strategies to plan for adoption with the child;

(2) identifying an appropriate prospective adoptive parent for the child by updating the
child's identified needs using the factors in section 260C.212, subdivision 2;

(3) making an adoptive placement that meets the child's needs by:

(i) completing or updating the relative search required under section 260C.221 and giving
notice of the need for an adoptive home for the child to:

(A) relatives who have kept the agency or the court apprised of their whereabouts and
who have indicated an interest in adopting the child; or

(B) relatives of the child who are located in an updated search;

(ii) an updated search is required whenever:

(A) there is no identified prospective adoptive placement for the child notwithstanding
a finding by the court that the agency made diligent efforts under section 260C.221, in a
hearing required under section 260C.202;

(B) the child is removed from the home of an adopting parent; or

(C) the court determines a relative search by the agency is in the best interests of the
child;

(iii) engaging the child's foster parent and the child's relatives identified as an adoptive
resource during the search conducted under section 260C.221, to commit to being the
prospective adoptive parent of the child; or

(iv) when there is no identified prospective adoptive parent:

(A) registering the child on the state adoption exchange as required in section 259.75
unless the agency documents to the court an exception to placing the child on the state
adoption exchange reported to the commissioner;

(B) reviewing all families with approved adoption home studies associated with the
responsible social services agency;

(C) presenting the child to adoption agencies and adoption personnel who may assist
with finding an adoptive home for the child;

(D) using newspapers and other media to promote the particular child;

(E) using a private agency under grant contract with the commissioner to provide adoption
services for intensive child-specific recruitment efforts; and

(F) making any other efforts or using any other resources reasonably calculated to identify
a prospective adoption parent for the child;

(4) updating and completing the social and medical history required under sections
deleted text begin 259.43deleted text endnew text begin 260C.212, subdivision 15,new text end and 260C.609;

(5) making, and keeping updated, appropriate referrals required by section 260.851, the
Interstate Compact on the Placement of Children;

(6) giving notice regarding the responsibilities of an adoptive parent to any prospective
adoptive parent as required under section 259.35;

(7) offering the adopting parent the opportunity to apply for or decline adoption assistance
under chapter deleted text begin259Adeleted text endnew text begin 256Nnew text end;

(8) certifying the child for adoption assistance, assessing the amount of adoption
assistance, and ascertaining the status of the commissioner's decision on the level of payment
if the adopting parent has applied for adoption assistance;

(9) placing the child with siblings. If the child is not placed with siblings, the agency
must document reasonable efforts to place the siblings together, as well as the reason for
separation. The agency may not cease reasonable efforts to place siblings together for final
adoption until the court finds further reasonable efforts would be futile or that placement
together for purposes of adoption is not in the best interests of one of the siblings; and

(10) working with the adopting parent to file a petition to adopt the child and with the
court administrator to obtain a timely hearing to finalize the adoption.

Sec. 40.

Minnesota Statutes 2020, section 260C.607, subdivision 6, is amended to read:


Subd. 6.

Motion and hearing to order adoptive placement.

(a) At any time after the
district court orders the child under the guardianship of the commissioner of human services,
but not later than 30 days after receiving notice required under section 260C.613, subdivision
1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's
foster parent may file a motion for an order for adoptive placement of a child who is under
the guardianship of the commissioner if the relative or the child's foster parent:

(1) has an adoption home study under section 259.41 approving the relative or foster
parent for adoption and has been a resident of Minnesota for at least six months before filing
the motion; the court may waive the residency requirement for the moving party if there is
a reasonable basis to do so; or

(2) is not a resident of Minnesota, but has an approved adoption home study by an agency
licensed or approved to complete an adoption home study in the state of the individual's
residence and the study is filed with the motion for adoptive placement.

(b) The motion shall be filed with the court conducting reviews of the child's progress
toward adoption under this section. The motion and supporting documents must make a
prima facie showing that the agency has been unreasonable in failing to make the requested
adoptive placement. The motion must be served according to the requirements for motions
under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all
individuals and entities listed in subdivision 2.

(c) If the motion and supporting documents do not make a prima facie showing for the
court to determine whether the agency has been unreasonable in failing to make the requested
adoptive placement, the court shall dismiss the motion. If the court determines a prima facie
basis is made, the court shall set the matter for evidentiary hearing.

(d) At the evidentiary hearing, the responsible social services agency shall proceed first
with evidence about the reason for not making the adoptive placement proposed by the
moving party. The moving party then has the burden of proving by a preponderance of the
evidence that the agency has been unreasonable in failing to make the adoptive placement.

(e) At the conclusion of the evidentiary hearing, if the court finds that the agency has
been unreasonable in failing to make the adoptive placement and that the relative or the
child's foster parent is the most suitable adoptive home to meet the child's needs using the
factors in section 260C.212, subdivision 2, paragraph (b), the court may order the responsible
social services agency to make an adoptive placement in the home of the relative or the
child's foster parent.

(f) If, in order to ensure that a timely adoption may occur, the court orders the responsible
social services agency to make an adoptive placement under this subdivision, the agency
shall:

(1) make reasonable efforts to obtain a fully executed adoption placement agreement;

(2) work with the moving party regarding eligibility for adoption assistance as required
under chapter deleted text begin259Adeleted text endnew text begin 256Nnew text end; and

(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval
of the adoptive placement through the Interstate Compact on the Placement of Children.

(g) Denial or granting of a motion for an order for adoptive placement after an evidentiary
hearing is an order which may be appealed by the responsible social services agency, the
moving party, the child, when age ten or over, the child's guardian ad litem, and any
individual who had a fully executed adoption placement agreement regarding the child at
the time the motion was filed if the court's order has the effect of terminating the adoption
placement agreement. An appeal shall be conducted according to the requirements of the
Rules of Juvenile Protection Procedure.

Sec. 41.

Minnesota Statutes 2020, section 260C.609, is amended to read:


260C.609 SOCIAL AND MEDICAL HISTORY.

deleted text begin (a) The responsible social services agency shall work with the birth family of the child,
foster family, medical and treatment providers, and the child's school to ensure there is a
detailed, thorough, and currently up-to-date social and medical history of the child as required
under section 259.43 on the forms required by the commissioner.
deleted text end

deleted text begin (b) When the child continues in foster care, the agency's reasonable efforts to complete
the history shall begin no later than the permanency progress review hearing required under
section 260C.204 or six months after the child's placement in foster care.
deleted text end

deleted text begin (c)deleted text endnew text begin (a)new text end Thenew text begin responsible social servicesnew text end agency shall thoroughly discuss the child's history
with the deleted text beginadoptingdeleted text endnew text begin prospective adoptivenew text end parent of the child and shall give anew text begin redactednew text end copy
of deleted text beginthe report ofdeleted text end the child's social and medical historynew text begin as described in section 260C.212,
subdivision 15, including redacted attachments,
new text end to the deleted text beginadoptingdeleted text endnew text begin prospective adoptivenew text end parent.new text begin
If the prospective adoptive parent does not pursue adoption of the child, the prospective
adoptive parent must return the child's social and medical history and redacted attachments
to the agency. The responsible social services agency may give
new text end anew text begin redactednew text end copy of the child's
social and medical history deleted text beginmay also be givendeleted text end to the childdeleted text begin, as appropriatedeleted text endnew text begin according to section
260C.212, subdivision 1
new text end.

deleted text begin (d)deleted text endnew text begin (b)new text end The report shall not include information that identifies birth relatives. Redacted
copies of allnew text begin ofnew text end the child's relevant evaluations, assessments, and records must be attached
to the social and medical history.

new text begin (c) The agency must submit the child's social and medical history to the Department of
Human Services at the time that the agency submits the child's adoption placement agreement.
Pursuant to section 260C.623, subdivision 4, the child's social and medical history must be
submitted to the court at the time the adoption petition is filed with the court.
new text end

Sec. 42.

Minnesota Statutes 2020, section 260C.615, is amended to read:


260C.615 DUTIES OF COMMISSIONER.

Subdivision 1.

Duties.

(a) For any child who is under the guardianship of the
commissioner, the commissioner has the exclusive rights to consent to:

(1) the medical care plan for the treatment of a child who is at imminent risk of death
or who has a chronic disease that, in a physician's judgment, will result in the child's death
in the near future including a physician's order not to resuscitate or intubate the child; and

(2) the child donating a part of the child's body to another person while the child is living;
the decision to donate a body part under this clause shall take into consideration the child's
wishes and the child's culture.

(b) In addition to the exclusive rights under paragraph (a), the commissioner has a duty
to:

(1) process any complete and accurate request for home study and placement through
the Interstate Compact on the Placement of Children under section 260.851;

(2) process any complete and accurate application for adoption assistance forwarded by
the responsible social services agency according to chapter deleted text begin259Adeleted text endnew text begin 256Nnew text end;

(3) deleted text begincomplete the execution ofdeleted text endnew text begin review and processnew text end an adoption placement agreement
forwarded to the commissioner by the responsible social services agency and return it to
the agency in a timely fashion; and

(4) maintain records as required in chapter 259.

Subd. 2.

Duties not reserved.

All duties, obligations, and consents not specifically
reserved to the commissioner in this section are delegated to the responsible social services
agencynew text begin, subject to supervision by the commissioner under section 393.07new text end.

Sec. 43.

Minnesota Statutes 2020, section 260C.704, is amended to read:


260C.704 REQUIREMENTS FOR THE QUALIFIED INDIVIDUAL'S
ASSESSMENT OF THE CHILD FOR PLACEMENT IN A QUALIFIED
RESIDENTIAL TREATMENT PROGRAM.

(a) A qualified individual must complete an assessment of the child prior to deleted text beginor withindeleted text end
deleted text begin 30 days ofdeleted text end the child's placement in a qualified residential treatment program in a format
approved by the commissioner of human servicesdeleted text begin, anddeleted text end new text beginunless, due to a crisis, the child must
immediately be placed in a qualified residential treatment program. When a child must
immediately be placed in a qualified residential treatment program without an assessment,
the qualified individual must complete the child's assessment within 30 days of the child's
placement. The qualified individual
new text end must:

(1) assess the child's needs and strengths, using an age-appropriate, evidence-based,
validated, functional assessment approved by the commissioner of human services;

(2) determine whether the child's needs can be met by the child's family members or
through placement in a family foster home; or, if not, determine which residential setting
would provide the child with the most effective and appropriate level of care to the child
in the least restrictive environment;

(3) develop a list of short- and long-term mental and behavioral health goals for the
child; and

(4) work with the child's family and permanency team using culturally competent
practices.

new text begin If a level of care determination was conducted under section 245.4885, that information
must be shared with the qualified individual and the juvenile treatment screening team.
new text end

(b) The child and the child's parents, when appropriate, may request that a specific
culturally competent qualified individual complete the child's assessment. The agency shall
make efforts to refer the child to the identified qualified individual to complete the
assessment. The assessment must not be delayed for a specific qualified individual to
complete the assessment.

(c) The qualified individual must provide the assessment, when complete, to the
responsible social services agencydeleted text begin, the child's parents or legal guardians, the guardian ad
litem, and the court
deleted text endnew text begin. If the assessment recommends placement of the child in a qualified
residential treatment facility, the agency must distribute the assessment to the child's parent
or legal guardian and file the assessment with the court report
new text end as required in section 260C.71new text begin,
subdivision 2. If the assessment does not recommend placement in a qualified residential
treatment facility, the agency must provide a copy of the assessment to the parents or legal
guardians and the guardian ad litem and file the assessment determination with the court at
the next required hearing as required in section 260C.71, subdivision 5
new text end. If court rules and
chapter 13 permit disclosure of the results of the child's assessment, the agency may share
the results of the child's assessment with the child's foster care provider, other members of
the child's family, and the family and permanency team. The agency must not share the
child's private medical data with the family and permanency team unless: (1) chapter 13
permits the agency to disclose the child's private medical data to the family and permanency
team; or (2) the child's parent has authorized the agency to disclose the child's private medical
data to the family and permanency team.

(d) For an Indian child, the assessment of the child must follow the order of placement
preferences in the Indian Child Welfare Act of 1978, United States Code, title 25, section
1915.

(e) In the assessment determination, the qualified individual must specify in writing:

(1) the reasons why the child's needs cannot be met by the child's family or in a family
foster home. A shortage of family foster homes is not an acceptable reason for determining
that a family foster home cannot meet a child's needs;

(2) why the recommended placement in a qualified residential treatment program will
provide the child with the most effective and appropriate level of care to meet the child's
needs in the least restrictive environment possible and how placing the child at the treatment
program is consistent with the short-term and long-term goals of the child's permanency
plan; and

(3) if the qualified individual's placement recommendation is not the placement setting
that the parent, family and permanency team, child, or tribe prefer, the qualified individual
must identify the reasons why the qualified individual does not recommend the parent's,
family and permanency team's, child's, or tribe's placement preferences. The out-of-home
placement plan under section 260C.708 must also include reasons why the qualified
individual did not recommend the preferences of the parents, family and permanency team,
child, or tribe.

(f) If the qualified individual determines that the child's family or a family foster home
or other less restrictive placement may meet the child's needs, the agency must move the
child out of the qualified residential treatment program and transition the child to a less
restrictive setting within 30 days of the determination.new text begin If the responsible social services
agency has placement authority of the child, the agency must make a plan for the child's
placement according to section 260C.212, subdivision 2. The agency must file the child's
assessment determination with the court at the next required hearing.
new text end

new text begin (g) If the qualified individual recommends placing the child in a qualified residential
treatment program and if the responsible social services agency has placement authority of
the child, the agency shall make referrals to appropriate qualified residential treatment
programs and, upon acceptance by an appropriate program, place the child in an approved
or certified qualified residential treatment program.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 44.

Minnesota Statutes 2020, section 260C.706, is amended to read:


260C.706 FAMILY AND PERMANENCY TEAM REQUIREMENTS.

(a) When the responsible social services agency's juvenile treatment screening team, as
defined in section 260C.157, recommends placing the child in a qualified residential treatment
program, the agency must assemble a family and permanency team within ten days.

(1) The team must include all appropriate biological family members, the child's parents,
legal guardians or custodians, foster care providers, and relatives as defined in section
260C.007, subdivisions deleted text begin26cdeleted text endnew text begin 26bnew text end and 27, and professionals, as appropriate, who are a resource
to the child's family, such as teachers, medical or mental health providers, or clergy.

(2) When a child is placed in foster care prior to the qualified residential treatment
program, the agency shall include relatives responding to the relative search notice as
required under section 260C.221 on this team, unless the juvenile court finds that contacting
a specific relative would deleted text beginendangerdeleted text end new text beginpresent a safety or health risk tonew text end the parent, guardian,
child, sibling, or any other family member.

(3) When a qualified residential treatment program is the child's initial placement setting,
the responsible social services agency must engage with the child and the child's parents to
determine the appropriate family and permanency team members.

(4) When the permanency goal is to reunify the child with the child's parent or legal
guardian, the purpose of the relative search and focus of the family and permanency team
is to preserve family relationships and identify and develop supports for the child and parents.

(5) The responsible agency must make a good faith effort to identify and assemble all
appropriate individuals to be part of the child's family and permanency team and request
input from the parents regarding relative search efforts consistent with section 260C.221.
The out-of-home placement plan in section 260C.708 must include all contact information
for the team members, as well as contact information for family members or relatives who
are not a part of the family and permanency team.

(6) If the child is age 14 or older, the team must include members of the family and
permanency team that the child selects in accordance with section 260C.212, subdivision
1
, paragraph (b).

(7) Consistent with section 260C.221, a responsible social services agency may disclose
relevant and appropriate private data about the child to relatives in order for the relatives
to participate in caring and planning for the child's placement.

(8) If the child is an Indian child under section 260.751, the responsible social services
agency must make active efforts to include the child's tribal representative on the family
and permanency team.

(b) The family and permanency team shall meet regarding the assessment required under
section 260C.704 to determine whether it is necessary and appropriate to place the child in
a qualified residential treatment program and to participate in case planning under section
260C.708.

(c) When reunification of the child with the child's parent or legal guardian is the
permanency plan, the family and permanency team shall support the parent-child relationship
by recognizing the parent's legal authority, consulting with the parent regarding ongoing
planning for the child, and assisting the parent with visiting and contacting the child.

(d) When the agency's permanency plan is to transfer the child's permanent legal and
physical custody to a relative or for the child's adoption, the team shall:

(1) coordinate with the proposed guardian to provide the child with educational services,
medical care, and dental care;

(2) coordinate with the proposed guardian, the agency, and the foster care facility to
meet the child's treatment needs after the child is placed in a permanent placement with the
proposed guardian;

(3) plan to meet the child's need for safety, stability, and connection with the child's
family and community after the child is placed in a permanent placement with the proposed
guardian; and

(4) in the case of an Indian child, communicate with the child's tribe to identify necessary
and appropriate services for the child, transition planning for the child, the child's treatment
needs, and how to maintain the child's connections to the child's community, family, and
tribe.

(e) The agency shall invite the family and permanency team to participate in case planning
and the agency shall give the team notice of court reviews under sections 260C.152 and
260C.221 until: (1) the child is reunited with the child's parents; or (2) the child's foster care
placement ends and the child is in a permanent placement.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 45.

Minnesota Statutes 2020, section 260C.708, is amended to read:


260C.708 OUT-OF-HOME PLACEMENT PLAN FOR QUALIFIED
RESIDENTIAL TREATMENT PROGRAM PLACEMENTS.

(a) When the responsible social services agency places a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the out-of-home
placement plan must include:

(1) the case plan requirements in section deleted text begin260.212, subdivision 1deleted text endnew text begin 260C.212new text end;

(2) the reasonable and good faith efforts of the responsible social services agency to
identify and include all of the individuals required to be on the child's family and permanency
team under section 260C.007;

(3) all contact information for members of the child's family and permanency team and
for other relatives who are not part of the family and permanency team;

(4) evidence that the agency scheduled meetings of the family and permanency team,
including meetings relating to the assessment required under section 260C.704, at a time
and place convenient for the family;

new text begin (5) evidence that the family and permanency team is involved in the assessment required
under section 260C.704 to determine the appropriateness of the child's placement in a
qualified residential treatment program;
new text end

new text begin (6) the family and permanency team's placement preferences for the child in the
assessment required under section 260C.704. When making a decision about the child's
placement preferences, the family and permanency team must recognize:
new text end

new text begin (i) that the agency should place a child with the child's siblings unless a court finds that
placing a child with the child's siblings is not possible due to a child's specialized placement
needs or is otherwise contrary to the child's best interests; and
new text end

new text begin (ii) that the agency should place an Indian child according to the requirements of the
Indian Child Welfare Act, the Minnesota Family Preservation Act under sections 260.751
to 260.835, and section 260C.193, subdivision 3, paragraph (g);
new text end

deleted text begin (5)deleted text endnew text begin (7)new text end when reunification of the child with the child's parent or legal guardian is the
agency's goal, evidence demonstrating that the parent or legal guardian provided input about
the members of the family and permanency team under section 260C.706;

deleted text begin (6)deleted text endnew text begin (8)new text end when the agency's permanency goal is to reunify the child with the child's parent
or legal guardian, the out-of-home placement plan must identify services and supports that
maintain the parent-child relationship and the parent's legal authority, decision-making, and
responsibility for ongoing planning for the child. In addition, the agency must assist the
parent with visiting and contacting the child;

deleted text begin (7)deleted text endnew text begin (9)new text end when the agency's permanency goal is to transfer permanent legal and physical
custody of the child to a proposed guardian or to finalize the child's adoption, the case plan
must document the agency's steps to transfer permanent legal and physical custody of the
child or finalize adoption, as required in section 260C.212, subdivision 1, paragraph (c),
clauses (6) and (7); and

deleted text begin (8)deleted text endnew text begin (10)new text end the qualified individual's recommendation regarding the child's placement in a
qualified residential treatment program and the court approval or disapproval of the placement
as required in section 260C.71.

(b) If the placement preferences of the family and permanency team, child, and tribe, if
applicable, are not consistent with the placement setting that the qualified individual
recommends, the case plan must include the reasons why the qualified individual did not
recommend following the preferences of the family and permanency team, child, and the
tribe.

(c) The agency must file the out-of-home placement plan with the court as part of the
60-day deleted text beginhearingdeleted text endnew text begin court ordernew text end under section 260C.71.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 46.

Minnesota Statutes 2020, section 260C.71, is amended to read:


260C.71 COURT APPROVAL REQUIREMENTS.

new text begin Subdivision 1.new text end

new text beginJudicial review.new text end

new text beginWhen the responsible social services agency has legal
authority to place a child at a qualified residential treatment facility under section 260C.007,
subdivision 21a, and the child's assessment under section 260C.704 recommends placing
the child in a qualified residential treatment facility, the agency shall place the child at a
qualified residential facility. Within 60 days of placing the child at a qualified residential
treatment facility, the agency must obtain a court order finding that the child's placement
is appropriate and meets the child's individualized needs.
new text end

new text begin Subd. 2.new text end

new text beginQualified residential treatment program; agency report to court.new text end

new text begin(a) The
responsible social services agency shall file a written report with the court after receiving
the qualified individual's assessment as specified in section 260C.704 prior to the child's
placement or within 35 days of the date of the child's placement in a qualified residential
treatment facility. The written report shall contain or have attached:
new text end

new text begin (1) the child's name, date of birth, race, gender, and current address;
new text end

new text begin (2) the names, races, dates of birth, residence, and post office address of the child's
parents or legal custodian, or guardian;
new text end

new text begin (3) the name and address of the qualified residential treatment program, including a
chief administrator of the facility;
new text end

new text begin (4) a statement of the facts that necessitated the child's foster care placement;
new text end

new text begin (5) the child's out-of-home placement plan under section 260C.212, subdivision 1,
including the requirements in section 260C.708;
new text end

new text begin (6) if the child is placed in an out-of-state qualified residential treatment program, the
compelling reasons why the child's needs cannot be met by an in-state placement;
new text end

new text begin (7) the qualified individual's assessment of the child under section 260C.704, paragraph
(c), in a format approved by the commissioner;
new text end

new text begin (8) if, at the time required for the report under this subdivision, the child's parent or legal
guardian, a child who is ten years of age or older, the family and permanency team, or a
tribe disagrees with the recommended qualified residential treatment program placement,
information regarding the disagreement and to the extent possible, the basis for the
disagreement in the report; and
new text end

new text begin (9) any other information that the responsible social services agency, child's parent, legal
custodian or guardian, child, or, in the case of an Indian child, tribe would like the court to
consider.
new text end

new text begin (b) The agency shall file the written report under paragraph (a) with the court and serve
on the parties a request for a hearing or a court order without a hearing.
new text end

new text begin (c) The agency must inform the child's parent or legal guardian and a child who is ten
years of age or older of the court review requirements of this section and the child and child's
parent's or legal guardian's right to submit information to the court:
new text end

new text begin (1) the agency must inform the child's parent or legal guardian and a child who is ten
years of age or older of the reporting date and the date by which the agency must receive
information from the child and child's parent so that the agency is able to submit the report
required by this subdivision to the court;
new text end

new text begin (2) the agency must inform the child's parent or legal guardian, and a child who is ten
years of age or older that the court will hold a hearing upon the request of the child or the
child's parent; and
new text end

new text begin (3) the agency must inform the child's parent or legal guardian, and a child who is ten
years of age or older that they have the right to request a hearing and the right to present
information to the court for the court's review under this subdivision.
new text end

new text begin Subd. 3.new text end

new text beginCourt hearing.new text end

new text begin(a) The court shall hold a hearing when a party or a child who
is ten years of age or older requests a hearing.
new text end

new text begin (b) In all other circumstances, the court has the discretion to hold a hearing or issue an
order without a hearing.
new text end

new text begin Subd. 4.new text end

new text beginCourt findings and order.new text end

(a) Within 60 days from the beginning of each
placement in a qualified residential treatment programnew text begin when the qualified individual's
assessment of the child recommends placing the child in a qualified residential treatment
program
new text end, the court mustnew text begin consider the qualified individual's assessment of the child under
section 260C.704 and issue an order to
new text end:

deleted text begin (1) consider the qualified individual's assessment of whether it is necessary and
appropriate to place the child in a qualified residential treatment program under section
260C.704;
deleted text end

deleted text begin (2)deleted text endnew text begin (1)new text end determine whether a family foster home can meet the child's needs, whether it is
necessary and appropriate to place a child in a qualified residential treatment program that
is the least restrictive environment possible, and whether the child's placement is consistent
with the child's short and long term goals as specified in the permanency plan; and

deleted text begin (3)deleted text endnew text begin (2)new text end approve or disapprove of the child's placement.

(b) deleted text beginIn the out-of-home placement plan, the agency must document the court's approval
or disapproval of the placement, as specified in section 260C.708.
deleted text endnew text begin If the court disapproves
of the child's placement in a qualified residential treatment program, the responsible social
services agency shall: (1) remove the child from the qualified residential treatment program
within 30 days of the court's order; and (2) make a plan for the child's placement that is
consistent with the child's best interests under section 260C.212, subdivision 2.
new text end

new text begin Subd. 5.new text end

new text beginCourt review and approval not required.new text end

new text beginWhen the responsible social services
agency has legal authority to place a child under section 260C.007, subdivision 21a, and
the qualified individual's assessment of the child does not recommend placing the child in
a qualified residential treatment program, the court is not required to hold a hearing and the
court is not required to issue an order. Pursuant to section 260C.704, paragraph (f), the
responsible social services agency shall make a plan for the child's placement consistent
with the child's best interests under section 260C.212, subdivision 2. The agency must file
the agency's assessment determination for the child with the court at the next required
hearing.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 47.

Minnesota Statutes 2020, section 260C.712, is amended to read:


260C.712 ONGOING REVIEWS AND PERMANENCY HEARING
REQUIREMENTS.

As long as a child remains placed in a qualified residential treatment program, the
responsible social services agency shall submit evidence at each administrative review under
section 260C.203; each court review under sections 260C.202, 260C.203, deleted text beginanddeleted text end 260C.204new text begin,
260D.06, 260D.07, and 260D.08
new text end; and each permanency hearing under section 260C.515,
260C.519, deleted text beginordeleted text end 260C.521,new text begin or 260D.07new text end that:

(1) demonstrates that an ongoing assessment of the strengths and needs of the child
continues to support the determination that the child's needs cannot be met through placement
in a family foster home;

(2) demonstrates that the placement of the child in a qualified residential treatment
program provides the most effective and appropriate level of care for the child in the least
restrictive environment;

(3) demonstrates how the placement is consistent with the short-term and long-term
goals for the child, as specified in the child's permanency plan;

(4) documents how the child's specific treatment or service needs will be met in the
placement;

(5) documents the length of time that the agency expects the child to need treatment or
services; deleted text beginand
deleted text end

(6) documents the responsible social services agency's efforts to prepare the child to
return home or to be placed with a fit and willing relative, legal guardian, adoptive parent,
or foster familydeleted text begin.deleted text endnew text begin; and
new text end

new text begin (7) if the child is placed in a qualified residential treatment program out-of-state,
documents the compelling reasons for placing the child out-of-state, and the reasons that
the child's needs cannot be met by an in-state placement.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 48.

Minnesota Statutes 2020, section 260C.714, is amended to read:


260C.714 REVIEW OF EXTENDED QUALIFIED RESIDENTIAL TREATMENT
PROGRAM PLACEMENTS.

(a) When a responsible social services agency places a child in a qualified residential
treatment program for more than 12 consecutive months or 18 nonconsecutive months or,
in the case of a child who is under 13 years of age, for more than six consecutive or
nonconsecutive months, the agency must submit: (1) the signed approval by the county
social services director of the responsible social services agency; and (2) the evidence
supporting the child's placement at the most recent court review or permanency hearing
under section 260C.712deleted text begin, paragraph (b)deleted text end.

(b) The commissioner shall specify the procedures and requirements for the agency's
review and approval of a child's extended qualified residential treatment program placement.
The commissioner may consult with counties, tribes, child-placing agencies, mental health
providers, licensed facilities, the child, the child's parents, and the family and permanency
team members to develop case plan requirements and engage in periodic reviews of the
case plan.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 49.

Minnesota Statutes 2020, section 260D.01, is amended to read:


260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.

(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for
treatment" provisions of the Juvenile Court Act.

(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary
foster care for treatment upon the filing of a report or petition required under this chapter.
All obligations of thenew text begin responsible social servicesnew text end agency to a child and family in foster care
contained in chapter 260C not inconsistent with this chapter are also obligations of the
agency with regard to a child in foster care for treatment under this chapter.

(c) This chapter shall be construed consistently with the mission of the children's mental
health service system as set out in section 245.487, subdivision 3, and the duties of an agency
under sections 256B.092 and 260C.157 and Minnesota Rules, parts 9525.0004 to 9525.0016,
to meet the needs of a child with a developmental disability or related condition. This
chapter:

(1) establishes voluntary foster care through a voluntary foster care agreement as the
means for an agency and a parent to provide needed treatment when the child must be in
foster care to receive necessary treatment for an emotional disturbance or developmental
disability or related condition;

(2) establishes court review requirements for a child in voluntary foster care for treatment
due to emotional disturbance or developmental disability or a related condition;

(3) establishes the ongoing responsibility of the parent as legal custodian to visit the
child, to plan together with the agency for the child's treatment needs, to be available and
accessible to the agency to make treatment decisions, and to obtain necessary medical,
dental, and other care for the child; deleted text beginand
deleted text end

(4) applies to voluntary foster care when the child's parent and the agency agree that the
child's treatment needs require foster care either:

(i) due to a level of care determination by the agency's screening team informed by thenew text begin
child's
new text end diagnostic and functional assessment under section 245.4885; or

(ii) due to a determination regarding the level of services needed bynew text begin the child bynew text end the
responsible social deleted text beginservices'deleted text endnew text begin services agency'snew text end screening team under section 256B.092, and
Minnesota Rules, parts 9525.0004 to 9525.0016deleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) includes the requirements for a child's placement in sections 260C.70 to 260C.714,
when the juvenile treatment screening team recommends placing a child in a qualified
residential treatment program, except as modified by this chapter.
new text end

(d) This chapter does not apply when there is a current determination under chapter
260E that the child requires child protective services or when the child is in foster care for
any reason other than treatment for the child's emotional disturbance or developmental
disability or related condition. When there is a determination under chapter 260E that the
child requires child protective services based on an assessment that there are safety and risk
issues for the child that have not been mitigated through the parent's engagement in services
or otherwise, or when the child is in foster care for any reason other than the child's emotional
disturbance or developmental disability or related condition, the provisions of chapter 260C
apply.

(e) The paramount consideration in all proceedings concerning a child in voluntary foster
care for treatment is the safety, health, and the best interests of the child. The purpose of
this chapter is:

(1) to ensurenew text begin thatnew text end a child with a disability is provided the services necessary to treat or
ameliorate the symptoms of the child's disability;

(2) to preserve and strengthen the child's family ties whenever possible and in the child's
best interests, approving the child's placement away from the child's parents only when the
child's need for care or treatment requires deleted text beginitdeleted text endnew text begin out-of-home placementnew text end and the child cannot
be maintained in the home of the parent; and

(3) to ensurenew text begin thatnew text end the child's parent retains legal custody of the child and associated
decision-making authority unless the child's parent willfully fails or is unable to make
decisions that meet the child's safety, health, and best interests. The court may not find that
the parent willfully fails or is unable to make decisions that meet the child's needs solely
because the parent disagrees with the agency's choice of foster care facility, unless the
agency files a petition under chapter 260C, and establishes by clear and convincing evidence
that the child is in need of protection or services.

(f) The legal parent-child relationship shall be supported under this chapter by maintaining
the parent's legal authority and responsibility for ongoing planning for the child and by the
agency's assisting the parent, deleted text beginwheredeleted text endnew text begin whennew text end necessary, to exercise the parent's ongoing right
and obligation to visit or to have reasonable contact with the child. Ongoing planning means:

(1) actively participating in the planning and provision of educational services, medical,
and dental care for the child;

(2) actively planning and participating with the agency and the foster care facility for
the child's treatment needs; deleted text beginand
deleted text end

(3) planning to meet the child's need for safety, stability, and permanency, and the child's
need to stay connected to the child's family and communitydeleted text begin.deleted text endnew text begin;
new text end

new text begin (4) engaging with the responsible social services agency to ensure that the family and
permanency team under section 260C.706 consists of appropriate family members. For
purposes of voluntary placement of a child in foster care for treatment under chapter 260D,
prior to forming the child's family and permanency team, the responsible social services
agency must consult with the child's parent or legal guardian, the child if the child is 14
years of age or older, and, if applicable, the child's tribe to obtain recommendations regarding
which individuals to include on the team and to ensure that the team is family-centered and
will act in the child's best interests. If the child, child's parents, or legal guardians raise
concerns about specific relatives or professionals, the team should not include those
individuals unless the individual is a treating professional or an important connection to the
youth as outlined in the case or crisis plan; and
new text end

new text begin (5) for a voluntary placement under this chapter in a qualified residential treatment
program, as defined in section 260C.007, subdivision 26d, for purposes of engaging in a
relative search as provided in section 260C.221, the county agency must consult with the
child's parent or legal guardian, the child if the child is 14 years of age or older, and, if
applicable, the child's tribe to obtain recommendations regarding which adult relatives the
county agency should notify. If the child, child's parents, or legal guardians raise concerns
about specific relatives, the county agency should not notify those relatives.
new text end

(g) The provisions of section 260.012 to ensure placement prevention, family
reunification, and all active and reasonable effort requirements of that section apply. This
chapter shall be construed consistently with the requirements of the Indian Child Welfare
Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the
Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 50.

Minnesota Statutes 2020, section 260D.05, is amended to read:


260D.05 ADMINISTRATIVE REVIEW OF CHILD IN VOLUNTARY FOSTER
CARE FOR TREATMENT.

The administrative reviews required under section 260C.203 must be conducted for a
child in voluntary foster care for treatment, except that the initial administrative review
must take place prior to the submission of the report to the court required under section
260D.06, subdivision 2.new text begin When a child is placed in a qualified residential treatment program
as defined in section 260C.007, subdivision 26d, the responsible social services agency
must submit evidence to the court as specified in section 260C.712.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 51.

Minnesota Statutes 2020, section 260D.06, subdivision 2, is amended to read:


Subd. 2.

Agency report to court; court review.

The agency shall obtain judicial review
by reporting to the court according to the following procedures:

(a) A written report shall be forwarded to the court within 165 days of the date of the
voluntary placement agreement. The written report shall contain or have attached:

(1) a statement of facts that necessitate the child's foster care placement;

(2) the child's name, date of birth, race, gender, and current address;

(3) the names, race, date of birth, residence, and post office addresses of the child's
parents or legal custodian;

(4) a statement regarding the child's eligibility for membership or enrollment in an Indian
tribe and the agency's compliance with applicable provisions of sections 260.751 to 260.835;

(5) the names and addresses of the foster parents or chief administrator of the facility in
which the child is placed, if the child is not in a family foster home or group home;

(6) a copy of the out-of-home placement plan required under section 260C.212,
subdivision 1;

(7) a written summary of the proceedings of any administrative review required under
section 260C.203; deleted text beginand
deleted text end

(8) new text beginevidence as specified in section 260C.712 when a child is placed in a qualified
residential treatment program as defined in section 260C.007, subdivision 26d; and
new text end

new text begin (9) new text endany other information the agency, parent or legal custodian, the child or the foster
parent, or other residential facility wants the court to consider.

(b) In the case of a child in placement due to emotional disturbance, the written report
shall include as an attachment, the child's individual treatment plan developed by the child's
treatment professional, as provided in section 245.4871, subdivision 21, or the child's
standard written plan, as provided in section 125A.023, subdivision 3, paragraph (e).

(c) In the case of a child in placement due to developmental disability or a related
condition, the written report shall include as an attachment, the child's individual service
plan, as provided in section 256B.092, subdivision 1b; the child's individual program plan,
as provided in Minnesota Rules, part 9525.0004, subpart 11; the child's waiver care plan;
or the child's standard written plan, as provided in section 125A.023, subdivision 3, paragraph
(e).

(d) The agency must inform the child, age 12 or older, the child's parent, and the foster
parent or foster care facility of the reporting and court review requirements of this section
and of their right to submit information to the court:

(1) if the child or the child's parent or the foster care provider wants to send information
to the court, the agency shall advise those persons of the reporting date and the date by
which the agency must receive the information they want forwarded to the court so the
agency is timely able submit it with the agency's report required under this subdivision;

(2) the agency must also inform the child, age 12 or older, the child's parent, and the
foster care facility that they have the right to be heard in person by the court and how to
exercise that right;

(3) the agency must also inform the child, age 12 or older, the child's parent, and the
foster care provider that an in-court hearing will be held if requested by the child, the parent,
or the foster care provider; and

(4) if, at the time required for the report under this section, a child, age 12 or older,
disagrees about the foster care facility or services provided under the out-of-home placement
plan required under section 260C.212, subdivision 1, the agency shall include information
regarding the child's disagreement, and to the extent possible, the basis for the child's
disagreement in the report required under this section.

(e) After receiving the required report, the court has jurisdiction to make the following
determinations and must do so within ten days of receiving the forwarded report, whether
a hearing is requested:

(1) whether the voluntary foster care arrangement is in the child's best interests;

(2) whether the parent and agency are appropriately planning for the child; and

(3) in the case of a child age 12 or older, who disagrees with the foster care facility or
services provided under the out-of-home placement plan, whether it is appropriate to appoint
counsel and a guardian ad litem for the child using standards and procedures under section
260C.163.

(f) Unless requested by a parent, representative of the foster care facility, or the child,
no in-court hearing is required in order for the court to make findings and issue an order as
required in paragraph (e).

(g) If the court finds the voluntary foster care arrangement is in the child's best interests
and that the agency and parent are appropriately planning for the child, the court shall issue
an order containing explicit, individualized findings to support its determination. The
individualized findings shall be based on the agency's written report and other materials
submitted to the court. The court may make this determination notwithstanding the child's
disagreement, if any, reported under paragraph (d).

(h) The court shall send a copy of the order to the county attorney, the agency, parent,
child, age 12 or older, and the foster parent or foster care facility.

(i) The court shall also send the parent, the child, age 12 or older, the foster parent, or
representative of the foster care facility notice of the permanency review hearing required
under section 260D.07, paragraph (e).

(j) If the court finds continuing the voluntary foster care arrangement is not in the child's
best interests or that the agency or the parent are not appropriately planning for the child,
the court shall notify the agency, the parent, the foster parent or foster care facility, the child,
age 12 or older, and the county attorney of the court's determinations and the basis for the
court's determinations. In this case, the court shall set the matter for hearing and appoint a
guardian ad litem for the child under section 260C.163, subdivision 5.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 52.

Minnesota Statutes 2020, section 260D.07, is amended to read:


260D.07 REQUIRED PERMANENCY REVIEW HEARING.

(a) When the court has found that the voluntary arrangement is in the child's best interests
and that the agency and parent are appropriately planning for the child pursuant to the report
submitted under section 260D.06, and the child continues in voluntary foster care as defined
in section 260D.02, subdivision 10, for 13 months from the date of the voluntary foster care
agreement, or has been in placement for 15 of the last 22 months, the agency must:

(1) terminate the voluntary foster care agreement and return the child home; or

(2) determine whether there are compelling reasons to continue the voluntary foster care
arrangement and, if the agency determines there are compelling reasons, seek judicial
approval of its determination; or

(3) file a petition for the termination of parental rights.

(b) When the agency is asking for the court's approval of its determination that there are
compelling reasons to continue the child in the voluntary foster care arrangement, the agency
shall file a "Petition for Permanency Review Regarding a Child in Voluntary Foster Care
for Treatment" and ask the court to proceed under this section.

(c) The "Petition for Permanency Review Regarding a Child in Voluntary Foster Care
for Treatment" shall be drafted or approved by the county attorney and be under oath. The
petition shall include:

(1) the date of the voluntary placement agreement;

(2) whether the petition is due to the child's developmental disability or emotional
disturbance;

(3) the plan for the ongoing care of the child and the parent's participation in the plan;

(4) a description of the parent's visitation and contact with the child;

(5) the date of the court finding that the foster care placement was in the best interests
of the child, if required under section 260D.06, or the date the agency filed the motion under
section 260D.09, paragraph (b);

(6) the agency's reasonable efforts to finalize the permanent plan for the child, including
returning the child to the care of the child's family; deleted text beginand
deleted text end

(7) a citation to this chapter as the basis for the petitiondeleted text begin.deleted text endnew text begin; and
new text end

new text begin (8) evidence as specified in section 260C.712 when a child is placed in a qualified
residential treatment program as defined in section 260C.007, subdivision 26d.
new text end

(d) An updated copy of the out-of-home placement plan required under section 260C.212,
subdivision 1
, shall be filed with the petition.

(e) The court shall set the date for the permanency review hearing no later than 14 months
after the child has been in placement or within 30 days of the petition filing date when the
child has been in placement 15 of the last 22 months. The court shall serve the petition
together with a notice of hearing by United States mail on the parent, the child age 12 or
older, the child's guardian ad litem, if one has been appointed, the agency, the county
attorney, and counsel for any party.

(f) The court shall conduct the permanency review hearing on the petition no later than
14 months after the date of the voluntary placement agreement, within 30 days of the filing
of the petition when the child has been in placement 15 of the last 22 months, or within 15
days of a motion to terminate jurisdiction and to dismiss an order for foster care under
chapter 260C, as provided in section 260D.09, paragraph (b).

(g) At the permanency review hearing, the court shall:

(1) inquire of the parent if the parent has reviewed the "Petition for Permanency Review
Regarding a Child in Voluntary Foster Care for Treatment," whether the petition is accurate,
and whether the parent agrees to the continued voluntary foster care arrangement as being
in the child's best interests;

(2) inquire of the parent if the parent is satisfied with the agency's reasonable efforts to
finalize the permanent plan for the child, including whether there are services available and
accessible to the parent that might allow the child to safely be with the child's family;

(3) inquire of the parent if the parent consents to the court entering an order that:

(i) approves the responsible agency's reasonable efforts to finalize the permanent plan
for the child, which includes ongoing future planning for the safety, health, and best interests
of the child; and

(ii) approves the responsible agency's determination that there are compelling reasons
why the continued voluntary foster care arrangement is in the child's best interests; and

(4) inquire of the child's guardian ad litem and any other party whether the guardian or
the party agrees that:

(i) the court should approve the responsible agency's reasonable efforts to finalize the
permanent plan for the child, which includes ongoing and future planning for the safety,
health, and best interests of the child; and

(ii) the court should approve of the responsible agency's determination that there are
compelling reasons why the continued voluntary foster care arrangement is in the child's
best interests.

(h) At a permanency review hearing under this section, the court may take the following
actions based on the contents of the sworn petition and the consent of the parent:

(1) approve the agency's compelling reasons that the voluntary foster care arrangement
is in the best interests of the child; and

(2) find that the agency has made reasonable efforts to finalize the permanent plan for
the child.

(i) A child, age 12 or older, may object to the agency's request that the court approve its
compelling reasons for the continued voluntary arrangement and may be heard on the reasons
for the objection. Notwithstanding the child's objection, the court may approve the agency's
compelling reasons and the voluntary arrangement.

(j) If the court does not approve the voluntary arrangement after hearing from the child
or the child's guardian ad litem, the court shall dismiss the petition. In this case, either:

(1) the child must be returned to the care of the parent; or

(2) the agency must file a petition under section 260C.141, asking for appropriate relief
under sections 260C.301 or 260C.503 to 260C.521.

(k) When the court approves the agency's compelling reasons for the child to continue
in voluntary foster care for treatment, and finds that the agency has made reasonable efforts
to finalize a permanent plan for the child, the court shall approve the continued voluntary
foster care arrangement, and continue the matter under the court's jurisdiction for the purposes
of reviewing the child's placement every 12 months while the child is in foster care.

(l) A finding that the court approves the continued voluntary placement means the agency
has continued legal authority to place the child while a voluntary placement agreement
remains in effect. The parent or the agency may terminate a voluntary agreement as provided
in section 260D.10. Termination of a voluntary foster care placement of an Indian child is
governed by section 260.765, subdivision 4.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 53.

Minnesota Statutes 2020, section 260D.08, is amended to read:


260D.08 ANNUAL REVIEW.

(a) After the court conducts a permanency review hearing under section 260D.07, the
matter must be returned to the court for further review of the responsible social services
reasonable efforts to finalize the permanent plan for the child and the child's foster care
placement at least every 12 months while the child is in foster care. The court shall give
notice to the parent and child, age 12 or older, and the foster parents of the continued review
requirements under this section at the permanency review hearing.

(b) Every 12 months, the court shall determine whether the agency made reasonable
efforts to finalize the permanency plan for the child, which means the exercise of due
diligence by the agency to:

(1) ensure that the agreement for voluntary foster care is the most appropriate legal
arrangement to meet the child's safety, health, and best interests and to conduct a genuine
examination of whether there is another permanency disposition order under chapter 260C,
including returning the child home, that would better serve the child's need for a stable and
permanent home;

(2) engage and support the parent in continued involvement in planning and decision
making for the needs of the child;

(3) strengthen the child's ties to the parent, relatives, and community;

(4) implement the out-of-home placement plan required under section 260C.212,
subdivision 1, and ensure that the plan requires the provision of appropriate services to
address the physical health, mental health, and educational needs of the child; deleted text beginand
deleted text end

new text begin (5) submit evidence to the court as specified in section 260C.712 when a child is placed
in a qualified residential treatment program setting as defined in section 260C.007,
subdivision 26d; and
new text end

deleted text begin (5)deleted text endnew text begin (6)new text end ensure appropriate planning for the child's safe, permanent, and independent
living arrangement after the child's 18th birthday.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective September 30, 2021.
new text end

Sec. 54.

Minnesota Statutes 2020, section 260D.14, is amended to read:


260D.14 SUCCESSFUL TRANSITION TO ADULTHOOD FOR deleted text beginCHILDRENdeleted text endnew text begin
YOUTH
new text end IN VOLUNTARY PLACEMENT.

Subdivision 1.

Case planning.

When deleted text beginthe childdeleted text endnew text begin a youthnew text end is 14 years of age or older, the
responsible social services agency shall ensurenew text begin thatnew text end a deleted text beginchilddeleted text endnew text begin youthnew text end in foster care under this
chapter is provided with the case plan requirements in section 260C.212, subdivisions 1
and 14.

Subd. 2.

Notification.

The responsible social services agency shall providenew text begin a youth withnew text end
written notice of deleted text beginthe right to continued access to services for certain children in foster care
past 18 years of age under section 260C.452, subdivision 3
deleted text endnew text begin foster care benefits that a youth
who is 18 years of age or older may continue to receive according to section 260C.451,
subdivision 1
new text end, and of the right to appeal a denial of social services under section 256.045.
The notice must be provided to the deleted text beginchilddeleted text endnew text begin youthnew text end six months before the deleted text beginchild'sdeleted text endnew text begin youth'snew text end 18th
birthday.

Subd. 3.

Administrative or court reviews.

When deleted text beginthe childdeleted text endnew text begin a youthnew text end is deleted text begin17deleted text endnew text begin 14new text end years of
age or older, the administrative review or court hearing must include a review of the
responsible social services agency's support for the deleted text beginchild'sdeleted text endnew text begin youth'snew text end successful transition to
adulthood as required in section 260C.452, subdivision 4.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

Sec. 55.

Minnesota Statutes 2020, section 260E.20, subdivision 2, is amended to read:


Subd. 2.

Face-to-face contact.

(a) Upon receipt of a screened in report, the local welfare
agency shall conduct a face-to-face contact with the child reported to be maltreated and
with the child's primary caregiver sufficient to complete a safety assessment and ensure the
immediate safety of the child.

(b) The face-to-face contact with the child and primary caregiver shall occur immediately
if sexual abuse or substantial child endangerment is alleged and within five calendar days
for all other reports. If the alleged offender was not already interviewed as the primary
caregiver, the local welfare agency shall also conduct a face-to-face interview with the
alleged offender in the early stages of the assessment or investigation.new text begin Face-to-face contact
with the child and primary caregiver in response to a report alleging sexual abuse or
substantial child endangerment may be postponed for no more than five calendar days if
the child is residing in a location that is confirmed to restrict contact with the alleged offender
as established in guidelines issued by the commissioner, or if the local welfare agency is
pursuing a court order for the child's caregiver to produce the child for questioning under
section 260E.22, subdivision 5.
new text end

(c) At the initial contact with the alleged offender, the local welfare agency or the agency
responsible for assessing or investigating the report must inform the alleged offender of the
complaints or allegations made against the individual in a manner consistent with laws
protecting the rights of the person who made the report. The interview with the alleged
offender may be postponed if it would jeopardize an active law enforcement investigation.

(d) The local welfare agency or the agency responsible for assessing or investigating
the report must provide the alleged offender with an opportunity to make a statement. The
alleged offender may submit supporting documentation relevant to the assessment or
investigation.

Sec. 56.

Minnesota Statutes 2020, section 260E.31, subdivision 1, is amended to read:


Subdivision 1.

Reports required.

(a) Except as provided in paragraph (b), a person
mandated to report under this chapter shall immediately report to the local welfare agency
if the person knows or has reason to believe that a woman is pregnant and has used a
controlled substance for a nonmedical purpose during the pregnancy, including but not
limited to tetrahydrocannabinol, or has consumed alcoholic beverages during the pregnancy
in any way that is habitual or excessive.

(b) A health care professional or a social service professional who is mandated to report
under this chapter is exempt from reporting under paragraph (a) deleted text begina woman's use or
consumption of tetrahydrocannabinol or alcoholic beverages during pregnancy
deleted text end if the
professional is providing new text beginor collaborating with other professionals to provide new text endthe woman
with prenatal carenew text begin, postpartum care,new text end or other health care servicesnew text begin, including care of the
woman's infant
new text end. new text beginIf the woman does not continue to receive regular prenatal or postpartum
care, after the woman's health care professional has made attempts to contact the woman,
then the professional is required to report under paragraph (a).
new text end

(c) Any person may make a voluntary report if the person knows or has reason to believe
that a woman is pregnant and has used a controlled substance for a nonmedical purpose
during the pregnancy, including but not limited to tetrahydrocannabinol, or has consumed
alcoholic beverages during the pregnancy in any way that is habitual or excessive.

(d) An oral report shall be made immediately by telephone or otherwise. An oral report
made by a person required to report shall be followed within 72 hours, exclusive of weekends
and holidays, by a report in writing to the local welfare agency. Any report shall be of
sufficient content to identify the pregnant woman, the nature and extent of the use, if known,
and the name and address of the reporter. The local welfare agency shall accept a report
made under paragraph (c) notwithstanding refusal by a voluntary reporter to provide the
reporter's name or address as long as the report is otherwise sufficient.

(e) For purposes of this section, "prenatal care" means the comprehensive package of
medical and psychological support provided throughout the pregnancy.

Sec. 57.

Minnesota Statutes 2020, section 260E.33, is amended by adding a subdivision
to read:


new text begin Subd. 6a.new text end

new text beginNotification of contested case hearing.new text end

new text beginWhen an appeal of a lead investigative
agency determination results in a contested case hearing under chapter 245A or 245C, the
administrative law judge shall notify the parent, legal custodian, or guardian of the child
who is the subject of the maltreatment determination. The notice must be sent by certified
mail and inform the parent, legal custodian, or guardian of the child of the right to file a
signed written statement in the proceedings and the right to attend and participate in the
hearing. The parent, legal custodian, or guardian of the child may file a written statement
with the administrative law judge hearing the case no later than five business days before
commencement of the hearing. The administrative law judge shall include the written
statement in the hearing record and consider the statement in deciding the appeal. The lead
investigative agency shall provide to the administrative law judge the address of the parent,
legal custodian, or guardian of the child. If the lead investigative agency is not reasonably
able to determine the address of the parent, legal custodian, or guardian of the child, the
administrative law judge is not required to send a hearing notice under this subdivision.
new text end

Sec. 58.

Minnesota Statutes 2020, section 260E.36, is amended by adding a subdivision
to read:


new text begin Subd. 1a.new text end

new text beginSex trafficking and sexual exploitation training requirement.new text end

new text beginAs required
by the Child Abuse Prevention and Treatment Act amendments through Public Law 114-22
and to implement Public Law 115-123, all child protection social workers and social services
staff who have responsibility for child protective duties under this chapter or chapter 260C
shall complete training implemented by the commissioner of human services regarding sex
trafficking and sexual exploitation of children and youth.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021.
new text end

Sec. 59.

Minnesota Statutes 2020, section 518.157, subdivision 1, is amended to read:


Subdivision 1.

Implementation; administration.

new text begin(a) new text endBy January 1, 1998, the chief
judge of each judicial district or a designee shall implement one or more parent education
programs within the judicial district for the purpose of educating parents about the impact
that divorce, the restructuring of families, and judicial proceedings have upon children and
families; methods for preventing parenting time conflicts; and dispute resolution options.
The chief judge of each judicial district or a designee may require that children attend a
separate education program designed to deal with the impact of divorce upon children as
part of the parent education program. Each parent education program must enable persons
to have timely and reasonable access to education sessions.

new text begin (b) The chief judge of each judicial district shall ensure that the judicial district's website
includes information on the parent education program or programs required under this
section.
new text end

Sec. 60.

Minnesota Statutes 2020, section 518.157, subdivision 3, is amended to read:


Subd. 3.

Attendance.

new text begin(a) new text endIn a proceeding under this chapter where new text beginthe parties have not
agreed to
new text endcustody or new text begina new text endparenting time deleted text beginis contesteddeleted text endnew text begin schedulenew text end, new text beginthe court shall ordernew text end the parents
of a minor child deleted text beginshall attenddeleted text end new text beginto attend or take onlinenew text end a minimum of eight hours in an
orientation and education program that meets the minimum standards promulgated by the
Minnesota Supreme Court.

new text begin (b)new text end In all other proceedings involving custody, support, or parenting time the court may
order the parents of a minor child to attend a parent education program.

new text begin (c)new text end The program shall provide the court with names of persons who fail to attend the
parent education program as ordered by the court. Persons who are separated or contemplating
involvement in a dissolution, paternity, custody, or parenting time proceeding may attend
a parent education program without a court order.

new text begin (d)new text end Unless otherwise ordered by the court, participation in a parent education program
must begin new text beginbefore an initial case management conference and new text endwithin 30 days after the first
filing with the court or as soon as practicable after that time based on the reasonable
availability of classes for the program for the parent. Parent education programs must offer
an opportunity to participate at all phases of a pending or postdecree proceeding.

new text begin (e)new text end Upon request of a party and a showing of good cause, the court may excuse the party
from attending the program. If past or present domestic abuse, as defined in chapter 518B,
is alleged, the court shall not require the parties to attend the same parent education sessions
and shall enter an order setting forth the manner in which the parties may safely participate
in the program.

new text begin (f) Before an initial case management conference for a proceeding under this chapter
where the parties have not agreed to custody or parenting time, the court shall notify the
parties of their option to resolve disagreements, including the development of a parenting
plan, through the use of private mediation.
new text end

Sec. 61.

Minnesota Statutes 2020, section 518.68, subdivision 2, is amended to read:


Subd. 2.

Contents.

The required notices must be substantially as follows:

IMPORTANT NOTICE

1. PAYMENTS TO PUBLIC AGENCY

According to Minnesota Statutes, section 518A.50, payments ordered for maintenance
and support must be paid to the public agency responsible for child support enforcement
as long as the person entitled to receive the payments is receiving or has applied for
public assistance or has applied for support and maintenance collection services. MAIL
PAYMENTS TO:

2. DEPRIVING ANOTHER OF CUSTODIAL OR PARENTAL RIGHTS -- A FELONY

A person may be charged with a felony who conceals a minor child or takes, obtains,
retains, or fails to return a minor child from or to the child's parent (or person with
custodial or visitation rights), according to Minnesota Statutes, section 609.26. A copy
of that section is available from any district court clerk.

3. NONSUPPORT OF A SPOUSE OR CHILD -- CRIMINAL PENALTIES

A person who fails to pay court-ordered child support or maintenance may be charged
with a crime, which may include misdemeanor, gross misdemeanor, or felony charges,
according to Minnesota Statutes, section 609.375. A copy of that section is available
from any district court clerk.

4. RULES OF SUPPORT, MAINTENANCE, PARENTING TIME

(a) Payment of support or spousal maintenance is to be as ordered, and the giving of
gifts or making purchases of food, clothing, and the like will not fulfill the obligation.

(b) Payment of support must be made as it becomes due, and failure to secure or denial
of parenting time is NOT an excuse for nonpayment, but the aggrieved party must seek
relief through a proper motion filed with the court.

(c) Nonpayment of support is not grounds to deny parenting time. The party entitled to
receive support may apply for support and collection services, file a contempt motion,
or obtain a judgment as provided in Minnesota Statutes, section 548.091.

(d) The payment of support or spousal maintenance takes priority over payment of debts
and other obligations.

(e) A party who accepts additional obligations of support does so with the full knowledge
of the party's prior obligation under this proceeding.

(f) Child support or maintenance is based on annual income, and it is the responsibility
of a person with seasonal employment to budget income so that payments are made
throughout the year as ordered.

(g) Reasonable parenting time guidelines are contained in Appendix B, which is available
from the court administrator.

(h) The nonpayment of support may be enforced through the denial of student grants;
interception of state and federal tax refunds; suspension of driver's, recreational, and
occupational licenses; referral to the department of revenue or private collection agencies;
seizure of assets, including bank accounts and other assets held by financial institutions;
reporting to credit bureaus; deleted text begininterest charging,deleted text end income withholdingdeleted text begin,deleted text end and contempt
proceedings; and other enforcement methods allowed by law.

(i) The public authority may suspend or resume collection of the amount allocated for
child care expenses if the conditions of Minnesota Statutes, section 518A.40, subdivision
4
, are met.

(j) The public authority may remove or resume a medical support offset if the conditions
of Minnesota Statutes, section 518A.41, subdivision 16, are met.

deleted text begin (k) The public authority may suspend or resume interest charging on child support
judgments if the conditions of Minnesota Statutes, section 548.091, subdivision 1a, are met.
deleted text end

5. MODIFYING CHILD SUPPORT

If either the obligor or obligee is laid off from employment or receives a pay reduction,
child support may be modified, increased, or decreased. Any modification will only take
effect when it is ordered by the court, and will only relate back to the time that a motion
is filed. Either the obligor or obligee may file a motion to modify child support, and may
request the public agency for help. UNTIL A MOTION IS FILED, THE CHILD
SUPPORT OBLIGATION WILL CONTINUE AT THE CURRENT LEVEL. THE
COURT IS NOT PERMITTED TO REDUCE SUPPORT RETROACTIVELY.

6. PARENTAL RIGHTS FROM MINNESOTA STATUTES, SECTION 518.17,
SUBDIVISION 3

Unless otherwise provided by the Court:

(a) Each party has the right of access to, and to receive copies of, school, medical, dental,
religious training, and other important records and information about the minor children.
Each party has the right of access to information regarding health or dental insurance
available to the minor children. Presentation of a copy of this order to the custodian of
a record or other information about the minor children constitutes sufficient authorization
for the release of the record or information to the requesting party.

(b) Each party shall keep the other informed as to the name and address of the school
of attendance of the minor children. Each party has the right to be informed by school
officials about the children's welfare, educational progress and status, and to attend
school and parent teacher conferences. The school is not required to hold a separate
conference for each party.

(c) In case of an accident or serious illness of a minor child, each party shall notify the
other party of the accident or illness, and the name of the health care provider and the
place of treatment.

(d) Each party has the right of reasonable access and telephone contact with the minor
children.

7. WAGE AND INCOME DEDUCTION OF SUPPORT AND MAINTENANCE

Child support and/or spousal maintenance may be withheld from income, with or without
notice to the person obligated to pay, when the conditions of Minnesota Statutes, section
518A.53 have been met. A copy of those sections is available from any district court
clerk.

8. CHANGE OF ADDRESS OR RESIDENCE

Unless otherwise ordered, each party shall notify the other party, the court, and the public
authority responsible for collection, if applicable, of the following information within
ten days of any change: the residential and mailing address, telephone number, driver's
license number, Social Security number, and name, address, and telephone number of
the employer.

9. COST OF LIVING INCREASE OF SUPPORT AND MAINTENANCE

Basic support and/or spousal maintenance may be adjusted every two years based upon
a change in the cost of living (using Department of Labor Consumer Price Index ..........,
unless otherwise specified in this order) when the conditions of Minnesota Statutes,
section 518A.75, are met. Cost of living increases are compounded. A copy of Minnesota
Statutes, section 518A.75, and forms necessary to request or contest a cost of living
increase are available from any district court clerk.

10. JUDGMENTS FOR UNPAID SUPPORT

If a person fails to make a child support payment, the payment owed becomes a judgment
against the person responsible to make the payment by operation of law on or after the
date the payment is due, and the person entitled to receive the payment or the public
agency may obtain entry and docketing of the judgment WITHOUT NOTICE to the
person responsible to make the payment under Minnesota Statutes, section 548.091.
deleted text begin Interest begins to accrue on a payment or installment of child support whenever the
unpaid amount due is greater than the current support due, according to Minnesota
Statutes, section 548.091, subdivision 1a.
deleted text end

11. JUDGMENTS FOR UNPAID MAINTENANCE

new text begin (a) new text endA judgment for unpaid spousal maintenance may be entered when the conditions of
Minnesota Statutes, section 548.091, are met. A copy of that section is available from
any district court clerk.

new text begin (b) The public authority is not responsible for calculating interest on any judgment for
unpaid spousal maintenance. When providing services in IV-D cases, as defined in
Minnesota Statutes, section 518A.26, subdivision 10, the public authority will only
collect interest on spousal maintenance if spousal maintenance is reduced to a sum
certain judgment.
new text end

12. ATTORNEY FEES AND COLLECTION COSTS FOR ENFORCEMENT OF CHILD
SUPPORT

A judgment for attorney fees and other collection costs incurred in enforcing a child
support order will be entered against the person responsible to pay support when the
conditions of Minnesota Statutes, section 518A.735, are met. A copy of Minnesota
Statutes, sections 518.14 and 518A.735 and forms necessary to request or contest these
attorney fees and collection costs are available from any district court clerk.

13. PARENTING TIME EXPEDITOR PROCESS

On request of either party or on its own motion, the court may appoint a parenting time
expeditor to resolve parenting time disputes under Minnesota Statutes, section 518.1751.
A copy of that section and a description of the expeditor process is available from any
district court clerk.

14. PARENTING TIME REMEDIES AND PENALTIES

Remedies and penalties for the wrongful denial of parenting time are available under
Minnesota Statutes, section 518.175, subdivision 6. These include compensatory parenting
time; civil penalties; bond requirements; contempt; and reversal of custody. A copy of
that subdivision and forms for requesting relief are available from any district court
clerk.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2022.
new text end

Sec. 62.

Minnesota Statutes 2020, section 518A.29, is amended to read:


518A.29 CALCULATION OF GROSS INCOME.

(a) Subject to the exclusions and deductions in this section, gross income includes any
form of periodic payment to an individual, including, but not limited to, salaries, wages,
commissions, self-employment income under section 518A.30, workers' compensation,
unemployment benefits, annuity payments, military and naval retirement, pension and
disability payments, spousal maintenance received under a previous order or the current
proceeding, Social Security or veterans benefits provided for a joint child under section
518A.31, and potential income under section 518A.32. Salaries, wages, commissions, or
other compensation paid by third parties shall be based upon gross income before
participation in an employer-sponsored benefit plan that allows an employee to pay for a
benefit or expense using pretax dollars, such as flexible spending plans and health savings
accounts. No deductions shall be allowed for contributions to pensions, 401-K, IRA, or
other retirement benefits.

(b) Gross income does not include compensation received by a party for employment
in excess of a 40-hour work week, provided that:

(1) child support is ordered in an amount at least equal to the guideline amount based
on gross income not excluded under this clause; and

(2) the party demonstrates, and the court finds, that:

(i) the excess employment began after the filing of the petition for dissolution or legal
separation or a petition related to custody, parenting time, or support;

(ii) the excess employment reflects an increase in the work schedule or hours worked
over that of the two years immediately preceding the filing of the petition;

(iii) the excess employment is voluntary and not a condition of employment;

(iv) the excess employment is in the nature of additional, part-time or overtime
employment compensable by the hour or fraction of an hour; and

(v) the party's compensation structure has not been changed for the purpose of affecting
a support or maintenance obligation.

(c) Expense reimbursements or in-kind payments received by a parent in the course of
employment, self-employment, or operation of a business shall be counted as income if
they reduce personal living expenses.

(d) Gross income may be calculated on either an annual or monthly basis. Weekly income
shall be translated to monthly income by multiplying the weekly income by 4.33.

(e) Gross income does not include a child support payment received by a party. It is a
rebuttable presumption that adoption assistance payments, Northstar kinship assistance
payments, and foster care subsidies are not gross income.

(f) Gross income does not include the income of the obligor's spouse and the obligee's
spouse.

(g) deleted text beginChild support ordeleted text end Spousal maintenance payments ordered by a court for a deleted text beginnonjoint
child or
deleted text end former spouse or ordered payable to the other party as part of the current proceeding
are deducted from other periodic payments received by a party for purposes of determining
gross income.

(h) Gross income does not include public assistance benefits received under section
256.741 or other forms of public assistance based on need.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023.
new text end

Sec. 63.

Minnesota Statutes 2020, section 518A.33, is amended to read:


518A.33 DEDUCTION FROM INCOME FOR NONJOINT CHILDREN.

(a) When either or both parents are legally responsible for a nonjoint child, a deduction
for this obligation shall be calculated under this section deleted text beginif:deleted text endnew text begin.
new text end

deleted text begin (1) the nonjoint child primarily resides in the parent's household; and
deleted text end

deleted text begin (2) the parent is not obligated to pay basic child support for the nonjoint child to the
other parent or a legal custodian of the child under an existing child support order.
deleted text end

(b) deleted text beginThe court shall use the guidelines under section 518A.35 to determine the basic child
support obligation for the nonjoint child or children by using the gross income of the parent
for whom the deduction is being calculated and the number of nonjoint children primarily
residing in the parent's household. If the number of nonjoint children to be used for the
determination is greater than two, the determination must be made using the number two
instead of the greater number.
deleted text endnew text begin Court-ordered child support for a nonjoint child shall be
deducted from the payor's gross income.
new text end

(c) deleted text beginThe deduction for nonjoint children is 50 percent of the guideline amount determined
under paragraph (b).
deleted text endnew text begin When a parent is legally responsible for a nonjoint child and the parent
is not obligated to pay basic child support for the nonjoint child to the other parent or a legal
custodian under an existing child support order, a deduction shall be calculated. The court
shall use the basic support guideline table under section 518A.35 to determine this deduction
by using the gross income of the parent for whom the deduction is being calculated, minus
any deduction under paragraph (b) and the number of eligible nonjoint children, up to six
children. The deduction for nonjoint children is 75 percent of the guideline amount
determined under this paragraph.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023.
new text end

Sec. 64.

Minnesota Statutes 2020, section 518A.35, subdivision 1, is amended to read:


Subdivision 1.

Determination of support obligation.

(a) The guideline in this section
is a rebuttable presumption and shall be used in any judicial or administrative proceeding
to establish or modify a support obligation under this chapter.

(b) The basic child support obligation shall be determined by referencing the guideline
for the appropriate number of joint children and the combined parental income for
determining child support of the parents.

(c) If a child is not in the custody of either parent and a support order is sought against
one or both parents, the basic child support obligation shall be determined by referencing
the guideline for the appropriate number of joint children, and the parent's individual parental
income for determining child support, not the combined parental incomes for determining
child support of the parents. Unless a parent has court-ordered parenting time, the parenting
expense adjustment formula under section 518A.34 must not be applied.

(d) If a child is deleted text beginin custody of either parentdeleted text end new text beginnot residing with the parent that has
court-ordered or statutory custody
new text end and a support order is sought deleted text beginby the public authoritydeleted text end
under section 256.87new text begin against one or both parentsnew text end, deleted text beginunless the parent against whom the support
order is sought has court-ordered parenting time,
deleted text end the new text beginbasicnew text end support obligation must be
determined by referencing the guideline for the appropriate number of joint children and
the parent's individual income without application of the parenting expense adjustment
formula under section 518A.34.

(e) For combined parental incomes for determining child support exceeding deleted text begin$15,000deleted text endnew text begin
$20,000
new text end per month, the presumed basic child support obligations shall be as for parents
with combined parental income for determining child support of deleted text begin$15,000deleted text endnew text begin $20,000new text end per month.
A basic child support obligation in excess of this level may be demonstrated for those reasons
set forth in section 518A.43.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023.
new text end

Sec. 65.

Minnesota Statutes 2020, section 518A.35, subdivision 2, is amended to read:


Subd. 2.

Basic support; guideline.

Unless otherwise agreed to by the parents and
approved by the court, when establishing basic support, the court must order that basic
support be divided between the parents based on their proportionate share of the parents'
combined monthly parental income for determining child support (PICS). Basic support
must be computed using the following guideline:

Combined Parental
Number of Children
Income for
Determining Child
Support
One
Two
Three
Four
Five
Six
$0- deleted text begin$799
deleted text endnew text begin $1,399
new text end
$50
deleted text begin$50
deleted text endnew text begin$60
new text end
deleted text begin$75
deleted text endnew text begin$70
new text end
deleted text begin$75
deleted text endnew text begin$80
new text end
deleted text begin$100
deleted text endnew text begin$90
new text end
$100
deleted text begin 800- 899
deleted text end
deleted text begin80
deleted text end
deleted text begin129
deleted text end
deleted text begin149
deleted text end
deleted text begin173
deleted text end
deleted text begin201
deleted text end
deleted text begin233
deleted text end
deleted text begin 900- 999
deleted text end
deleted text begin90
deleted text end
deleted text begin145
deleted text end
deleted text begin167
deleted text end
deleted text begin194
deleted text end
deleted text begin226
deleted text end
deleted text begin262
deleted text end
deleted text begin 1,000- 1,099
deleted text end
deleted text begin116
deleted text end
deleted text begin161
deleted text end
deleted text begin186
deleted text end
deleted text begin216
deleted text end
deleted text begin251
deleted text end
deleted text begin291
deleted text end
deleted text begin 1,100- 1,199
deleted text end
deleted text begin145
deleted text end
deleted text begin205
deleted text end
deleted text begin237
deleted text end
deleted text begin275
deleted text end
deleted text begin320
deleted text end
deleted text begin370
deleted text end
deleted text begin 1,200- 1,299
deleted text end
deleted text begin177
deleted text end
deleted text begin254
deleted text end
deleted text begin294
deleted text end
deleted text begin341
deleted text end
deleted text begin396
deleted text end
deleted text begin459
deleted text end
deleted text begin 1,300- 1,399
deleted text end
deleted text begin212
deleted text end
deleted text begin309
deleted text end
deleted text begin356
deleted text end
deleted text begin414
deleted text end
deleted text begin480
deleted text end
deleted text begin557
deleted text end
1,400- 1,499
deleted text begin 251
deleted text endnew text begin60
new text end
deleted text begin368
deleted text endnew text begin75
new text end
deleted text begin425
deleted text endnew text begin85
new text end
deleted text begin493
deleted text endnew text begin100
new text end
deleted text begin573
deleted text endnew text begin110
new text end
deleted text begin664
deleted text endnew text begin120
new text end
1,500- 1,599
deleted text begin 292
deleted text endnew text begin75
new text end
deleted text begin433
deleted text endnew text begin90
new text end
deleted text begin500
deleted text endnew text begin105
new text end
deleted text begin580
deleted text endnew text begin125
new text end
deleted text begin673
deleted text endnew text begin135
new text end
deleted text begin780
deleted text endnew text begin145
new text end
1,600- 1,699
deleted text begin 337
deleted text endnew text begin90
new text end
deleted text begin502
deleted text endnew text begin110
new text end
deleted text begin580
deleted text endnew text begin130
new text end
deleted text begin673
deleted text endnew text begin150
new text end
deleted text begin781
deleted text endnew text begin160
new text end
deleted text begin905
deleted text endnew text begin170
new text end
1,700- 1,799
deleted text begin 385
deleted text endnew text begin110
new text end
deleted text begin577
deleted text endnew text begin130
new text end
deleted text begin666
deleted text endnew text begin155
new text end
deleted text begin773
deleted text endnew text begin175
new text end
deleted text begin897
deleted text endnew text begin185
new text end
deleted text begin1,040
deleted text endnew text begin195
new text end
1,800- 1,899
deleted text begin 436
deleted text endnew text begin130
new text end
deleted text begin657
deleted text endnew text begin150
new text end
deleted text begin758
deleted text endnew text begin180
new text end
deleted text begin880
deleted text endnew text begin200
new text end
deleted text begin1,021
deleted text endnew text begin210
new text end
deleted text begin1,183
deleted text endnew text begin220
new text end
1,900- 1,999
deleted text begin 490
deleted text endnew text begin150
new text end
deleted text begin742
deleted text endnew text begin175
new text end
deleted text begin856
deleted text endnew text begin205
new text end
deleted text begin994
deleted text endnew text begin235
new text end
deleted text begin1,152
deleted text endnew text begin245
new text end
deleted text begin1,336
deleted text endnew text begin255
new text end
2,000- 2,099
deleted text begin 516
deleted text endnew text begin170
new text end
deleted text begin832
deleted text endnew text begin200
new text end
deleted text begin960
deleted text endnew text begin235
new text end
deleted text begin1,114
deleted text endnew text begin270
new text end
deleted text begin1,292
deleted text endnew text begin285
new text end
deleted text begin1,498
deleted text endnew text begin295
new text end
2,100- 2,199
deleted text begin 528
deleted text endnew text begin190
new text end
deleted text begin851
deleted text endnew text begin225
new text end
deleted text begin981
deleted text endnew text begin265
new text end
deleted text begin1,139
deleted text endnew text begin305
new text end
deleted text begin1,320
deleted text endnew text begin325
new text end
deleted text begin1,531
deleted text endnew text begin335
new text end
2,200- 2,299
deleted text begin 538
deleted text endnew text begin215
new text end
deleted text begin867
deleted text endnew text begin255
new text end
deleted text begin1,000
deleted text endnew text begin300
new text end
deleted text begin1,160
deleted text endnew text begin345
new text end
deleted text begin1,346
deleted text endnew text begin367
new text end
deleted text begin1,561
deleted text endnew text begin379
new text end
2,300- 2,399
deleted text begin 546
deleted text endnew text begin240
new text end
deleted text begin881
deleted text endnew text begin285
new text end
deleted text begin1,016
deleted text endnew text begin335
new text end
deleted text begin1,179
deleted text endnew text begin385
new text end
deleted text begin1,367
deleted text endnew text begin409
new text end
deleted text begin1,586
deleted text endnew text begin423
new text end
2,400- 2,499
deleted text begin 554
deleted text endnew text begin265
new text end
deleted text begin893
deleted text endnew text begin315
new text end
deleted text begin1,029
deleted text endnew text begin370
new text end
deleted text begin1,195
deleted text endnew text begin425
new text end
deleted text begin1,385
deleted text endnew text begin451
new text end
deleted text begin1,608
deleted text endnew text begin467
new text end
2,500- 2,599
deleted text begin 560
deleted text endnew text begin290
new text end
deleted text begin903
deleted text endnew text begin350
new text end
deleted text begin1,040
deleted text endnew text begin408
new text end
deleted text begin1,208
deleted text endnew text begin465
new text end
deleted text begin1,400
deleted text endnew text begin493
new text end
deleted text begin1,625
deleted text endnew text begin511
new text end
2,600- 2,699
deleted text begin 570
deleted text endnew text begin315
new text end
deleted text begin920
deleted text endnew text begin385
new text end
deleted text begin1,060
deleted text endnew text begin446
new text end
deleted text begin1,230
deleted text endnew text begin505
new text end
deleted text begin1,426
deleted text endnew text begin535
new text end
deleted text begin1,655
deleted text endnew text begin555
new text end
2,700- 2,799
deleted text begin 580
deleted text endnew text begin340
new text end
deleted text begin936
deleted text endnew text begin420
new text end
deleted text begin1,078
deleted text endnew text begin484
new text end
deleted text begin1,251
deleted text endnew text begin545
new text end
deleted text begin1,450
deleted text endnew text begin577
new text end
deleted text begin1,683
deleted text endnew text begin599
new text end
2,800- 2,899
deleted text begin 589
deleted text endnew text begin365
new text end
deleted text begin950
deleted text endnew text begin455
new text end
deleted text begin1,094
deleted text endnew text begin522
new text end
deleted text begin1,270
deleted text endnew text begin585
new text end
deleted text begin1,472
deleted text endnew text begin619
new text end
deleted text begin1,707
deleted text endnew text begin643
new text end
2,900- 2,999
deleted text begin 596
deleted text endnew text begin390
new text end
deleted text begin963
deleted text endnew text begin490
new text end
deleted text begin1,109
deleted text endnew text begin560
new text end
deleted text begin1,287
deleted text endnew text begin625
new text end
deleted text begin1,492
deleted text endnew text begin661
new text end
deleted text begin1,730
deleted text endnew text begin687
new text end
3,000- 3,099
deleted text begin 603
deleted text endnew text begin415
new text end
deleted text begin975
deleted text endnew text begin525
new text end
deleted text begin1,122
deleted text endnew text begin598
new text end
deleted text begin1,302
deleted text endnew text begin665
new text end
deleted text begin1,509
deleted text endnew text begin703
new text end
deleted text begin1,749
deleted text endnew text begin731
new text end
3,100- 3,199
deleted text begin 613
deleted text endnew text begin440
new text end
deleted text begin991
deleted text endnew text begin560
new text end
deleted text begin1,141
deleted text endnew text begin636
new text end
deleted text begin1,324
deleted text endnew text begin705
new text end
deleted text begin1,535
deleted text endnew text begin745
new text end
deleted text begin1,779
deleted text endnew text begin775
new text end
3,200- 3,299
deleted text begin 623
deleted text endnew text begin465
new text end
deleted text begin1,007
deleted text endnew text begin595
new text end
deleted text begin1,158
deleted text endnew text begin674
new text end
deleted text begin1,344
deleted text endnew text begin745
new text end
deleted text begin1,558
deleted text endnew text begin787
new text end
deleted text begin1,807
deleted text endnew text begin819
new text end
3,300- 3,399
deleted text begin 636
deleted text endnew text begin485
new text end
deleted text begin1,021
deleted text endnew text begin630
new text end
deleted text begin1,175
deleted text endnew text begin712
new text end
deleted text begin1,363
deleted text endnew text begin785
new text end
deleted text begin1,581
deleted text endnew text begin829
new text end
deleted text begin1,833
deleted text endnew text begin863
new text end
3,400- 3,499
deleted text begin 650
deleted text endnew text begin505
new text end
deleted text begin1,034
deleted text endnew text begin665
new text end
deleted text begin1,190
deleted text endnew text begin750
new text end
deleted text begin1,380
deleted text endnew text begin825
new text end
deleted text begin1,601
deleted text endnew text begin871
new text end
deleted text begin1,857
deleted text endnew text begin907
new text end
3,500- 3,599
deleted text begin 664
deleted text endnew text begin525
new text end
deleted text begin1,047
deleted text endnew text begin695
new text end
deleted text begin1,204
deleted text endnew text begin784
new text end
deleted text begin1,397
deleted text endnew text begin861
new text end
deleted text begin1,621
deleted text endnew text begin910
new text end
deleted text begin1,880
deleted text endnew text begin948
new text end
3,600- 3,699
deleted text begin 677
deleted text endnew text begin545
new text end
deleted text begin1,062
deleted text endnew text begin725
new text end
deleted text begin1,223
deleted text endnew text begin818
new text end
deleted text begin1,418
deleted text endnew text begin897
new text end
deleted text begin1,646
deleted text endnew text begin949
new text end
deleted text begin1,909
deleted text endnew text begin989
new text end
3,700- 3,799
deleted text begin 691
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13,800-13,899
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14,800-14,899
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14,900-14,999
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15,000deleted text begin, or the
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new text begin3,326
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new text begin 19,800-19,899
new text end
new text begin1,827
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new text begin2,558
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new text begin3,470
new text end
new text begin 19,900-19,999
new text end
new text begin1,833
new text end
new text begin2,567
new text end
new text begin2,925
new text end
new text begin3,159
new text end
new text begin3,348
new text end
new text begin3,481
new text end
new text begin 20,000 and over or
the amount in
effect under
subdivision 4
new text end
new text begin1,839
new text end
new text begin2,575
new text end
new text begin2,935
new text end
new text begin3,170
new text end
new text begin3,359
new text end
new text begin3,492
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023.
new text end

Sec. 66.

Minnesota Statutes 2020, section 518A.39, subdivision 7, is amended to read:


Subd. 7.

Child care exception.

Child care support must be based on the actual child
care expenses. The court may provide that a decrease in the amount of the child care based
on a decrease in the actual child care expenses is effective as of the date the expense is
decreased.new text begin Under section 518A.40, subdivision 4, paragraph (d), a decrease in the amount
of child care support shall be effective as of the date the expenses terminated unless otherwise
found by the court.
new text end

Sec. 67.

Minnesota Statutes 2020, section 518A.40, is amended by adding a subdivision
to read:


new text begin Subd. 3a.new text end

new text beginChild care cost information.new text end

new text begin(a) Upon the request of the obligor when child
care support is ordered to be paid, unless there is a protective or restraining order issued by
the court regarding one of the parties or on behalf of a joint child, or the obligee is a
participant in the Safe at Home program:
new text end

new text begin (1) the obligee must give the child care provider the name and address of the obligor
and must give the obligor the name, address, and telephone number of the child care provider;
new text end

new text begin (2) by February 1 of each year, the obligee must provide the obligor with verification
from the child care provider that indicates the total child care expenses paid for the previous
year; and
new text end

new text begin (3) when there is a change in the child care provider, the type of child care provider, or
the age group of the child, the obligee must provide updated information to the obligor
within 30 calendar days. If the obligee fails to provide the annual verification from the
provider or updated information, the obligor may request the verification from the provider.
new text end

new text begin (b) When the obligee is no longer incurring child care expenses, the obligee must notify
the obligor, and the public authority if it provides child support services, that the child care
expenses ended and on which date. If the public authority is providing services, the public
authority must follow the procedure outlined in subdivision 4.
new text end

Sec. 68.

Minnesota Statutes 2020, section 518A.40, subdivision 4, is amended to read:


Subd. 4.

Change in child care.

(a) When a court order provides for child care expenses,
and child care support is not assigned under section 256.741, the public authority, if the
public authority provides child support enforcement services, may suspend collecting the
amount allocated for child care expenses when either party informs the public authority that
no child care deleted text begincostsdeleted text endnew text begin expensesnew text end are being incurred and:

(1) the public authority verifies the accuracy of the information with the obligee; or

(2) the obligee fails to respond within 30 days of the date of a written request from the
public authority for information regarding child care costs. A written or oral response from
the obligee that child care costs are being incurred is sufficient for the public authority to
continue collecting child care expenses.

The suspension is effective as of the first day of the month following the date that the public
authority either verified the information with the obligee or the obligee failed to respond.

The public authority will resume collecting child care expenses when either party provides
information that child care costs are incurred, or when a child care support assignment takes
effect under section 256.741, subdivision 4. The resumption is effective as of the first day
of the month after the date that the public authority received the information.

(b) If the parties provide conflicting information to the public authority regarding whether
child care expenses are being incurred, the public authority will continue or resume collecting
child care expenses. Either party, by motion to the court, may challenge the suspension,
continuation, or resumption of the collection of child care expenses under this subdivision.
If the public authority suspends collection activities for the amount allocated for child care
expenses, all other provisions of the court order remain in effect.

(c) In cases where there is a substantial increase or decrease in child care expenses, the
parties may modify the order under section 518A.39.

new text begin (d) In cases where child care expenses have terminated, the parties may modify the order
under section 518A.39.
new text end

new text begin (e) When the public authority is providing child support services, the parties may contact
the public authority about the option of a stipulation to modify or terminate the child care
support amount.
new text end

Sec. 69.

Minnesota Statutes 2020, section 518A.42, is amended to read:


518A.42 ABILITY TO PAY; SELF-SUPPORT ADJUSTMENT.

Subdivision 1.

Ability to pay.

(a) It is a rebuttable presumption that a child support
order should not exceed the obligor's ability to pay. To determine the amount of child support
the obligor has the ability to pay, the court shall follow the procedure set out in this section.

(b) The court shall calculate the obligor's income available for support by subtracting a
monthly self-support reserve equal to 120 percent of the federal poverty guidelines for one
person from the obligor's deleted text begingross incomedeleted text endnew text begin parental income for determining child support (PICS)new text end.
If the obligor's income available for support calculated under this paragraph is equal to or
greater than the obligor's support obligation calculated under section 518A.34, the court
shall order child support under section 518A.34.

(c) If the obligor's income available for support calculated under paragraph (b) is more
than the minimum support amount under subdivision 2, but less than the guideline amount
under section 518A.34, then the court shall apply a reduction to the child support obligation
in the following order, until the support order is equal to the obligor's income available for
support:

(1) medical support obligation;

(2) child care support obligation; and

(3) basic support obligation.

(d) If the obligor's income available for support calculated under paragraph (b) is equal
to or less than the minimum support amount under subdivision 2 or if the obligor's gross
income is less than 120 percent of the federal poverty guidelines for one person, the minimum
support amount under subdivision 2 applies.

Subd. 2.

Minimum basic support amount.

(a) If the basic support amount applies, the
court must order the following amount as the minimum basic support obligation:

(1) for one deleted text beginor two childrendeleted text endnew text begin childnew text end, the obligor's basic support obligation is $50 per month;

(2) new text beginfor two children, the obligor's basic support obligation is $60 per month;
new text end

new text begin (3) new text endfor three deleted text beginor fourdeleted text end children, the obligor's basic support obligation is deleted text begin$75deleted text endnew text begin $70new text end per month;
deleted text begin and
deleted text end

new text begin (4) for four children, the obligor's basic support obligation is $80 per month;
new text end

deleted text begin (3)deleted text endnew text begin (5)new text end for five deleted text beginor moredeleted text end children, the obligor's basic support obligation is deleted text begin$100deleted text endnew text begin $90new text end per
monthdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (6) for six or more children, the obligor's basic support obligation is $100 per month.
new text end

(b) If the court orders the obligor to pay the minimum basic support amount under this
subdivision, the obligor is presumed unable to pay child care support and medical support.

deleted text begin If the court finds the obligor receives no income and completely lacks the ability to earn
income, the minimum basic support amount under this subdivision does not apply.
deleted text end

Subd. 3.

Exception.

new text begin(a) new text endThis section does not apply to an obligor who is incarcerated.

new text begin (b) If the court finds the obligor receives no income and completely lacks the ability to
earn income, the minimum basic support amount under this subdivision does not apply.
new text end

new text begin (c) If the obligor's basic support amount is reduced below the minimum basic support
amount due to the application of the parenting expense adjustment, the minimum basic
support amount under this subdivision does not apply and the lesser amount is the guideline
basic support.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023.
new text end

Sec. 70.

Minnesota Statutes 2020, section 518A.43, is amended by adding a subdivision
to read:


new text begin Subd. 1b.new text end

new text beginIncrease in income of custodial parent.new text end

new text beginIn a modification of support under
section 518A.39, the court may deviate from the presumptive child support obligation under
section 518A.34 when the only change in circumstances is an increase to the custodial
parent's income and:
new text end

new text begin (1) the basic support increases;
new text end

new text begin (2) the parties' combined gross income is $6,000 or less; or
new text end

new text begin (3) the obligor's income is $2,000 or less.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023.
new text end

Sec. 71.

Minnesota Statutes 2020, section 518A.685, is amended to read:


518A.685 CONSUMER REPORTING AGENCY; REPORTING ARREARS.

(a) If a public authority determines that an obligor has not paid the current monthly
support obligation plus any required arrearage payment for three months, the public authority
deleted text begin mustdeleted text endnew text begin maynew text end report this information to a consumer reporting agency.

(b) Before reporting that an obligor is in arrears for court-ordered child support, the
public authority must:

(1) provide written notice to the obligor that the public authority intends to report the
arrears to a consumer reporting agency; and

(2) mail the written notice to the obligor's last known mailing address at least 30 days
before the public authority reports the arrears to a consumer reporting agency.

(c) The obligor may, within 21 days of receipt of the notice, do the following to prevent
the public authority from reporting the arrears to a consumer reporting agency:

(1) pay the arrears in full; deleted text beginor
deleted text end

(2) request an administrative review. An administrative review is limited to issues of
mistaken identity, a pending legal action involving the arrears, or an incorrect arrears
balancedeleted text begin.deleted text endnew text begin; or
new text end

new text begin (3) enter into a written payment agreement pursuant to section 518A.69 that is approved
by a court, a child support magistrate, or the public authority responsible for child support
enforcement.
new text end

(d) A public authority that reports arrearage information under this section must make
monthly reports to a consumer reporting agency. The monthly report must be consistent
with credit reporting industry standards for child support.

(e) For purposes of this section, "consumer reporting agency" has the meaning given in
section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f).

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023.
new text end

Sec. 72.

new text begin[518A.80] MOTION TO TRANSFER TO TRIBAL COURT.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) For purposes of this section, the terms defined in this
subdivision have the meanings given.
new text end

new text begin (b) "Case participant" means a person who is a party to the case.
new text end

new text begin (c) "District court" means a district court of the state of Minnesota.
new text end

new text begin (d) "Party" means a person or entity named or admitted as a party or seeking to be
admitted as a party in the district court action, including the county IV-D agency, regardless
of whether the person or entity is named in the caption.
new text end

new text begin (e) "Tribal court" means a tribal court of a federally recognized Indian tribe located in
Minnesota that is receiving funding from the federal government to operate a child support
program under United States Code, title 42, chapter 7, subchapter IV, part D, sections 654
to 669b.
new text end

new text begin (f) "Tribal IV-D agency" has the meaning given in Code of Federal Regulations, title
45, part 309.05.
new text end

new text begin (g) "Title IV-D child support case" has the meaning given in section 518A.26, subdivision
10.
new text end

new text begin Subd. 2.new text end

new text beginActions eligible for transfer.new text end

new text beginUnder this section, a postjudgment child support,
custody, or parenting time action is eligible for transfer to a Tribal court. This section does
not apply to a child protection action or a dissolution action involving a child.
new text end

new text begin Subd. 3.new text end

new text beginMotion to transfer.new text end

new text begin(a) A party's or Tribal IV-D agency's motion to transfer a
child support, custody, or parenting time action to a Tribal court shall include:
new text end

new text begin (1) the address of each case participant;
new text end

new text begin (2) the Tribal affiliation of each case participant, if applicable;
new text end

new text begin (3) the name, Tribal affiliation if applicable, and date of birth of each living minor or
dependent child of a case participant who is subject to the action; and
new text end

new text begin (4) the legal and factual basis for the court to find that the district court and a Tribal
court have concurrent jurisdiction in the case.
new text end

new text begin (b) A party or Tribal IV-D agency bringing a motion to transfer a child support, custody,
or parenting time action to a Tribal court must file the motion with the district court and
serve the required documents on each party and the Tribal IV-D agency, regardless of
whether the Tribal IV-D agency is a party to the action.
new text end

new text begin (c) A party's or Tribal IV-D agency's motion to transfer a child support, custody, or
parenting time action to a Tribal court must be accompanied by an affidavit setting forth
facts in support of the motion.
new text end

new text begin (d) When a party other than the Tribal IV-D agency has filed a motion to transfer a child
support, custody, or parenting time action to a Tribal court, an affidavit of the Tribal IV-D
agency stating whether the Tribal IV-D agency provides services to a party must be filed
and served on each party within 15 days from the date of service of the motion to transfer
the action.
new text end

new text begin Subd. 4.new text end

new text beginOrder to transfer to Tribal court.new text end

new text begin(a) Unless a district court holds a hearing
under subdivision 6, upon motion of a party or a Tribal IV-D agency, a district court must
transfer a postjudgment child support, custody, or parenting time action to a Tribal court
when the district court finds that:
new text end

new text begin (1) the district court and Tribal court have concurrent jurisdiction of the action;
new text end

new text begin (2) a case participant in the action is receiving services from the Tribal IV-D agency;
and
new text end

new text begin (3) no party or Tribal IV-D agency files and serves a timely objection to transferring the
action to a Tribal court.
new text end

new text begin (b) When the district court finds that each requirement of this subdivision is satisfied,
the district court is not required to hold a hearing on the motion to transfer the action to a
Tribal court. The district court's order transferring the action to a Tribal court must include
written findings that describe how each requirement of this subdivision is met.
new text end

new text begin Subd. 5.new text end

new text beginObjection to motion to transfer.new text end

new text begin(a) To object to a motion to transfer a child
support, custody, or parenting time action to a Tribal court, a party or Tribal IV-D agency
must file with the court and serve on each party and the Tribal IV-D agency a responsive
motion objecting to the motion to transfer within 30 days of the motion to transfer's date of
service.
new text end

new text begin (b) If a party or Tribal IV-D agency files with the district court and properly serves a
timely objection to the motion to transfer a child support, custody, or parenting time action
to a Tribal court, the district court must hold a hearing on the motion.
new text end

new text begin Subd. 6.new text end

new text beginHearing.new text end

new text beginIf a district court holds a hearing under this section, the district court
must evaluate and make written findings about all relevant factors, including:
new text end

new text begin (1) whether an issue requires interpretation of Tribal law, including the Tribal constitution,
statutes, bylaws, ordinances, resolutions, treaties, or case law;
new text end

new text begin (2) whether the action involves Tribal traditional or cultural matters;
new text end

new text begin (3) whether the tribe is a party to the action;
new text end

new text begin (4) whether Tribal sovereignty, jurisdiction, or territory is an issue in the action;
new text end

new text begin (5) the Tribal membership status of each case participant in the action;
new text end

new text begin (6) where the claim arises that forms the basis of the action;
new text end

new text begin (7) the location of the residence of each case participant in the action and each child
who is a subject of the action;
new text end

new text begin (8) whether the parties have by contract chosen a forum or the law to be applied in the
event of a dispute;
new text end

new text begin (9) the timing of any motion to transfer the action to a Tribal court, each party's
expenditure of time and resources, the court's expenditure of time and resources, and the
district court's scheduling order;
new text end

new text begin (10) which court will hear and decide the action more expeditiously;
new text end

new text begin (11) the burden on each party if the court transfers the action to a Tribal court, including
costs, access to and admissibility of evidence, and matters of procedure; and
new text end

new text begin (12) any other factor that the court determines to be relevant.
new text end

new text begin Subd. 7.new text end

new text beginFuture exercise of jurisdiction.new text end

new text beginNothing in this section shall be construed to
limit the district court's exercise of jurisdiction when the Tribal court waives jurisdiction,
transfers the action back to district court, or otherwise declines to exercise jurisdiction over
the action.
new text end

new text begin Subd. 8.new text end

new text beginTransfer to Red Lake Nation Tribal Court.new text end

new text beginWhen a party or Tribal IV-D
agency brings a motion to transfer a child support, custody, or parenting time action to the
Red Lake Nation Tribal Court, the court must transfer the action to the Red Lake Nation
Tribal Court if the case participants and child resided within the boundaries of the Red Lake
Reservation for six months preceding the motion to transfer the action to the Red Lake
Nation Tribal Court.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 73.

Minnesota Statutes 2020, section 548.091, subdivision 1a, is amended to read:


Subd. 1a.

Child support judgment by operation of law.

deleted text begin(a)deleted text end Any payment or installment
of support required by a judgment or decree of dissolution or legal separation, determination
of parentage, an order under chapter 518C, an order under section 256.87, or an order under
section 260B.331 or 260C.331, that is not paid or withheld from the obligor's income as
required under section 518A.53, or which is ordered as child support by judgment, decree,
or order by a court in any other state, is a judgment by operation of law on and after the
date it is due, is entitled to full faith and credit in this state and any other state, and shall be
entered and docketed by the court administrator on the filing of affidavits as provided in
subdivision 2a. deleted text beginExcept as otherwise provided by paragraphs (b) and (e), interest accrues
from the date the unpaid amount due is greater than the current support due at the annual
rate provided in section 549.09, subdivision 1, not to exceed an annual rate of 18 percent.
deleted text end
A payment or installment of support that becomes a judgment by operation of law between
the date on which a party served notice of a motion for modification under section 518A.39,
subdivision 2
, and the date of the court's order on modification may be modified under that
subdivision.new text begin Beginning August 1, 2022, interest does not accrue on a past, current, or future
judgment for child support, confinement and pregnancy expenses, or genetic testing fees.
new text end

deleted text begin (b) Notwithstanding the provisions of section 549.09, upon motion to the court and upon
proof by the obligor of 12 consecutive months of complete and timely payments of both
current support and court-ordered paybacks of a child support debt or arrearage, the court
may order interest on the remaining debt or arrearage to stop accruing. Timely payments
are those made in the month in which they are due. If, after that time, the obligor fails to
make complete and timely payments of both current support and court-ordered paybacks
of child support debt or arrearage, the public authority or the obligee may move the court
for the reinstatement of interest as of the month in which the obligor ceased making complete
and timely payments.
deleted text end

deleted text begin The court shall provide copies of all orders issued under this section to the public
authority. The state court administrator shall prepare and make available to the court and
the parties forms to be submitted by the parties in support of a motion under this paragraph.
deleted text end

deleted text begin (c) Notwithstanding the provisions of section 549.09, upon motion to the court, the court
may order interest on a child support debt or arrearage to stop accruing where the court
finds that the obligor is:
deleted text end

deleted text begin (1) unable to pay support because of a significant physical or mental disability;
deleted text end

deleted text begin (2) a recipient of Supplemental Security Income (SSI), Title II Older Americans Survivor's
Disability Insurance (OASDI), other disability benefits, or public assistance based upon
need; or
deleted text end

deleted text begin (3) institutionalized or incarcerated for at least 30 days for an offense other than
nonsupport of the child or children involved, and is otherwise financially unable to pay
support.
deleted text end

deleted text begin (d) If the conditions in paragraph (c) no longer exist, upon motion to the court, the court
may order interest accrual to resume retroactively from the date of service of the motion to
resume the accrual of interest.
deleted text end

deleted text begin (e) Notwithstanding section 549.09, the public authority must suspend the charging of
interest when:
deleted text end

deleted text begin (1) the obligor makes a request to the public authority that the public authority suspend
the charging of interest;
deleted text end

deleted text begin (2) the public authority provides full IV-D child support services; and
deleted text end

deleted text begin (3) the obligor has made, through the public authority, 12 consecutive months of complete
and timely payments of both current support and court-ordered paybacks of a child support
debt or arrearage.
deleted text end

deleted text begin Timely payments are those made in the month in which they are due.
deleted text end

deleted text begin Interest charging must be suspended on the first of the month following the date of the
written notice of the public authority's action to suspend the charging of interest. If, after
interest charging has been suspended, the obligor fails to make complete and timely payments
of both current support and court-ordered paybacks of child support debt or arrearage, the
public authority may resume the charging of interest as of the first day of the month in which
the obligor ceased making complete and timely payments.
deleted text end

deleted text begin The public authority must provide written notice to the parties of the public authority's
action to suspend or resume the charging of interest. The notice must inform the parties of
the right to request a hearing to contest the public authority's action. The notice must be
sent by first class mail to the parties' last known addresses.
deleted text end

deleted text begin A party may contest the public authority's action to suspend or resume the charging of
interest if the party makes a written request for a hearing within 30 days of the date of written
notice. If a party makes a timely request for a hearing, the public authority must schedule
a hearing and send written notice of the hearing to the parties by mail to the parties' last
known addresses at least 14 days before the hearing. The hearing must be conducted in
district court or in the expedited child support process if section 484.702 applies. The district
court or child support magistrate must determine whether suspending or resuming the interest
charging is appropriate and, if appropriate, the effective date.
deleted text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2022.
new text end

Sec. 74.

Minnesota Statutes 2020, section 548.091, subdivision 2a, is amended to read:


Subd. 2a.

Entry and docketing of child support judgment.

(a) On or after the date an
unpaid amount becomes a judgment by operation of law under subdivision 1a, the obligee
or the public authority may file with the court administrator:

(1) a statement identifying, or a copy of, the judgment or decree of dissolution or legal
separation, determination of parentage, order under chapter 518B or 518C, an order under
section 256.87, an order under section 260B.331 or 260C.331, or judgment, decree, or order
for child support by a court in any other state, which provides for periodic installments of
child support, or a judgment or notice of attorney fees and collection costs under section
518A.735;

(2) an affidavit of default. The affidavit of default must state the full name, occupation,
place of residence, and last known post office address of the obligor, the name of the obligee,
the date or dates payment was due and not received and judgment was obtained by operation
of law, the total amount of the judgments to be entered and docketed; and

(3) an affidavit of service of a notice of intent to enter and docket judgment and to recover
attorney fees and collection costs on the obligor, in person or by first class mail at the
obligor's last known post office address. Service is completed upon mailing in the manner
designated. Where applicable, a notice of interstate lien in the form promulgated under
United States Code, title 42, section 652(a), is sufficient to satisfy the requirements of clauses
(1) and (2).

(b) A judgment entered and docketed under this subdivision has the same effect and is
subject to the same procedures, defenses, and proceedings as any other judgment in district
court, and may be enforced or satisfied in the same manner as judgments under section
548.09, except as otherwise provided.

new text begin (c) A judgment entered and docketed under this subdivision is not subject to interest
charging or accrual.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2022.
new text end

Sec. 75.

Minnesota Statutes 2020, section 548.091, subdivision 3b, is amended to read:


Subd. 3b.

Child support judgment administrative renewals.

Child support judgments
may be renewed by service of notice upon the debtor. Service must be by first class mail at
the last known address of the debtor, with service deemed complete upon mailing in the
manner designated, or in the manner provided for the service of civil process. Upon the
filing of the notice and proof of service, the court administrator shall administratively renew
the judgment for child support without any additional filing fee in the same court file as the
original child support judgment. The judgment must be renewed in an amount equal to the
unpaid principal plus the deleted text beginaccrueddeleted text end unpaid interestnew text begin accrued prior to August 1, 2022new text end. Child
support judgments may be renewed multiple times until paid.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2022.
new text end

Sec. 76.

Minnesota Statutes 2020, section 548.091, subdivision 9, is amended to read:


Subd. 9.

Payoff statement.

The public authority shall issue to the obligor, attorneys,
lenders, and closers, or their agents, a payoff statement setting forth conclusively the amount
necessary to satisfy the lien. Payoff statements must be issued within three business days
after receipt of a request by mail, personal delivery, telefacsimile, or electronic mail
transmission, and must be delivered to the requester by telefacsimile or electronic mail
transmission if requested and if appropriate technology is available to the public authority.new text begin
If the payoff statement includes amounts for unpaid maintenance, the statement shall specify
that the public authority does not calculate accrued interest and that an interest balance in
addition to the payoff statement may be owed.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2022.
new text end

Sec. 77.

Minnesota Statutes 2020, section 548.091, subdivision 10, is amended to read:


Subd. 10.

Release of lien.

Upon payment of the new text beginchild support new text endamount due, the public
authority shall execute and deliver a satisfaction of the judgment lien within five business
days.new text begin The public authority is not responsible for satisfaction of judgments for unpaid
maintenance.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2022.
new text end

Sec. 78.

Minnesota Statutes 2020, section 549.09, subdivision 1, is amended to read:


Subdivision 1.

When owed; rate.

(a) When a judgment or award is for the recovery of
money, including a judgment for the recovery of taxes, interest from the time of the verdict,
award, or report until judgment is finally entered shall be computed by the court administrator
or arbitrator as provided in paragraph (c) and added to the judgment or award.

(b) Except as otherwise provided by contract or allowed by law, preverdict, preaward,
or prereport interest on pecuniary damages shall be computed as provided in paragraph (c)
from the time of the commencement of the action or a demand for arbitration, or the time
of a written notice of claim, whichever occurs first, except as provided herein. The action
must be commenced within two years of a written notice of claim for interest to begin to
accrue from the time of the notice of claim. If either party serves a written offer of settlement,
the other party may serve a written acceptance or a written counteroffer within 30 days.
After that time, interest on the judgment or award shall be calculated by the judge or arbitrator
in the following manner. The prevailing party shall receive interest on any judgment or
award from the time of commencement of the action or a demand for arbitration, or the time
of a written notice of claim, or as to special damages from the time when special damages
were incurred, if later, until the time of verdict, award, or report only if the amount of its
offer is closer to the judgment or award than the amount of the opposing party's offer. If
the amount of the losing party's offer was closer to the judgment or award than the prevailing
party's offer, the prevailing party shall receive interest only on the amount of the settlement
offer or the judgment or award, whichever is less, and only from the time of commencement
of the action or a demand for arbitration, or the time of a written notice of claim, or as to
special damages from when the special damages were incurred, if later, until the time the
settlement offer was made. Subsequent offers and counteroffers supersede the legal effect
of earlier offers and counteroffers. For the purposes of clause (2), the amount of settlement
offer must be allocated between past and future damages in the same proportion as determined
by the trier of fact. Except as otherwise provided by contract or allowed by law, preverdict,
preaward, or prereport interest shall not be awarded on the following:

(1) judgments, awards, or benefits in workers' compensation cases, but not including
third-party actions;

(2) judgments or awards for future damages;

(3) punitive damages, fines, or other damages that are noncompensatory in nature;

(4) judgments or awards not in excess of the amount specified in section 491A.01; and

(5) that portion of any verdict, award, or report which is founded upon interest, or costs,
disbursements, attorney fees, or other similar items added by the court or arbitrator.

(c)(1)(i) For a judgment or award of $50,000 or less or a judgment or award for or against
the state or a political subdivision of the state, regardless of the amount, or a judgment or
award in a family court action, new text beginexcept for a child support judgment, new text endregardless of the amount,
the interest shall be computed as simple interest per annum. The rate of interest shall be
based on the secondary market yield of one year United States Treasury bills, calculated on
a bank discount basis as provided in this section.

On or before the 20th day of December of each year the state court administrator shall
determine the rate from the one-year constant maturity treasury yield for the most recent
calendar month, reported on a monthly basis in the latest statistical release of the board of
governors of the Federal Reserve System. This yield, rounded to the nearest one percent,
or four percent, whichever is greater, shall be the annual interest rate during the succeeding
calendar year. The state court administrator shall communicate the interest rates to the court
administrators and sheriffs for use in computing the interest on verdicts and shall make the
interest rates available to arbitrators.

This item applies to any section that references section 549.09 by citation for the purposes
of computing an interest rate on any amount owed to or by the state or a political subdivision
of the state, regardless of the amount.

(ii) The court, in a family court action, may order a lower interest rate or no interest rate
if the parties agree or if the court makes findings explaining why application of a lower
interest rate or no interest rate is necessary to avoid causing an unfair hardship to the debtor.
This item does not apply to child support or spousal maintenance judgments subject to
section 548.091.

(2) For a judgment or award over $50,000, other than a judgment or award for or against
the state or a political subdivision of the state or a judgment or award in a family court
action, the interest rate shall be ten percent per year until paid.

(3) When a judgment creditor, or the judgment creditor's attorney or agent, has received
a payment after entry of judgment, whether the payment is made voluntarily by or on behalf
of the judgment debtor, or is collected by legal process other than execution levy where a
proper return has been filed with the court administrator, the judgment creditor, or the
judgment creditor's attorney, before applying to the court administrator for an execution
shall file with the court administrator an affidavit of partial satisfaction. The affidavit must
state the dates and amounts of payments made upon the judgment after the most recent
affidavit of partial satisfaction filed, if any; the part of each payment that is applied to taxable
disbursements and to accrued interest and to the unpaid principal balance of the judgment;
and the accrued, but the unpaid interest owing, if any, after application of each payment.

new text begin (4) Beginning August 1, 2022, interest shall not accrue on past, current, or future child
support judgments.
new text end

(d) This section does not apply to arbitrations between employers and employees under
chapter 179 or 179A. An arbitrator is neither required to nor prohibited from awarding
interest under chapter 179 or under section 179A.16 for essential employees.

(e) For purposes of this subdivision:

(1) "state" includes a department, board, agency, commission, court, or other entity in
the executive, legislative, or judicial branch of the state; and

(2) "political subdivision" includes a town, statutory or home rule charter city, county,
school district, or any other political subdivision of the state.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2022.
new text end

Sec. 79. new text beginDIRECTION TO THE COMMISSIONER; QUALIFIED RESIDENTIAL
TREATMENT TRANSITION SUPPORTS.
new text end

new text begin The commissioner of human services shall consult with stakeholders to develop policies
regarding aftercare supports for the transition of a child from a qualified residential treatment
program, as defined in Minnesota Statutes, section 260C.007, subdivision 26d, to
reunification with the child's parent or legal guardian, including potential placement in a
less restrictive setting prior to reunification that aligns with the child's permanency plan and
person-centered support plan, when applicable. The policies must be consistent with
Minnesota Rules, part 2960.0190, and Minnesota Statutes, section 245A.25, subdivision 4,
paragraph (i), and address the coordination of the qualified residential treatment program
discharge planning and aftercare supports where needed, the county social services case
plan, and services from community-based providers, to maintain the child's progress with
behavioral health goals in the child's treatment plan. The commissioner must complete
development of the policy guidance by December 31, 2022.
new text end

Sec. 80. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall place the following first grade headnote in Minnesota
Statutes, chapter 260C, preceding Minnesota Statutes, sections 260C.70 to 260C.714:
PLACEMENT OF CHILDREN IN QUALIFIED RESIDENTIAL TREATMENT.
new text end

ARTICLE 11

BEHAVIORAL HEALTH

Section 1.

Minnesota Statutes 2020, section 245.735, subdivision 3, is amended to read:


Subd. 3.

Certified community behavioral health clinics.

(a) The commissioner shall
establish a state certification process for certified community behavioral health clinics
(CCBHCs)new text begin that satisfy all federal requirements necessary for CCBHCs certified under this
section to be eligible for reimbursement under medical assistance, without service area
limits based on geographic area or region
new text end. new text beginThe commissioner shall consult with CCBHC
stakeholders before establishing and implementing changes in the certification process and
requirements.
new text end Entities that choose to be CCBHCs must:

deleted text begin (1) comply with the CCBHC criteria published by the United States Department of
Health and Human Services;
deleted text end

new text begin (1) comply with state licensing requirements and other requirements issued by the
commissioner;
new text end

(2) employ or contract for clinic staff who have backgrounds in diverse disciplines,
including licensed mental health professionals and licensed alcohol and drug counselors,
and staff who are culturally and linguistically trained to meet the needs of the population
the clinic serves;

(3) ensure that clinic services are available and accessible to individuals and families of
all ages and genders and that crisis management services are available 24 hours per day;

(4) establish fees for clinic services for individuals who are not enrolled in medical
assistance using a sliding fee scale that ensures that services to patients are not denied or
limited due to an individual's inability to pay for services;

(5) comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data;

(6) provide crisis mental health and substance use services, withdrawal management
services, emergency crisis intervention services, and stabilization servicesnew text begin through existing
mobile crisis services
new text end; screening, assessment, and diagnosis services, including risk
assessments and level of care determinations; person- and family-centered treatment planning;
outpatient mental health and substance use services; targeted case management; psychiatric
rehabilitation services; peer support and counselor services and family support services;
and intensive community-based mental health services, including mental health services
for members of the armed forces and veteransdeleted text begin;deleted text endnew text begin. CCBHCs must directly provide the majority
of these services to enrollees, but may coordinate some services with another entity through
a collaboration or agreement, pursuant to paragraph (b);
new text end

(7) provide coordination of care across settings and providers to ensure seamless
transitions for individuals being served across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with:

(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified
health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or
community-based mental health providers; and

(ii) other community services, supports, and providers, including schools, child welfare
agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally
licensed health care and mental health facilities, urban Indian health clinics, Department of
Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals,
and hospital outpatient clinics;

(8) be certified as mental health clinics under section 245.69, subdivision 2;

(9) comply with standards new text beginestablished by the commissioner new text endrelating to deleted text beginmental health
services in Minnesota Rules, parts 9505.0370 to 9505.0372
deleted text endnew text begin CCBHC screenings, assessments,
and evaluations
new text end;

(10) be licensed to provide substance use disorder treatment under chapter 245G;

(11) be certified to provide children's therapeutic services and supports under section
256B.0943;

(12) be certified to provide adult rehabilitative mental health services under section
256B.0623;

(13) be enrolled to provide mental health crisis response services under sections
256B.0624 and 256B.0944;

(14) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;

(15) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926;

(16) provide services that comply with the evidence-based practices described in
paragraph (e); and

(17) comply with standards relating to peer services under sections 256B.0615,
256B.0616, and 245G.07, subdivision 1, paragraph (a), clause (5), as applicable when peer
services are provided.

(b) If deleted text beginan entitydeleted text endnew text begin a certified CCBHCnew text end is unable to provide one or more of the services listed
in paragraph (a), clauses (6) to (17), the deleted text begincommissioner may certify the entity as adeleted text end CCBHCdeleted text begin,
if the entity has a current
deleted text endnew text begin maynew text end contract with another entity that has the required authority
to provide that service and that meets deleted text beginfederal CCBHCdeleted text endnew text begin the followingnew text end criteria as a designated
collaborating organizationdeleted text begin, or, to the extent allowed by the federal CCBHC criteria, the
commissioner may approve a referral arrangement. The CCBHC must meet federal
requirements regarding the type and scope of services to be provided directly by the CCBHC.
deleted text endnew text begin:
new text end

new text begin (1) the entity has a formal agreement with the CCBHC to furnish one or more of the
services under paragraph (a), clause (6);
new text end

new text begin (2) the entity provides assurances that it will provide services according to CCBHC
service standards and provider requirements;
new text end

new text begin (3) the entity agrees that the CCBHC is responsible for coordinating care and has clinical
and financial responsibility for the services that the entity provides under the agreement;
and
new text end

new text begin (4) the entity meets any additional requirements issued by the commissioner.
new text end

(c) Notwithstanding any other law that requires a county contract or other form of county
approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets
CCBHC requirements may receive the prospective payment under section 256B.0625,
subdivision 5m
, for those services without a county contract or county approval. As part of
the certification process in paragraph (a), the commissioner shall require a letter of support
from the CCBHC's host county confirming that the CCBHC and the county or counties it
serves have an ongoing relationship to facilitate access and continuity of care, especially
for individuals who are uninsured or who may go on and off medical assistance.

(d) When the standards listed in paragraph (a) or other applicable standards conflict or
address similar issues in duplicative or incompatible ways, the commissioner may grant
variances to state requirements if the variances do not conflict with federal requirementsnew text begin
for services reimbursed under medical assistance
new text end. If standards overlap, the commissioner
may substitute all or a part of a licensure or certification that is substantially the same as
another licensure or certification. The commissioner shall consult with stakeholders, as
described in subdivision 4, before granting variances under this provision. For the CCBHC
that is certified but not approved for prospective payment under section 256B.0625,
subdivision 5m
, the commissioner may grant a variance under this paragraph if the variance
does not increase the state share of costs.

(e) The commissioner shall issue a list of required evidence-based practices to be
delivered by CCBHCs, and may also provide a list of recommended evidence-based practices.
The commissioner may update the list to reflect advances in outcomes research and medical
services for persons living with mental illnesses or substance use disorders. The commissioner
shall take into consideration the adequacy of evidence to support the efficacy of the practice,
the quality of workforce available, and the current availability of the practice in the state.
At least 30 days before issuing the initial list and any revisions, the commissioner shall
provide stakeholders with an opportunity to comment.

(f) The commissioner shall recertify CCBHCs at least every three years. The
commissioner shall establish a process for decertification and shall require corrective action,
medical assistance repayment, or decertification of a CCBHC that no longer meets the
requirements in this section or that fails to meet the standards provided by the commissioner
in the application and certification process.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained or denied.
new text end

Sec. 2.

Minnesota Statutes 2020, section 245.735, subdivision 5, is amended to read:


Subd. 5.

Information systems support.

The commissioner and the state chief information
officer shall provide information systems support to the projects as necessary to comply
with new text beginstate and new text endfederal requirements.

Sec. 3.

Minnesota Statutes 2020, section 245.735, is amended by adding a subdivision to
read:


new text begin Subd. 6.new text end

new text beginDemonstration entities.new text end

new text beginThe commissioner may operate the demonstration
program established by section 223 of the Protecting Access to Medicare Act if federal
funding for the demonstration program remains available from the United States Department
of Health and Human Services. To the extent practicable, the commissioner shall align the
requirements of the demonstration program with the requirements under this section for
CCBHCs receiving medical assistance reimbursement. A CCBHC may not apply to
participate as a billing provider in both the CCBHC federal demonstration and the benefit
for CCBHCs under the medical assistance program.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256B.0625, subdivision 5m, is amended to read:


Subd. 5m.

Certified community behavioral health clinic services.

(a) Medical
assistance covers certified community behavioral health clinic (CCBHC) services that meet
the requirements of section 245.735, subdivision 3.

(b) The commissioner shall deleted text beginestablish standards and methodologies for adeleted text end new text beginreimburse
CCBHCs on a per-visit basis under the
new text endprospective payment system for medical assistance
payments deleted text beginfor services delivered by a CCBHC, in accordance with guidance issued by the
Centers for Medicare and Medicaid Services
deleted text endnew text begin as described in paragraph (c)new text end. The commissioner
shall include a quality deleted text beginbonusdeleted text endnew text begin incentivenew text end payment in the prospective payment system deleted text beginbased
on federal criteria
deleted text endnew text beginas described in paragraph (e)new text end. There is no county share for medical
assistance services when reimbursed through the CCBHC prospective payment system.

(c) deleted text beginUnless otherwise indicated in applicable federal requirements, the prospective payment
system must continue to be based on the federal instructions issued for the federal section
223 CCBHC demonstration, except:
deleted text endnew text begin The commissioner shall ensure that the prospective
payment system for CCBHC payments under medical assistance meets the following
requirements:
new text end

new text begin (1) the prospective payment rate shall be a provider-specific rate calculated for each
CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable
costs for CCBHCs divided by the total annual number of CCBHC visits. For calculating
the payment rate, total annual visits include visits covered by medical assistance and visits
not covered by medical assistance. Allowable costs include but are not limited to the salaries
and benefits of medical assistance providers; the cost of CCBHC services provided under
section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as
insurance or supplies needed to provide CCBHC services;
new text end

new text begin (2) payment shall be limited to one payment per day per medical assistance enrollee for
each CCBHC visit eligible for reimbursement. A CCBHC visit is eligible for reimbursement
if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph
(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or
licensed agency employed by or under contract with a CCBHC;
new text end

new text begin (3) new payment rates set by the commissioner for newly certified CCBHCs under
section 245.735, subdivision 3, shall be based on rates for established CCBHCs with a
similar scope of services. If no comparable CCBHC exists, the commissioner shall establish
a clinic-specific rate using audited historical cost report data adjusted for the estimated cost
of delivering CCBHC services, including the estimated cost of providing the full scope of
services and the projected change in visits resulting from the change in scope;
new text end

deleted text begin (1)deleted text endnew text begin (4)new text end the commissioner shall rebase CCBHC rates deleted text beginat leastdeleted text endnew text begin oncenew text end every three yearsnew text begin and
no less than 12 months following an initial rate or a rate change due to a change in the scope
of services
new text end;

deleted text begin (2)deleted text endnew text begin (5)new text end the commissioner shall provide for a 60-day appeals process new text beginafter notice of the
results
new text endof the rebasing;

deleted text begin (3) the prohibition against inclusion of new facilities in the demonstration does not apply
after the demonstration ends;
deleted text end

deleted text begin (4)deleted text endnew text begin (6)new text end the prospective payment rate under this section does not apply to services rendered
by CCBHCs to individuals who are dually eligible for Medicare and medical assistance
when Medicare is the primary payer for the service. An entity that receives a prospective
payment system rate that overlaps with the CCBHC rate is not eligible for the CCBHC rate;

deleted text begin (5)deleted text endnew text begin (7)new text end payments for CCBHC services to individuals enrolled in managed care shall be
coordinated with the state's phase-out of CCBHC wrap paymentsnew text begin. The commissioner shall
complete the phase-out of CCBHC wrap payments within 60 days of the implementation
of the prospective payment system in the Medicaid Management Information System
(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments
due made payable to CCBHCs no later than 18 months thereafter
new text end;

deleted text begin (6) initial prospective payment rates for CCBHCs certified after July 1, 2019, shall be
based on rates for comparable CCBHCs. If no comparable provider exists, the commissioner
shall compute a CCBHC-specific rate based upon the CCBHC's audited costs adjusted for
changes in the scope of services;
deleted text end

deleted text begin (7)deleted text endnew text begin (8)new text end the prospective payment rate for each CCBHC shall be deleted text beginadjusted annuallydeleted text end new text beginupdated
new text end bynew text begin trending each provider-specific rate bynew text end the Medicare Economic Index deleted text beginas defined for the
federal section 223 CCBHC demonstration
deleted text endnew text begin for primary care services. This update shall
occur each year in between rebasing periods determined by the commissioner in accordance
with clause (4). CCBHCs must provide data on costs and visits to the state annually using
the CCBHC cost report established by the commissioner
new text end; and

new text begin (9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
services when such changes are expected to result in an adjustment to the CCBHC payment
rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
regarding the changes in the scope of services, including the estimated cost of providing
the new or modified services and any projected increase or decrease in the number of visits
resulting from the change. Rate adjustments for changes in scope shall occur no more than
once per year in between rebasing periods per CCBHC and are effective on the date of the
annual CCBHC rate update.
new text end

deleted text begin (8) the commissioner shall seek federal approval for a CCBHC rate methodology that
allows for rate modifications based on changes in scope for an individual CCBHC, including
for changes to the type, intensity, or duration of services. Upon federal approval, a CCBHC
may submit a change of scope request to the commissioner if the change in scope would
result in a change of 2.5 percent or more in the prospective payment system rate currently
received by the CCBHC. CCBHC change of scope requests must be according to a format
and timeline to be determined by the commissioner in consultation with CCBHCs.
deleted text end

(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
providers at the prospective payment rate. The commissioner shall monitor the effect of
this requirement on the rate of access to the services delivered by CCBHC providers. If, for
any contract 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 the amount equal
to any increase in rates that results from this provision. This paragraph expires if federal
approval is not received for this paragraph at any time.

new text begin (e) The commissioner shall implement a quality incentive payment program for CCBHCs
that meets the following requirements:
new text end

new text begin (1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
thresholds for performance metrics established by the commissioner, in addition to payments
for which the CCBHC is eligible under the prospective payment system described in
paragraph (c);
new text end

new text begin (2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement
year to be eligible for incentive payments;
new text end

new text begin (3) each CCBHC shall receive written notice of the criteria that must be met in order to
receive quality incentive payments at least 90 days prior to the measurement year; and
new text end

new text begin (4) a CCBHC must provide the commissioner with data needed to determine incentive
payment eligibility within six months following the measurement year. The commissioner
shall notify CCBHC providers of their performance on the required measures and the
incentive payment amount within 12 months following the measurement year.
new text end

new text begin (f) All claims to managed care plans for CCBHC services as provided under this section
shall be submitted directly to, and paid by, the commissioner on the dates specified no later
than January 1 of the following calendar year, if:
new text end

new text begin (1) one or more managed care plans does not comply with the federal requirement for
payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
section 447.45(b), and the managed care plan does not resolve the payment issue within 30
days of noncompliance; and
new text end

new text begin (2) the total amount of clean claims not paid in accordance with federal requirements
by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
eligible for payment by managed care plans.
new text end

new text begin If the conditions in this paragraph are met between January 1 and June 30 of a calendar
year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
the following year. If the conditions in this paragraph are met between July 1 and December
31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
on July 1 of the following year.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective July 1, 2021, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained or denied.
new text end

Sec. 5.

Minnesota Statutes 2020, section 297E.02, subdivision 3, is amended to read:


Subd. 3.

Collection; disposition.

(a) Taxes imposed by this section are due and payable
to the commissioner when the gambling tax return is required to be filed. Distributors must
file their monthly sales figures with the commissioner on a form prescribed by the
commissioner. Returns covering the taxes imposed under this section must be filed with
the commissioner on or before the 20th day of the month following the close of the previous
calendar month. The commissioner shall prescribe the content, format, and manner of returns
or other documents pursuant to section 270C.30. The proceeds, along with the revenue
received from all license fees and other fees under sections 349.11 to 349.191, 349.211,
and 349.213, must be paid to the commissioner of management and budget for deposit in
the general fund.

(b) The sales tax imposed by chapter 297A on the sale of pull-tabs and tipboards by the
distributor is imposed on the retail sales price. The retail sale of pull-tabs or tipboards by
the organization is exempt from taxes imposed by chapter 297A and is exempt from all
local taxes and license fees except a fee authorized under section 349.16, subdivision 8.

(c) One-half of one percent of the revenue deposited in the general fund under paragraph
(a), is appropriated to the commissioner of human services for the compulsive gambling
treatment program established under section 245.98. One-half of one percent of the revenue
deposited in the general fund under paragraph (a), is appropriated to the commissioner of
human services for a grant to the state affiliate recognized by the National Council on
Problem Gambling to increase public awareness of problem gambling, education and training
for individuals and organizations providing effective treatment services to problem gamblers
and their families, and research relating to problem gambling. Money appropriated by this
paragraph must supplement and must not replace existing state funding for these programs.

new text begin (d) The commissioner of human services must provide to the state affiliate recognized
by the National Council on Problem Gambling a monthly statement of the amounts deposited
under paragraph (c). Beginning January 1, 2022, the commissioner of human services must
provide to the chairs and ranking minority members of the legislative committees with
jurisdiction over treatment for problem gambling and to the state affiliate recognized by the
National Council on Problem Gambling an annual reconciliation of the amounts deposited
under paragraph (c). The annual reconciliation under this paragraph must include the amount
allocated to the commissioner of human services for the compulsive gambling treatment
program established under section 245.98, and the amount allocated to the state affiliate
recognized by the National Council on Problem Gambling.
new text end

Sec. 6. new text beginDIRECTION TO COMMISSIONERS OF HEALTH AND HUMAN
SERVICES; COMPULSIVE GAMBLING PROGRAMMING AND FUNDING.
new text end

new text begin By September 1, 2022, the commissioner of human services shall consult with the
commissioner of health and report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services with a
recommendation on whether the revenue appropriated to the commissioner of human services
for a grant to the state affiliate recognized by the National Council on Problem Gambling
under Minnesota Statutes, section 297E.02, subdivision 3, paragraph (c), is more properly
appropriated to and managed by an agency other than the Department of Human Services.
The commissioners shall also recommend whether the compulsive gambling treatment
program in Minnesota Statutes, section 245.98, should continue to be managed by the
Department of Human Services or be managed by another agency.
new text end

Sec. 7. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall replace "EXCELLENCE IN MENTAL HEALTH
DEMONSTRATION PROJECT" with "CERTIFIED COMMUNITY BEHAVIORAL
HEALTH CLINIC SERVICES" in the section headnote for Minnesota Statutes, section
245.735.
new text end

Sec. 8. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 245.735, subdivisions 1, 2, and 4,new text endnew text begin are repealed.
new text end

ARTICLE 12

DISABILITY SERVICES AND
CONTINUING CARE FOR OLDER ADULTS

Section 1.

Minnesota Statutes 2020, section 256.9741, subdivision 1, is amended to read:


Subdivision 1.

Long-term care facility.

"Long-term care facility" means a nursing home
licensed under sections 144A.02 to 144A.10; a boarding care home licensed under sections
144.50 to 144.56; an assisted living facility or an assisted living facility with dementia care
licensed under chapter 144G; deleted text beginordeleted text end a licensed or registered residential setting that provides or
arranges for the provision of home care servicesnew text begin; or a setting defined under section 144G.08,
subdivision 7, clauses (10) to (13), that provides or arranges for the provision of home care
services
new text end.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective August 1, 2021.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256B.0911, subdivision 3a, is amended to read:


Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment in order to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on which an assessment was requested or recommended. Upon statewide implementation
of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
requesting personal care assistance services. The commissioner shall provide at least a
90-day notice to lead agencies prior to the effective date of this requirement. Face-to-face
assessments must be conducted according to paragraphs (b) to (i).

(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.

(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, conversation-based, person-centered assessment.
The assessment must include the health, psychological, functional, environmental, and
social needs of the individual necessary to develop a person-centered community support
plan that meets the individual's needs and preferences.

(d) The assessment must be conducted by a certified assessor in a face-to-face
conversational interview with the person being assessed. The person's legal representative
must provide input during the assessment process and may do so remotely if requested. At
the request of the person, other individuals may participate in the assessment to provide
information on the needs, strengths, and preferences of the person necessary to develop a
community support plan that ensures the person's health and safety. Except for legal
representatives or family members invited by the person, persons participating in the
assessment may not be a provider of service or have any financial interest in the provision
of services. For persons who are to be assessed for elderly waiver customized living or adult
day services under chapter 256S, with the permission of the person being assessed or the
person's designated or legal representative, the client's current or proposed provider of
services may submit a copy of the provider's nursing assessment or written report outlining
its recommendations regarding the client's care needs. The person conducting the assessment
must notify the provider of the date by which this information is to be submitted. This
information shall be provided to the person conducting the assessment prior to the assessment.
For a person who is to be assessed for waiver services under section 256B.092 or 256B.49,
with the permission of the person being assessed or the person's designated legal
representative, the person's current provider of services may submit a written report outlining
recommendations regarding the person's care needs the person completed in consultation
with someone who is known to the person and has interaction with the person on a regular
basis. The provider must submit the report at least 60 days before the end of the person's
current service agreement. The certified assessor must consider the content of the submitted
report prior to finalizing the person's assessment or reassessment.

(e) The certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit. The
person or the person's legal representative must be provided with a written community
support plan within the timelines established by the commissioner, regardless of whether
the person is eligible for Minnesota health care programs.

(f) For a person being assessed for elderly waiver services under chapter 256S, a provider
who submitted information under paragraph (d) shall receive the final written community
support plan when available and the Residential Services Workbook.

(g) The written community support plan must include:

(1) a summary of assessed needs as defined in paragraphs (c) and (d);

(2) the individual's options and choices to meet identified needs, including:

(i) all available options for case management services and providers;

(ii) all available options for employment services, settings, and providers;

(iii) all available options for living arrangements;

(iv) all available options for self-directed services and supports, including self-directed
budget options; and

(v) service provided in a non-disability-specific setting;

(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;

(4) referral information; and

(5) informal caregiver supports, if applicable.

For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.

(h) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person must be transferred or referred to long-term care options counseling
services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
telephone assistance and follow up.

(i) The person has the right to make the final decision:

(1) between institutional placement and community placement after the recommendations
have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);

(2) between community placement in a setting controlled by a provider and living
independently in a setting not controlled by a provider;

(3) between day services and employment services; and

(4) regarding available options for self-directed services and supports, including
self-directed funding options.

(j) The lead agency must give the person receiving long-term care consultation services
or the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) written recommendations for community-based services and consumer-directed
options;

(2) documentation that the most cost-effective alternatives available were offered to the
individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;

(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the individual selects nursing facility placement, the lead
agency shall forward information needed to complete the level of care determinations and
screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;

(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, and state plan home care, case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);

(5) information about Minnesota health care programs;

(6) the person's freedom to accept or reject the recommendations of the team;

(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;

(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b);

(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3. The certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated;
and

(10) documentation that available options for employment services, independent living,
and self-directed services and supports were described to the individual.

(k) Face-to-face assessment completed as part of an eligibility determination for multiple
programs for the alternative care, elderly waiver, developmental disabilities, community
access for disability inclusion, community alternative care, and brain injury waiver programs
under chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish
service eligibility for no more than 60 calendar days after the date of assessment.

(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.

(m) If an eligibility update is completed within 90 days of the previous face-to-face
assessment and documented in the department's Medicaid Management Information System
(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
of the previous face-to-face assessment when all other eligibility requirements are met.

new text begin (n) If a person who receives home and community-based waiver services under section
256B.0913, 256B.092, or 256B.49 or chapter 256S temporarily enters for 121 days or fewer
a hospital, institution of mental disease, nursing facility, intensive residential treatment
services program, transitional care unit, or inpatient substance use disorder treatment setting,
the person may return to the community with home and community-based waiver services
under the same waiver, without requiring an assessment or reassessment under this section,
unless the person's annual reassessment is otherwise due. Nothing in this paragraph shall
change annual long-term care consultation reassessment requirements, payment for
institutional or treatment services, medical assistance financial eligibility, or any other law.
new text end

deleted text begin (n)deleted text endnew text begin (o)new text end At the time of reassessment, the certified assessor shall assess each person
receiving waiver residential supports and services currently residing in a community
residential setting, licensed adult foster care home that is either not the primary residence
of the license holder or in which the license holder is not the primary caregiver, family adult
foster care residence, customized living setting, or supervised living facility to determine
if that person would prefer to be served in a community-living setting as defined in section
256B.49, subdivision 23, in a setting not controlled by a provider, or to receive integrated
community supports as described in section 245D.03, subdivision 1, paragraph (c), clause
(8). The certified assessor shall offer the person, through a person-centered planning process,
the option to receive alternative housing and service options.

deleted text begin (o)deleted text endnew text begin (p)new text end At the time of reassessment, the certified assessor shall assess each person
receiving waiver day services to determine if that person would prefer to receive employment
services as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7).
The certified assessor shall describe to the person through a person-centered planning process
the option to receive employment services.

deleted text begin (p)deleted text endnew text begin (q)new text end At the time of reassessment, the certified assessor shall assess each person
receiving non-self-directed waiver services to determine if that person would prefer an
available service and setting option that would permit self-directed services and supports.
The certified assessor shall describe to the person through a person-centered planning process
the option to receive self-directed services and supports.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective upon federal approval. The commissioner
shall notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256I.05, subdivision 1a, is amended to read:


Subd. 1a.

Supplementary service rates.

(a) Subject to the provisions of section 256I.04,
subdivision 3
, the deleted text begincountydeleted text end agency may negotiate a payment not to exceed $426.37 for other
services necessary to provide room and board if the residence is licensed by or registered
by the Department of Health, or licensed by the Department of Human Services to provide
services in addition to room and board, and if the provider of services is not also concurrently
receiving funding for services for a recipient under a home and community-based waiver
under title XIX of the new text beginfederal new text endSocial Security Act; or funding from the medical assistance
program under section 256B.0659, for personal care services for residents in the setting; or
residing in a setting which receives funding under section 245.73. If funding is available
for other necessary services through a home and community-based waiver, or personal care
services under section 256B.0659, then the housing support rate is limited to the rate set in
subdivision 1. Unless otherwise provided in law, in no case may the supplementary service
rate exceed $426.37. The registration and licensure requirement does not apply to
establishments which are exempt from state licensure because they are located on Indian
reservations and for which the tribe has prescribed health and safety requirements. Service
payments under this section may be prohibited under rules to prevent the supplanting of
federal funds with state funds. The commissioner shall pursue the feasibility of obtaining
the approval of the Secretary of Health and Human Services to provide home and
community-based waiver services under title XIX of the new text beginfederal new text endSocial Security Act for
residents who are not eligible for an existing home and community-based waiver due to a
primary diagnosis of mental illness or chemical dependency and shall apply for a waiver if
it is determined to be cost-effective.

(b) The commissioner is authorized to make cost-neutral transfers from the housing
support fund for beds under this section to other funding programs administered by the
department after consultation with the deleted text begincounty or countiesdeleted text endnew text begin agencynew text end in which the affected beds
are located. The commissioner may also make cost-neutral transfers from the housing support
fund to deleted text begincounty human servicedeleted text end agencies for beds permanently removed from the housing
support census under a plan submitted by the deleted text begincountydeleted text end agency and approved by the
commissioner. The commissioner shall report the amount of any transfers under this provision
annually to the legislature.

(c) deleted text beginCountiesdeleted text endnew text begin Agenciesnew text end must not negotiate supplementary service rates with providers of
housing support that are licensed as board and lodging with special services and that do not
encourage a policy of sobriety on their premises and make referrals to available community
services for volunteer and employment opportunities for residents.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256I.05, subdivision 11, is amended to read:


Subd. 11.

Transfer of emergency shelter funds.

(a) The commissioner shall make a
cost-neutral transfer of funding from the housing support fund to deleted text begincounty human service
agencies
deleted text endnew text begin the agencynew text end for emergency shelter beds removed from the housing support census
under a biennial plan submitted by the deleted text begincountydeleted text endnew text begin agencynew text end and approved by the commissioner.
The plan must describe: (1) anticipated and actual outcomes for persons experiencing
homelessness in emergency shelters; (2) improved efficiencies in administration; (3)
requirements for individual eligibility; and (4) plans for quality assurance monitoring and
quality assurance outcomes. The commissioner shall review the deleted text begincountydeleted text endnew text begin agencynew text end plan to
monitor implementation and outcomes at least biennially, and more frequently if the
commissioner deems necessary.

(b) The funding under paragraph (a) may be used for the provision of room and board
or supplemental services according to section 256I.03, subdivisions 2 and 8. Providers must
meet the requirements of section 256I.04, subdivisions 2a to 2f. Funding must be allocated
annually, and the room and board portion of the allocation shall be adjusted according to
the percentage change in the housing support room and board rate. The room and board
portion of the allocation shall be determined at the time of transfer. The commissioner or
deleted text begin countydeleted text endnew text begin agencynew text end may return beds to the housing support fund with 180 days' notice, including
financial reconciliation.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 5. new text beginGOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.
new text end

new text begin The Governor's Council on an Age-Friendly Minnesota, established in Executive Order
19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and
private partners' collaborative work on emergency preparedness, with a focus on older
adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic.
The Governor's Council on an Age-Friendly Minnesota is extended and expires October 1,
2022.
new text end

Sec. 6. new text beginREVISOR INSTRUCTION.
new text end

new text begin (a) The revisor of statutes, in consultation with the Office of Senate Counsel, Research
and Fiscal Analysis, the Office of the House Research Department, and the commissioner
of human services, shall prepare legislation for the 2022 legislative session to recodify
Minnesota Statutes, sections 256.975, subdivisions 7 to 7d, and 256B.0911.
new text end

new text begin (b) The revisor of statutes, in consultation with the Office of Senate Counsel, Research
and Fiscal Analysis, the Office of the House Research Department, and the commissioner
of human services, shall to the greatest extent practicable renumber as subdivisions the
paragraphs of Minnesota Statutes, section 256B.4914, prior to the publication of the 2021
Supplement of Minnesota Statutes, and shall without changing the meaning or effect of
these provisions minimize the use of internal cross-references, including by drafting new
technical definitions as substitutes for necessary cross-references or by other means
acceptable to the commissioner of human services.
new text end

ARTICLE 13

COMMUNITY SUPPORTS POLICY

Section 1.

Minnesota Statutes 2020, section 245.4874, subdivision 1, is amended to read:


Subdivision 1.

Duties of county board.

(a) The county board must:

(1) develop a system of affordable and locally available children's mental health services
according to sections 245.487 to 245.4889;

(2) consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision 5, paragraph
(b), clause (3). The county shall provide, upon request of the local children's mental health
advisory council, readily available data to assist in the determination of unmet needs;

(3) assure that parents and providers in the county receive information about how to
gain access to services provided according to sections 245.487 to 245.4889;

(4) coordinate the delivery of children's mental health services with services provided
by social services, education, corrections, health, and vocational agencies to improve the
availability of mental health services to children and the cost-effectiveness of their delivery;

(5) assure that mental health services delivered according to sections 245.487 to 245.4889
are delivered expeditiously and are appropriate to the child's diagnostic assessment and
individual treatment plan;

(6) provide for case management services to each child with severe emotional disturbance
according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions
1, 3, and 5
;

(7) provide for screening of each child under section 245.4885 upon admission to a
residential treatment facility, acute care hospital inpatient treatment, or informal admission
to a regional treatment center;

(8) prudently administer grants and purchase-of-service contracts that the county board
determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4889;

(9) assure that mental health professionals, mental health practitioners, and case managers
employed by or under contract to the county to provide mental health services are qualified
under section 245.4871;

(10) assure that children's mental health services are coordinated with adult mental health
services specified in sections 245.461 to 245.486 so that a continuum of mental health
services is available to serve persons with mental illness, regardless of the person's age;

(11) assure that culturally competent mental health consultants are used as necessary to
assist the county board in assessing and providing appropriate treatment for children of
cultural or racial minority heritage; and

(12) consistent with section 245.486, arrange for or provide a children's mental health
screening for:

(i) a child receiving child protective services;

(ii) a child in out-of-home placement;

(iii) a child for whom parental rights have been terminated;

(iv) a child found to be delinquent; or

(v) a child found to have committed a juvenile petty offense for the third or subsequent
time.

A children's mental health screening is not required when a screening or diagnostic
assessment has been performed within the previous 180 days, or the child is currently under
the care of a mental health professional.

(b) When a child is receiving protective services or is in out-of-home placement, the
court or county agency must notify a parent or guardian whose parental rights have not been
terminated of the potential mental health screening and the option to prevent the screening
by notifying the court or county agency in writing.

(c) When a child is found to be delinquent or a child is found to have committed a
juvenile petty offense for the third or subsequent time, the court or county agency must
obtain written informed consent from the parent or legal guardian before a screening is
conducted unless the court, notwithstanding the parent's failure to consent, determines that
the screening is in the child's best interest.

(d) The screening shall be conducted with a screening instrument approved by the
commissioner of human services according to criteria that are updated and issued annually
to ensure that approved screening instruments are valid and useful for child welfare and
juvenile justice populations. Screenings shall be conducted by a mental health practitioner
as defined in section 245.4871, subdivision 26, or a probation officer or local social services
agency staff person who is trained in the use of the screening instrument. Training in the
use of the instrument shall include:

(1) training in the administration of the instrument;

(2) the interpretation of its validity given the child's current circumstances;

(3) the state and federal data practices laws and confidentiality standards;

(4) the parental consent requirement; and

(5) providing respect for families and cultural values.

If the screen indicates a need for assessment, the child's family, or if the family lacks
mental health insurance, the local social services agency, in consultation with the child's
family, shall have conducted a diagnostic assessment, including a functional assessment.
The administration of the screening shall safeguard the privacy of children receiving the
screening and their families and shall comply with the Minnesota Government Data Practices
Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of
1996, Public Law 104-191. Screening results deleted text beginshall be considered private datadeleted text end deleted text beginand the
commissioner shall not collect individual screening results
deleted text endnew text begin are classified as private data on
individuals, as defined by section 13.02, subdivision 12. The county board or Tribal nation
may provide the commissioner with access to the screening results for the purposes of
program evaluation and improvement
new text end.

(e) When the county board refers clients to providers of children's therapeutic services
and supports under section 256B.0943, the county board must clearly identify the desired
services components not covered under section 256B.0943 and identify the reimbursement
source for those requested services, the method of payment, and the payment rate to the
provider.

Sec. 2.

Minnesota Statutes 2020, section 245.697, subdivision 1, is amended to read:


Subdivision 1.

Creation.

(a) A State Advisory Council on Mental Health is created. The
council must have members appointed by the governor in accordance with federal
requirements. In making the appointments, the governor shall consider appropriate
representation of communities of color. The council must be composed of:

(1) the assistant commissioner of deleted text beginmental health fordeleted text end the Department of Human Services
new text begin who oversees behavioral health policynew text end;

(2) a representative of the Department of Human Services responsible for the medical
assistance program;

new text begin (3) a representative of the Department of Health;
new text end

deleted text begin (3)deleted text endnew text begin (4)new text end one member of each of the following professions:

(i) psychiatry;

(ii) psychology;

(iii) social work;

(iv) nursing;

(v) marriage and family therapy; and

(vi) professional clinical counseling;

deleted text begin (4)deleted text endnew text begin (5)new text end one representative from each of the following advocacy groups: Mental Health
Association of Minnesota, NAMI-MN, deleted text beginMental Health Consumer/Survivor Network of
Minnesota, and
deleted text end Minnesota Disability Law Centernew text begin, American Indian Mental Health Advisory
Council, and a consumer-run mental health advocacy group
new text end;

deleted text begin (5)deleted text endnew text begin (6)new text end providers of mental health services;

deleted text begin (6)deleted text endnew text begin (7)new text end consumers of mental health services;

deleted text begin (7)deleted text endnew text begin (8)new text end family members of persons with mental illnesses;

deleted text begin (8)deleted text endnew text begin (9)new text end legislators;

deleted text begin (9)deleted text endnew text begin (10)new text end social service agency directors;

deleted text begin (10)deleted text endnew text begin (11)new text end county commissioners; and

deleted text begin (11)deleted text endnew text begin (12)new text end other members reflecting a broad range of community interests, including
family physicians, or members as the United States Secretary of Health and Human Services
may prescribe by regulation or as may be selected by the governor.

(b) The council shall select a chair. Terms, compensation, and removal of members and
filling of vacancies are governed by section 15.059. Notwithstanding provisions of section
15.059, the council and its subcommittee on children's mental health do not expire. The
commissioner of human services shall provide staff support and supplies to the council.

Sec. 3.

Minnesota Statutes 2020, section 252.43, is amended to read:


252.43 COMMISSIONER'S DUTIES.

new text begin (a) new text endThe commissioner shall supervise lead agencies' provision of day services to adults
with disabilities. The commissioner shall:

(1) determine the need for day deleted text beginservicesdeleted text endnew text begin programsnew text end under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.4914new text begin and
252.41 to 252.46
new text end;

(2) establish payment rates as provided under section 256B.4914;

(3) adopt rules for the administration and provision of day services under sections
245A.01 to 245A.16deleted text begin,deleted text endnew text begin;new text end 252.28, subdivision 2deleted text begin,deleted text endnew text begin;new text end or 252.41 to 252.46deleted text begin,deleted text endnew text begin;new text end or Minnesota Rules,
parts 9525.1200 to 9525.1330;

(4) enter into interagency agreements necessary to ensure effective coordination and
provision of day services;

(5) monitor and evaluate the costs and effectiveness of day services; and

(6) provide information and technical help to lead agencies and vendors in their
administration and provision of day services.

new text begin (b) A determination of need in paragraph (a), clause (1), shall not be required for a
change in day service provider name or ownership.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 4.

Minnesota Statutes 2020, section 252A.01, subdivision 1, is amended to read:


Subdivision 1.

Policy.

(a) It is the policy of the state of Minnesota to provide a
coordinated approach to the supervision, protection, and habilitation of its adult citizens
with a developmental disability. In furtherance of this policy, sections 252A.01 to 252A.21
are enacted to authorize the commissioner of human services to:

(1) supervise those adult citizens with a developmental disability who are unable to fully
provide for their own needs and for whom no qualified person is willing and able to seek
guardianship deleted text beginor conservatorshipdeleted text end under sections 524.5-101 to 524.5-502; and

(2) protect adults with a developmental disability from violation of their human and civil
rights by deleted text beginassuringdeleted text endnew text begin ensuringnew text end that they receive the full range of needed social, financial,
residential, and habilitative services to which they are lawfully entitled.

(b) Public guardianship deleted text beginor conservatorshipdeleted text end is the most restrictive form of guardianship
deleted text begin or conservatorshipdeleted text end and should be imposed only when deleted text beginno other acceptable alternative is
available
deleted text endnew text begin less restrictive alternatives have been attempted and determined to be insufficient
to meet the person's needs. Less restrictive alternatives include but are not limited to
supported decision making, community or residential services, or appointment of a health
care agent
new text end.

Sec. 5.

Minnesota Statutes 2020, section 252A.02, subdivision 2, is amended to read:


Subd. 2.

Person with a developmental disability.

"Person with a developmental
disability" refers to any person age 18 or older whonew text begin:
new text end

new text begin (1)new text end has been diagnosed as having deleted text beginsignificantly subaverage intellectual functioning existing
concurrently with demonstrated deficits in adaptive behavior such as to require supervision
and protection for the person's welfare or the public welfare.
deleted text endnew text begin a developmental disability;
new text end

new text begin (2) is impaired to the extent of lacking sufficient understanding or capacity to make
personal decisions; and
new text end

new text begin (3) is unable to meet personal needs for medical care, nutrition, clothing, shelter, or
safety, even with appropriate technological and supported decision-making assistance.
new text end

Sec. 6.

Minnesota Statutes 2020, section 252A.02, subdivision 9, is amended to read:


Subd. 9.

deleted text beginWarddeleted text endnew text begin Person subject to public guardianshipnew text end.

deleted text begin"Ward"deleted text endnew text begin "Person subject to
public guardianship"
new text end means a person with a developmental disability for whom the court
has appointed a public guardian.

Sec. 7.

Minnesota Statutes 2020, section 252A.02, subdivision 11, is amended to read:


Subd. 11.

Interested person.

"Interested person" means an interested responsible adult,
deleted text begin including, but not limited to, a public official, guardian, spouse, parent, adult sibling, legal
counsel, adult child, or next of kin of a person alleged to have a developmental disability.
deleted text endnew text begin
including but not limited to:
new text end

new text begin (1) the person subject to guardianship, the protected person, or the respondent;
new text end

new text begin (2) a nominated guardian or conservator;
new text end

new text begin (3) a legal representative;
new text end

new text begin (4) a spouse; a parent, including a stepparent; adult children, including adult stepchildren
of a living spouse; and siblings. If no such persons are living or can be located, the next of
kin of the person subject to public guardianship or the respondent is an interested person;
new text end

new text begin (5) a representative of a state ombudsman's office or a federal protection and advocacy
program that has notified the commissioner or lead agency that it has a matter regarding
the protected person subject to guardianship, person subject to conservatorship, or respondent;
and
new text end

new text begin (6) a health care agent or proxy appointed pursuant to a health care directive as defined
in section 145C.01, subdivision 5a; a living will under chapter 145B; or other similar
documentation executed in another state and enforceable under the laws of this state.
new text end

Sec. 8.

Minnesota Statutes 2020, section 252A.02, subdivision 12, is amended to read:


Subd. 12.

Comprehensive evaluation.

new text begin(a) new text end"Comprehensive evaluation" deleted text beginshall consistdeleted text endnew text begin
consists
new text end of:

(1) a medical report on the health status and physical condition of the proposed deleted text beginward,deleted text endnew text begin
person subject to public guardianship
new text end prepared under the direction of a licensed physician
or advanced practice registered nurse;

(2) a report on the deleted text beginproposed ward'sdeleted text end intellectual capacity and functional abilitiesdeleted text begin, specifyingdeleted text endnew text begin
of the proposed person subject to public guardianship that specifies
new text end the tests and other data
used in reaching its conclusionsdeleted text begin,deleted text endnew text begin and isnew text end prepared by a psychologist who is qualified in the
diagnosis of developmental disability; and

(3) a report from the case manager that includes:

(i) the most current assessment of individual service needs as described in rules of the
commissioner;

(ii) the most current deleted text beginindividual servicedeleted text endnew text begin coordinated service and supportnew text end plan under section
256B.092, subdivision 1b; and

(iii) a description of contacts with and responses of near relatives of the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end notifying deleted text beginthemdeleted text endnew text begin the near relativesnew text end that a nomination
for public guardianship has been made and advising deleted text beginthemdeleted text endnew text begin the near relativesnew text end that they may
seek private guardianship.

new text begin (b) new text endEach report new text beginunder paragraph (a), clause (3), new text endshall contain recommendations as to the
amount of assistance and supervision required by the proposed deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end to function as independently as possible in society. To be considered part of
the comprehensive evaluation, new text beginthe new text endreports must be completed no more than one year before
filing the petition under section 252A.05.

Sec. 9.

Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision to
read:


new text begin Subd. 16.new text end

new text beginProtected person.new text end

new text begin"Protected person" means a person for whom a guardian
or conservator has been appointed or other protective order has been sought. A protected
person may be a minor.
new text end

Sec. 10.

Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision
to read:


new text begin Subd. 17.new text end

new text beginRespondent.new text end

new text begin"Respondent" means an individual for whom the appointment
of a guardian or conservator or other protective order is sought.
new text end

Sec. 11.

Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision
to read:


new text begin Subd. 18.new text end

new text beginSupported decision making.new text end

new text begin"Supported decision making" means assistance
to an individual with understanding the nature and consequences of personal and financial
decisions from one or more persons of the individual's choosing to enable the individual to
make the personal and financial decisions and, when consistent with the individual's wishes,
to communicate the individual's decisions.
new text end

Sec. 12.

Minnesota Statutes 2020, section 252A.03, subdivision 3, is amended to read:


Subd. 3.

Standard for acceptance.

The commissioner shall accept the nomination ifnew text begin:new text end
deleted text begin the comprehensive evaluation concludes that:
deleted text end

deleted text begin (1) the person alleged to have developmental disability is, in fact, developmentally
disabled;
deleted text endnew text begin (1) the person's assessment confirms that they are a person with a developmental
disability under section 252A.02, subdivision 2;
new text end

(2) the person is in need of the supervision and protection of a deleted text beginconservator ordeleted text end guardian;
deleted text begin and
deleted text end

(3) no qualified person is willing to assume guardianship deleted text beginor conservatorshipdeleted text end under
sections 524.5-101 to 524.5-502deleted text begin.deleted text endnew text begin; and
new text end

new text begin (4) the person subject to public guardianship was included in the process prior to the
submission of the nomination.
new text end

Sec. 13.

Minnesota Statutes 2020, section 252A.03, subdivision 4, is amended to read:


Subd. 4.

Alternatives.

new text begin(a) new text endPublic guardianship deleted text beginor conservatorshipdeleted text end may be imposed only
whennew text begin:
new text end

new text begin (1) the person subject to guardianship is impaired to the extent of lacking sufficient
understanding or capacity to make personal decisions;
new text end

new text begin (2) the person subject to guardianship is unable to meet personal needs for medical care,
nutrition, clothing, shelter, or safety, even with appropriate technological and supported
decision-making assistance; and
new text end

new text begin (3)new text end no acceptable, less restrictive form of guardianship deleted text beginor conservatorshipdeleted text end is available.

new text begin (b)new text end The commissioner shall seek parents, near relatives, and other interested persons to
assume guardianship for persons with developmental disabilities who are currently under
public guardianship. If a person seeks to become a guardian deleted text beginor conservatordeleted text end, costs to the
person may be reimbursed under section 524.5-502. The commissioner must provide technical
assistance to parents, near relatives, and interested persons seeking to become guardians deleted text beginor
conservators
deleted text end.

Sec. 14.

Minnesota Statutes 2020, section 252A.04, subdivision 1, is amended to read:


Subdivision 1.

Local agency.

Upon receipt of a written nomination, the commissioner
shall promptly order the local agency of the county in which the proposed deleted text beginwarddeleted text endnew text begin person
subject to public guardianship
new text end resides to coordinate or arrange for a comprehensive evaluation
of the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end.

Sec. 15.

Minnesota Statutes 2020, section 252A.04, subdivision 2, is amended to read:


Subd. 2.

Medication; treatment.

A proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
who, at the time the comprehensive evaluation is to be performed, has been under medical
care shall not be so under the influence or so suffer the effects of drugs, medication, or other
treatment as to be hampered in the testing or evaluation process. When in the opinion of
the licensed physician or advanced practice registered nurse attending the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end, the discontinuance of medication or other treatment
is not in the deleted text beginproposed ward'sdeleted text end best interestnew text begin of the proposed person subject to public
guardianship
new text end, the physician or advanced practice registered nurse shall record a list of all
drugs, medicationnew text begin,new text end or other treatment deleted text beginwhichdeleted text endnew text begin thatnew text end the proposed deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end received 48 hours immediately prior to any examination, testnew text begin,new text end or interview
conducted in preparation for the comprehensive evaluation.

Sec. 16.

Minnesota Statutes 2020, section 252A.04, subdivision 4, is amended to read:


Subd. 4.

File.

The comprehensive evaluation shall be kept on file at the Department of
Human Services and shall be open to the inspection of the proposed deleted text beginwarddeleted text endnew text begin person subject to
public guardianship
new text end and deleted text beginsuchdeleted text end other persons deleted text beginas may be given permissiondeleted text endnew text begin permittednew text end by the
commissioner.

Sec. 17.

Minnesota Statutes 2020, section 252A.05, is amended to read:


252A.05 COMMISSIONER'S PETITION FOR APPOINTMENT AS PUBLIC
GUARDIAN deleted text beginOR PUBLIC CONSERVATORdeleted text end.

In every case in which the commissioner agrees to accept a nomination, the local agency,
within 20 working days of receipt of the commissioner's acceptance, shall petition on behalf
of the commissioner in the county or court of the county of residence of the person with a
developmental disability for appointment to act as deleted text beginpublic conservator ordeleted text end public guardian of
the person with a developmental disability.

Sec. 18.

Minnesota Statutes 2020, section 252A.06, subdivision 1, is amended to read:


Subdivision 1.

Who may file.

deleted text beginThe commissioner, the local agency, a person with a
developmental disability or any parent, spouse or relative of a person with a developmental
disability may file
deleted text end A verified petition alleging that the appointment of a deleted text beginpublic conservator
or
deleted text end public guardian is requirednew text begin may be filed by: the commissioner; the local agency; a person
with a developmental disability; or a parent, stepparent, spouse, or relative of a person with
a developmental disability
new text end.

Sec. 19.

Minnesota Statutes 2020, section 252A.06, subdivision 2, is amended to read:


Subd. 2.

Contents.

The petition shall set forth:

(1) the name and address of the petitionerdeleted text begin,deleted text end and, in the case of a petition brought by a
person other than the commissioner, whether the petitioner is a parent, spouse, or relative
deleted text begin of the proposed warddeleted text endnew text begin of the proposed person subject to guardianshipnew text end;

(2) whether the commissioner has accepted a nomination to act as deleted text beginpublic conservator
or
deleted text end public guardian;

(3) the name, address, and date of birth of the proposed deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end;

(4) the names and addresses of the nearest relatives and spouse, if any, of the proposed
deleted text begin warddeleted text endnew text begin person subject to public guardianshipnew text end;

(5) the probable value and general character of the deleted text beginproposed ward'sdeleted text end real and personal
propertynew text begin of the proposed person subject to public guardianshipnew text end and the probable amount of
the deleted text beginproposed ward'sdeleted text end debtsnew text begin of the proposed person subject to public guardianshipnew text end;new text begin and
new text end

(6) the facts supporting the establishment of public deleted text beginconservatorship ordeleted text end guardianship,
including that no family member or other qualified individual is willing to assume
guardianship deleted text beginor conservatorshipdeleted text end responsibilities under sections 524.5-101 to 524.5-502deleted text begin;
and
deleted text endnew text begin.
new text end

deleted text begin (7) if conservatorship is requested, the powers the petitioner believes are necessary to
protect and supervise the proposed conservatee.
deleted text end

Sec. 20.

Minnesota Statutes 2020, section 252A.07, subdivision 1, is amended to read:


Subdivision 1.

With petition.

When a petition is brought by the commissioner or local
agency, a copy of the comprehensive evaluation shall be filed with the petition. If a petition
is brought by a person other than the commissioner or local agency and a comprehensive
evaluation has been prepared within a year of the filing of the petition, the local agency
shall deleted text beginforwarddeleted text endnew text begin sendnew text end a copy of the comprehensive evaluation to the court upon notice of the
filing of the petition. If a comprehensive evaluation has not been prepared within a year of
the filing of the petition, the local agency, upon notice of the filing of the petition, shall
arrange for a comprehensive evaluation to be prepared and deleted text beginforwardeddeleted text endnew text begin providednew text end to the court
within 90 days.

Sec. 21.

Minnesota Statutes 2020, section 252A.07, subdivision 2, is amended to read:


Subd. 2.

Copies.

A copy of the comprehensive evaluation shall be made available by
the court to the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, the deleted text beginproposed ward'sdeleted text end
counselnew text begin of the proposed person subject to public guardianshipnew text end, the county attorney, the
attorney generalnew text begin,new text end and the petitioner.

Sec. 22.

Minnesota Statutes 2020, section 252A.07, subdivision 3, is amended to read:


Subd. 3.

Evaluation required; exception.

new text begin(a) new text endNo action for the appointment of a public
guardian may proceed to hearing unless a comprehensive evaluation has been first filed
with the courtdeleted text begin; provided, however, that an action may proceed and a guardian appointeddeleted text endnew text begin.
new text end

new text begin (b) Paragraph (a) does not applynew text end if the director of the local agency responsible for
conducting the comprehensive evaluation has filed an affidavit that the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end refused to participate in the comprehensive evaluation
and the court finds on the basis of clear and convincing evidence that the proposed deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end is developmentally disabled and in need of the
supervision and protection of a guardian.

Sec. 23.

Minnesota Statutes 2020, section 252A.081, subdivision 2, is amended to read:


Subd. 2.

Service of notice.

Service of notice on the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end or proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end must be made by a
nonuniformed personnew text begin or nonuniformed visitornew text end. To the extent possible, the deleted text beginprocess server or
visitor
deleted text endnew text begin person or visitor serving the noticenew text end shall explain the document's meaning to the
proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end. In addition to the persons required to
be served under sections 524.5-113, 524.5-205, and 524.5-304, the mailed notice of the
hearing must be served on the commissioner, the local agency, and the county attorney.

Sec. 24.

Minnesota Statutes 2020, section 252A.081, subdivision 3, is amended to read:


Subd. 3.

Attorney.

In place of the notice of attorney provisions in sections 524.5-205
and 524.5-304, the notice must state that the court will appoint an attorney for the proposed
deleted text begin warddeleted text endnew text begin person subject to public guardianshipnew text end unless an attorney is provided by other persons.

Sec. 25.

Minnesota Statutes 2020, section 252A.081, subdivision 5, is amended to read:


Subd. 5.

Defective notice of service.

A defect in the service of notice or process, other
than personal service upon the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public
guardianship
new text end or service upon the commissioner and local agency within the time allowed
and the form prescribed in this section and sections 524.5-113, 524.5-205, and 524.5-304,
does not invalidate any public guardianship deleted text beginor conservatorshipdeleted text end proceedings.

Sec. 26.

Minnesota Statutes 2020, section 252A.09, subdivision 1, is amended to read:


Subdivision 1.

Attorney appointment.

Upon the filing of the petition, the court shall
appoint an attorney for the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, unless
such counsel is provided by others.

Sec. 27.

Minnesota Statutes 2020, section 252A.09, subdivision 2, is amended to read:


Subd. 2.

Representation.

Counsel shall visit with and, to the extent possible, consult
with the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end prior to the hearing and shall
be given adequate time to prepare deleted text begintherefordeleted text endnew text begin for the hearingnew text end. Counsel shall be given the full
right of subpoena and shall be supplied with a copy of all documents filed with or issued
by the court.

Sec. 28.

Minnesota Statutes 2020, section 252A.101, subdivision 2, is amended to read:


Subd. 2.

Waiver of presence.

The proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
may waive the right to be present at the hearing only if the proposed deleted text beginwarddeleted text endnew text begin person subject
to public guardianship
new text end has met with counsel and specifically waived the right to appear.

Sec. 29.

Minnesota Statutes 2020, section 252A.101, subdivision 3, is amended to read:


Subd. 3.

Medical care.

If, at the time of the hearing, the proposed deleted text beginwarddeleted text endnew text begin person subject
to public guardianship
new text end has been under medical care, the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end has the same rights regarding limitation on the use of drugs, medication, or
other treatment before the hearing that are available under section 252A.04, subdivision 2.

Sec. 30.

Minnesota Statutes 2020, section 252A.101, subdivision 5, is amended to read:


Subd. 5.

Findings.

(a) In all cases the court shall make specific written findings of fact,
conclusions of law, and direct entry of an appropriate judgment or order. The court shall
order the appointment of the commissioner as guardian deleted text beginor conservatordeleted text end if it finds that:

(1) the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end is a person
with a developmental disability as defined in section 252A.02, subdivision 2;

(2) the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end is incapable
of exercising specific legal rights, which must be enumerated in deleted text beginitsdeleted text endnew text begin the court'snew text end findings;

(3) the proposed deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end is in need
of the supervision and protection of a new text beginpublic new text endguardian deleted text beginor conservatordeleted text end; and

(4) no appropriate alternatives to public guardianship deleted text beginor public conservatorshipdeleted text end exist
that are less restrictive of the person's civil rights and liberties, such as appointing a new text beginprivate
new text end guardiannew text begin,new text end deleted text beginor conservatordeleted text endnew text begin supported decision maker, or health care agent; or arranging
residential or community services
new text end under sections 524.5-101 to 524.5-502.

(b) The court shall grant the specific powers that are necessary for the commissioner to
act as public guardian deleted text beginor conservatordeleted text end on behalf of the deleted text beginward or conservateedeleted text endnew text begin person subject
to public guardianship
new text end.

Sec. 31.

Minnesota Statutes 2020, section 252A.101, subdivision 6, is amended to read:


Subd. 6.

Notice of order; appeal.

A copy of the order shall be served by mail upon the
deleted text begin ward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end and the deleted text beginward'sdeleted text end counselnew text begin of the
person subject to public guardianship
new text end. The order must be accompanied by a notice that
advises the deleted text beginward or conservateedeleted text endnew text begin person subject to public guardianshipnew text end of the right to appeal
the guardianship deleted text beginor conservatorshipdeleted text end appointment within 30 days.

Sec. 32.

Minnesota Statutes 2020, section 252A.101, subdivision 7, is amended to read:


Subd. 7.

Letters of guardianship.

new text begin(a) new text endLetters of guardianship deleted text beginor conservatorshipdeleted text end must
be issued by the court and contain:

(1) the name, address, and telephone number of the deleted text beginward or conservateedeleted text endnew text begin person subject
to public guardianship
new text end; and

(2) the powers to be exercised on behalf of the deleted text beginward or conservateedeleted text endnew text begin person subject to
public guardianship
new text end.

new text begin (b) new text endThe lettersnew text begin under paragraph (a)new text end must be served by mail upon the deleted text beginward or conservateedeleted text endnew text begin
person subject to public guardianship
new text end, the deleted text beginward'sdeleted text end counselnew text begin of the person subject to public
guardianship
new text end, the commissioner, and the local agency.

Sec. 33.

Minnesota Statutes 2020, section 252A.101, subdivision 8, is amended to read:


Subd. 8.

Dismissal.

If upon the completion of the hearing and consideration of the record,
the court finds that the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end is not
developmentally disabled or is developmentally disabled but not in need of the supervision
and protection of a deleted text beginconservator ordeleted text endnew text begin publicnew text end guardian, deleted text beginitdeleted text endnew text begin the courtnew text end shall dismiss the application
and shall notify the proposed deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, the deleted text beginward'sdeleted text end counselnew text begin
of the person subject to public guardianship
new text end, and the petitionernew text begin of the court's findingsnew text end.

Sec. 34.

Minnesota Statutes 2020, section 252A.111, subdivision 2, is amended to read:


Subd. 2.

Additional powers.

In addition to the powers contained in sections 524.5-207
and 524.5-313, the powers of a public guardian that the court may grant include:

(1) the power to permit or withhold permission for the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end to marry;

(2) the power to begin legal action or defend against legal action in the name of the deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end; and

(3) the power to consent to the adoption of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
as provided in section 259.24.

Sec. 35.

Minnesota Statutes 2020, section 252A.111, subdivision 4, is amended to read:


Subd. 4.

Appointment of conservator.

If the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
has a personal estate beyond that which is necessary for the deleted text beginward'sdeleted text end personal and immediate
needsnew text begin of the person subject to public guardianshipnew text end, the commissioner shall determine whether
a conservator should be appointed. The commissioner shall consult with the parents, spouse,
or nearest relative of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end. The commissioner
may petition the court for the appointment of a private conservator of the deleted text beginwarddeleted text endnew text begin person
subject to public guardianship
new text end. The commissioner cannot act as conservator for public deleted text beginwardsdeleted text endnew text begin
persons subject to public guardianship
new text end or public protected persons.

Sec. 36.

Minnesota Statutes 2020, section 252A.111, subdivision 6, is amended to read:


Subd. 6.

Special duties.

In exercising powers and duties under this chapter, the
commissioner shall:

(1) maintain close contact with the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, visiting
at least twice a year;

(2) protect and exercise the legal rights of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end;

(3) take actions and make decisions on behalf of the deleted text beginwarddeleted text endnew text begin person subject to public
guardianship
new text end that encourage and allow the maximum level of independent functioning in a
manner least restrictive of the deleted text beginward'sdeleted text end personal freedom new text beginof the person subject to public
guardianship
new text endconsistent with the need for supervision and protection; and

(4) permit and encourage maximum self-reliance on the part of the deleted text beginwarddeleted text endnew text begin person subject
to public guardianship
new text end and permit and encourage input by the nearest relative of the deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end in planning and decision making on behalf of the
deleted text begin warddeleted text endnew text begin person subject to public guardianshipnew text end.

Sec. 37.

Minnesota Statutes 2020, section 252A.12, is amended to read:


252A.12 APPOINTMENT OF deleted text beginCONSERVATORdeleted text endnew text begin PUBLIC GUARDIANnew text end NOT A
FINDING OF INCOMPETENCY.

An appointment of the commissioner as deleted text beginconservatordeleted text endnew text begin public guardiannew text end shall not constitute
a judicial finding that the person with a developmental disability is legally incompetent
except for the restrictions deleted text beginwhichdeleted text endnew text begin thatnew text end the deleted text beginconservatorshipdeleted text endnew text begin public guardianshipnew text end places on the
deleted text begin conservateedeleted text endnew text begin person subject to public guardianshipnew text end. The appointment of a deleted text beginconservatordeleted text endnew text begin public
guardian
new text end shall not deprive the deleted text beginconservateedeleted text endnew text begin person subject to public guardianshipnew text end of the right
to vote.

Sec. 38.

Minnesota Statutes 2020, section 252A.16, is amended to read:


252A.16 ANNUAL REVIEW.

Subdivision 1.

Review required.

The commissioner shall require an annual review of
the physical, mental, and social adjustment and progress of every deleted text beginward and conservateedeleted text endnew text begin
person subject to public guardianship
new text end. A copy of this review shall be kept on file at the
Department of Human Services and may be inspected by the deleted text beginward or conservateedeleted text endnew text begin person
subject to public guardianship
new text end, the deleted text beginward's or conservatee'sdeleted text end parents, spouse, or relatives new text beginof
the person subject to public guardianship,
new text endand other persons who receive the permission of
the commissioner. The review shall contain information required under Minnesota Rules,
part 9525.3065, subpart 1.

Subd. 2.

Assessment of need for continued guardianship.

The commissioner shall
annually review the legal status of each deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end in light
of the progress indicated in the annual review. If the commissioner determines the deleted text beginwarddeleted text endnew text begin
person subject to public guardianship
new text end is no longer in need of public guardianship deleted text beginor
conservatorship
deleted text end or is capable of functioning under a less restrictive deleted text beginconservatorshipdeleted text endnew text begin
guardianship
new text end, the commissioner or local agency shall petition the court pursuant to section
252A.19 to restore the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end to capacity or for a
modification of the court's previous order.

Sec. 39.

Minnesota Statutes 2020, section 252A.17, is amended to read:


252A.17 EFFECT OF SUCCESSION IN OFFICE.

The appointment by the court of the commissioner deleted text beginof human servicesdeleted text end as public
deleted text begin conservator ordeleted text end guardian shall be by the title of the commissioner's office. The authority of
the commissioner as public deleted text beginconservator ordeleted text end guardian shall cease upon the termination of the
commissioner's term of office and shall vest in a successor or successors in office without
further court proceedings.

Sec. 40.

Minnesota Statutes 2020, section 252A.19, subdivision 2, is amended to read:


Subd. 2.

Petition.

The commissioner, deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end, or
any interested person may petition the appointing court or the court to which venue has
been transferred deleted text beginfor an order todeleted text endnew text begin:
new text end

new text begin (1) for an order tonew text end remove the guardianship deleted text beginor todeleted text endnew text begin;
new text end

new text begin (2) for an order tonew text end limit or expand the powers of the guardianship deleted text beginor todeleted text endnew text begin;
new text end

new text begin (3) for an order tonew text end appoint a guardian deleted text beginor conservatordeleted text end under sections 524.5-101 to
524.5-502 deleted text beginor todeleted text endnew text begin;
new text end

new text begin (4) for an order tonew text end restore the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected
person to full legal capacity deleted text beginor todeleted text endnew text begin;
new text end

new text begin (5) tonew text end review de novo any decision made by the public guardian deleted text beginor public conservatordeleted text end
for or on behalf of a deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected personnew text begin;new text end or

new text begin (6) new text endfor any other order as the court may deem just and equitable.

Sec. 41.

Minnesota Statutes 2020, section 252A.19, subdivision 4, is amended to read:


Subd. 4.

Comprehensive evaluation.

The commissioner shall, at the court's request,
arrange for the preparation of a comprehensive evaluation of the deleted text beginwarddeleted text endnew text begin person subject to
public guardianship
new text end or protected person.

Sec. 42.

Minnesota Statutes 2020, section 252A.19, subdivision 5, is amended to read:


Subd. 5.

Court order.

Upon proof of the allegations of the petition the court shall enter
an order removing the guardianship or limiting or expanding the powers of the guardianship
or restoring the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected person to full legal
capacity or may enter such other order as the court may deem just and equitable.

Sec. 43.

Minnesota Statutes 2020, section 252A.19, subdivision 7, is amended to read:


Subd. 7.

Attorney general's role; commissioner's role.

The attorney general may
appear and represent the commissioner in such proceedings. The commissioner shall support
or oppose the petition if the commissioner deems such action necessary for the protection
and supervision of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end or protected person.

Sec. 44.

Minnesota Statutes 2020, section 252A.19, subdivision 8, is amended to read:


Subd. 8.

deleted text beginCourt appointeddeleted text endnew text begin Court-appointednew text end counsel.

In all such proceedings, the
protected person or deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end shall be afforded an
opportunity to be represented by counsel, and if neither the protected person or deleted text beginwarddeleted text endnew text begin person
subject to public guardianship
new text end nor others provide counsel the court shall appoint counsel to
represent the protected person or deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end.

Sec. 45.

Minnesota Statutes 2020, section 252A.20, is amended to read:


252A.20 COSTS OF HEARINGS.

Subdivision 1.

Witness and attorney fees.

In each proceeding under sections 252A.01
to 252A.21, the court shall allow and order paid to each witness subpoenaed the fees and
mileage prescribed by law; to each physician, advanced practice registered nurse,
psychologist, or social worker who assists in the preparation of the comprehensive evaluation
and who is not deleted text beginin the employ ofdeleted text endnew text begin employed bynew text end the local agency or the state Department of
Human Services, a reasonable sum for services and for travel; and to the deleted text beginward'sdeleted text end counselnew text begin of
the person subject to public guardianship
new text end, when appointed by the court, a reasonable sum
for travel and for each day or portion of a day actually employed in court or actually
consumed in preparing for the hearing. Upon order the county auditor shall issue a warrant
on the county treasurer for payment of the amount allowed.

Subd. 2.

Expenses.

When the settlement of the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end
is found to be in another county, the court shall transmit to the county auditor a statement
of the expenses incurred pursuant to subdivision 1. The auditor shall transmit the statement
to the auditor of the county of the deleted text beginward'sdeleted text end settlement new text beginof the person subject to public
guardianship
new text endand this claim shall be paid as other claims against that county. If the auditor
to whom this claim is transmitted denies the claim, the auditor shall transmit it, together
with the objections thereto, to the commissioner, who shall determine the question of
settlement and certify findings to each auditor. If the claim is not paid within 30 days after
such certification, an action may be maintained thereon in the district court of the claimant
county.

Subd. 3.

Change of venue; cost of proceedings.

Whenever venue of a proceeding has
been transferred under sections 252A.01 to 252A.21, the costs of such proceedings shall be
reimbursed to the county of the deleted text beginward'sdeleted text end settlement new text beginof the person subject to public guardianship
new text end by the state.

Sec. 46.

Minnesota Statutes 2020, section 252A.21, subdivision 2, is amended to read:


Subd. 2.

Rules.

The commissioner shall adopt rules to implement this chapter. The rules
must include standards for performance of guardianship deleted text beginor conservatorshipdeleted text end duties includingdeleted text begin,deleted text end
but not limited to: twice a year visits with the deleted text beginwarddeleted text endnew text begin person subject to public guardianshipnew text end;
a requirement that the duties of guardianship deleted text beginor conservatorshipdeleted text end and case management not
be performed by the same person; specific standards for action on "do not resuscitate" orders
as recommended by a physician, an advanced practice registered nurse, or a physician
assistant; sterilization requests; and the use of psychotropic medication and aversive
procedures.

Sec. 47.

Minnesota Statutes 2020, section 252A.21, subdivision 4, is amended to read:


Subd. 4.

Private guardianships deleted text beginand conservatorshipsdeleted text end.

Nothing in sections 252A.01
to 252A.21 shall impair the right of individuals to establish private guardianships deleted text beginor
conservatorships
deleted text end in accordance with applicable law.

Sec. 48.

Minnesota Statutes 2020, section 254B.03, subdivision 2, is amended to read:


Subd. 2.

Chemical dependency fund payment.

(a) Payment from the chemical
dependency fund is limited to payments for services new text beginidentified in section 254B.05,new text end other
than detoxification licensed under Minnesota Rules, parts 9530.6510 to 9530.6590, deleted text beginthat, if
located outside of federally recognized tribal lands, would be required to be licensed by the
commissioner as a chemical dependency treatment or rehabilitation program under sections
245A.01 to 245A.16,
deleted text end and deleted text beginservices other thandeleted text end detoxification provided in another state that
would be required to be licensed as a chemical dependency program if the program were
in the state. Out of state vendors must also provide the commissioner with assurances that
the program complies substantially with state licensing requirements and possesses all
licenses and certifications required by the host state to provide chemical dependency
treatment. Vendors receiving payments from the chemical dependency fund must not require
co-payment from a recipient of benefits for services provided under this subdivision. The
vendor is prohibited from using the client's public benefits to offset the cost of services paid
under this section. The vendor shall not require the client to use public benefits for room
or board costs. This includes but is not limited to cash assistance benefits under chapters
119B, 256D, and 256J, or SNAP benefits. Retention of SNAP benefits is a right of a client
receiving services through the consolidated chemical dependency treatment fund or through
state contracted managed care entities. Payment from the chemical dependency fund shall
be made for necessary room and board costs provided by vendors meeting the criteria under
section 254B.05, subdivision 1a, or in a community hospital licensed by the commissioner
of health according to sections 144.50 to 144.56 to a client who is:

(1) determined to meet the criteria for placement in a residential chemical dependency
treatment program according to rules adopted under section 254A.03, subdivision 3; and

(2) concurrently receiving a chemical dependency treatment service in a program licensed
by the commissioner and reimbursed by the chemical dependency fund.

(b) A county may, from its own resources, provide chemical dependency services for
which state payments are not made. A county may elect to use the same invoice procedures
and obtain the same state payment services as are used for chemical dependency services
for which state payments are made under this section if county payments are made to the
state in advance of state payments to vendors. When a county uses the state system for
payment, the commissioner shall make monthly billings to the county using the most recent
available information to determine the anticipated services for which payments will be made
in the coming month. Adjustment of any overestimate or underestimate based on actual
expenditures shall be made by the state agency by adjusting the estimate for any succeeding
month.

(c) The commissioner shall coordinate chemical dependency services and determine
whether there is a need for any proposed expansion of chemical dependency treatment
services. The commissioner shall deny vendor certification to any provider that has not
received prior approval from the commissioner for the creation of new programs or the
expansion of existing program capacity. The commissioner shall consider the provider's
capacity to obtain clients from outside the state based on plans, agreements, and previous
utilization history, when determining the need for new treatment services.

Sec. 49.

Minnesota Statutes 2020, section 256B.051, subdivision 1, is amended to read:


Subdivision 1.

Purpose.

Housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services are established to provide
housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services to an individual with a disability that limits the
individual's ability to obtain or maintain stable housing. The services support an individual's
transition to housing in the community and increase long-term stability in housing, to avoid
future periods of being at risk of homelessness or institutionalization.

Sec. 50.

Minnesota Statutes 2020, section 256B.051, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

An individual with a disability is eligible for housing deleted text beginsupportdeleted text endnew text begin
stabilization
new text end services if the individual:

(1) is 18 years of age or older;

(2) is enrolled in medical assistance;

(3) has an assessment of functional need that determines a need for services due to
limitations caused by the individual's disability;

(4) resides in or plans to transition to a community-based setting as defined in Code of
Federal Regulations, title 42, section 441.301 (c); and

(5) has housing instability evidenced by:

(i) being homeless or at-risk of homelessness;

(ii) being in the process of transitioning from, or having transitioned in the past six
months from, an institution or licensed or registered setting;

(iii) being eligible for waiver services under chapter 256S or section 256B.092 or
256B.49; or

(iv) having been identified by a long-term care consultation under section 256B.0911
as at risk of institutionalization.

Sec. 51.

Minnesota Statutes 2020, section 256B.051, subdivision 5, is amended to read:


Subd. 5.

Housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services.

(a) Housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end
services include housing transition services and housing and tenancy sustaining services.

(b) Housing transition services are defined as:

(1) tenant screening and housing assessment;

(2) assistance with the housing search and application process;

(3) identifying resources to cover onetime moving expenses;

(4) ensuring a new living arrangement is safe and ready for move-in;

(5) assisting in arranging for and supporting details of a move; and

(6) developing a housing support crisis plan.

(c) Housing and tenancy sustaining services include:

(1) prevention and early identification of behaviors that may jeopardize continued stable
housing;

(2) education and training on roles, rights, and responsibilities of the tenant and the
property manager;

(3) coaching to develop and maintain key relationships with property managers and
neighbors;

(4) advocacy and referral to community resources to prevent eviction when housing is
at risk;

(5) assistance with housing recertification process;

(6) coordination with the tenant to regularly review, update, and modify the housing
support and crisis plan; and

(7) continuing training on being a good tenant, lease compliance, and household
management.

(d) A housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end service may include person-centered planning for
people who are not eligible to receive person-centered planning through any other service,
if the person-centered planning is provided by a consultation service provider that is under
contract with the department and enrolled as a Minnesota health care program.

Sec. 52.

Minnesota Statutes 2020, section 256B.051, subdivision 6, is amended to read:


Subd. 6.

Provider qualifications and duties.

A provider eligible for reimbursement
under this section shall:

(1) enroll as a medical assistance Minnesota health care program provider and meet all
applicable provider standards and requirements;

(2) demonstrate compliance with federal and state laws and policies for housing deleted text beginsupportdeleted text endnew text begin
stabilization
new text end services as determined by the commissioner;

(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results; deleted text beginand
deleted text end

(4) directly provide housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services and not use a subcontractor
or reporting agentdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) complete annual vulnerable adult training.
new text end

Sec. 53.

Minnesota Statutes 2020, section 256B.051, subdivision 7, is amended to read:


Subd. 7.

Housing support supplemental service rates.

Supplemental service rates for
individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph
(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year
period. This reduction only applies to supplemental service rates for individuals eligible for
housing deleted text beginsupportdeleted text endnew text begin stabilizationnew text end services under this section.

Sec. 54.

Minnesota Statutes 2020, section 256B.051, is amended by adding a subdivision
to read:


new text begin Subd. 8.new text end

new text beginDocumentation requirements.new text end

new text begin(a) Documentation may be collected and
maintained electronically or in paper form by providers and must be produced upon request
by the commissioner.
new text end

new text begin (b) Documentation of a delivered service must be in English and must be legible according
to the standard of a reasonable person.
new text end

new text begin (c) If the service is reimbursed at an hourly or specified minute-based rate, each
documentation of the provision of a service, unless otherwise specified, must include:
new text end

new text begin (1) the date the documentation occurred;
new text end

new text begin (2) the day, month, and year the service was provided;
new text end

new text begin (3) the start and stop times with a.m. and p.m. designations, except for person-centered
planning services described under subdivision 5, paragraph (d);
new text end

new text begin (4) the service name or description of the service provided; and
new text end

new text begin (5) the name, signature, and title, if any, of the provider of service. If the service is
provided by multiple staff members, the provider may designate a staff member responsible
for verifying services and completing the documentation required by this paragraph.
new text end

Sec. 55.

Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:


Subd. 6.

Service standards.

The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.

(a) The treatment team must use team treatment, not an individual treatment model.

(b) Services must be available at times that meet client needs.

(c) Services must be age-appropriate and meet the specific needs of the client.

(d) The initial functional assessment must be completed within ten days of intake and
updated at least every six months or prior to discharge from the service, whichever comes
first.

(e) new text beginThe treatment team must completenew text end an individual treatment plan new text beginfor each client and
the individual treatment plan
new text end must:

(1) be based on the information in the client's diagnostic assessment and baselines;

(2) identify goals and objectives of treatment, a treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment services and supports;

(3) be developed after completion of the client's diagnostic assessment by a mental health
professional or clinical trainee and before the provision of children's therapeutic services
and supports;

(4) be developed through a child-centered, family-driven, culturally appropriate planning
process, including allowing parents and guardians to observe or participate in individual
and family treatment services, assessments, and treatment planning;

(5) be reviewed at least once every six months and revised to document treatment progress
on each treatment objective and next goals or, if progress is not documented, to document
changes in treatment;

(6) be signed by the clinical supervisor and by the client or by the client's parent or other
person authorized by statute to consent to mental health services for the client. A client's
parent may approve the client's individual treatment plan by secure electronic signature or
by documented oral approval that is later verified by written signature;

(7) be completed in consultation with the client's current therapist and key providers and
provide for ongoing consultation with the client's current therapist to ensure therapeutic
continuity and to facilitate the client's return to the community. For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan;

(8) if a need for substance use disorder treatment is indicated by validated assessment:

(i) identify goals, objectives, and strategies of substance use disorder treatment; develop
a schedule for accomplishing treatment goals and objectives; and identify the individuals
responsible for providing treatment services and supports;

(ii) be reviewed at least once every 90 days and revised, if necessary;

(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by
the client's parent or other person authorized by statute to consent to mental health treatment
and substance use disorder treatment for the client; and

(10) provide for the client's transition out of intensive nonresidential rehabilitative mental
health services by defining the team's actions to assist the client and subsequent providers
in the transition to less intensive or "stepped down" services.

(f) The treatment team shall actively and assertively engage the client's family members
and significant others by establishing communication and collaboration with the family and
significant others and educating the family and significant others about the client's mental
illness, symptom management, and the family's role in treatment, unless the team knows or
has reason to suspect that the client has suffered or faces a threat of suffering any physical
or mental injury, abuse, or neglect from a family member or significant other.

(g) For a client age 18 or older, the treatment team may disclose to a family member,
other relative, or a close personal friend of the client, or other person identified by the client,
the protected health information directly relevant to such person's involvement with the
client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
client is present, the treatment team shall obtain the client's agreement, provide the client
with an opportunity to object, or reasonably infer from the circumstances, based on the
exercise of professional judgment, that the client does not object. If the client is not present
or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
team may, in the exercise of professional judgment, determine whether the disclosure is in
the best interests of the client and, if so, disclose only the protected health information that
is directly relevant to the family member's, relative's, friend's, or client-identified person's
involvement with the client's health care. The client may orally agree or object to the
disclosure and may prohibit or restrict disclosure to specific individuals.

(h) The treatment team shall provide interventions to promote positive interpersonal
relationships.

Sec. 56.

Minnesota Statutes 2020, section 256B.4912, subdivision 13, is amended to read:


Subd. 13.

Waiver transportation documentation and billing requirements.

(a) A
waiver transportation service must be a waiver transportation service that: (1) is not covered
by medical transportation under the Medicaid state plan; and (2) is not included as a
component of another waiver service.

(b) In addition to the documentation requirements in subdivision 12, a waiver
transportation service provider must maintain:

(1) odometer and other records pursuant to section 256B.0625, subdivision 17b, paragraph
(b), clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver
for a waiver transportation service that is billed directly by the mile. A common carrier as
defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or a publicly operated transit
system provider are exempt from this clause; and

(2) documentation demonstrating that a vehicle and a driver meet the deleted text beginstandards determined
by the Department of Human Services on vehicle and driver qualifications in section
256B.0625, subdivision 17, paragraph (c)
deleted text endnew text begin transportation waiver service provider standards
and qualifications according to the federally approved waiver plan
new text end.

Sec. 57.

Minnesota Statutes 2020, section 256B.69, subdivision 5a, is amended to read:


Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.

(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.

(d) The commissioner shall require that managed care plans use the assessment and
authorization processes, forms, timelines, standards, documentation, and data reporting
requirements, protocols, billing processes, and policies consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all personal
care assistance services under section 256B.0659new text begin and community first services and supports
under section 256B.85
new text end.

(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
the health plan's utilization in 2009. To earn the return of the withhold each subsequent
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
in subdivisions 23 and 28, compared to the previous measurement year until the final
performance target is reached. When measuring performance, the commissioner must
consider the difference in health risk in a managed care or county-based purchasing plan's
membership in the baseline year compared to the measurement year, and work with the
managed care or county-based purchasing plan to account for differences that they agree
are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program enrollees
is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
health plans in meeting this performance target and shall accept payment withholds that
may be returned to the hospitals if the performance target is achieved.

(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. To earn the return of the withhold each year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than five percent of the plan's hospital admission rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, compared to the previous calendar year until the final performance target is reached.
When measuring performance, the commissioner must consider the difference in health risk
in a managed care or county-based purchasing plan's membership in the baseline year
compared to the measurement year, and work with the managed care or county-based
purchasing plan to account for differences that they agree are significant.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
rate was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.

The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in calendar
year 2011, as determined by the commissioner. The hospital admissions in this performance
target do not include the admissions applicable to the subsequent hospital admission
performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
this performance target and shall accept payment withholds that may be returned to the
hospitals if the performance target is achieved.

(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each year,
the managed care plan or county-based purchasing plan must achieve a qualifying reduction
of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
percent compared to the previous calendar year until the final performance target is reached.

The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts commensurate
with achieved reductions in utilization less than the targeted amount.

The withhold described in this paragraph must continue for each consecutive contract
period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
2011. Hospitals shall cooperate with the plans in meeting this performance target and shall
accept payment withholds that must be returned to the hospitals if the performance target
is achieved.

(h) Effective for services rendered on or after January 1, 2013, through December 31,
2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.

(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
include as admitted assets under section 62D.044 any amount withheld under this section
that is reasonably expected to be returned.

(k) Contracts between the commissioner and a prepaid health plan are exempt from the
set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
7.

(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).

(m) Managed care plans and county-based purchasing plans shall maintain current and
fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.

Sec. 58.

Minnesota Statutes 2020, section 256B.85, subdivision 1, is amended to read:


Subdivision 1.

Basis and scope.

(a) Upon federal approval, the commissioner shall
establish a state plan option for the provision of home and community-based personal
assistance service and supports called "community first services and supports (CFSS)."

(b) CFSS is a participant-controlled method of selecting and providing services and
supports that allows the participant maximum control of the services and supports.
Participants may choose the degree to which they direct and manage their supports by
choosing to have a significant and meaningful role in the management of services and
supports including by directly employing support workers with the necessary supports to
perform that function.

(c) CFSS is available statewide to eligible people to assist with accomplishing activities
of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related
procedures and tasks through hands-on assistance to accomplish the task or constant
supervision and cueing to accomplish the task; and to assist with acquiring, maintaining,
and enhancing the skills necessary to accomplish ADLs, IADLs, and health-related
procedures and tasks. CFSS allows payment for new text beginthe participant for new text endcertain supports and
goods such as environmental modifications and technology that are intended to replace or
decrease the need for human assistance.

(d) Upon federal approval, CFSS will replace the personal care assistance program under
sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.

new text begin (e) For the purposes of this section, notwithstanding the provisions of section 144A.43,
subdivision 3, supports purchased under CFSS are not considered home care services.
new text end

Sec. 59.

Minnesota Statutes 2020, section 256B.85, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.

(b) "Activities of daily living" or "ADLs" means deleted text begineating, toileting, grooming, dressing,
bathing, mobility, positioning, and transferring.
deleted text endnew text begin:
new text end

new text begin (1) dressing, including assistance with choosing, applying, and changing clothing and
applying special appliances, wraps, or clothing;
new text end

new text begin (2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
care, except for recipients who are diabetic or have poor circulation;
new text end

new text begin (3) bathing, including assistance with basic personal hygiene and skin care;
new text end

new text begin (4) eating, including assistance with hand washing and applying orthotics required for
eating, transfers, or feeding;
new text end

new text begin (5) transfers, including assistance with transferring the participant from one seating or
reclining area to another;
new text end

new text begin (6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a participant;
new text end

new text begin (7) positioning, including assistance with positioning or turning a participant for necessary
care and comfort; and
new text end

new text begin (8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.
new text end

(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.

(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.

(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.

(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, new text beginadvanced practice registered nurse, or physician's assistant
new text end and is specified in a community support plan, including:

(1) tube feedings requiring:

(i) a gastrojejunostomy tube; or

(ii) continuous tube feeding lasting longer than 12 hours per day;

(2) wounds described as:

(i) stage III or stage IV;

(ii) multiple wounds;

(iii) requiring sterile or clean dressing changes or a wound vac; or

(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;

(3) parenteral therapy described as:

(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or

(ii) total parenteral nutrition (TPN) daily;

(4) respiratory interventions, including:

(i) oxygen required more than eight hours per day;

(ii) respiratory vest more than one time per day;

(iii) bronchial drainage treatments more than two times per day;

(iv) sterile or clean suctioning more than six times per day;

(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and

(vi) ventilator dependence under section 256B.0651;

(5) insertion and maintenance of catheter, including:

(i) sterile catheter changes more than one time per month;

(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or

(iii) bladder irrigations;

(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;

(7) neurological intervention, including:

(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or

(ii) swallowing disorders diagnosed by a physiciannew text begin, advanced practice registered nurse,
or physician's assistant
new text end and requiring specialized assistance from another on a daily basis;
and

(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.

(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.

(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the coordinated service
and support plan identified in deleted text beginsectiondeleted text endnew text begin sections 256B.092, subdivision 1b, andnew text end 256S.10.

(i) "Consultation services" means a Minnesota health care program enrolled provider
organization that provides assistance to the participant in making informed choices about
CFSS services in general and self-directed tasks in particular, and in developing a
person-centered CFSS service delivery plan to achieve quality service outcomes.

(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.

(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
deleted text begin maydeleted text endnew text begin mustnew text end not be found to be dependent in an activity of daily living if, because of the child's
age, an adult would either perform the activity for the child or assist the child with the
activity and the assistance needed is the assistance appropriate for a typical child of the
same age.

(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under chapter 256S and sections 256B.092,
subdivision 5
, and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants.new text begin Extended CFSS excludes the purchase of goods.
new text end

(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).

(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.

(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community.

(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(e).

(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.

(r) "Level I behavior" means physical aggression new text begintoward new text enddeleted text begintowardsdeleted text end self or others or
destruction of property that requires the immediate response of another person.

(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker deleted text beginmaydeleted text endnew text begin mustnew text end not determine
medication dose or time for medication or inject medications into veins, muscles, or skin:

(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;

(2) organizing medications as directed by the participant or the participant's representative;
and

(3) providing verbal or visual reminders to perform regularly scheduled medications.

(t) "Participant" means a person who is eligible for CFSS.

(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. deleted text beginThis authorization must be in
writing or by another method that clearly indicates the participant's free choice and may be
withdrawn at any time. The participant's representative must have no financial interest in
the provision of any services included in the participant's CFSS service delivery plan and
must be capable of providing the support necessary to assist the participant in the use of
CFSS. If through the assessment process described in subdivision 5 a participant is
determined to be in need of a participant's representative, one must be selected.
deleted text end If the
participant is unable to assist in the selection of a participant's representative, the legal
representative shall appoint one. deleted text beginTwo persons may be designated as a participant's
representative for reasons such as divided households and court-ordered custodies. Duties
of a participant's representatives may include:
deleted text end

deleted text begin (1) being available while services are provided in a method agreed upon by the participant
or the participant's legal representative and documented in the participant's CFSS service
delivery plan;
deleted text end

deleted text begin (2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is
being followed; and
deleted text end

deleted text begin (3) reviewing and signing CFSS time sheets after services are provided to provide
verification of the CFSS services.
deleted text end

(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.

(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.

(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into deleted text beginandeleted text endnew text begin a writtennew text end agreement to
receive services at the same time deleted text beginanddeleted text endnew text begin,new text end in the same setting deleted text beginbydeleted text endnew text begin, and throughnew text end the same deleted text beginemployerdeleted text endnew text begin
agency-provider or FMS provider
new text end.

(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.

(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.

(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.

(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
mileage reimbursement, health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.

(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.

Sec. 60.

Minnesota Statutes 2020, section 256B.85, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

(a) CFSS is available to a person who deleted text beginmeets one of the followingdeleted text end:

deleted text begin (1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056,
or 256B.057, subdivisions 5 and 9;
deleted text end

new text begin (1) is determined eligible for medical assistance under this chapter, excluding those
under section 256B.057, subdivisions 3, 3a, 3b, and 4;
new text end

(2) is a participant in the alternative care program under section 256B.0913;

(3) is a waiver participant as defined under chapter 256S or section 256B.092, 256B.093,
or 256B.49; or

(4) has medical services identified in a person's individualized education program and
is eligible for services as determined in section 256B.0625, subdivision 26.

(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
meet all of the following:

(1) require assistance and be determined dependent in one activity of daily living or
Level I behavior based on assessment under section 256B.0911; and

(2) is not a participant under a family support grant under section 252.32.

(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision
6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible
for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as
determined under section 256B.0911.

Sec. 61.

Minnesota Statutes 2020, section 256B.85, subdivision 4, is amended to read:


Subd. 4.

Eligibility for other services.

Selection of CFSS by a participant must not
restrict access to other medically necessary care and services furnished under the state plan
benefit or other services available through new text beginthe new text endalternative carenew text begin programnew text end.

Sec. 62.

Minnesota Statutes 2020, section 256B.85, subdivision 5, is amended to read:


Subd. 5.

Assessment requirements.

(a) The assessment of functional need must:

(1) be conducted by a certified assessor according to the criteria established in section
256B.0911, subdivision 3a;

(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
a significant change in the participant's condition or a change in the need for services and
supports, or at the request of the participant when the participant experiences a change in
condition or needs a change in the services or supports; and

(3) be completed using the format established by the commissioner.

(b) The results of the assessment and any recommendations and authorizations for CFSS
must be determined and communicated in writing by the lead agency's deleted text begincertifieddeleted text end assessor as
defined in section 256B.0911 to the participant deleted text beginand the agency-provider or FMS provider
chosen by the participant
deleted text endnew text begin or the participant's representative and chosen CFSS providersnew text end
within deleted text begin40 calendardeleted text end new text beginten business new text enddays and must include the participant's right to appeal new text beginthe
assessment
new text endunder section 256.045, subdivision 3.

(c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. new text beginThe lead agency assessor may authorize
a temporary authorization for CFSS services to be provided under the agency-provider
model without using the assessment process described in this subdivision.
new text endAuthorization
for a temporary level of CFSS services under the agency-provider model is limited to the
time specified by the commissioner, but shall not exceed 45 days. The level of services
authorized under this paragraph shall have no bearing on a future authorization. deleted text beginParticipants
approved for a temporary authorization shall access the consultation service
deleted text endnew text begin For CFSS
services needed beyond the 45-day temporary authorization, the lead agency must conduct
an assessment as described in this subdivision and participants must use consultation services
new text end
to complete their orientation and selection of a service model.

Sec. 63.

Minnesota Statutes 2020, section 256B.85, subdivision 6, is amended to read:


Subd. 6.

Community first services and supports service delivery plan.

(a) The CFSS
service delivery plan must be developed and evaluated through a person-centered planning
process by the participant, or the participant's representative or legal representative who
may be assisted by a consultation services provider. The CFSS service delivery plan must
reflect the services and supports that are important to the participant and for the participant
to meet the needs assessed by the certified assessor and identified in the coordinated service
and support plan identified in deleted text beginsectiondeleted text endnew text begin sections 256B.092, subdivision 1b, andnew text end 256S.10. The
CFSS service delivery plan must be reviewed by the participant, the consultation services
provider, and the agency-provider or FMS provider prior to starting services and at least
annually upon reassessment, or when there is a significant change in the participant's
condition, or a change in the need for services and supports.

(b) The commissioner shall establish the format and criteria for the CFSS service delivery
plan.

(c) The CFSS service delivery plan must be person-centered and:

(1) specify the consultation services provider, agency-provider, or FMS provider selected
by the participant;

(2) reflect the setting in which the participant resides that is chosen by the participant;

(3) reflect the participant's strengths and preferences;

(4) include the methods and supports used to address the needs as identified through an
assessment of functional needs;

(5) include the participant's identified goals and desired outcomes;

(6) reflect the services and supports, paid and unpaid, that will assist the participant to
achieve identified goals, including the costs of the services and supports, and the providers
of those services and supports, including natural supports;

(7) identify the amount and frequency of face-to-face supports and amount and frequency
of remote supports and technology that will be used;

(8) identify risk factors and measures in place to minimize them, including individualized
backup plans;

(9) be understandable to the participant and the individuals providing support;

(10) identify the individual or entity responsible for monitoring the plan;

(11) be finalized and agreed to in writing by the participant and signed by deleted text beginalldeleted text end individuals
and providers responsible for its implementation;

(12) be distributed to the participant and other people involved in the plan;

(13) prevent the provision of unnecessary or inappropriate care;

(14) include a detailed budget for expenditures for budget model participants or
participants under the agency-provider model if purchasing goods; and

(15) include a plan for worker training and development provided according to
subdivision 18a detailing what service components will be used, when the service components
will be used, how they will be provided, and how these service components relate to the
participant's individual needs and CFSS support worker services.

(d) new text beginThe CFSS service delivery plan must describe the units or dollar amount available
to the participant.
new text endThe total units of agency-provider services or the service budget amount
for the budget model include both annual totals and a monthly average amount that cover
the number of months of the service agreement. The amount used each month may vary,
but additional funds must not be provided above the annual service authorization amount,
determined according to subdivision 8, unless a change in condition is assessed and
authorized by the certified assessor and documented in the coordinated service and support
plan and CFSS service delivery plan.

(e) In assisting with the development or modification of the CFSS service delivery plan
during the authorization time period, the consultation services provider shall:

(1) consult with the FMS provider on the spending budget when applicable; and

(2) consult with the participant or participant's representative, agency-provider, and case
managerdeleted text begin/deleted text endnew text begin or new text endcare coordinator.

(f) The CFSS service delivery plan must be approved by the consultation services provider
for participants without a case manager or care coordinator who is responsible for authorizing
services. A case manager or care coordinator must approve the plan for a waiver or alternative
care program participant.

Sec. 64.

Minnesota Statutes 2020, section 256B.85, subdivision 7, is amended to read:


Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;

(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;

(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:

(i) relate to a need identified in a participant's CFSS service delivery plan; and

(ii) increase independence or substitute for human assistancenew text begin,new text end to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;

(4) observation and redirection for behavior or symptoms where there is a need for
assistance;

(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;

(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;

(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. These support
workers shall notnew text begin:
new text end

new text begin (i)new text end provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and

new text begin (ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
new text end

(9) worker training and development services as described in subdivision 18a.

Sec. 65.

Minnesota Statutes 2020, section 256B.85, subdivision 8, is amended to read:


Subd. 8.

Determination of CFSS service authorization amount.

(a) All community
first services and supports must be authorized by the commissioner or the commissioner's
designee before services begin. The authorization for CFSS must be completed as soon as
possible following an assessment but no later than 40 calendar days from the date of the
assessment.

(b) The amount of CFSS authorized must be based on the participant's home care rating
described in paragraphs (d) and (e) and any additional service units for which the participant
qualifies as described in paragraph (f).

(c) The home care rating shall be determined by the commissioner or the commissioner's
designee based on information submitted to the commissioner identifying the following for
a participant:

(1) the total number of dependencies of activities of daily living;

(2) the presence of complex health-related needs; and

(3) the presence of Level I behavior.

(d) The methodology to determine the total service units for CFSS for each home care
rating is based on the median paid units per day for each home care rating from fiscal year
2007 data for the PCA program.

(e) Each home care rating is designated by the letters P through Z and EN and has the
following base number of service units assigned:

(1) P home care rating requires Level I behavior or one to three dependencies in ADLs
and qualifies the person for five service units;

(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs
and qualifies the person for six service units;

(3) R home care rating requires a complex health-related need and one to three
dependencies in ADLs and qualifies the person for seven service units;

(4) S home care rating requires four to six dependencies in ADLs and qualifies the person
for ten service units;

(5) T home care rating requires four to six dependencies in ADLs and Level I behavior
and qualifies the person for 11 service units;

(6) U home care rating requires four to six dependencies in ADLs and a complex
health-related need and qualifies the person for 14 service units;

(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the
person for 17 service units;

(8) W home care rating requires seven to eight dependencies in ADLs and Level I
behavior and qualifies the person for 20 service units;

(9) Z home care rating requires seven to eight dependencies in ADLs and a complex
health-related need and qualifies the person for 30 service units; and

(10) EN home care rating includes ventilator dependency as defined in section 256B.0651,
subdivision 1
, paragraph (g). A person who meets the definition of ventilator-dependent
and the EN home care rating and utilize a combination of CFSS and home care nursing
services is limited to a total of 96 service units per day for those services in combination.
Additional units may be authorized when a person's assessment indicates a need for two
staff to perform activities. Additional time is limited to 16 service units per day.

(f) Additional service units are provided through the assessment and identification of
the following:

(1) 30 additional minutes per day for a dependency in each critical activity of daily
living;

(2) 30 additional minutes per day for each complex health-related need; and

(3) 30 additional minutes per day deleted text beginwhen thedeleted text endnew text begin for eachnew text end behavior new text beginunder this clause that
new text end requires assistance at least four times per week deleted text beginfor one or more of the following behaviorsdeleted text end:

(i) level I behaviornew text begin that requires the immediate response of another personnew text end;

(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
or

(iii) increased need for assistance for participants who are verbally aggressive or resistive
to care so that the time needed to perform activities of daily living is increased.

(g) The service budget for budget model participants shall be based on:

(1) assessed units as determined by the home care rating; and

(2) an adjustment needed for administrative expenses.

Sec. 66.

Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:


new text begin Subd. 8a.new text end

new text beginAuthorization; exceptions.new text end

new text beginAll CFSS services must be authorized by the
commissioner or the commissioner's designee as described in subdivision 8 except when:
new text end

new text begin (1) the lead agency temporarily authorizes services in the agency-provider model as
described in subdivision 5, paragraph (c);
new text end

new text begin (2) CFSS services in the agency-provider model were required to treat an emergency
medical condition that if not immediately treated could cause a participant serious physical
or mental disability, continuation of severe pain, or death. The CFSS agency provider must
request retroactive authorization from the lead agency no later than five working days after
providing the initial emergency service. The CFSS agency provider must be able to
substantiate the emergency through documentation such as reports, notes, and admission
or discharge histories. A lead agency must follow the authorization process in subdivision
5 after the lead agency receives the request for authorization from the agency provider;
new text end

new text begin (3) the lead agency authorizes a temporary increase to the amount of services authorized
in the agency or budget model to accommodate the participant's temporary higher need for
services. Authorization for a temporary level of CFSS services is limited to the time specified
by the commissioner, but shall not exceed 45 days. The level of services authorized under
this clause shall have no bearing on a future authorization;
new text end

new text begin (4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated,
and an authorization for CFSS services is completed based on the date of a current
assessment, eligibility, and request for authorization;
new text end

new text begin (5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization
requests must be submitted by the provider within 20 working days of the notice of denial
or adjustment. A copy of the notice must be included with the request;
new text end

new text begin (6) the commissioner has determined that a lead agency or state human services agency
has made an error; or
new text end

new text begin (7) a participant enrolled in managed care experiences a temporary disenrollment from
a health plan, in which case the commissioner shall accept the current health plan
authorization for CFSS services for up to 60 days. The request must be received within the
first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after
the 60 days and before 90 days, the provider shall request an additional 30-day extension
of the current health plan authorization, for a total limit of 90 days from the time of
disenrollment.
new text end

Sec. 67.

Minnesota Statutes 2020, section 256B.85, subdivision 9, is amended to read:


Subd. 9.

Noncovered services.

(a) Services or supports that are not eligible for payment
under this section include those that:

(1) are not authorized by the certified assessor or included in the CFSS service delivery
plan;

(2) are provided prior to the authorization of services and the approval of the CFSS
service delivery plan;

(3) are duplicative of other paid services in the CFSS service delivery plan;

(4) supplant natural unpaid supports that appropriately meet a need in the CFSS service
delivery plan, are provided voluntarily to the participant, and are selected by the participant
in lieu of other services and supports;

(5) are not effective means to meet the participant's needs; and

(6) are available through other funding sources, includingdeleted text begin,deleted text end but not limited todeleted text begin,deleted text end funding
through title IV-E of the Social Security Act.

(b) Additional services, goods, or supports that are not covered include:

(1) those that are not for the direct benefit of the participant, except that services for
caregivers such as training to improve the ability to provide CFSS are considered to directly
benefit the participant if chosen by the participant and approved in the support plan;

(2) any fees incurred by the participant, such as Minnesota health care programs fees
and co-pays, legal fees, or costs related to advocate agencies;

(3) insurance, except for insurance costs related to employee coverage;

(4) room and board costs for the participant;

(5) services, supports, or goods that are not related to the assessed needs;

(6) special education and related services provided under the Individuals with Disabilities
Education Act and vocational rehabilitation services provided under the Rehabilitation Act
of 1973;

(7) assistive technology devices and assistive technology services other than those for
back-up systems or mechanisms to ensure continuity of service and supports listed in
subdivision 7;

(8) medical supplies and equipment covered under medical assistance;

(9) environmental modifications, except as specified in subdivision 7;

(10) expenses for travel, lodging, or meals related to training the participant or the
participant's representative or legal representative;

(11) experimental treatments;

(12) any service or good covered by other state plan services, including prescription and
over-the-counter medications, compounds, and solutions and related fees, including premiums
and co-payments;

(13) membership dues or costs, except when the service is necessary and appropriate to
treat a health condition or to improve or maintain the new text beginadult new text endparticipant's health condition.
The condition must be identified in the participant's CFSS service delivery plan and
monitored by a Minnesota health care program enrolled physiciannew text begin, advanced practice
registered nurse, or physician's assistant
new text end;

(14) vacation expenses other than the cost of direct services;

(15) vehicle maintenance or modifications not related to the disability, health condition,
or physical need;

(16) tickets and related costs to attend sporting or other recreational or entertainment
events;

(17) services provided and billed by a provider who is not an enrolled CFSS provider;

(18) CFSS provided by a participant's representative or paid legal guardian;

(19) services that are used solely as a child care or babysitting service;

(20) services that are the responsibility or in the daily rate of a residential or program
license holder under the terms of a service agreement and administrative rules;

(21) sterile procedures;

(22) giving of injections into veins, muscles, or skin;

(23) homemaker services that are not an integral part of the assessed CFSS service;

(24) home maintenance or chore services;

(25) home care services, including hospice services if elected by the participant, covered
by Medicare or any other insurance held by the participant;

(26) services to other members of the participant's household;

(27) services not specified as covered under medical assistance as CFSS;

(28) application of restraints or implementation of deprivation procedures;

(29) assessments by CFSS provider organizations or by independently enrolled registered
nurses;

(30) services provided in lieu of legally required staffing in a residential or child care
setting; deleted text beginand
deleted text end

(31) services provided by deleted text beginthe residential or programdeleted text endnew text begin a foster carenew text end license holder deleted text beginin a
residence for more than four participants.
deleted text endnew text begin except when the home of the person receiving
services is the licensed foster care provider's primary residence;
new text end

new text begin (32) services that are the responsibility of the foster care provider under the terms of the
foster care placement agreement, assessment under sections 256N.24 and 260C.4411, and
administrative rules under sections 256N.24 and 260C.4411;
new text end

new text begin (33) services in a setting that has a licensed capacity greater than six, unless all conditions
for a variance under section 245A.04, subdivision 9a, are satisfied for a sibling, as defined
in section 260C.007, subdivision 32;
new text end

new text begin (34) services from a provider who owns or otherwise controls the living arrangement,
except when the provider of services is related by blood, marriage, or adoption or when the
provider is a licensed foster care provider who is not prohibited from providing services
under clauses (31) to (33);
new text end

new text begin (35) instrumental activities of daily living for children younger than 18 years of age,
except when immediate attention is needed for health or hygiene reasons integral to an
assessed need for assistance with activities of daily living, health-related procedures, and
tasks or behaviors; or
new text end

new text begin (36) services provided to a resident of a nursing facility, hospital, intermediate care
facility, or health care facility licensed by the commissioner of health.
new text end

Sec. 68.

Minnesota Statutes 2020, section 256B.85, subdivision 10, is amended to read:


Subd. 10.

Agency-provider and FMS provider qualifications and duties.

(a)
Agency-providers identified in subdivision 11 and FMS providers identified in subdivision
13a shall:

(1) enroll as a medical assistance Minnesota health care programs provider and meet all
applicable provider standards and requirementsnew text begin including completion of required provider
training as determined by the commissioner
new text end;

(2) demonstrate compliance with federal and state laws and policies for CFSS as
determined by the commissioner;

(3) comply with background study requirements under chapter 245C and maintain
documentation of background study requests and results;

(4) verify and maintain records of all services and expenditures by the participant,
including hours worked by support workers;

(5) not engage in any agency-initiated direct contact or marketing in person, by telephone,
or other electronic means to potential participants, guardians, family members, or participants'
representatives;

(6) directly provide services and not use a subcontractor or reporting agent;

(7) meet the financial requirements established by the commissioner for financial
solvency;

(8) have never had a lead agency contract or provider agreement discontinued due to
fraud, or have never had an owner, board member, or manager fail a state or FBI-based
criminal background check while enrolled or seeking enrollment as a Minnesota health care
programs provider; and

(9) have an office located in Minnesota.

(b) In conducting general duties, agency-providers and FMS providers shall:

(1) pay support workers based upon actual hours of services provided;

(2) pay for worker training and development services based upon actual hours of services
provided or the unit cost of the training session purchased;

(3) withhold and pay all applicable federal and state payroll taxes;

(4) make arrangements and pay unemployment insurance, taxes, workers' compensation,
liability insurance, and other benefits, if any;

(5) enter into a written agreement with the participant, participant's representative, or
legal representative that assigns roles and responsibilities to be performed before services,
supports, or goods are providednew text begin and that meets the requirements of subdivisions 20a, 20b,
and 20c for agency-providers
new text end;

(6) report maltreatment as required under section 626.557 and chapter 260E;

(7) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a;

(8) comply with any data requests from the department consistent with the Minnesota
Government Data Practices Act under chapter 13; deleted text beginand
deleted text end

(9) maintain documentation for the requirements under subdivision 16, paragraph (e),
clause (2), to qualify for an enhanced rate under this sectiondeleted text begin.deleted text endnew text begin; and
new text end

new text begin (10) request reassessments 60 days before the end of the current authorization for CFSS
on forms provided by the commissioner.
new text end

Sec. 69.

Minnesota Statutes 2020, section 256B.85, subdivision 11, is amended to read:


Subd. 11.

Agency-provider model.

(a) The agency-provider model includes services
provided by support workers and staff providing worker training and development services
who are employed by an agency-provider that meets the criteria established by the
commissioner, including required training.

(b) The agency-provider shall allow the participant to have a significant role in the
selection and dismissal of the support workers for the delivery of the services and supports
specified in the participant's CFSS service delivery plan.new text begin The agency must make a reasonable
effort to fulfill the participant's request for the participant's preferred support worker.
new text end

(c) A participant may use authorized units of CFSS services as needed within a service
agreement that is not greater than 12 months. Using authorized units in a flexible manner
in either the agency-provider model or the budget model does not increase the total amount
of services and supports authorized for a participant or included in the participant's CFSS
service delivery plan.

(d) A participant may share CFSS services. Two or three CFSS participants may share
services at the same time provided by the same support worker.

(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated
by the medical assistance payment for CFSS for support worker wages and benefits, except
all of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The agency-provider must document how this requirement is being met. The
revenue generated by the worker training and development services and the reasonable costs
associated with the worker training and development services must not be used in making
this calculation.

(f) The agency-provider model must be used by deleted text beginindividualsdeleted text endnew text begin participantsnew text end who are restricted
by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to
9505.2245.

(g) Participants purchasing goods under this model, along with support worker services,
must:

(1) specify the goods in the CFSS service delivery plan and detailed budget for
expenditures that must be approved by the consultation services provider, case manager, or
care coordinator; and

(2) use the FMS provider for the billing and payment of such goods.

Sec. 70.

Minnesota Statutes 2020, section 256B.85, subdivision 11b, is amended to read:


Subd. 11b.

Agency-provider model; support worker competency.

(a) The
agency-provider must ensure that support workers are competent to meet the participant's
assessed needs, goals, and additional requirements as written in the CFSS service delivery
plan. deleted text beginWithin 30 days of any support worker beginning to provide services for a participant,deleted text end
The agency-provider must evaluate the competency of the new text beginsupportnew text end worker through direct
observation of the support worker's performance of the job functions in a setting where the
participant is using CFSSdeleted text begin.deleted text endnew text begin within 30 days of:
new text end

new text begin (1) any support worker beginning to provide services for a participant; or
new text end

new text begin (2) any support worker beginning to provide shared services.
new text end

(b) The agency-provider must verify and maintain evidence of support worker
competency, including documentation of the support worker's:

(1) education and experience relevant to the job responsibilities assigned to the support
worker and the needs of the participant;

(2) relevant training received from sources other than the agency-provider;

(3) orientation and instruction to implement services and supports to participant needs
and preferences as identified in the CFSS service delivery plan; deleted text beginand
deleted text end

new text begin (4) orientation and instruction delivered by an individual competent to perform, teach,
or assign the health-related tasks for tracheostomy suctioning and services to participants
on ventilator support, including equipment operation and maintenance; and
new text end

deleted text begin (4)deleted text endnew text begin (5)new text end periodic performance reviews completed by the agency-provider at least annually,
including any evaluations required under subdivision 11a, paragraph (a). If a support worker
is a minor, all evaluations of worker competency must be completed in person and in a
setting where the participant is using CFSS.

(c) The agency-provider must develop a worker training and development plan with the
participant to ensure support worker competency. The worker training and development
plan must be updated when:

(1) the support worker begins providing services;

new text begin (2) the support worker begins providing shared services;
new text end

deleted text begin (2)deleted text endnew text begin (3)new text end there is any change in condition or a modification to the CFSS service delivery
plan; or

deleted text begin (3)deleted text endnew text begin (4)new text end a performance review indicates that additional training is needed.

Sec. 71.

Minnesota Statutes 2020, section 256B.85, subdivision 12, is amended to read:


Subd. 12.

Requirements for enrollment of CFSS agency-providers.

(a) All CFSS
agency-providers must provide, at the time of enrollment, reenrollment, and revalidation
as a CFSS agency-provider in a format determined by the commissioner, information and
documentation that includesdeleted text begin,deleted text end but is not limited todeleted text begin,deleted text end the following:

(1) the CFSS agency-provider's current contact information including address, telephone
number, and e-mail address;

(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's
Medicaid revenue in the previous calendar year is less than or equal to $300,000, the
agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid
revenue in the previous calendar year is greater than $300,000, the agency-provider must
purchase a surety bond of $100,000. The surety bond must be in a form approved by the
commissioner, must be renewed annually, and must allow for recovery of costs and fees in
pursuing a claim on the bond;

(3) proof of fidelity bond coverage in the amount of $20,000new text begin per provider locationnew text end;

(4) proof of workers' compensation insurance coverage;

(5) proof of liability insurance;

(6) a deleted text begindescriptiondeleted text endnew text begin copynew text end of the CFSS agency-provider's deleted text beginorganizationdeleted text endnew text begin organizational chartnew text end
identifying the names new text beginand roles new text endof all owners, managing employees, staff, board of directors,
and deleted text beginthedeleted text endnew text begin additional documentation reporting anynew text end affiliations of the directors and owners to
other service providers;

(7) deleted text begina copy ofdeleted text endnew text begin proof thatnew text end the CFSS deleted text beginagency-provider'sdeleted text endnew text begin agency-provider hasnew text end written policies
and procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety, including the process for notification and resolution of
participant grievances, incident response, identification and prevention of communicable
diseases, and employee misconduct;

(8) deleted text begincopies of all other formsdeleted text endnew text begin proof thatnew text end the CFSS agency-provider deleted text beginuses in the course of
daily business including, but not limited to
deleted text endnew text begin has all of the following forms and documentsnew text end:

(i) a copy of the CFSS agency-provider's time sheet; and

(ii) a copy of the participant's individual CFSS service delivery plan;

(9) a list of all training and classes that the CFSS agency-provider requires of its staff
providing CFSS services;

(10) documentation that the CFSS agency-provider and staff have successfully completed
all the training required by this section;

(11) documentation of the agency-provider's marketing practices;

(12) disclosure of ownership, leasing, or management of all residential properties that
are used or could be used for providing home care services;

(13) documentation that the agency-provider will use at least the following percentages
of revenue generated from the medical assistance rate paid for CFSS services for CFSS
support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except
100 percent of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The revenue generated by the worker training and development services and the
reasonable costs associated with the worker training and development services shall not be
used in making this calculation; and

(14) documentation that the agency-provider does not burden participants' free exercise
of their right to choose service providers by requiring CFSS support workers to sign an
agreement not to work with any particular CFSS participant or for another CFSS
agency-provider after leaving the agency and that the agency is not taking action on any
such agreements or requirements regardless of the date signed.

(b) CFSS agency-providers shall provide to the commissioner the information specified
in paragraph (a).

(c) All CFSS agency-providers shall require all employees in management and
supervisory positions and owners of the agency who are active in the day-to-day management
and operations of the agency to complete mandatory training as determined by the
commissioner. Employees in management and supervisory positions and owners who are
active in the day-to-day operations of an agency who have completed the required training
as an employee with a CFSS agency-provider do not need to repeat the required training if
they are hired by another agencydeleted text begin, ifdeleted text endnew text begin andnew text end they have completed the training within the past
three years. CFSS agency-provider billing staff shall complete training about CFSS program
financial management. Any new owners or employees in management and supervisory
positions involved in the day-to-day operations are required to complete mandatory training
as a requisite of working for the agency.

deleted text begin (d) The commissioner shall send annual review notifications to agency-providers 30
days prior to renewal. The notification must:
deleted text end

deleted text begin (1) list the materials and information the agency-provider is required to submit;
deleted text end

deleted text begin (2) provide instructions on submitting information to the commissioner; and
deleted text end

deleted text begin (3) provide a due date by which the commissioner must receive the requested information.
deleted text end

deleted text begin Agency-providers shall submit all required documentation for annual review within 30 days
of notification from the commissioner. If an agency-provider fails to submit all the required
documentation, the commissioner may take action under subdivision 23a.
deleted text end

new text begin (d) Agency-providers shall submit all required documentation in this section within 30
days of notification from the commissioner. If an agency-provider fails to submit all the
required documentation, the commissioner may take action under subdivision 23a.
new text end

Sec. 72.

Minnesota Statutes 2020, section 256B.85, subdivision 12b, is amended to read:


Subd. 12b.

CFSS agency-provider requirements; notice regarding termination of
services.

(a) An agency-provider must provide written notice when it intends to terminate
services with a participant at least deleted text begintendeleted text endnew text begin 30new text end calendar days before the proposed service
termination is to become effective, except in cases where:

(1) the participant engages in conduct that significantly alters the terms of the CFSS
service delivery plan with the agency-provider;

(2) the participant or other persons at the setting where services are being provided
engage in conduct that creates an imminent risk of harm to the support worker or other
agency-provider staff; or

(3) an emergency or a significant change in the participant's condition occurs within a
24-hour period that results in the participant's service needs exceeding the participant's
identified needs in the current CFSS service delivery plan so that the agency-provider cannot
safely meet the participant's needs.

(b) When a participant initiates a request to terminate CFSS services with the
agency-provider, the agency-provider must give the participant a written deleted text beginacknowledgementdeleted text endnew text begin
acknowledgment
new text end of the participant's service termination request that includes the date the
request was received by the agency-provider and the requested date of termination.

(c) The agency-provider must participate in a coordinated transfer of the participant to
a new agency-provider to ensure continuity of care.

Sec. 73.

Minnesota Statutes 2020, section 256B.85, subdivision 13, is amended to read:


Subd. 13.

Budget model.

(a) Under the budget model participants exercise responsibility
and control over the services and supports described and budgeted within the CFSS service
delivery plan. Participants must use services specified in subdivision 13a provided by an
FMS provider. Under this model, participants may use their approved service budget
allocation to:

(1) directly employ support workers, and pay wages, federal and state payroll taxes, and
premiums for workers' compensation, liability, and health insurance coverage; and

(2) obtain supports and goods as defined in subdivision 7.

(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may
authorize a legal representative or participant's representative to do so on their behalf.

new text begin (c) If two or more participants using the budget model live in the same household and
have the same support worker, the participants must use the same FMS provider.
new text end

new text begin (d) If the FMS provider advises that there is a joint employer in the budget model, all
participants associated with that joint employer must use the same FMS provider.
new text end

deleted text begin (c)deleted text endnew text begin (e)new text end The commissioner shall disenroll or exclude participants from the budget model
and transfer them to the agency-provider model under, but not limited to, the following
circumstances:

(1) when a participant has been restricted by the Minnesota restricted recipient program,
in which case the participant may be excluded for a specified time period under Minnesota
Rules, parts 9505.2160 to 9505.2245;

(2) when a participant exits the budget model during the participant's service plan year.
Upon transfer, the participant shall not access the budget model for the remainder of that
service plan year; or

(3) when the department determines that the participant or participant's representative
or legal representative is unable to fulfill the responsibilities under the budget model, as
specified in subdivision 14.

deleted text begin (d)deleted text endnew text begin (f)new text end A participant may appeal in writing to the department under section 256.045,
subdivision 3, to contest the department's decision under paragraph deleted text begin(c)deleted text endnew text begin (e)new text end, clause (3), to
disenroll or exclude the participant from the budget model.

Sec. 74.

Minnesota Statutes 2020, section 256B.85, subdivision 13a, is amended to read:


Subd. 13a.

Financial management services.

(a) Services provided by an FMS provider
include but are not limited to: filing and payment of federal and state payroll taxes on behalf
of the participant; initiating and complying with background study requirements under
chapter 245C and maintaining documentation of background study requests and results;
billing for approved CFSS services with authorized funds; monitoring expenditures;
accounting for and disbursing CFSS funds; providing assistance in obtaining and filing for
liability, workers' compensation, and unemployment coverage; and providing participant
instruction and technical assistance to the participant in fulfilling employer-related
requirements in accordance with section 3504 of the Internal Revenue Code and related
regulations and interpretations, including Code of Federal Regulations, title 26, section
31.3504-1.

(b) Agency-provider services shall not be provided by the FMS provider.

(c) The FMS provider shall provide service functions as determined by the commissioner
for budget model participants that include but are not limited to:

(1) assistance with the development of the detailed budget for expenditures portion of
the CFSS service delivery plan as requested by the consultation services provider or
participant;

(2) data recording and reporting of participant spending;

(3) other duties established by the department, including with respect to providing
assistance to the participant, participant's representative, or legal representative in performing
employer responsibilities regarding support workers. The support worker shall not be
considered the employee of the FMS provider; and

(4) billing, payment, and accounting of approved expenditures for goods.

(d) The FMS provider shall obtain an assurance statement from the participant employer
agreeing to follow state and federal regulations and CFSS policies regarding employment
of support workers.

(e) The FMS provider shall:

(1) not limit or restrict the participant's choice of service or support providers or service
delivery models consistent with any applicable state and federal requirements;

(2) provide the participant, consultation services provider, and case manager or care
coordinator, if applicable, with a monthly written summary of the spending for services and
supports that were billed against the spending budget;

(3) be knowledgeable of state and federal employment regulations, including those under
the Fair Labor Standards Act of 1938, and comply with the requirements under section 3504
of the Internal Revenue Code and related regulations and interpretations, including Code
of Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability
for vendor fiscal/employer agent, and any requirements necessary to process employer and
employee deductions, provide appropriate and timely submission of employer tax liabilities,
and maintain documentation to support medical assistance claims;

(4) have current and adequate liability insurance and bonding and sufficient cash flow
as determined by the commissioner and have on staff or under contract a certified public
accountant or an individual with a baccalaureate degree in accounting;

(5) assume fiscal accountability for state funds designated for the program and be held
liable for any overpayments or violations of applicable statutes or rules, including but not
limited to the Minnesota False Claims Act, chapter 15C; deleted text beginand
deleted text end

(6) maintain documentation of receipts, invoices, and bills to track all services and
supports expenditures for any goods purchased and maintain time records of support workers.
The documentation and time records must be maintained for a minimum of five years from
the claim date and be available for audit or review upon request by the commissioner. Claims
submitted by the FMS provider to the commissioner for payment must correspond with
services, amounts, and time periods as authorized in the participant's service budget and
service plan and must contain specific identifying information as determined by the
commissionerdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (7) provide written notice to the participant or the participant's representative at least 30
calendar days before a proposed service termination becomes effective.
new text end

(f) The commissioner deleted text beginof human servicesdeleted text end shall:

(1) establish rates and payment methodology for the FMS provider;

(2) identify a process to ensure quality and performance standards for the FMS provider
and ensure statewide access to FMS providers; and

(3) establish a uniform protocol for delivering and administering CFSS services to be
used by eligible FMS providers.

Sec. 75.

Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision
to read:


new text begin Subd. 14a.new text end

new text beginParticipant's representative responsibilities.new text end

new text begin(a) If a participant is unable
to direct the participant's own care, the participant must use a participant's representative
to receive CFSS services. A participant's representative is required if:
new text end

new text begin (1) the person is under 18 years of age;
new text end

new text begin (2) the person has a court-appointed guardian; or
new text end

new text begin (3) an assessment according to section 256B.0659, subdivision 3a, determines that the
participant is in need of a participant's representative.
new text end

new text begin (b) A participant's representative must:
new text end

new text begin (1) be at least 18 years of age;
new text end

new text begin (2) actively participate in planning and directing CFSS services;
new text end

new text begin (3) have sufficient knowledge of the participant's circumstances to use CFSS services
consistent with the participant's health and safety needs identified in the participant's service
delivery plan;
new text end

new text begin (4) not have a financial interest in the provision of any services included in the
participant's CFSS service delivery plan; and
new text end

new text begin (5) be capable of providing the support necessary to assist the participant in the use of
CFSS services.
new text end

new text begin (c) A participant's representative must not be the:
new text end

new text begin (1) support worker;
new text end

new text begin (2) worker training and development service provider;
new text end

new text begin (3) agency-provider staff, unless related to the participant by blood, marriage, or adoption;
new text end

new text begin (4) consultation service provider, unless related to the participant by blood, marriage,
or adoption;
new text end

new text begin (5) FMS staff, unless related to the participant by blood, marriage, or adoption;
new text end

new text begin (6) FMS owner or manager; or
new text end

new text begin (7) lead agency staff acting as part of employment.
new text end

new text begin (d) A licensed family foster parent who lives with the participant may be the participant's
representative if the family foster parent meets the other participant's representative
requirements.
new text end

new text begin (e) There may be two persons designated as the participant's representative, including
instances of divided households and court-ordered custodies. Each person named as the
participant's representative must meet the program criteria and responsibilities.
new text end

new text begin (f) The participant or the participant's legal representative shall appoint a participant's
representative. The participant's representative must be identified at the time of assessment
and listed on the participant's service agreement and CFSS service delivery plan.
new text end

new text begin (g) A participant's representative must enter into a written agreement with an
agency-provider or FMS on a form determined by the commissioner and maintained in the
participant's file, to:
new text end

new text begin (1) be available while care is provided using a method agreed upon by the participant
or the participant's legal representative and documented in the participant's service delivery
plan;
new text end

new text begin (2) monitor CFSS services to ensure the participant's service delivery plan is followed;
new text end

new text begin (3) review and sign support worker time sheets after services are provided to verify the
provision of services;
new text end

new text begin (4) review and sign vendor paperwork to verify receipt of goods; and
new text end

new text begin (5) in the budget model, review and sign documentation to verify worker training and
development expenditures.
new text end

new text begin (h) A participant's representative may delegate responsibility to another adult who is not
the support worker during a temporary absence of at least 24 hours but not more than six
months. To delegate responsibility, the participant's representative must:
new text end

new text begin (1) ensure that the delegate serving as the participant's representative satisfies the
requirements of the participant's representative;
new text end

new text begin (2) ensure that the delegate performs the functions of the participant's representative;
new text end

new text begin (3) communicate to the CFSS agency-provider or FMS provider about the need for a
delegate by updating the written agreement to include the name of the delegate and the
delegate's contact information; and
new text end

new text begin (4) ensure that the delegate protects the participant's privacy according to federal and
state data privacy laws.
new text end

new text begin (i) The designation of a participant's representative remains in place until:
new text end

new text begin (1) the participant revokes the designation;
new text end

new text begin (2) the participant's representative withdraws the designation or becomes unable to fulfill
the duties;
new text end

new text begin (3) the legal authority to act as a participant's representative changes; or
new text end

new text begin (4) the participant's representative is disqualified.
new text end

new text begin (j) A lead agency may disqualify a participant's representative who engages in conduct
that creates an imminent risk of harm to the participant, the support workers, or other staff.
A participant's representative who fails to provide support required by the participant must
be referred to the common entry point.
new text end

Sec. 76.

Minnesota Statutes 2020, section 256B.85, subdivision 15, is amended to read:


Subd. 15.

Documentation of support services provided; time sheets.

(a) CFSS services
provided to a participant by a support worker employed by either an agency-provider or the
participant employer must be documented daily by each support worker, on a time sheet.
Time sheets may be created, submitted, and maintained electronically. Time sheets must
be submitted by the support worker new text beginat least once per month new text endto the:

(1) agency-provider when the participant is using the agency-provider model. The
agency-provider must maintain a record of the time sheet and provide a copy of the time
sheet to the participant; or

(2) participant and the participant's FMS provider when the participant is using the
budget model. The participant and the FMS provider must maintain a record of the time
sheet.

(b) The documentation on the time sheet must correspond to the participant's assessed
needs within the scope of CFSS covered services. The accuracy of the time sheets must be
verified by the:

(1) agency-provider when the participant is using the agency-provider model; or

(2) participant employer and the participant's FMS provider when the participant is using
the budget model.

(c) The time sheet must document the time the support worker provides services to the
participant. The following elements must be included in the time sheet:

(1) the support worker's full name and individual provider number;

(2) the agency-provider's name and telephone numbers, when responsible for the CFSS
service delivery plan;

(3) the participant's full name;

(4) the dates within the pay period established by the agency-provider or FMS provider,
including month, day, and year, and arrival and departure times with a.m. or p.m. notations
for days worked within the established pay period;

(5) the covered services provided to the participant on each date of service;

(6) deleted text beginadeleted text endnew text begin thenew text end signature deleted text beginline fordeleted text endnew text begin ofnew text end the participant or the participant's representative and a
statement that the participant's or participant's representative's signature is verification of
the time sheet's accuracy;

(7) the deleted text beginpersonaldeleted text end signature of the support worker;

(8) any shared care provided, if applicable;

(9) a statement that it is a federal crime to provide false information on CFSS billings
for medical assistance payments; and

(10) dates and location of participant stays in a hospital, care facility, or incarceration
occurring within the established pay period.

Sec. 77.

Minnesota Statutes 2020, section 256B.85, subdivision 17a, is amended to read:


Subd. 17a.

Consultation services provider qualifications and
requirements.

Consultation services providers must meet the following qualifications and
requirements:

(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4)
and (5);

(2) are under contract with the department;

(3) are not the FMS provider, the lead agency, or the CFSS or home and community-based
services waiver vendor or agency-provider to the participant;

(4) meet the service standards as established by the commissioner;

new text begin (5) have proof of surety bond coverage. Upon new enrollment, or if the consultation
service provider's Medicaid revenue in the previous calendar year is less than or equal to
$300,000, the consultation service provider must purchase a surety bond of $50,000. If the
agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000,
the consultation service provider must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
new text end

deleted text begin (5)deleted text endnew text begin (6)new text end employ lead professional staff with a minimum of deleted text beginthreedeleted text end new text begintwonew text end years of experience
in providing services such as support planning, support broker, case management or care
coordination, or consultation services and consumer education to participants using a
self-directed program using FMS under medical assistance;

new text begin (7) report maltreatment as required under chapter 260E and section 626.557;
new text end

deleted text begin (6)deleted text endnew text begin (8)new text end comply with medical assistance provider requirements;

deleted text begin (7)deleted text endnew text begin (9)new text end understand the CFSS program and its policies;

deleted text begin (8)deleted text endnew text begin (10)new text end are knowledgeable about self-directed principles and the application of the
person-centered planning process;

deleted text begin (9)deleted text endnew text begin (11)new text end have general knowledge of the FMS provider duties and the vendor
fiscal/employer agent model, including all applicable federal, state, and local laws and
regulations regarding tax, labor, employment, and liability and workers' compensation
coverage for household workers; and

deleted text begin (10)deleted text endnew text begin (12)new text end have all employees, including lead professional staff, staff in management and
supervisory positions, and owners of the agency who are active in the day-to-day management
and operations of the agency, complete training as specified in the contract with the
department.

Sec. 78.

Minnesota Statutes 2020, section 256B.85, subdivision 18a, is amended to read:


Subd. 18a.

Worker training and development services.

(a) The commissioner shall
develop the scope of tasks and functions, service standards, and service limits for worker
training and development services.

(b) Worker training and development costs are in addition to the participant's assessed
service units or service budget. Services provided according to this subdivision must:

(1) help support workers obtain and expand the skills and knowledge necessary to ensure
competency in providing quality services as needed and defined in the participant's CFSS
service delivery plan and as required under subdivisions 11b and 14;

(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased
by the participant employer under the budget model as identified in subdivision 13; deleted text beginand
deleted text end

new text begin (3) be delivered by an individual competent to perform, teach, or assign the tasks,
including health-related tasks, identified in the plan through education, training, and work
experience relevant to the person's assessed needs; and
new text end

deleted text begin (3)deleted text endnew text begin (4)new text end be described in the participant's CFSS service delivery plan and documented in
the participant's file.

(c) Services covered under worker training and development shall include:

(1) support worker training on the participant's individual assessed needs and condition,
provided individually or in a group setting by a skilled and knowledgeable trainer beyond
any training the participant or participant's representative provides;

(2) tuition for professional classes and workshops for the participant's support workers
that relate to the participant's assessed needs and condition;

(3) direct observation, monitoring, coaching, and documentation of support worker job
skills and tasks, beyond any training the participant or participant's representative provides,
including supervision of health-related tasks or behavioral supports that is conducted by an
appropriate professional based on the participant's assessed needs. These services must be
provided at the start of services or the start of a new support worker except as provided in
paragraph (d) and must be specified in the participant's CFSS service delivery plan; and

(4) the activities to evaluate CFSS services and ensure support worker competency
described in subdivisions 11a and 11b.

(d) The services in paragraph (c), clause (3), are not required to be provided for a new
support worker providing services for a participant due to staffing failures, unless the support
worker is expected to provide ongoing backup staffing coverage.

(e) Worker training and development services shall not include:

(1) general agency training, worker orientation, or training on CFSS self-directed models;

(2) payment for preparation or development time for the trainer or presenter;

(3) payment of the support worker's salary or compensation during the training;

(4) training or supervision provided by the participant, the participant's support worker,
or the participant's informal supports, including the participant's representative; or

(5) services in excess of deleted text begin96 unitsdeleted text endnew text begin the limit set by the commissionernew text end per annual service
agreement, unless approved by the department.

Sec. 79.

Minnesota Statutes 2020, section 256B.85, subdivision 20b, is amended to read:


Subd. 20b.

Service-related rights under an agency-provider.

A participant receiving
CFSS from an agency-provider has service-related rights to:

(1) participate in and approve the initial development and ongoing modification and
evaluation of CFSS services provided to the participant;

(2) refuse or terminate services and be informed of the consequences of refusing or
terminating services;

(3) before services are initiated, be told the limits to the services available from the
agency-provider, including the agency-provider's knowledge, skill, and ability to meet the
participant's needs identified in the CFSS service delivery plan;

(4) a coordinated transfer of services when there will be a change in the agency-provider;

(5) before services are initiated, be told what the agency-provider charges for the services;

(6) before services are initiated, be told to what extent payment may be expected from
health insurance, public programs, or other sources, if known; and what charges the
participant may be responsible for paying;

(7) receive services from an individual who is competent and trained, who has
professional certification or licensure, as required, and who meets additional qualifications
identified in the participant's CFSS service delivery plan;

(8) have the participant's preferences for support workers identified and documented,
and have those preferences met when possible; and

(9) before services are initiated, be told the choices that are available from the
agency-provider for meeting the participant's assessed needs identified in the CFSS service
delivery plan, including but not limited to which support worker staff will be providing
services deleted text beginanddeleted text endnew text begin,new text end the proposed frequency and schedule of visitsnew text begin, and any agreements for shared
services
new text end.

Sec. 80.

Minnesota Statutes 2020, section 256B.85, subdivision 23, is amended to read:


Subd. 23.

Commissioner's access.

(a) When the commissioner is investigating a possible
overpayment of Medicaid funds, the commissioner must be given immediate access without
prior notice to the agency-provider, consultation services provider, or FMS provider's office
during regular business hours and to documentation and records related to services provided
and submission of claims for services provided. deleted text beginDenying the commissioner access to records
is cause for immediate suspension of payment and terminating
deleted text endnew text begin Ifnew text end the deleted text beginagency-provider's
enrollment or
deleted text endnew text begin agency-provider,new text end FMS deleted text beginprovider's enrollmentdeleted text endnew text begin provider, or consultation services
provider denies the commissioner access to records, the provider's payment may be
immediately suspended or the provider's enrollment may be terminated
new text end according to section
256B.064 deleted text beginor terminating the consultation services provider contractdeleted text end.

(b) The commissioner has the authority to request proof of compliance with laws, rules,
and policies from agency-providers, consultation services providers, FMS providers, and
participants.

(c) When relevant to an investigation conducted by the commissioner, the commissioner
must be given access to the business office, documents, and records of the agency-provider,
consultation services provider, or FMS provider, including records maintained in electronic
format; participants served by the program; and staff during regular business hours. The
commissioner must be given access without prior notice and as often as the commissioner
considers necessary if the commissioner is investigating an alleged violation of applicable
laws or rules. The commissioner may request and shall receive assistance from lead agencies
and other state, county, and municipal agencies and departments. The commissioner's access
includes being allowed to photocopy, photograph, and make audio and video recordings at
the commissioner's expense.

Sec. 81.

Minnesota Statutes 2020, section 256B.85, subdivision 23a, is amended to read:


Subd. 23a.

Sanctions; information for participants upon termination of services.

(a)
The commissioner may withhold payment from the provider or suspend or terminate the
provider enrollment number if the provider fails to comply fully with applicable laws or
rules. The provider has the right to appeal the decision of the commissioner under section
256B.064.

(b) Notwithstanding subdivision 13, paragraph (c), if a participant employer fails to
comply fully with applicable laws or rules, the commissioner may disenroll the participant
from the budget model. A participant may appeal in writing to the department under section
256.045, subdivision 3, to contest the department's decision to disenroll the participant from
the budget model.

(c) Agency-providers of CFSS services or FMS providers must provide each participant
with a copy of participant protections in subdivision 20c at least 30 days prior to terminating
services to a participant, if the termination results from sanctions under this subdivision or
section 256B.064, such as a payment withhold or a suspension or termination of the provider
enrollment number. If a CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services
provider
new text end determines it is unable to continue providing services to a participant because of
an action under this subdivision or section 256B.064, the agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin,
or consultation services provider
new text end must notify the participant, the participant's representative,
and the commissioner 30 days prior to terminating services to the participant, and must
assist the commissioner and lead agency in supporting the participant in transitioning to
another CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services providernew text end of the
participant's choice.

(d) In the event the commissioner withholds payment from a CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end
FMS providernew text begin, or consultation services providernew text end, or suspends or terminates a provider
enrollment number of a CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services
provider
new text end under this subdivision or section 256B.064, the commissioner may inform the
Office of Ombudsman for Long-Term Care and the lead agencies for all participants with
active service agreements with the agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation
services provider
new text end. At the commissioner's request, the lead agencies must contact participants
to ensure that the participants are continuing to receive needed care, and that the participants
have been given free choice of agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation services
provider
new text end if they transfer to another CFSS agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or consultation
services provider
new text end. In addition, the commissioner or the commissioner's delegate may directly
notify participants who receive care from the agency-provider deleted text beginordeleted text endnew text begin,new text end FMS providernew text begin, or
consultation services provider
new text end that payments have been new text beginor will be new text endwithheld or that the
provider's participation in medical assistance has been new text beginor will be new text endsuspended or terminated,
if the commissioner determines that the notification is necessary to protect the welfare of
the participants.

Sec. 82.

Minnesota Statutes 2020, section 256L.03, subdivision 1, is amended to read:


Subdivision 1.

Covered health services.

(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation
services, personal care assistance and case management services, new text begincommunity first services
and supports under Minnesota Statutes, section 256B.85,
new text end behavioral health home services
under section 256B.0757, new text beginhousing stabilization services under section 256B.051, new text endand nursing
home or intermediate care facilities services.

(b) No public funds shall be used for coverage of abortion under MinnesotaCare except
where the life of the female would be endangered or substantial and irreversible impairment
of a major bodily function would result if the fetus were carried to term; or where the
pregnancy is the result of rape or incest.

(c) Covered health services shall be expanded as provided in this section.

(d) For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.

Sec. 83. new text beginREVISOR INSTRUCTION.
new text end

new text begin (a) In Minnesota Statutes, sections 245A.191, paragraph (a); 245G.02, subdivision 3;
246.18, subdivision 2; 246.23, subdivision 2; 246.64, subdivision 3; 254A.03, subdivision
3; 254A.19, subdivision 4; 254B.03, subdivision 2; 254B.04, subdivision 1; 254B.05,
subdivisions 1a and 4; 254B.051; 254B.06, subdivision 1; 254B.12, subdivisions 1 and 2;
254B.13, subdivisions 2a and 5; 254B.14, subdivision 5; 256L.03, subdivision 2; and 295.53,
subdivision 1, the revisor of statutes must change the term "consolidated chemical
dependency treatment fund" or similar terms to "behavioral health fund." The revisor may
make grammatical changes related to the term change.
new text end

new text begin (b) In Minnesota Statutes, sections 245C.03, subdivision 13, and 256B.051, the revisor
of statutes must change the term "housing support services" or similar terms to "housing
stabilization services." The revisor may make grammatical changes related to the term
change.
new text end

new text begin (c) In Minnesota Statutes, section 245C.03, subdivision 10, the revisor of statutes must
change the term "group residential housing" to "housing support." The revisor may make
grammatical changes related to the term change.
new text end

Sec. 84. new text beginREPEALER.
new text end

new text begin (a)new text endnew text begin Minnesota Statutes 2020, section 252.28, subdivisions 1 and 5,new text endnew text begin are repealed.
new text end

new text begin (b)new text endnew text begin Minnesota Statutes 2020, sections 252A.02, subdivisions 8 and 10; and 252A.21,
subdivision 3,
new text endnew text begin are repealed.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginParagraph (a) is effective the day following final enactment.
Paragraph (b) is effective August 1, 2021.
new text end

ARTICLE 14

MISCELLANEOUS

Section 1.

new text begin[62A.082] NONDISCRIMINATION IN ACCESS TO TRANSPLANTS.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) For the purposes of this section, the following terms have
the meanings given unless the context clearly requires otherwise.
new text end

new text begin (b) "Disability" has the meaning given in section 363A.03, subdivision 12.
new text end

new text begin (c) "Enrollee" means a natural person covered by a health plan or group health plan and
includes an insured, policy holder, subscriber, covered person, member, contract holder, or
certificate holder.
new text end

new text begin (d) "Organ transplant" means the transplantation or transfusion of a part of a human
body into the body of another for the purpose of treating or curing a medical condition.
new text end

new text begin Subd. 2.new text end

new text beginTransplant discrimination prohibited.new text end

new text beginA health plan or group health plan
that provides coverage for anatomical gifts, organ transplants, or related treatment and
services shall not:
new text end

new text begin (1) deny coverage to an enrollee based on the enrollee's disability;
new text end

new text begin (2) deny eligibility, or continued eligibility, to enroll or to renew coverage under the
terms of the health plan or group health plan solely for the purpose of avoiding the
requirements of this section;
new text end

new text begin (3) penalize or otherwise reduce or limit the reimbursement of a health care provider,
or provide monetary or nonmonetary incentives to a health care provider, to induce the
provider to provide care to a patient in a manner inconsistent with this section; or
new text end

new text begin (4) reduce or limit an enrollee's coverage benefits because of the enrollee's disability for
medical services and other services related to organ transplantation performed pursuant to
this section as determined in consultation with the enrollee's treating health care provider
and the enrollee.
new text end

new text begin Subd. 3.new text end

new text beginCollective bargaining.new text end

new text beginIn the case of a group health plan maintained pursuant
to one or more collective bargaining agreements between employee representatives and one
or more employers, any plan amendment made pursuant to a collective bargaining agreement
relating to the plan which amends the plan solely to conform to any requirement imposed
pursuant to this section shall not be treated as a termination of the collective bargaining
agreement.
new text end

new text begin Subd. 4.new text end

new text beginCoverage limitation. new text end

new text beginNothing in this section shall be deemed to require a health
plan or group health plan to provide coverage for a medically inappropriate organ transplant.
new text end

Sec. 2.

new text begin[363A.50] NONDISCRIMINATION IN ACCESS TO TRANSPLANTS.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) For purposes of this section, the following terms have
the meanings given unless the context clearly requires otherwise.
new text end

new text begin (b) "Anatomical gift" has the meaning given in section 525A.02, subdivision 4.
new text end

new text begin (c) "Auxiliary aids and services" include, but are not limited to:
new text end

new text begin (1) qualified interpreters or other effective methods of making aurally delivered materials
available to individuals with hearing impairments;
new text end

new text begin (2) qualified readers, taped texts, texts in accessible electronic format, or other effective
methods of making visually delivered materials available to individuals with visual
impairments;
new text end

new text begin (3) the provision of information in a format that is accessible for individuals with
cognitive, neurological, developmental, intellectual, or physical disabilities;
new text end

new text begin (4) the provision of supported decision-making services; and
new text end

new text begin (5) the acquisition or modification of equipment or devices.
new text end

new text begin (d) "Covered entity" means:
new text end

new text begin (1) any licensed provider of health care services, including licensed health care
practitioners, hospitals, nursing facilities, laboratories, intermediate care facilities, psychiatric
residential treatment facilities, institutions for individuals with intellectual or developmental
disabilities, and prison health centers; or
new text end

new text begin (2) any entity responsible for matching anatomical gift donors to potential recipients.
new text end

new text begin (e) "Disability" has the meaning given in section 363A.03, subdivision 12.
new text end

new text begin (f) "Organ transplant" means the transplantation or infusion of a part of a human body
into the body of another for the purpose of treating or curing a medical condition.
new text end

new text begin (g) "Qualified individual" means an individual who, with or without available support
networks, the provision of auxiliary aids and services, or reasonable modifications to policies
or practices, meets the essential eligibility requirements for the receipt of an anatomical
gift.
new text end

new text begin (h) "Reasonable modifications" include, but are not limited to:
new text end

new text begin (1) communication with individuals responsible for supporting an individual with
postsurgical and post-transplantation care, including medication; and
new text end

new text begin (2) consideration of support networks available to the individual, including family,
friends, and home and community-based services, including home and community-based
services funded through Medicaid, Medicare, another health plan in which the individual
is enrolled, or any program or source of funding available to the individual, in determining
whether the individual is able to comply with post-transplant medical requirements.
new text end

new text begin (i) "Supported decision making" has the meaning given in section 524.5-102, subdivision
16a.
new text end

new text begin Subd. 2.new text end

new text beginProhibition of discrimination.new text end

new text begin(a) A covered entity may not, on the basis of
a qualified individual's mental or physical disability:
new text end

new text begin (1) deem an individual ineligible to receive an anatomical gift or organ transplant;
new text end

new text begin (2) deny medical or related organ transplantation services, including evaluation, surgery,
counseling, and postoperative treatment and care;
new text end

new text begin (3) refuse to refer the individual to a transplant center or other related specialist for the
purpose of evaluation or receipt of an anatomical gift or organ transplant;
new text end

new text begin (4) refuse to place an individual on an organ transplant waiting list or place the individual
at a lower-priority position on the list than the position at which the individual would have
been placed if not for the individual's disability; or
new text end

new text begin (5) decline insurance coverage for any procedure associated with the receipt of the
anatomical gift or organ transplant, including post-transplantation and postinfusion care.
new text end

new text begin (b) Notwithstanding paragraph (a), a covered entity may take an individual's disability
into account when making treatment or coverage recommendations or decisions, solely to
the extent that the physical or mental disability has been found by a physician, following
an individualized evaluation of the potential recipient to be medically significant to the
provision of the anatomical gift or organ transplant. The provisions of this section may not
be deemed to require referrals or recommendations for, or the performance of, organ
transplants that are not medically appropriate given the individual's overall health condition.
new text end

new text begin (c) If an individual has the necessary support system to assist the individual in complying
with post-transplant medical requirements, an individual's inability to independently comply
with those requirements may not be deemed to be medically significant for the purposes of
paragraph (b).
new text end

new text begin (d) A covered entity must make reasonable modifications to policies, practices, or
procedures, when such modifications are necessary to make services such as
transplantation-related counseling, information, coverage, or treatment available to qualified
individuals with disabilities, unless the entity can demonstrate that making such modifications
would fundamentally alter the nature of such services.
new text end

new text begin (e) A covered entity must take such steps as may be necessary to ensure that no qualified
individual with a disability is denied services such as transplantation-related counseling,
information, coverage, or treatment because of the absence of auxiliary aids and services,
unless the entity can demonstrate that taking such steps would fundamentally alter the nature
of the services being offered or result in an undue burden. A covered entity is not required
to provide supported decision-making services.
new text end

new text begin (f) A covered entity must otherwise comply with the requirements of Titles II and III of
the Americans with Disabilities Act of 1990, the Americans with Disabilities Act
Amendments Act of 2008, and the Minnesota Human Rights Act.
new text end

new text begin (g) The provisions of this section apply to each part of the organ transplant process.
new text end

new text begin Subd. 3.new text end

new text beginRemedies.new text end

new text beginIn addition to all other remedies available under this chapter, any
individual who has been subjected to discrimination in violation of this section may initiate
a civil action in a court of competent jurisdiction to enjoin violations of this section.
new text end

ARTICLE 15

MENTAL HEALTH UNIFORM SERVICE STANDARDS

Section 1.

new text begin[245I.01] PURPOSE AND CITATION.
new text end

new text begin Subdivision 1.new text end

new text beginCitation.new text end

new text beginThis chapter may be cited as the "Mental Health Uniform
Service Standards Act."
new text end

new text begin Subd. 2.new text end

new text beginPurpose.new text end

new text beginIn accordance with sections 245.461 and 245.487, the purpose of this
chapter is to create a system of mental health care that is unified, accountable, and
comprehensive, and to promote the recovery and resiliency of Minnesotans who have mental
illnesses. The state's public policy is to support Minnesotans' access to quality outpatient
and residential mental health services. Further, the state's public policy is to protect the
health and safety, rights, and well-being of Minnesotans receiving mental health services.
new text end

Sec. 2.

new text begin[245I.011] APPLICABILITY.
new text end

new text begin Subdivision 1.new text end

new text beginLicense requirements.new text end

new text beginA license holder under this chapter must comply
with the requirements in chapters 245A, 245C, and 260E; section 626.557; and Minnesota
Rules, chapter 9544.
new text end

new text begin Subd. 2.new text end

new text beginVariances.new text end

new text begin(a) The commissioner may grant a variance to an applicant, license
holder, or certification holder as long as the variance does not affect the staff qualifications
or the health or safety of any person in a licensed or certified program and the applicant,
license holder, or certification holder meets the following conditions:
new text end

new text begin (1) an applicant, license holder, or certification holder must request the variance on a
form approved by the commissioner and in a manner prescribed by the commissioner;
new text end

new text begin (2) the request for a variance must include the:
new text end

new text begin (i) reasons that the applicant, license holder, or certification holder cannot comply with
a requirement as stated in the law; and
new text end

new text begin (ii) alternative equivalent measures that the applicant, license holder, or certification
holder will follow to comply with the intent of the law; and
new text end

new text begin (3) the request for a variance must state the period of time when the variance is requested.
new text end

new text begin (b) The commissioner may grant a permanent variance when the conditions under which
the applicant, license holder, or certification holder requested the variance do not affect the
health or safety of any person whom the licensed or certified program serves, and when the
conditions of the variance do not compromise the qualifications of staff who provide services
to clients. A permanent variance expires when the conditions that warranted the variance
change in any way. Any applicant, license holder, or certification holder must inform the
commissioner of any changes to the conditions that warranted the permanent variance. If
an applicant, license holder, or certification holder fails to advise the commissioner of
changes to the conditions that warranted the variance, the commissioner must revoke the
permanent variance and may impose other sanctions under sections 245A.06 and 245A.07.
new text end

new text begin (c) The commissioner's decision to grant or deny a variance request is final and not
subject to appeal under the provisions of chapter 14.
new text end

new text begin Subd. 3.new text end

new text beginCertification required.new text end

new text begin(a) An individual, organization, or government entity
that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause
(19), and chooses to be identified as a certified mental health clinic must:
new text end

new text begin (1) be a mental health clinic that is certified under section 245I.20;
new text end

new text begin (2) comply with all of the responsibilities assigned to a license holder by this chapter
except subdivision 1; and
new text end

new text begin (3) comply with all of the responsibilities assigned to a certification holder by chapter
245A.
new text end

new text begin (b) An individual, organization, or government entity described by this subdivision must
obtain a criminal background study for each staff person or volunteer who provides direct
contact services to clients.
new text end

new text begin Subd. 4.new text end

new text beginLicense required.new text end

new text beginAn individual, organization, or government entity providing
intensive residential treatment services or residential crisis stabilization to adults must be
licensed under section 245I.23. An entity with an adult foster care license providing
residential crisis stabilization is exempt from licensure under section 245I.23.
new text end

new text begin Subd. 5.new text end

new text beginPrograms certified under chapter 256B.new text end

new text begin(a) An individual, organization, or
government entity certified under the following sections must comply with all of the
responsibilities assigned to a license holder under this chapter except subdivision 1:
new text end

new text begin (1) an assertive community treatment provider under section 256B.0622, subdivision
3a;
new text end

new text begin (2) an adult rehabilitative mental health services provider under section 256B.0623;
new text end

new text begin (3) a mobile crisis team under section 256B.0624;
new text end

new text begin (4) a children's therapeutic services and supports provider under section 256B.0943;
new text end

new text begin (5) an intensive treatment in foster care provider under section 256B.0946; and
new text end

new text begin (6) an intensive nonresidential rehabilitative mental health services provider under section
256B.0947.
new text end

new text begin (b) An individual, organization, or government entity certified under the sections listed
in paragraph (a), clauses (1) to (6), must obtain a criminal background study for each staff
person and volunteer providing direct contact services to a client.
new text end

Sec. 3.

new text begin[245I.02] DEFINITIONS.
new text end

new text begin Subdivision 1.new text end

new text beginScope.new text end

new text beginFor 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 beginApproval.new text end

new text begin"Approval" means the documented review of, opportunity to request
changes to, and agreement with a treatment document. An individual may demonstrate
approval with a written signature, secure electronic signature, or documented oral approval.
new text end

new text begin Subd. 3.new text end

new text beginBehavioral sciences or related fields.new text end

new text begin"Behavioral sciences or related fields"
means an education from an accredited college or university in social work, psychology,
sociology, community counseling, family social science, child development, child
psychology, community mental health, addiction counseling, counseling and guidance,
special education, nursing, and other similar fields approved by the commissioner.
new text end

new text begin Subd. 4.new text end

new text beginBusiness day.new text end

new text begin"Business day" means a weekday on which government offices
are open for business. Business day does not include state or federal holidays, Saturdays,
or Sundays.
new text end

new text begin Subd. 5.new text end

new text beginCase manager.new text end

new text begin"Case manager" means a client's case manager according to
section 256B.0596; 256B.0621; 256B.0625, subdivision 20; 256B.092, subdivision 1a;
256B.0924; 256B.093, subdivision 3a; 256B.094; or 256B.49.
new text end

new text begin Subd. 6.new text end

new text beginCertified rehabilitation specialist.new text end

new text begin"Certified rehabilitation specialist" means
a staff person who meets the qualifications of section 245I.04, subdivision 8.
new text end

new text begin Subd. 7.new text end

new text beginChild.new text end

new text begin"Child" means a client under the age of 18.
new text end

new text begin Subd. 8.new text end

new text beginClient.new text end

new text begin"Client" means a person who is seeking or receiving services regulated
by this chapter. For the purpose of a client's consent to services, client includes a parent,
guardian, or other individual legally authorized to consent on behalf of a client to services.
new text end

new text begin Subd. 9.new text end

new text beginClinical trainee.new text end

new text begin"Clinical trainee" means a staff person who is qualified
according to section 245I.04, subdivision 6.
new text end

new text begin Subd. 10.new text end

new text beginCommissioner.new text end

new text begin"Commissioner" means the commissioner of human services
or the commissioner's designee.
new text end

new text begin Subd. 11.new text end

new text beginCo-occurring substance use disorder treatment.new text end

new text begin"Co-occurring substance
use disorder treatment" means the treatment of a person who has a co-occurring mental
illness and substance use disorder. Co-occurring substance use disorder treatment is
characterized by stage-wise comprehensive treatment, treatment goal setting, and flexibility
for clients at each stage of treatment. Co-occurring substance use disorder treatment includes
assessing and tracking each client's stage of change readiness and treatment using a treatment
approach based on a client's stage of change, such as motivational interviewing when working
with a client at an earlier stage of change readiness and a cognitive behavioral approach
and relapse prevention to work with a client at a later stage of change; and facilitating a
client's access to community supports.
new text end

new text begin Subd. 12.new text end

new text beginCrisis plan.new text end

new text begin"Crisis plan" means a plan to prevent and de-escalate a client's
future crisis situation, with the goal of preventing future crises for the client and the client's
family and other natural supports. Crisis plan includes a crisis plan developed according to
section 245.4871, subdivision 9a.
new text end

new text begin Subd. 13.new text end

new text beginCritical incident.new text end

new text begin"Critical incident" means an occurrence involving a client
that requires a license holder to respond in a manner that is not part of the license holder's
ordinary daily routine. Critical incident includes a client's suicide, attempted suicide, or
homicide; a client's death; an injury to a client or other person that is life-threatening or
requires medical treatment; a fire that requires a fire department's response; alleged
maltreatment of a client; an assault of a client; an assault by a client; or other situation that
requires a response by law enforcement, the fire department, an ambulance, or another
emergency response provider.
new text end

new text begin Subd. 14.new text end

new text beginDiagnostic assessment.new text end

new text begin"Diagnostic assessment" means the evaluation and
report of a client's potential diagnoses that a mental health professional or clinical trainee
completes under section 245I.10, subdivisions 4 to 6.
new text end

new text begin Subd. 15.new text end

new text beginDirect 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. 16.new text end

new text beginFamily and other natural supports.new text end

new text begin"Family and other natural supports"
means the people whom a client identifies as having a high degree of importance to the
client. Family and other natural supports also means people that the client identifies as being
important to the client's mental health treatment, regardless of whether the person is related
to the client or lives in the same household as the client.
new text end

new text begin Subd. 17.new text end

new text beginFunctional assessment.new text end

new text begin"Functional assessment" means the assessment of a
client's current level of functioning relative to functioning that is appropriate for someone
the client's age. For a client five years of age or younger, a functional assessment is the
Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age,
a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII).
For a client 18 years of age or older, a functional assessment is the functional assessment
described in section 245I.10, subdivision 9.
new text end

new text begin Subd. 18.new text end

new text beginIndividual abuse prevention plan.new text end

new text begin"Individual abuse prevention plan" means
a plan according to section 245A.65, subdivision 2, paragraph (b), and section 626.557,
subdivision 14.
new text end

new text begin Subd. 19.new text end

new text beginLevel of care assessment.new text end

new text begin"Level of care assessment" means the level of care
decision support tool appropriate to the client's age. For a client five years of age or younger,
a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For
a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service
Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment
is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS).
new text end

new text begin Subd. 20.new text end

new text beginLicense.new text end

new text begin"License" has the meaning given in section 245A.02, subdivision 8.
new text end

new text begin Subd. 21.new text end

new text beginLicense holder.new text end

new text begin"License holder" has the meaning given in section 245A.02,
subdivision 9.
new text end

new text begin Subd. 22.new text end

new text beginLicensed prescriber.new text end

new text begin"Licensed prescriber" means an individual who is
authorized to prescribe legend drugs under section 151.37.
new text end

new text begin Subd. 23.new text end

new text beginMental health behavioral aide.new text end

new text begin"Mental health behavioral aide" means a
staff person who is qualified under section 245I.04, subdivision 16.
new text end

new text begin Subd. 24.new text end

new text beginMental health certified family peer specialist.new text end

new text begin"Mental health certified
family peer specialist" means a staff person who is qualified under section 245I.04,
subdivision 12.
new text end

new text begin Subd. 25.new text end

new text beginMental health certified peer specialist.new text end

new text begin"Mental health certified peer
specialist" means a staff person who is qualified under section 245I.04, subdivision 10.
new text end

new text begin Subd. 26.new text end

new text beginMental health practitioner.new text end

new text begin"Mental health practitioner" means a staff person
who is qualified under section 245I.04, subdivision 4.
new text end

new text begin Subd. 27.new text end

new text beginMental health professional.new text end

new text begin"Mental health professional" means a staff person
who is qualified under section 245I.04, subdivision 2.
new text end

new text begin Subd. 28.new text end

new text beginMental health rehabilitation worker.new text end

new text begin"Mental health rehabilitation worker"
means a staff person who is qualified under section 245I.04, subdivision 14.
new text end

new text begin Subd. 29.new text end

new text beginMental illness.new text end

new text begin"Mental illness" means any of the conditions included in the
most recent editions of the DC: 0-5 Diagnostic Classification of Mental Health and
Development Disorders of Infancy and Early Childhood published by Zero to Three or the
Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric
Association.
new text end

new text begin Subd. 30.new text end

new text beginOrganization.new text end

new text begin"Organization" has the meaning given in section 245A.02,
subdivision 10c.
new text end

new text begin Subd. 31.new text end

new text beginPersonnel file.new text end

new text begin"Personnel file" means a set of records under section 245I.07,
paragraph (a). Personnel files excludes information related to a person's employment that
is not included in section 245I.07.
new text end

new text begin Subd. 32.new text end

new text beginRegistered nurse.new text end

new text begin"Registered nurse" means a staff person who is qualified
under section 148.171, subdivision 20.
new text end

new text begin Subd. 33.new text end

new text beginRehabilitative mental health services.new text end

new text begin"Rehabilitative mental health services"
means mental health services provided to an adult client that enable the client to develop
and achieve psychiatric stability, social competencies, personal and emotional adjustment,
independent living skills, family roles, and community skills when symptoms of mental
illness has impaired any of the client's abilities in these areas.
new text end

new text begin Subd. 34.new text end

new text beginResidential program.new text end

new text begin"Residential program" has the meaning given in section
245A.02, subdivision 14.
new text end

new text begin Subd. 35.new text end

new text beginSignature.new text end

new text begin"Signature" means a written signature or an electronic signature
defined in section 325L.02, paragraph (h).
new text end

new text begin Subd. 36.new text end

new text beginStaff person.new text end

new text begin"Staff person" means an individual who works under a license
holder's direction or under a contract with a license holder. Staff person includes an intern,
consultant, contractor, individual who works part-time, and an individual who does not
provide direct contact services to clients. Staff person includes a volunteer who provides
treatment services to a client or a volunteer whom the license holder regards as a staff person
for the purpose of meeting staffing or service delivery requirements. A staff person must
be 18 years of age or older.
new text end

new text begin Subd. 37.new text end

new text beginStrengths.new text end

new text begin"Strengths" means a person's inner characteristics, virtues, external
relationships, activities, and connections to resources that contribute to a client's resilience
and core competencies. A person can build on strengths to support recovery.
new text end

new text begin Subd. 38.new text end

new text beginTrauma.new text end

new text begin"Trauma" means an event, series of events, or set of circumstances
that is experienced by an individual as physically or emotionally harmful or life-threatening
that has lasting adverse effects on the individual's functioning and mental, physical, social,
emotional, or spiritual well-being. Trauma includes group traumatic experiences. Group
traumatic experiences are emotional or psychological harm that a group experiences. Group
traumatic experiences can be transmitted across generations within a community and are
often associated with racial and ethnic population groups who suffer major intergenerational
losses.
new text end

new text begin Subd. 39.new text end

new text beginTreatment plan.new text end

new text begin"Treatment plan" means services that a license holder
formulates to respond to a client's needs and goals. A treatment plan includes individual
treatment plans under section 245I.10, subdivisions 7 and 8; initial treatment plans under
section 245I.23, subdivision 7; and crisis treatment plans under sections 245I.23, subdivision
8, and 256B.0624, subdivision 11.
new text end

new text begin Subd. 40.new text end

new text beginTreatment supervision.new text end

new text begin"Treatment supervision" means a mental health
professional's or certified rehabilitation specialist's oversight, direction, and evaluation of
a staff person providing services to a client according to section 245I.06.
new text end

new text begin Subd. 41.new text end

new text beginVolunteer.new text end

new text begin"Volunteer" means an individual who, under the direction of the
license holder, provides services to or facilitates an activity for a client without compensation.
new text end

Sec. 4.

new text begin[245I.03] REQUIRED POLICIES AND PROCEDURES.
new text end

new text begin Subdivision 1.new text end

new text beginGenerally.new text end

new text beginA license holder must establish, enforce, and maintain policies
and procedures to comply with the requirements of this chapter and chapters 245A, 245C,
and 260E; sections 626.557 and 626.5572; and Minnesota Rules, chapter 9544. The license
holder must make all policies and procedures available in writing to each staff person. The
license holder must complete and document a review of policies and procedures every two
years and update policies and procedures as necessary. Each policy and procedure must
identify the date that it was initiated and the dates of all revisions. The license holder must
clearly communicate any policy and procedural change to each staff person and provide
necessary training to each staff person to implement any policy and procedural change.
new text end

new text begin Subd. 2.new text end

new text beginHealth and safety.new text end

new text beginA license holder must have policies and procedures to
ensure the health and safety of each staff person and client during the provision of services,
including policies and procedures for services based in community settings.
new text end

new text begin Subd. 3.new text end

new text beginClient rights.new text end

new text beginA license holder must have policies and procedures to ensure
that each staff person complies with the client rights and protections requirements in section
245I.12.
new text end

new text begin Subd. 4.new text end

new text beginBehavioral emergencies.new text end

new text begin(a) A license holder must have procedures that each
staff person follows when responding to a client who exhibits behavior that threatens the
immediate safety of the client or others. A license holder's behavioral emergency procedures
must incorporate person-centered planning and trauma-informed care.
new text end

new text begin (b) A license holder's behavioral emergency procedures must include:
new text end

new text begin (1) a plan designed to prevent the client from inflicting self-harm and harming others;
new text end

new text begin (2) contact information for emergency resources that a staff person must use when the
license holder's behavioral emergency procedures are unsuccessful in controlling a client's
behavior;
new text end

new text begin (3) the types of behavioral emergency procedures that a staff person may use;
new text end

new text begin (4) the specific circumstances under which the program may use behavioral emergency
procedures; and
new text end

new text begin (5) the staff persons whom the license holder authorizes to implement behavioral
emergency procedures.
new text end

new text begin (c) The license holder's behavioral emergency procedures must not include secluding
or restraining a client except as allowed under section 245.8261.
new text end

new text begin (d) Staff persons must not use behavioral emergency procedures to enforce program
rules or for the convenience of staff persons. Behavioral emergency procedures must not
be part of any client's treatment plan. A staff person may not use behavioral emergency
procedures except in response to a client's current behavior that threatens the immediate
safety of the client or others.
new text end

new text begin Subd. 5.new text end

new text beginHealth services and medications.new text end

new text beginIf a license holder is licensed as a residential
program, stores or administers client medications, or observes clients self-administer
medications, the license holder must ensure that a staff person who is a registered nurse or
licensed prescriber reviews and approves of the license holder's policies and procedures to
comply with the health services and medications requirements in section 245I.11, the training
requirements in section 245I.05, subdivision 6, and the documentation requirements in
section 245I.08, subdivision 5.
new text end

new text begin Subd. 6.new text end

new text beginReporting maltreatment.new text end

new text beginA license holder must have policies and procedures
for reporting a staff person's suspected maltreatment, abuse, or neglect of a client according
to chapter 260E and section 626.557.
new text end

new text begin Subd. 7.new text end

new text beginCritical incidents.new text end

new text beginIf a license holder is licensed as a residential program, the
license holder must have policies and procedures for reporting and maintaining records of
critical incidents according to section 245I.13.
new text end

new text begin Subd. 8.new text end

new text beginPersonnel.new text end

new text beginA license holder must have personnel policies and procedures that:
new text end

new text begin (1) include a chart or description of the organizational structure of the program that
indicates positions and lines of authority;
new text end

new text begin (2) ensure that it will not adversely affect a staff person's retention, promotion, job
assignment, or pay when a staff person communicates in good faith with the Department
of Human Services, the Office of Ombudsman for Mental Health and Developmental
Disabilities, the Department of Health, a health-related licensing board, a law enforcement
agency, or a local agency investigating a complaint regarding a client's rights, health, or
safety;
new text end

new text begin (3) prohibit a staff person from having sexual contact with a client in violation of chapter
604, sections 609.344 or 609.345;
new text end

new text begin (4) prohibit a staff person from neglecting, abusing, or maltreating a client as described
in chapter 260E and sections 626.557 and 626.5572;
new text end

new text begin (5) include the drug and alcohol policy described in section 245A.04, subdivision 1,
paragraph (c);
new text end

new text begin (6) describe the process for disciplinary action, suspension, or dismissal of a staff person
for violating a policy provision described in clauses (3) to (5);
new text end

new text begin (7) describe the license holder's response to a staff person who violates other program
policies or who has a behavioral problem that interferes with providing treatment services
to clients; and
new text end

new text begin (8) describe each staff person's position that includes the staff person's responsibilities,
authority to execute the responsibilities, and qualifications for the position.
new text end

new text begin Subd. 9.new text end

new text beginVolunteers.new text end

new text beginA license holder must have policies and procedures for using
volunteers, including when a license holder must submit a background study for a volunteer,
and the specific tasks that a volunteer may perform.
new text end

new text begin Subd. 10.new text end

new text beginData privacy.new text end

new text begin(a) A license holder must have policies and procedures that
comply with all applicable state and federal law. A license holder's use of electronic record
keeping or electronic signatures does not alter a license holder's obligations to comply with
applicable state and federal law.
new text end

new text begin (b) A license holder must have policies and procedures for a staff person to promptly
document a client's revocation of consent to disclose the client's health record. The license
holder must verify that the license holder has permission to disclose a client's health record
before releasing any client data.
new text end

Sec. 5.

new text begin[245I.04] PROVIDER QUALIFICATIONS AND SCOPE OF PRACTICE.
new text end

new text begin Subdivision 1.new text end

new text beginTribal providers.new text end

new text beginFor purposes of this section, a Tribal entity may
credential an individual according to section 256B.02, subdivision 7, paragraphs (b) and
(c).
new text end

new text begin Subd. 2.new text end

new text beginMental health professional qualifications.new text end

new text beginThe following individuals may
provide services to a client as a mental health professional:
new text end

new text begin (1) a registered nurse who is licensed under sections 148.171 to 148.285 and is certified
as a: (i) clinical nurse specialist in child or adolescent, family, or adult psychiatric and
mental health nursing by a national certification organization; or (ii) nurse practitioner in
adult or family psychiatric and mental health nursing by a national nurse certification
organization;
new text end

new text begin (2) a licensed independent clinical social worker as defined in section 148E.050,
subdivision 5;
new text end

new text begin (3) a psychologist licensed by the Board of Psychology under sections 148.88 to 148.98;
new text end

new text begin (4) a physician licensed under chapter 147 if the physician is: (i) certified by the American
Board of Psychiatry and Neurology; (ii) certified by the American Osteopathic Board of
Neurology and Psychiatry; or (iii) eligible for board certification in psychiatry;
new text end

new text begin (5) a marriage and family therapist licensed under sections 148B.29 to 148B.392; or
new text end

new text begin (6) a licensed professional clinical counselor licensed under section 148B.5301.
new text end

new text begin Subd. 3.new text end

new text beginMental health professional scope of practice.new text end

new text beginA mental health professional
must maintain a valid license with the mental health professional's governing health-related
licensing board and must only provide services to a client within the scope of practice
determined by the applicable health-related licensing board.
new text end

new text begin Subd. 4.new text end

new text beginMental health practitioner qualifications.new text end

new text begin(a) An individual who is qualified
in at least one of the ways described in paragraph (b) to (d) may serve as a mental health
practitioner.
new text end

new text begin (b) An individual is qualified as a mental health practitioner through relevant coursework
if the individual completes at least 30 semester hours or 45 quarter hours in behavioral
sciences or related fields and:
new text end

new text begin (1) has at least 2,000 hours of experience providing services to individuals with:
new text end

new text begin (i) a mental illness or a substance use disorder; or
new text end

new text begin (ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to a client;
new text end

new text begin (2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the individual's clients belong, and completes the additional training described in section
245I.05, subdivision 3, paragraph (c), before providing direct contact services to a client;
new text end

new text begin (3) is working in a day treatment program under section 256B.0671, subdivision 3, or
256B.0943; or
new text end

new text begin (4) has completed a practicum or internship that (i) required direct interaction with adult
clients or child clients, and (ii) was focused on behavioral sciences or related fields.
new text end

new text begin (c) An individual is qualified as a mental health practitioner through work experience
if the individual:
new text end

new text begin (1) has at least 4,000 hours of experience in the delivery of services to individuals with:
new text end

new text begin (i) a mental illness or a substance use disorder; or
new text end

new text begin (ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients; or
new text end

new text begin (2) receives treatment supervision at least once per week until meeting the requirement
in clause (1) of 4,000 hours of experience and has at least 2,000 hours of experience providing
services to individuals with:
new text end

new text begin (i) a mental illness or a substance use disorder; or
new text end

new text begin (ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients.
new text end

new text begin (d) An individual is qualified as a mental health practitioner if the individual has a
master's or other graduate degree in behavioral sciences or related fields.
new text end

new text begin Subd. 5.new text end

new text beginMental health practitioner scope of practice.new text end

new text begin(a) A mental health practitioner
under the treatment supervision of a mental health professional or certified rehabilitation
specialist may provide an adult client with client education, rehabilitative mental health
services, functional assessments, level of care assessments, and treatment plans. A mental
health practitioner under the treatment supervision of a mental health professional may
provide skill-building services to a child client and complete treatment plans for a child
client.
new text end

new text begin (b) A mental health practitioner must not provide treatment supervision to other staff
persons. A mental health practitioner may provide direction to mental health rehabilitation
workers and mental health behavioral aides.
new text end

new text begin (c) A mental health practitioner who provides services to clients according to section
256B.0624 or 256B.0944 may perform crisis assessments and interventions for a client.
new text end

new text begin Subd. 6.new text end

new text beginClinical trainee qualifications.new text end

new text begin(a) A clinical trainee is a staff person who: (1)
is enrolled in an accredited graduate program of study to prepare the staff person for
independent licensure as a mental health professional and who is participating in a practicum
or internship with the license holder through the individual's graduate program; or (2) has
completed an accredited graduate program of study to prepare the staff person for independent
licensure as a mental health professional and who is in compliance with the requirements
of the applicable health-related licensing board, including requirements for supervised
practice.
new text end

new text begin (b) A clinical trainee is responsible for notifying and applying to a health-related licensing
board to ensure that the trainee meets the requirements of the health-related licensing board.
As permitted by a health-related licensing board, treatment supervision under this chapter
may be integrated into a plan to meet the supervisory requirements of the health-related
licensing board but does not supersede those requirements.
new text end

new text begin Subd. 7.new text end

new text beginClinical trainee scope of practice.new text end

new text begin(a) A clinical trainee under the treatment
supervision of a mental health professional may provide a client with psychotherapy, client
education, rehabilitative mental health services, diagnostic assessments, functional
assessments, level of care assessments, and treatment plans.
new text end

new text begin (b) A clinical trainee must not provide treatment supervision to other staff persons. A
clinical trainee may provide direction to mental health behavioral aides and mental health
rehabilitation workers.
new text end

new text begin (c) A psychological clinical trainee under the treatment supervision of a psychologist
may perform psychological testing of clients.
new text end

new text begin (d) A clinical trainee must not provide services to clients that violate any practice act of
a health-related licensing board, including failure to obtain licensure if licensure is required.
new text end

new text begin Subd. 8.new text end

new text beginCertified rehabilitation specialist qualifications.new text end

new text beginA certified rehabilitation
specialist must have:
new text end

new text begin (1) a master's degree from an accredited college or university in behavioral sciences or
related fields;
new text end

new text begin (2) at least 4,000 hours of post-master's supervised experience providing mental health
services to clients; and
new text end

new text begin (3) a valid national certification as a certified rehabilitation counselor or certified
psychosocial rehabilitation practitioner.
new text end

new text begin Subd. 9.new text end

new text beginCertified rehabilitation specialist scope of practice.new text end

new text begin(a) A certified
rehabilitation specialist may provide an adult client with client education, rehabilitative
mental health services, functional assessments, level of care assessments, and treatment
plans.
new text end

new text begin (b) A certified rehabilitation specialist may provide treatment supervision to a mental
health certified peer specialist, mental health practitioner, and mental health rehabilitation
worker.
new text end

new text begin Subd. 10.new text end

new text beginMental health certified peer specialist qualifications.new text end

new text beginA mental health
certified peer specialist must:
new text end

new text begin (1) have been diagnosed with a mental illness;
new text end

new text begin (2) be a current or former mental health services client; and
new text end

new text begin (3) have a valid certification as a mental health certified peer specialist under section
256B.0615.
new text end

new text begin Subd. 11.new text end

new text beginMental health certified peer specialist scope of practice.new text end

new text beginA mental health
certified peer specialist under the treatment supervision of a mental health professional or
certified rehabilitation specialist must:
new text end

new text begin (1) provide individualized peer support to each client;
new text end

new text begin (2) promote a client's recovery goals, self-sufficiency, self-advocacy, and development
of natural supports; and
new text end

new text begin (3) support a client's maintenance of skills that the client has learned from other services.
new text end

new text begin Subd. 12.new text end

new text beginMental health certified family peer specialist qualifications.new text end

new text beginA mental
health certified family peer specialist must:
new text end

new text begin (1) have raised or be currently raising a child with a mental illness;
new text end

new text begin (2) have experience navigating the children's mental health system; and
new text end

new text begin (3) have a valid certification as a mental health certified family peer specialist under
section 256B.0616.
new text end

new text begin Subd. 13.new text end

new text beginMental health certified family peer specialist scope of practice.new text end

new text beginA mental
health certified family peer specialist under the treatment supervision of a mental health
professional must provide services to increase the child's ability to function in the child's
home, school, and community. The mental health certified family peer specialist must:
new text end

new text begin (1) provide family peer support to build on a client's family's strengths and help the
family achieve desired outcomes;
new text end

new text begin (2) provide nonadversarial advocacy to a child client and the child's family that
encourages partnership and promotes the child's positive change and growth;
new text end

new text begin (3) support families in advocating for culturally appropriate services for a child in each
treatment setting;
new text end

new text begin (4) promote resiliency, self-advocacy, and development of natural supports;
new text end

new text begin (5) support maintenance of skills learned from other services;
new text end

new text begin (6) establish and lead parent support groups;
new text end

new text begin (7) assist parents in developing coping and problem-solving skills; and
new text end

new text begin (8) educate parents about mental illnesses and community resources, including resources
that connect parents with similar experiences to one another.
new text end

new text begin Subd. 14.new text end

new text beginMental health rehabilitation worker qualifications.new text end

new text begin(a) A mental health
rehabilitation worker must:
new text end

new text begin (1) have a high school diploma or equivalent; and
new text end

new text begin (2) meet one of the following qualification requirements:
new text end

new text begin (i) be fluent in the non-English language or competent in the culture of the ethnic group
to which at least 20 percent of the mental health rehabilitation worker's clients belong;
new text end

new text begin (ii) have an associate of arts degree;
new text end

new text begin (iii) have two years of full-time postsecondary education or a total of 15 semester hours
or 23 quarter hours in behavioral sciences or related fields;
new text end

new text begin (iv) be a registered nurse;
new text end

new text begin (v) have, within the previous ten years, three years of personal life experience with
mental illness;
new text end

new text begin (vi) have, within the previous ten years, three years of life experience as a primary
caregiver to an adult with a mental illness, traumatic brain injury, substance use disorder,
or developmental disability; or
new text end

new text begin (vii) have, within the previous ten years, 2,000 hours of work experience providing
health and human services to individuals.
new text end

new text begin (b) A mental health rehabilitation worker who is scheduled as an overnight staff person
and works alone is exempt from the additional qualification requirements in paragraph (a),
clause (2).
new text end

new text begin Subd. 15.new text end

new text beginMental health rehabilitation worker scope of practice.new text end

new text beginA mental health
rehabilitation worker under the treatment supervision of a mental health professional or
certified rehabilitation specialist may provide rehabilitative mental health services to an
adult client according to the client's treatment plan.
new text end

new text begin Subd. 16.new text end

new text beginMental health behavioral aide qualifications.new text end

new text begin(a) A level 1 mental health
behavioral aide must have: (1) a high school diploma or equivalent; or (2) two years of
experience as a primary caregiver to a child with mental illness within the previous ten
years.
new text end

new text begin (b) A level 2 mental health behavioral aide must: (1) have an associate or bachelor's
degree; or (2) be certified by a program under section 256B.0943, subdivision 8a.
new text end

new text begin Subd. 17.new text end

new text beginMental health behavioral aide scope of practice.new text end

new text beginWhile under the treatment
supervision of a mental health professional, a mental health behavioral aide may practice
psychosocial skills with a child client according to the child's treatment plan and individual
behavior plan that a mental health professional, clinical trainee, or mental health practitioner
has previously taught to the child.
new text end

Sec. 6.

new text begin[245I.05] TRAINING REQUIRED.
new text end

new text begin Subdivision 1.new text end

new text beginTraining plan.new text end

new text beginA license holder must develop a training plan to ensure
that staff persons receive ongoing training according to this section. The training plan must
include:
new text end

new text begin (1) a formal process to evaluate the training needs of each staff person. An annual
performance evaluation of a staff person satisfies this requirement;
new text end

new text begin (2) a description of how the license holder conducts ongoing training of each staff person,
including whether ongoing training is based on a staff person's hire date or a specified annual
cycle determined by the program;
new text end

new text begin (3) a description of how the license holder verifies and documents each staff person's
previous training experience. A license holder may consider a staff person to have met a
training requirement in subdivision 3, paragraph (d) or (e), if the staff person has received
equivalent postsecondary education in the previous four years or training experience in the
previous two years; and
new text end

new text begin (4) a description of how the license holder determines when a staff person needs
additional training, including when the license holder will provide additional training.
new text end

new text begin Subd. 2.new text end

new text beginDocumentation of training.new text end

new text begin(a) The license holder must provide training to
each staff person according to the training plan and must document that the license holder
provided the training to each staff person. The license holder must document the following
information for each staff person's training:
new text end

new text begin (1) the topics of the training;
new text end

new text begin (2) the name of the trainee;
new text end

new text begin (3) the name and credentials of the trainer;
new text end

new text begin (4) the license holder's method of evaluating the trainee's competency upon completion
of training;
new text end

new text begin (5) the date of the training; and
new text end

new text begin (6) the length of training in hours and minutes.
new text end

new text begin (b) Documentation of a staff person's continuing education credit accepted by the
governing health-related licensing board is sufficient to document training for purposes of
this subdivision.
new text end

new text begin Subd. 3.new text end

new text beginInitial training.new text end

new text begin(a) A staff person must receive training about:
new text end

new text begin (1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and
new text end

new text begin (2) the maltreatment of minor reporting requirements and definitions in chapter 260E
within 72 hours of first providing direct contact services to a client.
new text end

new text begin (b) Before providing direct contact services to a client, a staff person must receive training
about:
new text end

new text begin (1) client rights and protections under section 245I.12;
new text end

new text begin (2) the Minnesota Health Records Act, including client confidentiality, family engagement
under section 144.294, and client privacy;
new text end

new text begin (3) emergency procedures that the staff person must follow when responding to a fire,
inclement weather, a report of a missing person, and a behavioral or medical emergency;
new text end

new text begin (4) specific activities and job functions for which the staff person is responsible, including
the license holder's program policies and procedures applicable to the staff person's position;
new text end

new text begin (5) professional boundaries that the staff person must maintain; and
new text end

new text begin (6) specific needs of each client to whom the staff person will be providing direct contact
services, including each client's developmental status, cognitive functioning, physical and
mental abilities.
new text end

new text begin (c) Before providing direct contact services to a client, a mental health rehabilitation
worker, mental health behavioral aide, or mental health practitioner qualified under section
245I.04, subdivision 4, must receive 30 hours of training about:
new text end

new text begin (1) mental illnesses;
new text end

new text begin (2) client recovery and resiliency;
new text end

new text begin (3) mental health de-escalation techniques;
new text end

new text begin (4) co-occurring mental illness and substance use disorders; and
new text end

new text begin (5) psychotropic medications and medication side effects.
new text end

new text begin (d) Within 90 days of first providing direct contact services to an adult client, a clinical
trainee, mental health practitioner, mental health certified peer specialist, or mental health
rehabilitation worker must receive training about:
new text end

new text begin (1) trauma-informed care and secondary trauma;
new text end

new text begin (2) person-centered individual treatment plans, including seeking partnerships with
family and other natural supports;
new text end

new text begin (3) co-occurring substance use disorders; and
new text end

new text begin (4) culturally responsive treatment practices.
new text end

new text begin (e) Within 90 days of first providing direct contact services to a child client, a clinical
trainee, mental health practitioner, mental health certified family peer specialist, mental
health certified peer specialist, or mental health behavioral aide must receive training about
the topics in clauses (1) to (5). This training must address the developmental characteristics
of each child served by the license holder and address the needs of each child in the context
of the child's family, support system, and culture. Training topics must include:
new text end

new text begin (1) trauma-informed care and secondary trauma, including adverse childhood experiences
(ACEs);
new text end

new text begin (2) family-centered treatment plan development, including seeking partnership with a
child client's family and other natural supports;
new text end

new text begin (3) mental illness and co-occurring substance use disorders in family systems;
new text end

new text begin (4) culturally responsive treatment practices; and
new text end

new text begin (5) child development, including cognitive functioning, and physical and mental abilities.
new text end

new text begin (f) For a mental health behavioral aide, the training under paragraph (e) must include
parent team training using a curriculum approved by the commissioner.
new text end

new text begin Subd. 4.new text end

new text beginOngoing training.new text end

new text begin(a) A license holder must ensure that staff persons who
provide direct contact services to clients receive annual training about the topics in
subdivision 3, paragraphs (a) and (b), clauses (1) to (3).
new text end

new text begin (b) A license holder must ensure that each staff person who is qualified under section
245I.04 who is not a mental health professional receives 30 hours of training every two
years. The training topics must be based on the program's needs and the staff person's areas
of competency.
new text end

new text begin Subd. 5.new text end

new text beginAdditional training for medication administration.new text end

new text begin(a) Prior to administering
medications to a client under delegated authority or observing a client self-administer
medications, a staff person who is not a licensed prescriber, registered nurse, or licensed
practical nurse qualified under section 148.171, subdivision 8, must receive training about
psychotropic medications, side effects, and medication management.
new text end

new text begin (b) Prior to administering medications to a client under delegated authority, a staff person
must successfully complete a:
new text end

new text begin (1) medication administration training program for unlicensed personnel through an
accredited Minnesota postsecondary educational institution with completion of the course
documented in writing and placed in the staff person's personnel file; or
new text end

new text begin (2) formalized training program taught by a registered nurse or licensed prescriber that
is offered by the license holder. A staff person's successful completion of the formalized
training program must include direct observation of the staff person to determine the staff
person's areas of competency.
new text end

Sec. 7.

new text begin[245I.06] TREATMENT SUPERVISION.
new text end

new text begin Subdivision 1.new text end

new text beginGenerally.new text end

new text begin(a) A license holder must ensure that a mental health
professional or certified rehabilitation specialist provides treatment supervision to each staff
person who provides services to a client and who is not a mental health professional or
certified rehabilitation specialist. When providing treatment supervision, a treatment
supervisor must follow a staff person's written treatment supervision plan.
new text end

new text begin (b) Treatment supervision must focus on each client's treatment needs and the ability of
the staff person under treatment supervision to provide services to each client, including
the following topics related to the staff person's current caseload:
new text end

new text begin (1) a review and evaluation of the interventions that the staff person delivers to each
client;
new text end

new text begin (2) instruction on alternative strategies if a client is not achieving treatment goals;
new text end

new text begin (3) a review and evaluation of each client's assessments, treatment plans, and progress
notes for accuracy and appropriateness;
new text end

new text begin (4) instruction on the cultural norms or values of the clients and communities that the
license holder serves and the impact that a client's culture has on providing treatment;
new text end

new text begin (5) evaluation of and feedback regarding a direct service staff person's areas of
competency; and
new text end

new text begin (6) coaching, teaching, and practicing skills with a staff person.
new text end

new text begin (c) A treatment supervisor must provide treatment supervision to a staff person using
methods that allow for immediate feedback, including in-person, telephone, and interactive
video supervision.
new text end

new text begin (d) A treatment supervisor's responsibility for a staff person receiving treatment
supervision is limited to the services provided by the associated license holder. If a staff
person receiving treatment supervision is employed by multiple license holders, each license
holder is responsible for providing treatment supervision related to the treatment of the
license holder's clients.
new text end

new text begin Subd. 2.new text end

new text beginTreatment supervision planning.new text end

new text begin(a) A treatment supervisor and the staff
person supervised by the treatment supervisor must develop a written treatment supervision
plan. The license holder must ensure that a new staff person's treatment supervision plan is
completed and implemented by a treatment supervisor and the new staff person within 30
days of the new staff person's first day of employment. The license holder must review and
update each staff person's treatment supervision plan annually.
new text end

new text begin (b) Each staff person's treatment supervision plan must include:
new text end

new text begin (1) the name and qualifications of the staff person receiving treatment supervision;
new text end

new text begin (2) the names and licensures of the treatment supervisors who are supervising the staff
person;
new text end

new text begin (3) how frequently the treatment supervisors must provide treatment supervision to the
staff person; and
new text end

new text begin (4) the staff person's authorized scope of practice, including a description of the client
population that the staff person serves, and a description of the treatment methods and
modalities that the staff person may use to provide services to clients.
new text end

new text begin Subd. 3.new text end

new text beginTreatment supervision and direct observation of mental health
rehabilitation workers and mental health behavioral aides.
new text end

new text begin(a) A mental health behavioral
aide or a mental health rehabilitation worker must receive direct observation from a mental
health professional, clinical trainee, certified rehabilitation specialist, or mental health
practitioner while the mental health behavioral aide or mental health rehabilitation worker
provides treatment services to clients, no less than twice per month for the first six months
of employment and once per month thereafter. The staff person performing the direct
observation must approve of the progress note for the observed treatment service.
new text end

new text begin (b) For a mental health rehabilitation worker qualified under section 245I.04, subdivision
14, paragraph (a), clause (2), item (i), treatment supervision in the first 2,000 hours of work
must at a minimum consist of:
new text end

new text begin (1) monthly individual supervision; and
new text end

new text begin (2) direct observation twice per month.
new text end

Sec. 8.

new text begin[245I.07] PERSONNEL FILES.
new text end

new text begin (a) For each staff person, a license holder must maintain a personnel file that includes:
new text end

new text begin (1) verification of the staff person's qualifications required for the position including
training, education, practicum or internship agreement, licensure, and any other required
qualifications;
new text end

new text begin (2) documentation related to the staff person's background study;
new text end

new text begin (3) the hiring date of the staff person;
new text end

new text begin (4) a description of the staff person's job responsibilities with the license holder;
new text end

new text begin (5) the date that the staff person's specific duties and responsibilities became effective,
including the date that the staff person began having direct contact with clients;
new text end

new text begin (6) documentation of the staff person's training as required by section 245I.05, subdivision
2;
new text end

new text begin (7) a verification copy of license renewals that the staff person completed during the
staff person's employment;
new text end

new text begin (8) annual job performance evaluations; and
new text end

new text begin (9) if applicable, the staff person's alleged and substantiated violations of the license
holder's policies under section 245I.03, subdivision 8, clauses (3) to (7), and the license
holder's response.
new text end

new text begin (b) The license holder must ensure that all personnel files are readily accessible for the
commissioner's review. The license holder is not required to keep personnel files in a single
location.
new text end

Sec. 9.

new text begin[245I.08] DOCUMENTATION STANDARDS.
new text end

new text begin Subdivision 1.new text end

new text beginGenerally.new text end

new text beginA license holder must ensure that all documentation required
by this chapter complies with this section.
new text end

new text begin Subd. 2.new text end

new text beginDocumentation standards.new text end

new text beginA license holder must ensure that all documentation
required by this chapter:
new text end

new text begin (1) is legible;
new text end

new text begin (2) identifies the applicable client and staff person on each page; and
new text end

new text begin (3) is signed and dated by the staff persons who provided services to the client or
completed the documentation, including the staff persons' credentials.
new text end

new text begin Subd. 3.new text end

new text beginDocumenting approval.new text end

new text beginA license holder must ensure that all diagnostic
assessments, functional assessments, level of care assessments, and treatment plans completed
by a clinical trainee or mental health practitioner contain documentation of approval by a
treatment supervisor within five business days of initial completion by the staff person under
treatment supervision.
new text end

new text begin Subd. 4.new text end

new text beginProgress notes.new text end

new text beginA license holder must use a progress note to document each
occurrence of a mental health service that a staff person provides to a client. A progress
note must include the following:
new text end

new text begin (1) the type of service;
new text end

new text begin (2) the date of service;
new text end

new text begin (3) the start and stop time of the service unless the license holder is licensed as a
residential program;
new text end

new text begin (4) the location of the service;
new text end

new text begin (5) the scope of the service, including: (i) the targeted goal and objective; (ii) the
intervention that the staff person provided to the client and the methods that the staff person
used; (iii) the client's response to the intervention; (iv) the staff person's plan to take future
actions, including changes in treatment that the staff person will implement if the intervention
was ineffective; and (v) the service modality;
new text end

new text begin (6) the signature, printed name, and credentials of the staff person who provided the
service to the client;
new text end

new text begin (7) the mental health provider travel documentation required by section 256B.0625, if
applicable; and
new text end

new text begin (8) significant observations by the staff person, if applicable, including: (i) the client's
current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with
or referrals to other professionals, family, or significant others; and (iv) changes in the
client's mental or physical symptoms.
new text end

new text begin Subd. 5.new text end

new text beginMedication administration record.new text end

new text beginIf a license holder administers or observes
a client self-administer medications, the license holder must maintain a medication
administration record for each client that contains the following, as applicable:
new text end

new text begin (1) the client's date of birth;
new text end

new text begin (2) the client's allergies;
new text end

new text begin (3) all medication orders for the client, including client-specific orders for
over-the-counter medications and approved condition-specific protocols;
new text end

new text begin (4) the name of each ordered medication, date of each medication's expiration, each
medication's dosage frequency, method of administration, and time;
new text end

new text begin (5) the licensed prescriber's name and telephone number;
new text end

new text begin (6) the date of initiation;
new text end

new text begin (7) the signature, printed name, and credentials of the staff person who administered the
medication or observed the client self-administer the medication; and
new text end

new text begin (8) the reason that the license holder did not administer the client's prescribed medication
or observe the client self-administer the client's prescribed medication.
new text end

Sec. 10.

new text begin[245I.09] CLIENT FILES.
new text end

new text begin Subdivision 1.new text end

new text beginGenerally.new text end

new text begin(a) A license holder must maintain a file for each client that
contains the client's current and accurate records. The license holder must store each client
file on the premises where the license holder provides or coordinates services for the client.
The license holder must ensure that all client files are readily accessible for the
commissioner's review. The license holder is not required to keep client files in a single
location.
new text end

new text begin (b) The license holder must protect client records against loss, tampering, or unauthorized
disclosure of confidential client data according to the Minnesota Government Data Practices
Act, chapter 13; the privacy provisions of the Minnesota health care programs provider
agreement; the Health Insurance Portability and Accountability Act of 1996 (HIPAA),
Public Law 104-191; and the Minnesota Health Records Act, sections 144.291 to 144.298.
new text end

new text begin Subd. 2.new text end

new text beginRecord retention.new text end

new text beginA license holder must retain client records of a discharged
client for a minimum of five years from the date of the client's discharge. A license holder
who ceases to provide treatment services to a client must retain the client's records for a
minimum of five years from the date that the license holder stopped providing services to
the client and must notify the commissioner of the location of the client records and the
name of the individual responsible for storing and maintaining the client records.
new text end

new text begin Subd. 3.new text end

new text beginContents.new text end

new text beginA license holder must retain a clear and complete record of the
information that the license holder receives regarding a client, and of the services that the
license holder provides to the client. If applicable, each client's file must include the following
information:
new text end

new text begin (1) the client's screenings, assessments, and testing;
new text end

new text begin (2) the client's treatment plans and reviews of the client's treatment plan;
new text end

new text begin (3) the client's individual abuse prevention plans;
new text end

new text begin (4) the client's health care directive under section 145C.01, subdivision 5a, and the
client's emergency contacts;
new text end

new text begin (5) the client's crisis plans;
new text end

new text begin (6) the client's consents for releases of information and documentation of the client's
releases of information;
new text end

new text begin (7) the client's significant medical and health-related information;
new text end

new text begin (8) a record of each communication that a staff person has with the client's other mental
health providers and persons interested in the client, including the client's case manager,
family members, primary caregiver, legal representatives, court representatives,
representatives from the correctional system, or school administration;
new text end

new text begin (9) written information by the client that the client requests to include in the client's file;
and
new text end

new text begin (10) the date of the client's discharge from the license holder's program, the reason that
the license holder discontinued services for the client, and the client's discharge summaries.
new text end

Sec. 11.

new text begin[245I.10] ASSESSMENT AND TREATMENT PLANNING.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) "Diagnostic formulation" means a written analysis and
explanation of a client's clinical assessment to develop a hypothesis about the cause and
nature of a client's presenting problems and to identify the most suitable approach for treating
the client.
new text end

new text begin (b) "Responsivity factors" means the factors other than the diagnostic formulation that
may modify a client's treatment needs. This includes a client's learning style, abilities,
cognitive functioning, cultural background, and personal circumstances. When documenting
a client's responsivity factors a mental health professional or clinical trainee must include
an analysis of how a client's strengths are reflected in the license holder's plan to deliver
services to the client.
new text end

new text begin Subd. 2.new text end

new text beginGenerally.new text end

new text begin(a) A license holder must use a client's diagnostic assessment or
crisis assessment to determine a client's eligibility for mental health services, except as
provided in this section.
new text end

new text begin (b) Prior to completing a client's initial diagnostic assessment, a license holder may
provide a client with the following services:
new text end

new text begin (1) an explanation of findings;
new text end

new text begin (2) neuropsychological testing, neuropsychological assessment, and psychological
testing;
new text end

new text begin (3) any combination of psychotherapy sessions, family psychotherapy sessions, and
family psychoeducation sessions not to exceed three sessions;
new text end

new text begin (4) crisis assessment services according to section 256B.0624; and
new text end

new text begin (5) ten days of intensive residential treatment services according to the assessment and
treatment planning standards in section 245.23, subdivision 7.
new text end

new text begin (c) Based on the client's needs that a crisis assessment identifies under section 256B.0624,
a license holder may provide a client with the following services:
new text end

new text begin (1) crisis intervention and stabilization services under section 245I.23 or 256B.0624;
and
new text end

new text begin (2) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization.
new text end

new text begin (d) Based on the client's needs in the client's brief diagnostic assessment, a license holder
may provide a client with any combination of psychotherapy sessions, group psychotherapy
sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed
ten sessions within a 12-month period without prior authorization for any new client or for
an existing client who the license holder projects will need fewer than ten sessions during
the next 12 months.
new text end

new text begin (e) Based on the client's needs that a hospital's medical history and presentation
examination identifies, a license holder may provide a client with:
new text end

new text begin (1) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization for any new client or for an existing
client who the license holder projects will need fewer than ten sessions during the next 12
months; and
new text end

new text begin (2) up to five days of day treatment services or partial hospitalization.
new text end

new text begin (f) A license holder must complete a new standard diagnostic assessment of a client:
new text end

new text begin (1) when the client requires services of a greater number or intensity than the services
that paragraphs (b) to (e) describe;
new text end

new text begin (2) at least annually following the client's initial diagnostic assessment if the client needs
additional mental health services and the client does not meet the criteria for a brief
assessment;
new text end

new text begin (3) when the client's mental health condition has changed markedly since the client's
most recent diagnostic assessment; or
new text end

new text begin (4) when the client's current mental health condition does not meet the criteria of the
client's current diagnosis.
new text end

new text begin (g) For an existing client, the license holder must ensure that a new standard diagnostic
assessment includes a written update containing all significant new or changed information
about the client, and an update regarding what information has not significantly changed,
including a discussion with the client about changes in the client's life situation, functioning,
presenting problems, and progress with achieving treatment goals since the client's last
diagnostic assessment was completed.
new text end

new text begin Subd. 3.new text end

new text beginContinuity of services.new text end

new text begin(a) For any client with a diagnostic assessment
completed under Minnesota Rules, parts 9505.0370 to 9505.0372, before the effective date
of this section, the diagnostic assessment is valid for authorizing the client's treatment and
billing for one calendar year after the date that the assessment was completed.
new text end

new text begin (b) For any client with an individual treatment plan completed under section 256B.0622,
256B.0623, 256B.0943, 256B.0946, or 256B.0947 or Minnesota Rules, parts 9505.0370 to
9505.0372, the client's treatment plan is valid for authorizing treatment and billing until the
treatment plan's expiration date.
new text end

new text begin (c) This subdivision expires July 1, 2023.
new text end

new text begin Subd. 4.new text end

new text beginDiagnostic assessment.new text end

new text beginA client's diagnostic assessment must: (1) identify at
least one mental health diagnosis for which the client meets the diagnostic criteria and
recommend mental health services to develop the client's mental health services and treatment
plan; or (2) include a finding that the client does not meet the criteria for a mental health
disorder.
new text end

new text begin Subd. 5.new text end

new text beginBrief diagnostic assessment; required elements.new text end

new text begin(a) Only a mental health
professional or clinical trainee may complete a brief diagnostic assessment of a client. A
license holder may only use a brief diagnostic assessment for a client who is six years of
age or older.
new text end

new text begin (b) When conducting a brief diagnostic assessment of a client, the assessor must complete
a face-to-face interview with the client and a written evaluation of the client. The assessor
must gather and document initial components of the client's standard diagnostic assessment,
including the client's:
new text end

new text begin (1) age;
new text end

new text begin (2) description of symptoms, including the reason for the client's referral;
new text end

new text begin (3) history of mental health treatment;
new text end

new text begin (4) cultural influences on the client; and
new text end

new text begin (5) mental status examination.
new text end

new text begin (c) Based on the initial components of the assessment, the assessor must develop a
provisional diagnostic formulation about the client. The assessor may use the client's
provisional diagnostic formulation to address the client's immediate needs and presenting
problems.
new text end

new text begin (d) A mental health professional or clinical trainee may use treatment sessions with the
client authorized by a brief diagnostic assessment to gather additional information about
the client to complete the client's standard diagnostic assessment if the number of sessions
will exceed the coverage limits in subdivision 2.
new text end

new text begin Subd. 6.new text end

new text beginStandard diagnostic assessment; required elements.new text end

new text begin(a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context.
new text end

new text begin (b) When completing a standard diagnostic assessment of a client, the assessor must
gather and document information about the client's current life situation, including the
following information:
new text end

new text begin (1) the client's age;
new text end

new text begin (2) the client's current living situation, including the client's housing status and household
members;
new text end

new text begin (3) the status of the client's basic needs;
new text end

new text begin (4) the client's education level and employment status;
new text end

new text begin (5) the client's current medications;
new text end

new text begin (6) any immediate risks to the client's health and safety;
new text end

new text begin (7) the client's perceptions of the client's condition;
new text end

new text begin (8) the client's description of the client's symptoms, including the reason for the client's
referral;
new text end

new text begin (9) the client's history of mental health treatment; and
new text end

new text begin (10) cultural influences on the client.
new text end

new text begin (c) If the assessor cannot obtain the information that this subdivision requires without
retraumatizing the client or harming the client's willingness to engage in treatment, the
assessor must identify which topics will require further assessment during the course of the
client's treatment. The assessor must gather and document information related to the following
topics:
new text end

new text begin (1) the client's relationship with the client's family and other significant personal
relationships, including the client's evaluation of the quality of each relationship;
new text end

new text begin (2) the client's strengths and resources, including the extent and quality of the client's
social networks;
new text end

new text begin (3) important developmental incidents in the client's life;
new text end

new text begin (4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
new text end

new text begin (5) the client's history of or exposure to alcohol and drug usage and treatment; and
new text end

new text begin (6) the client's health history and the client's family health history, including the client's
physical, chemical, and mental health history.
new text end

new text begin (d) When completing a standard diagnostic assessment of a client, an assessor must use
a recognized diagnostic framework.
new text end

new text begin (1) When completing a standard diagnostic assessment of a client who is five years of
age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
Classification of Mental Health and Development Disorders of Infancy and Early Childhood
published by Zero to Three.
new text end

new text begin (2) When completing a standard diagnostic assessment of a client who is six years of
age or older, the assessor must use the current edition of the Diagnostic and Statistical
Manual of Mental Disorders published by the American Psychiatric Association.
new text end

new text begin (3) When completing a standard diagnostic assessment of a client who is five years of
age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
(ECSII) to the client and include the results in the client's assessment.
new text end

new text begin (4) When completing a standard diagnostic assessment of a client who is six to 17 years
of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
(CASII) to the client and include the results in the client's assessment.
new text end

new text begin (5) When completing a standard diagnostic assessment of a client who is 18 years of
age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association to screen and assess the client for a
substance use disorder.
new text end

new text begin (e) When completing a standard diagnostic assessment of a client, the assessor must
include and document the following components of the assessment:
new text end

new text begin (1) the client's mental status examination;
new text end

new text begin (2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
vulnerabilities; safety needs, including client information that supports the assessor's findings
after applying a recognized diagnostic framework from paragraph (d); and any differential
diagnosis of the client;
new text end

new text begin (3) an explanation of: (i) how the assessor diagnosed the client using the information
from the client's interview, assessment, psychological testing, and collateral information
about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
and (v) the client's responsivity factors.
new text end

new text begin (f) When completing a standard diagnostic assessment of a client, the assessor must
consult the client and the client's family about which services that the client and the family
prefer to treat the client. The assessor must make referrals for the client as to services required
by law.
new text end

new text begin Subd. 7.new text end

new text beginIndividual treatment plan.new text end

new text beginA license holder must follow each client's written
individual treatment plan when providing services to the client with the following exceptions:
new text end

new text begin (1) services that do not require that a license holder completes a standard diagnostic
assessment of a client before providing services to the client;
new text end

new text begin (2) when developing a service plan; and
new text end

new text begin (3) when a client re-engages in services under subdivision 8, paragraph (b).
new text end

new text begin Subd. 8.new text end

new text beginIndividual treatment plan; required elements.new text end

new text begin(a) After completing a client's
diagnostic assessment and before providing services to the client, the license holder must
complete the client's individual treatment plan. The license holder must:
new text end

new text begin (1) base the client's individual treatment plan on the client's diagnostic assessment and
baseline measurements;
new text end

new text begin (2) for a child client, use a child-centered, family-driven, and culturally appropriate
planning process that allows the child's parents and guardians to observe and participate in
the child's individual and family treatment services, assessments, and treatment planning;
new text end

new text begin (3) for an adult client, use a person-centered, culturally appropriate planning process
that allows the client's family and other natural supports to observe and participate in the
client's treatment services, assessments, and treatment planning;
new text end

new text begin (4) identify the client's treatment goals, measureable treatment objectives, a schedule
for accomplishing the client's treatment goals and objectives, a treatment strategy, and the
individuals responsible for providing treatment services and supports to the client. The
license holder must have a treatment strategy to engage the client in treatment if the client:
new text end

new text begin (i) has a history of not engaging in treatment; and
new text end

new text begin (ii) is ordered by a court to participate in treatment services or to take neuroleptic
medications;
new text end

new text begin (5) identify the participants involved in the client's treatment planning. The client must
be a participant in the client's treatment planning. If applicable, the license holder must
document the reasons that the license holder did not involve the client's family or other
natural supports in the client's treatment planning;
new text end

new text begin (6) review the client's individual treatment plan every 180 days and update the client's
individual treatment plan with the client's treatment progress, new treatment objectives and
goals or, if the client has not made treatment progress, changes in the license holder's
approach to treatment; and
new text end

new text begin (7) ensure that the client approves of the client's individual treatment plan unless a court
orders the client's treatment plan under chapter 253B.
new text end

new text begin (b) If the client disagrees with the client's treatment plan, the license holder must
document in the client file the reasons why the client does not agree with the treatment plan.
If the license holder cannot obtain the client's approval of the treatment plan, a mental health
professional must make efforts to obtain approval from a person who is authorized to consent
on the client's behalf within 30 days after the client's previous individual treatment plan
expired. A license holder may not deny a client service during this time period solely because
the license holder could not obtain the client's approval of the client's individual treatment
plan. A license holder may continue to bill for the client's otherwise eligible services when
the client re-engages in services.
new text end

new text begin Subd. 9.new text end

new text beginFunctional assessment; required elements.new text end

new text beginWhen a license holder is
completing a functional assessment for an adult client, the license holder must:
new text end

new text begin (1) complete a functional assessment of the client after completing the client's diagnostic
assessment;
new text end

new text begin (2) use a collaborative process that allows the client and the client's family and other
natural supports, the client's referral sources, and the client's providers to provide information
about how the client's symptoms of mental illness impact the client's functioning;
new text end

new text begin (3) if applicable, document the reasons that the license holder did not contact the client's
family and other natural supports;
new text end

new text begin (4) assess and document how the client's symptoms of mental illness impact the client's
functioning in the following areas:
new text end

new text begin (i) the client's mental health symptoms;
new text end

new text begin (ii) the client's mental health service needs;
new text end

new text begin (iii) the client's substance use;
new text end

new text begin (iv) the client's vocational and educational functioning;
new text end

new text begin (v) the client's social functioning, including the use of leisure time;
new text end

new text begin (vi) the client's interpersonal functioning, including relationships with the client's family
and other natural supports;
new text end

new text begin (vii) the client's ability to provide self-care and live independently;
new text end

new text begin (viii) the client's medical and dental health;
new text end

new text begin (ix) the client's financial assistance needs; and
new text end

new text begin (x) the client's housing and transportation needs;
new text end

new text begin (5) include a narrative summarizing the client's strengths, resources, and all areas of
functional impairment;
new text end

new text begin (6) complete the client's functional assessment before the client's initial individual
treatment plan unless a service specifies otherwise; and
new text end

new text begin (7) update the client's functional assessment with the client's current functioning whenever
there is a significant change in the client's functioning or at least every 180 days, unless a
service specifies otherwise.
new text end

Sec. 12.

new text begin[245I.11] HEALTH SERVICES AND MEDICATIONS.
new text end

new text begin Subdivision 1.new text end

new text beginGenerally.new text end

new text beginIf a license holder is licensed as a residential program, stores
or administers client medications, or observes clients self-administer medications, the license
holder must ensure that a staff person who is a registered nurse or licensed prescriber is
responsible for overseeing storage and administration of client medications and observing
as a client self-administers medications, including training according to section 245I.05,
subdivision 6, and documenting the occurrence according to section 245I.08, subdivision
5.
new text end

new text begin Subd. 2.new text end

new text beginHealth services.new text end

new text beginIf a license holder is licensed as a residential program, the
license holder must:
new text end

new text begin (1) ensure that a client is screened for health issues within 72 hours of the client's
admission;
new text end

new text begin (2) monitor the physical health needs of each client on an ongoing basis;
new text end

new text begin (3) offer referrals to clients and coordinate each client's care with psychiatric and medical
services;
new text end

new text begin (4) identify circumstances in which a staff person must notify a registered nurse or
licensed prescriber of any of a client's health concerns and the process for providing
notification of client health concerns; and
new text end

new text begin (5) identify the circumstances in which the license holder must obtain medical care for
a client and the process for obtaining medical care for a client.
new text end

new text begin Subd. 3.new text end

new text beginStoring and accounting for medications.new text end

new text begin(a) If a license holder stores client
medications, the license holder must:
new text end

new text begin (1) store client medications in original containers in a locked location;
new text end

new text begin (2) store refrigerated client medications in special trays or containers that are separate
from food;
new text end

new text begin (3) store client medications marked "for external use only" in a compartment that is
separate from other client medications;
new text end

new text begin (4) store Schedule II to IV drugs listed in section 152.02, subdivisions 3 to 5, in a
compartment that is locked separately from other medications;
new text end

new text begin (5) ensure that only authorized staff persons have access to stored client medications;
new text end

new text begin (6) follow a documentation procedure on each shift to account for all scheduled drugs;
and
new text end

new text begin (7) record each incident when a staff person accepts a supply of client medications and
destroy discontinued, outdated, or deteriorated client medications.
new text end

new text begin (b) If a license holder is licensed as a residential program, the license holder must allow
clients who self-administer medications to keep a private medication supply. The license
holder must ensure that the client stores all private medication in a locked container in the
client's private living area, unless the private medication supply poses a health and safety
risk to any clients. A client must not maintain a private medication supply of a prescription
medication without a written medication order from a licensed prescriber and a prescription
label that includes the client's name.
new text end

new text begin Subd. 4.new text end

new text beginMedication orders.new text end

new text begin(a) If a license holder stores, prescribes, or administers
medications or observes a client self-administer medications, the license holder must:
new text end

new text begin (1) ensure that a licensed prescriber writes all orders to accept, administer, or discontinue
client medications;
new text end

new text begin (2) accept nonwritten orders to administer client medications in emergency circumstances
only;
new text end

new text begin (3) establish a timeline and process for obtaining a written order with the licensed
prescriber's signature when the license holder accepts a nonwritten order to administer client
medications;
new text end

new text begin (4) obtain prescription medication renewals from a licensed prescriber for each client
every 90 days for psychotropic medications and annually for all other medications; and
new text end

new text begin (5) maintain the client's right to privacy and dignity.
new text end

new text begin (b) If a license holder employs a licensed prescriber, the license holder must inform the
client about potential medication effects and side effects and obtain and document the client's
informed consent before the licensed prescriber prescribes a medication.
new text end

new text begin Subd. 5.new text end

new text beginMedication administration.new text end

new text beginIf a license holder is licensed as a residential
program, the license holder must:
new text end

new text begin (1) assess and document each client's ability to self-administer medication. In the
assessment, the license holder must evaluate the client's ability to: (i) comply with prescribed
medication regimens; and (ii) store the client's medications safely and in a manner that
protects other individuals in the facility. Through the assessment process, the license holder
must assist the client in developing the skills necessary to safely self-administer medication;
new text end

new text begin (2) monitor the effectiveness of medications, side effects of medications, and adverse
reactions to medications for each client. The license holder must address and document any
concerns about a client's medications;
new text end

new text begin (3) ensure that no staff person or client gives a legend drug supply for one client to
another client;
new text end

new text begin (4) have policies and procedures for: (i) keeping a record of each client's medication
orders; (ii) keeping a record of any incident of deferring a client's medications; (iii)
documenting any incident when a client's medication is omitted; and (iv) documenting when
a client refuses to take medications as prescribed; and
new text end

new text begin (5) document and track medication errors, document whether the license holder notified
anyone about the medication error, determine if the license holder must take any follow-up
actions, and identify the staff persons who are responsible for taking follow-up actions.
new text end

Sec. 13.

new text begin[245I.12] CLIENT RIGHTS AND PROTECTIONS.
new text end

new text begin Subdivision 1.new text end

new text beginClient rights.new text end

new text beginA license holder must ensure that all clients have the
following rights:
new text end

new text begin (1) the rights listed in the health care bill of rights in section 144.651;
new text end

new text begin (2) the right to be free from discrimination based on age, race, color, creed, religion,
national origin, gender, marital status, disability, sexual orientation, and status with regard
to public assistance. The license holder must follow all applicable state and federal laws
including the Minnesota Human Rights Act, chapter 363A; and
new text end

new text begin (3) the right to be informed prior to a photograph or audio or video recording being made
of the client. The client has the right to refuse to allow any recording or photograph of the
client that is not for the purposes of identification or supervision by the license holder.
new text end

new text begin Subd. 2.new text end

new text beginRestrictions to client rights.new text end

new text beginIf the license holder restricts a client's right, the
license holder must document in the client file a mental health professional's approval of
the restriction and the reasons for the restriction.
new text end

new text begin Subd. 3.new text end

new text beginNotice of rights.new text end

new text beginThe license holder must give a copy of the client's rights
according to this section to each client on the day of the client's admission. The license
holder must document that the license holder gave a copy of the client's rights to each client
on the day of the client's admission according to this section. The license holder must post
a copy of the client rights in an area visible or accessible to all clients. The license holder
must include the client rights in Minnesota Rules, chapter 9544, for applicable clients.
new text end

new text begin Subd. 4.new text end

new text beginClient property.new text end

new text begin(a) The license holder must meet the requirements of section
245A.04, subdivision 13.
new text end

new text begin (b) If the license holder is unable to obtain a client's signature acknowledging the receipt
or disbursement of the client's funds or property required by section 245A.04, subdivision
13, paragraph (c), clause (1), two staff persons must sign documentation acknowledging
that the staff persons witnessed the client's receipt or disbursement of the client's funds or
property.
new text end

new text begin (c) The license holder must return all of the client's funds and other property to the client
except for the following items:
new text end

new text begin (1) illicit drugs, drug paraphernalia, and drug containers that are subject to forfeiture
under section 609.5316. The license holder must give illicit drugs, drug paraphernalia, and
drug containers to a local law enforcement agency or destroy the items; and
new text end

new text begin (2) weapons, explosives, and other property that may cause serious harm to the client
or others. The license holder may give a client's weapons and explosives to a local law
enforcement agency. The license holder must notify the client that a local law enforcement
agency has the client's property and that the client has the right to reclaim the property if
the client has a legal right to possess the item.
new text end

new text begin (d) If a client leaves the license holder's program but abandons the client's funds or
property, the license holder must retain and store the client's funds or property, including
medications, for a minimum of 30 days after the client's discharge from the program.
new text end

new text begin Subd. 5.new text end

new text beginClient grievances.new text end

new text begin(a) The license holder must have a grievance procedure
that:
new text end

new text begin (1) describes to clients how the license holder will meet the requirements in this
subdivision; and
new text end

new text begin (2) contains the current public contact information of the Department of Human Services,
Licensing Division; the Office of Ombudsman for Mental Health and Developmental
Disabilities; the Department of Health, Office of Health Facilities Complaints; and all
applicable health-related licensing boards.
new text end

new text begin (b) On the day of each client's admission, the license holder must explain the grievance
procedure to the client.
new text end

new text begin (c) The license holder must:
new text end

new text begin (1) post the grievance procedure in a place visible to clients and provide a copy of the
grievance procedure upon request;
new text end

new text begin (2) allow clients, former clients, and their authorized representatives to submit a grievance
to the license holder;
new text end

new text begin (3) within three business days of receiving a client's grievance, acknowledge in writing
that the license holder received the client's grievance. If applicable, the license holder must
include a notice of the client's separate appeal rights for a managed care organization's
reduction, termination, or denial of a covered service;
new text end

new text begin (4) within 15 business days of receiving a client's grievance, provide a written final
response to the client's grievance containing the license holder's official response to the
grievance; and
new text end

new text begin (5) allow the client to bring a grievance to the person with the highest level of authority
in the program.
new text end

Sec. 14.

new text begin[245I.13] CRITICAL INCIDENTS.
new text end

new text begin If a license holder is licensed as a residential program, the license holder must report all
critical incidents to the commissioner within ten days of learning of the incident on a form
approved by the commissioner. The license holder must keep a record of critical incidents
in a central location that is readily accessible to the commissioner for review upon the
commissioner's request for a minimum of two licensing periods.
new text end

Sec. 15.

new text begin[245I.20] MENTAL HEALTH CLINIC.
new text end

new text begin Subdivision 1.new text end

new text beginPurpose.new text end

new text beginCertified mental health clinics provide clinical services for the
treatment of mental illnesses with a treatment team that reflects multiple disciplines and
areas of expertise.
new text end

new text begin Subd. 2.new text end

new text beginDefinitions.new text end

new text begin(a) "Clinical services" means services provided to a client to
diagnose, describe, predict, and explain the client's status relative to a condition or problem
as described in the: (1) current edition of the Diagnostic and Statistical Manual of Mental
Disorders published by the American Psychiatric Association; or (2) current edition of the
DC: 0-5 Diagnostic Classification of Mental Health and Development Disorders of Infancy
and Early Childhood published by Zero to Three. Where necessary, clinical services includes
services to treat a client to reduce the client's impairment due to the client's condition.
Clinical services also includes individual treatment planning, case review, record-keeping
required for a client's treatment, and treatment supervision. For the purposes of this section,
clinical services excludes services delivered to a client under a separate license and services
listed under section 245I.011, subdivision 5.
new text end

new text begin (b) "Competent" means having professional education, training, continuing education,
consultation, supervision, experience, or a combination thereof necessary to demonstrate
sufficient knowledge of and proficiency in a specific clinical service.
new text end

new text begin (c) "Discipline" means a branch of professional knowledge or skill acquired through a
specific course of study, training, and supervised practice. Discipline is usually documented
by a specific educational degree, licensure, or certification of proficiency. Examples of the
mental health disciplines include but are not limited to psychiatry, psychology, clinical
social work, marriage and family therapy, clinical counseling, and psychiatric nursing.
new text end

new text begin (d) "Treatment team" means the mental health professionals, mental health practitioners,
and clinical trainees who provide clinical services to clients.
new text end

new text begin Subd. 3.new text end

new text beginOrganizational structure.new text end

new text begin(a) A mental health clinic location must be an entire
facility or a clearly identified unit within a facility that is administratively and clinically
separate from the rest of the facility. The mental health clinic location may provide services
other than clinical services to clients, including medical services, substance use disorder
services, social services, training, and education.
new text end

new text begin (b) The certification holder must notify the commissioner of all mental health clinic
locations. If there is more than one mental health clinic location, the certification holder
must designate one location as the main location and all of the other locations as satellite
locations. The main location as a unit and the clinic as a whole must comply with the
minimum staffing standards in subdivision 4.
new text end

new text begin (c) The certification holder must ensure that each satellite location:
new text end

new text begin (1) adheres to the same policies and procedures as the main location;
new text end

new text begin (2) provides treatment team members with face-to-face or telephone access to a mental
health professional for the purposes of supervision whenever the satellite location is open.
The certification holder must maintain a schedule of the mental health professionals who
will be available and the contact information for each available mental health professional.
The schedule must be current and readily available to treatment team members; and
new text end

new text begin (3) enables clients to access all of the mental health clinic's clinical services and treatment
team members, as needed.
new text end

new text begin Subd. 4.new text end

new text beginMinimum staffing standards.new text end

new text begin(a) A certification holder's treatment team must
consist of at least four mental health professionals. At least two of the mental health
professionals must be employed by or under contract with the mental health clinic for a
minimum of 35 hours per week each. Each of the two mental health professionals must
specialize in a different mental health discipline.
new text end

new text begin (b) The treatment team must include:
new text end

new text begin (1) a physician qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (4), or a nurse qualified as a mental health professional according to
section 245I.04, subdivision 2, clause (1); and
new text end

new text begin (2) a psychologist qualified as a mental health professional according to section 245I.04,
subdivision 2, clause (3).
new text end

new text begin (c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical
services at least:
new text end

new text begin (1) eight hours every two weeks if the mental health clinic has over 25.0 full-time
equivalent treatment team members;
new text end

new text begin (2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent
treatment team members;
new text end

new text begin (3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent
treatment team members; or
new text end

new text begin (4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent
treatment team members or only provides in-home services to clients.
new text end

new text begin (d) The certification holder must maintain a record that demonstrates compliance with
this subdivision.
new text end

new text begin Subd. 5.new text end

new text beginTreatment supervision specified.new text end

new text begin(a) A mental health professional must remain
responsible for each client's case. The certification holder must document the name of the
mental health professional responsible for each case and the dates that the mental health
professional is responsible for the client's case from beginning date to end date. The
certification holder must assign each client's case for assessment, diagnosis, and treatment
services to a treatment team member who is competent in the assigned clinical service, the
recommended treatment strategy, and in treating the client's characteristics.
new text end

new text begin (b) Treatment supervision of mental health practitioners and clinical trainees required
by section 245I.06 must include case reviews as described in this paragraph. Every two
months, a mental health professional must complete a case review of each client assigned
to the mental health professional when the client is receiving clinical services from a mental
health practitioner or clinical trainee. The case review must include a consultation process
that thoroughly examines the client's condition and treatment, including: (1) a review of the
client's reason for seeking treatment, diagnoses and assessments, and the individual treatment
plan; (2) a review of the appropriateness, duration, and outcome of treatment provided to
the client; and (3) treatment recommendations.
new text end

new text begin Subd. 6.new text end

new text beginAdditional policy and procedure requirements.new text end

new text begin(a) In addition to the policies
and procedures required by section 245I.03, the certification holder must establish, enforce,
and maintain the policies and procedures required by this subdivision.
new text end

new text begin (b) The certification holder must have a clinical evaluation procedure to identify and
document each treatment team member's areas of competence.
new text end

new text begin (c) The certification holder must have policies and procedures for client intake and case
assignment that:
new text end

new text begin (1) outline the client intake process;
new text end

new text begin (2) describe how the mental health clinic determines the appropriateness of accepting a
client into treatment by reviewing the client's condition and need for treatment, the clinical
services that the mental health clinic offers to clients, and other available resources; and
new text end

new text begin (3) contain a process for assigning a client's case to a mental health professional who is
responsible for the client's case and other treatment team members.
new text end

new text begin Subd. 7.new text end

new text beginReferrals.new text end

new text beginIf necessary treatment for a client or treatment desired by a client
is not available at the mental health clinic, the certification holder must facilitate appropriate
referrals for the client. When making a referral for a client, the treatment team member must
document a discussion with the client that includes: (1) the reason for the client's referral;
(2) potential treatment resources for the client; and (3) the client's response to receiving a
referral.
new text end

new text begin Subd. 8.new text end

new text beginEmergency service.new text end

new text beginFor the certification holder's telephone numbers that clients
regularly access, the certification holder must include the contact information for the area's
mental health crisis services as part of the certification holder's message when a live operator
is not available to answer clients' calls.
new text end

new text begin Subd. 9.new text end

new text beginQuality assurance and improvement plan.new text end

new text begin(a) At a minimum, a certification
holder must develop a written quality assurance and improvement plan that includes a plan
for:
new text end

new text begin (1) encouraging ongoing consultation among members of the treatment team;
new text end

new text begin (2) obtaining and evaluating feedback about services from clients, family and other
natural supports, referral sources, and staff persons;
new text end

new text begin (3) measuring and evaluating client outcomes;
new text end

new text begin (4) reviewing client suicide deaths and suicide attempts;
new text end

new text begin (5) examining the quality of clinical service delivery to clients; and
new text end

new text begin (6) self-monitoring of compliance with this chapter.
new text end

new text begin (b) At least annually, the certification holder must review, evaluate, and update the
quality assurance and improvement plan. The review must: (1) include documentation of
the actions that the certification holder will take as a result of information obtained from
monitoring activities in the plan; and (2) establish goals for improved service delivery to
clients for the next year.
new text end

new text begin Subd. 10.new text end

new text beginApplication procedures.new text end

new text begin(a) The applicant for certification must submit any
documents that the commissioner requires on forms approved by the commissioner.
new text end

new text begin (b) Upon submitting an application for certification, an applicant must pay the application
fee required by section 245A.10, subdivision 3.
new text end

new text begin (c) The commissioner must act on an application within 90 working days of receiving
a completed application.
new text end

new text begin (d) When the commissioner receives an application for initial certification that is
incomplete because the applicant failed to submit required documents or is deficient because
the submitted documents do not meet certification requirements, the commissioner must
provide the applicant with written notice that the application is incomplete or deficient. In
the notice, the commissioner must identify the particular documents that are missing or
deficient and give the applicant 45 days to submit a second application that is complete. An
applicant's failure to submit a complete application within 45 days after receiving notice
from the commissioner is a basis for certification denial.
new text end

new text begin (e) The commissioner must give notice of a denial to an applicant when the commissioner
has made the decision to deny the certification application. In the notice of denial, the
commissioner must state the reasons for the denial in plain language. The commissioner
must send or deliver the notice of denial to an applicant by certified mail or personal service.
In the notice of denial, the commissioner must state the reasons that the commissioner denied
the application and must inform the applicant of the applicant's right to request a contested
case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The
applicant may appeal the denial by notifying the commissioner in writing by certified mail
or personal service. If mailed, the appeal must be postmarked and sent to the commissioner
within 20 calendar days after the applicant received the notice of denial. If an applicant
delivers an appeal by personal service, the commissioner must receive the appeal within 20
calendar days after the applicant received the notice of denial.
new text end

new text begin Subd. 11.new text end

new text beginCommissioner's right of access.new text end

new text begin(a) When the commissioner is exercising
the powers conferred to the commissioner by this chapter, if the mental health clinic is in
operation and the information is relevant to the commissioner's inspection or investigation,
the certification holder must provide the commissioner access to:
new text end

new text begin (1) the physical facility and grounds where the program is located;
new text end

new text begin (2) documentation and records, including electronically maintained records;
new text end

new text begin (3) clients served by the mental health clinic;
new text end

new text begin (4) staff persons of the mental health clinic; and
new text end

new text begin (5) personnel records of current and former staff of the mental health clinic.
new text end

new text begin (b) The certification holder must provide the commissioner with access to the facility
and grounds, documentation and records, clients, and staff without prior notice and as often
as the commissioner considers necessary if the commissioner is investigating alleged
maltreatment or a violation of a law or rule, or conducting an inspection. When conducting
an inspection, the commissioner may request and must receive assistance from other state,
county, and municipal governmental agencies and departments. The applicant or certification
holder must allow the commissioner, at the commissioner's expense, to photocopy,
photograph, and make audio and video recordings during an inspection.
new text end

new text begin Subd. 12.new text end

new text beginMonitoring and inspections.new text end

new text begin(a) The commissioner may conduct a certification
review of the certified mental health clinic every two years to determine the certification
holder's compliance with applicable rules and statutes.
new text end

new text begin (b) The commissioner must offer the certification holder a choice of dates for an
announced certification review. A certification review must occur during the clinic's normal
working hours.
new text end

new text begin (c) The commissioner must make the results of certification reviews and the results of
investigations that result in a correction order publicly available on the department's website.
new text end

new text begin Subd. 13.new text end

new text beginCorrection orders.new text end

new text begin(a) If the applicant or certification holder fails to comply
with a law or rule, the commissioner may issue a correction order. The correction order
must state:
new text end

new text begin (1) the condition that constitutes a violation of the law or rule;
new text end

new text begin (2) the specific law or rule that the applicant or certification holder has violated; and
new text end

new text begin (3) the time that the applicant or certification holder is allowed to correct each violation.
new text end

new text begin (b) If the applicant or certification holder believes that the commissioner's correction
order is erroneous, the applicant or certification holder may ask the commissioner to
reconsider the part of the correction order that is allegedly erroneous. An applicant or
certification holder must make a request for reconsideration in writing. The request must
be postmarked and sent to the commissioner within 20 calendar days after the applicant or
certification holder received the correction order; and the request must:
new text end

new text begin (1) specify the part of the correction order that is allegedly erroneous;
new text end

new text begin (2) explain why the specified part is erroneous; and
new text end

new text begin (3) include documentation to support the allegation of error.
new text end

new text begin (c) A request for reconsideration does not stay any provision or requirement of the
correction order. The commissioner's disposition of a request for reconsideration is final
and not subject to appeal.
new text end

new text begin (d) If the commissioner finds that the applicant or certification holder failed to correct
the violation specified in the correction order, the commissioner may decertify the certified
mental health clinic according to subdivision 14.
new text end

new text begin (e) Nothing in this subdivision prohibits the commissioner from decertifying a mental
health clinic according to subdivision 14.
new text end

new text begin Subd. 14.new text end

new text beginDecertification.new text end

new text begin(a) The commissioner may decertify a mental health clinic
if a certification holder:
new text end

new text begin (1) failed to comply with an applicable law or rule; or
new text end

new text begin (2) knowingly withheld relevant information from or gave false or misleading information
to the commissioner in connection with an application for certification, during an
investigation, or regarding compliance with applicable laws or rules.
new text end

new text begin (b) When considering decertification of a mental health clinic, the commissioner must
consider the nature, chronicity, or severity of the violation of law or rule and the effect of
the violation on the health, safety, or rights of clients.
new text end

new text begin (c) If the commissioner decertifies a mental health clinic, the order of decertification
must inform the certification holder of the right to have a contested case hearing under
chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The certification holder
may appeal the decertification. The certification holder must appeal a decertification in
writing and send or deliver the appeal to the commissioner by certified mail or personal
service. If the certification holder mails the appeal, the appeal must be postmarked and sent
to the commissioner within ten calendar days after the certification holder receives the order
of decertification. If the certification holder delivers an appeal by personal service, the
commissioner must receive the appeal within ten calendar days after the certification holder
received the order. If a certification holder submits a timely appeal of an order of
decertification, the certification holder may continue to operate the program until the
commissioner issues a final order on the decertification.
new text end

new text begin (d) If the commissioner decertifies a mental health clinic pursuant to paragraph (a),
clause (1), based on a determination that the mental health clinic was responsible for
maltreatment, and if the certification holder appeals the decertification according to paragraph
(c), and appeals the maltreatment determination under section 260E.33, the final
decertification determination is stayed until the commissioner issues a final decision regarding
the maltreatment appeal.
new text end

new text begin Subd. 15.new text end

new text beginTransfer prohibited.new text end

new text beginA certification issued under this section is only valid
for the premises and the individual, organization, or government entity identified by the
commissioner on the certification. A certification is not transferable or assignable.
new text end

new text begin Subd. 16.new text end

new text beginNotifications required and noncompliance.new text end

new text begin(a) A certification holder must
notify the commissioner, in a manner prescribed by the commissioner, and obtain the
commissioner's approval before making any change to the name of the certification holder
or the location of the mental health clinic.
new text end

new text begin (b) Changes in mental health clinic organization, staffing, treatment, or quality assurance
procedures that affect the ability of the certification holder to comply with the minimum
standards of this section must be reported in writing by the certification holder to the
commissioner within 15 days of the occurrence. Review of the change must be conducted
by the commissioner. A certification holder with changes resulting in noncompliance in
minimum standards must receive written notice and may have up to 180 days to correct the
areas of noncompliance before being decertified. Interim procedures to resolve the
noncompliance on a temporary basis must be developed and submitted in writing to the
commissioner for approval within 30 days of the commissioner's determination of the
noncompliance. Not reporting an occurrence of a change that results in noncompliance
within 15 days, failure to develop an approved interim procedure within 30 days of the
determination of the noncompliance, or nonresolution of the noncompliance within 180
days will result in immediate decertification.
new text end

new text begin (c) The mental health clinic may be required to submit written information to the
department to document that the mental health clinic has maintained compliance with this
section and mental health clinic procedures.
new text end

Sec. 16.

new text begin[245I.23] INTENSIVE RESIDENTIAL TREATMENT SERVICES AND
RESIDENTIAL CRISIS STABILIZATION.
new text end

new text begin Subdivision 1.new text end

new text beginPurpose.new text end

new text begin(a) Intensive residential treatment services is a community-based
medically monitored level of care for an adult client that uses established rehabilitative
principles to promote a client's recovery and to develop and achieve psychiatric stability,
personal and emotional adjustment, self-sufficiency, and other skills that help a client
transition to a more independent setting.
new text end

new text begin (b) Residential crisis stabilization provides structure and support to an adult client in a
community living environment when a client has experienced a mental health crisis and
needs short-term services to ensure that the client can safely return to the client's home or
precrisis living environment with additional services and supports identified in the client's
crisis assessment.
new text end

new text begin Subd. 2.new text end

new text beginDefinitions.new text end

new text begin(a) "Program location" means a set of rooms that are each physically
self-contained and have defining walls extending from floor to ceiling. Program location
includes bedrooms, living rooms or lounge areas, bathrooms, and connecting areas.
new text end

new text begin (b) "Treatment team" means a group of staff persons who provide intensive residential
treatment services or residential crisis stabilization to clients. The treatment team includes
mental health professionals, mental health practitioners, clinical trainees, certified
rehabilitation specialists, mental health rehabilitation workers, and mental health certified
peer specialists.
new text end

new text begin Subd. 3.new text end

new text beginTreatment services description.new text end

new text beginThe license holder must describe in writing
all treatment services that the license holder provides. The license holder must have the
description readily available for the commissioner upon the commissioner's request.
new text end

new text begin Subd. 4.new text end

new text beginRequired intensive residential treatment services.new text end

new text begin(a) On a daily basis, the
license holder must follow a client's treatment plan to provide intensive residential treatment
services to the client to improve the client's functioning.
new text end

new text begin (b) The license holder must offer and have the capacity to directly provide the following
treatment services to each client:
new text end

new text begin (1) rehabilitative mental health services;
new text end

new text begin (2) crisis prevention planning to assist a client with:
new text end

new text begin (i) identifying and addressing patterns in the client's history and experience of the client's
mental illness; and
new text end

new text begin (ii) developing crisis prevention strategies that include de-escalation strategies that have
been effective for the client in the past;
new text end

new text begin (3) health services and administering medication;
new text end

new text begin (4) co-occurring substance use disorder treatment;
new text end

new text begin (5) engaging the client's family and other natural supports in the client's treatment and
educating the client's family and other natural supports to strengthen the client's social and
family relationships; and
new text end

new text begin (6) making referrals for the client to other service providers in the community and
supporting the client's transition from intensive residential treatment services to another
setting.
new text end

new text begin (c) The license holder must include Illness Management and Recovery (IMR), Enhanced
Illness Management and Recovery (E-IMR), or other similar interventions in the license
holder's programming as approved by the commissioner.
new text end

new text begin Subd. 5.new text end

new text beginRequired residential crisis stabilization services.new text end

new text begin(a) On a daily basis, the
license holder must follow a client's individual crisis treatment plan to provide services to
the client in residential crisis stabilization to improve the client's functioning.
new text end

new text begin (b) The license holder must offer and have the capacity to directly provide the following
treatment services to the client:
new text end

new text begin (1) crisis stabilization services as described in section 256B.0624, subdivision 7;
new text end

new text begin (2) rehabilitative mental health services;
new text end

new text begin (3) health services and administering the client's medications; and
new text end

new text begin (4) making referrals for the client to other service providers in the community and
supporting the client's transition from residential crisis stabilization to another setting.
new text end

new text begin Subd. 6.new text end

new text beginOptional treatment services.new text end

new text begin(a) If the license holder offers additional treatment
services to a client, the treatment service must be:
new text end

new text begin (1) approved by the commissioner; and
new text end

new text begin (2)(i) a mental health evidence-based practice that the federal Department of Health and
Human Services Substance Abuse and Mental Health Service Administration has adopted;
new text end

new text begin (ii) a nationally recognized mental health service that substantial research has validated
as effective in helping individuals with serious mental illness achieve treatment goals; or
new text end

new text begin (iii) developed under state-sponsored research of publicly funded mental health programs
and validated to be effective for individuals, families, and communities.
new text end

new text begin (b) Before providing an optional treatment service to a client, the license holder must
provide adequate training to a staff person about providing the optional treatment service
to a client.
new text end

new text begin Subd. 7.new text end

new text beginIntensive residential treatment services assessment and treatment
planning.
new text end

new text begin(a) Within 12 hours of a client's admission, the license holder must evaluate and
document the client's immediate needs, including the client's:
new text end

new text begin (1) health and safety, including the client's need for crisis assistance;
new text end

new text begin (2) responsibilities for children, family and other natural supports, and employers; and
new text end

new text begin (3) housing and legal issues.
new text end

new text begin (b) Within 24 hours of the client's admission, the license holder must complete an initial
treatment plan for the client. The license holder must:
new text end

new text begin (1) base the client's initial treatment plan on the client's referral information and an
assessment of the client's immediate needs;
new text end

new text begin (2) consider crisis assistance strategies that have been effective for the client in the past;
new text end

new text begin (3) identify the client's initial treatment goals, measurable treatment objectives, and
specific interventions that the license holder will use to help the client engage in treatment;
new text end

new text begin (4) identify the participants involved in the client's treatment planning. The client must
be a participant; and
new text end

new text begin (5) ensure that a treatment supervisor approves of the client's initial treatment plan if a
mental health practitioner or clinical trainee completes the client's treatment plan,
notwithstanding section 245I.08, subdivision 3.
new text end

new text begin (c) According to section 245A.65, subdivision 2, paragraph (b), the license holder must
complete an individual abuse prevention plan as part of a client's initial treatment plan.
new text end

new text begin (d) Within five days of the client's admission and again within 60 days after the client's
admission, the license holder must complete a level of care assessment of the client. If the
license holder determines that a client does not need a medically monitored level of service,
a treatment supervisor must document how the client's admission to and continued services
in intensive residential treatment services are medically necessary for the client.
new text end

new text begin (e) Within ten days of a client's admission, the license holder must complete or review
and update the client's standard diagnostic assessment.
new text end

new text begin (f) Within ten days of a client's admission, the license holder must complete the client's
individual treatment plan, notwithstanding section 245I.10, subdivision 8. Within 40 days
after the client's admission and again within 70 days after the client's admission, the license
holder must update the client's individual treatment plan. The license holder must focus the
client's treatment planning on preparing the client for a successful transition from intensive
residential treatment services to another setting. In addition to the required elements of an
individual treatment plan under section 245I.10, subdivision 8, the license holder must
identify the following information in the client's individual treatment plan: (1) the client's
referrals and resources for the client's health and safety; and (2) the staff persons who are
responsible for following up with the client's referrals and resources. If the client does not
receive a referral or resource that the client needs, the license holder must document the
reason that the license holder did not make the referral or did not connect the client to a
particular resource. The license holder is responsible for determining whether additional
follow-up is required on behalf of the client.
new text end

new text begin (g) Within 30 days of the client's admission, the license holder must complete a functional
assessment of the client. Within 60 days after the client's admission, the license holder must
update the client's functional assessment to include any changes in the client's functioning
and symptoms.
new text end

new text begin (h) For a client with a current substance use disorder diagnosis and for a client whose
substance use disorder screening in the client's standard diagnostic assessment indicates the
possibility that the client has a substance use disorder, the license holder must complete a
written assessment of the client's substance use within 30 days of the client's admission. In
the substance use assessment, the license holder must: (1) evaluate the client's history of
substance use, relapses, and hospitalizations related to substance use; (2) assess the effects
of the client's substance use on the client's relationships including with family member and
others; (3) identify financial problems, health issues, housing instability, and unemployment;
(4) assess the client's legal problems, past and pending incarceration, violence, and
victimization; and (5) evaluate the client's suicide attempts, noncompliance with taking
prescribed medications, and noncompliance with psychosocial treatment.
new text end

new text begin (i) On a weekly basis, a mental health professional or certified rehabilitation specialist
must review each client's treatment plan and individual abuse prevention plan. The license
holder must document in the client's file each weekly review of the client's treatment plan
and individual abuse prevention plan.
new text end

new text begin Subd. 8.new text end

new text beginResidential crisis stabilization assessment and treatment planning.new text end

new text begin(a)
Within 12 hours of a client's admission, the license holder must evaluate the client and
document the client's immediate needs, including the client's:
new text end

new text begin (1) health and safety, including the client's need for crisis assistance;
new text end

new text begin (2) responsibilities for children, family and other natural supports, and employers; and
new text end

new text begin (3) housing and legal issues.
new text end

new text begin (b) Within 24 hours of a client's admission, the license holder must complete a crisis
treatment plan for the client under section 256B.0624, subdivision 11. The license holder
must base the client's crisis treatment plan on the client's referral information and an
assessment of the client's immediate needs.
new text end

new text begin (c) Section 245A.65, subdivision 2, paragraph (b), requires the license holder to complete
an individual abuse prevention plan for a client as part of the client's crisis treatment plan.
new text end

new text begin Subd. 9.new text end

new text beginKey staff positions.new text end

new text begin(a) The license holder must have a staff person assigned
to each of the following key staff positions at all times:
new text end

new text begin (1) a program director who qualifies as a mental health practitioner. The license holder
must designate the program director as responsible for all aspects of the operation of the
program and the program's compliance with all applicable requirements. The program
director must know and understand the implications of this chapter; chapters 245A, 245C,
and 260E; sections 626.557 and 626.5572; Minnesota Rules, chapter 9544; and all other
applicable requirements. The license holder must document in the program director's
personnel file how the program director demonstrates knowledge of these requirements.
The program director may also serve as the treatment director of the program, if qualified;
new text end

new text begin (2) a treatment director who qualifies as a mental health professional. The treatment
director must be responsible for overseeing treatment services for clients and the treatment
supervision of all staff persons; and
new text end

new text begin (3) a registered nurse who qualifies as a mental health practitioner. The registered nurse
must:
new text end

new text begin (i) work at the program location a minimum of eight hours per week;
new text end

new text begin (ii) provide monitoring and supervision of staff persons as defined in section 148.171,
subdivisions 8a and 23;
new text end

new text begin (iii) be responsible for the review and approval of health service and medication policies
and procedures under section 245I.03, subdivision 5; and
new text end

new text begin (iv) oversee the license holder's provision of health services to clients, medication storage,
and medication administration to clients.
new text end

new text begin (b) Within five business days of a change in a key staff position, the license holder must
notify the commissioner of the staffing change. The license holder must notify the
commissioner of the staffing change on a form approved by the commissioner and include
the name of the staff person now assigned to the key staff position and the staff person's
qualifications.
new text end

new text begin Subd. 10.new text end

new text beginMinimum treatment team staffing levels and ratios.new text end

new text begin(a) The license holder
must maintain a treatment team staffing level sufficient to:
new text end

new text begin (1) provide continuous daily coverage of all shifts;
new text end

new text begin (2) follow each client's treatment plan and meet each client's needs as identified in the
client's treatment plan;
new text end

new text begin (3) implement program requirements; and
new text end

new text begin (4) safely monitor and guide the activities of each client, taking into account the client's
level of behavioral and psychiatric stability, cultural needs, and vulnerabilities.
new text end

new text begin (b) The license holder must ensure that treatment team members:
new text end

new text begin (1) remain awake during all work hours; and
new text end

new text begin (2) are available to monitor and guide the activities of each client whenever clients are
present in the program.
new text end

new text begin (c) On each shift, the license holder must maintain a treatment team staffing ratio of at
least one treatment team member to nine clients. If the license holder is serving nine or
fewer clients, at least one treatment team member on the day shift must be a mental health
professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner.
If the license holder is serving more than nine clients, at least one of the treatment team
members working during both the day and evening shifts must be a mental health
professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner.
new text end

new text begin (d) If the license holder provides residential crisis stabilization to clients and is serving
at least one client in residential crisis stabilization and more than four clients in residential
crisis stabilization and intensive residential treatment services, the license holder must
maintain a treatment team staffing ratio on each shift of at least two treatment team members
during the client's first 48 hours in residential crisis stabilization.
new text end

new text begin Subd. 11.new text end

new text beginShift exchange.new text end

new text beginA license holder must ensure that treatment team members
working on different shifts exchange information about a client as necessary to effectively
care for the client and to follow and update a client's treatment plan and individual abuse
prevention plan.
new text end

new text begin Subd. 12.new text end

new text beginDaily documentation.new text end

new text begin(a) For each day that a client is present in the program,
the license holder must provide a daily summary in the client's file that includes observations
about the client's behavior and symptoms, including any critical incidents in which the client
was involved.
new text end

new text begin (b) For each day that a client is not present in the program, the license holder must
document the reason for a client's absence in the client's file.
new text end

new text begin Subd. 13.new text end

new text beginAccess to a mental health professional, clinical trainee, certified
rehabilitation specialist, or mental health practitioner.
new text end

new text beginTreatment team members must
have access in person or by telephone to a mental health professional, clinical trainee,
certified rehabilitation specialist, or mental health practitioner within 30 minutes. The license
holder must maintain a schedule of mental health professionals, clinical trainees, certified
rehabilitation specialists, or mental health practitioners who will be available and contact
information to reach them. The license holder must keep the schedule current and make the
schedule readily available to treatment team members.
new text end

new text begin Subd. 14.new text end

new text beginWeekly team meetings.new text end

new text begin(a) The license holder must hold weekly team meetings
and ancillary meetings according to this subdivision.
new text end

new text begin (b) A mental health professional or certified rehabilitation specialist must hold at least
one team meeting each calendar week and be physically present at the team meeting. All
treatment team members, including treatment team members who work on a part-time or
intermittent basis, must participate in a minimum of one team meeting during each calendar
week when the treatment team member is working for the license holder. The license holder
must document all weekly team meetings, including the names of meeting attendees.
new text end

new text begin (c) If a treatment team member cannot participate in a weekly team meeting, the treatment
team member must participate in an ancillary meeting. A mental health professional, certified
rehabilitation specialist, clinical trainee, or mental health practitioner who participated in
the most recent weekly team meeting may lead the ancillary meeting. During the ancillary
meeting, the treatment team member leading the ancillary meeting must review the
information that was shared at the most recent weekly team meeting, including revisions
to client treatment plans and other information that the treatment supervisors exchanged
with treatment team members. The license holder must document all ancillary meetings,
including the names of meeting attendees.
new text end

new text begin Subd. 15.new text end

new text beginIntensive residential treatment services admission criteria.new text end

new text begin(a) An eligible
client for intensive residential treatment services is an individual who:
new text end

new text begin (1) is age 18 or older;
new text end

new text begin (2) is diagnosed with a mental illness;
new text end

new text begin (3) because of a mental illness, has a substantial disability and functional impairment
in three or more areas listed in section 245I.10, subdivision 9, clause (4), that markedly
reduce the individual's self-sufficiency;
new text end

new text begin (4) has one or more of the following: a history of recurring or prolonged inpatient
hospitalizations during the past year, significant independent living instability, homelessness,
or very frequent use of mental health and related services with poor outcomes for the
individual; and
new text end

new text begin (5) in the written opinion of a mental health professional, needs mental health services
that available community-based services cannot provide, or is likely to experience a mental
health crisis or require a more restrictive setting if the individual does not receive intensive
rehabilitative mental health services.
new text end

new text begin (b) The license holder must not limit or restrict intensive residential treatment services
to a client based solely on:
new text end

new text begin (1) the client's substance use;
new text end

new text begin (2) the county in which the client resides; or
new text end

new text begin (3) whether the client elects to receive other services for which the client may be eligible,
including case management services.
new text end

new text begin (c) This subdivision does not prohibit the license holder from restricting admissions of
individuals who present an imminent risk of harm or danger to themselves or others.
new text end

new text begin Subd. 16.new text end

new text beginResidential crisis stabilization services admission criteria.new text end

new text beginAn eligible client
for residential crisis stabilization is an individual who is age 18 or older and meets the
eligibility criteria in section 256B.0624, subdivision 3.
new text end

new text begin Subd. 17.new text end

new text beginAdmissions referrals and determinations.new text end

new text begin(a) The license holder must
identify the information that the license holder needs to make a determination about a
person's admission referral.
new text end

new text begin (b) The license holder must:
new text end

new text begin (1) always be available to receive referral information about a person seeking admission
to the license holder's program;
new text end

new text begin (2) respond to the referral source within eight hours of receiving a referral and, within
eight hours, communicate with the referral source about what information the license holder
needs to make a determination concerning the person's admission;
new text end

new text begin (3) consider the license holder's staffing ratio and the areas of treatment team members'
competency when determining whether the license holder is able to meet the needs of a
person seeking admission; and
new text end

new text begin (4) determine whether to admit a person within 72 hours of receiving all necessary
information from the referral source.
new text end

new text begin Subd. 18.new text end

new text beginDischarge standards.new text end

new text begin(a) When a license holder discharges a client from a
program, the license holder must categorize the discharge as a successful discharge,
program-initiated discharge, or non-program-initiated discharge according to the criteria in
this subdivision. The license holder must meet the standards associated with the type of
discharge according to this subdivision.
new text end

new text begin (b) To successfully discharge a client from a program, the license holder must ensure
that the following criteria are met:
new text end

new text begin (1) the client must substantially meet the client's documented treatment plan goals and
objectives;
new text end

new text begin (2) the client must complete discharge planning with the treatment team; and
new text end

new text begin (3) the client and treatment team must arrange for the client to receive continuing care
at a less intensive level of care after discharge.
new text end

new text begin (c) Prior to successfully discharging a client from a program, the license holder must
complete the client's discharge summary and provide the client with a copy of the client's
discharge summary in plain language that includes:
new text end

new text begin (1) a brief review of the client's problems and strengths during the period that the license
holder provided services to the client;
new text end

new text begin (2) the client's response to the client's treatment plan;
new text end

new text begin (3) the goals and objectives that the license holder recommends that the client addresses
during the first three months following the client's discharge from the program;
new text end

new text begin (4) the recommended actions, supports, and services that will assist the client with a
successful transition from the program to another setting;
new text end

new text begin (5) the client's crisis plan; and
new text end

new text begin (6) the client's forwarding address and telephone number.
new text end

new text begin (d) For a non-program-initiated discharge of a client from a program, the following
criteria must be met:
new text end

new text begin (1)(i) the client has withdrawn the client's consent for treatment; (ii) the license holder
has determined that the client has the capacity to make an informed decision; and (iii) the
client does not meet the criteria for an emergency hold under section 253B.051, subdivision
2;
new text end

new text begin (2) the client has left the program against staff person advice;
new text end

new text begin (3) an entity with legal authority to remove the client has decided to remove the client
from the program; or
new text end

new text begin (4) a source of payment for the services is no longer available.
new text end

new text begin (e) Within ten days of a non-program-initiated discharge of a client from a program, the
license holder must complete the client's discharge summary in plain language that includes:
new text end

new text begin (1) the reasons for the client's discharge;
new text end

new text begin (2) a description of attempts by staff persons to enable the client to continue treatment
or to consent to treatment; and
new text end

new text begin (3) recommended actions, supports, and services that will assist the client with a
successful transition from the program to another setting.
new text end

new text begin (f) For a program-initiated discharge of a client from a program, the following criteria
must be met:
new text end

new text begin (1) the client is competent but has not participated in treatment or has not followed the
program rules and regulations and the client has not participated to such a degree that the
program's level of care is ineffective or unsafe for the client, despite multiple, documented
attempts that the license holder has made to address the client's lack of participation in
treatment;
new text end

new text begin (2) the client has not made progress toward the client's treatment goals and objectives
despite the license holder's persistent efforts to engage the client in treatment, and the license
holder has no reasonable expectation that the client will make progress at the program's
level of care nor does the client require the program's level of care to maintain the current
level of functioning;
new text end

new text begin (3) a court order or the client's legal status requires the client to participate in the program
but the client has left the program against staff person advice; or
new text end

new text begin (4) the client meets criteria for a more intensive level of care and a more intensive level
of care is available to the client.
new text end

new text begin (g) Prior to a program-initiated discharge of a client from a program, the license holder
must consult the client, the client's family and other natural supports, and the client's case
manager, if applicable, to review the issues involved in the program's decision to discharge
the client from the program. During the discharge review process, which must not exceed
five working days, the license holder must determine whether the license holder, treatment
team, and any interested persons can develop additional strategies to resolve the issues
leading to the client's discharge and to permit the client to have an opportunity to continue
receiving services from the license holder. The license holder may temporarily remove a
client from the program facility during the five-day discharge review period. The license
holder must document the client's discharge review in the client's file.
new text end

new text begin (h) Prior to a program-initiated discharge of a client from the program, the license holder
must complete the client's discharge summary and provide the client with a copy of the
discharge summary in plain language that includes:
new text end

new text begin (1) the reasons for the client's discharge;
new text end

new text begin (2) the alternatives to discharge that the license holder considered or attempted to
implement;
new text end

new text begin (3) the names of each individual who is involved in the decision to discharge the client
and a description of each individual's involvement; and
new text end

new text begin (4) recommended actions, supports, and services that will assist the client with a
successful transition from the program to another setting.
new text end

new text begin Subd. 19.new text end

new text beginProgram facility.new text end

new text begin(a) The license holder must be licensed or certified as a
board and lodging facility, supervised living facility, or a boarding care home by the
Department of Health.
new text end

new text begin (b) The license holder must have a capacity of five to 16 beds and the program must not
be declared as an institution for mental disease.
new text end

new text begin (c) The license holder must furnish each program location to meet the psychological,
emotional, and developmental needs of clients.
new text end

new text begin (d) The license holder must provide one living room or lounge area per program location.
There must be space available to provide services according to each client's treatment plan,
such as an area for learning recreation time skills and areas for learning independent living
skills, such as laundering clothes and preparing meals.
new text end

new text begin (e) The license holder must ensure that each program location allows each client to have
privacy. Each client must have privacy during assessment interviews and counseling sessions.
Each client must have a space designated for the client to see outside visitors at the program
facility.
new text end

new text begin Subd. 20.new text end

new text beginPhysical separation of services.new text end

new text beginIf the license holder offers services to
individuals who are not receiving intensive residential treatment services or residential
stabilization at the program location, the license holder must inform the commissioner and
submit a plan for approval to the commissioner about how and when the license holder will
provide services. The license holder must only provide services to clients who are not
receiving intensive residential treatment services or residential crisis stabilization in an area
that is physically separated from the area in which the license holder provides clients with
intensive residential treatment services or residential crisis stabilization.
new text end

new text begin Subd. 21.new text end

new text beginDividing staff time between locations.new text end

new text beginA license holder must obtain approval
from the commissioner prior to providing intensive residential treatment services or
residential crisis stabilization to clients in more than one program location under one license
and dividing one staff person's time between program locations during the same work period.
new text end

new text begin Subd. 22.new text end

new text beginAdditional policy and procedure requirements.new text end

new text begin(a) In addition to the policies
and procedures in section 245I.03, the license holder must establish, enforce, and maintain
the policies and procedures in this subdivision.
new text end

new text begin (b) The license holder must have policies and procedures for receiving referrals and
making admissions determinations about referred persons under subdivisions 14 to 16.
new text end

new text begin (c) The license holder must have policies and procedures for discharging clients under
subdivision 17. In the policies and procedures, the license holder must identify the staff
persons who are authorized to discharge clients from the program.
new text end

new text begin Subd. 23.new text end

new text beginQuality assurance and improvement plan.new text end

new text begin(a) A license holder must develop
a written quality assurance and improvement plan that includes a plan to:
new text end

new text begin (1) encourage ongoing consultation between members of the treatment team;
new text end

new text begin (2) obtain and evaluate feedback about services from clients, family and other natural
supports, referral sources, and staff persons;
new text end

new text begin (3) measure and evaluate client outcomes in the program;
new text end

new text begin (4) review critical incidents in the program;
new text end

new text begin (5) examine the quality of clinical services in the program; and
new text end

new text begin (6) self-monitor the license holder's compliance with this chapter.
new text end

new text begin (b) At least annually, the license holder must review, evaluate, and update the license
holder's quality assurance and improvement plan. The license holder's review must:
new text end

new text begin (1) document the actions that the license holder will take in response to the information
that the license holder obtains from the monitoring activities in the plan; and
new text end

new text begin (2) establish goals for improving the license holder's services to clients during the next
year.
new text end

new text begin Subd. 24.new text end

new text beginApplication.new text end

new text beginWhen an applicant requests licensure to provide intensive
residential treatment services, residential crisis stabilization, or both to clients, the applicant
must submit, on forms that the commissioner provides, any documents that the commissioner
requires.
new text end

Sec. 17.

new text begin[256B.0671] COVERED MENTAL HEALTH SERVICES.
new text end

new text begin Subdivision 1.new text end

new text beginDefinitions.new text end

new text begin(a) "Clinical trainee" means a staff person who is qualified
under section 245I.04, subdivision 6.
new text end

new text begin (b) "Mental health practitioner" means a staff person who is qualified under section
245I.04, subdivision 4.
new text end

new text begin (c) "Mental health professional" means a staff person who is qualified under section
245I.04, subdivision 2.
new text end

new text begin Subd. 2.new text end

new text beginGenerally.new text end

new text begin(a) An individual, organization, or government entity providing
mental health services to a client under this section must obtain a criminal background study
of each staff person or volunteer who is providing direct contact services to a client.
new text end

new text begin (b) An individual, organization, or government entity providing mental health services
to a client under this section must comply with all responsibilities that chapter 245I assigns
to a license holder, except section 245I.011, subdivision 1, unless all of the individual's,
organization's, or government entity's treatment staff are qualified as mental health
professionals.
new text end

new text begin (c) An individual, organization, or government entity providing mental health services
to a client under this section must comply with the following requirements if all of the
license holder's treatment staff are qualified as mental health professionals:
new text end

new text begin (1) provider qualifications and scopes of practice under section 245I.04;
new text end

new text begin (2) maintaining and updating personnel files under section 245I.07;
new text end

new text begin (3) documenting under section 245I.08;
new text end

new text begin (4) maintaining and updating client files under section 245I.09;
new text end

new text begin (5) completing client assessments and treatment planning under section 245I.10;
new text end

new text begin (6) providing clients with health services and medications under section 245I.11; and
new text end

new text begin (7) respecting and enforcing client rights under section 245I.12.
new text end

new text begin Subd. 3.new text end

new text beginAdult day treatment services.new text end

new text begin(a) Subject to federal approval, medical
assistance covers adult day treatment (ADT) services that are provided under contract with
the county board. Adult day treatment payment is subject to the conditions in paragraphs
(b) to (e). The provider must make reasonable and good faith efforts to report individual
client outcomes to the commissioner using instruments, protocols, and forms approved by
the commissioner.
new text end

new text begin (b) Adult day treatment is an intensive psychotherapeutic treatment to reduce or relieve
the effects of mental illness on a client to enable the client to benefit from a lower level of
care and to live and function more independently in the community. Adult day treatment
services must be provided to a client to stabilize the client's mental health and to improve
the client's independent living and socialization skills. Adult day treatment must consist of
at least one hour of group psychotherapy and must include group time focused on
rehabilitative interventions or other therapeutic services that a multidisciplinary team provides
to each client. Adult day treatment services are not a part of inpatient or residential treatment
services. The following providers may apply to become adult day treatment providers:
new text end

new text begin (1) a hospital accredited by the Joint Commission on Accreditation of Health
Organizations and licensed under sections 144.50 to 144.55;
new text end

new text begin (2) a community mental health center under section 256B.0625, subdivision 5; or
new text end

new text begin (3) an entity that is under contract with the county board to operate a program that meets
the requirements of section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170
to 9505.0475.
new text end

new text begin (c) An adult day treatment (ADT) services provider must:
new text end

new text begin (1) ensure that the commissioner has approved of the organization as an adult day
treatment provider organization;
new text end

new text begin (2) ensure that a multidisciplinary team provides ADT services to a group of clients. A
mental health professional must supervise each multidisciplinary staff person who provides
ADT services;
new text end

new text begin (3) make ADT services available to the client at least two days a week for at least three
consecutive hours per day. ADT services may be longer than three hours per day, but medical
assistance may not reimburse a provider for more than 15 hours per week;
new text end

new text begin (4) provide ADT services to each client that includes group psychotherapy by a mental
health professional or clinical trainee and daily rehabilitative interventions by a mental
health professional, clinical trainee, or mental health practitioner; and
new text end

new text begin (5) include ADT services in the client's individual treatment plan, when appropriate.
The adult day treatment provider must:
new text end

new text begin (i) complete a functional assessment of each client under section 245I.10, subdivision
9;
new text end

new text begin (ii) notwithstanding section 245I.10, subdivision 8, review the client's progress and
update the individual treatment plan at least every 90 days until the client is discharged
from the program; and
new text end

new text begin (iii) include a discharge plan for the client in the client's individual treatment plan.
new text end

new text begin (d) To be eligible for adult day treatment, a client must:
new text end

new text begin (1) be 18 years of age or older;
new text end

new text begin (2) not reside in a nursing facility, hospital, institute of mental disease, or state-operated
treatment center unless the client has an active discharge plan that indicates a move to an
independent living setting within 180 days;
new text end

new text begin (3) have the capacity to engage in rehabilitative programming, skills activities, and
psychotherapy in the structured, therapeutic setting of an adult day treatment program and
demonstrate measurable improvements in functioning resulting from participation in the
adult day treatment program;
new text end

new text begin (4) have a level of care assessment under section 245I.02, subdivision 19, recommending
that the client participate in services with the level of intensity and duration of an adult day
treatment program; and
new text end

new text begin (5) have the recommendation of a mental health professional for adult day treatment
services. The mental health professional must find that adult day treatment services are
medically necessary for the client.
new text end

new text begin (e) Medical assistance does not cover the following services as adult day treatment
services:
new text end

new text begin (1) services that are primarily recreational or that are provided in a setting that is not
under medical supervision, including sports activities, exercise groups, craft hours, leisure
time, social hours, meal or snack time, trips to community activities, and tours;
new text end

new text begin (2) social or educational services that do not have or cannot reasonably be expected to
have a therapeutic outcome related to the client's mental illness;
new text end

new text begin (3) consultations with other providers or service agency staff persons about the care or
progress of a client;
new text end

new text begin (4) prevention or education programs that are provided to the community;
new text end

new text begin (5) day treatment for clients with a primary diagnosis of a substance use disorder;
new text end

new text begin (6) day treatment provided in the client's home;
new text end

new text begin (7) psychotherapy for more than two hours per day; and
new text end

new text begin (8) participation in meal preparation and eating that is not part of a clinical treatment
plan to address the client's eating disorder.
new text end

new text begin Subd. 4.new text end

new text beginExplanation of findings.new text end

new text begin(a) Subject to federal approval, medical assistance
covers an explanation of findings that a mental health professional or clinical trainee provides
when the provider has obtained the authorization from the client or the client's representative
to release the information.
new text end

new text begin (b) A mental health professional or clinical trainee provides an explanation of findings
to assist the client or related parties in understanding the results of the client's testing or
diagnostic assessment and the client's mental illness, and provides professional insight that
the client or related parties need to carry out a client's treatment plan. Related parties may
include the client's family and other natural supports and other service providers working
with the client.
new text end

new text begin (c) An explanation of findings is not paid for separately when a mental health professional
or clinical trainee explains the results of psychological testing or a diagnostic assessment
to the client or the client's representative as part of the client's psychological testing or a
diagnostic assessment.
new text end

new text begin Subd. 5.new text end

new text beginFamily psychoeducation services.new text end

new text begin(a) Subject to federal approval, medical
assistance covers family psychoeducation services provided to a child up to age 21 with a
diagnosed mental health condition when identified in the child's individual treatment plan
and provided by a mental health professional or a clinical trainee who has determined it
medically necessary to involve family members in the child's care.
new text end

new text begin (b) "Family psychoeducation services" means information or demonstration provided
to an individual or family as part of an individual, family, multifamily group, or peer group
session to explain, educate, and support the child and family in understanding a child's
symptoms of mental illness, the impact on the child's development, and needed components
of treatment and skill development so that the individual, family, or group can help the child
to prevent relapse, prevent the acquisition of comorbid disorders, and achieve optimal mental
health and long-term resilience.
new text end

new text begin Subd. 6.new text end

new text beginDialectical behavior therapy.new text end

new text begin(a) Subject to federal approval, medical assistance
covers intensive mental health outpatient treatment for dialectical behavior therapy for
adults. A dialectical behavior therapy provider must make reasonable and good faith efforts
to report individual client outcomes to the commissioner using instruments and protocols
that are approved by the commissioner.
new text end

new text begin (b) "Dialectical behavior therapy" means an evidence-based treatment approach that a
mental health professional or clinical trainee provides to a client or a group of clients in an
intensive outpatient treatment program using a combination of individualized rehabilitative
and psychotherapeutic interventions. A dialectical behavior therapy program involves:
individual dialectical behavior therapy, group skills training, telephone coaching, and team
consultation meetings.
new text end

new text begin (c) To be eligible for dialectical behavior therapy, a client must:
new text end

new text begin (1) be 18 years of age or older;
new text end

new text begin (2) have mental health needs that available community-based services cannot meet or
that the client must receive concurrently with other community-based services;
new text end

new text begin (3) have either:
new text end

new text begin (i) a diagnosis of borderline personality disorder; or
new text end

new text begin (ii) multiple mental health diagnoses, exhibit behaviors characterized by impulsivity or
intentional self-harm, and be at significant risk of death, morbidity, disability, or severe
dysfunction in multiple areas of the client's life;
new text end

new text begin (4) be cognitively capable of participating in dialectical behavior therapy as an intensive
therapy program and be able and willing to follow program policies and rules to ensure the
safety of the client and others; and
new text end

new text begin (5) be at significant risk of one or more of the following if the client does not receive
dialectical behavior therapy:
new text end

new text begin (i) having a mental health crisis;
new text end

new text begin (ii) requiring a more restrictive setting such as hospitalization;
new text end

new text begin (iii) decompensating; or
new text end

new text begin (iv) engaging in intentional self-harm behavior.
new text end

new text begin (d) Individual dialectical behavior therapy combines individualized rehabilitative and
psychotherapeutic interventions to treat a client's suicidal and other dysfunctional behaviors
and to reinforce a client's use of adaptive skillful behaviors. A mental health professional
or clinical trainee must provide individual dialectical behavior therapy to a client. A mental
health professional or clinical trainee providing dialectical behavior therapy to a client must:
new text end

new text begin (1) identify, prioritize, and sequence the client's behavioral targets;
new text end

new text begin (2) treat the client's behavioral targets;
new text end

new text begin (3) assist the client in applying dialectical behavior therapy skills to the client's natural
environment through telephone coaching outside of treatment sessions;
new text end

new text begin (4) measure the client's progress toward dialectical behavior therapy targets;
new text end

new text begin (5) help the client manage mental health crises and life-threatening behaviors; and
new text end

new text begin (6) help the client learn and apply effective behaviors when working with other treatment
providers.
new text end

new text begin (e) Group skills training combines individualized psychotherapeutic and psychiatric
rehabilitative interventions conducted in a group setting to reduce the client's suicidal and
other dysfunctional coping behaviors and restore function. Group skills training must teach
the client adaptive skills in the following areas: (1) mindfulness; (2) interpersonal
effectiveness; (3) emotional regulation; and (4) distress tolerance.
new text end

new text begin (f) Group skills training must be provided by two mental health professionals or by a
mental health professional co-facilitating with a clinical trainee or a mental health practitioner.
Individual skills training must be provided by a mental health professional, a clinical trainee,
or a mental health practitioner.
new text end

new text begin (g) Before a program provides dialectical behavior therapy to a client, the commissioner
must certify the program as a dialectical behavior therapy provider. To qualify for
certification as a dialectical behavior therapy provider, a provider must:
new text end

new text begin (1) allow the commissioner to inspect the provider's program;
new text end

new text begin (2) provide evidence to the commissioner that the program's policies, procedures, and
practices meet the requirements of this subdivision and chapter 245I;
new text end

new text begin (3) be enrolled as a MHCP provider; and
new text end

new text begin (4) have a manual that outlines the program's policies, procedures, and practices that
meet the requirements of this subdivision.
new text end

new text begin Subd. 7.new text end

new text beginMental health clinical care consultation.new text end

new text begin(a) Subject to federal approval,
medical assistance covers clinical care consultation for a person up to age 21 who is
diagnosed with a complex mental health condition or a mental health condition that co-occurs
with other complex and chronic conditions, when described in the person's individual
treatment plan and provided by a mental health professional or a clinical trainee.
new text end

new text begin (b) "Clinical care consultation" means communication from a treating mental health
professional to other providers or educators not under the treatment supervision of the
treating mental health professional who are working with the same client to inform, inquire,
and instruct regarding the client's symptoms; strategies for effective engagement, care, and
intervention needs; and treatment expectations across service settings and to direct and
coordinate clinical service components provided to the client and family.
new text end

new text begin Subd. 8.new text end

new text beginNeuropsychological assessment.new text end

new text begin(a) Subject to federal approval, medical
assistance covers a client's neuropsychological assessment.
new text end

new text begin (b) Neuropsychological assessment" means a specialized clinical assessment of the
client's underlying cognitive abilities related to thinking, reasoning, and judgment that is
conducted by a qualified neuropsychologist. A neuropsychological assessment must include
a face-to-face interview with the client, interpretation of the test results, and preparation
and completion of a report.
new text end

new text begin (c) A client is eligible for a neuropsychological assessment if the client meets at least
one of the following criteria:
new text end

new text begin (1) the client has a known or strongly suspected brain disorder based on the client's
medical history or the client's prior neurological evaluation, including a history of significant
head trauma, brain tumor, stroke, seizure disorder, multiple sclerosis, neurodegenerative
disorder, significant exposure to neurotoxins, central nervous system infection, metabolic
or toxic encephalopathy, fetal alcohol syndrome, or congenital malformation of the brain;
or
new text end

new text begin (2) the client has cognitive or behavioral symptoms that suggest that the client has an
organic condition that cannot be readily attributed to functional psychopathology or suspected
neuropsychological impairment in addition to functional psychopathology. The client's
symptoms may include:
new text end

new text begin (i) having a poor memory or impaired problem solving;
new text end

new text begin (ii) experiencing change in mental status evidenced by lethargy, confusion, or
disorientation;
new text end

new text begin (iii) experiencing a deteriorating level of functioning;
new text end

new text begin (iv) displaying a marked change in behavior or personality;
new text end

new text begin (v) in a child or an adolescent, having significant delays in acquiring academic skill or
poor attention relative to peers;
new text end

new text begin (vi) in a child or an adolescent, having reached a significant plateau in expected
development of cognitive, social, emotional, or physical functioning relative to peers; and
new text end

new text begin (vii) in a child or an adolescent, significant inability to develop expected knowledge,
skills, or abilities to adapt to new or changing cognitive, social, emotional, or physical
demands.
new text end

new text begin (d) The neuropsychological assessment must be completed by a neuropsychologist who:
new text end

new text begin (1) was awarded a diploma by the American Board of Clinical Neuropsychology, the
American Board of Professional Neuropsychology, or the American Board of Pediatric
Neuropsychology;
new text end

new text begin (2) earned a doctoral degree in psychology from an accredited university training program
and:
new text end

new text begin (i) completed an internship or its equivalent in a clinically relevant area of professional
psychology;
new text end

new text begin (ii) completed the equivalent of two full-time years of experience and specialized training,
at least one of which is at the postdoctoral level, supervised by a clinical neuropsychologist
in the study and practice of clinical neuropsychology and related neurosciences; and
new text end

new text begin (iii) holds a current license to practice psychology independently according to sections
144.88 to 144.98;
new text end

new text begin (3) is licensed or credentialed by another state's board of psychology examiners in the
specialty of neuropsychology using requirements equivalent to requirements specified by
one of the boards named in clause (1); or
new text end

new text begin (4) was approved by the commissioner as an eligible provider of neuropsychological
assessments prior to December 31, 2010.
new text end

new text begin Subd. 9.new text end

new text beginNeuropsychological testing.new text end

new text begin(a) Subject to federal approval, medical assistance
covers neuropsychological testing for clients.
new text end

new text begin (b) "Neuropsychological testing" means administering standardized tests and measures
designed to evaluate the client's ability to attend to, process, interpret, comprehend,
communicate, learn, and recall information and use problem solving and judgment.
new text end

new text begin (c) Medical assistance covers neuropsychological testing of a client when the client:
new text end

new text begin (1) has a significant mental status change that is not a result of a metabolic disorder and
that has failed to respond to treatment;
new text end

new text begin (2) is a child or adolescent with a significant plateau in expected development of
cognitive, social, emotional, or physical function relative to peers;
new text end

new text begin (3) is a child or adolescent with a significant inability to develop expected knowledge,
skills, or abilities to adapt to new or changing cognitive, social, physical, or emotional
demands; or
new text end

new text begin (4) has a significant behavioral change, memory loss, or suspected neuropsychological
impairment in addition to functional psychopathology, or other organic brain injury or one
of the following:
new text end

new text begin (i) traumatic brain injury;
new text end

new text begin (ii) stroke;
new text end

new text begin (iii) brain tumor;
new text end

new text begin (iv) substance use disorder;
new text end

new text begin (v) cerebral anoxic or hypoxic episode;
new text end

new text begin (vi) central nervous system infection or other infectious disease;
new text end

new text begin (vii) neoplasms or vascular injury of the central nervous system;
new text end

new text begin (viii) neurodegenerative disorders;
new text end

new text begin (ix) demyelinating disease;
new text end

new text begin (x) extrapyramidal disease;
new text end

new text begin (xi) exposure to systemic or intrathecal agents or cranial radiation known to be associated
with cerebral dysfunction;
new text end

new text begin (xii) systemic medical conditions known to be associated with cerebral dysfunction,
including renal disease, hepatic encephalopathy, cardiac anomaly, sickle cell disease, and
related hematologic anomalies, and autoimmune disorders, including lupus, erythematosus,
or celiac disease;
new text end

new text begin (xiii) congenital genetic or metabolic disorders known to be associated with cerebral
dysfunction, including phenylketonuria, craniofacial syndromes, or congenital hydrocephalus;
new text end

new text begin (xiv) severe or prolonged nutrition or malabsorption syndromes; or
new text end

new text begin (xv) a condition presenting in a manner difficult for a clinician to distinguish between
the neurocognitive effects of a neurogenic syndrome, including dementia or encephalopathy;
and a major depressive disorder when adequate treatment for major depressive disorder has
not improved the client's neurocognitive functioning; or another disorder, including autism,
selective mutism, anxiety disorder, or reactive attachment disorder.
new text end

new text begin (d) Neuropsychological testing must be administered or clinically supervised by a
qualified neuropsychologist under subdivision 8, paragraph (c).
new text end

new text begin (e) Medical assistance does not cover neuropsychological testing of a client when the
testing is:
new text end

new text begin (1) primarily for educational purposes;
new text end

new text begin (2) primarily for vocational counseling or training;
new text end

new text begin (3) for personnel or employment testing;
new text end

new text begin (4) a routine battery of psychological tests given to the client at the client's inpatient
admission or during a client's continued inpatient stay; or
new text end

new text begin (5) for legal or forensic purposes.
new text end

new text begin Subd. 10.new text end

new text beginPsychological testing.new text end

new text begin(a) Subject to federal approval, medical assistance
covers psychological testing of a client.
new text end

new text begin (b) "Psychological testing" means the use of tests or other psychometric instruments to
determine the status of a client's mental, intellectual, and emotional functioning.
new text end

new text begin (c) The psychological testing must:
new text end

new text begin (1) be administered or supervised by a licensed psychologist qualified under section
245I.04, subdivision 2, clause (3), who is competent in the area of psychological testing;
and
new text end

new text begin (2) be validated in a face-to-face interview between the client and a licensed psychologist
or a clinical trainee in psychology under the treatment supervision of a licensed psychologist
under section 245I.06.
new text end

new text begin (d) A licensed psychologist must supervise the administration, scoring, and interpretation
of a client's psychological tests when a clinical psychology trainee, technician, psychometrist,
or psychological assistant or a computer-assisted psychological testing program completes
the psychological testing of the client. The report resulting from the psychological testing
must be signed by the licensed psychologist who conducts the face-to-face interview with
the client. The licensed psychologist or a staff person who is under treatment supervision
must place the client's psychological testing report in the client's record and release one
copy of the report to the client and additional copies to individuals authorized by the client
to receive the report.
new text end

new text begin Subd. 11.new text end

new text beginPsychotherapy.new text end

new text begin(a) Subject to federal approval, medical assistance covers
psychotherapy for a client.
new text end

new text begin (b) "Psychotherapy" means treatment of a client with mental illness that applies to the
most appropriate psychological, psychiatric, psychosocial, or interpersonal method that
conforms to prevailing community standards of professional practice to meet the mental
health needs of the client. Medical assistance covers psychotherapy if a mental health
professional or a clinical trainee provides psychotherapy to a client.
new text end

new text begin (c) "Individual psychotherapy" means psychotherapy that a mental health professional
or clinical trainee designs for a client.
new text end

new text begin (d) "Family psychotherapy" means psychotherapy that a mental health professional or
clinical trainee designs for a client and one or more of the client's family members or primary
caregiver whose participation is necessary to accomplish the client's treatment goals. Family
members or primary caregivers participating in a therapy session do not need to be eligible
for medical assistance for medical assistance to cover family psychotherapy. For purposes
of this paragraph, "primary caregiver whose participation is necessary to accomplish the
client's treatment goals" excludes shift or facility staff persons who work at the client's
residence. Medical assistance payments for family psychotherapy are limited to face-to-face
sessions during which the client is present throughout the session, unless the mental health
professional or clinical trainee believes that the client's exclusion from the family
psychotherapy session is necessary to meet the goals of the client's individual treatment
plan. If the client is excluded from a family psychotherapy session, a mental health
professional or clinical trainee must document the reason for the client's exclusion and the
length of time that the client is excluded. The mental health professional must also document
any reason that a member of the client's family is excluded from a psychotherapy session.
new text end

new text begin (e) Group psychotherapy is appropriate for a client who, because of the nature of the
client's emotional, behavioral, or social dysfunctions, can benefit from treatment in a group
setting. For a group of three to eight clients, at least one mental health professional or clinical
trainee must provide psychotherapy to the group. For a group of nine to 12 clients, a team
of at least two mental health professionals or two clinical trainees or one mental health
professional and one clinical trainee must provide psychotherapy to the group. Medical
assistance will cover group psychotherapy for a group of no more than 12 persons.
new text end

new text begin (f) A multiple-family group psychotherapy session is eligible for medical assistance if
a mental health professional or clinical trainee designs the psychotherapy session for at least
two but not more than five families. A mental health professional or clinical trainee must
design multiple-family group psychotherapy sessions to meet the treatment needs of each
client. If the client is excluded from a psychotherapy session, the mental health professional
or clinical trainee must document the reason for the client's exclusion and the length of time
that the client was excluded. The mental health professional or clinical trainee must document
any reason that a member of the client's family was excluded from a psychotherapy session.
new text end

new text begin Subd. 12.new text end

new text beginPartial hospitalization.new text end

new text begin(a) Subject to federal approval, medical assistance
covers a client's partial hospitalization.
new text end

new text begin (b) "Partial hospitalization" means a provider's time-limited, structured program of
psychotherapy and other therapeutic services, as defined in United States Code, title 42,
chapter 7, subchapter XVIII, part E, section 1395x(ff), that a multidisciplinary staff person
provides in an outpatient hospital facility or community mental health center that meets
Medicare requirements to provide partial hospitalization services to a client.
new text end

new text begin (c) Partial hospitalization is an appropriate alternative to inpatient hospitalization for a
client who is experiencing an acute episode of mental illness who meets the criteria for an
inpatient hospital admission under Minnesota Rules, part 9505.0520, subpart 1, and who
has family and community resources that support the client's residence in the community.
Partial hospitalization consists of multiple intensive short-term therapeutic services for a
client that a multidisciplinary staff person provides to a client to treat the client's mental
illness.
new text end

new text begin Subd. 13.new text end

new text beginDiagnostic assessments.new text end

new text beginSubject to federal approval, medical assistance covers
a client's diagnostic assessments that a mental health professional or clinical trainee completes
under section 245I.10.
new text end

Sec. 18. new text beginDIRECTION TO COMMISSIONER; SINGLE COMPREHENSIVE
LICENSE STRUCTURE.
new text end

new text begin The commissioner of human services, in consultation with stakeholders including
counties, tribes, managed care organizations, provider organizations, advocacy groups, and
clients and clients' families, shall develop recommendations to develop a single
comprehensive licensing structure for mental health service programs, including outpatient
and residential services for adults and children. The recommendations must prioritize
program integrity, the welfare of clients and clients' families, improved integration of mental
health and substance use disorder services, and the reduction of administrative burden on
providers.
new text end

Sec. 19. new text beginEFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2022, or upon federal approval, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

ARTICLE 16

CRISIS RESPONSE SERVICES

Section 1.

Minnesota Statutes 2020, section 245.469, subdivision 1, is amended to read:


Subdivision 1.

Availability of emergency services.

deleted text beginBy July 1, 1988,deleted text end new text begin(a)new text end County boards
must provide or contract for enough emergency services within the county to meet the needs
of adultsnew text begin, children, and familiesnew text end in the county who are experiencing an emotional crisis or
mental illness. deleted text beginClients may be required to pay a fee according to section deleted text enddeleted text begin.deleted text end new text beginEmergency
service providers must not delay the timely provision of emergency services to a client
because of the unwillingness or inability of the client to pay for services.
new text endEmergency services
must include assessment, crisis intervention, and appropriate case disposition. Emergency
services must:

(1) promote the safety and emotional stability of deleted text beginadults with mental illness or emotional
crises
deleted text endnew text begin each clientnew text end;

(2) minimize further deterioration of deleted text beginadults with mental illness or emotional crisesdeleted text endnew text begin each
client
new text end;

(3) help deleted text beginadults with mental illness or emotional crisesdeleted text endnew text begin each clientnew text end to obtain ongoing care
and treatment; deleted text beginand
deleted text end

(4) prevent placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet client needsdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) provide support, psychoeducation, and referrals to each client's family members,
service providers, and other third parties on behalf of the client in need of emergency
services.
new text end

new text begin (b) If a county provides engagement services under section 253B.041, the county's
emergency service providers must refer clients to engagement services when the client
meets the criteria for engagement services.
new text end

Sec. 2.

Minnesota Statutes 2020, section 245.469, subdivision 2, is amended to read:


Subd. 2.

Specific requirements.

(a) The county board shall require that all service
providers of emergency services to adults with mental illness provide immediate direct
access to a mental health professional during regular business hours. For evenings, weekends,
and holidays, the service may be by direct toll-free telephone access to a mental health
professional, deleted text beginadeleted text endnew text begin clinical trainee, ornew text end mental health practitionerdeleted text begin, or until January 1, 1991, a
designated person with training in human services who receives clinical supervision from
a mental health professional
deleted text end.

(b) The commissioner may waive the requirement in paragraph (a) that the evening,
weekend, and holiday service be provided by a mental health professionalnew text begin, clinical trainee,new text end
or mental health practitioner deleted text beginafter January 1, 1991,deleted text end if the county documents that:

(1) mental health professionalsnew text begin, clinical trainees,new text end or mental health practitioners are
unavailable to provide this service;

(2) services are provided by a designated person with training in human services who
receives deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision from a mental health professional; and

(3) the service provider is not also the provider of fire and public safety emergency
services.

(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the
evening, weekend, and holiday service not be provided by the provider of fire and public
safety emergency services if:

(1) every person who will be providing the first telephone contact has received at least
eight hours of training on emergency mental health services deleted text beginreviewed by the state advisory
council on mental health and then
deleted text end approved by the commissioner;

(2) every person who will be providing the first telephone contact will annually receive
at least four hours of continued training on emergency mental health services deleted text beginreviewed by
the state advisory council on mental health and then
deleted text end approved by the commissioner;

(3) the local social service agency has provided public education about available
emergency mental health services and can assure potential users of emergency services that
their calls will be handled appropriately;

(4) the local social service agency agrees to provide the commissioner with accurate
data on the number of emergency mental health service calls received;

(5) the local social service agency agrees to monitor the frequency and quality of
emergency services; and

(6) the local social service agency describes how it will comply with paragraph (d).

(d) Whenever emergency service during nonbusiness hours is provided by anyone other
than a mental health professional, a mental health professional must be available on call for
an emergency assessment and crisis intervention services, and must be available for at least
telephone consultation within 30 minutes.

Sec. 3.

Minnesota Statutes 2020, section 245.4879, subdivision 1, is amended to read:


Subdivision 1.

Availability of emergency services.

County boards must provide or
contract for deleted text beginenoughdeleted text end mental health emergency services deleted text beginwithin the county to meet the needs
of children, and children's families when clinically appropriate, in the county who are
experiencing an emotional crisis or emotional disturbance. The county board shall ensure
that parents, providers, and county residents are informed about when and how to access
emergency mental health services for children. A child or the child's parent may be required
to pay a fee according to section 245.481. Emergency service providers shall not delay the
timely provision of emergency service because of delays in determining this fee or because
of the unwillingness or inability of the parent to pay the fee. Emergency services must
include assessment, crisis intervention, and appropriate case disposition. Emergency services
must:
deleted text endnew text begin according to section 245.469.
new text end

deleted text begin (1) promote the safety and emotional stability of children with emotional disturbances
or emotional crises;
deleted text end

deleted text begin (2) minimize further deterioration of the child with emotional disturbance or emotional
crisis;
deleted text end

deleted text begin (3) help each child with an emotional disturbance or emotional crisis to obtain ongoing
care and treatment; and
deleted text end

deleted text begin (4) prevent placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet the child's needs.
deleted text end

Sec. 4.

Minnesota Statutes 2020, section 256B.0624, is amended to read:


256B.0624 deleted text beginADULTdeleted text end CRISIS RESPONSE SERVICES COVERED.

Subdivision 1.

Scope.

deleted text beginMedical assistance covers adult mental health crisis response
services as defined in subdivision 2, paragraphs (c) to (e),
deleted text end new text begin(a) new text endSubject to federal approval,
deleted text begin if provided to a recipient as defined in subdivision 3 and provided by a qualified provider
entity as defined in this section and by a qualified individual provider working within the
provider's scope of practice and as defined in this subdivision and identified in the recipient's
individual crisis treatment plan as defined in subdivision 11 and if determined to be medically
necessary
deleted text endnew text begin medical assistance covers medically necessary crisis response services when the
services are provided according to the standards in this section
new text end.

new text begin (b) Subject to federal approval, medical assistance covers medically necessary residential
crisis stabilization for adults when the services are provided by an entity licensed under and
meeting the standards in section 245I.23 or an entity with an adult foster care license meeting
the standards in this section.
new text end

new text begin (c) The provider entity must make reasonable and good faith efforts to report individual
client outcomes to the commissioner using instruments and protocols approved by the
commissioner.
new text end

Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

deleted text begin (a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation
which, but for the provision of crisis response services, would likely result in significantly
reduced levels of functioning in primary activities of daily living, or in an emergency
situation, or in the placement of the recipient in a more restrictive setting, including, but
not limited to, inpatient hospitalization.
deleted text end

deleted text begin (b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric situation
which causes an immediate need for mental health services and is consistent with section
62Q.55.
deleted text end

deleted text begin A mental health crisis or emergency is determined for medical assistance service
reimbursement by a physician, a mental health professional, or crisis mental health
practitioner with input from the recipient whenever possible.
deleted text end

new text begin (a) "Certified rehabilitation specialist" means a staff person who is qualified under section
245I.04, subdivision 8.
new text end

new text begin (b) "Clinical trainee" means a staff person who is qualified under section 245I.04,
subdivision 6.
new text end

(c) "deleted text beginMental healthdeleted text end Crisis assessment" means an immediate face-to-face assessment by
a physician, a mental health professional, or deleted text beginmental health practitioner under the clinical
supervision of a mental health professional, following a screening that suggests that the
adult may be experiencing a mental health crisis or mental health emergency situation. It
includes, when feasible, assessing whether the person might be willing to voluntarily accept
treatment, determining whether the person has an advance directive, and obtaining
information and history from involved family members or caretakers
deleted text endnew text begin a qualified member
of a crisis team, as described in subdivision 6a
new text end.

(d) "deleted text beginMental health mobiledeleted text end Crisis intervention deleted text beginservicesdeleted text end" means face-to-face, short-term
intensive mental health services initiated during a mental health crisis deleted text beginor mental health
emergency
deleted text end to help the recipient cope with immediate stressors, identify and utilize available
resources and strengths, engage in voluntary treatment, and begin to return to the recipient's
baseline level of functioning. deleted text beginThe services, including screening and treatment plan
recommendations, must be culturally and linguistically appropriate.
deleted text end

deleted text begin (1) This service is provided on site by a mobile crisis intervention team outside of an
inpatient hospital setting. Mental health mobile crisis intervention services must be available
24 hours a day, seven days a week.
deleted text end

deleted text begin (2) The initial screening must consider other available services to determine which
service intervention would best address the recipient's needs and circumstances.
deleted text end

deleted text begin (3) The mobile crisis intervention team must be available to meet promptly face-to-face
with a person in mental health crisis or emergency in a community setting or hospital
emergency room.
deleted text end

deleted text begin (4) The intervention must consist of a mental health crisis assessment and a crisis
treatment plan.
deleted text end

deleted text begin (5) The team must be available to individuals who are experiencing a co-occurring
substance use disorder, who do not need the level of care provided in a detoxification facility.
deleted text end

deleted text begin (6) The treatment plan must include recommendations for any needed crisis stabilization
services for the recipient, including engagement in treatment planning and family
psychoeducation.
deleted text end

new text begin (e) "Crisis screening" means a screening of a client's potential mental health crisis
situation under subdivision 6.
new text end

deleted text begin (e)deleted text endnew text begin (f)new text end "deleted text beginMental healthdeleted text end Crisis stabilization deleted text beginservicesdeleted text end" means individualized mental health
services provided to a recipient deleted text beginfollowing crisis intervention servicesdeleted text end which are designed
to restore the recipient to the recipient's prior functional level. deleted text beginMental healthdeleted text end Crisis
stabilization services may be provided in the recipient's home, the home of a family member
or friend of the recipient, another community setting, deleted text beginordeleted text end a short-term supervised, licensed
residential programnew text begin, or an emergency departmentnew text end. deleted text beginMental health crisis stabilization does
not include partial hospitalization or day treatment. Mental health
deleted text end Crisis stabilization services
includes family psychoeducation.

new text begin (g) "Crisis team" means the staff of a provider entity who are supervised and prepared
to provide mobile crisis services to a client in a potential mental health crisis situation.
new text end

new text begin (h) "Mental health certified family peer specialist" means a staff person who is qualified
under section 245I.04, subdivision 12.
new text end

new text begin (i) "Mental health certified peer specialist" means a staff person who is qualified under
section 245I.04, subdivision 10.
new text end

new text begin (j) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without
the provision of crisis response services, would likely result in significantly reducing the
recipient's levels of functioning in primary activities of daily living, in an emergency situation
under section 62Q.55, or in the placement of the recipient in a more restrictive setting,
including but not limited to inpatient hospitalization.
new text end

new text begin (k) "Mental health practitioner" means a staff person who is qualified under section
245I.04, subdivision 4.
new text end

new text begin (l) "Mental health professional" means a staff person who is qualified under section
245I.04, subdivision 2.
new text end

new text begin (m) "Mental health rehabilitation worker" means a staff person who is qualified under
section 245I.04, subdivision 14.
new text end

new text begin (n) "Mobile crisis services" means screening, assessment, intervention, and
community-based stabilization, excluding residential crisis stabilization, that is provided to
a recipient.
new text end

Subd. 3.

Eligibility.

deleted text beginAn eligible recipient is an individual who:
deleted text end

deleted text begin (1) is age 18 or older;
deleted text end

deleted text begin (2) is screened as possibly experiencing a mental health crisis or emergency where a
mental health crisis assessment is needed; and
deleted text end

deleted text begin (3) is assessed as experiencing a mental health crisis or emergency, and mental health
crisis intervention or crisis intervention and stabilization services are determined to be
medically necessary.
deleted text end

new text begin (a) A recipient is eligible for crisis assessment services when the recipient has screened
positive for a potential mental health crisis during a crisis screening.
new text end

new text begin (b) A recipient is eligible for crisis intervention services and crisis stabilization services
when the recipient has been assessed during a crisis assessment to be experiencing a mental
health crisis.
new text end

Subd. 4.

Provider entity standards.

(a) A deleted text beginprovider entity is an entity that meets the
standards listed in paragraph (c) and
deleted text endnew text begin mobile crisis provider must benew text end:

(1) deleted text beginisdeleted text end a county board operated entity; deleted text beginor
deleted text end

new text begin (2) an Indian health services facility or facility owned and operated by a tribe or Tribal
organization operating under United States Code, title 325, section 450f; or
new text end

deleted text begin (2) isdeleted text endnew text begin (3)new text end a provider entity that is under contract with the county board in the county
where the potential crisis or emergency is occurring. To provide services under this section,
the provider entity must directly provide the services; or if services are subcontracted, the
provider entity must maintain responsibility for services and billing.

new text begin (b) A mobile crisis provider must meet the following standards:
new text end

new text begin (1) ensure that crisis screenings, crisis assessments, and crisis intervention services are
available to a recipient 24 hours a day, seven days a week;
new text end

new text begin (2) be able to respond to a call for services in a designated service area or according to
a written agreement with the local mental health authority for an adjacent area;
new text end

new text begin (3) have at least one mental health professional on staff at all times and at least one
additional staff member capable of leading a crisis response in the community; and
new text end

new text begin (4) provide the commissioner with information about the number of requests for service,
the number of people that the provider serves face-to-face, outcomes, and the protocols that
the provider uses when deciding when to respond in the community.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end A provider entity that provides crisis stabilization services in a residential setting
under subdivision 7 is not required to meet the requirements of deleted text beginparagraphdeleted text endnew text begin paragraphsnew text end (a)deleted text begin,
clauses (1) and (2)
deleted text endnew text begin and (b)new text end, but must meet all other requirements of this subdivision.

deleted text begin (c) The adult mental healthdeleted text endnew text begin (d) Anew text end crisis deleted text beginresponsedeleted text end services provider deleted text beginentitydeleted text end must have the
capacity to meet and carry out the new text beginstandards in section 245I.011, subdivision 5, and the
new text end following standards:

(1) deleted text beginhas the capacity to recruit, hire, and manage and train mental health professionals,
practitioners, and rehabilitation workers
deleted text endnew text begin ensures that staff persons provide support for a
recipient's family and natural supports, by enabling the recipient's family and natural supports
to observe and participate in the recipient's treatment, assessments, and planning services
new text end;

(2) has adequate administrative ability to ensure availability of services;

deleted text begin (3) is able to ensure adequate preservice and in-service training;
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end is able to ensure that staff providing these services are skilled in the delivery of
mental health crisis response services to recipients;

deleted text begin (5)deleted text endnew text begin (4)new text end is able to ensure that staff are deleted text begincapable ofdeleted text end implementing culturally specific treatment
identified in the deleted text beginindividualdeleted text endnew text begin crisisnew text end treatment plan that is meaningful and appropriate as
determined by the recipient's culture, beliefs, values, and language;

deleted text begin (6)deleted text endnew text begin (5)new text end is able to ensure enough flexibility to respond to the changing intervention and
care needs of a recipient as identified by the recipient new text beginor family membernew text end during the service
partnership between the recipient and providers;

deleted text begin (7)deleted text endnew text begin (6)new text end is able to ensure that deleted text beginmental health professionals and mental health practitionersdeleted text endnew text begin
staff
new text end have the communication tools and procedures to communicate and consult promptly
about crisis assessment and interventions as services occur;

deleted text begin (8)deleted text endnew text begin (7)new text end is able to coordinate these services with county emergency services, community
hospitals, ambulance, transportation services, social services, law enforcementnew text begin, engagement
services
new text end, and mental health crisis services through regularly scheduled interagency meetings;

deleted text begin (9) is able to ensure that mental health crisis assessment and mobile crisis intervention
services are available 24 hours a day, seven days a week;
deleted text end

deleted text begin (10)deleted text endnew text begin (8)new text end is able to ensure that services are coordinated with other deleted text beginmentaldeleted text endnew text begin behavioralnew text end
health service providers, county mental health authorities, or federally recognized American
Indian authorities and others as necessary, with the consent of the deleted text beginadultdeleted text endnew text begin recipient or parent
or guardian
new text end. Services must also be coordinated with the recipient's case manager if the deleted text beginadultdeleted text endnew text begin
recipient
new text end is receiving case management services;

deleted text begin (11)deleted text endnew text begin (9)new text end is able to ensure that crisis intervention services are provided in a manner
consistent with sections 245.461 to 245.486new text begin and 245.487 to 245.4879new text end;

deleted text begin (12) is able to submit information as required by the state;
deleted text end

deleted text begin (13) maintains staff training and personnel files;
deleted text end

new text begin (10) is able to coordinate detoxification services for the recipient according to Minnesota
Rules, parts 9530.6605 to 9530.6655, or withdrawal management according to chapter 245F;
new text end

deleted text begin (14)deleted text endnew text begin (11)new text end is able to establish and maintain a quality assurance and evaluation plan to
evaluate the outcomes of services and recipient satisfaction;new text begin and
new text end

deleted text begin (15) is able to keep records as required by applicable laws;
deleted text end

deleted text begin (16) is able to comply with all applicable laws and statutes;
deleted text end

deleted text begin (17)deleted text endnew text begin (12)new text end is an enrolled medical assistance providerdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (18) develops and maintains written policies and procedures regarding service provision
and administration of the provider entity, including safety of staff and recipients in high-risk
situations.
deleted text end

Subd. 4a.

Alternative provider standards.

If a county new text beginor tribe new text enddemonstrates that, due
to geographic or other barriers, it is not feasible to provide mobile crisis intervention services
according to the standards in subdivision 4, paragraph deleted text begin(c), clause (9)deleted text endnew text begin (b)new text end, the commissioner
may approve deleted text begina crisis response provider based ondeleted text end an alternative plan proposed by a county
or deleted text begingroup of countiesdeleted text endnew text begin tribenew text end. The alternative plan must:

(1) result in increased access and a reduction in disparities in the availability of new text beginmobile
new text end crisis services;

(2) provide mobile new text begincrisis new text endservices outside of the usual nine-to-five office hours and on
weekends and holidays; and

(3) comply with standards for emergency mental health services in section 245.469.

Subd. 5.

deleted text beginMobiledeleted text end Crisis new text beginassessment and new text endintervention staff qualifications.

deleted text beginFor provision
of adult mental health mobile crisis intervention services, a mobile crisis intervention team
is comprised of at least two mental health professionals as defined in section 245.462,
subdivision 18
, clauses (1) to (6), or a combination of at least one mental health professional
and one mental health practitioner as defined in section 245.462, subdivision 17, with the
required mental health crisis training and under the clinical supervision of a mental health
professional on the team. The team must have at least two people with at least one member
providing on-site crisis intervention services when needed.
deleted text end new text begin(a) Qualified individual staff of
a qualified provider entity must provide crisis assessment and intervention services to a
recipient. A staff member providing crisis assessment and intervention services to a recipient
must be qualified as a:
new text end

new text begin (1) mental health professional;
new text end

new text begin (2) clinical trainee;
new text end

new text begin (3) mental health practitioner;
new text end

new text begin (4) mental health certified family peer specialist; or
new text end

new text begin (5) mental health certified peer specialist.
new text end

new text begin (b) When crisis assessment and intervention services are provided to a recipient in the
community, a mental health professional, clinical trainee, or mental health practitioner must
lead the response.
new text end

new text begin (c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph
(b), must be specific to providing crisis services to children and adults and include training
about evidence-based practices identified by the commissioner of health to reduce the
recipient's risk of suicide and self-injurious behavior.
new text end

new text begin (d) new text endTeam members must be experienced in deleted text beginmental healthdeleted text endnew text begin crisisnew text end assessment, crisis
intervention techniques, treatment engagement strategies, working with families, and clinical
decision-making under emergency conditions and have knowledge of local services and
resources. deleted text beginThe team must recommend and coordinate the team's services with appropriate
local resources such as the county social services agency, mental health services, and local
law enforcement when necessary.
deleted text end

Subd. 6.

Crisis deleted text beginassessment and mobile intervention treatment planningdeleted text endnew text begin screeningnew text end.

(a)
deleted text begin Prior to initiating mobile crisis intervention services, a screening of the potential crisis
situation must be conducted.
deleted text end The new text begincrisis new text endscreening may use the resources of deleted text begincrisis assistance
and
deleted text end emergency services as defined in deleted text beginsections 245.462, subdivision 6, anddeleted text endnew text begin sectionnew text end 245.469,
subdivisions 1 and 2. The new text begincrisis new text endscreening must gather information, determine whether a
new text begin mental health new text endcrisis situation exists, identify parties involved, and determine an appropriate
response.

new text begin (b) When conducting the crisis screening of a recipient, a provider must:
new text end

new text begin (1) employ evidence-based practices to reduce the recipient's risk of suicide and
self-injurious behavior;
new text end

new text begin (2) work with the recipient to establish a plan and time frame for responding to the
recipient's mental health crisis, including responding to the recipient's immediate need for
support by telephone or text message until the provider can respond to the recipient
face-to-face;
new text end

new text begin (3) document significant factors in determining whether the recipient is experiencing a
mental health crisis, including prior requests for crisis services, a recipient's recent
presentation at an emergency department, known calls to 911 or law enforcement, or
information from third parties with knowledge of a recipient's history or current needs;
new text end

new text begin (4) accept calls from interested third parties and consider the additional needs or potential
mental health crises that the third parties may be experiencing;
new text end

new text begin (5) provide psychoeducation, including means reduction, to relevant third parties
including family members or other persons living with the recipient; and
new text end

new text begin (6) consider other available services to determine which service intervention would best
address the recipient's needs and circumstances.
new text end

new text begin (c) For the purposes of this section, the following situations indicate a positive screen
for a potential mental health crisis and the provider must prioritize providing a face-to-face
crisis assessment of the recipient, unless a provider documents specific evidence to show
why this was not possible, including insufficient staffing resources, concerns for staff or
recipient safety, or other clinical factors:
new text end

new text begin (1) the recipient presents at an emergency department or urgent care setting and the
health care team at that location requested crisis services; or
new text end

new text begin (2) a peace officer requested crisis services for a recipient who is potentially subject to
transportation under section 253B.051.
new text end

new text begin (d) A provider is not required to have direct contact with the recipient to determine that
the recipient is experiencing a potential mental health crisis. A mobile crisis provider may
gather relevant information about the recipient from a third party to establish the recipient's
need for services and potential safety factors.
new text end

new text begin Subd. 6a.new text end

new text beginCrisis assessment.new text end

deleted text begin(b)deleted text endnew text begin (a)new text end If a deleted text begincrisis existsdeleted text endnew text begin recipient screens positive for
potential mental health crisis
new text end, a crisis assessment must be completed. A crisis assessment
evaluates any immediate needs for which deleted text beginemergencydeleted text end services are needed and, as time
permits, the recipient's current life situation, new text beginhealth information, including current
medications,
new text endsources of stress, mental health problems and symptoms, strengths, cultural
considerations, support network, vulnerabilities, current functioning, and the recipient's
preferences as communicated directly by the recipient, or as communicated in a health care
directive as described in chapters 145C and 253B, the new text begincrisis new text endtreatment plan described under
deleted text begin paragraph (d)deleted text endnew text begin subdivision 11new text end, a crisis prevention plan, or a wellness recovery action plan.

new text begin (b) A provider must conduct a crisis assessment at the recipient's location whenever
possible.
new text end

new text begin (c) Whenever possible, the assessor must attempt to include input from the recipient and
the recipient's family and other natural supports to assess whether a crisis exists.
new text end

new text begin (d) A crisis assessment includes: (1) determining (i) whether the recipient is willing to
voluntarily engage in treatment, or (ii) whether the recipient has an advance directive, and
(2) gathering the recipient's information and history from involved family or other natural
supports.
new text end

new text begin (e) A crisis assessment must include coordinated response with other health care providers
if the assessment indicates that a recipient needs detoxification, withdrawal management,
or medical stabilization in addition to crisis response services. If the recipient does not need
an acute level of care, a team must serve an otherwise eligible recipient who has a
co-occurring substance use disorder.
new text end

new text begin (f) If, after completing a crisis assessment of a recipient, a provider refers a recipient to
an intensive setting, including an emergency department, inpatient hospitalization, or
residential crisis stabilization, one of the crisis team members who completed or conferred
about the recipient's crisis assessment must immediately contact the referral entity and
consult with the triage nurse or other staff responsible for intake at the referral entity. During
the consultation, the crisis team member must convey key findings or concerns that led to
the recipient's referral. Following the immediate consultation, the provider must also send
written documentation upon completion. The provider must document if these releases
occurred with authorization by the recipient, the recipient's legal guardian, or as allowed
by section 144.293, subdivision 5.
new text end

new text begin Subd. 6b.new text end

new text beginCrisis intervention services.new text end

deleted text begin(c)deleted text endnew text begin (a)new text end If the crisis assessment determines mobile
crisis intervention services are needed, the new text begincrisis new text endintervention services must be provided
promptly. As opportunity presents during the intervention, at least two members of the
mobile crisis intervention team must confer directly or by telephone about the new text begincrisis
new text end assessment, new text begincrisis new text endtreatment plan, and actions taken and needed. At least one of the team
members must be deleted text beginon sitedeleted text end providing new text beginface-to-face new text endcrisis intervention services. If providing
deleted text begin on-sitedeleted text end crisis intervention services, a new text beginclinical trainee or new text endmental health practitioner must seek
deleted text begin clinicaldeleted text endnew text begin treatmentnew text end supervision as required in subdivision 9.

new text begin (b) If a provider delivers crisis intervention services while the recipient is absent, the
provider must document the reason for delivering services while the recipient is absent.
new text end

deleted text begin (d)deleted text endnew text begin (c)new text end The mobile crisis intervention team must develop deleted text beginan initial, briefdeleted text endnew text begin anew text end crisis treatment
plan deleted text beginas soon as appropriate but no later than 24 hours after the initial face-to-face interventiondeleted text endnew text begin
according to subdivision 11
new text end. deleted text beginThe plan must address the needs and problems noted in the
crisis assessment and include
deleted text enddeleted text beginmeasurable short-term goals, cultural considerations, and
frequency and type of services to be provided to achieve the goals and reduce or eliminate
the crisis. The treatment plan must be updated as needed to reflect current goals and services.
deleted text end

deleted text begin (e)deleted text endnew text begin (d)new text end The new text beginmobile crisis intervention new text endteam must document which deleted text beginshort-term goalsdeleted text endnew text begin crisis
treatment plan goals and objectives
new text end have been met and when no further crisis intervention
services are required.

deleted text begin (f)deleted text endnew text begin (e)new text end If the recipient's new text beginmental health new text endcrisis is stabilized, but the recipient needs a referral
to other services, the team must provide referrals to these services. If the recipient has a
case manager, planning for other services must be coordinated with the case manager. If
the recipient is unable to follow up on the referral, the team must link the recipient to the
service and follow up to ensure the recipient is receiving the service.

deleted text begin (g)deleted text endnew text begin (f)new text end If the recipient's new text beginmental health new text endcrisis is stabilized and the recipient does not have
an advance directive, the case manager or crisis team shall offer to work with the recipient
to develop one.

Subd. 7.

Crisis stabilization services.

(a) Crisis stabilization services must be provided
by qualified staff of a crisis stabilization services provider entity and must meet the following
standards:

(1) a crisis deleted text beginstabilizationdeleted text end treatment plan must be developed deleted text beginwhichdeleted text endnew text begin thatnew text end meets the criteria
in subdivision 11;

(2) staff must be qualified as defined in subdivision 8; deleted text beginand
deleted text end

(3) new text begincrisis stabilization new text endservices must be delivered according to the new text begincrisis new text endtreatment plan
and include face-to-face contact with the recipient by qualified staff for further assessment,
help with referrals, updating of the crisis deleted text beginstabilizationdeleted text end treatment plan, deleted text beginsupportive counseling,deleted text end
skills training, and collaboration with other service providers in the communitydeleted text begin.deleted text endnew text begin; and
new text end

new text begin (4) if a provider delivers crisis stabilization services while the recipient is absent, the
provider must document the reason for delivering services while the recipient is absent.
new text end

deleted text begin (b) If crisis stabilization services are provided in a supervised, licensed residential setting,
the recipient must be contacted face-to-face daily by a qualified mental health practitioner
or mental health professional. The program must have 24-hour-a-day residential staffing
which may include staff who do not meet the qualifications in subdivision 8. The residential
staff must have 24-hour-a-day immediate direct or telephone access to a qualified mental
health professional or practitioner.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end If crisis stabilization services are provided in a supervised, licensed residential
setting that serves no more than four adult residents, and one or more individuals are present
at the setting to receive residential crisis stabilization deleted text beginservicesdeleted text end, the residential staff must
include, for at least eight hours per day, at least one deleted text beginindividual who meets the qualifications
in subdivision 8, paragraph (a), clause (1) or (2)
deleted text endnew text begin mental health professional, clinical trainee,
certified rehabilitation specialist, or mental health practitioner
new text end.

deleted text begin (d) If crisis stabilization services are provided in a supervised, licensed residential setting
that serves more than four adult residents, and one or more are recipients of crisis stabilization
services, the residential staff must include, for 24 hours a day, at least one individual who
meets the qualifications in subdivision 8. During the first 48 hours that a recipient is in the
residential program, the residential program must have at least two staff working 24 hours
a day. Staffing levels may be adjusted thereafter according to the needs of the recipient as
specified in the crisis stabilization treatment plan.
deleted text end

Subd. 8.

deleted text beginAdultdeleted text end Crisis stabilization staff qualifications.

(a) deleted text beginAdultdeleted text end Mental health crisis
stabilization services must be provided by qualified individual staff of a qualified provider
entity. deleted text beginIndividual provider staff must have the following qualificationsdeleted text endnew text begin A staff member
providing crisis stabilization services to a recipient must be qualified as a
new text end:

(1) deleted text beginbe adeleted text end mental health professional deleted text beginas defined in section 245.462, subdivision 18, clauses
(1) to (6)
deleted text end;

(2) deleted text beginbe adeleted text endnew text begin certified rehabilitation specialist;
new text end

new text begin (3) clinical trainee;
new text end

new text begin (4)new text end mental health practitioner deleted text beginas defined in section 245.462, subdivision 17. The mental
health practitioner must work under the clinical supervision of a mental health professional
deleted text end;

new text begin (5) mental health certified family peer specialist;
new text end

deleted text begin (3) be adeleted text endnew text begin (6) mental healthnew text end certified peer specialist deleted text beginunder section 256B.0615. The certified
peer specialist must work under the clinical supervision of a mental health professional
deleted text end; or

deleted text begin (4) be adeleted text endnew text begin (7)new text end mental health rehabilitation worker deleted text beginwho meets the criteria in section
256B.0623, subdivision 5, paragraph (a), clause (4); works under the direction of a mental
health practitioner as defined in section 245.462, subdivision 17, or under direction of a
mental health professional; and works under the clinical supervision of a mental health
professional
deleted text end.

(b) deleted text beginMental health practitioners and mental health rehabilitation workers must have
completed at least 30 hours of training in crisis intervention and stabilization during the
past two years.
deleted text endnew text begin The 30 hours of ongoing training required in section 245I.05, subdivision
4, paragraph (b), must be specific to providing crisis services to children and adults and
include training about evidence-based practices identified by the commissioner of health
to reduce a recipient's risk of suicide and self-injurious behavior.
new text end

Subd. 9.

Supervision.

new text beginClinical trainees and new text endmental health practitioners may provide
crisis assessment and deleted text beginmobiledeleted text end crisis intervention services if the following deleted text beginclinicaldeleted text endnew text begin treatmentnew text end
supervision requirements are met:

(1) the mental health provider entity must accept full responsibility for the services
provided;

(2) the mental health professional of the provider entitydeleted text begin, who is an employee or under
contract with the provider entity,
deleted text end must be immediately available by phone or in person for
deleted text begin clinicaldeleted text endnew text begin treatmentnew text end supervision;

(3) the mental health professional is consulted, in person or by phone, during the first
three hours when a new text beginclinical trainee or new text endmental health practitioner provides deleted text beginon-site servicedeleted text endnew text begin
crisis assessment or crisis intervention services
new text end;new text begin and
new text end

(4) the mental health professional must:

(i) review and approvenew text begin, as defined in section 245I.02, subdivision 2,new text end of the tentative
crisis assessment and crisis treatment plannew text begin within 24 hours of first providing services to the
recipient, notwithstanding section 245I.08, subdivision 3
new text end;new text begin and
new text end

(ii) document the consultationdeleted text begin; anddeleted text endnew text begin required in clause (3).
new text end

deleted text begin (iii) sign the crisis assessment and treatment plan within the next business day;
deleted text end

deleted text begin (5) if the mobile crisis intervention services continue into a second calendar day, a mental
health professional must contact the recipient face-to-face on the second day to provide
services and update the crisis treatment plan; and
deleted text end

deleted text begin (6) the on-site observation must be documented in the recipient's record and signed by
the mental health professional.
deleted text end

deleted text begin Subd. 10.deleted text end

deleted text beginRecipient file.deleted text end

deleted text beginProviders of mobile crisis intervention or crisis stabilization
services must maintain a file for each recipient containing the following information:
deleted text end

deleted text begin (1) individual crisis treatment plans signed by the recipient, mental health professional,
and mental health practitioner who developed the crisis treatment plan, or if the recipient
refused to sign the plan, the date and reason stated by the recipient as to why the recipient
would not sign the plan;
deleted text end

deleted text begin (2) signed release forms;
deleted text end

deleted text begin (3) recipient health information and current medications;
deleted text end

deleted text begin (4) emergency contacts for the recipient;
deleted text end

deleted text begin (5) case records which document the date of service, place of service delivery, signature
of the person providing the service, and the nature, extent, and units of service. Direct or
telephone contact with the recipient's family or others should be documented;
deleted text end

deleted text begin (6) required clinical supervision by mental health professionals;
deleted text end

deleted text begin (7) summary of the recipient's case reviews by staff;
deleted text end

deleted text begin (8) any written information by the recipient that the recipient wants in the file; and
deleted text end

deleted text begin (9) an advance directive, if there is one available.
deleted text end

deleted text begin Documentation in the file must comply with all requirements of the commissioner.
deleted text end

Subd. 11.

new text beginCrisis new text endtreatment plan.

deleted text beginThe individual crisis stabilization treatment plan must
include, at a minimum:
deleted text end

deleted text begin (1) a list of problems identified in the assessment;
deleted text end

deleted text begin (2) a list of the recipient's strengths and resources;
deleted text end

deleted text begin (3) concrete, measurable short-term goals and tasks to be achieved, including time frames
for achievement;
deleted text end

deleted text begin (4) specific objectives directed toward the achievement of each one of the goals;
deleted text end

deleted text begin (5) documentation of the participants involved in the service planning. The recipient, if
possible, must be a participant. The recipient or the recipient's legal guardian must sign the
service plan or documentation must be provided why this was not possible. A copy of the
plan must be given to the recipient and the recipient's legal guardian. The plan should include
services arranged, including specific providers where applicable;
deleted text end

deleted text begin (6) planned frequency and type of services initiated;
deleted text end

deleted text begin (7) a crisis response action plan if a crisis should occur;
deleted text end

deleted text begin (8) clear progress notes on outcome of goals;
deleted text end

deleted text begin (9) a written plan must be completed within 24 hours of beginning services with the
recipient; and
deleted text end

deleted text begin (10) a treatment plan must be developed by a mental health professional or mental health
practitioner under the clinical supervision of a mental health professional. The mental health
professional must approve and sign all treatment plans.
deleted text end

new text begin (a) Within 24 hours of the recipient's admission, the provider entity must complete the
recipient's crisis treatment plan. The provider entity must:
new text end

new text begin (1) base the recipient's crisis treatment plan on the recipient's crisis assessment;
new text end

new text begin (2) consider crisis assistance strategies that have been effective for the recipient in the
past;
new text end

new text begin (3) for a child recipient, use a child-centered, family-driven, and culturally appropriate
planning process that allows the recipient's parents and guardians to observe or participate
in the recipient's individual and family treatment services, assessment, and treatment
planning;
new text end

new text begin (4) for an adult recipient, use a person-centered, culturally appropriate planning process
that allows the recipient's family and other natural supports to observe or participate in
treatment services, assessment, and treatment planning;
new text end

new text begin (5) identify the participants involved in the recipient's treatment planning. The recipient,
if possible, must be a participant;
new text end

new text begin (6) identify the recipient's initial treatment goals, measurable treatment objectives, and
specific interventions that the license holder will use to help the recipient engage in treatment;
new text end

new text begin (7) include documentation of referral to and scheduling of services, including specific
providers where applicable;
new text end

new text begin (8) ensure that the recipient or the recipient's legal guardian approves under section
245I.02, subdivision 2, of the recipient's crisis treatment plan unless a court orders the
recipient's treatment plan under chapter 253B. If the recipient or the recipient's legal guardian
disagrees with the crisis treatment plan, the license holder must document in the client file
the reasons why the recipient disagrees with the crisis treatment plan; and
new text end

new text begin (9) ensure that a treatment supervisor approves under section 245I.02, subdivision 2, of
the recipient's treatment plan within 24 hours of the recipient's admission if a mental health
practitioner or clinical trainee completes the crisis treatment plan, notwithstanding section
245I.08, subdivision 3.
new text end

new text begin (b) The provider entity must provide the recipient and the recipient's legal guardian with
a copy of the recipient's crisis treatment plan.
new text end

Subd. 12.

Excluded services.

The following services are excluded from reimbursement
under this section:

(1) room and board services;

(2) services delivered to a recipient while admitted to an inpatient hospital;

(3) recipient transportation costs may be covered under other medical assistance
provisions, but transportation services are not an adult mental health crisis response service;

(4) services provided and billed by a provider who is not enrolled under medical
assistance to provide adult mental health crisis response services;

(5) services performed by volunteers;

(6) direct billing of time spent "on call" when not delivering services to a recipient;

(7) provider service time included in case management reimbursement. When a provider
is eligible to provide more than one type of medical assistance service, the recipient must
have a choice of provider for each service, unless otherwise provided for by law;

(8) outreach services to potential recipients; deleted text beginand
deleted text end

(9) a mental health service that is not medically necessarydeleted text begin.deleted text endnew text begin;
new text end

new text begin (10) services that a residential treatment center licensed under Minnesota Rules, chapter
2960, provides to a client;
new text end

new text begin (11) partial hospitalization or day treatment; and
new text end

new text begin (12) a crisis assessment that a residential provider completes when a daily rate is paid
for the recipient's crisis stabilization.
new text end

Sec. 5. new text beginEFFECTIVE DATE.
new text end

new text begin This article is effective July 1, 2022, or upon federal approval, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

ARTICLE 17

MENTAL HEALTH UNIFORM SERVICE STANDARDS; CONFORMING
CHANGES

Section 1.

Minnesota Statutes 2020, section 62A.152, subdivision 3, is amended to read:


Subd. 3.

Provider discrimination prohibited.

All group policies and group subscriber
contracts that provide benefits for mental or nervous disorder treatments in a hospital must
provide direct reimbursement for those services if performed by a mental health professionaldeleted text begin,
as defined in sections 245.462, subdivision 18, clauses (1) to (5); and 245.4871, subdivision
27
, clauses (1) to (5)
deleted text endnew text begin qualified according to section 245I.04, subdivision 2new text end, to the extent that
the services and treatment are within the scope of mental health professional licensure.

This subdivision is intended to provide payment of benefits for mental or nervous disorder
treatments performed by a licensed mental health professional in a hospital and is not
intended to change or add benefits for those services provided in policies or contracts to
which this subdivision applies.

Sec. 2.

Minnesota Statutes 2020, section 62A.3094, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For purposes of this section, the terms defined in
paragraphs (b) to (d) have the meanings given.

(b) "Autism spectrum disorders" means the conditions as determined by criteria set forth
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of
the American Psychiatric Association.

(c) "Medically necessary care" means health care services appropriate, in terms of type,
frequency, level, setting, and duration, to the enrollee's condition, and diagnostic testing
and preventative services. Medically necessary care must be consistent with generally
accepted practice parameters as determined by physicians and licensed psychologists who
typically manage patients who have autism spectrum disorders.

(d) "Mental health professional" means a mental health professional deleted text beginas defined in section
245.4871, subdivision 27
deleted text endnew text begin who is qualified according to section 245I.04, subdivision 2new text end,
clause (1), (2), (3), (4), or (6), who has training and expertise in autism spectrum disorder
and child development.

Sec. 3.

Minnesota Statutes 2020, section 62Q.096, is amended to read:


62Q.096 CREDENTIALING OF PROVIDERS.

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) deleted text beginmeets the requirements of Minnesota Rules, parts 9520.0750 to 9520.0870deleted text endnew text begin is a mental
health clinic certified under section 245I.20
new text end;

(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.

A health plan company shall not refuse to credential these providers on the grounds that
their provider network has a sufficient number of providers of that type.

Sec. 4.

Minnesota Statutes 2020, section 144.651, subdivision 2, is amended to read:


Subd. 2.

Definitions.

For the purposes of this section, "patient" means a person who is
admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for
the purpose of diagnosis or treatment bearing on the physical or mental health of that person.
For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means a
person who receives health care services at an outpatient surgical center or at a birth center
licensed under section 144.615. "Patient" also means a minor who is admitted to a residential
program as defined in section 253C.01. For purposes of subdivisions 1, 3 to 16, 18, 20 and
30, "patient" also means any person who is receiving mental health treatment on an outpatient
basis or in a community support program or other community-based program. "Resident"
means a person who is admitted to a nonacute care facility including extended care facilities,
nursing homes, and boarding care homes for care required because of prolonged mental or
physical illness or disability, recovery from injury or disease, or advancing age. For purposes
of all subdivisions except subdivisions 28 and 29, "resident" also means a person who is
admitted to a facility licensed as a board and lodging facility under Minnesota Rules, parts
4625.0100 to 4625.2355, new text begina boarding care home under sections 144.50 to 144.56, new text endor a
supervised living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which
operates a rehabilitation program licensed under chapter 245G new text beginor 245I, new text endor Minnesota Rules,
parts 9530.6510 to 9530.6590.

Sec. 5.

Minnesota Statutes 2020, section 144D.01, subdivision 4, is amended to read:


Subd. 4.

Housing with services establishment or establishment.

(a) "Housing with
services establishment" or "establishment" means:

(1) an establishment providing sleeping accommodations to one or more adult residents,
at least 80 percent of which are 55 years of age or older, and offering or providing, for a
fee, one or more regularly scheduled health-related services or two or more regularly
scheduled supportive services, whether offered or provided directly by the establishment
or by another entity arranged for by the establishment; or

(2) an establishment that registers under section 144D.025.

(b) Housing with services establishment does not include:

(1) a nursing home licensed under chapter 144A;

(2) a hospital, certified boarding care home, or supervised living facility licensed under
sections 144.50 to 144.56;

(3) a board and lodging establishment licensed under chapter 157 and Minnesota Rules,
parts 9520.0500 to 9520.0670, or under chapter 245D deleted text beginordeleted text endnew text begin,new text end 245Gnew text begin, or 245Inew text end;

(4) a board and lodging establishment which serves as a shelter for battered women or
other similar purpose;

(5) a family adult foster care home licensed by the Department of Human Services;

(6) private homes in which the residents are related by kinship, law, or affinity with the
providers of services;

(7) residential settings for persons with developmental disabilities in which the services
are licensed under chapter 245D;

(8) a home-sharing arrangement such as when an elderly or disabled person or
single-parent family makes lodging in a private residence available to another person in
exchange for services or rent, or both;

(9) a duly organized condominium, cooperative, common interest community, or owners'
association of the foregoing where at least 80 percent of the units that comprise the
condominium, cooperative, or common interest community are occupied by individuals
who are the owners, members, or shareholders of the units;

(10) services for persons with developmental disabilities that are provided under a license
under chapter 245D; or

(11) a temporary family health care dwelling as defined in sections 394.307 and 462.3593.

Sec. 6.

Minnesota Statutes 2020, section 144G.08, subdivision 7, as amended by Laws
2020, Seventh Special Session chapter 1, article 6, section 5, is amended to read:


Subd. 7.

Assisted living facility.

"Assisted living facility" means a facility that provides
sleeping accommodations and assisted living services to one or more adults. Assisted living
facility includes assisted living facility with dementia care, and does not include:

(1) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as defined under section 116L.361;

(2) a nursing home licensed under chapter 144A;

(3) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;

(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D deleted text beginordeleted text endnew text begin,new text end 245Gnew text begin, or 245Inew text end;

(5) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;

(6) a private home in which the residents are related by kinship, law, or affinity with the
provider of services;

(7) a duly organized condominium, cooperative, and common interest community, or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;

(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;

(9) a setting offering services conducted by and for the adherents of any recognized
church or religious denomination for its members exclusively through spiritual means or
by prayer for healing;

(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
low-income housing tax credits pursuant to United States Code, title 26, section 42, and
units financed by the Minnesota Housing Finance Agency that are intended to serve
individuals with disabilities or individuals who are homeless, except for those developments
that market or hold themselves out as assisted living facilities and provide assisted living
services;

(11) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;

(12) rental housing designated for occupancy by only elderly or elderly and disabled
residents under United States Code, title 42, section 1437e, or rental housing for qualifying
families under Code of Federal Regulations, title 24, section 983.56;

(13) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011;

(14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b); or

(15) any establishment that exclusively or primarily serves as a shelter or temporary
shelter for victims of domestic or any other form of violence.

Sec. 7.

Minnesota Statutes 2020, section 148B.5301, subdivision 2, is amended to read:


Subd. 2.

Supervision.

(a) To qualify as a LPCC, an applicant must have completed
4,000 hours of post-master's degree supervised professional practice in the delivery of
clinical services in the diagnosis and treatment of mental illnesses and disorders in both
children and adults. The supervised practice shall be conducted according to the requirements
in paragraphs (b) to (e).

(b) The supervision must have been received under a contract that defines clinical practice
and supervision from a mental health professional deleted text beginas defined in section 245.462, subdivision
18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6)
deleted text endnew text begin who is qualified
according to section 245I.04, subdivision 2
new text end, or by a board-approved supervisor, who has at
least two years of postlicensure experience in the delivery of clinical services in the diagnosis
and treatment of mental illnesses and disorders. All supervisors must meet the supervisor
requirements in Minnesota Rules, part 2150.5010.

(c) The supervision must be obtained at the rate of two hours of supervision per 40 hours
of professional practice. The supervision must be evenly distributed over the course of the
supervised professional practice. At least 75 percent of the required supervision hours must
be received in person. The remaining 25 percent of the required hours may be received by
telephone or by audio or audiovisual electronic device. At least 50 percent of the required
hours of supervision must be received on an individual basis. The remaining 50 percent
may be received in a group setting.

(d) The supervised practice must include at least 1,800 hours of clinical client contact.

(e) The supervised practice must be clinical practice. Supervision includes the observation
by the supervisor of the successful application of professional counseling knowledge, skills,
and values in the differential diagnosis and treatment of psychosocial function, disability,
or impairment, including addictions and emotional, mental, and behavioral disorders.

Sec. 8.

Minnesota Statutes 2020, section 148E.120, subdivision 2, is amended to read:


Subd. 2.

Alternate supervisors.

(a) The board may approve an alternate supervisor as
determined in this subdivision. The board shall approve up to 25 percent of the required
supervision hours by a deleted text beginlicenseddeleted text end mental health professional who is competent and qualified
to provide supervision according to the mental health professional's respective licensing
board, as established by section deleted text begin245.462, subdivision 18, clauses (1) to (6), or 245.4871,
subdivision 27
, clauses (1) to (6)
deleted text endnew text begin 245I.04, subdivision 2new text end.

(b) The board shall approve up to 100 percent of the required supervision hours by an
alternate supervisor if the board determines that:

(1) there are five or fewer supervisors in the county where the licensee practices social
work who meet the applicable licensure requirements in subdivision 1;

(2) the supervisor is an unlicensed social worker who is employed in, and provides the
supervision in, a setting exempt from licensure by section 148E.065, and who has
qualifications equivalent to the applicable requirements specified in sections 148E.100 to
148E.115;

(3) the supervisor is a social worker engaged in authorized social work practice in Iowa,
Manitoba, North Dakota, Ontario, South Dakota, or Wisconsin, and has the qualifications
equivalent to the applicable requirements in sections 148E.100 to 148E.115; or

(4) the applicant or licensee is engaged in nonclinical authorized social work practice
outside of Minnesota and the supervisor meets the qualifications equivalent to the applicable
requirements in sections 148E.100 to 148E.115, or the supervisor is an equivalent mental
health professional, as determined by the board, who is credentialed by a state, territorial,
provincial, or foreign licensing agency; or

(5) the applicant or licensee is engaged in clinical authorized social work practice outside
of Minnesota and the supervisor meets qualifications equivalent to the applicable
requirements in section 148E.115, or the supervisor is an equivalent mental health
professional as determined by the board, who is credentialed by a state, territorial, provincial,
or foreign licensing agency.

(c) In order for the board to consider an alternate supervisor under this section, the
licensee must:

(1) request in the supervision plan and verification submitted according to section
148E.125 that an alternate supervisor conduct the supervision; and

(2) describe the proposed supervision and the name and qualifications of the proposed
alternate supervisor. The board may audit the information provided to determine compliance
with the requirements of this section.

Sec. 9.

Minnesota Statutes 2020, section 148F.11, subdivision 1, is amended to read:


Subdivision 1.

Other professionals.

(a) Nothing in this chapter prevents members of
other professions or occupations from performing functions for which they are qualified or
licensed. This exception includes, but is not limited to: licensed physicians; registered nurses;
licensed practical nurses; licensed psychologists and licensed psychological practitioners;
members of the clergy provided such services are provided within the scope of regular
ministries; American Indian medicine men and women; licensed attorneys; probation officers;
licensed marriage and family therapists; licensed social workers; social workers employed
by city, county, or state agencies; licensed professional counselors; licensed professional
clinical counselors; licensed school counselors; registered occupational therapists or
occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders
(UMICAD) certified counselors when providing services to Native American people; city,
county, or state employees when providing assessments or case management under Minnesota
Rules, chapter 9530; and individuals defined in section 256B.0623, subdivision 5, paragraph
(a), clauses (1) deleted text beginand (2)deleted text endnew text begin to (6)new text end, providing deleted text beginintegrated dual diagnosisdeleted text endnew text begin co-occurring substance
use disorder
new text end treatment in adult mental health rehabilitative programs certified new text beginor licensed
new text end by the Department of Human Services under section new text begin245I.23, new text end256B.0622new text begin,new text end or 256B.0623.

(b) Nothing in this chapter prohibits technicians and resident managers in programs
licensed by the Department of Human Services from discharging their duties as provided
in Minnesota Rules, chapter 9530.

(c) Any person who is exempt from licensure under this section must not use a title
incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
counselor" or otherwise hold himself or herself out to the public by any title or description
stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
use of one of the titles in paragraph (a).

Sec. 10.

Minnesota Statutes 2020, section 245.462, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

The definitions in this section apply to sections 245.461 to
deleted text begin 245.486deleted text endnew text begin 245.4863new text end.

Sec. 11.

Minnesota Statutes 2020, section 245.462, subdivision 6, is amended to read:


Subd. 6.

Community support services program.

"Community support services program"
means services, other than inpatient or residential treatment services, provided or coordinated
by an identified program and staff under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health
professional designed to help adults with serious and persistent mental illness to function
and remain in the community. A community support services program includes:

(1) client outreach,

(2) medication monitoring,

(3) assistance in independent living skills,

(4) development of employability and work-related opportunities,

(5) crisis assistance,

(6) psychosocial rehabilitation,

(7) help in applying for government benefits, and

(8) housing support services.

The community support services program must be coordinated with the case management
services specified in section 245.4711.

Sec. 12.

Minnesota Statutes 2020, section 245.462, subdivision 8, is amended to read:


Subd. 8.

Day treatment services.

"Day treatment," "day treatment services," or "day
treatment program" means deleted text begina structured program of treatment and care provided to an adult
in or by: (1) a hospital accredited by the joint commission on accreditation of health
organizations and licensed under sections 144.50 to 144.55; (2) a community mental health
center under section 245.62; or (3) an entity that is under contract with the county board to
operate a program that meets the requirements of section 245.4712, subdivision 2, and
Minnesota Rules, parts 9505.0170 to 9505.0475. Day treatment consists of group
psychotherapy and other intensive therapeutic services that are provided at least two days
a week by a multidisciplinary staff under the clinical supervision of a mental health
professional. Day treatment may include education and consultation provided to families
and other individuals as part of the treatment process. The services are aimed at stabilizing
the adult's mental health status, providing mental health services, and developing and
improving the adult's independent living and socialization skills. The goal of day treatment
is to reduce or relieve mental illness and to enable the adult to live in the community. Day
treatment services are not a part of inpatient or residential treatment services. Day treatment
services are distinguished from day care by their structured therapeutic program of
psychotherapy services. The commissioner may limit medical assistance reimbursement
for day treatment to 15 hours per week per person
deleted text endnew text begin the treatment services described by section
256B.0671, subdivision 3
new text end.

Sec. 13.

Minnesota Statutes 2020, section 245.462, subdivision 9, is amended to read:


Subd. 9.

Diagnostic assessment.

deleted text begin(a)deleted text end "Diagnostic assessment" has the meaning given in
deleted text begin Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota
Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a
standard, extended, or brief diagnostic assessment, or an adult update
deleted text endnew text begin section 245I.10,
subdivisions 4 to 6
new text end.

deleted text begin (b) A brief diagnostic assessment must include a face-to-face interview with the client
and a written evaluation of the client by a mental health professional or a clinical trainee,
as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or
clinical trainee must gather initial components of a standard diagnostic assessment, including
the client's:
deleted text end

deleted text begin (1) age;
deleted text end

deleted text begin (2) description of symptoms, including reason for referral;
deleted text end

deleted text begin (3) history of mental health treatment;
deleted text end

deleted text begin (4) cultural influences and their impact on the client; and
deleted text end

deleted text begin (5) mental status examination.
deleted text end

deleted text begin (c) On the basis of the initial components, the professional or clinical trainee must draw
a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's
immediate needs or presenting problem.
deleted text end

deleted text begin (d) Treatment sessions conducted under authorization of a brief assessment may be used
to gather additional information necessary to complete a standard diagnostic assessment or
an extended diagnostic assessment.
deleted text end

deleted text begin (e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible
for psychological testing as part of the diagnostic process.
deleted text end

deleted text begin (f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction
with the diagnostic assessment process, a client is eligible for up to three individual or family
psychotherapy sessions or family psychoeducation sessions or a combination of the above
sessions not to exceed three sessions.
deleted text end

deleted text begin (g) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item B, subitem (3),
unit (a), a brief diagnostic assessment may be used for a client's family who requires a
language interpreter to participate in the assessment.
deleted text end

Sec. 14.

Minnesota Statutes 2020, section 245.462, subdivision 14, is amended to read:


Subd. 14.

Individual treatment plan.

"Individual treatment plan" means deleted text begina written plan
of intervention, treatment, and services for an adult with mental illness that is developed
by a service provider under the clinical supervision of a mental health professional on the
basis of a diagnostic assessment. The plan identifies goals and objectives of treatment,
treatment strategy, a schedule for accomplishing treatment goals and objectives, and the
individual responsible for providing treatment to the adult with mental illness
deleted text endnew text begin the formulation
of planned services that are responsive to the needs and goals of a client. An individual
treatment plan must be completed according to section 245I.10, subdivisions 7 and 8
new text end.

Sec. 15.

Minnesota Statutes 2020, section 245.462, subdivision 16, is amended to read:


Subd. 16.

Mental health funds.

"Mental health funds" are funds expended under sections
245.73 and 256E.12, federal mental health block grant funds, and funds expended under
section 256D.06 to facilities licensed under new text beginsection 245I.23 or new text endMinnesota Rules, parts
9520.0500 to 9520.0670.

Sec. 16.

Minnesota Statutes 2020, section 245.462, subdivision 17, is amended to read:


Subd. 17.

Mental health practitioner.

deleted text begin(a)deleted text end "Mental health practitioner" means a new text beginstaff
new text end person deleted text beginproviding services to adults with mental illness or children with emotional disturbance
who is qualified in at least one of the ways described in paragraphs (b) to (g). A mental
health practitioner for a child client must have training working with children. A mental
health practitioner for an adult client must have training working with adults
deleted text endnew text begin qualified
according to section 245I.04, subdivision 4
new text end.

deleted text begin (b) For purposes of this subdivision, a practitioner is qualified through relevant
coursework if the practitioner completes at least 30 semester hours or 45 quarter hours in
behavioral sciences or related fields and:
deleted text end

deleted text begin (1) has at least 2,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, substance use disorder, or emotional disturbance; or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities and completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects;
deleted text end

deleted text begin (2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the practitioner's clients belong, completes 40 hours of training in the delivery of services
to adults with mental illness or children with emotional disturbance, and receives clinical
supervision from a mental health professional at least once a week until the requirement of
2,000 hours of supervised experience is met;
deleted text end

deleted text begin (3) is working in a day treatment program under section 245.4712, subdivision 2; or
deleted text end

deleted text begin (4) has completed a practicum or internship that (i) requires direct interaction with adults
or children served, and (ii) is focused on behavioral sciences or related fields.
deleted text end

deleted text begin (c) For purposes of this subdivision, a practitioner is qualified through work experience
if the person:
deleted text end

deleted text begin (1) has at least 4,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, substance use disorder, or emotional disturbance; or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities and completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects; or
deleted text end

deleted text begin (2) has at least 2,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, emotional disturbance, or substance use disorder, and receives clinical
supervision as required by applicable statutes and rules from a mental health professional
at least once a week until the requirement of 4,000 hours of supervised experience is met;
or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities; completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects; and
receives clinical supervision as required by applicable statutes and rules at least once a week
from a mental health professional until the requirement of 4,000 hours of supervised
experience is met.
deleted text end

deleted text begin (d) For purposes of this subdivision, a practitioner is qualified through a graduate student
internship if the practitioner is a graduate student in behavioral sciences or related fields
and is formally assigned by an accredited college or university to an agency or facility for
clinical training.
deleted text end

deleted text begin (e) For purposes of this subdivision, a practitioner is qualified by a bachelor's or master's
degree if the practitioner:
deleted text end

deleted text begin (1) holds a master's or other graduate degree in behavioral sciences or related fields; or
deleted text end

deleted text begin (2) holds a bachelor's degree in behavioral sciences or related fields and completes a
practicum or internship that (i) requires direct interaction with adults or children served,
and (ii) is focused on behavioral sciences or related fields.
deleted text end

deleted text begin (f) For purposes of this subdivision, a practitioner is qualified as a vendor of medical
care if the practitioner meets the definition of vendor of medical care in section 256B.02,
subdivision 7, paragraphs (b) and (c), and is serving a federally recognized tribe.
deleted text end

deleted text begin (g) For purposes of medical assistance coverage of diagnostic assessments, explanations
of findings, and psychotherapy under section 256B.0625, subdivision 65, a mental health
practitioner working as a clinical trainee means that the practitioner's clinical supervision
experience is helping the practitioner gain knowledge and skills necessary to practice
effectively and independently. This may include supervision of direct practice, treatment
team collaboration, continued professional learning, and job management. The practitioner
must also:
deleted text end

deleted text begin (1) comply with requirements for licensure or board certification as a mental health
professional, according to the qualifications under Minnesota Rules, part 9505.0371, subpart
5, item A, including supervised practice in the delivery of mental health services for the
treatment of mental illness; or
deleted text end

deleted text begin (2) be a student in a bona fide field placement or internship under a program leading to
completion of the requirements for licensure as a mental health professional according to
the qualifications under Minnesota Rules, part 9505.0371, subpart 5, item A.
deleted text end

deleted text begin (h) For purposes of this subdivision, "behavioral sciences or related fields" has the
meaning given in section 256B.0623, subdivision 5, paragraph (d).
deleted text end

deleted text begin (i) Notwithstanding the licensing requirements established by a health-related licensing
board, as defined in section 214.01, subdivision 2, this subdivision supersedes any other
statute or rule.
deleted text end

Sec. 17.

Minnesota Statutes 2020, section 245.462, subdivision 18, is amended to read:


Subd. 18.

Mental health professional.

"Mental health professional" means a new text beginstaff new text endperson
deleted text begin providing clinical services in the treatment of mental illness who is qualified in at least one
of the following ways:
deleted text endnew text begin who is qualified according to section 245I.04, subdivision 2.
new text end

deleted text begin (1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171 to
148.285; and:
deleted text end

deleted text begin (i) who is certified as a clinical specialist or as a nurse practitioner in adult or family
psychiatric and mental health nursing by a national nurse certification organization; or
deleted text end

deleted text begin (ii) who has a master's degree in nursing or one of the behavioral sciences or related
fields from an accredited college or university or its equivalent, with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental illness;
deleted text end

deleted text begin (2) in clinical social work: a person licensed as an independent clinical social worker
under chapter 148D, or a person with a master's degree in social work from an accredited
college or university, with at least 4,000 hours of post-master's supervised experience in
the delivery of clinical services in the treatment of mental illness;
deleted text end

deleted text begin (3) in psychology: an individual licensed by the Board of Psychology under sections
148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis
and treatment of mental illness;
deleted text end

deleted text begin (4) in psychiatry: a physician licensed under chapter 147 and certified by the American
Board of Psychiatry and Neurology or eligible for board certification in psychiatry, or an
osteopathic physician licensed under chapter 147 and certified by the American Osteopathic
Board of Neurology and Psychiatry or eligible for board certification in psychiatry;
deleted text end

deleted text begin (5) in marriage and family therapy: the mental health professional must be a marriage
and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental illness;
deleted text end

deleted text begin (6) in licensed professional clinical counseling, the mental health professional shall be
a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental illness; or
deleted text end

deleted text begin (7) in allied fields: a person with a master's degree from an accredited college or university
in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's
supervised experience in the delivery of clinical services in the treatment of mental illness.
deleted text end

Sec. 18.

Minnesota Statutes 2020, section 245.462, subdivision 21, is amended to read:


Subd. 21.

Outpatient services.

"Outpatient services" means mental health services,
excluding day treatment and community support services programs, provided by or under
the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional to adults with mental
illness who live outside a hospital. Outpatient services include clinical activities such as
individual, group, and family therapy; individual treatment planning; diagnostic assessments;
medication management; and psychological testing.

Sec. 19.

Minnesota Statutes 2020, section 245.462, subdivision 23, is amended to read:


Subd. 23.

Residential treatment.

"Residential treatment" means a 24-hour-a-day program
under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional, in a community
residential setting other than an acute care hospital or regional treatment center inpatient
unit, that must be licensed as a residential treatment program for adults with mental illness
under new text beginchapter 245I, new text endMinnesota Rules, parts 9520.0500 to 9520.0670new text begin,new text end or other rules adopted
by the commissioner.

Sec. 20.

Minnesota Statutes 2020, section 245.462, is amended by adding a subdivision
to read:


new text begin Subd. 27.new text end

new text beginTreatment supervision.new text end

new text begin"Treatment supervision" means the treatment
supervision described by section 245I.06.
new text end

Sec. 21.

Minnesota Statutes 2020, section 245.4661, subdivision 5, is amended to read:


Subd. 5.

Planning for pilot projects.

(a) Each local plan for a pilot project, with the
exception of the placement of a Minnesota specialty treatment facility as defined in paragraph
(c), must be developed under the direction of the county board, or multiple county boards
acting jointly, as the local mental health authority. The planning process for each pilot shall
include, but not be limited to, mental health consumers, families, advocates, local mental
health advisory councils, local and state providers, representatives of state and local public
employee bargaining units, and the department of human services. As part of the planning
process, the county board or boards shall designate a managing entity responsible for receipt
of funds and management of the pilot project.

(b) For Minnesota specialty treatment facilities, the commissioner shall issue a request
for proposal for regions in which a need has been identified for services.

(c) For purposes of this section, "Minnesota specialty treatment facility" is defined as
an intensive residential treatment service new text beginlicensed new text endunder deleted text beginsection 256B.0622, subdivision 2,
paragraph (b)
deleted text endnew text begin chapter 245Inew text end.

Sec. 22.

Minnesota Statutes 2020, section 245.4662, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

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

(b) "Community partnership" means a project involving the collaboration of two or more
eligible applicants.

(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service
provider, hospital, or community partnership. Eligible applicant does not include a
state-operated direct care and treatment facility or program under chapter 246.

(d) "Intensive residential treatment services" has the meaning given in section 256B.0622deleted text begin,
subdivision 2
deleted text end.

(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section
473.121, subdivision 2.

Sec. 23.

Minnesota Statutes 2020, section 245.467, subdivision 2, is amended to read:


Subd. 2.

Diagnostic assessment.

deleted text beginAll providers of residential, acute care hospital inpatient,
and regional treatment centers must complete a diagnostic assessment for each of their
clients within five days of admission. Providers of day treatment services must complete a
diagnostic assessment within five days after the adult's second visit or within 30 days after
intake, whichever occurs first. In cases where a diagnostic assessment is available and has
been completed within three years preceding admission, only an adult diagnostic assessment
update is necessary. An "adult diagnostic assessment update" means a written summary by
a mental health professional of the adult's current mental health status and service needs
and includes a face-to-face interview with the adult. If the adult's mental health status has
changed markedly since the adult's most recent diagnostic assessment, a new diagnostic
assessment is required. Compliance with the provisions of this subdivision does not ensure
eligibility for medical assistance reimbursement under chapter 256B.
deleted text endnew text begin Providers of services
governed by this section must complete a diagnostic assessment according to the standards
of section 245I.10, subdivisions 4 to 6.
new text end

Sec. 24.

Minnesota Statutes 2020, section 245.467, subdivision 3, is amended to read:


Subd. 3.

Individual treatment plans.

deleted text beginAll providers of outpatient services, day treatment
services, residential treatment, acute care hospital inpatient treatment, and all regional
treatment centers must develop an individual treatment plan for each of their adult clients.
The individual treatment plan must be based on a diagnostic assessment. To the extent
possible, the adult client shall be involved in all phases of developing and implementing
the individual treatment plan. Providers of residential treatment and acute care hospital
inpatient treatment, and all regional treatment centers must develop the individual treatment
plan within ten days of client intake and must review the individual treatment plan every
90 days after intake. Providers of day treatment services must develop the individual
treatment plan before the completion of five working days in which service is provided or
within 30 days after the diagnostic assessment is completed or obtained, whichever occurs
first. Providers of outpatient services must develop the individual treatment plan within 30
days after the diagnostic assessment is completed or obtained or by the end of the second
session of an outpatient service, not including the session in which the diagnostic assessment
was provided, whichever occurs first. Outpatient and day treatment services providers must
review the individual treatment plan every 90 days after intake.
deleted text endnew text begin Providers of services
governed by this section must complete an individual treatment plan according to the
standards of section 245I.10, subdivisions 7 and 8.
new text end

Sec. 25.

Minnesota Statutes 2020, section 245.470, subdivision 1, is amended to read:


Subdivision 1.

Availability of outpatient services.

(a) County boards must provide or
contract for enough outpatient services within the county to meet the needs of adults with
mental illness residing in the county. Services may be provided directly by the county
through county-operated deleted text beginmental health centers ordeleted text end mental health clinics deleted text beginapproved by the
commissioner under section 245.69, subdivision 2
deleted text endnew text begin meeting the standards of chapter 245Inew text end;
by contract with privately operated deleted text beginmental health centers ordeleted text end mental health clinics deleted text beginapproved
by the commissioner under section 245.69, subdivision 2
deleted text endnew text begin meeting the standards of chapter
245I
new text end; by contract with hospital mental health outpatient programs certified by the Joint
Commission on Accreditation of Hospital Organizations; or by contract with a deleted text beginlicenseddeleted text end
mental health professional deleted text beginas defined in section 245.462, subdivision 18, clauses (1) to (6)deleted text end.
Clients may be required to pay a fee according to section 245.481. Outpatient services
include:

(1) conducting diagnostic assessments;

(2) conducting psychological testing;

(3) developing or modifying individual treatment plans;

(4) making referrals and recommending placements as appropriate;

(5) treating an adult's mental health needs through therapy;

(6) prescribing and managing medication and evaluating the effectiveness of prescribed
medication; and

(7) preventing placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet client needs.

(b) County boards may request a waiver allowing outpatient services to be provided in
a nearby trade area if it is determined that the client can best be served outside the county.

Sec. 26.

Minnesota Statutes 2020, section 245.4712, subdivision 2, is amended to read:


Subd. 2.

Day treatment services provided.

(a) Day treatment services must be developed
as a part of the community support services available to adults with serious and persistent
mental illness residing in the county. Adults may be required to pay a fee according to
section 245.481. Day treatment services must be designed to:

(1) provide a structured environment for treatment;

(2) provide support for residing in the community;

(3) prevent placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet client need;

(4) coordinate with or be offered in conjunction with a local education agency's special
education program; and

(5) operate on a continuous basis throughout the year.

(b) deleted text beginFor purposes of complying with medical assistance requirements, an adult day
treatment program must comply with the method of clinical supervision specified in
Minnesota Rules, part 9505.0371, subpart 4. The clinical supervision must be performed
by a qualified supervisor who satisfies the requirements of Minnesota Rules, part 9505.0371,
subpart 5.
deleted text endnew text begin An adult day treatment program must comply with medical assistance requirements
in section 256B.0671, subdivision 3.
new text end

deleted text begin A day treatment program must demonstrate compliance with this clinical supervision
requirement by the commissioner's review and approval of the program according to
Minnesota Rules, part 9505.0372, subpart 8.
deleted text end

(c) County boards may request a waiver from including day treatment services if they
can document that:

(1) an alternative plan of care exists through the county's community support services
for clients who would otherwise need day treatment services;

(2) day treatment, if included, would be duplicative of other components of the
community support services; and

(3) county demographics and geography make the provision of day treatment services
cost ineffective and infeasible.

Sec. 27.

Minnesota Statutes 2020, section 245.472, subdivision 2, is amended to read:


Subd. 2.

Specific requirements.

Providers of residential services must be licensed under
new text begin chapter 245I or new text endapplicable rules adopted by the commissioner deleted text beginand must be clinically
supervised by a mental health professional. Persons employed in facilities licensed under
Minnesota Rules, parts 9520.0500 to 9520.0670, in the capacity of program director as of
July 1, 1987, in accordance with Minnesota Rules, parts 9520.0500 to 9520.0670, may be
allowed to continue providing clinical supervision within a facility, provided they continue
to be employed as a program director in a facility licensed under Minnesota Rules, parts
9520.0500 to 9520.0670
deleted text end.new text begin Residential services must be provided under treatment supervision.
new text end

Sec. 28.

Minnesota Statutes 2020, section 245.4863, is amended to read:


245.4863 INTEGRATED CO-OCCURRING DISORDER TREATMENT.

(a) The commissioner shall require individuals who perform chemical dependency
assessments to screen clients for co-occurring mental health disorders, and staff who perform
mental health diagnostic assessments to screen for co-occurring substance use disorders.
Screening tools must be approved by the commissioner. If a client screens positive for a
co-occurring mental health or substance use disorder, the individual performing the screening
must document what actions will be taken in response to the results and whether further
assessments must be performed.

(b) Notwithstanding paragraph (a), screening is not required when:

(1) the presence of co-occurring disorders was documented for the client in the past 12
months;

(2) the client is currently receiving co-occurring disorders treatment;

(3) the client is being referred for co-occurring disorders treatment; or

(4) a mental health professionaldeleted text begin, as defined in Minnesota Rules, part 9505.0370, subpart
18,
deleted text end who is competent to perform diagnostic assessments of co-occurring disorders is
performing a diagnostic assessment deleted text beginthat meets the requirements in Minnesota Rules, part
9533.0090, subpart 5,
deleted text end to identify whether the client may have co-occurring mental health
and chemical dependency disorders. If an individual is identified to have co-occurring
mental health and substance use disorders, the assessing mental health professional must
document what actions will be taken to address the client's co-occurring disorders.

(c) The commissioner shall adopt rules as necessary to implement this section. The
commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing
a certification process for integrated dual disorder treatment providers and a system through
which individuals receive integrated dual diagnosis treatment if assessed as having both a
substance use disorder and either a serious mental illness or emotional disturbance.

(d) The commissioner shall apply for any federal waivers necessary to secure, to the
extent allowed by law, federal financial participation for the provision of integrated dual
diagnosis treatment to persons with co-occurring disorders.

Sec. 29.

Minnesota Statutes 2020, section 245.4871, subdivision 9a, is amended to read:


Subd. 9a.

Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end.

"Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end" means deleted text beginassistance to
the child, the child's family, and all providers of services to the child to: recognize factors
precipitating a mental health crisis, identify behaviors related to the crisis, and be informed
of available resources to resolve the crisis. Crisis assistance requires the development of a
plan which addresses prevention and intervention strategies to be used in a potential crisis.
Other interventions include: (1) arranging for admission to acute care hospital inpatient
treatment
deleted text endnew text begin the development of a written plan to assist a child and the child's family in
preventing and addressing a potential crisis and is distinct from mobile crisis services defined
in section 256B.0624. The plan must address prevention, deescalation, and intervention
strategies to be used in a crisis. The plan identifies factors that might precipitate a crisis,
behaviors or symptoms related to the emergence of a crisis, and the resources available to
resolve a crisis. The plan must address the following potential needs: (1) acute care
new text end; (2)
crisis placement; (3) community resources for follow-up; and (4) emotional support to the
family during crisis. new text beginWhen appropriate for the child's needs, the plan must include strategies
to reduce the child's risk of suicide and self-injurious behavior.
new text end Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end
does not include services designed to secure the safety of a child who is at risk of abuse or
neglect or necessary emergency services.

Sec. 30.

Minnesota Statutes 2020, section 245.4871, subdivision 10, is amended to read:


Subd. 10.

Day treatment services.

"Day treatment," "day treatment services," or "day
treatment program" means a structured program of treatment and care provided to a child
in:

(1) an outpatient hospital accredited by the Joint Commission on Accreditation of Health
Organizations and licensed under sections 144.50 to 144.55;

(2) a community mental health center under section 245.62;

(3) an entity that is under contract with the county board to operate a program that meets
the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170
to 9505.0475; deleted text beginor
deleted text end

(4) an entity that operates a program that meets the requirements of section 245.4884,
subdivision 2
, and Minnesota Rules, parts 9505.0170 to 9505.0475, that is under contract
with an entity that is under contract with a county boarddeleted text begin.deleted text endnew text begin; or
new text end

new text begin (5) a program certified under section 256B.0943.
new text end

Day treatment consists of group psychotherapy and other intensive therapeutic services
that are provided for a minimum two-hour time block by a multidisciplinary staff under the
deleted text begin clinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional. Day treatment may include
education and consultation provided to families and other individuals as an extension of the
treatment process. The services are aimed at stabilizing the child's mental health status, and
developing and improving the child's daily independent living and socialization skills. Day
treatment services are distinguished from day care by their structured therapeutic program
of psychotherapy services. Day treatment services are not a part of inpatient hospital or
residential treatment services.

A day treatment service must be available to a child up to 15 hours a week throughout
the year and must be coordinated with, integrated with, or part of an education program
offered by the child's school.

Sec. 31.

Minnesota Statutes 2020, section 245.4871, subdivision 11a, is amended to read:


Subd. 11a.

Diagnostic assessment.

deleted text begin(a)deleted text end "Diagnostic assessment" has the meaning given
in deleted text beginMinnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota
Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a
standard, extended, or brief diagnostic assessment, or an adult update
deleted text endnew text begin section 245I.10,
subdivisions 4 to 6
new text end.

deleted text begin (b) A brief diagnostic assessment must include a face-to-face interview with the client
and a written evaluation of the client by a mental health professional or a clinical trainee,
as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or
clinical trainee must gather initial components of a standard diagnostic assessment, including
the client's:
deleted text end

deleted text begin (1) age;
deleted text end

deleted text begin (2) description of symptoms, including reason for referral;
deleted text end

deleted text begin (3) history of mental health treatment;
deleted text end

deleted text begin (4) cultural influences and their impact on the client; and
deleted text end

deleted text begin (5) mental status examination.
deleted text end

deleted text begin (c) On the basis of the brief components, the professional or clinical trainee must draw
a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's
immediate needs or presenting problem.
deleted text end

deleted text begin (d) Treatment sessions conducted under authorization of a brief assessment may be used
to gather additional information necessary to complete a standard diagnostic assessment or
an extended diagnostic assessment.
deleted text end

deleted text begin (e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible
for psychological testing as part of the diagnostic process.
deleted text end

deleted text begin (f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1),
unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction
with the diagnostic assessment process, a client is eligible for up to three individual or family
psychotherapy sessions or family psychoeducation sessions or a combination of the above
sessions not to exceed three sessions.
deleted text end

Sec. 32.

Minnesota Statutes 2020, section 245.4871, subdivision 17, is amended to read:


Subd. 17.

Family community support services.

"Family community support services"
means services provided under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health
professional and designed to help each child with severe emotional disturbance to function
and remain with the child's family in the community. Family community support services
do not include acute care hospital inpatient treatment, residential treatment services, or
regional treatment center services. Family community support services include:

(1) client outreach to each child with severe emotional disturbance and the child's family;

(2) medication monitoring where necessary;

(3) assistance in developing independent living skills;

(4) assistance in developing parenting skills necessary to address the needs of the child
with severe emotional disturbance;

(5) assistance with leisure and recreational activities;

(6) crisis deleted text beginassistancedeleted text endnew text begin planningnew text end, including crisis placement and respite care;

(7) professional home-based family treatment;

(8) foster care with therapeutic supports;

(9) day treatment;

(10) assistance in locating respite care and special needs day care; and

(11) assistance in obtaining potential financial resources, including those benefits listed
in section 245.4884, subdivision 5.

Sec. 33.

Minnesota Statutes 2020, section 245.4871, subdivision 21, is amended to read:


Subd. 21.

Individual treatment plan.

"Individual treatment plan" means deleted text begina written plan
of intervention, treatment, and services for a child with an emotional disturbance that is
developed by a service provider under the clinical supervision of a mental health professional
on the basis of a diagnostic assessment. An individual treatment plan for a child must be
developed in conjunction with the family unless clinically inappropriate. The plan identifies
goals and objectives of treatment, treatment strategy, a schedule for accomplishing treatment
goals and objectives, and the individuals responsible for providing treatment to the child
with an emotional disturbance
deleted text endnew text begin the formulation of planned services that are responsive to
the needs and goals of a client. An individual treatment plan must be completed according
to section 245I.10, subdivisions 7 and 8
new text end.

Sec. 34.

Minnesota Statutes 2020, section 245.4871, subdivision 26, is amended to read:


Subd. 26.

Mental health practitioner.

"Mental health practitioner" deleted text beginhas the meaning
given in section 245.462, subdivision 17
deleted text endnew text begin means a staff person who is qualified according
to section 245I.04, subdivision 4
new text end.

Sec. 35.

Minnesota Statutes 2020, section 245.4871, subdivision 27, is amended to read:


Subd. 27.

Mental health professional.

"Mental health professional" means a new text beginstaff new text endperson
deleted text begin providing clinical services in the diagnosis and treatment of children's emotional disorders.
A mental health professional must have training and experience in working with children
consistent with the age group to which the mental health professional is assigned. A mental
health professional must be qualified in at least one of the following ways:
deleted text endnew text begin who is qualified
according to section 245I.04, subdivision 2.
new text end

deleted text begin (1) in psychiatric nursing, the mental health professional must be a registered nurse who
is licensed under sections 148.171 to 148.285 and who is certified as a clinical specialist in
child and adolescent psychiatric or mental health nursing by a national nurse certification
organization or who has a master's degree in nursing or one of the behavioral sciences or
related fields from an accredited college or university or its equivalent, with at least 4,000
hours of post-master's supervised experience in the delivery of clinical services in the
treatment of mental illness;
deleted text end

deleted text begin (2) in clinical social work, the mental health professional must be a person licensed as
an independent clinical social worker under chapter 148D, or a person with a master's degree
in social work from an accredited college or university, with at least 4,000 hours of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental disorders;
deleted text end

deleted text begin (3) in psychology, the mental health professional must be an individual licensed by the
board of psychology under sections 148.88 to 148.98 who has stated to the board of
psychology competencies in the diagnosis and treatment of mental disorders;
deleted text end

deleted text begin (4) in psychiatry, the mental health professional must be a physician licensed under
chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible
for board certification in psychiatry or an osteopathic physician licensed under chapter 147
and certified by the American Osteopathic Board of Neurology and Psychiatry or eligible
for board certification in psychiatry;
deleted text end

deleted text begin (5) in marriage and family therapy, the mental health professional must be a marriage
and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of
post-master's supervised experience in the delivery of clinical services in the treatment of
mental disorders or emotional disturbances;
deleted text end

deleted text begin (6) in licensed professional clinical counseling, the mental health professional shall be
a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours
of post-master's supervised experience in the delivery of clinical services in the treatment
of mental disorders or emotional disturbances; or
deleted text end

deleted text begin (7) in allied fields, the mental health professional must be a person with a master's degree
from an accredited college or university in one of the behavioral sciences or related fields,
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical
services in the treatment of emotional disturbances.
deleted text end

Sec. 36.

Minnesota Statutes 2020, section 245.4871, subdivision 29, is amended to read:


Subd. 29.

Outpatient services.

"Outpatient services" means mental health services,
excluding day treatment and community support services programs, provided by or under
the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional to children with emotional
disturbances who live outside a hospital. Outpatient services include clinical activities such
as individual, group, and family therapy; individual treatment planning; diagnostic
assessments; medication management; and psychological testing.

Sec. 37.

Minnesota Statutes 2020, section 245.4871, subdivision 31, is amended to read:


Subd. 31.

Professional home-based family treatment.

"Professional home-based family
treatment" means intensive mental health services provided to children because of an
emotional disturbance (1) who are at risk of out-of-home placement; (2) who are in
out-of-home placement; or (3) who are returning from out-of-home placement. Services
are provided to the child and the child's family primarily in the child's home environment.
Services may also be provided in the child's school, child care setting, or other community
setting appropriate to the child. Services must be provided on an individual family basis,
must be child-oriented and family-oriented, and must be designed using information from
diagnostic and functional assessments to meet the specific mental health needs of the child
and the child's family. Examples of services are: (1) individual therapy; (2) family therapy;
(3) client outreach; (4) assistance in developing individual living skills; (5) assistance in
developing parenting skills necessary to address the needs of the child; (6) assistance with
leisure and recreational services; (7) crisis deleted text beginassistancedeleted text endnew text begin planningnew text end, including crisis respite care
and arranging for crisis placement; and (8) assistance in locating respite and child care.
Services must be coordinated with other services provided to the child and family.

Sec. 38.

Minnesota Statutes 2020, section 245.4871, subdivision 32, is amended to read:


Subd. 32.

Residential treatment.

"Residential treatment" means a 24-hour-a-day program
under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional, in a community
residential setting other than an acute care hospital or regional treatment center inpatient
unit, that must be licensed as a residential treatment program for children with emotional
disturbances under Minnesota Rules, parts 2960.0580 to 2960.0700, or other rules adopted
by the commissioner.

Sec. 39.

Minnesota Statutes 2020, section 245.4871, subdivision 34, is amended to read:


Subd. 34.

Therapeutic support of foster care.

"Therapeutic support of foster care"
means the mental health training and mental health support services and deleted text beginclinicaldeleted text endnew text begin treatmentnew text end
supervision provided by a mental health professional to foster families caring for children
with severe emotional disturbance to provide a therapeutic family environment and support
for the child's improved functioning.new text begin Therapeutic support of foster care includes services
provided under section 256B.0946.
new text end

Sec. 40.

Minnesota Statutes 2020, section 245.4871, is amended by adding a subdivision
to read:


new text begin Subd. 36.new text end

new text beginTreatment supervision.new text end

new text begin"Treatment supervision" means the treatment
supervision described by section 245I.06.
new text end

Sec. 41.

Minnesota Statutes 2020, section 245.4876, subdivision 2, is amended to read:


Subd. 2.

Diagnostic assessment.

deleted text beginAll residential treatment facilities and acute care
hospital inpatient treatment facilities that provide mental health services for children must
complete a diagnostic assessment for each of their child clients within five working days
of admission. Providers of day treatment services for children must complete a diagnostic
assessment within five days after the child's second visit or 30 days after intake, whichever
occurs first. In cases where a diagnostic assessment is available and has been completed
within 180 days preceding admission, only updating is necessary. "Updating" means a
written summary by a mental health professional of the child's current mental health status
and service needs. If the child's mental health status has changed markedly since the child's
most recent diagnostic assessment, a new diagnostic assessment is required. Compliance
with the provisions of this subdivision does not ensure eligibility for medical assistance
reimbursement under chapter 256B.
deleted text endnew text begin Providers of services governed by this section shall
complete a diagnostic assessment according to the standards of section 245I.10, subdivisions
4 to 6.
new text end

Sec. 42.

Minnesota Statutes 2020, section 245.4876, subdivision 3, is amended to read:


Subd. 3.

Individual treatment plans.

deleted text beginAll providers of outpatient services, day treatment
services, professional home-based family treatment, residential treatment, and acute care
hospital inpatient treatment, and all regional treatment centers that provide mental health
services for children must develop an individual treatment plan for each child client. The
individual treatment plan must be based on a diagnostic assessment. To the extent appropriate,
the child and the child's family shall be involved in all phases of developing and
implementing the individual treatment plan. Providers of residential treatment, professional
home-based family treatment, and acute care hospital inpatient treatment, and regional
treatment centers must develop the individual treatment plan within ten working days of
client intake or admission and must review the individual treatment plan every 90 days after
intake, except that the administrative review of the treatment plan of a child placed in a
residential facility shall be as specified in sections 260C.203 and 260C.212, subdivision 9.
Providers of day treatment services must develop the individual treatment plan before the
completion of five working days in which service is provided or within 30 days after the
diagnostic assessment is completed or obtained, whichever occurs first. Providers of
outpatient services must develop the individual treatment plan within 30 days after the
diagnostic assessment is completed or obtained or by the end of the second session of an
outpatient service, not including the session in which the diagnostic assessment was provided,
whichever occurs first. Providers of outpatient and day treatment services must review the
individual treatment plan every 90 days after intake.
deleted text endnew text begin Providers of services governed by this
section shall complete an individual treatment plan according to the standards of section
245I.10, subdivisions 7 and 8.
new text end

Sec. 43.

Minnesota Statutes 2020, section 245.488, subdivision 1, is amended to read:


Subdivision 1.

Availability of outpatient services.

(a) County boards must provide or
contract for enough outpatient services within the county to meet the needs of each child
with emotional disturbance residing in the county and the child's family. Services may be
provided directly by the county through county-operated deleted text beginmental health centers ordeleted text end mental
health clinics deleted text beginapproved by the commissioner under section 245.69, subdivision 2deleted text endnew text begin meeting
the standards of chapter 245I
new text end; by contract with privately operated deleted text beginmental health centers ordeleted text end
mental health clinics deleted text beginapproved by the commissioner under section 245.69, subdivision 2deleted text endnew text begin
meeting the standards of chapter 245I
new text end; by contract with hospital mental health outpatient
programs certified by the Joint Commission on Accreditation of Hospital Organizations;
or by contract with a deleted text beginlicenseddeleted text end mental health professional deleted text beginas defined in section 245.4871,
subdivision 27
, clauses (1) to (6)
deleted text end. A child or a child's parent may be required to pay a fee
based in accordance with section 245.481. Outpatient services include:

(1) conducting diagnostic assessments;

(2) conducting psychological testing;

(3) developing or modifying individual treatment plans;

(4) making referrals and recommending placements as appropriate;

(5) treating the child's mental health needs through therapy; and

(6) prescribing and managing medication and evaluating the effectiveness of prescribed
medication.

(b) County boards may request a waiver allowing outpatient services to be provided in
a nearby trade area if it is determined that the child requires necessary and appropriate
services that are only available outside the county.

(c) Outpatient services offered by the county board to prevent placement must be at the
level of treatment appropriate to the child's diagnostic assessment.

Sec. 44.

Minnesota Statutes 2020, section 245.4901, subdivision 2, is amended to read:


Subd. 2.

Eligible applicants.

An eligible applicant for school-linked mental health grants
is an entity that is:

(1) new text begina mental health clinic new text endcertified under deleted text beginMinnesota Rules, parts 9520.0750 to 9520.0870deleted text endnew text begin
section 245I.20
new text end;

(2) a community mental health center under section 256B.0625, subdivision 5;

(3) an Indian health service facility or a facility owned and operated by a tribe or tribal
organization operating under United States Code, title 25, section 5321;

(4) a provider of children's therapeutic services and supports as defined in section
256B.0943; or

(5) enrolled in medical assistance as a mental health or substance use disorder provider
agency and employs at least two full-time equivalent mental health professionals qualified
according to section deleted text begin245I.16deleted text endnew text begin 245I.04new text end, subdivision 2, or two alcohol and drug counselors
licensed or exempt from licensure under chapter 148F who are qualified to provide clinical
services to children and families.

Sec. 45.

Minnesota Statutes 2020, section 245.62, subdivision 2, is amended to read:


Subd. 2.

Definition.

A community mental health center is a private nonprofit corporation
or public agency approved under the deleted text beginrules promulgated by the commissioner pursuant to
subdivision 4
deleted text endnew text begin standards of section 256B.0625, subdivision 5new text end.

Sec. 46.

Minnesota Statutes 2020, section 245A.04, subdivision 5, is amended to read:


Subd. 5.

Commissioner's right of access.

(a) When the commissioner is exercising the
powers conferred by this chapter, deleted text beginsections 245.69 anddeleted text endnew text begin sectionnew text end 626.557, and chapter 260E,
the commissioner must be given access to:

(1) the physical plant and grounds where the program is provided;

(2) documents and records, including records maintained in electronic format;

(3) persons served by the program; and

(4) staff and personnel records of current and former staff whenever the program is in
operation and the information is relevant to inspections or investigations conducted by the
commissioner. Upon request, the license holder must provide the commissioner verification
of documentation of staff work experience, training, or educational requirements.

The commissioner must be given access without prior notice and as often as the
commissioner considers necessary if the commissioner is investigating alleged maltreatment,
conducting a licensing inspection, or investigating an alleged violation of applicable laws
or rules. In conducting inspections, the commissioner may request and shall receive assistance
from other state, county, and municipal governmental agencies and departments. The
applicant or license holder shall allow the commissioner to photocopy, photograph, and
make audio and video tape recordings during the inspection of the program at the
commissioner's expense. The commissioner shall obtain a court order or the consent of the
subject of the records or the parents or legal guardian of the subject before photocopying
hospital medical records.

(b) Persons served by the program have the right to refuse to consent to be interviewed,
photographed, or audio or videotaped. Failure or refusal of an applicant or license holder
to fully comply with this subdivision is reasonable cause for the commissioner to deny the
application or immediately suspend or revoke the license.

Sec. 47.

Minnesota Statutes 2020, section 245A.10, subdivision 4, is amended to read:


Subd. 4.

License or certification fee for certain programs.

(a) Child care centers shall
pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity
Child Care Center
License Fee
1 to 24 persons
$200
25 to 49 persons
$300
50 to 74 persons
$400
75 to 99 persons
$500
100 to 124 persons
$600
125 to 149 persons
$700
150 to 174 persons
$800
175 to 199 persons
$900
200 to 224 persons
$1,000
225 or more persons
$1,100

(b)(1) A program licensed to provide one or more of the home and community-based
services and supports identified under chapter 245D to persons with disabilities or age 65
and older, shall pay an annual nonrefundable license fee based on revenues derived from
the provision of services that would require licensure under chapter 245D during the calendar
year immediately preceding the year in which the license fee is paid, according to the
following schedule:

License Holder Annual Revenue
License Fee
less than or equal to $10,000
$200
greater than $10,000 but less than or
equal to $25,000
$300
greater than $25,000 but less than or
equal to $50,000
$400
greater than $50,000 but less than or
equal to $100,000
$500
greater than $100,000 but less than or
equal to $150,000
$600
greater than $150,000 but less than or
equal to $200,000
$800
greater than $200,000 but less than or
equal to $250,000
$1,000
greater than $250,000 but less than or
equal to $300,000
$1,200
greater than $300,000 but less than or
equal to $350,000
$1,400
greater than $350,000 but less than or
equal to $400,000
$1,600
greater than $400,000 but less than or
equal to $450,000
$1,800
greater than $450,000 but less than or
equal to $500,000
$2,000
greater than $500,000 but less than or
equal to $600,000
$2,250
greater than $600,000 but less than or
equal to $700,000
$2,500
greater than $700,000 but less than or
equal to $800,000
$2,750
greater than $800,000 but less than or
equal to $900,000
$3,000
greater than $900,000 but less than or
equal to $1,000,000
$3,250
greater than $1,000,000 but less than or
equal to $1,250,000
$3,500
greater than $1,250,000 but less than or
equal to $1,500,000
$3,750
greater than $1,500,000 but less than or
equal to $1,750,000
$4,000
greater than $1,750,000 but less than or
equal to $2,000,000
$4,250
greater than $2,000,000 but less than or
equal to $2,500,000
$4,500
greater than $2,500,000 but less than or
equal to $3,000,000
$4,750
greater than $3,000,000 but less than or
equal to $3,500,000
$5,000
greater than $3,500,000 but less than or
equal to $4,000,000
$5,500
greater than $4,000,000 but less than or
equal to $4,500,000
$6,000
greater than $4,500,000 but less than or
equal to $5,000,000
$6,500
greater than $5,000,000 but less than or
equal to $7,500,000
$7,000
greater than $7,500,000 but less than or
equal to $10,000,000
$8,500
greater than $10,000,000 but less than or
equal to $12,500,000
$10,000
greater than $12,500,000 but less than or
equal to $15,000,000
$14,000
greater than $15,000,000
$18,000

(2) If requested, the license holder shall provide the commissioner information to verify
the license holder's annual revenues or other information as needed, including copies of
documents submitted to the Department of Revenue.

(3) At each annual renewal, a license holder may elect to pay the highest renewal fee,
and not provide annual revenue information to the commissioner.

(4) A license holder that knowingly provides the commissioner incorrect revenue amounts
for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount
of double the fee the provider should have paid.

(5) Notwithstanding clause (1), a license holder providing services under one or more
licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license
fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license
holder for all licenses held under chapter 245B for calendar year 2013. For calendar year
2017 and thereafter, the license holder shall pay an annual license fee according to clause
(1).

(c) A chemical dependency treatment program licensed under chapter 245G, to provide
chemical dependency treatment shall pay an annual nonrefundable license fee based on the
following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$600
25 to 49 persons
$800
50 to 74 persons
$1,000
75 to 99 persons
$1,200
100 or more persons
$1,400

(d) A chemical dependency program licensed under Minnesota Rules, parts 9530.6510
to 9530.6590, to provide detoxification services shall pay an annual nonrefundable license
fee based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$760
25 to 49 persons
$960
50 or more persons
$1,160

(e) Except for child foster care, a residential facility licensed under Minnesota Rules,
chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the
following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$1,000
25 to 49 persons
$1,100
50 to 74 persons
$1,200
75 to 99 persons
$1,300
100 or more persons
$1,400

(f) A residential facility licensed under new text beginsection 245I.23 or new text endMinnesota Rules, parts
9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual
nonrefundable license fee based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$2,525
25 or more persons
$2,725

(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400,
to serve persons with physical disabilities shall pay an annual nonrefundable license fee
based on the following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$450
25 to 49 persons
$650
50 to 74 persons
$850
75 to 99 persons
$1,050
100 or more persons
$1,250

(h) A program licensed to provide independent living assistance for youth under section
245A.22 shall pay an annual nonrefundable license fee of $1,500.

(i) A private agency licensed to provide foster care and adoption services under Minnesota
Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.

(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts
9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the
following schedule:

Licensed Capacity
License Fee
1 to 24 persons
$500
25 to 49 persons
$700
50 to 74 persons
$900
75 to 99 persons
$1,100
100 or more persons
$1,300

(k) A program licensed to provide treatment services to persons with sexual psychopathic
personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to
9515.3110, shall pay an annual nonrefundable license fee of $20,000.

(l) A deleted text beginmental health center ordeleted text end mental health clinic deleted text beginrequesting certification for purposes
of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750
to 9520.0870
deleted text endnew text begin certified under section 245I.20new text enddeleted text begin,deleted text end shall pay deleted text beginadeleted text end new text beginan annual nonrefundablenew text end certification
fee of $1,550 deleted text beginper yeardeleted text end. If the deleted text beginmentaldeleted text end deleted text beginhealth center ordeleted text end mental health clinic provides services
at a primary location with satellite facilities, the satellite facilities shall be certified with the
primary location without an additional charge.

Sec. 48.

Minnesota Statutes 2020, section 245A.65, subdivision 2, is amended to read:


Subd. 2.

Abuse prevention plans.

All license holders shall establish and enforce ongoing
written program abuse prevention plans and individual abuse prevention plans as required
under section 626.557, subdivision 14.

(a) The scope of the program abuse prevention plan is limited to the population, physical
plant, and environment within the control of the license holder and the location where
licensed services are provided. In addition to the requirements in section 626.557, subdivision
14
, the program abuse prevention plan shall meet the requirements in clauses (1) to (5).

(1) The assessment of the population shall include an evaluation of the following factors:
age, gender, mental functioning, physical and emotional health or behavior of the client;
the need for specialized programs of care for clients; the need for training of staff to meet
identified individual needs; and the knowledge a license holder may have regarding previous
abuse that is relevant to minimizing risk of abuse for clients.

(2) The assessment of the physical plant where the licensed services are provided shall
include an evaluation of the following factors: the condition and design of the building as
it relates to the safety of the clients; and the existence of areas in the building which are
difficult to supervise.

(3) The assessment of the environment for each facility and for each site when living
arrangements are provided by the agency shall include an evaluation of the following factors:
the location of the program in a particular neighborhood or community; the type of grounds
and terrain surrounding the building; the type of internal programming; and the program's
staffing patterns.

(4) The license holder shall provide an orientation to the program abuse prevention plan
for clients receiving services. If applicable, the client's legal representative must be notified
of the orientation. The license holder shall provide this orientation for each new person
within 24 hours of admission, or for persons who would benefit more from a later orientation,
the orientation may take place within 72 hours.

(5) The license holder's governing body or the governing body's delegated representative
shall review the plan at least annually using the assessment factors in the plan and any
substantiated maltreatment findings that occurred since the last review. The governing body
or the governing body's delegated representative shall revise the plan, if necessary, to reflect
the review results.

(6) A copy of the program abuse prevention plan shall be posted in a prominent location
in the program and be available upon request to mandated reporters, persons receiving
services, and legal representatives.

(b) In addition to the requirements in section 626.557, subdivision 14, the individual
abuse prevention plan shall meet the requirements in clauses (1) and (2).

(1) The plan shall include a statement of measures that will be taken to minimize the
risk of abuse to the vulnerable adult when the individual assessment required in section
626.557, subdivision 14, paragraph (b), indicates the need for measures in addition to the
specific measures identified in the program abuse prevention plan. The measures shall
include the specific actions the program will take to minimize the risk of abuse within the
scope of the licensed services, and will identify referrals made when the vulnerable adult
is susceptible to abuse outside the scope or control of the licensed services. When the
assessment indicates that the vulnerable adult does not need specific risk reduction measures
in addition to those identified in the program abuse prevention plan, the individual abuse
prevention plan shall document this determination.

(2) An individual abuse prevention plan shall be developed for each new person as part
of the initial individual program plan or service plan required under the applicable licensing
rulenew text begin or statutenew text end. The review and evaluation of the individual abuse prevention plan shall be
done as part of the review of the program plan deleted text beginordeleted text endnew text begin,new text end service plannew text begin, or treatment plannew text end. The person
receiving services shall participate in the development of the individual abuse prevention
plan to the full extent of the person's abilities. If applicable, the person's legal representative
shall be given the opportunity to participate with or for the person in the development of
the plan. The interdisciplinary team shall document the review of all abuse prevention plans
at least annually, using the individual assessment and any reports of abuse relating to the
person. The plan shall be revised to reflect the results of this review.

Sec. 49.

Minnesota Statutes 2020, section 245D.02, subdivision 20, is amended to read:


Subd. 20.

Mental health crisis intervention team.

"Mental health crisis intervention
team" means a mental health crisis response provider as identified in section 256B.0624deleted text begin,
subdivision 2, paragraph (d), for adults, and in section 256B.0944, subdivision 1, paragraph
(d), for children
deleted text end.

Sec. 50.

Minnesota Statutes 2020, section 256B.0615, subdivision 1, is amended to read:


Subdivision 1.

Scope.

Medical assistance covers mental health certified peer specialist
services, as established in subdivision 2, subject to federal approval, if provided to recipients
who are eligible for services under sections 256B.0622, 256B.0623, and 256B.0624 and
are provided by a new text beginmental health new text endcertified peer specialist who has completed the training
under subdivision 5new text begin and is qualified according to section 245I.04, subdivision 10new text end.

Sec. 51.

Minnesota Statutes 2020, section 256B.0615, subdivision 5, is amended to read:


Subd. 5.

Certified peer specialist training and certification.

The commissioner of
human services shall develop a training and certification process for certified peer specialistsdeleted text begin,
who must be at least 21 years of age
deleted text end. The candidates must have had a primary diagnosis of
mental illness, be a current or former consumer of mental health services, and must
demonstrate leadership and advocacy skills and a strong dedication to recovery. The training
curriculum must teach participating consumers specific skills relevant to providing peer
support to other consumers. In addition to initial training and certification, the commissioner
shall develop ongoing continuing educational workshops on pertinent issues related to peer
support counseling.

Sec. 52.

Minnesota Statutes 2020, section 256B.0616, subdivision 1, is amended to read:


Subdivision 1.

Scope.

Medical assistance covers mental health certified family peer
specialists services, as established in subdivision 2, subject to federal approval, if provided
to recipients who have an emotional disturbance or severe emotional disturbance under
chapter 245, and are provided by a new text beginmental health new text endcertified family peer specialist who has
completed the training under subdivision 5new text begin and is qualified according to section 245I.04,
subdivision 12
new text end. A family peer specialist cannot provide services to the peer specialist's
family.

Sec. 53.

Minnesota Statutes 2020, section 256B.0616, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

Family peer support services may be deleted text beginlocated indeleted text endnew text begin provided to recipients
of
new text end inpatient hospitalization, partial hospitalization, residential treatment, new text beginintensive new text endtreatment
new text begin in new text endfoster care, day treatment, children's therapeutic services and supports, or crisis services.

Sec. 54.

Minnesota Statutes 2020, section 256B.0616, subdivision 5, is amended to read:


Subd. 5.

Certified family peer specialist training and certification.

The commissioner
shall develop a training and certification process for certified family peer specialists deleted text beginwho
must be at least 21 years of age
deleted text end. The candidates must have raised or be currently raising a
child with a mental illness, have had experience navigating the children's mental health
system, and must demonstrate leadership and advocacy skills and a strong dedication to
family-driven and family-focused services. The training curriculum must teach participating
family peer specialists specific skills relevant to providing peer support to other parents. In
addition to initial training and certification, the commissioner shall develop ongoing
continuing educational workshops on pertinent issues related to family peer support
counseling.

Sec. 55.

Minnesota Statutes 2020, section 256B.0622, subdivision 1, is amended to read:


Subdivision 1.

Scope.

new text begin(a) new text endSubject to federal approval, medical assistance covers medically
necessary, assertive community treatment deleted text beginfor clients as defined in subdivision 2a and
intensive residential treatment services for clients as defined in subdivision 3,
deleted text end when the
services are provided by an entity new text begincertified under and new text endmeeting the standards in this section.

new text begin (b) Subject to federal approval, medical assistance covers medically necessary, intensive
residential treatment services when the services are provided by an entity licensed under
and meeting the standards in section 245I.23.
new text end

new text begin (c) The provider entity must make reasonable and good faith efforts to report individual
client outcomes to the commissioner, using instruments and protocols approved by the
commissioner.
new text end

Sec. 56.

Minnesota Statutes 2020, section 256B.0622, subdivision 2, is amended to read:


Subd. 2.

Definitions.

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

(b) "ACT team" means the group of interdisciplinary mental health staff who work as
a team to provide assertive community treatment.

(c) "Assertive community treatment" means intensive nonresidential treatment and
rehabilitative mental health services provided according to the assertive community treatment
model. Assertive community treatment provides a single, fixed point of responsibility for
treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per
day, seven days per week, in a community-based setting.

(d) "Individual treatment plan" means deleted text beginthe document that results from a person-centered
planning process of determining real-life outcomes with clients and developing strategies
to achieve those outcomes
deleted text endnew text begin a plan described by section 245I.10, subdivisions 7 and 8new text end.

deleted text begin (e) "Assertive engagement" means the use of collaborative strategies to engage clients
to receive services.
deleted text end

deleted text begin (f) "Benefits and finance support" means assisting clients in capably managing financial
affairs. Services include, but are not limited to, assisting clients in applying for benefits;
assisting with redetermination of benefits; providing financial crisis management; teaching
and supporting budgeting skills and asset development; and coordinating with a client's
representative payee, if applicable.
deleted text end

deleted text begin (g) "Co-occurring disorder treatment" means the treatment of co-occurring mental illness
and substance use disorders and is characterized by assertive outreach, stage-wise
comprehensive treatment, treatment goal setting, and flexibility to work within each stage
of treatment. Services include, but are not limited to, assessing and tracking clients' stages
of change readiness and treatment; applying the appropriate treatment based on stages of
change, such as outreach and motivational interviewing techniques to work with clients in
earlier stages of change readiness and cognitive behavioral approaches and relapse prevention
to work with clients in later stages of change; and facilitating access to community supports.
deleted text end

deleted text begin (h)deleted text endnew text begin (e)new text end "Crisis assessment and intervention" means mental health crisis response services
as defined in section 256B.0624, subdivision 2deleted text begin, paragraphs (c) to (e)deleted text end.

deleted text begin (i) "Employment services" means assisting clients to work at jobs of their choosing.
Services must follow the principles of the individual placement and support (IPS)
employment model, including focusing on competitive employment; emphasizing individual
client preferences and strengths; ensuring employment services are integrated with mental
health services; conducting rapid job searches and systematic job development according
to client preferences and choices; providing benefits counseling; and offering all services
in an individualized and time-unlimited manner. Services shall also include educating clients
about opportunities and benefits of work and school and assisting the client in learning job
skills, navigating the work place, and managing work relationships.
deleted text end

deleted text begin (j) "Family psychoeducation and support" means services provided to the client's family
and other natural supports to restore and strengthen the client's unique social and family
relationships. Services include, but are not limited to, individualized psychoeducation about
the client's illness and the role of the family and other significant people in the therapeutic
process; family intervention to restore contact, resolve conflict, and maintain relationships
with family and other significant people in the client's life; ongoing communication and
collaboration between the ACT team and the family; introduction and referral to family
self-help programs and advocacy organizations that promote recovery and family
engagement, individual supportive counseling, parenting training, and service coordination
to help clients fulfill parenting responsibilities; coordinating services for the child and
restoring relationships with children who are not in the client's custody; and coordinating
with child welfare and family agencies, if applicable. These services must be provided with
the client's agreement and consent.
deleted text end

deleted text begin (k) "Housing access support" means assisting clients to find, obtain, retain, and move
to safe and adequate housing of their choice. Housing access support includes, but is not
limited to, locating housing options with a focus on integrated independent settings; applying
for housing subsidies, programs, or resources; assisting the client in developing relationships
with local landlords; providing tenancy support and advocacy for the individual's tenancy
rights at the client's home; and assisting with relocation.
deleted text end

deleted text begin (l)deleted text endnew text begin (f)new text end "Individual treatment team" means a minimum of three members of the ACT team
who are responsible for consistently carrying out most of a client's assertive community
treatment services.

deleted text begin (m) "Intensive residential treatment services treatment team" means all staff who provide
intensive residential treatment services under this section to clients. At a minimum, this
includes the clinical supervisor; mental health professionals as defined in section 245.462,
subdivision 18
, clauses (1) to (6); mental health practitioners as defined in section 245.462,
subdivision 17
; mental health rehabilitation workers under section 256B.0623, subdivision
5
, paragraph (a), clause (4); and mental health certified peer specialists under section
256B.0615.
deleted text end

deleted text begin (n) "Intensive residential treatment services" means short-term, time-limited services
provided in a residential setting to clients who are in need of more restrictive settings and
are at risk of significant functional deterioration if they do not receive these services. Services
are designed to develop and enhance psychiatric stability, personal and emotional adjustment,
self-sufficiency, and skills to live in a more independent setting. Services must be directed
toward a targeted discharge date with specified client outcomes.
deleted text end

deleted text begin (o) "Medication assistance and support" means assisting clients in accessing medication,
developing the ability to take medications with greater independence, and providing
medication setup. This includes the prescription, administration, and order of medication
by appropriate medical staff.
deleted text end

deleted text begin (p) "Medication education" means educating clients on the role and effects of medications
in treating symptoms of mental illness and the side effects of medications.
deleted text end

deleted text begin (q) "Overnight staff" means a member of the intensive residential treatment services
team who is responsible during hours when clients are typically asleep.
deleted text end

deleted text begin (r) "Mental health certified peer specialist services" has the meaning given in section
256B.0615.
deleted text end

deleted text begin (s) "Physical health services" means any service or treatment to meet the physical health
needs of the client to support the client's mental health recovery. Services include, but are
not limited to, education on primary health issues, including wellness education; medication
administration and monitoring; providing and coordinating medical screening and follow-up;
scheduling routine and acute medical and dental care visits; tobacco cessation strategies;
assisting clients in attending appointments; communicating with other providers; and
integrating all physical and mental health treatment.
deleted text end

deleted text begin (t)deleted text endnew text begin (g)new text end "Primary team member" means the person who leads and coordinates the activities
of the individual treatment team and is the individual treatment team member who has
primary responsibility for establishing and maintaining a therapeutic relationship with the
client on a continuing basis.

deleted text begin (u) "Rehabilitative mental health services" means mental health services that are
rehabilitative and enable the client to develop and enhance psychiatric stability, social
competencies, personal and emotional adjustment, independent living, parenting skills, and
community skills, when these abilities are impaired by the symptoms of mental illness.
deleted text end

deleted text begin (v) "Symptom management" means supporting clients in identifying and targeting the
symptoms and occurrence patterns of their mental illness and developing strategies to reduce
the impact of those symptoms.
deleted text end

deleted text begin (w) "Therapeutic interventions" means empirically supported techniques to address
specific symptoms and behaviors such as anxiety, psychotic symptoms, emotional
dysregulation, and trauma symptoms. Interventions include empirically supported
psychotherapies including, but not limited to, cognitive behavioral therapy, exposure therapy,
acceptance and commitment therapy, interpersonal therapy, and motivational interviewing.
deleted text end

deleted text begin (x) "Wellness self-management and prevention" means a combination of approaches to
working with the client to build and apply skills related to recovery, and to support the client
in participating in leisure and recreational activities, civic participation, and meaningful
structure.
deleted text end

new text begin (h) "Certified rehabilitation specialist" means a staff person who is qualified according
to section 245I.04, subdivision 8.
new text end

new text begin (i) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6.
new text end

new text begin (j) "Mental health certified peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 10.
new text end

new text begin (k) "Mental health practitioner" means a staff person who is qualified according to section
245I.04, subdivision 4.
new text end

new text begin (l) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.
new text end

new text begin (m) "Mental health rehabilitation worker" means a staff person who is qualified according
to section 245I.04, subdivision 14.
new text end

Sec. 57.

Minnesota Statutes 2020, section 256B.0622, subdivision 3a, is amended to read:


Subd. 3a.

Provider certification and contract requirements for assertive community
treatment.

(a) The assertive community treatment provider must:

(1) have a contract with the host county to provide assertive community treatment
services; and

(2) have each ACT team be certified by the state following the certification process and
procedures developed by the commissioner. The certification process determines whether
the ACT team meets the standards for assertive community treatment under this section deleted text beginas
well as
deleted text endnew text begin, the standards in chapter 245I as required in section 245I.011, subdivision 5, andnew text end
minimum program fidelity standards as measured by a nationally recognized fidelity tool
approved by the commissioner. Recertification must occur at least every three years.

(b) An ACT team certified under this subdivision must meet the following standards:

(1) have capacity to recruit, hire, manage, and train required ACT team members;

(2) have adequate administrative ability to ensure availability of services;

deleted text begin (3) ensure adequate preservice and ongoing training for staff;
deleted text end

deleted text begin (4) ensure that staff is capable of implementing culturally specific services that are
culturally responsive and appropriate as determined by the client's culture, beliefs, values,
and language as identified in the individual treatment plan;
deleted text end

deleted text begin (5)deleted text endnew text begin (3)new text end ensure flexibility in service delivery to respond to the changing and intermittent
care needs of a client as identified by the client and the individual treatment plan;

deleted text begin (6) develop and maintain client files, individual treatment plans, and contact charting;
deleted text end

deleted text begin (7) develop and maintain staff training and personnel files;
deleted text end

deleted text begin (8) submit information as required by the state;
deleted text end

deleted text begin (9)deleted text endnew text begin (4)new text end keep all necessary records required by law;

deleted text begin (10) comply with all applicable laws;
deleted text end

deleted text begin (11)deleted text endnew text begin (5)new text end be an enrolled Medicaid provider;new text begin and
new text end

deleted text begin (12)deleted text endnew text begin (6)new text end establish and maintain a quality assurance plan to determine specific service
outcomes and the client's satisfaction with servicesdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (13) develop and maintain written policies and procedures regarding service provision
and administration of the provider entity.
deleted text end

(c) The commissioner may intervene at any time and decertify an ACT team with cause.
The commissioner shall establish a process for decertification of an ACT team and shall
require corrective action, medical assistance repayment, or decertification of an ACT team
that no longer meets the requirements in this section or that fails to meet the clinical quality
standards or administrative standards provided by the commissioner in the application and
certification process. The decertification is subject to appeal to the state.

Sec. 58.

Minnesota Statutes 2020, section 256B.0622, subdivision 4, is amended to read:


Subd. 4.

Provider entity licensure and contract requirements for intensive residential
treatment services.

deleted text begin(a) The intensive residential treatment services provider entity must:
deleted text end

deleted text begin (1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;
deleted text end

deleted text begin (2) not exceed 16 beds per site; and
deleted text end

deleted text begin (3) comply with the additional standards in this section.
deleted text end

deleted text begin (b)deleted text endnew text begin (a)new text end The commissioner shall develop procedures for counties and providers to submit
other documentation as needed to allow the commissioner to determine whether the standards
in this section are met.

deleted text begin (c)deleted text endnew text begin (b)new text end A provider entity must specify in the provider entity's application what geographic
area and populations will be served by the proposed program. A provider entity must
document that the capacity or program specialties of existing programs are not sufficient
to meet the service needs of the target population. A provider entity must submit evidence
of ongoing relationships with other providers and levels of care to facilitate referrals to and
from the proposed program.

deleted text begin (d)deleted text endnew text begin (c)new text end A provider entity must submit documentation that the provider entity requested
a statement of need from each county board and tribal authority that serves as a local mental
health authority in the proposed service area. The statement of need must specify if the local
mental health authority supports or does not support the need for the proposed program and
the basis for this determination. If a local mental health authority does not respond within
60 days of the receipt of the request, the commissioner shall determine the need for the
program based on the documentation submitted by the provider entity.

Sec. 59.

Minnesota Statutes 2020, section 256B.0622, subdivision 7, is amended to read:


Subd. 7.

Assertive community treatment service standards.

(a) ACT teams must offer
and have the capacity to directly provide the following services:

(1) assertive engagementnew text begin using collaborative strategies to encourage clients to receive
services
new text end;

(2) benefits and finance supportnew text begin that assists clients to capably manage financial affairs.
Services include but are not limited to assisting clients in applying for benefits, assisting
with redetermination of benefits, providing financial crisis management, teaching and
supporting budgeting skills and asset development, and coordinating with a client's
representative payee, if applicable
new text end;

(3) co-occurring new text beginsubstance use new text enddisorder treatmentnew text begin as defined in section 245I.02,
subdivision 11
new text end;

(4) crisis assessment and intervention;

(5) employment servicesnew text begin that assist clients to work at jobs of the clients' choosing.
Services must follow the principles of the individual placement and support employment
model, including focusing on competitive employment, emphasizing individual client
preferences and strengths, ensuring employment services are integrated with mental health
services, conducting rapid job searches and systematic job development according to client
preferences and choices, providing benefits counseling, and offering all services in an
individualized and time-unlimited manner. Services must also include educating clients
about opportunities and benefits of work and school and assisting the client in learning job
skills, navigating the workplace, workplace accommodations, and managing work
relationships
new text end;

(6) family psychoeducation and supportnew text begin provided to the client's family and other natural
supports to restore and strengthen the client's unique social and family relationships. Services
include but are not limited to individualized psychoeducation about the client's illness and
the role of the family and other significant people in the therapeutic process; family
intervention to restore contact, resolve conflict, and maintain relationships with family and
other significant people in the client's life; ongoing communication and collaboration between
the ACT team and the family; introduction and referral to family self-help programs and
advocacy organizations that promote recovery and family engagement, individual supportive
counseling, parenting training, and service coordination to help clients fulfill parenting
responsibilities; coordinating services for the child and restoring relationships with children
who are not in the client's custody; and coordinating with child welfare and family agencies,
if applicable. These services must be provided with the client's agreement and consent
new text end;

(7) housing access supportnew text begin that assists clients to find, obtain, retain, and move to safe
and adequate housing of their choice. Housing access support includes but is not limited to
locating housing options with a focus on integrated independent settings; applying for
housing subsidies, programs, or resources; assisting the client in developing relationships
with local landlords; providing tenancy support and advocacy for the individual's tenancy
rights at the client's home; and assisting with relocation
new text end;

(8) medication assistance and supportnew text begin that assists clients in accessing medication,
developing the ability to take medications with greater independence, and providing
medication setup. Medication assistance and support includes assisting the client with the
prescription, administration, and ordering of medication by appropriate medical staff
new text end;

(9) medication educationnew text begin that educates clients on the role and effects of medications in
treating symptoms of mental illness and the side effects of medications
new text end;

(10) mental health certified peer specialists servicesnew text begin according to section 256B.0615new text end;

(11) physical health servicesnew text begin to meet the physical health needs of the client to support
the client's mental health recovery. Services include but are not limited to education on
primary health and wellness issues, medication administration and monitoring, providing
and coordinating medical screening and follow-up, scheduling routine and acute medical
and dental care visits, tobacco cessation strategies, assisting clients in attending appointments,
communicating with other providers, and integrating all physical and mental health treatment
new text end;

(12) rehabilitative mental health servicesnew text begin as defined in section 245I.02, subdivision 33new text end;

(13) symptom managementnew text begin that supports clients in identifying and targeting the symptoms
and occurrence patterns of their mental illness and developing strategies to reduce the impact
of those symptoms
new text end;

(14) therapeutic interventionsnew text begin to address specific symptoms and behaviors such as
anxiety, psychotic symptoms, emotional dysregulation, and trauma symptoms. Interventions
include empirically supported psychotherapies including but not limited to cognitive
behavioral therapy, exposure therapy, acceptance and commitment therapy, interpersonal
therapy, and motivational interviewing
new text end;

(15) wellness self-management and preventionnew text begin that includes a combination of approaches
to working with the client to build and apply skills related to recovery, and to support the
client in participating in leisure and recreational activities, civic participation, and meaningful
structure
new text end; and

(16) other services based on client needs as identified in a client's assertive community
treatment individual treatment plan.

(b) ACT teams must ensure the provision of all services necessary to meet a client's
needs as identified in the client's individual treatment plan.

Sec. 60.

Minnesota Statutes 2020, section 256B.0622, subdivision 7a, is amended to read:


Subd. 7a.

Assertive community treatment team staff requirements and roles.

(a)
The required treatment staff qualifications and roles for an ACT team are:

(1) the team leader:

(i) shall be a deleted text beginlicenseddeleted text end mental health professional deleted text beginwho is qualified under Minnesota Rules,
part 9505.0371, subpart 5, item A
deleted text end. Individuals who are not licensed but who are eligible
for licensure and are otherwise qualified may also fulfill this role but must obtain full
licensure within 24 months of assuming the role of team leader;

(ii) must be an active member of the ACT team and provide some direct services to
clients;

(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the team, providing deleted text beginclinical
oversight
deleted text endnew text begin treatment supervisionnew text end of services in conjunction with the psychiatrist or psychiatric
care provider, and supervising team members to ensure delivery of best and ethical practices;
and

(iv) must be available to provide overall deleted text beginclinical oversightdeleted text endnew text begin treatment supervisionnew text end to the
ACT team after regular business hours and on weekends and holidays. The team leader may
delegate this duty to another qualified member of the ACT team;

(2) the psychiatric care provider:

(i) must be a deleted text beginlicensed psychiatrist certified by the American Board of Psychiatry and
Neurology or eligible for board certification or certified by the American Osteopathic Board
of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who
is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A
deleted text endnew text begin mental health
professional permitted to prescribe psychiatric medications as part of the mental health
professional's scope of practice
new text end. The psychiatric care provider must have demonstrated
clinical experience working with individuals with serious and persistent mental illness;

(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide deleted text beginclinicaldeleted text endnew text begin
treatment
new text end supervision to the team;

(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;

(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;

(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role;

(vi) may not provide specific roles and responsibilities by telemedicine unless approved
by the commissioner; and

(vii) shall provide psychiatric backup to the program after regular business hours and
on weekends and holidays. The psychiatric care provider may delegate this duty to another
qualified psychiatric provider;

(3) the nursing staff:

(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;

(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and

(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;

(4) the co-occurring disorder specialist:

(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in section 245G.11, subdivision 5. No more than two co-occurring
disorder specialists may occupy this role; and

(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;

(5) the vocational specialist:

(i) shall be a full-time vocational specialist who has at least one-year experience providing
employment services or advanced education that involved field training in vocational services
to individuals with mental illness. An individual who does not meet these qualifications
may also serve as the vocational specialist upon completing a training plan approved by the
commissioner;

(ii) shall provide or facilitate the provision of vocational services to clients. The vocational
specialist serves as a consultant and educator to fellow ACT team members on these services;
and

(iii) deleted text beginshoulddeleted text endnew text begin mustnew text end not refer individuals to receive any type of vocational services or linkage
by providers outside of the ACT team;

(6) the mental health certified peer specialist:

(i) shall be a full-time equivalent deleted text beginmental health certified peer specialist as defined in
section 256B.0615
deleted text end. No more than two individuals can share this position. The mental health
certified peer specialist is a fully integrated team member who provides highly individualized
services in the community and promotes the self-determination and shared decision-making
abilities of clients. This requirement may be waived due to workforce shortages upon
approval of the commissioner;

(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and

(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;

(7) the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and

(8) additional staff:

(i) shall be based on team size. Additional treatment team staff may include deleted text beginlicenseddeleted text end
mental health professionals deleted text beginas defined in Minnesota Rules, part 9505.0371, subpart 5, item
A
deleted text end; new text beginclinical trainees; certified rehabilitation specialists; new text endmental health practitioners deleted text beginas defined
in section 245.462, subdivision 17; a mental health practitioner working as a clinical trainee
according to Minnesota Rules, part 9505.0371, subpart 5, item C
deleted text end; or mental health
rehabilitation workers deleted text beginas defined in section 256B.0623, subdivision 5, paragraph (a), clause
(4)
deleted text end. These individuals shall have the knowledge, skills, and abilities required by the
population served to carry out rehabilitation and support functions; and

(ii) shall be selected based on specific program needs or the population served.

(b) Each ACT team must clearly document schedules for all ACT team members.

(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.

(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in their respective discipline and be able to work collaboratively
as a member of a multidisciplinary team to deliver the majority of the treatment,
rehabilitation, and support services clients require to fully benefit from receiving assertive
community treatment.

(e) Each ACT team member must fulfill training requirements established by the
commissioner.

Sec. 61.

Minnesota Statutes 2020, section 256B.0622, subdivision 7b, is amended to read:


Subd. 7b.

Assertive community treatment program size and opportunities.

(a) Each
ACT team shall maintain an annual average caseload that does not exceed 100 clients.
Staff-to-client ratios shall be based on team size as follows:

(1) a small ACT team must:

(i) employ at least six but no more than seven full-time treatment team staff, excluding
the program assistant and the psychiatric care provider;

(ii) serve an annual average maximum of no more than 50 clients;

(iii) ensure at least one full-time equivalent position for every eight clients served;

(iv) schedule ACT team staff for at least eight-hour shift coverage on weekdays and
on-call duty to provide crisis services and deliver services after hours when staff are not
working;

(v) provide crisis services during business hours if the small ACT team does not have
sufficient staff numbers to operate an after-hours on-call system. During all other hours,
the ACT team may arrange for coverage for crisis assessment and intervention services
through a reliable crisis-intervention provider as long as there is a mechanism by which the
ACT team communicates routinely with the crisis-intervention provider and the on-call
ACT team staff are available to see clients face-to-face when necessary or if requested by
the crisis-intervention services provider;

(vi) adjust schedules and provide staff to carry out the needed service activities in the
evenings or on weekend days or holidays, when necessary;

(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team's psychiatric
care provider during all hours is not feasible, alternative psychiatric prescriber backup must
be arranged and a mechanism of timely communication and coordination established in
writing; and

(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each
week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time
equivalent nursing, one full-time deleted text beginsubstance abusedeleted text endnew text begin co-occurring disordernew text end specialist, one
full-time equivalent mental health certified peer specialist, one full-time vocational specialist,
one full-time program assistant, and at least one additional full-time ACT team member
who has mental health professionalnew text begin, certified rehabilitation specialist, clinical trainee,new text end or
new text begin mental health new text endpractitioner status; and

(2) a midsize ACT team shall:

(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry
time for 51 clients, with an additional two hours for every six clients added to the team, 1.5
to two full-time equivalent nursing staff, one full-time deleted text beginsubstance abusedeleted text endnew text begin co-occurring disordernew text end
specialist, one full-time equivalent mental health certified peer specialist, one full-time
vocational specialist, one full-time program assistant, and at least 1.5 to two additional
full-time equivalent ACT members, with at least one dedicated full-time staff member with
mental health professional status. Remaining team members may have mental health
professionalnew text begin, certified rehabilitation specialist, clinical trainee,new text end or new text beginmental health new text endpractitioner
status;

(ii) employ seven or more treatment team full-time equivalents, excluding the program
assistant and the psychiatric care provider;

(iii) serve an annual average maximum caseload of 51 to 74 clients;

(iv) ensure at least one full-time equivalent position for every nine clients served;

(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays
and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum
specifications, staff are regularly scheduled to provide the necessary services on a
client-by-client basis in the evenings and on weekends and holidays;

(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working;

(vii) have the authority to arrange for coverage for crisis assessment and intervention
services through a reliable crisis-intervention provider as long as there is a mechanism by
which the ACT team communicates routinely with the crisis-intervention provider and the
on-call ACT team staff are available to see clients face-to-face when necessary or if requested
by the crisis-intervention services provider; and

(viii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the psychiatric care provider
during all hours is not feasible, alternative psychiatric prescriber backup must be arranged
and a mechanism of timely communication and coordination established in writing;

(3) a large ACT team must:

(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week
per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff,
one full-time deleted text beginsubstance abusedeleted text endnew text begin co-occurring disordernew text end specialist, one full-time equivalent
mental health certified peer specialist, one full-time vocational specialist, one full-time
program assistant, and at least two additional full-time equivalent ACT team members, with
at least one dedicated full-time staff member with mental health professional status.
Remaining team members may have mental health professional or mental health practitioner
status;

(ii) employ nine or more treatment team full-time equivalents, excluding the program
assistant and psychiatric care provider;

(iii) serve an annual average maximum caseload of 75 to 100 clients;

(iv) ensure at least one full-time equivalent position for every nine individuals served;

(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the
second shift providing services at least 12 hours per day weekdays. For weekends and
holidays, the team must operate and schedule ACT team staff to work one eight-hour shift,
with a minimum of two staff each weekend day and every holiday;

(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working; and

(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team psychiatric care
provider during all hours is not feasible, alternative psychiatric backup must be arranged
and a mechanism of timely communication and coordination established in writing.

(b) An ACT team of any size may have a staff-to-client ratio that is lower than the
requirements described in paragraph (a) upon approval by the commissioner, but may not
exceed a one-to-ten staff-to-client ratio.

Sec. 62.

Minnesota Statutes 2020, section 256B.0622, subdivision 7d, is amended to read:


Subd. 7d.

Assertive community treatment assessment and individual treatment
plan.

(a) An initial assessmentdeleted text begin, including a diagnostic assessment that meets the requirements
of Minnesota Rules, part 9505.0372, subpart 1, and a 30-day treatment plan
deleted text end shall be
completed the day of the client's admission to assertive community treatment by the ACT
team leader or the psychiatric care provider, with participation by designated ACT team
members and the client. new text beginThe initial assessment must include obtaining or completing a
standard diagnostic assessment according to section 245I.10, subdivision 6, and completing
a 30-day individual treatment plan.
new text endThe team leader, psychiatric care provider, or other
mental health professional designated by the team leader or psychiatric care provider, must
update the client's diagnostic assessment at least annually.

(b) deleted text beginAn initialdeleted text endnew text begin Anew text end functional assessment must be completed deleted text beginwithin ten days of intake and
updated every six months for assertive community treatment, or prior to discharge from the
service, whichever comes first
deleted text endnew text begin according to section 245I.10, subdivision 9new text end.

deleted text begin (c) Within 30 days of the client's assertive community treatment admission, the ACT
team shall complete an in-depth assessment of the domains listed under section 245.462,
subdivision 11a
.
deleted text end

deleted text begin (d)deleted text end Each part of the deleted text beginin-depthdeleted text endnew text begin functionalnew text end assessment areas shall be completed by each
respective team specialist or an ACT team member with skill and knowledge in the area
being assessed. deleted text beginThe assessments are based upon all available information, including that
from client interview family and identified natural supports, and written summaries from
other agencies, including police, courts, county social service agencies, outpatient facilities,
and inpatient facilities, where applicable.
deleted text end

deleted text begin (e)deleted text endnew text begin (c)new text end Between 30 and 45 days after the client's admission to assertive community
treatment, the entire ACT team must hold a comprehensive case conference, where all team
members, including the psychiatric provider, present information discovered from the
completed deleted text beginin-depthdeleted text end assessments and provide treatment recommendations. The conference
must serve as the basis for the first deleted text beginsix-monthdeleted text endnew text begin individualnew text end treatment plan, which must be
written by the primary team member.

deleted text begin (f)deleted text endnew text begin (d)new text end The client's psychiatric care provider, primary team member, and individual
treatment team members shall assume responsibility for preparing the written narrative of
the results from the psychiatric and social functioning history timeline and the comprehensive
assessment.

deleted text begin (g)deleted text endnew text begin (e)new text end The primary team member and individual treatment team members shall be
assigned by the team leader in collaboration with the psychiatric care provider by the time
of the first treatment planning meeting or 30 days after admission, whichever occurs first.

deleted text begin (h)deleted text endnew text begin (f)new text end Individual treatment plans must be developed through the following treatment
planning process:

(1) The individual treatment plan shall be developed in collaboration with the client and
the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT
team shall evaluate, together with each client, the client's needs, strengths, and preferences
and develop the individual treatment plan collaboratively. The ACT team shall make every
effort to ensure that the client and the client's family and natural supports, with the client's
consent, are in attendance at the treatment planning meeting, are involved in ongoing
meetings related to treatment, and have the necessary supports to fully participate. The
client's participation in the development of the individual treatment plan shall be documented.

(2) The client and the ACT team shall work together to formulate and prioritize the
issues, set goals, research approaches and interventions, and establish the plan. The plan is
individually tailored so that the treatment, rehabilitation, and support approaches and
interventions achieve optimum symptom reduction, help fulfill the personal needs and
aspirations of the client, take into account the cultural beliefs and realities of the individual,
and improve all the aspects of psychosocial functioning that are important to the client. The
process supports strengths, rehabilitation, and recovery.

(3) Each client's individual treatment plan shall identify service needs, strengths and
capacities, and barriers, and set specific and measurable short- and long-term goals for each
service need. The individual treatment plan must clearly specify the approaches and
interventions necessary for the client to achieve the individual goals, when the interventions
shall happen, and identify which ACT team member shall carry out the approaches and
interventions.

(4) The primary team member and the individual treatment team, together with the client
and the client's family and natural supports with the client's consent, are responsible for
reviewing and rewriting the treatment goals and individual treatment plan whenever there
is a major decision point in the client's course of treatment or at least every six months.

(5) The primary team member shall prepare a summary that thoroughly describes in
writing the client's and the individual treatment team's evaluation of the client's progress
and goal attainment, the effectiveness of the interventions, and the satisfaction with services
since the last individual treatment plan. The client's most recent diagnostic assessment must
be included with the treatment plan summary.

(6) The individual treatment plan and review must be deleted text beginsigneddeleted text endnew text begin approvednew text end or acknowledged
by the client, the primary team member, the team leader, the psychiatric care provider, and
all individual treatment team members. A copy of the deleted text beginsigneddeleted text endnew text begin approvednew text end individual treatment
plan deleted text beginisdeleted text endnew text begin must benew text end made available to the client.

Sec. 63.

Minnesota Statutes 2020, section 256B.0623, subdivision 1, is amended to read:


Subdivision 1.

Scope.

new text beginSubject to federal approval, new text endmedical assistance covers new text beginmedically
necessary
new text endadult rehabilitative mental health services deleted text beginas defined in subdivision 2, subject to
federal approval, if provided to recipients as defined in subdivision 3 and provided by a
qualified provider entity meeting the standards in this section and by a qualified individual
provider working within the provider's scope of practice and identified in the recipient's
individual treatment plan as defined in section 245.462, subdivision 14, and if determined
to be medically necessary according to section 62Q.53
deleted text endnew text begin when the services are provided by
an entity meeting the standards in this section
new text end.new text begin The provider entity must make reasonable
and good faith efforts to report individual client outcomes to the commissioner, using
instruments and protocols approved by the commissioner.
new text end

Sec. 64.

Minnesota Statutes 2020, section 256B.0623, subdivision 2, is amended to read:


Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

(a) "Adult rehabilitative mental health services" means deleted text beginmental health services which are
rehabilitative and enable the recipient to develop and enhance psychiatric stability, social
competencies, personal and emotional adjustment, independent living, parenting skills, and
community skills, when these abilities are impaired by the symptoms of mental illness.
Adult rehabilitative mental health services are also appropriate when provided to enable a
recipient to retain stability and functioning, if the recipient would be at risk of significant
functional decompensation or more restrictive service settings without these services
deleted text endnew text begin the
services described in section 245I.02, subdivision 33
new text end.

deleted text begin (1) Adult rehabilitative mental health services instruct, assist, and support the recipient
in areas such as: interpersonal communication skills, community resource utilization and
integration skills, crisis assistance, relapse prevention skills, health care directives, budgeting
and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills,
transportation skills, medication education and monitoring, mental illness symptom
management skills, household management skills, employment-related skills, parenting
skills, and transition to community living services.
deleted text end

deleted text begin (2) These services shall be provided to the recipient on a one-to-one basis in the recipient's
home or another community setting or in groups.
deleted text end

(b) "Medication education services" means services provided individually or in groups
which focus on educating the recipient about mental illness and symptoms; the role and
effects of medications in treating symptoms of mental illness; and the side effects of
medications. Medication education is coordinated with medication management services
and does not duplicate it. Medication education services are provided by physicians, advanced
practice registered nurses, pharmacists, physician assistants, or registered nurses.

(c) "Transition to community living services" means services which maintain continuity
of contact between the rehabilitation services provider and the recipient and which facilitate
discharge from a hospital, residential treatment program deleted text beginunder Minnesota Rules, chapter
9505
deleted text end, board and lodging facility, or nursing home. Transition to community living services
are not intended to provide other areas of adult rehabilitative mental health services.

Sec. 65.

Minnesota Statutes 2020, section 256B.0623, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

An eligible recipient is an individual who:

(1) is age 18 or older;

(2) is diagnosed with a medical condition, such as mental illness or traumatic brain
injury, for which adult rehabilitative mental health services are needed;

(3) has substantial disability and functional impairment in three or more of the areas
listed in section deleted text begin245.462, subdivision 11adeleted text endnew text begin 245I.10, subdivision 9, clause (4)new text end, so that
self-sufficiency is markedly reduced; and

(4) has had a recent new text beginstandard new text enddiagnostic assessment deleted text beginor an adult diagnostic assessment
update
deleted text end by a qualified professional that documents adult rehabilitative mental health services
are medically necessary to address identified disability and functional impairments and
individual recipient goals.

Sec. 66.

Minnesota Statutes 2020, section 256B.0623, subdivision 4, is amended to read:


Subd. 4.

Provider entity standards.

(a) The provider entity must be certified by the
state following the certification process and procedures developed by the commissioner.

(b) The certification process is a determination as to whether the entity meets the standards
in this deleted text beginsubdivisiondeleted text endnew text begin section and chapter 245I, as required in section 245I.011, subdivision 5new text end.
The certification must specify which adult rehabilitative mental health services the entity
is qualified to provide.

(c) A noncounty provider entity must obtain additional certification from each county
in which it will provide services. The additional certification must be based on the adequacy
of the entity's knowledge of that county's local health and human service system, and the
ability of the entity to coordinate its services with the other services available in that county.
A county-operated entity must obtain this additional certification from any other county in
which it will provide services.

(d) new text beginState-level new text endrecertification must occur at least every three years.

(e) The commissioner may intervene at any time and decertify providers with cause.
The decertification is subject to appeal to the state. A county board may recommend that
the state decertify a provider for cause.

(f) The adult rehabilitative mental health services provider entity must meet the following
standards:

(1) have capacity to recruit, hire, manage, and train deleted text beginmental health professionals, mental
health practitioners, and mental health rehabilitation workers
deleted text endnew text begin qualified staffnew text end;

(2) have adequate administrative ability to ensure availability of services;

deleted text begin (3) ensure adequate preservice and inservice and ongoing training for staff;
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end ensure that deleted text beginmental health professionals, mental health practitioners, and mental
health rehabilitation workers
deleted text endnew text begin staffnew text end are skilled in the delivery of the specific adult rehabilitative
mental health services provided to the individual eligible recipient;

deleted text begin (5) ensure that staff is capable of implementing culturally specific services that are
culturally competent and appropriate as determined by the recipient's culture, beliefs, values,
and language as identified in the individual treatment plan;
deleted text end

deleted text begin (6)deleted text endnew text begin (4)new text end ensure enough flexibility in service delivery to respond to the changing and
intermittent care needs of a recipient as identified by the recipient and the individual treatment
plan;

deleted text begin (7) ensure that the mental health professional or mental health practitioner, who is under
the clinical supervision of a mental health professional, involved in a recipient's services
participates in the development of the individual treatment plan;
deleted text end

deleted text begin (8)deleted text endnew text begin (5)new text end assist the recipient in arranging needed crisis assessment, intervention, and
stabilization services;

deleted text begin (9)deleted text endnew text begin (6)new text end ensure that services are coordinated with other recipient mental health services
providers and the county mental health authority and the federally recognized American
Indian authority and necessary others after obtaining the consent of the recipient. Services
must also be coordinated with the recipient's case manager or care coordinator if the recipient
is receiving case management or care coordination services;

deleted text begin (10) develop and maintain recipient files, individual treatment plans, and contact charting;
deleted text end

deleted text begin (11) develop and maintain staff training and personnel files;
deleted text end

deleted text begin (12) submit information as required by the state;
deleted text end

deleted text begin (13) establish and maintain a quality assurance plan to evaluate the outcome of services
provided;
deleted text end

deleted text begin (14)deleted text endnew text begin (7)new text end keep all necessary records required by law;

deleted text begin (15)deleted text endnew text begin (8)new text end deliver services as required by section 245.461;

deleted text begin (16) comply with all applicable laws;
deleted text end

deleted text begin (17)deleted text endnew text begin (9)new text end be an enrolled Medicaid provider;new text begin and
new text end

deleted text begin (18)deleted text endnew text begin (10)new text end maintain a quality assurance plan to determine specific service outcomes and
the recipient's satisfaction with servicesdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (19) develop and maintain written policies and procedures regarding service provision
and administration of the provider entity.
deleted text end

Sec. 67.

Minnesota Statutes 2020, section 256B.0623, subdivision 5, is amended to read:


Subd. 5.

Qualifications of provider staff.

deleted text begin(a)deleted text end Adult rehabilitative mental health services
must be provided by qualified individual provider staff of a certified provider entity.
Individual provider staff must be qualified deleted text beginunder one of the following criteriadeleted text endnew text begin asnew text end:

(1) a mental health professional deleted text beginas defined in section 245.462, subdivision 18, clauses
(1) to (6). If the recipient has a current diagnostic assessment by a licensed mental health
professional as defined in section 245.462, subdivision 18, clauses (1) to (6), recommending
receipt of adult mental health rehabilitative services, the definition of mental health
professional for purposes of this section includes a person who is qualified under section
245.462, subdivision 18, clause (7), and who holds a current and valid national certification
as a certified rehabilitation counselor or certified psychosocial rehabilitation practitioner
deleted text endnew text begin
who is qualified according to section 245I.04, subdivision 2
new text end;

(2)new text begin a certified rehabilitation specialist who is qualified according to section 245I.04,
subdivision 8;
new text end

new text begin (3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
new text end

new text begin (4)new text end a mental health practitioner deleted text beginas defined in section 245.462, subdivision 17. The mental
health practitioner must work under the clinical supervision of a mental health professional
deleted text endnew text begin
qualified according to section 245I.04, subdivision 4
new text end;

deleted text begin (3)deleted text endnew text begin (5)new text end a new text beginmental health new text endcertified peer specialist deleted text beginunder section 256B.0615. The certified
peer specialist must work under the clinical supervision of a mental health professional
deleted text endnew text begin who
is qualified according to section 245I.04, subdivision 10
new text end; or

deleted text begin (4)deleted text endnew text begin (6)new text end a mental health rehabilitation workernew text begin who is qualified according to section 245I.04,
subdivision 14
new text end. deleted text beginA mental health rehabilitation worker means a staff person working under
the direction of a mental health practitioner or mental health professional and under the
clinical supervision of a mental health professional in the implementation of rehabilitative
mental health services as identified in the recipient's individual treatment plan who:
deleted text end

deleted text begin (i) is at least 21 years of age;
deleted text end

deleted text begin (ii) has a high school diploma or equivalent;
deleted text end

deleted text begin (iii) has successfully completed 30 hours of training during the two years immediately
prior to the date of hire, or before provision of direct services, in all of the following areas:
recovery from mental illness, mental health de-escalation techniques, recipient rights,
recipient-centered individual treatment planning, behavioral terminology, mental illness,
co-occurring mental illness and substance abuse, psychotropic medications and side effects,
functional assessment, local community resources, adult vulnerability, recipient
confidentiality; and
deleted text end

deleted text begin (iv) meets the qualifications in paragraph (b).
deleted text end

deleted text begin (b) In addition to the requirements in paragraph (a), a mental health rehabilitation worker
must also meet the qualifications in clause (1), (2), or (3):
deleted text end

deleted text begin (1) has an associates of arts degree, two years of full-time postsecondary education, or
a total of 15 semester hours or 23 quarter hours in behavioral sciences or related fields; is
a registered nurse; or within the previous ten years has:
deleted text end

deleted text begin (i) three years of personal life experience with serious mental illness;
deleted text end

deleted text begin (ii) three years of life experience as a primary caregiver to an adult with a serious mental
illness, traumatic brain injury, substance use disorder, or developmental disability; or
deleted text end

deleted text begin (iii) 2,000 hours of supervised work experience in the delivery of mental health services
to adults with a serious mental illness, traumatic brain injury, substance use disorder, or
developmental disability;
deleted text end

deleted text begin (2)(i) is fluent in the non-English language or competent in the culture of the ethnic
group to which at least 20 percent of the mental health rehabilitation worker's clients belong;
deleted text end

deleted text begin (ii) receives during the first 2,000 hours of work, monthly documented individual clinical
supervision by a mental health professional;
deleted text end

deleted text begin (iii) has 18 hours of documented field supervision by a mental health professional or
mental health practitioner during the first 160 hours of contact work with recipients, and at
least six hours of field supervision quarterly during the following year;
deleted text end

deleted text begin (iv) has review and cosignature of charting of recipient contacts during field supervision
by a mental health professional or mental health practitioner; and
deleted text end

deleted text begin (v) has 15 hours of additional continuing education on mental health topics during the
first year of employment and 15 hours during every additional year of employment; or
deleted text end

deleted text begin (3) for providers of crisis residential services, intensive residential treatment services,
partial hospitalization, and day treatment services:
deleted text end

deleted text begin (i) satisfies clause (2), items (ii) to (iv); and
deleted text end

deleted text begin (ii) has 40 hours of additional continuing education on mental health topics during the
first year of employment.
deleted text end

deleted text begin (c) A mental health rehabilitation worker who solely acts and is scheduled as overnight
staff is not required to comply with paragraph (a), clause (4), item (iv).
deleted text end

deleted text begin (d) For purposes of this subdivision, "behavioral sciences or related fields" means an
education from an accredited college or university and includes but is not limited to social
work, psychology, sociology, community counseling, family social science, child
development, child psychology, community mental health, addiction counseling, counseling
and guidance, special education, and other fields as approved by the commissioner.
deleted text end

Sec. 68.

Minnesota Statutes 2020, section 256B.0623, subdivision 6, is amended to read:


Subd. 6.

Required deleted text begintraining anddeleted text end supervision.

deleted text begin(a) Mental health rehabilitation workers
must receive ongoing continuing education training of at least 30 hours every two years in
areas of mental illness and mental health services and other areas specific to the population
being served. Mental health rehabilitation workers must also be subject to the ongoing
direction and clinical supervision standards in paragraphs (c) and (d).
deleted text end

deleted text begin (b) Mental health practitioners must receive ongoing continuing education training as
required by their professional license; or if the practitioner is not licensed, the practitioner
must receive ongoing continuing education training of at least 30 hours every two years in
areas of mental illness and mental health services. Mental health practitioners must meet
the ongoing clinical supervision standards in paragraph (c).
deleted text end

deleted text begin (c) Clinical supervision may be provided by a full- or part-time qualified professional
employed by or under contract with the provider entity. Clinical supervision may be provided
by interactive videoconferencing according to procedures developed by the commissioner.
A mental health professional providing clinical supervision of staff delivering adult
rehabilitative mental health services must provide the following guidance:
deleted text end

deleted text begin (1) review the information in the recipient's file;
deleted text end

deleted text begin (2) review and approve initial and updates of individual treatment plans;
deleted text end

new text begin (a) A treatment supervisor providing treatment supervision required by section 245I.06
must:
new text end

deleted text begin (3)deleted text endnew text begin (1)new text end meet with deleted text beginmental health rehabilitation workers and practitioners, individually or
in small groups,
deleted text endnew text begin staff receiving treatment supervisionnew text end at least monthly to discuss treatment
topics of interest deleted text beginto the workers and practitioners;
deleted text end

deleted text begin (4) meet with mental health rehabilitation workers and practitioners, individually or in
small groups, at least monthly to discuss
deleted text endnew text begin andnew text end treatment plans of recipientsdeleted text begin, and approve by
signature and document in the recipient's file any resulting plan updates
deleted text end;new text begin and
new text end

deleted text begin (5)deleted text endnew text begin (2)new text end meet at least monthly with the directing new text beginclinical trainee or new text endmental health
practitioner, if there is one, to review needs of the adult rehabilitative mental health services
program, review staff on-site observations and evaluate mental health rehabilitation workers,
plan staff training, review program evaluation and development, and consult with the
directing new text beginclinical trainee or mental health new text endpractitionerdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (6) be available for urgent consultation as the individual recipient needs or the situation
necessitates.
deleted text end

deleted text begin (d)deleted text endnew text begin (b)new text end An adult rehabilitative mental health services provider entity must have a treatment
director who is a deleted text beginmental health practitioner ordeleted text end mental health professionalnew text begin clinical trainee,
certified rehabilitation specialist, or mental health practitioner
new text end. The treatment director must
deleted text begin ensure the followingdeleted text end:

(1) deleted text beginwhile delivering direct services to recipients, a newly hired mental health rehabilitation
worker must be directly observed delivering services to recipients by a mental health
practitioner or mental health professional for at least six hours per 40 hours worked during
the first 160 hours that the mental health rehabilitation worker works
deleted text endnew text begin ensure the direct
observation of mental health rehabilitation workers required by section 245I.06, subdivision
3, is provided
new text end;

deleted text begin (2) the mental health rehabilitation worker must receive ongoing on-site direct service
observation by a mental health professional or mental health practitioner for at least six
hours for every six months of employment;
deleted text end

deleted text begin (3) progress notes are reviewed from on-site service observation prepared by the mental
health rehabilitation worker and mental health practitioner for accuracy and consistency
with actual recipient contact and the individual treatment plan and goals;
deleted text end

deleted text begin (4)deleted text endnew text begin (2) ensurenew text end immediate availability by phone or in person for consultation by a mental
health professionalnew text begin, certified rehabilitation specialist, clinical trainee,new text end or a mental health
practitioner to the mental health rehabilitation deleted text beginservicesdeleted text end worker during service provision;

deleted text begin (5) oversee the identification of changes in individual recipient treatment strategies,
revise the plan, and communicate treatment instructions and methodologies as appropriate
to ensure that treatment is implemented correctly;
deleted text end

deleted text begin (6)deleted text endnew text begin (3)new text end model service practices which: respect the recipient, include the recipient in
planning and implementation of the individual treatment plan, recognize the recipient's
strengths, collaborate and coordinate with other involved parties and providers;

deleted text begin (7)deleted text endnew text begin (4)new text end ensure that new text beginclinical trainees, new text endmental health practitionersnew text begin,new text end and mental health
rehabilitation workers are able to effectively communicate with the recipients, significant
others, and providers; and

deleted text begin (8)deleted text endnew text begin (5)new text end oversee the record of the results of deleted text beginon-sitedeleted text endnew text begin directnew text end observation deleted text beginand chartingdeleted text endnew text begin, progress
note
new text end evaluationnew text begin,new text end and corrective actions taken to modify the work of the new text beginclinical trainees,
new text end mental health practitionersnew text begin,new text end and mental health rehabilitation workers.

deleted text begin (e)deleted text endnew text begin (c)new text end A new text beginclinical trainee or new text endmental health practitioner who is providing treatment direction
for a provider entity must receive new text begintreatment new text endsupervision at least monthly deleted text beginfrom a mental
health professional
deleted text end to:

(1) identify and plan for general needs of the recipient population served;

(2) identify and plan to address provider entity program needs and effectiveness;

(3) identify and plan provider entity staff training and personnel needs and issues; and

(4) plan, implement, and evaluate provider entity quality improvement programs.

Sec. 69.

Minnesota Statutes 2020, section 256B.0623, subdivision 9, is amended to read:


Subd. 9.

Functional assessment.

new text begin(a) new text endProviders of adult rehabilitative mental health
services must complete a written functional assessment deleted text beginas defined in section 245.462,
subdivision 11a
deleted text endnew text begin according to section 245I.10, subdivision 9new text end, for each recipient. deleted text beginThe functional
assessment must be completed within 30 days of intake, and reviewed and updated at least
every six months after it is developed, unless there is a significant change in the functioning
of the recipient. If there is a significant change in functioning, the assessment must be
updated. A single functional assessment can meet case management and adult rehabilitative
mental health services requirements if agreed to by the recipient. Unless the recipient refuses,
the recipient must have significant participation in the development of the functional
assessment.
deleted text end

new text begin (b) When a provider of adult rehabilitative mental health services completes a written
functional assessment, the provider must also complete a level of care assessment as defined
in section 245I.02, subdivision 19, for the recipient.
new text end

Sec. 70.

Minnesota Statutes 2020, section 256B.0623, subdivision 12, is amended to read:


Subd. 12.

Additional requirements.

(a) Providers of adult rehabilitative mental health
services must comply with the requirements relating to referrals for case management in
section 245.467, subdivision 4.

(b) Adult rehabilitative mental health services are provided for most recipients in the
recipient's home and community. Services may also be provided at the home of a relative
or significant other, job site, psychosocial clubhouse, drop-in center, social setting, classroom,
or other places in the community. Except for "transition to community services," the place
of service does not include a regional treatment center, nursing home, residential treatment
facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36)new text begin, or section
245I.23
new text end, or an acute care hospital.

(c) Adult rehabilitative mental health services may be provided in group settings if
appropriate to each participating recipient's needs and new text beginindividual new text endtreatment plan. A group
is defined as two to ten clients, at least one of whom is a recipient, who is concurrently
receiving a service which is identified in this section. The service and group must be specified
in the recipient's new text beginindividual new text endtreatment plan. No more than two qualified staff may bill
Medicaid for services provided to the same group of recipients. If two adult rehabilitative
mental health workers bill for recipients in the same group session, they must each bill for
different recipients.

new text begin (d) Adult rehabilitative mental health services are appropriate if provided to enable a
recipient to retain stability and functioning, when the recipient is at risk of significant
functional decompensation or requiring more restrictive service settings without these
services.
new text end

new text begin (e) Adult rehabilitative mental health services instruct, assist, and support the recipient
in areas including: interpersonal communication skills, community resource utilization and
integration skills, crisis planning, relapse prevention skills, health care directives, budgeting
and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills,
transportation skills, medication education and monitoring, mental illness symptom
management skills, household management skills, employment-related skills, parenting
skills, and transition to community living services.
new text end

new text begin (f) Community intervention, including consultation with relatives, guardians, friends,
employers, treatment providers, and other significant individuals, is appropriate when
directed exclusively to the treatment of the client.
new text end

Sec. 71.

Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:


Subd. 3b.

Telemedicine services.

(a) Medical assistance covers medically necessary
services and consultations delivered by a licensed health care provider via telemedicine in
the same manner as if the service or consultation was delivered in person. Coverage is
limited to three telemedicine services per enrollee per calendar week, except as provided
in paragraph (f). Telemedicine services shall be paid at the full allowable rate.

(b) The commissioner shall establish criteria that a health care provider must attest to
in order to demonstrate the safety or efficacy of delivering a particular service via
telemedicine. The attestation may include that the health care provider:

(1) has identified the categories or types of services the health care provider will provide
via telemedicine;

(2) has written policies and procedures specific to telemedicine services that are regularly
reviewed and updated;

(3) has policies and procedures that adequately address patient safety before, during,
and after the telemedicine service is rendered;

(4) has established protocols addressing how and when to discontinue telemedicine
services; and

(5) has an established quality assurance process related to telemedicine services.

(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service provided by telemedicine to a medical assistance enrollee.
Health care service records for services provided by telemedicine must meet the requirements
set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:

(1) the type of service provided by telemedicine;

(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;

(3) the licensed health care provider's basis for determining that telemedicine is an
appropriate and effective means for delivering the service to the enrollee;

(4) the mode of transmission of the telemedicine service and records evidencing that a
particular mode of transmission was utilized;

(5) the location of the originating site and the distant site;

(6) if the claim for payment is based on a physician's telemedicine consultation with
another physician, the written opinion from the consulting physician providing the
telemedicine consultation; and

(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).

(d) For purposes of this subdivision, unless otherwise covered under this chapter,
"telemedicine" is defined as the delivery of health care services or consultations while the
patient is at an originating site and the licensed health care provider is at a distant site. A
communication between licensed health care providers, or a licensed health care provider
and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission
does not constitute telemedicine consultations or services. Telemedicine may be provided
by means of real-time two-way, interactive audio and visual communications, including the
application of secure video conferencing or store-and-forward technology to provide or
support health care delivery, which facilitate the assessment, diagnosis, consultation,
treatment, education, and care management of a patient's health care.

(e) For purposes of this section, "licensed health care provider" means a licensed health
care provider under section 62A.671, subdivision 6, a community paramedic as defined
under section 144E.001, subdivision 5f, deleted text beginordeleted text endnew text begin a clinical trainee who is qualified according to
section 245I.04, subdivision 6,
new text end a mental health practitioner deleted text begindefined under section 245.462,
subdivision 17
, or 245.4871, subdivision 26, working under the general supervision of a
mental health professional
deleted text endnew text begin qualified according to section 245I.04, subdivision 4new text end, and a
community health worker who meets the criteria under subdivision 49, paragraph (a); "health
care provider" is defined under section 62A.671, subdivision 3; and "originating site" is
defined under section 62A.671, subdivision 7.

(f) The limit on coverage of three telemedicine services per enrollee per calendar week
does not apply if:

(1) the telemedicine services provided by the licensed health care provider are for the
treatment and control of tuberculosis; and

(2) the services are provided in a manner consistent with the recommendations and best
practices specified by the Centers for Disease Control and Prevention and the commissioner
of health.

Sec. 72.

Minnesota Statutes 2020, section 256B.0625, subdivision 5, is amended to read:


Subd. 5.

Community mental health center services.

Medical assistance covers
community mental health center services provided by a community mental health center
that meets the requirements in paragraphs (a) to (j).

(a) The provider deleted text beginis licensed under Minnesota Rules, parts 9520.0750 to 9520.0870deleted text endnew text begin must
be certified as a mental health clinic under section 245I.20
new text end.

(b) deleted text beginThe provider provides mental health services under the clinical supervision of a
mental health professional who is licensed for independent practice at the doctoral level or
by a board-certified psychiatrist
deleted text endnew text begin In addition to the policies and procedures required by
section 245I.03, the provider must establish, enforce, and maintain the policies and procedures
for oversight of clinical services by a doctoral level psychologist
new text end or a new text beginboard certified or
board eligible
new text end psychiatrist deleted text beginwho is eligible for board certificationdeleted text end. deleted text beginClinical supervision has
the meaning given in Minnesota Rules, part 9505.0370, subpart 6.
deleted text endnew text begin These policies and
procedures must be developed with the involvement of a doctoral level psychologist and a
board certified or board eligible psychiatrist, and must include:
new text end

new text begin (1) requirements for when to seek clinical consultation with a doctoral level psychologist
or a board certified or board eligible psychiatrist;
new text end

new text begin (2) requirements for the involvement of a doctoral level psychologist or a board certified
or board eligible psychiatrist in the direction of clinical services; and
new text end

new text begin (3) involvement of a doctoral level psychologist or a board certified or board eligible
psychiatrist in quality improvement initiatives and review as part of a multidisciplinary care
team.
new text end

(c) The provider must be a private nonprofit corporation or a governmental agency and
have a community board of directors as specified by section 245.66.

(d) The provider must have a sliding fee scale that meets the requirements in section
245.481, and agree to serve within the limits of its capacity all individuals residing in its
service delivery area.

(e) At a minimum, the provider must provide the following outpatient mental health
services: diagnostic assessment; explanation of findings; family, group, and individual
psychotherapy, including crisis intervention psychotherapy services, deleted text beginmultiple family group
psychotherapy,
deleted text end psychological testing, and medication management. In addition, the provider
must provide or be capable of providing upon request of the local mental health authority
day treatment servicesnew text begin, multiple family group psychotherapy,new text end and professional home-based
mental health services. The provider must have the capacity to provide such services to
specialized populations such as the elderly, families with children, persons who are seriously
and persistently mentally ill, and children who are seriously emotionally disturbed.

(f) The provider must be capable of providing the services specified in paragraph (e) to
individuals who are deleted text begindiagnosed with bothdeleted text endnew text begin dually diagnosed withnew text end mental illness or emotional
disturbance, and deleted text beginchemical dependencydeleted text endnew text begin substance use disordernew text end, and to individualsnew text begin who arenew text end
dually diagnosed with a mental illness or emotional disturbance and developmental disability.

(g) The provider must provide 24-hour emergency care services or demonstrate the
capacity to assist recipients in need of such services to access such services on a 24-hour
basis.

(h) The provider must have a contract with the local mental health authority to provide
one or more of the services specified in paragraph (e).

(i) The provider must agree, upon request of the local mental health authority, to enter
into a contract with the county to provide mental health services not reimbursable under
the medical assistance program.

(j) The provider may not be enrolled with the medical assistance program as both a
hospital and a community mental health center. The community mental health center's
administrative, organizational, and financial structure must be separate and distinct from
that of the hospital.

new text begin (k) The commissioner may require the provider to annually attest that the provider meets
the requirements in this subdivision using a form that the commissioner provides.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginParagraphs (b), (e), (f), and (k) are effective the day following
final enactment.
new text end

Sec. 73.

Minnesota Statutes 2020, section 256B.0625, subdivision 19c, is amended to
read:


Subd. 19c.

Personal care.

Medical assistance covers personal care assistance services
provided by an individual who is qualified to provide the services according to subdivision
19a and sections 256B.0651 to 256B.0654, provided in accordance with a plan, and
supervised by a qualified professional.

"Qualified professional" means a mental health professional deleted text beginas defined in section 245.462,
subdivision 18
, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6)
deleted text end; a registered
nurse as defined in sections 148.171 to 148.285, a licensed social worker as defined in
sections 148E.010 and 148E.055, or a qualified designated coordinator under section
245D.081, subdivision 2. The qualified professional shall perform the duties required in
section 256B.0659.

Sec. 74.

Minnesota Statutes 2020, section 256B.0625, subdivision 28a, is amended to
read:


Subd. 28a.

Licensed physician assistant services.

(a) Medical assistance covers services
performed by a licensed physician assistant if the service is otherwise covered under this
chapter as a physician service and if the service is within the scope of practice of a licensed
physician assistant as defined in section 147A.09.

(b) Licensed physician assistants, who are supervised by a physician certified by the
American Board of Psychiatry and Neurology or eligible for board certification in psychiatry,
may bill for medication management and evaluation and management services provided to
medical assistance enrollees in inpatient hospital settings, and in outpatient settings after
the licensed physician assistant completes 2,000 hours of clinical experience in the evaluation
and treatment of mental health, consistent with their authorized scope of practice, as defined
in section 147A.09, with the exception of performing psychotherapy or diagnostic
assessments or providing deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision.

Sec. 75.

Minnesota Statutes 2020, section 256B.0625, subdivision 42, is amended to read:


Subd. 42.

Mental health professional.

Notwithstanding Minnesota Rules, part
9505.0175, subpart 28, the definition of a mental health professional deleted text beginshall include a person
who is
deleted text end qualified deleted text beginas specified indeleted text endnew text begin according tonew text end section deleted text begin245.462, subdivision 18, clauses (1) to
(6); or 245.4871, subdivision 27, clauses (1) to (6)
deleted text endnew text begin 245I.04, subdivision 2new text end, for the purpose
of this section and Minnesota Rules, parts 9505.0170 to 9505.0475.

Sec. 76.

Minnesota Statutes 2020, section 256B.0625, subdivision 48, is amended to read:


Subd. 48.

Psychiatric consultation to primary care practitioners.

Medical assistance
covers consultation provided by a deleted text beginpsychiatrist, a psychologist, an advanced practice registered
nurse certified in psychiatric mental health, a licensed independent clinical social worker,
as defined in section 245.462, subdivision 18, clause (2), or a licensed marriage and family
therapist, as defined in section 245.462, subdivision 18, clause (5)
deleted text endnew text begin mental health professional
qualified according to section 245I.04, subdivision 2, except a licensed professional clinical
counselor licensed under section 148B.5301
new text end, via telephone, e-mail, facsimile, or other means
of communication to primary care practitioners, including pediatricians. The need for
consultation and the receipt of the consultation must be documented in the patient record
maintained by the primary care practitioner. If the patient consents, and subject to federal
limitations and data privacy provisions, the consultation may be provided without the patient
present.

Sec. 77.

Minnesota Statutes 2020, section 256B.0625, subdivision 49, is amended to read:


Subd. 49.

Community health worker.

(a) Medical assistance covers the care
coordination and patient education services provided by a community health worker if the
community health worker hasdeleted text begin:
deleted text end

deleted text begin (1)deleted text end received a certificate from the Minnesota State Colleges and Universities System
approved community health worker curriculumdeleted text begin; ordeleted text endnew text begin.
new text end

deleted text begin (2) at least five years of supervised experience with an enrolled physician, registered
nurse, advanced practice registered nurse, mental health professional as defined in section
245.462, subdivision 18, clauses (1) to (6), and section 245.4871, subdivision 27, clauses
(1) to (5), or dentist, or at least five years of supervised experience by a certified public
health nurse operating under the direct authority of an enrolled unit of government.
deleted text end

deleted text begin Community health workers eligible for payment under clause (2) must complete the
certification program by January 1, 2010, to continue to be eligible for payment.
deleted text end

(b) Community health workers must work under the supervision of a medical assistance
enrolled physician, registered nurse, advanced practice registered nurse, mental health
professional deleted text beginas defined in section 245.462, subdivision 18, clauses (1) to (6), and section
245.4871, subdivision 27, clauses (1) to (5)
deleted text end, or dentist, or work under the supervision of a
certified public health nurse operating under the direct authority of an enrolled unit of
government.

(c) Care coordination and patient education services covered under this subdivision
include, but are not limited to, services relating to oral health and dental care.

Sec. 78.

Minnesota Statutes 2020, section 256B.0625, subdivision 56a, is amended to
read:


Subd. 56a.

Officer-involved community-based care coordination.

(a) Medical
assistance covers officer-involved community-based care coordination for an individual
who:

(1) has screened positive for benefiting from treatment for a mental illness or substance
use disorder using a tool approved by the commissioner;

(2) does not require the security of a public detention facility and is not considered an
inmate of a public institution as defined in Code of Federal Regulations, title 42, section
435.1010;

(3) meets the eligibility requirements in section 256B.056; and

(4) has agreed to participate in officer-involved community-based care coordination.

(b) Officer-involved community-based care coordination means navigating services to
address a client's mental health, chemical health, social, economic, and housing needs, or
any other activity targeted at reducing the incidence of jail utilization and connecting
individuals with existing covered services available to them, including, but not limited to,
targeted case management, waiver case management, or care coordination.

(c) Officer-involved community-based care coordination must be provided by an
individual who is an employee of or is under contract with a county, or is an employee of
or under contract with an Indian health service facility or facility owned and operated by a
tribe or a tribal organization operating under Public Law 93-638 as a 638 facility to provide
officer-involved community-based care coordination and is qualified under one of the
following criteria:

(1) a deleted text beginlicenseddeleted text end mental health professional deleted text beginas defined in section 245.462, subdivision 18,
clauses (1) to (6)
deleted text end;

(2)new text begin a clinical trainee qualified according to section 245I.04, subdivision 6, working under
the treatment supervision of a mental health professional according to section 245I.06;
new text end

new text begin (3)new text end a mental health practitioner deleted text beginas defined in section 245.462, subdivision 17deleted text endnew text begin qualified
according to section 245I.04, subdivision 4
new text end, working under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision
of a mental health professionalnew text begin according to section 245I.06new text end;

deleted text begin (3)deleted text endnew text begin (4)new text end a new text beginmental health new text endcertified peer specialist deleted text beginunder section 256B.0615deleted text endnew text begin qualified
according to section 245I.04, subdivision 10
new text end, working under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision
of a mental health professionalnew text begin according to section 245I.06new text end;

(4) an individual qualified as an alcohol and drug counselor under section 245G.11,
subdivision 5; or

(5) a recovery peer qualified under section 245G.11, subdivision 8, working under the
supervision of an individual qualified as an alcohol and drug counselor under section
245G.11, subdivision 5.

(d) Reimbursement is allowed for up to 60 days following the initial determination of
eligibility.

(e) Providers of officer-involved community-based care coordination shall annually
report to the commissioner on the number of individuals served, and number of the
community-based services that were accessed by recipients. The commissioner shall ensure
that services and payments provided under officer-involved community-based care
coordination do not duplicate services or payments provided under section 256B.0625,
subdivision 20
, 256B.0753, 256B.0755, or 256B.0757.

(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for
officer-involved community-based care coordination services shall be provided by the
county providing the services, from sources other than federal funds or funds used to match
other federal funds.

Sec. 79.

Minnesota Statutes 2020, section 256B.0757, subdivision 4c, is amended to read:


Subd. 4c.

Behavioral health home services staff qualifications.

(a) A behavioral health
home services provider must maintain staff with required professional qualifications
appropriate to the setting.

(b) If behavioral health home services are offered in a mental health setting, the
integration specialist must be a registered nurse licensed under the Minnesota Nurse Practice
Act, sections 148.171 to 148.285.

(c) If behavioral health home services are offered in a primary care setting, the integration
specialist must be a mental health professional deleted text beginas defined indeleted text endnew text begin who is qualified according tonew text end
section deleted text begin245.462, subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1)
to (6)
deleted text endnew text begin 245I.04, subdivision 2new text end.

(d) If behavioral health home services are offered in either a primary care setting or
mental health setting, the systems navigator must be a mental health practitioner deleted text beginas defined
in
deleted text endnew text begin who is qualified according tonew text end section deleted text begin245.462, subdivision 17deleted text endnew text begin 245I.04, subdivision 4new text end, or
a community health worker as defined in section 256B.0625, subdivision 49.

(e) If behavioral health home services are offered in either a primary care setting or
mental health setting, the qualified health home specialist must be one of the following:

(1) a new text beginmental health certified new text endpeer deleted text beginsupportdeleted text end specialist deleted text beginas defined indeleted text endnew text begin who is qualified
according to
new text end section deleted text begin256B.0615deleted text endnew text begin 245I.04, subdivision 10new text end;

(2) a new text beginmental health certified new text endfamily peer deleted text beginsupportdeleted text end specialist deleted text beginas defined indeleted text endnew text begin who is qualified
according to
new text end section deleted text begin256B.0616deleted text endnew text begin 245I.04, subdivision 12new text end;

(3) a case management associate as defined in section 245.462, subdivision 4, paragraph
(g), or 245.4871, subdivision 4, paragraph (j);

(4) a mental health rehabilitation worker deleted text beginas defined indeleted text endnew text begin who is qualified according tonew text end
section deleted text begin256B.0623, subdivision 5, clause (4)deleted text endnew text begin 245I.04, subdivision 14new text end;

(5) a community paramedic as defined in section 144E.28, subdivision 9;

(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5);
or

(7) a community health worker as defined in section 256B.0625, subdivision 49.

Sec. 80.

Minnesota Statutes 2020, section 256B.0941, subdivision 1, is amended to read:


Subdivision 1.

Eligibility.

(a) An individual who is eligible for mental health treatment
services in a psychiatric residential treatment facility must meet all of the following criteria:

(1) before admission, services are determined to be medically necessary according to
Code of Federal Regulations, title 42, section 441.152;

(2) is younger than 21 years of age at the time of admission. Services may continue until
the individual meets criteria for discharge or reaches 22 years of age, whichever occurs
first;

(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic
and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression,
or a finding that the individual is a risk to self or others;

(4) has functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; an inability to adequately care for
one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill
the individual's needs;

(5) requires psychiatric residential treatment under the direction of a physician to improve
the individual's condition or prevent further regression so that services will no longer be
needed;

(6) utilized and exhausted other community-based mental health services, or clinical
evidence indicates that such services cannot provide the level of care needed; and

(7) was referred for treatment in a psychiatric residential treatment facility by a deleted text beginqualifieddeleted text end
mental health professional deleted text beginlicensed as defined indeleted text endnew text begin qualified according tonew text end section deleted text begin245.4871,
subdivision 27
, clauses (1) to (6)
deleted text endnew text begin 245I.04, subdivision 2new text end.

(b) The commissioner shall provide oversight and review the use of referrals for clients
admitted to psychiatric residential treatment facilities to ensure that eligibility criteria,
clinical services, and treatment planning reflect clinical, state, and federal standards for
psychiatric residential treatment facility level of care. The commissioner shall coordinate
the production of a statewide list of children and youth who meet the medical necessity
criteria for psychiatric residential treatment facility level of care and who are awaiting
admission. The commissioner and any recipient of the list shall not use the statewide list to
direct admission of children and youth to specific facilities.

Sec. 81.

Minnesota Statutes 2020, section 256B.0943, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given them.

(a) "Children's therapeutic services and supports" means the flexible package of mental
health services for children who require varying therapeutic and rehabilitative levels of
intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
subdivision 15
, or a diagnosed mental illness, as defined in section 245.462, subdivision
20. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified
in the individual treatment plan.

deleted text begin (b) "Clinical supervision" means the overall responsibility of the mental health
professional for the control and direction of individualized treatment planning, service
delivery, and treatment review for each client. A mental health professional who is an
enrolled Minnesota health care program provider accepts full professional responsibility
for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
and oversees or directs the supervisee's work.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end "Clinical trainee" means a deleted text beginmental health practitioner who meets the qualifications
specified in Minnesota Rules, part 9505.0371, subpart 5, item C
deleted text endnew text begin staff person who is qualified
according to section 245I.04, subdivision 6
new text end.

deleted text begin (d)deleted text endnew text begin (c)new text end "Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end" has the meaning given in section 245.4871, subdivision
9a
. deleted text beginCrisis assistance entails the development of a written plan to assist a child's family to
contend with a potential crisis and is distinct from the immediate provision of crisis
intervention services.
deleted text end

deleted text begin (e)deleted text endnew text begin (d)new text end "Culturally competent provider" means a provider who understands and can
utilize to a client's benefit the client's culture when providing services to the client. A provider
may be culturally competent because the provider is of the same cultural or ethnic group
as the client or the provider has developed the knowledge and skills through training and
experience to provide services to culturally diverse clients.

deleted text begin (f)deleted text endnew text begin (e)new text end "Day treatment program" for children means a site-based structured mental health
program consisting of psychotherapy for three or more individuals and individual or group
skills training provided by a deleted text beginmultidisciplinarydeleted text end team, under the deleted text beginclinicaldeleted text end new text begintreatmentnew text end supervision
of a mental health professional.

deleted text begin (g)deleted text endnew text begin (f)new text end "new text beginStandard new text enddiagnostic assessment" deleted text beginhas the meaning given in Minnesota Rules, part
9505.0372, subpart 1
deleted text endnew text begin means the assessment described in 245I.10, subdivision 6new text end.

deleted text begin (h)deleted text endnew text begin (g)new text end "Direct service time" means the time that a mental health professional, clinical
trainee, mental health practitioner, or mental health behavioral aide spends face-to-face with
a client and the client's family or providing covered telemedicine services. Direct service
time includes time in which the provider obtains a client's history, develops a client's
treatment plan, records individual treatment outcomes, or provides service components of
children's therapeutic services and supports. Direct service time does not include time doing
work before and after providing direct services, including scheduling or maintaining clinical
records.

deleted text begin (i)deleted text endnew text begin (h)new text end "Direction of mental health behavioral aide" means the activities of a mental
health professionalnew text begin, clinical trainee,new text end or mental health practitioner in guiding the mental
health behavioral aide in providing services to a client. The direction of a mental health
behavioral aide must be based on the client's deleted text beginindividualizeddeleted text endnew text begin individualnew text end treatment plan and
meet the requirements in subdivision 6, paragraph (b), clause (5).

deleted text begin (j)deleted text endnew text begin (i)new text end "Emotional disturbance" has the meaning given in section 245.4871, subdivision
15
.

deleted text begin (k)deleted text endnew text begin (j)new text end "Individual behavioral plan" means a plan of intervention, treatment, and services
for a child written by a mental health professional new text beginor a clinical trainee new text endor mental health
practitionerdeleted text begin,deleted text end under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional, to
guide the work of the mental health behavioral aide. The individual behavioral plan may
be incorporated into the child's individual treatment plan so long as the behavioral plan is
separately communicable to the mental health behavioral aide.

deleted text begin (l)deleted text endnew text begin (k)new text end "Individual treatment plan" deleted text beginhas the meaning given in Minnesota Rules, part
9505.0371, subpart 7
deleted text endnew text begin means the plan described in section 245I.10, subdivisions 7 and 8new text end.

deleted text begin (m)deleted text endnew text begin (l)new text end "Mental health behavioral aide services" means medically necessary one-on-one
activities performed by a deleted text begintrained paraprofessional qualified as provided in subdivision 7,
paragraph (b), clause (3)
deleted text endnew text begin mental health behavioral aide qualified according to section 245I.04,
subdivision 16
new text end, to assist a child retain or generalize psychosocial skills as previously trained
by a mental health professionalnew text begin, clinical trainee,new text end or mental health practitioner and as described
in the child's individual treatment plan and individual behavior plan. Activities involve
working directly with the child or child's family as provided in subdivision 9, paragraph
(b), clause (4).

new text begin (m) "Mental health certified family peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 12.
new text end

(n) "Mental health practitioner" deleted text beginhas the meaning given in section 245.462, subdivision
17
, except that a practitioner working in a day treatment setting may qualify as a mental
health practitioner if the practitioner holds a bachelor's degree in one of the behavioral
sciences or related fields from an accredited college or university, and: (1) has at least 2,000
hours of clinically supervised experience in the delivery of mental health services to clients
with mental illness; (2) is fluent in the language, other than English, of the cultural group
that makes up at least 50 percent of the practitioner's clients, completes 40 hours of training
on the delivery of services to clients with mental illness, and receives clinical supervision
from a mental health professional at least once per week until meeting the required 2,000
hours of supervised experience; or (3) receives 40 hours of training on the delivery of
deleted text enddeleted text begin services to clients with mental illness within six months of employment, and clinical
supervision from a mental health professional at least once per week until meeting the
required 2,000 hours of supervised experience
deleted text endnew text begin means a staff person who is qualified according
to section 245I.04, subdivision 4
new text end.

(o) "Mental health professional" means deleted text beginan individual as defined in Minnesota Rules,
part 9505.0370, subpart 18
deleted text endnew text begin a staff person who is qualified according to section 245I.04,
subdivision 2
new text end.

(p) "Mental health service plan development" includes:

(1) the development, review, and revision of a child's individual treatment plan, deleted text beginas
provided in Minnesota Rules, part 9505.0371, subpart 7,
deleted text end including involvement of the client
or client's parents, primary caregiver, or other person authorized to consent to mental health
services for the client, and including arrangement of treatment and support activities specified
in the individual treatment plan; and

(2) administering new text beginand reporting the new text endstandardized outcome deleted text beginmeasurement instruments,
determined and updated by the commissioner
deleted text endnew text begin measurements in section 245I.10, subdivision
6, paragraph (d), clauses (3) and (4), and other standardized outcome measurements approved
by the commissioner
new text end, as periodically needed to evaluate the effectiveness of treatment deleted text beginfor
children receiving clinical services and reporting outcome measures, as required by the
commissioner
deleted text end.

(q) "Mental illness," for persons at least age 18 but under age 21, has the meaning given
in section 245.462, subdivision 20, paragraph (a).

(r) "Psychotherapy" means the treatment deleted text beginof mental or emotional disorders or
maladjustment by psychological means. Psychotherapy may be provided in many modalities
in accordance with Minnesota Rules, part 9505.0372, subpart 6, including patient and/or
family psychotherapy; family psychotherapy; psychotherapy for crisis; group psychotherapy;
or multiple-family psychotherapy. Beginning with the American Medical Association's
Current Procedural Terminology, standard edition, 2014, the procedure "individual
psychotherapy" is replaced with "patient and/or family psychotherapy," a substantive change
that permits the therapist to work with the client's family without the client present to obtain
information about the client or to explain the client's treatment plan to the family.
Psychotherapy is appropriate for crisis response when a child has become dysregulated or
experienced new trauma since the diagnostic assessment was completed and needs
psychotherapy to address issues not currently included in the child's individual treatment
plan
deleted text endnew text begin described in section 256B.0671, subdivision 11new text end.

(s) "Rehabilitative services" or "psychiatric rehabilitation services" means deleted text begina series or
multidisciplinary combination of psychiatric and psychosocial
deleted text end interventions to: (1) restore
a child or adolescent to an age-appropriate developmental trajectory that had been disrupted
by a psychiatric illness; or (2) enable the child to self-monitor, compensate for, cope with,
counteract, or replace psychosocial skills deficits or maladaptive skills acquired over the
course of a psychiatric illness. Psychiatric rehabilitation services for children combine
new text begin coordinated new text endpsychotherapy to address internal psychological, emotional, and intellectual
processing deficits, and skills training to restore personal and social functioning. Psychiatric
rehabilitation services establish a progressive series of goals with each achievement building
upon a prior achievement. deleted text beginContinuing progress toward goals is expected, and rehabilitative
potential ceases when successive improvement is not observable over a period of time.
deleted text end

(t) "Skills training" means individual, family, or group training, delivered by or under
the supervision of a mental health professional, designed to facilitate the acquisition of
psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
to the service delivery requirements under subdivision 9, paragraph (b), clause (2).

new text begin (u) "Treatment supervision" means the supervision described in section 245I.06.
new text end

Sec. 82.

Minnesota Statutes 2020, section 256B.0943, subdivision 2, is amended to read:


Subd. 2.

Covered service components of children's therapeutic services and
supports.

(a) Subject to federal approval, medical assistance covers medically necessary
children's therapeutic services and supports deleted text beginas defined in this section thatdeleted text endnew text begin when the services
are provided by
new text end an eligible provider entity certified under deleted text beginsubdivision 4 provides to a client
eligible under subdivision 3
deleted text endnew text begin and meeting the standards in this sectionnew text end.new text begin The provider entity
must make reasonable and good faith efforts to report individual client outcomes to the
commissioner, using instruments and protocols approved by the commissioner.
new text end

(b) The service components of children's therapeutic services and supports are:

(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis,
and group psychotherapy;

(2) individual, family, or group skills training provided by a mental health professionalnew text begin,
clinical trainee,
new text end or mental health practitioner;

(3) crisis deleted text beginassistancedeleted text endnew text begin planningnew text end;

(4) mental health behavioral aide services;

(5) direction of a mental health behavioral aide;

(6) mental health service plan development; and

(7) children's day treatment.

Sec. 83.

Minnesota Statutes 2020, section 256B.0943, subdivision 3, is amended to read:


Subd. 3.

Determination of client eligibility.

new text begin(a) new text endA client's eligibility to receive children's
therapeutic services and supports under this section shall be determined based on a new text beginstandard
new text end diagnostic assessment by a mental health professional or a deleted text beginmental health practitioner who
meets the requirements of a clinical trainee as defined in Minnesota Rules, part 9505.0371,
subpart 5, item C,
deleted text endnew text begin clinical traineenew text end that is performed within one year before the initial start
of service. The new text beginstandard new text enddiagnostic assessment must deleted text beginmeet the requirements for a standard
or extended diagnostic assessment as defined in Minnesota Rules, part 9505.0372, subpart
1, items B and C, and
deleted text end:

deleted text begin (1) include current diagnoses, including any differential diagnosis, in accordance with
all criteria for a complete diagnosis and diagnostic profile as specified in the current edition
of the Diagnostic and Statistical Manual of the American Psychiatric Association, or, for
children under age five, as specified in the current edition of the Diagnostic Classification
of Mental Health Disorders of Infancy and Early Childhood;
deleted text end

deleted text begin (2)deleted text endnew text begin (1)new text end determine whether a child under age 18 has a diagnosis of emotional disturbance
or, if the person is between the ages of 18 and 21, whether the person has a mental illness;

deleted text begin (3)deleted text endnew text begin (2)new text end document children's therapeutic services and supports as medically necessary to
address an identified disability, functional impairment, and the individual client's needs and
goals;new text begin and
new text end

deleted text begin (4)deleted text endnew text begin (3)new text end be used in the development of the deleted text beginindividualizeddeleted text endnew text begin individualnew text end treatment plandeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (5) be completed annually until age 18. For individuals between age 18 and 21, unless
a client's mental health condition has changed markedly since the client's most recent
diagnostic assessment, annual updating is necessary. For the purpose of this section,
"updating" means an adult diagnostic update as defined in Minnesota Rules, part 9505.0371,
subpart 2, item E.
deleted text end

new text begin (b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to
five days of day treatment under this section based on a hospital's medical history and
presentation examination of the client.
new text end

Sec. 84.

Minnesota Statutes 2020, section 256B.0943, subdivision 4, is amended to read:


Subd. 4.

Provider entity certification.

(a) The commissioner shall establish an initial
provider entity application and certification process and recertification process to determine
whether a provider entity has an administrative and clinical infrastructure that meets the
requirements in subdivisions 5 and 6. A provider entity must be certified for the three core
rehabilitation services of psychotherapy, skills training, and crisis deleted text beginassistancedeleted text endnew text begin planningnew text end. The
commissioner shall recertify a provider entity at least every three years. The commissioner
shall establish a process for decertification of a provider entity and shall require corrective
action, medical assistance repayment, or decertification of a provider entity that no longer
meets the requirements in this section or that fails to meet the clinical quality standards or
administrative standards provided by the commissioner in the application and certification
process.

(b) For purposes of this section, a provider entity must new text beginmeet the standards in this section
and chapter 245I, as required under section 245I.011, subdivision 5, and
new text endbe:

(1) an Indian health services facility or a facility owned and operated by a tribe or tribal
organization operating as a 638 facility under Public Law 93-638 certified by the state;

(2) a county-operated entity certified by the state; or

(3) a noncounty entity certified by the state.

Sec. 85.

Minnesota Statutes 2020, section 256B.0943, subdivision 5, is amended to read:


Subd. 5.

Provider entity administrative infrastructure requirements.

(a) deleted text beginTo be an
eligible provider entity under this section, a provider entity must have an administrative
infrastructure that establishes authority and accountability for decision making and oversight
of functions, including finance, personnel, system management, clinical practice, and
individual treatment outcomes measurement.
deleted text end An eligible provider entity shall demonstrate
the availability, by means of employment or contract, of at least one backup mental health
professional in the event of the primary mental health professional's absence. deleted text beginThe provider
must have written policies and procedures that it reviews and updates every three years and
distributes to staff initially and upon each subsequent update.
deleted text end

(b) deleted text beginThe administrative infrastructure writtendeleted text endnew text begin In addition to the policies and procedures
required under section 245I.03, the
new text end policies and procedures must include:

deleted text begin (1) personnel procedures, including a process for: (i) recruiting, hiring, training, and
retention of culturally and linguistically competent providers; (ii) conducting a criminal
background check on all direct service providers and volunteers; (iii) investigating, reporting,
and acting on violations of ethical conduct standards; (iv) investigating, reporting, and acting
on violations of data privacy policies that are compliant with federal and state laws; (v)
utilizing volunteers, including screening applicants, training and supervising volunteers,
and providing liability coverage for volunteers; and (vi) documenting that each mental
health professional, mental health practitioner, or mental health behavioral aide meets the
applicable provider qualification criteria, training criteria under subdivision 8, and clinical
supervision or direction of a mental health behavioral aide requirements under subdivision
6;
deleted text end

deleted text begin (2)deleted text endnew text begin (1)new text end fiscal procedures, including internal fiscal control practices and a process for
collecting revenue that is compliant with federal and state laws;new text begin and
new text end

deleted text begin (3)deleted text endnew text begin (2)new text end a client-specific treatment outcomes measurement system, including baseline
measures, to measure a client's progress toward achieving mental health rehabilitation goals.
deleted text begin Effective July 1, 2017, to be eligible for medical assistance payment, a provider entity must
report individual client outcomes to the commissioner, using instruments and protocols
approved by the commissioner; and
deleted text end

deleted text begin (4) a process to establish and maintain individual client records. The client's records
must include:
deleted text end

deleted text begin (i) the client's personal information;
deleted text end

deleted text begin (ii) forms applicable to data privacy;
deleted text end

deleted text begin (iii) the client's diagnostic assessment, updates, results of tests, individual treatment
plan, and individual behavior plan, if necessary;
deleted text end

deleted text begin (iv) documentation of service delivery as specified under subdivision 6;
deleted text end

deleted text begin (v) telephone contacts;
deleted text end

deleted text begin (vi) discharge plan; and
deleted text end

deleted text begin (vii) if applicable, insurance information.
deleted text end

(c) A provider entity that uses a restrictive procedure with a client must meet the
requirements of section 245.8261.

Sec. 86.

Minnesota Statutes 2020, section 256B.0943, subdivision 5a, is amended to read:


Subd. 5a.

Background studies.

The requirements for background studies under deleted text beginthisdeleted text end
section new text begin245I.011, subdivision 4, paragraph (d), new text endmay be met by a children's therapeutic
services and supports services agency through the commissioner's NETStudy system as
provided under sections 245C.03, subdivision 7, and 245C.10, subdivision 8.

Sec. 87.

Minnesota Statutes 2020, section 256B.0943, subdivision 6, is amended to read:


Subd. 6.

Provider entity clinical infrastructure requirements.

(a) To be an eligible
provider entity under this section, a provider entity must have a clinical infrastructure that
utilizes diagnostic assessment, deleted text beginindividualizeddeleted text endnew text begin individualnew text end treatment plans, service delivery,
and individual treatment plan review that are culturally competent, child-centered, and
family-driven to achieve maximum benefit for the client. The provider entity must review,
and update as necessary, the clinical policies and procedures every three years, must distribute
the policies and procedures to staff initially and upon each subsequent update, and must
train staff accordingly.

(b) The clinical infrastructure written policies and procedures must include policies and
procedures fornew text begin meeting the requirements in this subdivisionnew text end:

(1) providing or obtaining a client's new text beginstandard new text enddiagnostic assessment, including a new text beginstandard
new text end diagnostic assessment deleted text beginperformed by an outside or independent clinician, that identifies acute
and chronic clinical disorders, co-occurring medical conditions, and sources of psychological
and environmental problems, including baselines, and a functional assessment. The functional
assessment component must clearly summarize the client's individual strengths and needs.
deleted text end
When required components of the new text beginstandard new text enddiagnostic assessmentdeleted text begin, such as baseline measures,deleted text end
are not provided in an outside or independent assessment or deleted text beginwhen baseline measuresdeleted text end cannot
be attained deleted text beginin a one-session standard diagnostic assessmentdeleted text endnew text begin immediatelynew text end, the provider entity
must determine the missing information within 30 days and amend the child's new text beginstandard
new text end diagnostic assessment or incorporate the deleted text beginbaselinesdeleted text endnew text begin informationnew text end into the child's individual
treatment plan;

(2) developing an individual treatment plan deleted text beginthat:deleted text endnew text begin;
new text end

deleted text begin (i) is based on the information in the client's diagnostic assessment and baselines;
deleted text end

deleted text begin (ii) identified goals and objectives of treatment, treatment strategy, schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment services and supports;
deleted text end

deleted text begin (iii) is developed after completion of the client's diagnostic assessment by a mental health
professional or clinical trainee and before the provision of children's therapeutic services
and supports;
deleted text end

deleted text begin (iv) is developed through a child-centered, family-driven, culturally appropriate planning
process, including allowing parents and guardians to observe or participate in individual
and family treatment services, assessment, and treatment planning;
deleted text end

deleted text begin (v) is reviewed at least once every 90 days and revised to document treatment progress
on each treatment objective and next goals or, if progress is not documented, to document
changes in treatment; and
deleted text end

deleted text begin (vi) is signed by the clinical supervisor and by the client or by the client's parent or other
person authorized by statute to consent to mental health services for the client. A client's
parent may approve the client's individual treatment plan by secure electronic signature or
by documented oral approval that is later verified by written signature;
deleted text end

(3) developing an individual behavior plan that documents deleted text begintreatment strategiesdeleted text endnew text begin and
describes interventions
new text end to be provided by the mental health behavioral aide. The individual
behavior plan must include:

(i) detailed instructions on the deleted text begintreatment strategies to be provideddeleted text endnew text begin psychosocial skills to
be practiced
new text end;

(ii) time allocated to each deleted text begintreatment strategydeleted text endnew text begin interventionnew text end;

(iii) methods of documenting the child's behavior;

(iv) methods of monitoring the child's progress in reaching objectives; and

(v) goals to increase or decrease targeted behavior as identified in the individual treatment
plan;

(4) providing deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision plans for deleted text beginmental health practitioners and
mental health behavioral aides. A mental health professional must document the clinical
supervision the professional provides by cosigning individual treatment plans and making
entries in the client's record on supervisory activities. The clinical supervisor also shall
document supervisee-specific supervision in the supervisee's personnel file. Clinical
deleted text endnew text begin staff
according to section 245I.06. Treatment
new text end supervision does not include the authority to make
or terminate court-ordered placements of the child. A deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervisor must be
available for urgent consultation as required by the individual client's needs or the situationdeleted text begin.
Clinical supervision may occur individually or in a small group to discuss treatment and
review progress toward goals. The focus of clinical supervision must be the client's treatment
needs and progress and the mental health practitioner's or behavioral aide's ability to provide
services
deleted text end;

(4a) meeting day treatment program conditions in items (i) deleted text beginto (iii)deleted text endnew text begin and (ii)new text end:

(i) the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervisor must be present and available on the premises more
than 50 percent of the time in a provider's standard working week during which the supervisee
is providing a mental health service;new text begin and
new text end

deleted text begin (ii) the diagnosis and the client's individual treatment plan or a change in the diagnosis
or individual treatment plan must be made by or reviewed, approved, and signed by the
clinical supervisor; and
deleted text end

deleted text begin (iii)deleted text endnew text begin (ii)new text end every 30 days, the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervisor must review and sign the record
indicating the supervisor has reviewed the client's care for all activities in the preceding
30-day period;

(4b) meeting the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision standards in items (i) deleted text beginto (iv)deleted text endnew text begin and (ii)new text end for
all other services provided under CTSS:

deleted text begin (i) medical assistance shall reimburse for services provided by a mental health practitioner
who is delivering services that fall within the scope of the practitioner's practice and who
is supervised by a mental health professional who accepts full professional responsibility;
deleted text end

deleted text begin (ii) medical assistance shall reimburse for services provided by a mental health behavioral
aide who is delivering services that fall within the scope of the aide's practice and who is
supervised by a mental health professional who accepts full professional responsibility and
has an approved plan for clinical supervision of the behavioral aide. Plans must be developed
in accordance with supervision standards defined in Minnesota Rules, part 9505.0371,
subpart 4, items A to D;
deleted text end

deleted text begin (iii)deleted text endnew text begin (i)new text end the mental health professional is required to be present at the site of service
delivery for observation as clinically appropriate when the new text beginclinical trainee, new text endmental health
practitionernew text begin,new text end or mental health behavioral aide is providing CTSS services; and

deleted text begin (iv)deleted text endnew text begin (ii)new text end when conducted, the on-site presence of the mental health professional must be
documented in the child's record and signed by the mental health professional who accepts
full professional responsibility;

(5) providing direction to a mental health behavioral aide. For entities that employ mental
health behavioral aides, the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervisor must be employed by the provider
entity or other provider certified to provide mental health behavioral aide services to ensure
necessary and appropriate oversight for the client's treatment and continuity of care. The
deleted text begin mental health professional or mental health practitionerdeleted text endnew text begin staffnew text end giving direction must begin
with the goals on the deleted text beginindividualizeddeleted text endnew text begin individualnew text end treatment plan, and instruct the mental health
behavioral aide on how to implement therapeutic activities and interventions that will lead
to goal attainment. The deleted text beginprofessional or practitionerdeleted text endnew text begin staffnew text end giving direction must also instruct
the mental health behavioral aide about the client's diagnosis, functional status, and other
characteristics that are likely to affect service delivery. Direction must also include
determining that the mental health behavioral aide has the skills to interact with the client
and the client's family in ways that convey personal and cultural respect and that the aide
actively solicits information relevant to treatment from the family. The aide must be able
to clearly explain or demonstrate the activities the aide is doing with the client and the
activities' relationship to treatment goals. Direction is more didactic than is supervision and
requires the deleted text beginprofessional or practitionerdeleted text endnew text begin staffnew text end providing it to continuously evaluate the mental
health behavioral aide's ability to carry out the activities of the deleted text beginindividualizeddeleted text endnew text begin individualnew text end
treatment plan and the deleted text beginindividualizeddeleted text endnew text begin individualnew text end behavior plan. When providing direction,
the deleted text beginprofessional or practitionerdeleted text endnew text begin staffnew text end must:

(i) review progress notes prepared by the mental health behavioral aide for accuracy and
consistency with diagnostic assessment, treatment plan, and behavior goals and the
deleted text begin professional or practitionerdeleted text endnew text begin staffnew text end must approve and sign the progress notes;

(ii) identify changes in treatment strategies, revise the individual behavior plan, and
communicate treatment instructions and methodologies as appropriate to ensure that treatment
is implemented correctly;

(iii) demonstrate family-friendly behaviors that support healthy collaboration among
the child, the child's family, and providers as treatment is planned and implemented;

(iv) ensure that the mental health behavioral aide is able to effectively communicate
with the child, the child's family, and the provider; deleted text beginand
deleted text end

(v) record the results of any evaluation and corrective actions taken to modify the work
of the mental health behavioral aide;new text begin and
new text end

new text begin (vi) ensure the immediate accessibility of a mental health professional, clinical trainee,
or mental health practitioner to the behavioral aide during service delivery;
new text end

(6) providing service delivery that implements the individual treatment plan and meets
the requirements under subdivision 9; and

(7) individual treatment plan review. The review must determine the extent to which
the services have met each of the goals and objectives in the treatment plan. The review
must assess the client's progress and ensure that services and treatment goals continue to
be necessary and appropriate to the client and the client's family or foster family. deleted text beginRevision
of the individual treatment plan does not require a new diagnostic assessment unless the
client's mental health status has changed markedly. The updated treatment plan must be
signed by the clinical supervisor and by the client, if appropriate, and by the client's parent
or other person authorized by statute to give consent to the mental health services for the
child.
deleted text end

Sec. 88.

Minnesota Statutes 2020, section 256B.0943, subdivision 7, is amended to read:


Subd. 7.

Qualifications of individual and team providers.

(a) An individual or team
provider working within the scope of the provider's practice or qualifications may provide
service components of children's therapeutic services and supports that are identified as
medically necessary in a client's individual treatment plan.

(b) An individual provider must be qualified asnew text begin anew text end:

(1) deleted text beginadeleted text end mental health professional deleted text beginas defined in subdivision 1, paragraph (o)deleted text end; deleted text beginor
deleted text end

(2) deleted text beginadeleted text endnew text begin clinical trainee;
new text end

new text begin (3)new text end mental health practitioner deleted text beginor clinical trainee. The mental health practitioner or clinical
trainee must work under the clinical supervision of a mental health professional
deleted text end; deleted text beginor
deleted text end

new text begin (4) mental health certified family peer specialist; or
new text end

deleted text begin (3) adeleted text endnew text begin (5)new text end mental health behavioral aide deleted text beginworking under the clinical supervision of a mental
health professional to implement the rehabilitative mental health services previously
introduced by a mental health professional or practitioner and identified in the client's
individual treatment plan and individual behavior plan.
deleted text end

deleted text begin (A) A level I mental health behavioral aide must:
deleted text end

deleted text begin (i) be at least 18 years old;
deleted text end

deleted text begin (ii) have a high school diploma or commissioner of education-selected high school
equivalency certification or two years of experience as a primary caregiver to a child with
severe emotional disturbance within the previous ten years; and
deleted text end

deleted text begin (iii) meet preservice and continuing education requirements under subdivision 8.
deleted text end

deleted text begin (B) A level II mental health behavioral aide must:
deleted text end

deleted text begin (i) be at least 18 years old;
deleted text end

deleted text begin (ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
clinical services in the treatment of mental illness concerning children or adolescents or
complete a certificate program established under subdivision 8a; and
deleted text end

deleted text begin (iii) meet preservice and continuing education requirements in subdivision 8.
deleted text end

(c) A day treatment deleted text beginmultidisciplinarydeleted text end team must include at least one mental health
professional or clinical trainee and one mental health practitioner.

Sec. 89.

Minnesota Statutes 2020, section 256B.0943, subdivision 9, is amended to read:


Subd. 9.

Service delivery criteria.

(a) In delivering services under this section, a certified
provider entity must ensure that:

(1) deleted text begineach individual provider's caseload size permits the provider to deliver services to
both clients with severe, complex needs and clients with less intensive needs.
deleted text end the provider's
caseload size should reasonably enable the provider to play an active role in service planning,
monitoring, and delivering services to meet the client's and client's family's needs, as specified
in each client's individual treatment plan;

(2) site-based programs, including day treatment programs, provide staffing and facilities
to ensure the client's health, safety, and protection of rights, and that the programs are able
to implement each client's individual treatment plan; and

(3) a day treatment program is provided to a group of clients by a deleted text beginmultidisciplinarydeleted text end team
under the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision of a mental health professional. The day treatment
program must be provided in and by: (i) an outpatient hospital accredited by the Joint
Commission on Accreditation of Health Organizations and licensed under sections 144.50
to 144.55; (ii) a community mental health center under section 245.62; or (iii) an entity that
is certified under subdivision 4 to operate a program that meets the requirements of section
245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day
treatment program must stabilize the client's mental health status while developing and
improving the client's independent living and socialization skills. The goal of the day
treatment program must be to reduce or relieve the effects of mental illness and provide
training to enable the client to live in the community. The program must be available
year-round at least three to five days per week, two or three hours per day, unless the normal
five-day school week is shortened by a holiday, weather-related cancellation, or other
districtwide reduction in a school week. A child transitioning into or out of day treatment
must receive a minimum treatment of one day a week for a two-hour time block. The
two-hour time block must include at least one hour of patient and/or family or group
psychotherapy. The remainder of the structured treatment program may include patient
and/or family or group psychotherapy, and individual or group skills training, if included
in the client's individual treatment plan. Day treatment programs are not part of inpatient
or residential treatment services. When a day treatment group that meets the minimum group
size requirement temporarily falls below the minimum group size because of a member's
temporary absence, medical assistance covers a group session conducted for the group
members in attendance. A day treatment program may provide fewer than the minimally
required hours for a particular child during a billing period in which the child is transitioning
into, or out of, the program.

(b) To be eligible for medical assistance payment, a provider entity must deliver the
service components of children's therapeutic services and supports in compliance with the
following requirements:

(1) deleted text beginpatient and/or family, family, and group psychotherapy must be delivered as specified
in Minnesota Rules, part 9505.0372, subpart 6.
deleted text end psychotherapy to address the child's
underlying mental health disorder must be documented as part of the child's ongoing
treatment. A provider must deliver, or arrange for, medically necessary psychotherapy,
unless the child's parent or caregiver chooses not to receive it. When a provider delivering
other services to a child under this section deems it not medically necessary to provide
psychotherapy to the child for a period of 90 days or longer, the provider entity must
document the medical reasons why psychotherapy is not necessary. When a provider
determines that a child needs psychotherapy but psychotherapy cannot be delivered due to
a shortage of licensed mental health professionals in the child's community, the provider
must document the lack of access in the child's medical record;

(2) individual, family, or group skills training deleted text beginmust be provided by a mental health
professional or a mental health practitioner who is delivering services that fall within the
scope of the provider's practice and is supervised by a mental health professional who
accepts full professional responsibility for the training. Skills training
deleted text end is subject to the
following requirements:

(i) a mental health professional, clinical trainee, or mental health practitioner shall provide
skills training;

(ii) skills training delivered to a child or the child's family must be targeted to the specific
deficits or maladaptations of the child's mental health disorder and must be prescribed in
the child's individual treatment plan;

(iii) the mental health professional delivering or supervising the delivery of skills training
must document any underlying psychiatric condition and must document how skills training
is being used in conjunction with psychotherapy to address the underlying condition;

(iv) skills training delivered to the child's family must teach skills needed by parents to
enhance the child's skill development, to help the child utilize daily life skills taught by a
mental health professional, clinical trainee, or mental health practitioner, and to develop or
maintain a home environment that supports the child's progressive use of skills;

(v) group skills training may be provided to multiple recipients who, because of the
nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
interaction in a group setting, which must be staffed as follows:

(A) one mental health professional deleted text beginor onedeleted text endnew text begin,new text end clinical traineenew text begin,new text end or mental health practitioner
deleted text begin under supervision of a licensed mental health professionaldeleted text end must work with a group of three
to eight clients; or

(B) new text beginany combination of new text endtwo mental health professionals, deleted text begintwodeleted text end clinical traineesnew text begin,new text end or mental
health practitioners deleted text beginunder supervision of a licensed mental health professional, or one mental
health professional or clinical trainee and one mental health practitioner
deleted text end must work with a
group of nine to 12 clients;

(vi) a mental health professional, clinical trainee, or mental health practitioner must have
taught the psychosocial skill before a mental health behavioral aide may practice that skill
with the client; and

(vii) for group skills training, when a skills group that meets the minimum group size
requirement temporarily falls below the minimum group size because of a group member's
temporary absence, the provider may conduct the session for the group members in
attendance;

(3) crisis deleted text beginassistancedeleted text endnew text begin planningnew text end to a child and family must include development of a written
plan that anticipates the particular factors specific to the child that may precipitate a
psychiatric crisis for the child in the near future. The written plan must document actions
that the family should be prepared to take to resolve or stabilize a crisis, such as advance
arrangements for direct intervention and support services to the child and the child's family.
Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end must include preparing resources designed to address abrupt or
substantial changes in the functioning of the child or the child's family when sudden change
in behavior or a loss of usual coping mechanisms is observed, or the child begins to present
a danger to self or others;

(4) mental health behavioral aide services must be medically necessary treatment services,
identified in the child's individual treatment plan and individual behavior plan, deleted text beginwhich are
performed minimally by a paraprofessional qualified according to subdivision 7, paragraph
(b), clause (3),
deleted text end and which are designed to improve the functioning of the child in the
progressive use of developmentally appropriate psychosocial skills. Activities involve
working directly with the child, child-peer groupings, or child-family groupings to practice,
repeat, reintroduce, and master the skills defined in subdivision 1, paragraph (t), as previously
taught by a mental health professional, clinical trainee, or mental health practitioner including:

(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions
so that the child progressively recognizes and responds to the cues independently;

(ii) performing as a practice partner or role-play partner;

(iii) reinforcing the child's accomplishments;

(iv) generalizing skill-building activities in the child's multiple natural settings;

(v) assigning further practice activities; and

(vi) intervening as necessary to redirect the child's target behavior and to de-escalate
behavior that puts the child or other person at risk of injury.

To be eligible for medical assistance payment, mental health behavioral aide services must
be delivered to a child who has been diagnosed with an emotional disturbance or a mental
illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must
implement treatment strategies in the individual treatment plan and the individual behavior
plan as developed by the mental health professional, clinical trainee, or mental health
practitioner providing direction for the mental health behavioral aide. The mental health
behavioral aide must document the delivery of services in written progress notes. Progress
notes must reflect implementation of the treatment strategies, as performed by the mental
health behavioral aide and the child's responses to the treatment strategies;new text begin and
new text end

deleted text begin (5) direction of a mental health behavioral aide must include the following:
deleted text end

deleted text begin (i) ongoing face-to-face observation of the mental health behavioral aide delivering
services to a child by a mental health professional or mental health practitioner for at least
a total of one hour during every 40 hours of service provided to a child; and
deleted text end

deleted text begin (ii) immediate accessibility of the mental health professional, clinical trainee, or mental
health practitioner to the mental health behavioral aide during service provision;
deleted text end

deleted text begin (6)deleted text endnew text begin (5)new text end mental health service plan development must be performed in consultation with
the child's family and, when appropriate, with other key participants in the child's life by
the child's treating mental health professional or clinical trainee or by a mental health
practitioner and approved by the treating mental health professional. Treatment plan drafting
consists of development, review, and revision by face-to-face or electronic communication.
The provider must document events, including the time spent with the family and other key
participants in the child's life to deleted text beginreview, revise, and signdeleted text endnew text begin approvenew text end the individual treatment
plan. deleted text beginNotwithstanding Minnesota Rules, part 9505.0371, subpart 7,deleted text end Medical assistance
covers service plan development before completion of the child's individual treatment plan.
Service plan development is covered only if a treatment plan is completed for the child. If
upon review it is determined that a treatment plan was not completed for the child, the
commissioner shall recover the payment for the service plan developmentdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (7) to be eligible for payment, a diagnostic assessment must be complete with regard to
all required components, including multiple assessment appointments required for an
extended diagnostic assessment and the written report. Dates of the multiple assessment
appointments must be noted in the client's clinical record.
deleted text end

Sec. 90.

Minnesota Statutes 2020, section 256B.0943, subdivision 11, is amended to read:


Subd. 11.

Documentation and billing.

deleted text begin(a)deleted text end A provider entity must document the services
it provides under this section. The provider entity must ensure that documentation complies
with Minnesota Rules, parts 9505.2175 and 9505.2197. Services billed under this section
that are not documented according to this subdivision shall be subject to monetary recovery
by the commissioner. Billing for covered service components under subdivision 2, paragraph
(b), must not include anything other than direct service time.

deleted text begin (b) An individual mental health provider must promptly document the following in a
client's record after providing services to the client:
deleted text end

deleted text begin (1) each occurrence of the client's mental health service, including the date, type, start
and stop times, scope of the service as described in the child's individual treatment plan,
and outcome of the service compared to baselines and objectives;
deleted text end

deleted text begin (2) the name, dated signature, and credentials of the person who delivered the service;
deleted text end

deleted text begin (3) contact made with other persons interested in the client, including representatives
of the courts, corrections systems, or schools. The provider must document the name and
date of each contact;
deleted text end

deleted text begin (4) any contact made with the client's other mental health providers, case manager,
family members, primary caregiver, legal representative, or the reason the provider did not
contact the client's family members, primary caregiver, or legal representative, if applicable;
deleted text end

deleted text begin (5) required clinical supervision directly related to the identified client's services and
needs, as appropriate, with co-signatures of the supervisor and supervisee; and
deleted text end

deleted text begin (6) the date when services are discontinued and reasons for discontinuation of services.
deleted text end

Sec. 91.

Minnesota Statutes 2020, section 256B.0946, subdivision 1, is amended to read:


Subdivision 1.

Required covered service components.

(a) deleted text beginEffective May 23, 2013,
and
deleted text end Subject to federal approval, medical assistance covers medically necessary intensive
treatment services deleted text begindescribed under paragraph (b) thatdeleted text endnew text begin when the servicesnew text end are provided by a
provider entity deleted text begineligible under subdivision 3 to a client eligible under subdivision 2 who is
placed in a foster home licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or
placed in a foster home licensed under the regulations established by a federally recognized
Minnesota tribe
deleted text endnew text begin certified under and meeting the standards in this sectionnew text end.new text begin The provider entity
must make reasonable and good faith efforts to report individual client outcomes to the
commissioner, using instruments and protocols approved by the commissioner.
new text end

(b) Intensive treatment services to children with mental illness residing in foster family
settings that comprise specific required service components provided in clauses (1) to (5)
are reimbursed by medical assistance when they meet the following standards:

(1) psychotherapy provided by a mental health professional deleted text beginas defined in Minnesota
Rules, part 9505.0371, subpart 5, item A,
deleted text end or a clinical traineedeleted text begin, as defined in Minnesota
Rules, part 9505.0371, subpart 5, item C
deleted text end;

(2) crisis deleted text beginassistance provided according to standards for children's therapeutic services
and supports in section 256B.0943
deleted text endnew text begin planningnew text end;

(3) individual, family, and group psychoeducation servicesdeleted text begin, defined in subdivision 1a,
paragraph (q),
deleted text end provided by a mental health professional or a clinical trainee;

(4) clinical care consultationdeleted text begin, as defined in subdivision 1a, anddeleted text end provided by a mental
health professional or a clinical trainee; and

(5) service delivery payment requirements as provided under subdivision 4.

Sec. 92.

Minnesota Statutes 2020, section 256B.0946, subdivision 1a, is amended to read:


Subd. 1a.

Definitions.

For the purposes of this section, the following terms have the
meanings given them.

(a) "Clinical care consultation" means communication from a treating clinician to other
providers working with the same client to inform, inquire, and instruct regarding the client's
symptoms, strategies for effective engagement, care and intervention needs, and treatment
expectations across service settings, including but not limited to the client's school, social
services, day care, probation, home, primary care, medication prescribers, disabilities
services, and other mental health providers and to direct and coordinate clinical service
components provided to the client and family.

deleted text begin (b) "Clinical supervision" means the documented time a clinical supervisor and supervisee
spend together to discuss the supervisee's work, to review individual client cases, and for
the supervisee's professional development. It includes the documented oversight and
supervision responsibility for planning, implementation, and evaluation of services for a
client's mental health treatment.
deleted text end

deleted text begin (c) "Clinical supervisor" means the mental health professional who is responsible for
clinical supervision.
deleted text end

deleted text begin (d)deleted text endnew text begin (b)new text end "Clinical trainee" deleted text beginhas the meaning given in Minnesota Rules, part 9505.0371,
subpart 5, item C;
deleted text endnew text begin means a staff person who is qualified according to section 245I.04,
subdivision 6.
new text end

deleted text begin (e)deleted text endnew text begin (c)new text end "Crisis deleted text beginassistancedeleted text endnew text begin planningnew text end" has the meaning given in section 245.4871, subdivision
9a
deleted text begin, including the development of a plan that addresses prevention and intervention strategies
to be used in a potential crisis, but does not include actual crisis intervention
deleted text end.

deleted text begin (f)deleted text endnew text begin (d)new text end "Culturally appropriate" means providing mental health services in a manner that
incorporates the child's cultural influencesdeleted text begin, as defined in Minnesota Rules, part 9505.0370,
subpart 9,
deleted text end into interventions as a way to maximize resiliency factors and utilize cultural
strengths and resources to promote overall wellness.

deleted text begin (g)deleted text endnew text begin (e)new text end "Culture" means the distinct ways of living and understanding the world that are
used by a group of people and are transmitted from one generation to another or adopted
by an individual.

deleted text begin (h)deleted text endnew text begin (f)new text end "new text beginStandard new text enddiagnostic assessment" deleted text beginhas the meaning given in Minnesota Rules, part
9505.0370, subpart 11
deleted text endnew text begin means the assessment described in section 245I.10, subdivision 6new text end.

deleted text begin (i)deleted text endnew text begin (g)new text end "Family" means a person who is identified by the client or the client's parent or
guardian as being important to the client's mental health treatment. Family may include,
but is not limited to, parents, foster parents, children, spouse, committed partners, former
spouses, persons related by blood or adoption, persons who are a part of the client's
permanency plan, or persons who are presently residing together as a family unit.

deleted text begin (j)deleted text endnew text begin (h)new text end "Foster care" has the meaning given in section 260C.007, subdivision 18.

deleted text begin (k)deleted text endnew text begin (i)new text end "Foster family setting" means the foster home in which the license holder resides.

deleted text begin (l)deleted text endnew text begin (j)new text end "Individual treatment plan" deleted text beginhas the meaning given in Minnesota Rules, part
9505.0370, subpart 15
deleted text endnew text begin means the plan described in section 245I.10, subdivisions 7 and 8new text end.

deleted text begin (m) "Mental health practitioner" has the meaning given in section 245.462, subdivision
17
, and a mental health practitioner working as a clinical trainee according to Minnesota
Rules, part 9505.0371, subpart 5, item C.
deleted text end

new text begin (k) "Mental health certified family peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 12.
new text end

deleted text begin (n)deleted text endnew text begin (l)new text end "Mental health professional" deleted text beginhas the meaning given in Minnesota Rules, part
9505.0370, subpart 18
deleted text endnew text begin means a staff person who is qualified according to section 245I.04,
subdivision 2
new text end.

deleted text begin (o)deleted text endnew text begin (m)new text end "Mental illness" has the meaning given in deleted text beginMinnesota Rules, part 9505.0370,
subpart 20
deleted text endnew text begin section 245I.02, subdivision 29new text end.

deleted text begin (p)deleted text endnew text begin (n)new text end "Parent" has the meaning given in section 260C.007, subdivision 25.

deleted text begin (q)deleted text endnew text begin (o)new text end "Psychoeducation services" means information or demonstration provided to an
individual, family, or group to explain, educate, and support the individual, family, or group
in understanding a child's symptoms of mental illness, the impact on the child's development,
and needed components of treatment and skill development so that the individual, family,
or group can help the child to prevent relapse, prevent the acquisition of comorbid disorders,
and achieve optimal mental health and long-term resilience.

deleted text begin (r)deleted text endnew text begin (p)new text end "Psychotherapy" deleted text beginhas the meaning given in Minnesota Rules, part 9505.0370,
subpart 27
deleted text endnew text begin means the treatment described in section 256B.0671, subdivision 11new text end.

deleted text begin (s)deleted text endnew text begin (q)new text end "Team consultation and treatment planning" means the coordination of treatment
plans and consultation among providers in a group concerning the treatment needs of the
child, including disseminating the child's treatment service schedule to all members of the
service team. Team members must include all mental health professionals working with the
child, a parent, the child unless the team lead or parent deem it clinically inappropriate, and
at least two of the following: an individualized education program case manager; probation
agent; children's mental health case manager; child welfare worker, including adoption or
guardianship worker; primary care provider; foster parent; and any other member of the
child's service team.

new text begin (r) "Trauma" has the meaning given in section 245I.02, subdivision 38.
new text end

new text begin (s) "Treatment supervision" means the supervision described under section 245I.06.
new text end

Sec. 93.

Minnesota Statutes 2020, section 256B.0946, subdivision 2, is amended to read:


Subd. 2.

Determination of client eligibility.

An eligible recipient is an individual, from
birth through age 20, who is currently placed in a foster home licensed under Minnesota
Rules, parts 2960.3000 to 2960.3340, new text beginor placed in a foster home licensed under the
regulations established by a federally recognized Minnesota tribe,
new text endand has receivednew text begin: (1)new text end a
new text begin standard new text enddiagnostic assessment deleted text beginand an evaluation of level of care needed, as defined in
paragraphs (a) and (b).
deleted text endnew text begin within 180 days before the start of service that documents that
intensive treatment services are medically necessary within a foster family setting to
ameliorate identified symptoms and functional impairments; and (2) a level of care
assessment as defined in section 245I.02, subdivision 19, that demonstrates that the individual
requires intensive intervention without 24-hour medical monitoring, and a functional
assessment as defined in section 245I.02, subdivision 17. The level of care assessment and
the functional assessment must include information gathered from the placing county, tribe,
or case manager.
new text end

deleted text begin (a) The diagnostic assessment must:
deleted text end

deleted text begin (1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
conducted by a mental health professional or a clinical trainee;
deleted text end

deleted text begin (2) determine whether or not a child meets the criteria for mental illness, as defined in
Minnesota Rules, part 9505.0370, subpart 20;
deleted text end

deleted text begin (3) document that intensive treatment services are medically necessary within a foster
family setting to ameliorate identified symptoms and functional impairments;
deleted text end

deleted text begin (4) be performed within 180 days before the start of service; and
deleted text end

deleted text begin (5) be completed as either a standard or extended diagnostic assessment annually to
determine continued eligibility for the service.
deleted text end

deleted text begin (b) The evaluation of level of care must be conducted by the placing county, tribe, or
case manager in conjunction with the diagnostic assessment as described by Minnesota
Rules, part 9505.0372, subpart 1, item B, using a validated tool approved by the
commissioner of human services and not subject to the rulemaking process, consistent with
section 245.4885, subdivision 1, paragraph (d), the result of which evaluation demonstrates
that the child requires intensive intervention without 24-hour medical monitoring. The
commissioner shall update the list of approved level of care tools annually and publish on
the department's website.
deleted text end

Sec. 94.

Minnesota Statutes 2020, section 256B.0946, subdivision 3, is amended to read:


Subd. 3.

Eligible mental health services providers.

(a) Eligible providers for intensive
children's mental health services in a foster family setting must be certified by the state and
have a service provision contract with a county board or a reservation tribal council and
must be able to demonstrate the ability to provide all of the services required in this sectionnew text begin
and meet the standards in chapter 245I, as required in section 245I.011, subdivision 5
new text end.

(b) For purposes of this section, a provider agency must be:

(1) a county-operated entity certified by the state;

(2) an Indian Health Services facility operated by a tribe or tribal organization under
funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or

(3) a noncounty entity.

(c) Certified providers that do not meet the service delivery standards required in this
section shall be subject to a decertification process.

(d) For the purposes of this section, all services delivered to a client must be provided
by a mental health professional or a clinical trainee.

Sec. 95.

Minnesota Statutes 2020, section 256B.0946, subdivision 4, is amended to read:


Subd. 4.

Service delivery payment requirements.

(a) To be eligible for payment under
this section, a provider must develop and practice written policies and procedures for
intensive treatment in foster care, consistent with subdivision 1, paragraph (b), and comply
with the following requirements in paragraphs (b) to deleted text begin(n)deleted text endnew text begin (l)new text end.

deleted text begin (b) A qualified clinical supervisor, as defined in and performing in compliance with
Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
provision of services described in this section.
deleted text end

deleted text begin (c) Each client receiving treatment services must receive an extended diagnostic
assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within 30
days of enrollment in this service unless the client has a previous extended diagnostic
assessment that the client, parent, and mental health professional agree still accurately
describes the client's current mental health functioning.
deleted text end

deleted text begin (d)deleted text endnew text begin (b)new text end Each previous and current mental health, school, and physical health treatment
provider must be contacted to request documentation of treatment and assessments that the
eligible client has received. This information must be reviewed and incorporated into the
new text begin standard new text enddiagnostic assessment and team consultation and treatment planning review process.

deleted text begin (e)deleted text endnew text begin (c)new text end Each client receiving treatment must be assessed for a trauma history, and the
client's treatment plan must document how the results of the assessment will be incorporated
into treatment.

new text begin (d) The level of care assessment as defined in section 245I.02, subdivision 19, and
functional assessment as defined in section 245I.02, subdivision 17, must be updated at
least every 90 days or prior to discharge from the service, whichever comes first.
new text end

deleted text begin (f)deleted text endnew text begin (e)new text end Each client receiving treatment services must have an individual treatment plan
that is reviewed, evaluated, and deleted text beginsigneddeleted text endnew text begin approvednew text end every 90 days using the team consultation
and treatment planning processdeleted text begin, as defined in subdivision 1a, paragraph (s)deleted text end.

deleted text begin (g)deleted text endnew text begin (f) Clinicalnew text end care consultationdeleted text begin, as defined in subdivision 1a, paragraph (a),deleted text end must be
provided in accordance with the client's individual treatment plan.

deleted text begin (h)deleted text endnew text begin (g)new text end Each client must have a crisis deleted text beginassistancedeleted text end plan within ten days of initiating services
and must have access to clinical phone support 24 hours per day, seven days per week,
during the course of treatment. The crisis plan must demonstrate coordination with the local
or regional mobile crisis intervention team.

deleted text begin (i)deleted text endnew text begin (h)new text end Services must be delivered and documented at least three days per week, equaling
at least six hours of treatment per week, unless reduced units of service are specified on the
treatment plan as part of transition or on a discharge plan to another service or level of care.
deleted text begin Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
deleted text end

deleted text begin (j)deleted text endnew text begin (i)new text end Location of service delivery must be in the client's home, day care setting, school,
or other community-based setting that is specified on the client's individualized treatment
plan.

deleted text begin (k)deleted text endnew text begin (j)new text end Treatment must be developmentally and culturally appropriate for the client.

deleted text begin (l)deleted text endnew text begin (k)new text end Services must be delivered in continual collaboration and consultation with the
client's medical providers and, in particular, with prescribers of psychotropic medications,
including those prescribed on an off-label basis. Members of the service team must be aware
of the medication regimen and potential side effects.

deleted text begin (m)deleted text endnew text begin (l)new text end Parents, siblings, foster parents, and members of the child's permanency plan
must be involved in treatment and service delivery unless otherwise noted in the treatment
plan.

deleted text begin (n)deleted text endnew text begin (m)new text end Transition planning for the child must be conducted starting with the first
treatment plan and must be addressed throughout treatment to support the child's permanency
plan and postdischarge mental health service needs.

Sec. 96.

Minnesota Statutes 2020, section 256B.0946, subdivision 6, is amended to read:


Subd. 6.

Excluded services.

(a) Services in clauses (1) to (7) are not covered under this
section and are not eligible for medical assistance payment as components of intensive
treatment in foster care services, but may be billed separately:

(1) inpatient psychiatric hospital treatment;

(2) mental health targeted case management;

(3) partial hospitalization;

(4) medication management;

(5) children's mental health day treatment services;

(6) crisis response services under section deleted text begin256B.0944deleted text endnew text begin 256B.0624new text end; deleted text beginand
deleted text end

(7) transportationdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (8) mental health certified family peer specialist services under section 256B.0616.
new text end

(b) Children receiving intensive treatment in foster care services are not eligible for
medical assistance reimbursement for the following services while receiving intensive
treatment in foster care:

(1) psychotherapy and skills training components of children's therapeutic services and
supports under section deleted text begin256B.0625, subdivision 35bdeleted text endnew text begin 256B.0943new text end;

(2) mental health behavioral aide services as defined in section 256B.0943, subdivision
1, paragraph deleted text begin(m)deleted text endnew text begin (l)new text end;

(3) home and community-based waiver services;

(4) mental health residential treatment; and

(5) room and board costs as defined in section 256I.03, subdivision 6.

Sec. 97.

Minnesota Statutes 2020, section 256B.0947, subdivision 1, is amended to read:


Subdivision 1.

Scope.

deleted text beginEffective November 1, 2011, anddeleted text end Subject to federal approval,
medical assistance covers medically necessary, intensive nonresidential rehabilitative mental
health services deleted text beginas defined in subdivision 2, for recipients as defined in subdivision 3,deleted text end when
the services are provided by an entity meeting the standards in this section.new text begin The provider
entity must make reasonable and good faith efforts to report individual client outcomes to
the commissioner, using instruments and protocols approved by the commissioner.
new text end

Sec. 98.

Minnesota Statutes 2020, section 256B.0947, subdivision 2, is amended to read:


Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

(a) "Intensive nonresidential rehabilitative mental health services" means child
rehabilitative mental health services as defined in section 256B.0943, except that these
services are provided by a multidisciplinary staff using a total team approach consistent
with assertive community treatment, as adapted for youth, and are directed to recipients
deleted text begin ages 16, 17, 18, 19, or 20 with a serious mental illness or co-occurring mental illness and
substance abuse addiction
deleted text end who require intensive services to prevent admission to an inpatient
psychiatric hospital or placement in a residential treatment facility or who require intensive
services to step down from inpatient or residential care to community-based care.

(b) "Co-occurring mental illness and substance deleted text beginabuse addictiondeleted text endnew text begin use disordernew text end" means a
dual diagnosis of at least one form of mental illness and at least one substance use disorder.
Substance use disorders include alcohol or drug abuse or dependence, excluding nicotine
use.

(c) "new text beginStandard new text enddiagnostic assessment" deleted text beginhas the meaning given to it in Minnesota Rules,
part 9505.0370, subpart 11. A diagnostic assessment must be provided according to
Minnesota Rules, part 9505.0372, subpart 1, and for this section must incorporate a
determination of the youth's necessary level of care using a standardized functional
assessment instrument approved and periodically updated by the commissioner
deleted text endnew text begin means the
assessment described in section 245I.10, subdivision 6
new text end.

deleted text begin (d) "Education specialist" means an individual with knowledge and experience working
with youth regarding special education requirements and goals, special education plans,
and coordination of educational activities with health care activities.
deleted text end

deleted text begin (e) "Housing access support" means an ancillary activity to help an individual find,
obtain, retain, and move to safe and adequate housing. Housing access support does not
provide monetary assistance for rent, damage deposits, or application fees.
deleted text end

deleted text begin (f) "Integrated dual disorders treatment" means the integrated treatment of co-occurring
mental illness and substance use disorders by a team of cross-trained clinicians within the
same program, and is characterized by assertive outreach, stage-wise comprehensive
treatment, treatment goal setting, and flexibility to work within each stage of treatment.
deleted text end

deleted text begin (g)deleted text endnew text begin (d)new text end "Medication education services" means services provided individually or in
groups, which focus on:

(1) educating the client and client's family or significant nonfamilial supporters about
mental illness and symptoms;

(2) the role and effects of medications in treating symptoms of mental illness; and

(3) the side effects of medications.

Medication education is coordinated with medication management services and does not
duplicate it. Medication education services are provided by physicians, pharmacists, or
registered nurses with certification in psychiatric and mental health care.

deleted text begin (h) "Peer specialist" means an employed team member who is a mental health certified
peer specialist according to section 256B.0615 and also a former children's mental health
consumer who:
deleted text end

deleted text begin (1) provides direct services to clients including social, emotional, and instrumental
support and outreach;
deleted text end

deleted text begin (2) assists younger peers to identify and achieve specific life goals;
deleted text end

deleted text begin (3) works directly with clients to promote the client's self-determination, personal
responsibility, and empowerment;
deleted text end

deleted text begin (4) assists youth with mental illness to regain control over their lives and their
developmental process in order to move effectively into adulthood;
deleted text end

deleted text begin (5) provides training and education to other team members, consumer advocacy
organizations, and clients on resiliency and peer support; and
deleted text end

deleted text begin (6) meets the following criteria:
deleted text end

deleted text begin (i) is at least 22 years of age;
deleted text end

deleted text begin (ii) has had a diagnosis of mental illness, as defined in Minnesota Rules, part 9505.0370,
subpart 20, or co-occurring mental illness and substance abuse addiction;
deleted text end

deleted text begin (iii) is a former consumer of child and adolescent mental health services, or a former or
current consumer of adult mental health services for a period of at least two years;
deleted text end

deleted text begin (iv) has at least a high school diploma or equivalent;
deleted text end

deleted text begin (v) has successfully completed training requirements determined and periodically updated
by the commissioner;
deleted text end

deleted text begin (vi) is willing to disclose the individual's own mental health history to team members
and clients; and
deleted text end

deleted text begin (vii) must be free of substance use problems for at least one year.
deleted text end

new text begin (e) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.
new text end

deleted text begin (i)deleted text endnew text begin (f)new text end "Provider agency" means a for-profit or nonprofit organization established to
administer an assertive community treatment for youth team.

deleted text begin (j)deleted text endnew text begin (g)new text end "Substance use disorders" means one or more of the disorders defined in the
diagnostic and statistical manual of mental disorders, current edition.

deleted text begin (k)deleted text endnew text begin (h)new text end "Transition services" means:

(1) activities, materials, consultation, and coordination that ensures continuity of the
client's care in advance of and in preparation for the client's move from one stage of care
or life to another by maintaining contact with the client and assisting the client to establish
provider relationships;

(2) providing the client with knowledge and skills needed posttransition;

(3) establishing communication between sending and receiving entities;

(4) supporting a client's request for service authorization and enrollment; and

(5) establishing and enforcing procedures and schedules.

A youth's transition from the children's mental health system and services to the adult
mental health system and services and return to the client's home and entry or re-entry into
community-based mental health services following discharge from an out-of-home placement
or inpatient hospital stay.

deleted text begin (l)deleted text endnew text begin (i)new text end "Treatment team" means all staff who provide services to recipients under this
section.

deleted text begin (m)deleted text endnew text begin (j)new text end "Family peer specialist" means a staff person new text beginwho is new text endqualified under section
256B.0616.

Sec. 99.

Minnesota Statutes 2020, section 256B.0947, subdivision 3, is amended to read:


Subd. 3.

Client eligibility.

An eligible recipient is an individual who:

(1) is age 16, 17, 18, 19, or 20; and

(2) is diagnosed with a serious mental illness or co-occurring mental illness and substance
deleted text begin abuse addictiondeleted text endnew text begin use disordernew text end, for which intensive nonresidential rehabilitative mental health
services are needed;

(3) has received a deleted text beginlevel-of-care determination, using an instrument approved by the
commissioner
deleted text endnew text begin level of care assessment as defined in section 245I.02, subdivision 19new text end, that
indicates a need for intensive integrated intervention without 24-hour medical monitoring
and a need for extensive collaboration among multiple providers;

(4) hasnew text begin receivednew text end anew text begin functional assessment as defined in section 245I.02, subdivision 17,
that indicates
new text end functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; or who is likely to need services from
the adult mental health system within the next two years; and

(5) has had a recent new text beginstandard new text enddiagnostic assessmentdeleted text begin, as provided in Minnesota Rules,
part 9505.0372, subpart 1, by a mental health professional who is qualified under Minnesota
Rules, part 9505.0371, subpart 5, item A,
deleted text end that documents that intensive nonresidential
rehabilitative mental health services are medically necessary to ameliorate identified
symptoms and functional impairments and to achieve individual transition goals.

Sec. 100.

Minnesota Statutes 2020, section 256B.0947, subdivision 3a, is amended to
read:


Subd. 3a.

Required service components.

deleted text begin(a) Subject to federal approval, medical
assistance covers all medically necessary intensive nonresidential rehabilitative mental
health services and supports, as defined in this section, under a single daily rate per client.
Services and supports must be delivered by an eligible provider under subdivision 5 to an
eligible client under subdivision 3.
deleted text end

deleted text begin (b)deleted text endnew text begin (a)new text end Intensive nonresidential rehabilitative mental health services, supports, and
ancillary activities new text beginare new text endcovered by deleted text beginthedeleted text endnew text begin anew text end single daily rate per client must include the following,
as needed by the individual client:

(1) individual, family, and group psychotherapy;

(2) individual, family, and group skills training, as defined in section 256B.0943,
subdivision 1, paragraph (t);

(3) crisis deleted text beginassistancedeleted text endnew text begin planningnew text end as defined in section 245.4871, subdivision 9adeleted text begin, which
includes recognition of factors precipitating a mental health crisis, identification of behaviors
related to the crisis, and the development of a plan to address prevention, intervention, and
follow-up strategies to be used in the lead-up to or onset of, and conclusion of, a mental
health crisis; crisis assistance does not mean crisis response services or crisis intervention
services provided in section 256B.0944
deleted text end;

(4) medication management provided by a physician or an advanced practice registered
nurse with certification in psychiatric and mental health care;

(5) mental health case management as provided in section 256B.0625, subdivision 20;

(6) medication education services as defined in this section;

(7) care coordination by a client-specific lead worker assigned by and responsible to the
treatment team;

(8) psychoeducation of and consultation and coordination with the client's biological,
adoptive, or foster family and, in the case of a youth living independently, the client's
immediate nonfamilial support network;

(9) clinical consultation to a client's employer or school or to other service agencies or
to the courts to assist in managing the mental illness or co-occurring disorder and to develop
client support systems;

(10) coordination with, or performance of, crisis intervention and stabilization services
as defined in section deleted text begin256B.0944deleted text endnew text begin 256B.0624new text end;

deleted text begin (11) assessment of a client's treatment progress and effectiveness of services using
standardized outcome measures published by the commissioner;
deleted text end

deleted text begin (12)deleted text endnew text begin (11)new text end transition services deleted text beginas defined in this sectiondeleted text end;

deleted text begin (13) integrated dual disorders treatment as defined in this sectiondeleted text endnew text begin (12) co-occurring
substance use disorder treatment as defined in section 245I.02, subdivision 11
new text end; and

deleted text begin (14)deleted text endnew text begin (13)new text end housing access supportnew text begin that assists clients to find, obtain, retain, and move to
safe and adequate housing. Housing access support does not provide monetary assistance
for rent, damage deposits, or application fees
new text end.

deleted text begin (c)deleted text endnew text begin (b)new text end The provider shall ensure and document the following by means of performing
the required function or by contracting with a qualified person or entity:

deleted text begin (1)deleted text end client access to crisis intervention services, as defined in section deleted text begin256B.0944deleted text endnew text begin
256B.0624
new text end, and available 24 hours per day and seven days per weekdeleted text begin;deleted text endnew text begin.
new text end

deleted text begin (2) completion of an extended diagnostic assessment, as defined in Minnesota Rules,
part 9505.0372, subpart 1, item C; and
deleted text end

deleted text begin (3) determination of the client's needed level of care using an instrument approved and
periodically updated by the commissioner.
deleted text end

Sec. 101.

Minnesota Statutes 2020, section 256B.0947, subdivision 5, is amended to read:


Subd. 5.

Standards for intensive nonresidential rehabilitative providers.

(a) Services
must deleted text beginbe provided by a provider entity as provided in subdivision 4deleted text endnew text begin meet the standards in
this section and chapter 245I as required in section 245I.011, subdivision 5
new text end.

(b) The treatment team for intensive nonresidential rehabilitative mental health services
comprises both permanently employed core team members and client-specific team members
as follows:

(1) deleted text beginThe core treatment team is an entity that operates under the direction of an
independently licensed mental health professional, who is qualified under Minnesota Rules,
part 9505.0371, subpart 5, item A, and that assumes comprehensive clinical responsibility
for clients.
deleted text end Based on professional qualifications and client needs, clinically qualified core
team members are assigned on a rotating basis as the client's lead worker to coordinate a
client's care. The core team must comprise at least four full-time equivalent direct care staff
and must new text beginminimally new text endincludedeleted text begin, but is not limited todeleted text end:

(i) deleted text beginan independently licenseddeleted text endnew text begin anew text end mental health professionaldeleted text begin, qualified under Minnesota
Rules, part 9505.0371, subpart 5, item A,
deleted text end who serves as team leader to provide administrative
direction and deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervision to the team;

(ii) an advanced-practice registered nurse with certification in psychiatric or mental
health care or a board-certified child and adolescent psychiatrist, either of which must be
credentialed to prescribe medications;

(iii) a licensed alcohol and drug counselor who is also trained in mental health
interventions; and

(iv) a new text beginmental health certified new text endpeer specialist deleted text beginas defined in subdivision 2, paragraph (h)deleted text endnew text begin
who is qualified according to section 245I.04, subdivision 10, and is also a former children's
mental health consumer
new text end.

(2) The core team may also include any of the following:

(i) additional mental health professionals;

(ii) a vocational specialist;

(iii) an educational specialistnew text begin with knowledge and experience working with youth
regarding special education requirements and goals, special education plans, and coordination
of educational activities with health care activities
new text end;

(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;

(v)new text begin a clinical trainee qualified according to section 245I.04, subdivision 6;
new text end

new text begin (vi)new text end a mental health practitionerdeleted text begin, as defined in section 245.4871, subdivision 26deleted text endnew text begin qualified
according to section 245I.04, subdivision 4
new text end;

deleted text begin (vi)deleted text endnew text begin (vii)new text end a case management service provider, as defined in section 245.4871, subdivision
4
;

deleted text begin (vii)deleted text endnew text begin (viii)new text end a housing access specialist; and

deleted text begin (viii)deleted text endnew text begin (ix)new text end a family peer specialist as defined in subdivision 2, paragraph (m).

(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc
members not employed by the team who consult on a specific client and who must accept
overall clinical direction from the treatment team for the duration of the client's placement
with the treatment team and must be paid by the provider agency at the rate for a typical
session by that provider with that client or at a rate negotiated with the client-specific
member. Client-specific treatment team members may include:

(i) the mental health professional treating the client prior to placement with the treatment
team;

(ii) the client's current substance deleted text beginabusedeleted text endnew text begin usenew text end counselor, if applicable;

(iii) a lead member of the client's individualized education program team or school-based
mental health provider, if applicable;

(iv) a representative from the client's health care home or primary care clinic, as needed
to ensure integration of medical and behavioral health care;

(v) the client's probation officer or other juvenile justice representative, if applicable;
and

(vi) the client's current vocational or employment counselor, if applicable.

(c) The deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervisor shall be an active member of the treatment team
and shall function as a practicing clinician at least on a part-time basis. The treatment team
shall meet with the deleted text beginclinicaldeleted text endnew text begin treatmentnew text end supervisor at least weekly to discuss recipients' progress
and make rapid adjustments to meet recipients' needs. The team meeting must include
client-specific case reviews and general treatment discussions among team members.
Client-specific case reviews and planning must be documented in the individual client's
treatment record.

(d) The staffing ratio must not exceed ten clients to one full-time equivalent treatment
team position.

(e) The treatment team shall serve no more than 80 clients at any one time. Should local
demand exceed the team's capacity, an additional team must be established rather than
exceed this limit.

(f) Nonclinical staff shall have prompt access in person or by telephone to a mental
health practitionernew text begin, clinical trainee,new text end or mental health professional. The provider shall have
the capacity to promptly and appropriately respond to emergent needs and make any
necessary staffing adjustments to ensure the health and safety of clients.

(g) The intensive nonresidential rehabilitative mental health services provider shall
participate in evaluation of the assertive community treatment for youth (Youth ACT) model
as conducted by the commissioner, including the collection and reporting of data and the
reporting of performance measures as specified by contract with the commissioner.

(h) A regional treatment team may serve multiple counties.

Sec. 102.

Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:


Subd. 6.

Service standards.

The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.

(a) The treatment team must use team treatment, not an individual treatment model.

(b) Services must be available at times that meet client needs.

(c) Services must be age-appropriate and meet the specific needs of the client.

(d) The deleted text begininitial functional assessment must be completed within ten days of intake anddeleted text endnew text begin
level of care assessment as defined in section 245I.02, subdivision 19, and functional
assessment as defined in section 245I.02, subdivision 17, must be
new text end updated at least every deleted text beginsix
months
deleted text end new text begin90 days new text endor prior to discharge from the service, whichever comes first.

(e) new text beginThe treatment team must complete new text endan individual treatment plan deleted text beginmustdeleted text endnew text begin for each client,
according to section 245I.10, subdivisions 7 and 8, and the individual treatment plan must
new text end:

deleted text begin (1) be based on the information in the client's diagnostic assessment and baselines;
deleted text end

deleted text begin (2) identify goals and objectives of treatment, a treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment services and supports;
deleted text end

deleted text begin (3) be developed after completion of the client's diagnostic assessment by a mental health
professional or clinical trainee and before the provision of children's therapeutic services
and supports;
deleted text end

deleted text begin (4) be developed through a child-centered, family-driven, culturally appropriate planning
process, including allowing parents and guardians to observe or participate in individual
and family treatment services, assessments, and treatment planning;
deleted text end

deleted text begin (5) be reviewed at least once every six months and revised to document treatment progress
on each treatment objective and next goals or, if progress is not documented, to document
changes in treatment;
deleted text end

deleted text begin (6) be signed by the clinical supervisor and by the client or by the client's parent or other
person authorized by statute to consent to mental health services for the client. A client's
parent may approve the client's individual treatment plan by secure electronic signature or
by documented oral approval that is later verified by written signature;
deleted text end

deleted text begin (7)deleted text endnew text begin (1)new text end be completed in consultation with the client's current therapist and key providers
and provide for ongoing consultation with the client's current therapist to ensure therapeutic
continuity and to facilitate the client's return to the community. For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan;

deleted text begin (8)deleted text endnew text begin (2)new text end if a need for substance use disorder treatment is indicated by validated assessment:

(i) identify goals, objectives, and strategies of substance use disorder treatment;

new text begin (ii)new text end develop a schedule for accomplishingnew text begin substance use disordernew text end treatment goals and
objectives; and

new text begin (iii)new text end identify the individuals responsible for providingnew text begin substance use disordernew text end treatment
services and supports;

deleted text begin (ii) be reviewed at least once every 90 days and revised, if necessary;
deleted text end

deleted text begin (9) be signed by the clinical supervisor and by the client and, if the client is a minor, by
the client's parent or other person authorized by statute to consent to mental health treatment
and substance use disorder treatment for the client; and
deleted text end

deleted text begin (10)deleted text endnew text begin (3)new text end provide for the client's transition out of intensive nonresidential rehabilitative
mental health services by defining the team's actions to assist the client and subsequent
providers in the transition to less intensive or "stepped down" servicesdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (4) notwithstanding section 245I.10, subdivision 8, be reviewed at least every 90 days
and revised to document treatment progress or, if progress is not documented, to document
changes in treatment.
new text end

(f) The treatment team shall actively and assertively engage the client's family members
and significant others by establishing communication and collaboration with the family and
significant others and educating the family and significant others about the client's mental
illness, symptom management, and the family's role in treatment, unless the team knows or
has reason to suspect that the client has suffered or faces a threat of suffering any physical
or mental injury, abuse, or neglect from a family member or significant other.

(g) For a client age 18 or older, the treatment team may disclose to a family member,
other relative, or a close personal friend of the client, or other person identified by the client,
the protected health information directly relevant to such person's involvement with the
client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
client is present, the treatment team shall obtain the client's agreement, provide the client
with an opportunity to object, or reasonably infer from the circumstances, based on the
exercise of professional judgment, that the client does not object. If the client is not present
or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
team may, in the exercise of professional judgment, determine whether the disclosure is in
the best interests of the client and, if so, disclose only the protected health information that
is directly relevant to the family member's, relative's, friend's, or client-identified person's
involvement with the client's health care. The client may orally agree or object to the
disclosure and may prohibit or restrict disclosure to specific individuals.

(h) The treatment team shall provide interventions to promote positive interpersonal
relationships.

Sec. 103.

Minnesota Statutes 2020, section 256B.0947, subdivision 7, is amended to read:


Subd. 7.

Medical assistance payment and rate setting.

(a) Payment for services in this
section must be based on one daily encounter rate per provider inclusive of the following
services received by an eligible client in a given calendar day: all rehabilitative services,
supports, and ancillary activities under this section, staff travel time to provide rehabilitative
services under this section, and crisis response services under section deleted text begin256B.0944deleted text endnew text begin 256B.0624new text end.

(b) Payment must not be made to more than one entity for each client for services
provided under this section on a given day. If services under this section are provided by a
team that includes staff from more than one entity, the team shall determine how to distribute
the payment among the members.

(c) The commissioner shall establish regional cost-based rates for entities that will bill
medical assistance for nonresidential intensive rehabilitative mental health services. In
developing these rates, the commissioner shall consider:

(1) the cost for similar services in the health care trade area;

(2) actual costs incurred by entities providing the services;

(3) the intensity and frequency of services to be provided to each client;

(4) the degree to which clients will receive services other than services under this section;
and

(5) the costs of other services that will be separately reimbursed.

(d) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers.

Sec. 104.

Minnesota Statutes 2020, section 256B.0949, subdivision 2, is amended to read:


Subd. 2.

Definitions.

(a) The terms used in this section have the meanings given in this
subdivision.

(b) "Agency" means the legal entity that is enrolled with Minnesota health care programs
as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide
EIDBI services and that has the legal responsibility to ensure that its employees or contractors
carry out the responsibilities defined in this section. Agency includes a licensed individual
professional who practices independently and acts as an agency.

(c) "Autism spectrum disorder or a related condition" or "ASD or a related condition"
means either autism spectrum disorder (ASD) as defined in the current version of the
Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found
to be closely related to ASD, as identified under the current version of the DSM, and meets
all of the following criteria:

(1) is severe and chronic;

(2) results in impairment of adaptive behavior and function similar to that of a person
with ASD;

(3) requires treatment or services similar to those required for a person with ASD; and

(4) results in substantial functional limitations in three core developmental deficits of
ASD: social or interpersonal interaction; functional communication, including nonverbal
or social communication; and restrictive or repetitive behaviors or hyperreactivity or
hyporeactivity to sensory input; and may include deficits or a high level of support in one
or more of the following domains:

(i) behavioral challenges and self-regulation;

(ii) cognition;

(iii) learning and play;

(iv) self-care; or

(v) safety.

(d) "Person" means a person under 21 years of age.

(e) "Clinical supervision" means the overall responsibility for the control and direction
of EIDBI service delivery, including individual treatment planning, staff supervision,
individual treatment plan progress monitoring, and treatment review for each person. Clinical
supervision is provided by a qualified supervising professional (QSP) who takes full
professional responsibility for the service provided by each supervisee.

(f) "Commissioner" means the commissioner of human services, unless otherwise
specified.

(g) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive
evaluation of a person to determine medical necessity for EIDBI services based on the
requirements in subdivision 5.

(h) "Department" means the Department of Human Services, unless otherwise specified.

(i) "Early intensive developmental and behavioral intervention benefit" or "EIDBI
benefit" means a variety of individualized, intensive treatment modalities approved and
published by the commissioner that are based in behavioral and developmental science
consistent with best practices on effectiveness.

(j) "Generalizable goals" means results or gains that are observed during a variety of
activities over time with different people, such as providers, family members, other adults,
and people, and in different environments including, but not limited to, clinics, homes,
schools, and the community.

(k) "Incident" means when any of the following occur:

(1) an illness, accident, or injury that requires first aid treatment;

(2) a bump or blow to the head; or

(3) an unusual or unexpected event that jeopardizes the safety of a person or staff,
including a person leaving the agency unattended.

(l) "Individual treatment plan" or "ITP" means the person-centered, individualized written
plan of care that integrates and coordinates person and family information from the CMDE
for a person who meets medical necessity for the EIDBI benefit. An individual treatment
plan must meet the standards in subdivision 6.

(m) "Legal representative" means the parent of a child who is under 18 years of age, a
court-appointed guardian, or other representative with legal authority to make decisions
about service for a person. For the purpose of this subdivision, "other representative with
legal authority to make decisions" includes a health care agent or an attorney-in-fact
authorized through a health care directive or power of attorney.

(n) "Mental health professional" deleted text beginhas the meaning given indeleted text endnew text begin means a staff person who is
qualified according to
new text end section deleted text begin245.4871, subdivision 27, clauses (1) to (6)deleted text endnew text begin 245I.04,
subdivision 2
new text end.

(o) "Person-centered" means a service that both responds to the identified needs, interests,
values, preferences, and desired outcomes of the person or the person's legal representative
and respects the person's history, dignity, and cultural background and allows inclusion and
participation in the person's community.

(p) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II, or
level III treatment provider.

Sec. 105.

Minnesota Statutes 2020, section 256B.0949, subdivision 4, is amended to read:


Subd. 4.

Diagnosis.

(a) A diagnosis of ASD or a related condition must:

(1) be based upon current DSM criteria including direct observations of the person and
information from the person's legal representative or primary caregivers;

(2) be completed by either (i) a licensed physician or advanced practice registered nurse
or (ii) a mental health professional; and

(3) meet the requirements of deleted text beginMinnesota Rules, part 9505.0372, subpart 1, items B and
C
deleted text endnew text begin a standard diagnostic assessment according to section 245I.10, subdivision 6new text end.

(b) Additional assessment information may be considered to complete a diagnostic
assessment including specialized tests administered through special education evaluations
and licensed school personnel, and from professionals licensed in the fields of medicine,
speech and language, psychology, occupational therapy, and physical therapy. A diagnostic
assessment may include treatment recommendations.

Sec. 106.

Minnesota Statutes 2020, section 256B.0949, subdivision 5a, is amended to
read:


Subd. 5a.

Comprehensive multidisciplinary evaluation provider qualification.

A
CMDE provider must:

(1) be a licensed physician, advanced practice registered nurse, a mental health
professional, or a deleted text beginmental health practitioner who meets the requirements of adeleted text end clinical trainee
deleted text begin as defined in Minnesota Rules, part 9505.0371, subpart 5, item Cdeleted text endnew text begin who is qualified according
to section 245I.04, subdivision 6
new text end;

(2) have at least 2,000 hours of clinical experience in the evaluation and treatment of
people with ASD or a related condition or equivalent documented coursework at the graduate
level by an accredited university in the following content areas: ASD or a related condition
diagnosis, ASD or a related condition treatment strategies, and child development; and

(3) be able to diagnose, evaluate, or provide treatment within the provider's scope of
practice and professional license.

Sec. 107.

Minnesota Statutes 2020, section 256B.25, subdivision 3, is amended to read:


Subd. 3.

Payment exceptions.

The limitation in subdivision 2 shall not apply to:

(1) payment of Minnesota supplemental assistance funds to recipients who reside in
facilities which are involved in litigation contesting their designation as an institution for
treatment of mental disease;

(2) payment or grants to a boarding care home or supervised living facility licensed by
the Department of Human Services under Minnesota Rules, parts 2960.0130 to 2960.0220
deleted text begin ordeleted text endnew text begin,new text end 2960.0580 to 2960.0700,new text begin ornew text end 9520.0500 to 9520.0670, or new text beginunder new text endchapter 245Gnew text begin or 245Inew text end,
or payment to recipients who reside in these facilities;

(3) payments or grants to a boarding care home or supervised living facility which are
ineligible for certification under United States Code, title 42, sections 1396-1396p;

(4) payments or grants otherwise specifically authorized by statute or rule.

Sec. 108.

Minnesota Statutes 2020, section 256B.761, is amended to read:


256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

(a) Effective for services rendered on or after July 1, 2001, payment for medication
management provided to psychiatric patients, outpatient mental health services, day treatment
services, home-based mental health services, and family community support services shall
be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of
1999 charges.

(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation services in the most recent
calendar year who are medical assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient rehabilitation facility and
provided to residents of nursing facilities owned by the entity.

deleted text begin (c) The commissioner shall establish three levels of payment for mental health diagnostic
assessment, based on three levels of complexity. The aggregate payment under the tiered
rates must not exceed the projected aggregate payments for mental health diagnostic
assessment under the previous single rate. The new rate structure is effective January 1,
2011, or upon federal approval, whichever is later.
deleted text end

deleted text begin (d)deleted text endnew text begin (c)new text end In addition to rate increases otherwise provided, the commissioner may restructure
coverage policy and rates to improve access to adult rehabilitative mental health services
under section 256B.0623 and related mental health support services under section 256B.021,
subdivision 4
, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected
state share of increased costs due to this paragraph is transferred from adult mental health
grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent
base adjustment for subsequent fiscal years. Payments made to managed care plans and
county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect
the rate changes described in this paragraph.

deleted text begin (e)deleted text endnew text begin (d)new text end Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

Sec. 109.

Minnesota Statutes 2020, section 256B.763, is amended to read:


256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.

(a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment
rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:

(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;

(2) community mental health centers under section 256B.0625, subdivision 5; and

(3) mental health clinics deleted text beginand centersdeleted text end certified under deleted text beginMinnesota Rules, parts 9520.0750
to 9520.0870
deleted text endnew text begin section 245I.20new text end, or hospital outpatient psychiatric departments that are
designated as essential community providers under section 62Q.19.

(b) This increase applies to group skills training when provided as a component of
children's therapeutic services and support, psychotherapy, medication management,
evaluation and management, diagnostic assessment, explanation of findings, psychological
testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.

(c) This increase does not apply to rates that are governed by section 256B.0625,
subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated
with the county, rates that are established by the federal government, or rates that increased
between January 1, 2004, and January 1, 2005.

(d) The commissioner shall adjust rates paid to prepaid health plans under contract with
the commissioner to reflect the rate increases provided in paragraphs (a), (e), and (f). The
prepaid health plan must pass this rate increase to the providers identified in paragraphs (a),
(e), (f), and (g).

(e) Payment rates shall be increased by 23.7 percent over the rates in effect on December
31, 2007, for:

(1) medication education services provided on or after January 1, 2008, by adult
rehabilitative mental health services providers certified under section 256B.0623; and

(2) mental health behavioral aide services provided on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943.

(f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943 and
not already included in paragraph (a), payment rates shall be increased by 23.7 percent over
the rates in effect on December 31, 2007.

(g) Payment rates shall be increased by 2.3 percent over the rates in effect on December
31, 2007, for individual and family skills training provided on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943.

(h) For services described in paragraphs (b), (e), and (g) and rendered on or after July
1, 2017, payment rates for mental health clinics deleted text beginand centersdeleted text end certified under deleted text beginMinnesota Rules,
parts 9520.0750 to 9520.0870
deleted text endnew text begin section 245I.20new text end, that are not designated as essential community
providers under section 62Q.19 shall be equal to payment rates for mental health clinics
deleted text begin and centersdeleted text end certified under deleted text beginMinnesota Rules, parts 9520.0750 to 9520.0870deleted text endnew text begin section 245I.20new text end,
that are designated as essential community providers under section 62Q.19. In order to
receive increased payment rates under this paragraph, a provider must demonstrate a
commitment to serve low-income and underserved populations by:

(1) charging for services on a sliding-fee schedule based on current poverty income
guidelines; and

(2) not restricting access or services because of a client's financial limitation.

Sec. 110.

Minnesota Statutes 2020, section 256P.01, subdivision 6a, is amended to read:


Subd. 6a.

Qualified professional.

(a) For illness, injury, or incapacity, a "qualified
professional" means a licensed physician, physician assistant, advanced practice registered
nurse, physical therapist, occupational therapist, or licensed chiropractor, according to their
scope of practice.

(b) For developmental disability, learning disability, and intelligence testing, a "qualified
professional" means a licensed physician, physician assistant, advanced practice registered
nurse, licensed independent clinical social worker, licensed psychologist, certified school
psychologist, or certified psychometrist working under the supervision of a licensed
psychologist.

(c) For mental health, a "qualified professional" means a licensed physician, advanced
practice registered nurse, or qualified mental health professional under section deleted text begin245.462,
subdivision 18, clauses (1) to (6)
deleted text endnew text begin 245I.04, subdivision 2new text end.

(d) For substance use disorder, a "qualified professional" means a licensed physician, a
qualified mental health professional under section 245.462, subdivision 18, clauses (1) to
(6), or an individual as defined in section 245G.11, subdivision 3, 4, or 5.

Sec. 111.

Minnesota Statutes 2020, section 295.50, subdivision 9b, is amended to read:


Subd. 9b.

Patient services.

(a) "Patient services" means inpatient and outpatient services
and other goods and services provided by hospitals, surgical centers, or health care providers.
They include the following health care goods and services provided to a patient or consumer:

(1) bed and board;

(2) nursing services and other related services;

(3) use of hospitals, surgical centers, or health care provider facilities;

(4) medical social services;

(5) drugs, biologicals, supplies, appliances, and equipment;

(6) other diagnostic or therapeutic items or services;

(7) medical or surgical services;

(8) items and services furnished to ambulatory patients not requiring emergency care;
and

(9) emergency services.

(b) "Patient services" does not include:

(1) services provided to nursing homes licensed under chapter 144A;

(2) examinations for purposes of utilization reviews, insurance claims or eligibility,
litigation, and employment, including reviews of medical records for those purposes;

(3) services provided to and by community residential mental health facilities licensed
under new text beginsection 245I.23 or new text endMinnesota Rules, parts 9520.0500 to 9520.0670, and to and by
residential treatment programs for children with severe emotional disturbance licensed or
certified under chapter 245A;

(4) services provided under the following programs: day treatment services as defined
in section 245.462, subdivision 8; assertive community treatment as described in section
256B.0622; adult rehabilitative mental health services as described in section 256B.0623;
deleted text begin adultdeleted text end crisis response services as described in section 256B.0624; new text beginand new text endchildren's therapeutic
services and supports as described in section 256B.0943; deleted text beginand children's mental health crisis
response services as described in section 256B.0944;
deleted text end

(5) services provided to and by community mental health centers as defined in section
245.62, subdivision 2;

(6) services provided to and by assisted living programs and congregate housing
programs;

(7) hospice care services;

(8) home and community-based waivered services under chapter 256S and sections
256B.49 and 256B.501;

(9) targeted case management services under sections 256B.0621; 256B.0625,
subdivisions 20, 20a, 33, and 44
; and 256B.094; and

(10) services provided to the following: supervised living facilities for persons with
developmental disabilities licensed under Minnesota Rules, parts 4665.0100 to 4665.9900;
housing with services establishments required to be registered under chapter 144D; board
and lodging establishments providing only custodial services that are licensed under chapter
157 and registered under section 157.17 to provide supportive services or health supervision
services; adult foster homes as defined in Minnesota Rules, part 9555.5105; day training
and habilitation services for adults with developmental disabilities as defined in section
252.41, subdivision 3; boarding care homes as defined in Minnesota Rules, part 4655.0100;
adult day care services as defined in section 245A.02, subdivision 2a; and home health
agencies as defined in Minnesota Rules, part 9505.0175, subpart 15, or licensed under
chapter 144A.

Sec. 112.

Minnesota Statutes 2020, section 325F.721, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

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

(b) "Covered setting" means an unlicensed setting providing sleeping accommodations
to one or more adult residents, at least 80 percent of which are 55 years of age or older, and
offering or providing, for a fee, supportive services. For the purposes of this section, covered
setting does not mean:

(1) emergency shelter, transitional housing, or any other residential units serving
exclusively or primarily homeless individuals, as defined under section 116L.361;

(2) a nursing home licensed under chapter 144A;

(3) a hospital, certified boarding care, or supervised living facility licensed under sections
144.50 to 144.56;

(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts
9520.0500 to 9520.0670, or under chapter 245D deleted text beginordeleted text endnew text begin,new text end 245Gnew text begin, or 245Inew text end;

(5) services and residential settings licensed under chapter 245A, including adult foster
care and services and settings governed under the standards in chapter 245D;

(6) private homes in which the residents are related by kinship, law, or affinity with the
providers of services;

(7) a duly organized condominium, cooperative, and common interest community, or
owners' association of the condominium, cooperative, and common interest community
where at least 80 percent of the units that comprise the condominium, cooperative, or
common interest community are occupied by individuals who are the owners, members, or
shareholders of the units;

(8) temporary family health care dwellings as defined in sections 394.307 and 462.3593;

(9) settings offering services conducted by and for the adherents of any recognized
church or religious denomination for its members exclusively through spiritual means or
by prayer for healing;

(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with
low-income housing tax credits pursuant to United States Code, title 26, section 42, and
units financed by the Minnesota Housing Finance Agency that are intended to serve
individuals with disabilities or individuals who are homeless, except for those developments
that market or hold themselves out as assisted living facilities and provide assisted living
services;

(11) rental housing developed under United States Code, title 42, section 1437, or United
States Code, title 12, section 1701q;

(12) rental housing designated for occupancy by only elderly or elderly and disabled
residents under United States Code, title 42, section 1437e, or rental housing for qualifying
families under Code of Federal Regulations, title 24, section 983.56;

(13) rental housing funded under United States Code, title 42, chapter 89, or United
States Code, title 42, section 8011; or

(14) an assisted living facility licensed under chapter 144G.

(c) "'I'm okay' check services" means providing a service to, by any means, check on
the safety of a resident.

(d) "Resident" means a person entering into written contract for housing and services
with a covered setting.

(e) "Supportive services" means:

(1) assistance with laundry, shopping, and household chores;

(2) housekeeping services;

(3) provision of meals or assistance with meals or food preparation;

(4) help with arranging, or arranging transportation to, medical, social, recreational,
personal, or social services appointments; or

(5) provision of social or recreational services.

Arranging for services does not include making referrals or contacting a service provider
in an emergency.

Sec. 113. new text beginREPEALER.
new text end

new text begin (a)new text endnew text begin Minnesota Statutes 2020, sections 245.462, subdivision 4a; 245.4879, subdivision
2; 245.62, subdivisions 3 and 4; 245.69, subdivision 2; 256B.0615, subdivision 2; 256B.0616,
subdivision 2; 256B.0622, subdivisions 3 and 5a; 256B.0623, subdivisions 7, 8, 10, and 11;
256B.0625, subdivisions 5l, 35a, 35b, 61, 62, and 65; 256B.0943, subdivisions 8 and 10;
256B.0944; and 256B.0946, subdivision 5,
new text endnew text begin are repealed.
new text end

new text begin (b)new text endnew text begin Minnesota Rules, parts 9505.0370; 9505.0371; 9505.0372; 9520.0010; 9520.0020;
9520.0030; 9520.0040; 9520.0050; 9520.0060; 9520.0070; 9520.0080; 9520.0090;
9520.0100; 9520.0110; 9520.0120; 9520.0130; 9520.0140; 9520.0150; 9520.0160;
9520.0170; 9520.0180; 9520.0190; 9520.0200; 9520.0210; 9520.0230; 9520.0750;
9520.0760; 9520.0770; 9520.0780; 9520.0790; 9520.0800; 9520.0810; 9520.0820;
9520.0830; 9520.0840; 9520.0850; 9520.0860; and 9520.0870,
new text endnew text begin are repealed.
new text end

Sec. 114. new text beginEFFECTIVE DATE.
new text end

new text begin Unless otherwise stated, this article is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

ARTICLE 18

FORECAST ADJUSTMENTS

Section 1. new text beginDEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
new text end

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 2019, First Special
Session chapter 9, article 14, from the general fund, or any other fund named, to the
commissioner of human services for the purposes specified in this article, to be available
for the fiscal year indicated for each purpose. The figure "2021" used in this article means
that the appropriations listed are available for the fiscal year ending June 30, 2021.
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 2021
new text end

Sec. 2. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1.new text end

new text beginTotal Appropriation
new text end

new text begin$
new text end
new text begin(816,996,000)
new text end
new text begin Appropriations by Fund
new text end
new text begin 2021
new text end
new text begin General
new text end
new text begin(745,266,000)
new text end
new text begin Health Care Access
new text end
new text begin(36,893,000)
new text end
new text begin Federal TANF
new text end
new text begin(34,837,000)
new text end

new text begin Subd. 2.new text end

new text beginForecasted Programs
new text end

new text begin (a) Minnesota Family
Investment Program
(MFIP)/Diversionary Work
Program (DWP)
new text end
new text begin Appropriations by Fund
new text end
new text begin 2021
new text end
new text begin General
new text end
new text begin59,004,000
new text end
new text begin Federal TANF
new text end
new text begin(34,843,000)
new text end
new text begin (b) MFIP Child Care Assistance
new text end
new text begin(54,158,000)
new text end
new text begin (c) General Assistance
new text end
new text begin3,925,000
new text end
new text begin (d) Minnesota Supplemental Aid
new text end
new text begin3,849,000
new text end
new text begin (e) Housing Support
new text end
new text begin3,022,000
new text end
new text begin (f) Northstar Care for Children
new text end
new text begin(8,639,000)
new text end
new text begin (g) MinnesotaCare
new text end
new text begin(36,893,000)
new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin (h) Medical Assistance
new text end
new text begin Appropriations by Fund
new text end
new text begin 2021
new text end
new text begin General
new text end
new text begin(694,938,000)
new text end
new text begin Health Care Access
new text end
new text begin-0-
new text end
new text begin (i) Alternative Care
new text end
new text begin247,000
new text end
new text begin (j) Consolidated Chemical Dependency
Treatment Fund (CCDTF) Entitlement
new text end
new text begin(57,578,000)
new text end

new text begin Subd. 3.new text end

new text beginTechnical Activities
new text end

new text begin6,000
new text end

new text begin This appropriation is from the federal TANF
fund.
new text end

Sec. 3. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 and 2 are effective the day following final enactment.
new text end

ARTICLE 19

EFFECTIVE DATES

Section 1. new text beginEFFECTIVE DATES.
new text end

new text begin All sections in this act are effective July 1, 2021, unless another effective date is
specified.
new text end"

Delete the title and insert:

"A bill for an act
relating to state government; modifying policy provisions governing health, health
care, human services, human services licensing and background studies,
health-related licensing boards, prescription drugs, health insurance, telehealth,
children and family services, behavioral health, disability services and continuing
care for older adults, community supports, and chemical and mental health services;
implementing mental health uniform service standards; making forecast
adjustments; making technical and conforming changes; requiring reports;
modifying appropriations; amending Minnesota Statutes 2020, sections 62A.152,
subdivision 3; 62A.3094, subdivision 1; 62J.495, subdivision 3; 62J.498; 62J.4981;
62J.4982; 62J.84, subdivisions 3, 4, 5, 6, 9; 62Q.096; 62W.11; 144.05, by adding
a subdivision; 144.1205, subdivisions 2, 4, 8, 9, by adding a subdivision; 144.1481,
subdivision 1; 144.1911, subdivision 6; 144.223; 144.225, subdivision 7; 144.651,
subdivision 2; 144D.01, subdivision 4; 144G.08, subdivision 7, as amended;
144G.84; 145.893, subdivision 1; 145.894; 145.897; 145.899; 148B.5301,
subdivision 2; 148E.120, subdivision 2; 148F.11, subdivision 1; 151.01, subdivision
29, by adding subdivisions; 151.555, subdivisions 1, 7, 11, by adding a subdivision;
151.72, subdivision 5; 152.22, subdivisions 6, 11, by adding a subdivision; 152.23;
152.26; 152.27, subdivisions 2, 3, 4; 152.28, subdivision 1; 152.29, subdivisions
1, 3, by adding subdivisions; 152.31; 157.22; 245.462, subdivisions 1, 6, 8, 9, 14,
16, 17, 18, 21, 23, by adding a subdivision; 245.4661, subdivision 5; 245.4662,
subdivision 1; 245.467, subdivisions 2, 3; 245.469, subdivisions 1, 2; 245.470,
subdivision 1; 245.4712, subdivision 2; 245.472, subdivision 2; 245.4863;
245.4871, subdivisions 9a, 10, 11a, 17, 21, 26, 27, 29, 31, 32, 34, by adding a
subdivision; 245.4874, subdivision 1; 245.4876, subdivisions 2, 3; 245.4879,
subdivision 1; 245.488, subdivision 1; 245.4885, subdivision 1; 245.4901,
subdivision 2; 245.62, subdivision 2; 245.697, subdivision 1; 245.735, subdivisions
3, 5, by adding a subdivision; 245A.02, by adding subdivisions; 245A.04,
subdivision 5; 245A.041, by adding a subdivision; 245A.043, subdivision 3;
245A.10, subdivision 4; 245A.65, subdivision 2; 245D.02, subdivision 20; 245F.04,
subdivision 2; 245G.03, subdivision 2; 252.43; 252A.01, subdivision 1; 252A.02,
subdivisions 2, 9, 11, 12, by adding subdivisions; 252A.03, subdivisions 3, 4;
252A.04, subdivisions 1, 2, 4; 252A.05; 252A.06, subdivisions 1, 2; 252A.07,
subdivisions 1, 2, 3; 252A.081, subdivisions 2, 3, 5; 252A.09, subdivisions 1, 2;
252A.101, subdivisions 2, 3, 5, 6, 7, 8; 252A.111, subdivisions 2, 4, 6; 252A.12;
252A.16; 252A.17; 252A.19, subdivisions 2, 4, 5, 7, 8; 252A.20; 252A.21,
subdivisions 2, 4; 254B.03, subdivision 2; 256.01, subdivision 14b, by adding a
subdivision; 256.0112, subdivision 6; 256.741, by adding subdivisions; 256.969,
subdivisions 2b, 9, by adding a subdivision; 256.9695, subdivision 1; 256.9741,
subdivision 1; 256.98, subdivision 1; 256.983; 256B.051, subdivisions 1, 3, 5, 6,
7, by adding a subdivision; 256B.057, subdivision 3; 256B.0615, subdivisions 1,
5; 256B.0616, subdivisions 1, 3, 5; 256B.0622, subdivisions 1, 2, 3a, 4, 7, 7a, 7b,
7d; 256B.0623, subdivisions 1, 2, 3, 4, 5, 6, 9, 12; 256B.0624; 256B.0625,
subdivisions 3b, 3c, 3d, 3e, 5, 5m, 19c, 28a, 30, 42, 48, 49, 56a; 256B.0638,
subdivisions 3, 5, 6; 256B.0659, subdivision 13; 256B.0757, subdivision 4c;
256B.0911, subdivision 3a; 256B.0941, subdivision 1; 256B.0943, subdivisions
1, 2, 3, 4, 5, 5a, 6, 7, 9, 11; 256B.0946, subdivisions 1, 1a, 2, 3, 4, 6; 256B.0947,
subdivisions 1, 2, 3, 3a, 5, 6, 7; 256B.0949, subdivisions 2, 4, 5a; 256B.196,
subdivision 2; 256B.25, subdivision 3; 256B.4912, subdivision 13; 256B.69,
subdivision 5a; 256B.6928, subdivision 5; 256B.761; 256B.763; 256B.85,
subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12, 12b, 13, 13a, 15, 17a, 18a,
20b, 23, 23a, by adding subdivisions; 256E.34, subdivision 1; 256I.05, subdivisions
1a, 11; 256J.08, subdivision 21; 256J.09, subdivision 3; 256J.30, subdivision 8;
256J.45, subdivision 1; 256J.626, subdivision 1; 256J.95, subdivision 5; 256L.01,
subdivision 5; 256L.03, subdivision 1; 256L.04, subdivision 7b; 256L.05,
subdivision 3a; 256N.02, subdivisions 16, 17; 256N.22, subdivision 1; 256N.23,
subdivisions 2, 6; 256N.24, subdivisions 1, 8, 11, 12, 14; 256N.25, subdivision 1,
by adding a subdivision; 256P.01, subdivision 6a; 259.22, subdivision 4; 259.241;
259.35, subdivision 1; 259.53, subdivision 4; 259.73; 259.75, subdivisions 5, 6,
9; 259.83, subdivision 1a; 259A.75, subdivisions 1, 2, 3, 4; 260C.007, subdivisions
22a, 26c, 31; 260C.157, subdivision 3; 260C.212, subdivisions 1, 1a, 2, 13, by
adding a subdivision; 260C.219, subdivision 5; 260C.4412; 260C.452; 260C.503,
subdivision 2; 260C.515, subdivision 3; 260C.605, subdivision 1; 260C.607,
subdivision 6; 260C.609; 260C.615; 260C.704; 260C.706; 260C.708; 260C.71;
260C.712; 260C.714; 260D.01; 260D.05; 260D.06, subdivision 2; 260D.07;
260D.08; 260D.14; 260E.20, subdivision 2; 260E.31, subdivision 1; 260E.33, by
adding a subdivision; 260E.36, by adding a subdivision; 295.50, subdivision 9b;
295.53, subdivision 1; 297E.02, subdivision 3; 325F.721, subdivision 1; 326.71,
subdivision 4; 326.75, subdivisions 1, 2, 3; 518.157, subdivisions 1, 3; 518.68,
subdivision 2; 518A.29; 518A.33; 518A.35, subdivisions 1, 2; 518A.39, subdivision
7; 518A.40, subdivision 4, by adding a subdivision; 518A.42; 518A.43, by adding
a subdivision; 518A.685; 548.091, subdivisions 1a, 2a, 3b, 9, 10; 549.09,
subdivision 1; Laws 2008, chapter 364, section 17; Laws 2019, First Special Session
chapter 9, article 14, section 3, as amended; Laws 2020, Seventh Special Session
chapter 1, article 6, section 12, subdivision 4; proposing coding for new law in
Minnesota Statutes, chapters 62A; 62Q; 145; 145A; 151; 245A; 256B; 363A;
518A; proposing coding for new law as Minnesota Statutes, chapter 245I; repealing
Minnesota Statutes 2020, sections 151.19, subdivision 3; 245.462, subdivision 4a;
245.4879, subdivision 2; 245.62, subdivisions 3, 4; 245.69, subdivision 2; 245.735,
subdivisions 1, 2, 4; 252.28, subdivisions 1, 5; 252A.02, subdivisions 8, 10;
252A.21, subdivision 3; 256B.0615, subdivision 2; 256B.0616, subdivision 2;
256B.0622, subdivisions 3, 5a; 256B.0623, subdivisions 7, 8, 10, 11; 256B.0625,
subdivisions 5l, 35a, 35b, 61, 62, 65; 256B.0943, subdivisions 8, 10; 256B.0944;
256B.0946, subdivision 5; Minnesota Rules, parts 9505.0370; 9505.0371;
9505.0372; 9520.0010; 9520.0020; 9520.0030; 9520.0040; 9520.0050; 9520.0060;
9520.0070; 9520.0080; 9520.0090; 9520.0100; 9520.0110; 9520.0120; 9520.0130;
9520.0140; 9520.0150; 9520.0160; 9520.0170; 9520.0180; 9520.0190; 9520.0200;
9520.0210; 9520.0230; 9520.0750; 9520.0760; 9520.0770; 9520.0780; 9520.0790;
9520.0800; 9520.0810; 9520.0820; 9520.0830; 9520.0840; 9520.0850; 9520.0860;
9520.0870; 9530.6800; 9530.6810."

We request the adoption of this report and repassage of the bill.
House Conferees:
.
.
.
Tina Liebling
Jennifer Schultz
.
.
Aisha Gomez
Dave Pinto
.
Joe Schomacker
Senate Conferees:
.
.
.
Michelle Benson
Jim Abeler
.
.
Paul Utke
Mark Koran
.
John Hoffman