1.1 	CONFERENCE COMMITTEE REPORT ON H. F. No. 2128
1.2 	A bill for an act
1.3 	relating to state government; modifying provisions governing health, health care, 
1.4 	human services, human services licensing and background studies, health-related 
1.5 	licensing boards, prescription drugs, health insurance, telehealth, children and 
1.6 	family services, behavioral health, direct care and treatment, disability services 
1.7 	and continuing care for older adults, community supports, and chemical and mental 
1.8 	health services; establishing a budget for health and human services; making 
1.9 	forecast adjustments; making technical and conforming changes; requiring reports; 
1.10 	transferring money; appropriating money;amending Minnesota Statutes 2020, 
1.11 	sections 16A.151, subdivision 2; 62A.04, subdivision 2; 62A.10, by adding a 
1.12 	subdivision; 62A.15, subdivision 4, by adding a subdivision; 62A.152, subdivision 
1.13 	3; 62A.3094, subdivision 1; 62A.65, subdivision 1, by adding a subdivision; 
1.14 	62C.01, by adding a subdivision; 62D.01, by adding a subdivision; 62D.095, 
1.15 	subdivisions 2, 3, 4, 5; 62J.495, subdivisions 1, 2, 3, 4; 62J.497, subdivisions 1, 
1.16 	3; 62J.498; 62J.4981; 62J.4982; 62J.63, subdivisions 1, 2; 62Q.01, subdivision 
1.17 	2a; 62Q.02; 62Q.096; 62Q.46; 62Q.677, by adding a subdivision; 62Q.81; 62U.04, 
1.18 	subdivisions 4, 5, 11; 62V.05, by adding a subdivision; 62W.11; 103H.201, 
1.19 	subdivision 1; 119B.011, subdivision 15; 119B.025, subdivision 4; 119B.03, 
1.20 	subdivisions 4, 6; 119B.09, subdivision 4; 119B.11, subdivision 2a; 119B.125, 
1.21 	subdivision 1; 119B.13, subdivisions 1, 1a, 6, 7; 119B.25, subdivision 3; 122A.18, 
1.22 	subdivision 8; 136A.128, subdivisions 2, 4; 144.0724, subdivisions 1, 2, 3a, 4, 5, 
1.23 	7, 8, 9, 12; 144.1205, subdivisions 2, 4, 8, 9, by adding a subdivision; 144.125, 
1.24 	subdivision 1; 144.1481, subdivision 1; 144.1501, subdivisions 1, 2, 3; 144.1911, 
1.25 	subdivision 6; 144.212, by adding a subdivision; 144.225, subdivisions 2, 7; 
1.26 	144.226, by adding subdivisions; 144.55, subdivisions 4, 6; 144.551, subdivision 
1.27 	1, by adding a subdivision; 144.555; 144.651, subdivision 2; 144.9501, subdivision 
1.28 	17; 144.9502, subdivision 3; 144.9504, subdivisions 2, 5; 144D.01, subdivision 
1.29 	4; 144G.08, subdivision 7, as amended; 144G.54, subdivision 3; 144G.84; 145.893, 
1.30 	subdivision 1; 145.894; 145.897; 145.899; 145.901, subdivisions 2, 4; 147.033; 
1.31 	148.90, subdivision 2; 148.911; 148B.30, subdivision 1; 148B.31; 148B.51; 
1.32 	148B.5301, subdivision 2; 148B.54, subdivision 2; 148E.010, by adding a 
1.33 	subdivision; 148E.120, subdivision 2; 148E.130, subdivision 1, by adding a 
1.34 	subdivision; 148F.11, subdivision 1; 151.01, by adding subdivisions; 151.071, 
1.35 	subdivisions 1, 2; 151.37, subdivision 2; 151.555, subdivisions 1, 7, 11, by adding 
1.36 	a subdivision; 152.01, subdivision 23; 152.02, subdivisions 2, 3; 152.11, subdivision 
1.37 	1a, by adding a subdivision; 152.12, by adding a subdivision; 152.125, subdivision 
1.38 	3; 152.22, subdivisions 6, 11, by adding subdivisions; 152.23; 152.25, by adding 
1.39 	a subdivision; 152.26; 152.27, subdivisions 3, 4, 6; 152.28, subdivision 1; 152.29, 
1.40 	subdivisions 1, 3, by adding subdivisions; 152.31; 152.32, subdivision 3; 156.12, 
1.41 	subdivision 2; 171.07, by adding a subdivision; 174.30, subdivision 3; 245.462, 
1.42 	subdivisions 1, 6, 8, 9, 14, 16, 17, 18, 21, 23, by adding a subdivision; 245.4661, 
1.43 	subdivision 5; 245.4662, subdivision 1; 245.467, subdivisions 2, 3; 245.469, 
2.1 	subdivisions 1, 2; 245.470, subdivision 1; 245.4712, subdivision 2; 245.472, 
2.2 	subdivision 2; 245.4863; 245.4871, subdivisions 9a, 10, 11a, 17, 21, 26, 27, 29, 
2.3 	31, 32, 34, by adding a subdivision; 245.4876, subdivisions 2, 3; 245.4879, 
2.4 	subdivision 1; 245.488, subdivision 1; 245.4882, subdivisions 1, 3; 245.4885, 
2.5 	subdivision 1; 245.4889, subdivision 1; 245.4901, subdivision 2; 245.62, 
2.6 	subdivision 2; 245.735, subdivisions 3, 5, by adding a subdivision; 245A.02, by 
2.7 	adding subdivisions; 245A.03, subdivision 7; 245A.04, subdivision 5; 245A.041, 
2.8 	by adding a subdivision; 245A.043, subdivision 3; 245A.05; 245A.07, subdivision 
2.9 	1; 245A.10, subdivision 4; 245A.14, subdivision 4; 245A.16, by adding a 
2.10 	subdivision; 245A.50, subdivisions 7, 9; 245A.65, subdivision 2; 245C.02, 
2.11 	subdivisions 4a, 5, by adding subdivisions; 245C.03; 245C.05, subdivisions 1, 2, 
2.12 	2a, 2b, 2c, 2d, 4; 245C.08, subdivision 3, by adding a subdivision; 245C.10, 
2.13 	subdivision 15, by adding subdivisions; 245C.13, subdivision 2; 245C.14, 
2.14 	subdivision 1, by adding a subdivision; 245C.15, by adding a subdivision; 245C.16, 
2.15 	subdivisions 1, 2; 245C.17, subdivision 1, by adding a subdivision; 245C.18; 
2.16 	245C.24, subdivisions 2, 3, 4, by adding a subdivision; 245C.32, subdivision 1a; 
2.17 	245D.02, subdivision 20; 245F.04, subdivision 2; 245G.01, subdivisions 13, 26; 
2.18 	245G.03, subdivision 2; 245G.06, subdivision 1; 246.54, subdivision 1b; 254A.19, 
2.19 	subdivision 5; 254B.01, subdivision 4a, by adding a subdivision; 254B.05, 
2.20 	subdivision 5; 254B.12, by adding a subdivision; 256.01, subdivisions 14b, 28; 
2.21 	256.0112, subdivision 6; 256.041; 256.042, subdivisions 2, 4; 256.043, subdivision 
2.22 	3; 256.969, subdivisions 2b, 9, by adding a subdivision; 256.9695, subdivision 1; 
2.23 	256.9741, subdivision 1; 256.98, subdivision 1; 256.983; 256B.04, subdivisions 
2.24 	12, 14; 256B.055, subdivision 6; 256B.056, subdivision 10; 256B.057, subdivision 
2.25 	3; 256B.06, subdivision 4; 256B.0615, subdivisions 1, 5; 256B.0616, subdivisions 
2.26 	1, 3, 5; 256B.0621, subdivision 10; 256B.0622, subdivisions 1, 2, 3a, 4, 7, 7a, 7b, 
2.27 	7d; 256B.0623, subdivisions 1, 2, 3, 4, 5, 6, 9, 12; 256B.0624; 256B.0625, 
2.28 	subdivisions 3b, 3c, 3d, 3e, 5, 5m, 9, 10, 13, 13c, 13d, 13e, 13h, 17, 17b, 18, 18b, 
2.29 	19c, 20, 20b, 28a, 30, 31, 42, 46, 48, 49, 52, 56a, 58, by adding subdivisions; 
2.30 	256B.0631, subdivision 1; 256B.0638, subdivisions 3, 5, 6; 256B.0659, subdivisions 
2.31 	13, 21, 24, by adding subdivisions; 256B.0757, subdivision 4c; 256B.0759, 
2.32 	subdivisions 2, 4, by adding subdivisions; 256B.0911, subdivisions 1a, 3a, 3f, 4d; 
2.33 	256B.092, subdivisions 4, 5, 12; 256B.0924, subdivision 6; 256B.094, subdivision 
2.34 	6; 256B.0941, subdivision 1; 256B.0943, subdivisions 1, 2, 3, 4, 5, 5a, 6, 7, 9, 11; 
2.35 	256B.0946, subdivisions 1, 1a, 2, 3, 4, 6; 256B.0947, subdivisions 1, 2, 3, 3a, 5, 
2.36 	6, 7; 256B.0949, subdivisions 2, 4, 5a, by adding a subdivision; 256B.097, by 
2.37 	adding subdivisions; 256B.196, subdivision 2; 256B.25, subdivision 3; 256B.439, 
2.38 	by adding subdivisions; 256B.49, subdivisions 11, 11a, 14, 17, by adding a 
2.39 	subdivision; 256B.4914, subdivisions 5, 6, 7, 8, 9, by adding a subdivision; 
2.40 	256B.69, subdivisions 5a, 6, 6d, by adding subdivisions; 256B.6928, subdivision 
2.41 	5; 256B.75; 256B.76, subdivisions 2, 4; 256B.761; 256B.763; 256B.79, 
2.42 	subdivisions 1, 3; 256B.85, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12, 
2.43 	12b, 13, 13a, 15, 17a, 18a, 20b, 23, 23a, by adding subdivisions; 256D.03, by 
2.44 	adding a subdivision; 256D.051, by adding subdivisions; 256D.0515; 256D.0516, 
2.45 	subdivision 2; 256E.34, subdivision 1; 256I.03, subdivision 13; 256I.04, subdivision 
2.46 	3; 256I.05, subdivisions 1a, 1c, 11; 256I.06, subdivisions 6, 8; 256J.08, subdivisions 
2.47 	15, 71, 79; 256J.09, subdivision 3; 256J.10; 256J.21, subdivisions 3, 4, 5; 256J.24, 
2.48 	subdivision 5; 256J.30, subdivision 8; 256J.33, subdivisions 1, 2, 4; 256J.37, 
2.49 	subdivisions 1, 1b, 3, 3a; 256J.45, subdivision 1; 256J.626, subdivision 1; 256J.95, 
2.50 	subdivision 9; 256L.01, subdivision 5; 256L.03, subdivision 5; 256L.04, subdivision 
2.51 	7b; 256L.05, subdivision 3a; 256L.07, subdivision 2; 256L.11, subdivisions 6a, 
2.52 	7; 256L.15, subdivision 2; 256N.25, subdivisions 2, 3; 256N.26, subdivisions 11, 
2.53 	13; 256P.01, subdivisions 3, 6a, by adding a subdivision; 256P.04, subdivisions 
2.54 	4, 8; 256P.06, subdivisions 2, 3; 256P.07; 256S.05, subdivision 2; 256S.18, 
2.55 	subdivision 7; 256S.20, subdivision 1; 257.0755, subdivision 1; 257.076, 
2.56 	subdivisions 3, 5; 257.0768, subdivisions 1, 6; 257.0769; 260.761, subdivision 2; 
2.57 	260C.007, subdivisions 6, 14, 26c, 31; 260C.157, subdivision 3; 260C.212, 
2.58 	subdivisions 1a, 13; 260C.215, subdivision 4; 260C.4412; 260C.452; 260C.704; 
3.1 	260C.706; 260C.708; 260C.71; 260C.712; 260C.714; 260D.01; 260D.05; 260D.06, 
3.2 	subdivision 2; 260D.07; 260D.08; 260D.14; 260E.01; 260E.02, subdivision 1; 
3.3 	260E.03, subdivision 22, by adding subdivisions; 260E.06, subdivision 1; 260E.14, 
3.4 	subdivisions 2, 5; 260E.17, subdivision 1; 260E.18; 260E.20, subdivision 2; 
3.5 	260E.24, subdivisions 2, 7; 260E.31, subdivision 1; 260E.33, subdivision 1, by 
3.6 	adding a subdivision; 260E.35, subdivision 6; 260E.36, by adding a subdivision; 
3.7 	295.50, subdivision 9b; 295.53, subdivision 1; 325F.721, subdivision 1; 326.71, 
3.8 	subdivision 4; 326.75, subdivisions 1, 2, 3; Laws 2019, First Special Session 
3.9 	chapter 9, article 14, section 3, as amended; Laws 2020, First Special Session 
3.10 	chapter 7, section 1, subdivision 2, as amended; Laws 2020, Seventh Special 
3.11 	Session chapter 1, article 6, section 12, subdivision 4; proposing coding for new 
3.12 	law in Minnesota Statutes, chapters 3; 62A; 62J; 62Q; 62W; 119B; 144; 145; 151; 
3.13 	245; 245A; 245C; 254B; 256; 256B; 256P; 256S; proposing coding for new law 
3.14 	as Minnesota Statutes, chapter 245I; repealing Minnesota Statutes 2020, sections 
3.15 	16A.724, subdivision 2; 62A.67; 62A.671; 62A.672; 62J.63, subdivision 3; 
3.16 	119B.125, subdivision 5; 144.0721, subdivision 1; 144.0722; 144.0724, subdivision 
3.17 	10; 144.693; 245.462, subdivision 4a; 245.4871, subdivision 32a; 245.4879, 
3.18 	subdivision 2; 245.62, subdivisions 3, 4; 245.69, subdivision 2; 245.735, 
3.19 	subdivisions 1, 2, 4; 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 7, 8, 9, 9a, 10, 11, 12, 
3.20 	13, 14, 16; 256B.0596; 256B.0615, subdivision 2; 256B.0616, subdivision 2; 
3.21 	256B.0622, subdivisions 3, 5a; 256B.0623, subdivisions 7, 8, 10, 11; 256B.0625, 
3.22 	subdivisions 5l, 18c, 18d, 18e, 18h, 35a, 35b, 61, 62, 65; 256B.0916, subdivisions 
3.23 	2, 3, 4, 5, 8, 11, 12; 256B.0924, subdivision 4a; 256B.0943, subdivisions 8, 10; 
3.24 	256B.0944; 256B.0946, subdivision 5; 256B.097, subdivisions 1, 2, 3, 4, 5, 6; 
3.25 	256B.49, subdivisions 26, 27; 256D.051, subdivisions 1, 1a, 2, 2a, 3, 3a, 3b, 6b, 
3.26 	6c, 7, 8, 9, 18; 256D.052, subdivision 3; 256J.08, subdivisions 10, 53, 61, 62, 81, 
3.27 	83; 256J.21, subdivisions 1, 2; 256J.30, subdivisions 5, 7, 8; 256J.33, subdivisions 
3.28 	3, 4, 5; 256J.34, subdivisions 1, 2, 3, 4; 256J.37, subdivision 10; 256S.20, 
3.29 	subdivision 2; Minnesota Rules, parts 9505.0275; 9505.0370; 9505.0371; 
3.30 	9505.0372; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 
3.31 	15, 16, 17, 18, 19, 20, 21, 22; 9505.1699; 9505.1701; 9505.1703; 9505.1706; 
3.32 	9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730; 9505.1733; 
3.33 	9505.1736; 9505.1739; 9505.1742; 9505.1745; 9505.1748; 9520.0010; 9520.0020; 
3.34 	9520.0030; 9520.0040; 9520.0050; 9520.0060; 9520.0070; 9520.0080; 9520.0090; 
3.35 	9520.0100; 9520.0110; 9520.0120; 9520.0130; 9520.0140; 9520.0150; 9520.0160; 
3.36 	9520.0170; 9520.0180; 9520.0190; 9520.0200; 9520.0210; 9520.0230; 9520.0750; 
3.37 	9520.0760; 9520.0770; 9520.0780; 9520.0790; 9520.0800; 9520.0810; 9520.0820; 
3.38 	9520.0830; 9520.0840; 9520.0850; 9520.0860; 9520.0870; 9530.6800; 9530.6810.
3.39 	May 16, 2021
3.40 	The Honorable Melissa Hortman
3.41 	Speaker of the House of Representatives
3.42 	The Honorable Jeremy R. Miller
3.43 	President of the Senate
3.44 	We, the undersigned conferees for H. F. No. 2128 report that we have agreed upon the 
3.45 	items in dispute and recommend as follows:
3.46 	That the Senate recede from its amendments and that H. F. No. 2128 be further amended 
3.47 	as follows:
3.48 	Delete everything after the enacting clause and insert:

4.1 	ARTICLE 1
4.2 	DEPARTMENT OF HUMAN SERVICES HEALTH CARE PROGRAMS

4.3 	Section 1. Minnesota Statutes 2020, section 256.01, is amended by adding a subdivision 
4.4 	to read:
4.5 		Subd. 42.Expiration of report mandates. (a) If the submission of a report by the 
4.6 	commissioner of human services to the legislature is mandated by statute and the enabling 
4.7 	legislation does not include a date for the submission of a final report, the mandate to submit 
4.8 	the report shall expire in accordance with this section.
4.9 	(b) If the mandate requires the submission of an annual report and the mandate was 
4.10 	enacted before January 1, 2021, the mandate shall expire on January 1, 2023. If the mandate 
4.11 	requires the submission of a biennial or less frequent report and the mandate was enacted 
4.12 	before January 1, 2021, the mandate shall expire on January 1, 2024.
4.13 	(c) Any reporting mandate enacted on or after January 1, 2021, shall expire three years 
4.14 	after the date of enactment if the mandate requires the submission of an annual report and 
4.15 	shall expire five years after the date of enactment if the mandate requires the submission 
4.16 	of a biennial or less frequent report unless the enacting legislation provides for a different 
4.17 	expiration date.
4.18 	(d) The commissioner shall submit a list to the chairs and ranking minority members of 
4.19 	the legislative committee with jurisdiction over human services by February 15 of each 
4.20 	year, beginning February 15, 2022, of all reports set to expire during the following calendar 
4.21 	year in accordance with this section.

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

4.23 	Sec. 2. Minnesota Statutes 2020, section 256.969, subdivision 2b, is amended to read:
4.24 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
4.25 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
4.26 	to the following:
4.27 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
4.28 	methodology;
4.29 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
4.30 	under subdivision 25;
5.1 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
5.2 	distinct parts as defined by Medicare shall be paid according to the methodology under 
5.3 	subdivision 12; and
5.4 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
5.5 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
5.6 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
5.7 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
5.8 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
5.9 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
5.10 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
5.11 	period as other hospitals.
5.12 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
5.13 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
5.14 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
5.15 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
5.16 	manner similar to Medicare. The base year or years for the rates effective November 1, 
5.17 	2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, 
5.18 	ensuring that the total aggregate payments under the rebased system are equal to the total 
5.19 	aggregate payments that were made for the same number and types of services in the base 
5.20 	year. Separate budget neutrality calculations shall be determined for payments made to 
5.21 	critical access hospitals and payments made to hospitals paid under the DRG system. Only 
5.22 	the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being 
5.23 	rebased during the entire base period shall be incorporated into the budget neutrality 
5.24 	calculation.
5.25 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
5.26 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
5.27 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
5.28 	a five percent increase or decrease from the base year payments for any hospital. Any 
5.29 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
5.30 	shall maintain budget neutrality as described in paragraph (c).
5.31 	(e) For discharges occurring on or after November 1, 2014, the commissioner may make 
5.32 	additional adjustments to the rebased rates, and when evaluating whether additional 
5.33 	adjustments should be made, the commissioner shall consider the impact of the rates on the 
5.34 	following:
6.1 	(1) pediatric services;
6.2 	(2) behavioral health services;
6.3 	(3) trauma services as defined by the National Uniform Billing Committee;
6.4 	(4) transplant services;
6.5 	(5) obstetric services, newborn services, and behavioral health services provided by 
6.6 	hospitals outside the seven-county metropolitan area;
6.7 	(6) outlier admissions;
6.8 	(7) low-volume providers; and
6.9 	(8) services provided by small rural hospitals that are not critical access hospitals.
6.10 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
6.11 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
6.12 	admission is standardized by the applicable Medicare wage index and adjusted by the 
6.13 	hospital's disproportionate population adjustment;
6.14 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
6.15 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
6.16 	October 31, 2014;
6.17 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
6.18 	inpatient services covered by medical assistance; and
6.19 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
6.20 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
6.21 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
6.22 	program in effect during the base year or years. In determining hospital payment rates for 
6.23 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
6.24 	methods and allowable costs of the Medicare program in effect during the base year or 
6.25 	years.
6.26 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
6.27 	the rates established under paragraph (c), and any adjustments made to the rates under 
6.28 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
6.29 	total aggregate payments for the same number and types of services under the rebased rates 
6.30 	are equal to the total aggregate payments made during calendar year 2013.
7.1 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
7.2 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
7.3 	in hospital costs between the existing base year or years and the next base year or years. In 
7.4 	any year that inpatient claims volume falls below the threshold required to ensure a statically 
7.5 	valid sample of claims, the commissioner may combine claims data from two consecutive 
7.6 	years to serve as the base year. Years in which inpatient claims volume is reduced or altered 
7.7 	due to a pandemic or other public health emergency shall not be used as a base year or part 
7.8 	of a base year if the base year includes more than one year. Changes in costs between base 
7.9 	years shall be measured using the lower of the hospital cost index defined in subdivision 1, 
7.10 	paragraph (a), or the percentage change in the case mix adjusted cost per claim. The 
7.11 	commissioner shall establish the base year for each rebasing period considering the most 
7.12 	recent year or years for which filed Medicare cost reports are available. The estimated 
7.13 	change in the average payment per hospital discharge resulting from a scheduled rebasing 
7.14 	must be calculated and made available to the legislature by January 15 of each year in which 
7.15 	rebasing is scheduled to occur, and must include by hospital the differential in payment 
7.16 	rates compared to the individual hospital's costs.
7.17 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
7.18 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
7.19 	using a new cost-based methodology. The commissioner shall establish within the 
7.20 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
7.21 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
7.22 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
7.23 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
7.24 	decrease from the base year payments for any hospital, except a hospital that had payments 
7.25 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
7.26 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
7.27 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
7.28 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
7.29 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
7.30 	following criteria:
7.31 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
7.32 	shall have a rate set that equals 85 percent of their base year costs;
7.33 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
7.34 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
7.35 	base year costs; and
8.1 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
8.2 	shall have a rate set that equals 100 percent of their base year costs.
8.3 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
8.4 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
8.5 	methodology may include, but are not limited to:
8.6 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
8.7 	hospital's charges to the medical assistance program;
8.8 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
8.9 	hospital's payments received from the medical assistance program for the care of medical 
8.10 	assistance patients;
8.11 	(3) the ratio between the hospital's charges to the medical assistance program and the 
8.12 	hospital's payments received from the medical assistance program for the care of medical 
8.13 	assistance patients;
8.14 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
8.15 	(5) the proportion of that hospital's costs that are administrative and trends in 
8.16 	administrative costs; and
8.17 	(6) geographic location.

8.18 	Sec. 3. Minnesota Statutes 2020, section 256.969, is amended by adding a subdivision to 
8.19 	read:
8.20 		Subd. 2f.Alternate inpatient payment rate. Effective January 1, 2022, for a hospital 
8.21 	eligible to receive disproportionate share hospital payments under subdivision 9, paragraph 
8.22 	(d), clause (6), the commissioner shall reduce the amount calculated under subdivision 9, 
8.23 	paragraph (d), clause (6), by 99 percent and compute an alternate inpatient payment rate. 
8.24 	The alternate payment rate shall be structured to target a total aggregate reimbursement 
8.25 	amount equal to what the hospital would have received for providing fee-for-service inpatient 
8.26 	services under this section to patients enrolled in medical assistance had the hospital received 
8.27 	the entire amount calculated under subdivision 9, paragraph (d), clause (6).

8.28 	EFFECTIVE DATE. This section is effective January 1, 2022.

8.29 	Sec. 4. Minnesota Statutes 2020, section 256.969, subdivision 9, is amended to read:
8.30 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For admissions 
8.31 	occurring on or after July 1, 1993, the medical assistance disproportionate population 
9.1 	adjustment shall comply with federal law and shall be paid to a hospital, excluding regional 
9.2 	treatment centers and facilities of the federal Indian Health Service, with a medical assistance 
9.3 	inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined 
9.4 	as follows:
9.5 	(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic 
9.6 	mean for all hospitals excluding regional treatment centers and facilities of the federal Indian 
9.7 	Health Service but less than or equal to one standard deviation above the mean, the 
9.8 	adjustment must be determined by multiplying the total of the operating and property 
9.9 	payment rates by the difference between the hospital's actual medical assistance inpatient 
9.10 	utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers 
9.11 	and facilities of the federal Indian Health Service; and
9.12 	(2) for a hospital with a medical assistance inpatient utilization rate above one standard 
9.13 	deviation above the mean, the adjustment must be determined by multiplying the adjustment 
9.14 	that would be determined under clause (1) for that hospital by 1.1. The commissioner shall 
9.15 	report annually on the number of hospitals likely to receive the adjustment authorized by 
9.16 	this paragraph. The commissioner shall specifically report on the adjustments received by 
9.17 	public hospitals and public hospital corporations located in cities of the first class.
9.18 	(b) Certified public expenditures made by Hennepin County Medical Center shall be 
9.19 	considered Medicaid disproportionate share hospital payments. Hennepin County and 
9.20 	Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning 
9.21 	July 1, 2005, or another date specified by the commissioner, that may qualify for 
9.22 	reimbursement under federal law. Based on these reports, the commissioner shall apply for 
9.23 	federal matching funds.
9.24 	(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective 
9.25 	retroactively from July 1, 2005, or the earliest effective date approved by the Centers for 
9.26 	Medicare and Medicaid Services.
9.27 	(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid 
9.28 	in accordance with a new methodology using 2012 as the base year. Annual payments made 
9.29 	under this paragraph shall equal the total amount of payments made for 2012. A licensed 
9.30 	children's hospital shall receive only a single DSH factor for children's hospitals. Other 
9.31 	DSH factors may be combined to arrive at a single factor for each hospital that is eligible 
9.32 	for DSH payments. The new methodology shall make payments only to hospitals located 
9.33 	in Minnesota and include the following factors:
10.1 	(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the 
10.2 	base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000 
10.3 	fee-for-service discharges in the base year shall receive a factor of 0.7880;
10.4 	(2) a hospital that has in effect for the initial rate year a contract with the commissioner 
10.5 	to provide extended psychiatric inpatient services under section 256.9693 shall receive a 
10.6 	factor of 0.0160;
10.7 	(3) a hospital that has received medical assistance payment from the fee-for-service 
10.8 	program for at least 20 transplant services in the base year shall receive a factor of 0.0435;
10.9 	(4) a hospital that has a medical assistance utilization rate in the base year between 20 
10.10 	percent up to one standard deviation above the statewide mean utilization rate shall receive 
10.11 	a factor of 0.0468;
10.12 	(5) a hospital that has a medical assistance utilization rate in the base year that is at least 
10.13 	one standard deviation above the statewide mean utilization rate but is less than two and 
10.14 	one-half standard deviations above the mean shall receive a factor of 0.2300; and
10.15 	(6) a hospital that is a level one trauma center and that has a medical assistance utilization 
10.16 	rate in the base year that is at least two and one-half standard deviations above the statewide 
10.17 	mean utilization rate shall receive a factor of 0.3711.
10.18 	(e) For the purposes of determining eligibility for the disproportionate share hospital 
10.19 	factors in paragraph (d), clauses (1) to (6), the medical assistance utilization rate and 
10.20 	discharge thresholds shall be measured using only one year when a two-year base period 
10.21 	is used.
10.22 	(e) (f) Any payments or portion of payments made to a hospital under this subdivision 
10.23 	that are subsequently returned to the commissioner because the payments are found to 
10.24 	exceed the hospital-specific DSH limit for that hospital shall be redistributed, proportionate 
10.25 	to the number of fee-for-service discharges, to other DSH-eligible non-children's hospitals 
10.26 	that have a medical assistance utilization rate that is at least one standard deviation above 
10.27 	the mean.
10.28 	(f) (g) An additional payment adjustment shall be established by the commissioner under 
10.29 	this subdivision for a hospital that provides high levels of administering high-cost drugs to 
10.30 	enrollees in fee-for-service medical assistance. The commissioner shall consider factors 
10.31 	including fee-for-service medical assistance utilization rates and payments made for drugs 
10.32 	purchased through the 340B drug purchasing program and administered to fee-for-service 
10.33 	enrollees. If any part of this adjustment exceeds a hospital's hospital-specific disproportionate 
11.1 	share hospital limit, the commissioner shall make a payment to the hospital that equals the 
11.2 	nonfederal share of the amount that exceeds the limit. The total nonfederal share of the 
11.3 	amount of the payment adjustment under this paragraph shall not exceed $1,500,000.

11.4 	EFFECTIVE DATE. This section is effective July 1, 2021.

11.5 	Sec. 5. Minnesota Statutes 2020, section 256.9695, subdivision 1, is amended to read:
11.6 		Subdivision 1.Appeals. A hospital may appeal a decision arising from the application 
11.7 	of standards or methods under section 256.9685, 256.9686, or 256.969, if an appeal would 
11.8 	result in a change to the hospital's payment rate or payments. Both overpayments and 
11.9 	underpayments that result from the submission of appeals shall be implemented. Regardless 
11.10 	of any appeal outcome, relative values, Medicare wage indexes, Medicare cost-to-charge 
11.11 	ratios, and policy adjusters shall not be changed. The appeal shall be heard by an 
11.12 	administrative law judge according to sections 14.57 to 14.62, or upon agreement by both 
11.13 	parties, according to a modified appeals procedure established by the commissioner and the 
11.14 	Office of Administrative Hearings. In any proceeding under this section, the appealing party 
11.15 	must demonstrate by a preponderance of the evidence that the commissioner's determination 
11.16 	is incorrect or not according to law.
11.17 	To appeal a payment rate or payment determination or a determination made from base 
11.18 	year information, the hospital shall file a written appeal request to the commissioner within 
11.19 	60 days of the date the preliminary payment rate determination was mailed. The appeal 
11.20 	request shall specify: (i) the disputed items; (ii) the authority in federal or state statute or 
11.21 	rule upon which the hospital relies for each disputed item; and (iii) the name and address 
11.22 	of the person to contact regarding the appeal. Facts to be considered in any appeal of base 
11.23 	year information are limited to those in existence 12 18 months after the last day of the 
11.24 	calendar year that is the base year for the payment rates in dispute.

11.25 	Sec. 6. Minnesota Statutes 2020, section 256.983, is amended to read:
11.26 	256.983 FRAUD PREVENTION INVESTIGATIONS.
11.27 		Subdivision 1.Programs established. Within the limits of available appropriations, the 
11.28 	commissioner of human services shall require the maintenance of budget neutral fraud 
11.29 	prevention investigation programs in the counties or tribal agencies participating in the 
11.30 	fraud prevention investigation project established under this section. If funds are sufficient, 
11.31 	the commissioner may also extend fraud prevention investigation programs to other counties 
11.32 	or tribal agencies provided the expansion is budget neutral to the state. Under any expansion, 
12.1 	the commissioner has the final authority in decisions regarding the creation and realignment 
12.2 	of individual county, tribal agency, or regional operations.
12.3 		Subd. 2.County and tribal agency proposals. Each participating county and tribal 
12.4 	agency shall develop and submit an annual staffing and funding proposal to the commissioner 
12.5 	no later than April 30 of each year. Each proposal shall include, but not be limited to, the 
12.6 	staffing and funding of the fraud prevention investigation program, a job description for 
12.7 	investigators involved in the fraud prevention investigation program, and the organizational 
12.8 	structure of the county or tribal agency unit, training programs for case workers, and the 
12.9 	operational requirements which may be directed by the commissioner. The proposal shall 
12.10 	be approved, to include any changes directed or negotiated by the commissioner, no later 
12.11 	than June 30 of each year.
12.12 		Subd. 3.Department responsibilities. The commissioner shall establish training 
12.13 	programs which shall be attended by all investigative and supervisory staff of the involved 
12.14 	county and tribal agencies. The commissioner shall also develop the necessary operational 
12.15 	guidelines, forms, and reporting mechanisms, which shall be used by the involved county
12.16 	or tribal agencies. An individual's application or redetermination form for public assistance 
12.17 	benefits, including child care assistance programs and medical care programs, must include 
12.18 	an authorization for release by the individual to obtain documentation for any information 
12.19 	on that form which is involved in a fraud prevention investigation. The authorization for 
12.20 	release is effective for six months after public assistance benefits have ceased.
12.21 		Subd. 4.Funding. (a) County and tribal agency reimbursement shall be made through 
12.22 	the settlement provisions applicable to the Supplemental Nutrition Assistance Program 
12.23 	(SNAP), MFIP, child care assistance programs, the medical assistance program, and other 
12.24 	federal and state-funded programs.
12.25 	(b) The commissioner will maintain program compliance if for any three consecutive 
12.26 	month period, a county or tribal agency fails to comply with fraud prevention investigation 
12.27 	program guidelines, or fails to meet the cost-effectiveness standards developed by the 
12.28 	commissioner. This result is contingent on the commissioner providing written notice, 
12.29 	including an offer of technical assistance, within 30 days of the end of the third or subsequent 
12.30 	month of noncompliance. The county or tribal agency shall be required to submit a corrective 
12.31 	action plan to the commissioner within 30 days of receipt of a notice of noncompliance. 
12.32 	Failure to submit a corrective action plan or, continued deviation from standards of more 
12.33 	than ten percent after submission of a corrective action plan, will result in denial of funding 
12.34 	for each subsequent month, or billing the county or tribal agency for fraud prevention 
12.35 	investigation (FPI) service provided by the commissioner, or reallocation of program grant 
13.1 	funds, or investigative resources, or both, to other counties or tribal agencies. The denial of 
13.2 	funding shall apply to the general settlement received by the county or tribal agency on a 
13.3 	quarterly basis and shall not reduce the grant amount applicable to the FPI project.
13.4 		Subd. 5.Child care providers; financial misconduct. (a) A county or tribal agency 
13.5 	may conduct investigations of financial misconduct by child care providers as described in 
13.6 	chapter 245E. Prior to opening an investigation, a county or tribal agency must contact the 
13.7 	commissioner to determine whether an investigation under this chapter may compromise 
13.8 	an ongoing investigation.
13.9 	(b) If, upon investigation, a preponderance of evidence shows a provider committed an 
13.10 	intentional program violation, intentionally gave the county or tribe materially false 
13.11 	information on the provider's billing forms, provided false attendance records to a county, 
13.12 	tribe, or the commissioner, or committed financial misconduct as described in section 
13.13 	245E.01, subdivision 8, the county or tribal agency may suspend a provider's payment 
13.14 	pursuant to chapter 245E, or deny or revoke a provider's authorization pursuant to section 
13.15 	119B.13, subdivision 6, paragraph (d), clause (2), prior to pursuing other available remedies. 
13.16 	The county or tribe must send notice in accordance with the requirements of section 
13.17 	119B.161, subdivision 2. If a provider's payment is suspended under this section, the payment 
13.18 	suspension shall remain in effect until: (1) the commissioner, county, tribe, or a law 
13.19 	enforcement authority determines that there is insufficient evidence warranting the action 
13.20 	and a county, tribe, or the commissioner does not pursue an additional administrative remedy 
13.21 	under chapter 119B or 245E, or section 256.046 or 256.98; or (2) all criminal, civil, and 
13.22 	administrative proceedings related to the provider's alleged misconduct conclude and any 
13.23 	appeal rights are exhausted.
13.24 	(c) For the purposes of this section, an intentional program violation includes intentionally 
13.25 	making false or misleading statements; intentionally misrepresenting, concealing, or 
13.26 	withholding facts; and repeatedly and intentionally violating program regulations under 
13.27 	chapters 119B and 245E.
13.28 	(d) A provider has the right to administrative review under section 119B.161 if: (1) 
13.29 	payment is suspended under chapter 245E; or (2) the provider's authorization was denied 
13.30 	or revoked under section 119B.13, subdivision 6, paragraph (d), clause (2).

13.31 	Sec. 7. Minnesota Statutes 2020, section 256B.057, subdivision 3, is amended to read:
13.32 		Subd. 3.Qualified Medicare beneficiaries. (a) A person who is entitled to Part A 
13.33 	Medicare benefits, whose income is equal to or less than 100 percent of the federal poverty 
13.34 	guidelines, and whose assets are no more than $10,000 for a single individual and $18,000 
14.1 	for a married couple or family of two or more, is eligible for medical assistance 
14.2 	reimbursement of Medicare Part A and Part B premiums, Part A and Part B coinsurance 
14.3 	and deductibles, and cost-effective premiums for enrollment with a health maintenance 
14.4 	organization or a competitive medical plan under section 1876 of the Social Security Act.
14.5 	if:
14.6 	(1) the person is entitled to Medicare Part A benefits;
14.7 	(2) the person's income is equal to or less than 100 percent of the federal poverty 
14.8 	guidelines; and
14.9 	(3) the person's assets are no more than (i) $10,000 for a single individual, or (ii) $18,000 
14.10 	for a married couple or family of two or more; or, when the resource limits for eligibility 
14.11 	for the Medicare Part D extra help low income subsidy (LIS) exceed either amount in item 
14.12 	(i) or (ii), the person's assets are no more than the LIS resource limit in United States Code, 
14.13 	title 42, section 1396d, subsection (p).
14.14 	(b) Reimbursement of the Medicare coinsurance and deductibles, when added to the 
14.15 	amount paid by Medicare, must not exceed the total rate the provider would have received 
14.16 	for the same service or services if the person were a medical assistance recipient with 
14.17 	Medicare coverage. Increases in benefits under Title II of the Social Security Act shall not 
14.18 	be counted as income for purposes of this subdivision until July 1 of each year.

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

14.20 	Sec. 8. Minnesota Statutes 2020, section 256B.0625, subdivision 3c, is amended to read:
14.21 		Subd. 3c.Health Services Policy Committee Advisory Council. (a) The commissioner, 
14.22 	after receiving recommendations from professional physician associations, professional 
14.23 	associations representing licensed nonphysician health care professionals, and consumer 
14.24 	groups, shall establish a 13-member 14-member Health Services Policy Committee Advisory 
14.25 	Council, which consists of 12 13 voting members and one nonvoting member. The Health 
14.26 	Services Policy Committee Advisory Council shall advise the commissioner regarding (1)
14.27 	health services pertaining to the administration of health care benefits covered under the 
14.28 	medical assistance and MinnesotaCare programs Minnesota health care programs (MHCP); 
14.29 	and (2) evidence-based decision-making and health care benefit and coverage policies for 
14.30 	MHCP. The Health Services Advisory Council shall consider available evidence regarding 
14.31 	quality, safety, and cost-effectiveness when advising the commissioner. The Health Services 
14.32 	Policy Committee Advisory Council shall meet at least quarterly. The Health Services Policy 
14.33 	Committee Advisory Council shall annually elect select a physician chair from among its 
15.1 	members, who shall work directly with the commissioner's medical director, to establish 
15.2 	the agenda for each meeting. The Health Services Policy Committee shall also Advisory 
15.3 	Council may recommend criteria for verifying centers of excellence for specific aspects of 
15.4 	medical care where a specific set of combined services, a volume of patients necessary to 
15.5 	maintain a high level of competency, or a specific level of technical capacity is associated 
15.6 	with improved health outcomes.
15.7 	(b) The commissioner shall establish a dental subcommittee subcouncil to operate under 
15.8 	the Health Services Policy Committee Advisory Council. The dental subcommittee
15.9 	subcouncil consists of general dentists, dental specialists, safety net providers, dental 
15.10 	hygienists, health plan company and county and public health representatives, health 
15.11 	researchers, consumers, and a designee of the commissioner of health. The dental 
15.12 	subcommittee subcouncil shall advise the commissioner regarding:
15.13 	(1) the critical access dental program under section 256B.76, subdivision 4, including 
15.14 	but not limited to criteria for designating and terminating critical access dental providers;
15.15 	(2) any changes to the critical access dental provider program necessary to comply with 
15.16 	program expenditure limits;
15.17 	(3) dental coverage policy based on evidence, quality, continuity of care, and best 
15.18 	practices;
15.19 	(4) the development of dental delivery models; and
15.20 	(5) dental services to be added or eliminated from subdivision 9, paragraph (b).
15.21 	(c) The Health Services Policy Committee shall study approaches to making provider 
15.22 	reimbursement under the medical assistance and MinnesotaCare programs contingent on 
15.23 	patient participation in a patient-centered decision-making process, and shall evaluate the 
15.24 	impact of these approaches on health care quality, patient satisfaction, and health care costs. 
15.25 	The committee shall present findings and recommendations to the commissioner and the 
15.26 	legislative committees with jurisdiction over health care by January 15, 2010.
15.27 	(d) (c) The Health Services Policy Committee shall Advisory Council may monitor and 
15.28 	track the practice patterns of physicians providing services to medical assistance and 
15.29 	MinnesotaCare enrollees health care providers who serve MHCP recipients under 
15.30 	fee-for-service, managed care, and county-based purchasing. The committee monitoring 
15.31 	and tracking shall focus on services or specialties for which there is a high variation in 
15.32 	utilization or quality across physicians providers, or which are associated with high medical 
15.33 	costs. The commissioner, based upon the findings of the committee Health Services Advisory 
16.1 	Council, shall regularly may notify physicians providers whose practice patterns indicate 
16.2 	below average quality or higher than average utilization or costs. Managed care and 
16.3 	county-based purchasing plans shall provide the commissioner with utilization and cost 
16.4 	data necessary to implement this paragraph, and the commissioner shall make this these
16.5 	data available to the committee Health Services Advisory Council.
16.6 	(e) The Health Services Policy Committee shall review caesarean section rates for the 
16.7 	fee-for-service medical assistance population. The committee may develop best practices 
16.8 	policies related to the minimization of caesarean sections, including but not limited to 
16.9 	standards and guidelines for health care providers and health care facilities.

16.10 	Sec. 9. Minnesota Statutes 2020, section 256B.0625, subdivision 3d, is amended to read:
16.11 		Subd. 3d.Health Services Policy Committee Advisory Council members. (a) The 
16.12 	Health Services Policy Committee Advisory Council consists of:
16.13 	(1) seven six voting members who are licensed physicians actively engaged in the practice 
16.14 	of medicine in Minnesota, one of whom must be actively engaged in the treatment of persons 
16.15 	with mental illness, and three of whom must represent health plans currently under contract 
16.16 	to serve medical assistance MHCP recipients;
16.17 	(2) two voting members who are licensed physician specialists actively practicing their 
16.18 	specialty in Minnesota;
16.19 	(3) two voting members who are nonphysician health care professionals licensed or 
16.20 	registered in their profession and actively engaged in their practice of their profession in 
16.21 	Minnesota;
16.22 	(4) one voting member who is a health care or mental health professional licensed or 
16.23 	registered in the member's profession, actively engaged in the practice of the member's 
16.24 	profession in Minnesota, and actively engaged in the treatment of persons with mental 
16.25 	illness;
16.26 	(4) one consumer (5) two consumers who shall serve as a voting member members; and
16.27 	(5) (6) the commissioner's medical director who shall serve as a nonvoting member.
16.28 	(b) Members of the Health Services Policy Committee Advisory Council shall not be 
16.29 	employed by the Department of Human Services state of Minnesota, except for the medical 
16.30 	director. A quorum shall comprise a simple majority of the voting members. Vacant seats 
16.31 	shall not count toward a quorum.

17.1 	Sec. 10. Minnesota Statutes 2020, section 256B.0625, subdivision 3e, is amended to read:
17.2 		Subd. 3e.Health Services Policy Committee Advisory Council terms and 
17.3 	compensation. Committee Members shall serve staggered three-year terms, with one-third 
17.4 	of the voting members' terms expiring annually. Members may be reappointed by the 
17.5 	commissioner. The commissioner may require more frequent Health Services Policy 
17.6 	Committee Advisory Council meetings as needed. An honorarium of $200 per meeting and 
17.7 	reimbursement for mileage and parking shall be paid to each committee council member 
17.8 	in attendance except the medical director. The Health Services Policy Committee Advisory 
17.9 	Council does not expire as provided in section 15.059, subdivision 6.

17.10 	Sec. 11. Minnesota Statutes 2020, section 256B.0625, subdivision 30, is amended to read:
17.11 		Subd. 30.Other clinic services. (a) Medical assistance covers rural health clinic services, 
17.12 	federally qualified health center services, nonprofit community health clinic services, and 
17.13 	public health clinic services. Rural health clinic services and federally qualified health center 
17.14 	services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and 
17.15 	(C). Payment for rural health clinic and federally qualified health center services shall be 
17.16 	made according to applicable federal law and regulation.
17.17 	(b) A federally qualified health center (FQHC) that is beginning initial operation shall 
17.18 	submit an estimate of budgeted costs and visits for the initial reporting period in the form 
17.19 	and detail required by the commissioner. An FQHC that is already in operation shall submit 
17.20 	an initial report using actual costs and visits for the initial reporting period. Within 90 days 
17.21 	of the end of its reporting period, an FQHC shall submit, in the form and detail required by 
17.22 	the commissioner, a report of its operations, including allowable costs actually incurred for 
17.23 	the period and the actual number of visits for services furnished during the period, and other 
17.24 	information required by the commissioner. FQHCs that file Medicare cost reports shall 
17.25 	provide the commissioner with a copy of the most recent Medicare cost report filed with 
17.26 	the Medicare program intermediary for the reporting year which support the costs claimed 
17.27 	on their cost report to the state.
17.28 	(c) In order to continue cost-based payment under the medical assistance program 
17.29 	according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation 
17.30 	as an essential community provider within six months of final adoption of rules by the 
17.31 	Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and 
17.32 	rural health clinics that have applied for essential community provider status within the 
17.33 	six-month time prescribed, medical assistance payments will continue to be made according 
17.34 	to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural 
18.1 	health clinics that either do not apply within the time specified above or who have had 
18.2 	essential community provider status for three years, medical assistance payments for health 
18.3 	services provided by these entities shall be according to the same rates and conditions 
18.4 	applicable to the same service provided by health care providers that are not FQHCs or rural 
18.5 	health clinics.
18.6 	(d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural 
18.7 	health clinic to make application for an essential community provider designation in order 
18.8 	to have cost-based payments made according to paragraphs (a) and (b) no longer apply.
18.9 	(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall 
18.10 	be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
18.11 	(f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health 
18.12 	clinic may elect to be paid either under the prospective payment system established in United 
18.13 	States Code, title 42, section 1396a(aa), or under an alternative payment methodology 
18.14 	consistent with the requirements of United States Code, title 42, section 1396a(aa), and 
18.15 	approved by the Centers for Medicare and Medicaid Services. The alternative payment 
18.16 	methodology shall be 100 percent of cost as determined according to Medicare cost 
18.17 	principles.
18.18 	(g) Effective for services provided on or after January 1, 2021, all claims for payment 
18.19 	of clinic services provided by FQHCs and rural health clinics shall be paid by the 
18.20 	commissioner, according to an annual election by the FQHC or rural health clinic, under 
18.21 	the current prospective payment system described in paragraph (f) or the alternative payment 
18.22 	methodology described in paragraph (l).
18.23 	(h) For purposes of this section, "nonprofit community clinic" is a clinic that:
18.24 	(1) has nonprofit status as specified in chapter 317A;
18.25 	(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
18.26 	(3) is established to provide health services to low-income population groups, uninsured, 
18.27 	high-risk and special needs populations, underserved and other special needs populations;
18.28 	(4) employs professional staff at least one-half of which are familiar with the cultural 
18.29 	background of their clients;
18.30 	(5) charges for services on a sliding fee scale designed to provide assistance to 
18.31 	low-income clients based on current poverty income guidelines and family size; and
19.1 	(6) does not restrict access or services because of a client's financial limitations or public 
19.2 	assistance status and provides no-cost care as needed.
19.3 	(i) Effective for services provided on or after January 1, 2015, all claims for payment 
19.4 	of clinic services provided by FQHCs and rural health clinics shall be paid by the 
19.5 	commissioner. the commissioner shall determine the most feasible method for paying claims 
19.6 	from the following options:
19.7 	(1) FQHCs and rural health clinics submit claims directly to the commissioner for 
19.8 	payment, and the commissioner provides claims information for recipients enrolled in a 
19.9 	managed care or county-based purchasing plan to the plan, on a regular basis; or
19.10 	(2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed 
19.11 	care or county-based purchasing plan to the plan, and those claims are submitted by the 
19.12 	plan to the commissioner for payment to the clinic.
19.13 	(j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate 
19.14 	and pay monthly the proposed managed care supplemental payments to clinics, and clinics 
19.15 	shall conduct a timely review of the payment calculation data in order to finalize all 
19.16 	supplemental payments in accordance with federal law. Any issues arising from a clinic's 
19.17 	review must be reported to the commissioner by January 1, 2017. Upon final agreement 
19.18 	between the commissioner and a clinic on issues identified under this subdivision, and in 
19.19 	accordance with United States Code, title 42, section 1396a(bb), no supplemental payments 
19.20 	for managed care plan or county-based purchasing plan claims for services provided prior 
19.21 	to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are 
19.22 	unable to resolve issues under this subdivision, the parties shall submit the dispute to the 
19.23 	arbitration process under section 14.57.
19.24 	(k) The commissioner shall seek a federal waiver, authorized under section 1115 of the 
19.25 	Social Security Act, to obtain federal financial participation at the 100 percent federal 
19.26 	matching percentage available to facilities of the Indian Health Service or tribal organization 
19.27 	in accordance with section 1905(b) of the Social Security Act for expenditures made to 
19.28 	organizations dually certified under Title V of the Indian Health Care Improvement Act, 
19.29 	Public Law 94-437, and as a federally qualified health center under paragraph (a) that 
19.30 	provides services to American Indian and Alaskan Native individuals eligible for services 
19.31 	under this subdivision.
19.32 	(l) All claims for payment of clinic services provided by FQHCs and rural health clinics, 
19.33 	that have elected to be paid under this paragraph, shall be paid by the commissioner according 
19.34 	to the following requirements:
20.1 	(1) the commissioner shall establish a single medical and single dental organization 
20.2 	encounter rate for each FQHC and rural health clinic when applicable;
20.3 	(2) each FQHC and rural health clinic is eligible for same day reimbursement of one 
20.4 	medical and one dental organization encounter rate if eligible medical and dental visits are 
20.5 	provided on the same day;
20.6 	(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance 
20.7 	with current applicable Medicare cost principles, their allowable costs, including direct 
20.8 	patient care costs and patient-related support services. Nonallowable costs include, but are 
20.9 	not limited to:
20.10 	(i) general social services and administrative costs;
20.11 	(ii) retail pharmacy;
20.12 	(iii) patient incentives, food, housing assistance, and utility assistance;
20.13 	(iv) external lab and x-ray;
20.14 	(v) navigation services;
20.15 	(vi) health care taxes;
20.16 	(vii) advertising, public relations, and marketing;
20.17 	(viii) office entertainment costs, food, alcohol, and gifts;
20.18 	(ix) contributions and donations;
20.19 	(x) bad debts or losses on awards or contracts;
20.20 	(xi) fines, penalties, damages, or other settlements;
20.21 	(xii) fund-raising, investment management, and associated administrative costs;
20.22 	(xiii) research and associated administrative costs;
20.23 	(xiv) nonpaid workers;
20.24 	(xv) lobbying;
20.25 	(xvi) scholarships and student aid; and
20.26 	(xvii) nonmedical assistance covered services;
20.27 	(4) the commissioner shall review the list of nonallowable costs in the years between 
20.28 	the rebasing process established in clause (5), in consultation with the Minnesota Association 
21.1 	of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall 
21.2 	publish the list and any updates in the Minnesota health care programs provider manual;
21.3 	(5) the initial applicable base year organization encounter rates for FQHCs and rural 
21.4 	health clinics shall be computed for services delivered on or after January 1, 2021, and:
21.5 	(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports 
21.6 	from 2017 and 2018;
21.7 	(ii) must be according to current applicable Medicare cost principles as applicable to 
21.8 	FQHCs and rural health clinics without the application of productivity screens and upper 
21.9 	payment limits or the Medicare prospective payment system FQHC aggregate mean upper 
21.10 	payment limit;
21.11 	(iii) must be subsequently rebased every two years thereafter using the Medicare cost 
21.12 	reports that are three and four years prior to the rebasing year. Years in which organizational 
21.13 	cost or claims volume is reduced or altered due to a pandemic, disease, or other public health 
21.14 	emergency shall not be used as part of a base year when the base year includes more than 
21.15 	one year. The commissioner may use the Medicare cost reports of a year unaffected by a 
21.16 	pandemic, disease, or other public health emergency, or previous two consecutive years, 
21.17 	inflated to the base year as established under item (iv);
21.18 	(iv) must be inflated to the base year using the inflation factor described in clause (6); 
21.19 	and
21.20 	(v) the commissioner must provide for a 60-day appeals process under section 14.57;
21.21 	(6) the commissioner shall annually inflate the applicable organization encounter rates 
21.22 	for FQHCs and rural health clinics from the base year payment rate to the effective date by 
21.23 	using the CMS FQHC Market Basket inflator established under United States Code, title 
21.24 	42, section 1395m(o), less productivity;
21.25 	(7) FQHCs and rural health clinics that have elected the alternative payment methodology 
21.26 	under this paragraph shall submit all necessary documentation required by the commissioner 
21.27 	to compute the rebased organization encounter rates no later than six months following the 
21.28 	date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid 
21.29 	Services;
21.30 	(8) the commissioner shall reimburse FQHCs and rural health clinics an additional 
21.31 	amount relative to their medical and dental organization encounter rates that is attributable 
21.32 	to the tax required to be paid according to section 295.52, if applicable;
22.1 	(9) FQHCs and rural health clinics may submit change of scope requests to the 
22.2 	commissioner if the change of scope would result in an increase or decrease of 2.5 percent 
22.3 	or higher in the medical or dental organization encounter rate currently received by the 
22.4 	FQHC or rural health clinic;
22.5 	(10) for FQHCs and rural health clinics seeking a change in scope with the commissioner 
22.6 	under clause (9) that requires the approval of the scope change by the federal Health 
22.7 	Resources Services Administration:
22.8 	(i) FQHCs and rural health clinics shall submit the change of scope request, including 
22.9 	the start date of services, to the commissioner within seven business days of submission of 
22.10 	the scope change to the federal Health Resources Services Administration;
22.11 	(ii) the commissioner shall establish the effective date of the payment change as the 
22.12 	federal Health Resources Services Administration date of approval of the FQHC's or rural 
22.13 	health clinic's scope change request, or the effective start date of services, whichever is 
22.14 	later; and
22.15 	(iii) within 45 days of one year after the effective date established in item (ii), the 
22.16 	commissioner shall conduct a retroactive review to determine if the actual costs established 
22.17 	under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in 
22.18 	the medical or dental organization encounter rate, and if this is the case, the commissioner 
22.19 	shall revise the rate accordingly and shall adjust payments retrospectively to the effective 
22.20 	date established in item (ii);
22.21 	(11) for change of scope requests that do not require federal Health Resources Services 
22.22 	Administration approval, the FQHC and rural health clinic shall submit the request to the 
22.23 	commissioner before implementing the change, and the effective date of the change is the 
22.24 	date the commissioner received the FQHC's or rural health clinic's request, or the effective 
22.25 	start date of the service, whichever is later. The commissioner shall provide a response to 
22.26 	the FQHC's or rural health clinic's request within 45 days of submission and provide a final 
22.27 	approval within 120 days of submission. This timeline may be waived at the mutual 
22.28 	agreement of the commissioner and the FQHC or rural health clinic if more information is 
22.29 	needed to evaluate the request;
22.30 	(12) the commissioner, when establishing organization encounter rates for new FQHCs 
22.31 	and rural health clinics, shall consider the patient caseload of existing FQHCs and rural 
22.32 	health clinics in a 60-mile radius for organizations established outside of the seven-county 
22.33 	metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan 
23.1 	area. If this information is not available, the commissioner may use Medicare cost reports 
23.2 	or audited financial statements to establish base rate;
23.3 	(13) the commissioner shall establish a quality measures workgroup that includes 
23.4 	representatives from the Minnesota Association of Community Health Centers, FQHCs, 
23.5 	and rural health clinics, to evaluate clinical and nonclinical measures; and
23.6 	(14) the commissioner shall not disallow or reduce costs that are related to an FQHC's 
23.7 	or rural health clinic's participation in health care educational programs to the extent that 
23.8 	the costs are not accounted for in the alternative payment methodology encounter rate 
23.9 	established in this paragraph.

23.10 	Sec. 12. Minnesota Statutes 2020, section 256B.0638, subdivision 3, is amended to read:
23.11 		Subd. 3.Opioid prescribing work group. (a) The commissioner of human services, in 
23.12 	consultation with the commissioner of health, shall appoint the following voting members 
23.13 	to an opioid prescribing work group:
23.14 	(1) two consumer members who have been impacted by an opioid abuse disorder or 
23.15 	opioid dependence disorder, either personally or with family members;
23.16 	(2) one member who is a licensed physician actively practicing in Minnesota and 
23.17 	registered as a practitioner with the DEA;
23.18 	(3) one member who is a licensed pharmacist actively practicing in Minnesota and 
23.19 	registered as a practitioner with the DEA;
23.20 	(4) one member who is a licensed nurse practitioner actively practicing in Minnesota 
23.21 	and registered as a practitioner with the DEA;
23.22 	(5) one member who is a licensed dentist actively practicing in Minnesota and registered 
23.23 	as a practitioner with the DEA;
23.24 	(6) two members who are nonphysician licensed health care professionals actively 
23.25 	engaged in the practice of their profession in Minnesota, and their practice includes treating 
23.26 	pain;
23.27 	(7) one member who is a mental health professional who is licensed or registered in a 
23.28 	mental health profession, who is actively engaged in the practice of that profession in 
23.29 	Minnesota, and whose practice includes treating patients with chemical dependency or 
23.30 	substance abuse;
23.31 	(8) one member who is a medical examiner for a Minnesota county;
24.1 	(9) one member of the Health Services Policy Committee established under section 
24.2 	256B.0625, subdivisions 3c to 3e;
24.3 	(10) one member who is a medical director of a health plan company doing business in 
24.4 	Minnesota;
24.5 	(11) one member who is a pharmacy director of a health plan company doing business 
24.6 	in Minnesota; and
24.7 	(12) one member representing Minnesota law enforcement.; and
24.8 	(13) two consumer members who are Minnesota residents and who have used or are 
24.9 	using opioids to manage chronic pain.
24.10 	(b) In addition, the work group shall include the following nonvoting members:
24.11 	(1) the medical director for the medical assistance program;
24.12 	(2) a member representing the Department of Human Services pharmacy unit; and
24.13 	(3) the medical director for the Department of Labor and Industry.; and
24.14 	(4) a member representing the Minnesota Department of Health.
24.15 	(c) An honorarium of $200 per meeting and reimbursement for mileage and parking 
24.16 	shall be paid to each voting member in attendance.

24.17 	Sec. 13. Minnesota Statutes 2020, section 256B.0638, subdivision 5, is amended to read:
24.18 		Subd. 5.Program implementation. (a) The commissioner shall implement the programs 
24.19 	within the Minnesota health care program to improve the health of and quality of care 
24.20 	provided to Minnesota health care program enrollees. The commissioner shall annually 
24.21 	collect and report to provider groups the sentinel measures of data showing individual opioid 
24.22 	prescribers data showing the sentinel measures of their prescribers' opioid prescribing 
24.23 	patterns compared to their anonymized peers. Provider groups shall distribute data to their 
24.24 	affiliated, contracted, or employed opioid prescribers.
24.25 	(b) The commissioner shall notify an opioid prescriber and all provider groups with 
24.26 	which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing 
24.27 	pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber 
24.28 	and any provider group that receives a notice under this paragraph shall submit to the 
24.29 	commissioner a quality improvement plan for review and approval by the commissioner 
24.30 	with the goal of bringing the opioid prescriber's prescribing practices into alignment with 
24.31 	community standards. A quality improvement plan must include:
25.1 	(1) components of the program described in subdivision 4, paragraph (a);
25.2 	(2) internal practice-based measures to review the prescribing practice of the opioid 
25.3 	prescriber and, where appropriate, any other opioid prescribers employed by or affiliated 
25.4 	with any of the provider groups with which the opioid prescriber is employed or affiliated; 
25.5 	and
25.6 	(3) appropriate use of the prescription monitoring program under section 152.126.
25.7 	(c) If, after a year from the commissioner's notice under paragraph (b), the opioid 
25.8 	prescriber's prescribing practices do not improve so that they are consistent with community 
25.9 	standards, the commissioner shall take one or more of the following steps:
25.10 	(1) monitor prescribing practices more frequently than annually;
25.11 	(2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel 
25.12 	measures; or
25.13 	(3) require the opioid prescriber to participate in additional quality improvement efforts, 
25.14 	including but not limited to mandatory use of the prescription monitoring program established 
25.15 	under section 152.126.
25.16 	(d) The commissioner shall terminate from Minnesota health care programs all opioid 
25.17 	prescribers and provider groups whose prescribing practices fall within the applicable opioid 
25.18 	disenrollment standards.

25.19 	Sec. 14. Minnesota Statutes 2020, section 256B.0638, subdivision 6, is amended to read:
25.20 		Subd. 6.Data practices. (a) Reports and data identifying an opioid prescriber are private 
25.21 	data on individuals as defined under section 13.02, subdivision 12, until an opioid prescriber 
25.22 	is subject to termination as a medical assistance provider under this section. Notwithstanding 
25.23 	this data classification, the commissioner shall share with all of the provider groups with 
25.24 	which an opioid prescriber is employed, contracted, or affiliated, a report identifying an 
25.25 	opioid prescriber who is subject to quality improvement activities the data under subdivision 
25.26 	5, paragraph (a), (b), or (c).
25.27 	(b) Reports and data identifying a provider group are nonpublic data as defined under 
25.28 	section 13.02, subdivision 9, until the provider group is subject to termination as a medical 
25.29 	assistance provider under this section.
25.30 	(c) Upon termination under this section, reports and data identifying an opioid prescriber 
25.31 	or provider group are public, except that any identifying information of Minnesota health 
25.32 	care program enrollees must be redacted by the commissioner.

26.1 	Sec. 15. Minnesota Statutes 2020, section 256B.0659, subdivision 13, is amended to read:
26.2 		Subd. 13.Qualified professional; qualifications. (a) The qualified professional must 
26.3 	work for a personal care assistance provider agency, meet the definition of qualified 
26.4 	professional under section 256B.0625, subdivision 19c, and enroll with the department as 
26.5 	a qualified professional after clearing clear a background study, and meet provider training 
26.6 	requirements. Before a qualified professional provides services, the personal care assistance 
26.7 	provider agency must initiate a background study on the qualified professional under chapter 
26.8 	245C, and the personal care assistance provider agency must have received a notice from 
26.9 	the commissioner that the qualified professional:
26.10 	(1) is not disqualified under section 245C.14; or
26.11 	(2) is disqualified, but the qualified professional has received a set aside of the 
26.12 	disqualification under section 245C.22.
26.13 	(b) The qualified professional shall perform the duties of training, supervision, and 
26.14 	evaluation of the personal care assistance staff and evaluation of the effectiveness of personal 
26.15 	care assistance services. The qualified professional shall:
26.16 	(1) develop and monitor with the recipient a personal care assistance care plan based on 
26.17 	the service plan and individualized needs of the recipient;
26.18 	(2) develop and monitor with the recipient a monthly plan for the use of personal care 
26.19 	assistance services;
26.20 	(3) review documentation of personal care assistance services provided;
26.21 	(4) provide training and ensure competency for the personal care assistant in the individual 
26.22 	needs of the recipient; and
26.23 	(5) document all training, communication, evaluations, and needed actions to improve 
26.24 	performance of the personal care assistants.
26.25 	(c) Effective July 1, 2011, The qualified professional shall complete the provider training 
26.26 	with basic information about the personal care assistance program approved by the 
26.27 	commissioner. Newly hired qualified professionals must complete the training within six 
26.28 	months of the date hired by a personal care assistance provider agency. Qualified 
26.29 	professionals who have completed the required training as a worker from a personal care 
26.30 	assistance provider agency do not need to repeat the required training if they are hired by 
26.31 	another agency, if they have completed the training within the last three years. The required 
26.32 	training must be available with meaningful access according to title VI of the Civil Rights 
26.33 	Act and federal regulations adopted under that law or any guidance from the United States 
27.1 	Health and Human Services Department. The required training must be available online or 
27.2 	by electronic remote connection. The required training must provide for competency testing 
27.3 	to demonstrate an understanding of the content without attending in-person training. A 
27.4 	qualified professional is allowed to be employed and is not subject to the training requirement 
27.5 	until the training is offered online or through remote electronic connection. A qualified 
27.6 	professional employed by a personal care assistance provider agency certified for 
27.7 	participation in Medicare as a home health agency is exempt from the training required in 
27.8 	this subdivision. When available, the qualified professional working for a Medicare-certified 
27.9 	home health agency must successfully complete the competency test. The commissioner 
27.10 	shall ensure there is a mechanism in place to verify the identity of persons completing the 
27.11 	competency testing electronically.

27.12 	Sec. 16. Minnesota Statutes 2020, section 256B.196, subdivision 2, is amended to read:
27.13 		Subd. 2.Commissioner's duties. (a) For the purposes of this subdivision and subdivision 
27.14 	3, the commissioner shall determine the fee-for-service outpatient hospital services upper 
27.15 	payment limit for nonstate government hospitals. The commissioner shall then determine 
27.16 	the amount of a supplemental payment to Hennepin County Medical Center and Regions 
27.17 	Hospital for these services that would increase medical assistance spending in this category 
27.18 	to the aggregate upper payment limit for all nonstate government hospitals in Minnesota. 
27.19 	In making this determination, the commissioner shall allot the available increases between 
27.20 	Hennepin County Medical Center and Regions Hospital based on the ratio of medical 
27.21 	assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner 
27.22 	shall adjust this allotment as necessary based on federal approvals, the amount of 
27.23 	intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors, 
27.24 	in order to maximize the additional total payments. The commissioner shall inform Hennepin 
27.25 	County and Ramsey County of the periodic intergovernmental transfers necessary to match 
27.26 	federal Medicaid payments available under this subdivision in order to make supplementary 
27.27 	medical assistance payments to Hennepin County Medical Center and Regions Hospital 
27.28 	equal to an amount that when combined with existing medical assistance payments to 
27.29 	nonstate governmental hospitals would increase total payments to hospitals in this category 
27.30 	for outpatient services to the aggregate upper payment limit for all hospitals in this category 
27.31 	in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make 
27.32 	supplementary payments to Hennepin County Medical Center and Regions Hospital.
27.33 	(b) For the purposes of this subdivision and subdivision 3, the commissioner shall 
27.34 	determine an upper payment limit for physicians and other billing professionals affiliated 
27.35 	with Hennepin County Medical Center and with Regions Hospital. The upper payment limit 
28.1 	shall be based on the average commercial rate or be determined using another method 
28.2 	acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall 
28.3 	inform Hennepin County and Ramsey County of the periodic intergovernmental transfers 
28.4 	necessary to match the federal Medicaid payments available under this subdivision in order 
28.5 	to make supplementary payments to physicians and other billing professionals affiliated 
28.6 	with Hennepin County Medical Center and to make supplementary payments to physicians 
28.7 	and other billing professionals affiliated with Regions Hospital through HealthPartners 
28.8 	Medical Group equal to the difference between the established medical assistance payment 
28.9 	for physician and other billing professional services and the upper payment limit. Upon 
28.10 	receipt of these periodic transfers, the commissioner shall make supplementary payments 
28.11 	to physicians and other billing professionals affiliated with Hennepin County Medical Center 
28.12 	and shall make supplementary payments to physicians and other billing professionals 
28.13 	affiliated with Regions Hospital through HealthPartners Medical Group.
28.14 	(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make monthly 
28.15 	voluntary intergovernmental transfers to the commissioner in amounts not to exceed 
28.16 	$12,000,000 per year from Hennepin County and $6,000,000 per year from Ramsey County. 
28.17 	The commissioner shall increase the medical assistance capitation payments to any licensed 
28.18 	health plan under contract with the medical assistance program that agrees to make enhanced 
28.19 	payments to Hennepin County Medical Center or Regions Hospital. The increase shall be 
28.20 	in an amount equal to the annual value of the monthly transfers plus federal financial 
28.21 	participation, with each health plan receiving its pro rata share of the increase based on the 
28.22 	pro rata share of medical assistance admissions to Hennepin County Medical Center and
28.23 	Regions Hospital by those plans. For the purposes of this paragraph, "the base amount" 
28.24 	means the total annual value of increased medical assistance capitation payments, including 
28.25 	the voluntary intergovernmental transfers, under this paragraph in calendar year 2017. For 
28.26 	managed care contracts beginning on or after January 1, 2018, the commissioner shall reduce 
28.27 	the total annual value of increased medical assistance capitation payments under this 
28.28 	paragraph by an amount equal to ten percent of the base amount, and by an additional ten 
28.29 	percent of the base amount for each subsequent contract year until December 31, 2025. 
28.30 	Upon the request of the commissioner, health plans shall submit individual-level cost data 
28.31 	for verification purposes. The commissioner may ratably reduce these payments on a pro 
28.32 	rata basis in order to satisfy federal requirements for actuarial soundness. If payments are 
28.33 	reduced, transfers shall be reduced accordingly. Any licensed health plan that receives 
28.34 	increased medical assistance capitation payments under the intergovernmental transfer 
28.35 	described in this paragraph shall increase its medical assistance payments to Hennepin 
28.36 	County Medical Center and Regions Hospital by the same amount as the increased payments 
29.1 	received in the capitation payment described in this paragraph. This paragraph expires 
29.2 	January 1, 2026.
29.3 	(d) For the purposes of this subdivision and subdivision 3, the commissioner shall 
29.4 	determine an upper payment limit for ambulance services affiliated with Hennepin County 
29.5 	Medical Center and the city of St. Paul, and ambulance services owned and operated by 
29.6 	another governmental entity that chooses to participate by requesting the commissioner to 
29.7 	determine an upper payment limit. The upper payment limit shall be based on the average 
29.8 	commercial rate or be determined using another method acceptable to the Centers for 
29.9 	Medicare and Medicaid Services. The commissioner shall inform Hennepin County, the 
29.10 	city of St. Paul, and other participating governmental entities of the periodic 
29.11 	intergovernmental transfers necessary to match the federal Medicaid payments available 
29.12 	under this subdivision in order to make supplementary payments to Hennepin County 
29.13 	Medical Center, the city of St. Paul, and other participating governmental entities equal to 
29.14 	the difference between the established medical assistance payment for ambulance services 
29.15 	and the upper payment limit. Upon receipt of these periodic transfers, the commissioner 
29.16 	shall make supplementary payments to Hennepin County Medical Center, the city of St. 
29.17 	Paul, and other participating governmental entities. A tribal government that owns and 
29.18 	operates an ambulance service is not eligible to participate under this subdivision.
29.19 	(e) For the purposes of this subdivision and subdivision 3, the commissioner shall 
29.20 	determine an upper payment limit for physicians, dentists, and other billing professionals 
29.21 	affiliated with the University of Minnesota and University of Minnesota Physicians. The 
29.22 	upper payment limit shall be based on the average commercial rate or be determined using 
29.23 	another method acceptable to the Centers for Medicare and Medicaid Services. The 
29.24 	commissioner shall inform the University of Minnesota Medical School and University of 
29.25 	Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to 
29.26 	match the federal Medicaid payments available under this subdivision in order to make 
29.27 	supplementary payments to physicians, dentists, and other billing professionals affiliated 
29.28 	with the University of Minnesota and the University of Minnesota Physicians equal to the 
29.29 	difference between the established medical assistance payment for physician, dentist, and 
29.30 	other billing professional services and the upper payment limit. Upon receipt of these periodic 
29.31 	transfers, the commissioner shall make supplementary payments to physicians, dentists, 
29.32 	and other billing professionals affiliated with the University of Minnesota and the University 
29.33 	of Minnesota Physicians.
29.34 	(f) The commissioner shall inform the transferring governmental entities on an ongoing 
29.35 	basis of the need for any changes needed in the intergovernmental transfers in order to 
30.1 	continue the payments under paragraphs (a) to (e), at their maximum level, including 
30.2 	increases in upper payment limits, changes in the federal Medicaid match, and other factors.
30.3 	(g) The payments in paragraphs (a) to (e) shall be implemented independently of each 
30.4 	other, subject to federal approval and to the receipt of transfers under subdivision 3.
30.5 	(h) All of the data and funding transactions related to the payments in paragraphs (a) to 
30.6 	(e) shall be between the commissioner and the governmental entities.
30.7 	(i) For purposes of this subdivision, billing professionals are limited to physicians, nurse 
30.8 	practitioners, nurse midwives, clinical nurse specialists, physician assistants, 
30.9 	anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and 
30.10 	dental therapists.

30.11 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval 
30.12 	of both this section and Minnesota Statutes, section 256B.1973, whichever is later. The 
30.13 	commissioner of human services shall notify the revisor of statutes when federal approval 
30.14 	is obtained.

30.15 	Sec. 17. [256B.1973] DIRECTED PAYMENT ARRANGEMENTS.
30.16 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
30.17 	the meanings given them.
30.18 	(b) "Billing professionals" means physicians, nurse practitioners, nurse midwives, clinical 
30.19 	nurse specialists, physician assistants, anesthesiologists, and certified registered anesthetists, 
30.20 	and may include dentists, individually enrolled dental hygienists, and dental therapists.
30.21 	(c) "Health plan" means a managed care or county-based purchasing plan that is under 
30.22 	contract with the commissioner to deliver services to medical assistance enrollees under 
30.23 	section 256B.69.
30.24 	(d) "High medical assistance utilization" means a medical assistance utilization rate 
30.25 	equal to the standard established in section 256.969, subdivision 9, paragraph (d), clause 
30.26 	(6).
30.27 		Subd. 2.Federal approval required. Each directed payment arrangement under this 
30.28 	section is contingent on federal approval and must conform with the requirements for 
30.29 	permissible directed managed care organization expenditures under section 256B.6928, 
30.30 	subdivision 5.
30.31 		Subd. 3.Eligible providers. Eligible providers under this section are nonstate government 
30.32 	teaching hospitals with high medical assistance utilization and a level 1 trauma center and 
31.1 	all of the hospital's owned or affiliated billing professionals, ambulance services, sites, and 
31.2 	clinics.
31.3 		Subd. 4.Voluntary intergovernmental transfers. A nonstate governmental entity that 
31.4 	is eligible to perform intergovernmental transfers may make voluntary intergovernmental 
31.5 	transfers to the commissioner. The commissioner shall inform the nonstate governmental 
31.6 	entity of the intergovernmental transfers necessary to maximize the allowable directed 
31.7 	payments.
31.8 		Subd. 5.Commissioner's duties; state-directed fee schedule requirement. (a) For 
31.9 	each federally approved directed payment arrangement that is a state-directed fee schedule 
31.10 	requirement, the commissioner shall determine a uniform adjustment factor to be applied 
31.11 	to each claim submitted by an eligible provider to a health plan. The uniform adjustment 
31.12 	factor shall be determined using the average commercial payer rate or using another method 
31.13 	acceptable to the Centers for Medicare and Medicaid Services if the average commercial 
31.14 	payer rate is not approved, minus the amount necessary for the plan to satisfy tax liabilities 
31.15 	under sections 256.9657 and 297I.05 attributable to the directed payment arrangement. The 
31.16 	commissioner shall ensure that the application of the uniform adjustment factor maximizes 
31.17 	the allowable directed payments and does not result in payments exceeding federal limits, 
31.18 	and may use an annual settle-up process. The directed payment shall be specific to each 
31.19 	health plan and prospectively incorporated into capitation payments for that plan.
31.20 	(b) For each federally approved directed payment arrangement that is a state-directed 
31.21 	fee schedule requirement, the commissioner shall develop a plan for the initial 
31.22 	implementation of the state-directed fee schedule requirement to ensure that the eligible 
31.23 	provider receives the entire permissible value of the federally approved directed payment 
31.24 	arrangement. If federal approval of a directed payment arrangement under this subdivision 
31.25 	is retroactive, the commissioner shall make a onetime pro rata increase to the uniform 
31.26 	adjustment factor and the initial payments in order to include claims submitted between the 
31.27 	retroactive federal approval date and the period captured by the initial payments.
31.28 		Subd. 6.Health plan duties; submission of claims. In accordance with its contract, 
31.29 	each health plan shall submit to the commissioner payment information for each claim paid 
31.30 	to an eligible provider for services provided to a medical assistance enrollee.
31.31 		Subd. 7.Health plan duties; directed payments. In accordance with its contract, each 
31.32 	health plan shall make directed payments to the eligible provider in an amount equal to the 
31.33 	payment amounts the plan received from the commissioner.
32.1 		Subd. 8.State quality goals. The directed payment arrangement and state-directed fee 
32.2 	schedule requirement must align the state quality goals to Hennepin Healthcare medical 
32.3 	assistance patients, including unstably housed individuals, those with higher levels of social 
32.4 	and clinical risk, limited English proficiency (LEP) patients, adults with serious chronic 
32.5 	conditions, and individuals of color. The directed payment arrangement must maintain 
32.6 	quality and access to a full range of health care delivery mechanisms for these patients that 
32.7 	may include behavioral health, emergent care, preventive care, hospitalization, transportation, 
32.8 	interpreter services, and pharmaceutical services. The commissioner, in consultation with 
32.9 	Hennepin Healthcare, shall submit to the Centers for Medicare and Medicaid Services a 
32.10 	methodology to measure access to care and the achievement of state quality goals.

32.11 	EFFECTIVE DATE. This section is effective January 1, 2022, or upon federal approval, 
32.12 	whichever is later, unless the federal approval provides for an effective date after July 1, 
32.13 	2021, but before the date of federal approval, in which case the federally approved effective 
32.14 	date applies.

32.15 	Sec. 18. Minnesota Statutes 2020, section 256B.6928, subdivision 5, is amended to read:
32.16 		Subd. 5.Direction of managed care organization expenditures. (a) The commissioner 
32.17 	shall not direct managed care organizations expenditures under the managed care contract, 
32.18 	except in as permitted under Code of Federal Regulations, part 42, section 438.6(c). The 
32.19 	exception under this paragraph includes the following situations:
32.20 	(1) implementation of a value-based purchasing model for provider reimbursement, 
32.21 	including pay-for-performance arrangements, bundled payments, or other service payments 
32.22 	intended to recognize value or outcomes over volume of services;
32.23 	(2) participation in a multipayer or medical assistance-specific delivery system reform 
32.24 	or performance improvement initiative; or
32.25 	(3) implementation of a minimum or maximum fee schedule, or a uniform dollar or 
32.26 	percentage increase for network providers that provide a particular service. The maximum 
32.27 	fee schedule must allow the managed care organization the ability to reasonably manage 
32.28 	risk and provide discretion in accomplishing the goals of the contract.
32.29 	(b) Any managed care contract that directs managed care organization expenditures as 
32.30 	permitted under paragraph (a), clauses (1) to (3), must be developed in accordance with 
32.31 	Code of Federal Regulations, part 42, sections 438.4 and 438.5; comply with actuarial 
32.32 	soundness and generally accepted actuarial principles and practices; and have written 
33.1 	approval from the Centers for Medicare and Medicaid Services before implementation. To 
33.2 	obtain approval, the commissioner shall demonstrate in writing that the contract arrangement:
33.3 	(1) is based on the utilization and delivery of services;
33.4 	(2) directs expenditures equally, using the same terms of performance for a class of 
33.5 	providers providing service under the contract;
33.6 	(3) is intended to advance at least one of the goals and objectives in the commissioner's 
33.7 	quality strategy;
33.8 	(4) has an evaluation plan that measures the degree to which the arrangement advances 
33.9 	at least one of the goals in the commissioner's quality strategy;
33.10 	(5) does not condition network provider participation on the network provider entering 
33.11 	into or adhering to an intergovernmental transfer agreement; and
33.12 	(6) is not renewed automatically.
33.13 	(c) For contract arrangements identified in paragraph (a), clauses (1) and (2), the 
33.14 	commissioner shall:
33.15 	(1) make participation in the value-based purchasing model, special delivery system 
33.16 	reform, or performance improvement initiative available, using the same terms of 
33.17 	performance, to a class of providers providing services under the contract related to the 
33.18 	model, reform, or initiative; and
33.19 	(2) use a common set of performance measures across all payers and providers.
33.20 	(d) The commissioner shall not set the amount or frequency of the expenditures or recoup 
33.21 	from the managed care organization any unspent funds allocated for these arrangements.

33.22 	Sec. 19. Minnesota Statutes 2020, section 256L.01, subdivision 5, is amended to read:
33.23 		Subd. 5.Income.  "Income" has the meaning given for modified adjusted gross income, 
33.24 	as defined in Code of Federal Regulations, title 26, section 1.36B-1, and means a household's 
33.25 	current income, or if income fluctuates month to month, the income for the 12-month 
33.26 	eligibility period projected annual income for the applicable tax year.

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

34.1 	Sec. 20. Minnesota Statutes 2020, section 256L.04, subdivision 7b, is amended to read:
34.2 		Subd. 7b.Annual income limits adjustment. The commissioner shall adjust the income 
34.3 	limits under this section annually each July 1 on January 1 as described in section 256B.056, 
34.4 	subdivision 1c provided in Code of Federal Regulations, title 26, section 1.36B-1(h).

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

34.6 	Sec. 21. Minnesota Statutes 2020, section 256L.05, subdivision 3a, is amended to read:
34.7 		Subd. 3a.Redetermination of eligibility. (a) An enrollee's eligibility must be 
34.8 	redetermined on an annual basis, in accordance with Code of Federal Regulations, title 42, 
34.9 	section 435.916 (a). The 12-month eligibility period begins the month of application. 
34.10 	Beginning July 1, 2017, the commissioner shall adjust the eligibility period for enrollees to 
34.11 	implement renewals throughout the year according to guidance from the Centers for Medicare 
34.12 	and Medicaid Services. The period of eligibility is the entire calendar year following the 
34.13 	year in which eligibility is redetermined. Eligibility redeterminations shall occur during the 
34.14 	open enrollment period for qualified health plans as specified in Code of Federal Regulations, 
34.15 	title 45, section 155.410(e)(3).
34.16 	(b) Each new period of eligibility must take into account any changes in circumstances 
34.17 	that impact eligibility and premium amount. Coverage begins as provided in section 256L.06.

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

34.19 	Sec. 22. Minnesota Statutes 2020, section 295.53, subdivision 1, is amended to read:
34.20 		Subdivision 1.Exclusions and exemptions. (a) The following payments are excluded 
34.21 	from the gross revenues subject to the hospital, surgical center, or health care provider taxes 
34.22 	under sections 295.50 to 295.59:
34.23 	(1) payments received by a health care provider or the wholly owned subsidiary of a 
34.24 	health care provider for care provided outside Minnesota;
34.25 	(2) government payments received by the commissioner of human services for 
34.26 	state-operated services;
34.27 	(3) payments received by a health care provider for hearing aids and related equipment 
34.28 	or prescription eyewear delivered outside of Minnesota; and
34.29 	(4) payments received by an educational institution from student tuition, student activity 
34.30 	fees, health care service fees, government appropriations, donations, or grants, and for 
34.31 	services identified in and provided under an individualized education program as defined 
35.1 	in section 256B.0625 or Code of Federal Regulations, chapter 34, section 300.340(a). Fee 
35.2 	for service payments and payments for extended coverage are taxable.
35.3 	(b) The following payments are exempted from the gross revenues subject to hospital, 
35.4 	surgical center, or health care provider taxes under sections 295.50 to 295.59:
35.5 	(1) payments received for services provided under the Medicare program, including 
35.6 	payments received from the government and organizations governed by sections 1833, 
35.7 	1853, and 1876 of title XVIII of the federal Social Security Act, United States Code, title 
35.8 	42, section 1395; and enrollee deductibles, co-insurance, and co-payments, whether paid 
35.9 	by the Medicare enrollee, by Medicare supplemental coverage as described in section 
35.10 	62A.011, subdivision 3, clause (10), or by Medicaid payments under title XIX of the federal 
35.11 	Social Security Act. Payments for services not covered by Medicare are taxable;
35.12 	(2) payments received for home health care services;
35.13 	(3) payments received from hospitals or surgical centers for goods and services on which 
35.14 	liability for tax is imposed under section 295.52 or the source of funds for the payment is 
35.15 	exempt under clause (1), (6), (9), (10), or (11);
35.16 	(4) payments received from the health care providers for goods and services on which 
35.17 	liability for tax is imposed under this chapter or the source of funds for the payment is 
35.18 	exempt under clause (1), (6), (9), (10), or (11);
35.19 	(5) amounts paid for legend drugs to a wholesale drug distributor who is subject to tax 
35.20 	under section 295.52, subdivision 3, reduced by reimbursement received for legend drugs 
35.21 	otherwise exempt under this chapter;
35.22 	(6) payments received from the chemical dependency fund under chapter 254B;
35.23 	(7) payments received in the nature of charitable donations that are not designated for 
35.24 	providing patient services to a specific individual or group;
35.25 	(8) payments received for providing patient services incurred through a formal program 
35.26 	of health care research conducted in conformity with federal regulations governing research 
35.27 	on human subjects. Payments received from patients or from other persons paying on behalf 
35.28 	of the patients are subject to tax;
35.29 	(9) payments received from any governmental agency for services benefiting the public, 
35.30 	not including payments made by the government in its capacity as an employer or insurer 
35.31 	or payments made by the government for services provided under the MinnesotaCare 
35.32 	program or the medical assistance program governed by title XIX of the federal Social 
35.33 	Security Act, United States Code, title 42, sections 1396 to 1396v;
36.1 	(10) payments received under the federal Employees Health Benefits Act, United States 
36.2 	Code, title 5, section 8909(f), as amended by the Omnibus Reconciliation Act of 1990. 
36.3 	Enrollee deductibles, co-insurance, and co-payments are subject to tax;
36.4 	(11) payments received under the federal Tricare program, Code of Federal Regulations, 
36.5 	title 32, section 199.17(a)(7). Enrollee deductibles, co-insurance, and co-payments are 
36.6 	subject to tax; and
36.7 	(12) supplemental or, enhanced, or uniform adjustment factor payments authorized under 
36.8 	section 256B.196or,256B.197, or 256B.1973.
36.9 	(c) Payments received by wholesale drug distributors for legend drugs sold directly to 
36.10 	veterinarians or veterinary bulk purchasing organizations are excluded from the gross 
36.11 	revenues subject to the wholesale drug distributor tax under sections 295.50 to 295.59.

36.12 	EFFECTIVE DATE. This section is effective for taxable years beginning after December 
36.13 	31, 2021.

36.14 	Sec. 23. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; 
36.15 	FUNDING FOR RECUPERATIVE CARE.
 36.16 	The commissioner of human services shall develop a medical assistance reimbursable 
36.17 	recuperative care service, not limited to a health home model, designed to serve individuals 
36.18 	with chronic conditions, as defined in United States Code, title 42, section 1396w-4(h), who 
36.19 	also lack a permanent place of residence at the time of discharge from an emergency 
36.20 	department or hospital in order to prevent a return to the emergency department, readmittance 
36.21 	to the hospital, or hospitalization. This section is contingent on the receipt of nonstate 
36.22 	funding to the commissioner of human services for this purpose as permitted by Minnesota 
36.23 	Statutes, section 256.01, subdivision 25.

36.24 	Sec. 24. REVISOR INSTRUCTION.
 36.25 	The revisor of statutes must change the term "Health Services Policy Committee" to 
36.26 	"Health Services Advisory Council" wherever the term appears in Minnesota Statutes and 
36.27 	may make any necessary changes to grammar or sentence structure to preserve the meaning 
36.28 	of the text.

37.1 	ARTICLE 2
37.2 	DEPARTMENT OF HUMAN SERVICES 
37.3 	LICENSING AND BACKGROUND STUDIES

37.4 	Section 1. Minnesota Statutes 2020, section 245A.043, subdivision 3, is amended to read:
37.5 		Subd. 3.Change of ownership process. (a) When a change in ownership is proposed 
37.6 	and the party intends to assume operation without an interruption in service longer than 60 
37.7 	days after acquiring the program or service, the license holder must provide the commissioner 
37.8 	with written notice of the proposed change on a form provided by the commissioner at least 
37.9 	60 days before the anticipated date of the change in ownership. For purposes of this 
37.10 	subdivision and subdivision 4, "party" means the party that intends to operate the service 
37.11 	or program.
37.12 	(b) The party must submit a license application under this chapter on the form and in 
37.13 	the manner prescribed by the commissioner at least 30 days before the change in ownership 
37.14 	is complete, and must include documentation to support the upcoming change. The party 
37.15 	must comply with background study requirements under chapter 245C and shall pay the 
37.16 	application fee required under section 245A.10. A party that intends to assume operation 
37.17 	without an interruption in service longer than 60 days after acquiring the program or service 
37.18 	is exempt from the requirements of Minnesota Rules, part 9530.6800 sections 245G.03, 
37.19 	subdivision 2, paragraph (b), and 254B.03, subdivision 2, paragraphs (d) and (e).
37.20 	(c) The commissioner may streamline application procedures when the party is an existing 
37.21 	license holder under this chapter and is acquiring a program licensed under this chapter or 
37.22 	service in the same service class as one or more licensed programs or services the party 
37.23 	operates and those licenses are in substantial compliance. For purposes of this subdivision, 
37.24 	"substantial compliance" means within the previous 12 months the commissioner did not 
37.25 	(1) issue a sanction under section 245A.07 against a license held by the party, or (2) make 
37.26 	a license held by the party conditional according to section 245A.06.
37.27 	(d) Except when a temporary change in ownership license is issued pursuant to 
37.28 	subdivision 4, the existing license holder is solely responsible for operating the program 
37.29 	according to applicable laws and rules until a license under this chapter is issued to the 
37.30 	party.
37.31 	(e) If a licensing inspection of the program or service was conducted within the previous 
37.32 	12 months and the existing license holder's license record demonstrates substantial 
37.33 	compliance with the applicable licensing requirements, the commissioner may waive the 
37.34 	party's inspection required by section 245A.04, subdivision 4. The party must submit to the 
38.1 	commissioner (1) proof that the premises was inspected by a fire marshal or that the fire 
38.2 	marshal deemed that an inspection was not warranted, and (2) proof that the premises was 
38.3 	inspected for compliance with the building code or that no inspection was deemed warranted.
38.4 	(f) If the party is seeking a license for a program or service that has an outstanding action 
38.5 	under section 245A.06 or 245A.07, the party must submit a letter as part of the application 
38.6 	process identifying how the party has or will come into full compliance with the licensing 
38.7 	requirements.
38.8 	(g) The commissioner shall evaluate the party's application according to section 245A.04, 
38.9 	subdivision 6. If the commissioner determines that the party has remedied or demonstrates 
38.10 	the ability to remedy the outstanding actions under section 245A.06 or 245A.07 and has 
38.11 	determined that the program otherwise complies with all applicable laws and rules, the 
38.12 	commissioner shall issue a license or conditional license under this chapter. The conditional 
38.13 	license remains in effect until the commissioner determines that the grounds for the action 
38.14 	are corrected or no longer exist.
38.15 	(h) The commissioner may deny an application as provided in section 245A.05. An 
38.16 	applicant whose application was denied by the commissioner may appeal the denial according 
38.17 	to section 245A.05.
38.18 	(i) This subdivision does not apply to a licensed program or service located in a home 
38.19 	where the license holder resides.

38.20 	Sec. 2. Minnesota Statutes 2020, section 245F.04, subdivision 2, is amended to read:
38.21 		Subd. 2.Contents of application. Prior to the issuance of a license, an applicant must 
38.22 	submit, on forms provided by the commissioner, documentation demonstrating the following:
38.23 	(1) compliance with this section;
38.24 	(2) compliance with applicable building, fire, and safety codes; health rules; zoning 
38.25 	ordinances; and other applicable rules and regulations or documentation that a waiver has 
38.26 	been granted. The granting of a waiver does not constitute modification of any requirement 
38.27 	of this section; and
38.28 	(3) completion of an assessment of need for a new or expanded program as required by 
38.29 	Minnesota Rules, part 9530.6800; and
38.30 	(4) (3) insurance coverage, including bonding, sufficient to cover all patient funds, 
38.31 	property, and interests.

39.1 	Sec. 3. Minnesota Statutes 2020, section 245G.03, subdivision 2, is amended to read:
39.2 		Subd. 2.Application. (a) Before the commissioner issues a license, an applicant must 
39.3 	submit, on forms provided by the commissioner, any documents the commissioner requires.
39.4 	(b) The applicant must submit documentation that the applicant has notified the county 
39.5 	as required under section 254B.03, subdivision 2.

39.6 	Sec. 4. Minnesota Statutes 2020, section 254B.03, subdivision 2, is amended to read:
39.7 		Subd. 2.Chemical dependency fund payment. (a) Payment from the chemical 
39.8 	dependency fund is limited to payments for services other than detoxification licensed under 
39.9 	Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally 
39.10 	recognized tribal lands, would be required to be licensed by the commissioner as a chemical 
39.11 	dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and 
39.12 	services other than detoxification provided in another state that would be required to be 
39.13 	licensed as a chemical dependency program if the program were in the state. Out of state 
39.14 	vendors must also provide the commissioner with assurances that the program complies 
39.15 	substantially with state licensing requirements and possesses all licenses and certifications 
39.16 	required by the host state to provide chemical dependency treatment. Vendors receiving 
39.17 	payments from the chemical dependency fund must not require co-payment from a recipient 
39.18 	of benefits for services provided under this subdivision. The vendor is prohibited from using 
39.19 	the client's public benefits to offset the cost of services paid under this section. The vendor 
39.20 	shall not require the client to use public benefits for room or board costs. This includes but 
39.21 	is not limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP 
39.22 	benefits. Retention of SNAP benefits is a right of a client receiving services through the 
39.23 	consolidated chemical dependency treatment fund or through state contracted managed care 
39.24 	entities. Payment from the chemical dependency fund shall be made for necessary room 
39.25 	and board costs provided by vendors meeting the criteria under section 254B.05, subdivision 
39.26 	1a, or in a community hospital licensed by the commissioner of health according to sections 
39.27 	144.50 to 144.56 to a client who is:
39.28 	(1) determined to meet the criteria for placement in a residential chemical dependency 
39.29 	treatment program according to rules adopted under section 254A.03, subdivision 3; and
39.30 	(2) concurrently receiving a chemical dependency treatment service in a program licensed 
39.31 	by the commissioner and reimbursed by the chemical dependency fund.
39.32 	(b) A county may, from its own resources, provide chemical dependency services for 
39.33 	which state payments are not made. A county may elect to use the same invoice procedures 
40.1 	and obtain the same state payment services as are used for chemical dependency services 
40.2 	for which state payments are made under this section if county payments are made to the 
40.3 	state in advance of state payments to vendors. When a county uses the state system for 
40.4 	payment, the commissioner shall make monthly billings to the county using the most recent 
40.5 	available information to determine the anticipated services for which payments will be made 
40.6 	in the coming month. Adjustment of any overestimate or underestimate based on actual 
40.7 	expenditures shall be made by the state agency by adjusting the estimate for any succeeding 
40.8 	month.
40.9 	(c) The commissioner shall coordinate chemical dependency services and determine 
40.10 	whether there is a need for any proposed expansion of chemical dependency treatment 
40.11 	services. The commissioner shall deny vendor certification to any provider that has not 
40.12 	received prior approval from the commissioner for the creation of new programs or the 
40.13 	expansion of existing program capacity. The commissioner shall consider the provider's 
40.14 	capacity to obtain clients from outside the state based on plans, agreements, and previous 
40.15 	utilization history, when determining the need for new treatment services.
40.16 	(d) At least 60 days prior to submitting an application for new licensure under chapter 
40.17 	245G, the applicant must notify the county human services director in writing of the 
40.18 	applicant's intent to open a new treatment program. The written notification must include, 
40.19 	at a minimum:
40.20 	(1) a description of the proposed treatment program; and
40.21 	(2) a description of the target population to be served by the treatment program.
40.22 	(e) The county human services director may submit a written statement to the 
40.23 	commissioner, within 60 days of receiving notice from the applicant, regarding the county's 
40.24 	support of or opposition to the opening of the new treatment program. The written statement 
40.25 	must include documentation of the rationale for the county's determination. The commissioner 
40.26 	shall consider the county's written statement when determining whether there is a need for 
40.27 	the treatment program as required by paragraph (c).

40.28 	Sec. 5. REPEALER.
 40.29 	Minnesota Rules, parts 9530.6800; and 9530.6810, are repealed.

41.1 	ARTICLE 3
41.2 	HEALTH DEPARTMENT

41.3 	Section 1. Minnesota Statutes 2020, section 62J.495, subdivision 3, is amended to read:
41.4 		Subd. 3.Interoperable electronic health record requirements.  (a) Hospitals and health 
41.5 	care providers must meet the following criteria when implementing an interoperable 
41.6 	electronic health records system within their hospital system or clinical practice setting.
41.7 	(b) The electronic health record must be a qualified electronic health record.
41.8 	(c) The electronic health record must be certified by the Office of the National 
41.9 	Coordinator pursuant to the HITECH Act. This criterion only applies to hospitals and health 
41.10 	care providers if a certified electronic health record product for the provider's particular 
41.11 	practice setting is available. This criterion shall be considered met if a hospital or health 
41.12 	care provider is using an electronic health records system that has been certified within the 
41.13 	last three years, even if a more current version of the system has been certified within the 
41.14 	three-year period.
41.15 	(d) The electronic health record must meet the standards established according to section 
41.16 	3004 of the HITECH Act as applicable.
41.17 	(e) The electronic health record must have the ability to generate information on clinical 
41.18 	quality measures and other measures reported under sections 4101, 4102, and 4201 of the 
41.19 	HITECH Act.
41.20 	(f) The electronic health record system must be connected to a state-certified health 
41.21 	information organization either directly or through a connection facilitated by a state-certified
41.22 	health data intermediary as defined in section 62J.498.
41.23 	(g) A health care provider who is a prescriber or dispenser of legend drugs must have 
41.24 	an electronic health record system that meets the requirements of section 62J.497.

41.25 	Sec. 2. Minnesota Statutes 2020, section 62J.498, is amended to read:
41.26 	62J.498 HEALTH INFORMATION EXCHANGE.
41.27 		Subdivision 1.Definitions. (a) The following definitions apply to sections 62J.498 to 
41.28 	62J.4982:
41.29 	(b) "Clinical data repository" means a real time database that consolidates data from a 
41.30 	variety of clinical sources to present a unified view of a single patient and is used by a 
41.31 	state-certified health information exchange service provider to enable health information 
41.32 	exchange among health care providers that are not related health care entities as defined in 
42.1 	section 144.291, subdivision 2, paragraph (k). This does not include clinical data that are 
42.2 	submitted to the commissioner for public health purposes required or permitted by law, 
42.3 	including any rules adopted by the commissioner.
42.4 	(c) "Clinical transaction" means any meaningful use transaction or other health 
42.5 	information exchange transaction that is not covered by section 62J.536.
42.6 	(d) "Commissioner" means the commissioner of health.
42.7 	(e) "Health care provider" or "provider" means a health care provider or provider as 
42.8 	defined in section 62J.03, subdivision 8.
42.9 	(f) "Health data intermediary" means an entity that provides the technical capabilities 
42.10 	or related products and services to enable health information exchange among health care 
42.11 	providers that are not related health care entities as defined in section 144.291, subdivision 
42.12 	2, paragraph (k). This includes but is not limited to health information service providers 
42.13 	(HISP), electronic health record vendors, and pharmaceutical electronic data intermediaries 
42.14 	as defined in section 62J.495.
42.15 	(g) "Health information exchange" means the electronic transmission of health-related 
42.16 	information between organizations according to nationally recognized standards.
42.17 	(h) "Health information exchange service provider" means a health data intermediary 
42.18 	or health information organization.
42.19 	(i) "Health information organization" means an organization that oversees, governs, and 
42.20 	facilitates health information exchange among health care providers that are not related 
42.21 	health care entities as defined in section 144.291, subdivision 2, paragraph (k), to improve 
42.22 	coordination of patient care and the efficiency of health care delivery.
42.23 	(j) "HITECH Act" means the Health Information Technology for Economic and Clinical 
42.24 	Health Act as defined in section 62J.495.
42.25 	(k) (j) "Major participating entity" means:
42.26 	(1) a participating entity that receives compensation for services that is greater than 30 
42.27 	percent of the health information organization's gross annual revenues from the health 
42.28 	information exchange service provider;
42.29 	(2) a participating entity providing administrative, financial, or management services to 
42.30 	the health information organization, if the total payment for all services provided by the 
42.31 	participating entity exceeds three percent of the gross revenue of the health information 
42.32 	organization; and
43.1 	(3) a participating entity that nominates or appoints 30 percent or more of the board of 
43.2 	directors or equivalent governing body of the health information organization.
43.3 	(l) (k) "Master patient index" means an electronic database that holds unique identifiers 
43.4 	of patients registered at a care facility and is used by a state-certified health information 
43.5 	exchange service provider to enable health information exchange among health care providers 
43.6 	that are not related health care entities as defined in section 144.291, subdivision 2, paragraph 
43.7 	(k). This does not include data that are submitted to the commissioner for public health 
43.8 	purposes required or permitted by law, including any rules adopted by the commissioner.
43.9 	(m) "Meaningful use" means use of certified electronic health record technology to 
43.10 	improve quality, safety, and efficiency and reduce health disparities; engage patients and 
43.11 	families; improve care coordination and population and public health; and maintain privacy 
43.12 	and security of patient health information as established by the Centers for Medicare and 
43.13 	Medicaid Services and the Minnesota Department of Human Services pursuant to sections 
43.14 	4101, 4102, and 4201 of the HITECH Act.
43.15 	(n) "Meaningful use transaction" means an electronic transaction that a health care 
43.16 	provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare 
43.17 	penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.
43.18 	(o) (l) "Participating entity" means any of the following persons, health care providers, 
43.19 	companies, or other organizations with which a health information organization or health 
43.20 	data intermediary has contracts or other agreements for the provision of health information 
43.21 	exchange services:
43.22 	(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home 
43.23 	licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise 
43.24 	licensed under the laws of this state or registered with the commissioner;
43.25 	(2) a health care provider, and any other health care professional otherwise licensed 
43.26 	under the laws of this state or registered with the commissioner;
43.27 	(3) a group, professional corporation, or other organization that provides the services of 
43.28 	individuals or entities identified in clause (2), including but not limited to a medical clinic, 
43.29 	a medical group, a home health care agency, an urgent care center, and an emergent care 
43.30 	center;
43.31 	(4) a health plan as defined in section 62A.011, subdivision 3; and
43.32 	(5) a state agency as defined in section 13.02, subdivision 17.
44.1 	(p) (m) "Reciprocal agreement" means an arrangement in which two or more health 
44.2 	information exchange service providers agree to share in-kind services and resources to 
44.3 	allow for the pass-through of clinical transactions.
44.4 	(q) "State-certified health data intermediary" means a health data intermediary that has 
44.5 	been issued a certificate of authority to operate in Minnesota.
44.6 	(r) (n) "State-certified health information organization" means a health information 
44.7 	organization that has been issued a certificate of authority to operate in Minnesota.
44.8 		Subd. 2.Health information exchange oversight. (a) The commissioner shall protect 
44.9 	the public interest on matters pertaining to health information exchange. The commissioner 
44.10 	shall:
44.11 	(1) review and act on applications from health data intermediaries and health information 
44.12 	organizations for certificates of authority to operate in Minnesota;
44.13 	(2) require information to be provided as needed from health information exchange 
44.14 	service providers in order to meet requirements established under sections 62J.498 to 
44.15 	62J.4982;
44.16 	(2) (3) provide ongoing monitoring to ensure compliance with criteria established under 
44.17 	sections 62J.498 to 62J.4982;
44.18 	(3) (4) respond to public complaints related to health information exchange services;
44.19 	(4) (5) take enforcement actions as necessary, including the imposition of fines, 
44.20 	suspension, or revocation of certificates of authority as outlined in section 62J.4982;
44.21 	(5) (6) provide a biennial report on the status of health information exchange services 
44.22 	that includes but is not limited to:
44.23 	(i) recommendations on actions necessary to ensure that health information exchange 
44.24 	services are adequate to meet the needs of Minnesota citizens and providers statewide;
44.25 	(ii) recommendations on enforcement actions to ensure that health information exchange 
44.26 	service providers act in the public interest without causing disruption in health information 
44.27 	exchange services;
44.28 	(iii) recommendations on updates to criteria for obtaining certificates of authority under 
44.29 	this section; and
44.30 	(iv) recommendations on standard operating procedures for health information exchange, 
44.31 	including but not limited to the management of consumer preferences; and
45.1 	(6) (7) other duties necessary to protect the public interest.
45.2 	(b) As part of the application review process for certification under paragraph (a), prior 
45.3 	to issuing a certificate of authority, the commissioner shall:
45.4 	(1) make all portions of the application classified as public data available to the public 
45.5 	for at least ten days while an application is under consideration. At the request of the 
45.6 	commissioner, the applicant shall participate in a public hearing by presenting an overview 
45.7 	of their application and responding to questions from interested parties; and
45.8 	(2) consult with hospitals, physicians, and other providers prior to issuing a certificate 
45.9 	of authority.
45.10 	(c) When the commissioner is actively considering a suspension or revocation of a 
45.11 	certificate of authority as described in section 62J.4982, subdivision 3, all investigatory data 
45.12 	that are collected, created, or maintained related to the suspension or revocation are classified 
45.13 	as confidential data on individuals and as protected nonpublic data in the case of data not 
45.14 	on individuals.
45.15 	(d) The commissioner may disclose data classified as protected nonpublic or confidential 
45.16 	under paragraph (c) if disclosing the data will protect the health or safety of patients.
45.17 	(e) After the commissioner makes a final determination regarding a suspension or 
45.18 	revocation of a certificate of authority, all minutes, orders for hearing, findings of fact, 
45.19 	conclusions of law, and the specification of the final disciplinary action, are classified as 
45.20 	public data.

45.21 	Sec. 3. Minnesota Statutes 2020, section 62J.4981, is amended to read:
45.22 	62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH 
45.23 	INFORMATION EXCHANGE SERVICES.
45.24 		Subdivision 1.Authority to require organizations to apply. The commissioner shall 
45.25 	require a health data intermediary or a health information organization to apply for a 
45.26 	certificate of authority under this section. An applicant may continue to operate until the 
45.27 	commissioner acts on the application. If the application is denied, the applicant is considered 
45.28 	a health information exchange service provider whose certificate of authority has been 
45.29 	revoked under section 62J.4982, subdivision 2, paragraph (d).
45.30 		Subd. 2.Certificate of authority for health data intermediaries. (a) A health data 
45.31 	intermediary must be certified by the state and comply with requirements established in this 
45.32 	section.
46.1 	(b) Notwithstanding any law to the contrary, any corporation organized to do so may 
46.2 	apply to the commissioner for a certificate of authority to establish and operate as a health 
46.3 	data intermediary in compliance with this section. No person shall establish or operate a 
46.4 	health data intermediary in this state, nor sell or offer to sell, or solicit offers to purchase 
46.5 	or receive advance or periodic consideration in conjunction with a health data intermediary 
46.6 	contract unless the organization has a certificate of authority or has an application under 
46.7 	active consideration under this section.
46.8 	(c) In issuing the certificate of authority, the commissioner shall determine whether the 
46.9 	applicant for the certificate of authority has demonstrated that the applicant meets the 
46.10 	following minimum criteria:
46.11 	(1) hold reciprocal agreements with at least one state-certified health information 
46.12 	organization to access patient data, and for the transmission and receipt of clinical 
46.13 	transactions. Reciprocal agreements must meet the requirements established in subdivision 
46.14 	5; and
46.15 	(2) participate in statewide shared health information exchange services as defined by 
46.16 	the commissioner to support interoperability between state-certified health information 
46.17 	organizations and state-certified health data intermediaries.
46.18 		Subd. 3.Certificate of authority for health information organizations. (a) A health 
46.19 	information organization must obtain a certificate of authority from the commissioner and 
46.20 	demonstrate compliance with the criteria in paragraph (c).
46.21 	(b) Notwithstanding any law to the contrary, an organization may apply for a certificate 
46.22 	of authority to establish and operate a health information organization under this section. 
46.23 	No person shall establish or operate a health information organization in this state, nor sell 
46.24 	or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in 
46.25 	conjunction with a health information organization or health information contract unless 
46.26 	the organization has a certificate of authority under this section.
46.27 	(c) In issuing the certificate of authority, the commissioner shall determine whether the 
46.28 	applicant for the certificate of authority has demonstrated that the applicant meets the 
46.29 	following minimum criteria:
46.30 	(1) the entity is a legally established organization;
46.31 	(2) appropriate insurance, including liability insurance, for the operation of the health 
46.32 	information organization is in place and sufficient to protect the interest of the public and 
46.33 	participating entities;
47.1 	(3) strategic and operational plans address governance, technical infrastructure, legal 
47.2 	and policy issues, finance, and business operations in regard to how the organization will 
47.3 	expand to support providers in achieving health information exchange goals over time;
47.4 	(4) the entity addresses the parameters to be used with participating entities and other 
47.5 	health information exchange service providers for clinical transactions, compliance with 
47.6 	Minnesota law, and interstate health information exchange trust agreements;
47.7 	(5) the entity's board of directors or equivalent governing body is composed of members 
47.8 	that broadly represent the health information organization's participating entities and 
47.9 	consumers;
47.10 	(6) the entity maintains a professional staff responsible to the board of directors or 
47.11 	equivalent governing body with the capacity to ensure accountability to the organization's 
47.12 	mission;
47.13 	(7) the organization is compliant with national certification and accreditation programs 
47.14 	designated by the commissioner;
47.15 	(8) the entity maintains the capability to query for patient information based on national 
47.16 	standards. The query capability may utilize a master patient index, clinical data repository, 
47.17 	or record locator service as defined in section 144.291, subdivision 2, paragraph (j). The 
47.18 	entity must be compliant with the requirements of section 144.293, subdivision 8, when 
47.19 	conducting clinical transactions;
47.20 	(9) the organization demonstrates interoperability with all other state-certified health 
47.21 	information organizations using nationally recognized standards;
47.22 	(10) the organization demonstrates compliance with all privacy and security requirements 
47.23 	required by state and federal law; and
47.24 	(11) the organization uses financial policies and procedures consistent with generally 
47.25 	accepted accounting principles and has an independent audit of the organization's financials 
47.26 	on an annual basis.
47.27 	(d) Health information organizations that have obtained a certificate of authority must:
47.28 	(1) meet the requirements established for connecting to the National eHealth Exchange;
47.29 	(2) annually submit strategic and operational plans for review by the commissioner that 
47.30 	address:
48.1 	(i) progress in achieving objectives included in previously submitted strategic and 
48.2 	operational plans across the following domains: business and technical operations, technical 
48.3 	infrastructure, legal and policy issues, finance, and organizational governance;
48.4 	(ii) plans for ensuring the necessary capacity to support clinical transactions;
48.5 	(iii) approach for attaining financial sustainability, including public and private financing 
48.6 	strategies, and rate structures;
48.7 	(iv) rates of adoption, utilization, and transaction volume, and mechanisms to support 
48.8 	health information exchange; and
48.9 	(v) an explanation of methods employed to address the needs of community clinics, 
48.10 	critical access hospitals, and free clinics in accessing health information exchange services;
48.11 	(3) enter into reciprocal agreements with all other state-certified health information 
48.12 	organizations and state-certified health data intermediaries to enable access to patient data, 
48.13 	and for the transmission and receipt of clinical transactions. Reciprocal agreements must 
48.14 	meet the requirements in subdivision 5;
48.15 	(4) participate in statewide shared health information exchange services as defined by 
48.16 	the commissioner to support interoperability between state-certified health information 
48.17 	organizations and state-certified health data intermediaries; and
48.18 	(5) comply with additional requirements for the certification or recertification of health 
48.19 	information organizations that may be established by the commissioner.
48.20 		Subd. 4.Application for certificate of authority for health information exchange 
48.21 	service providers organizations. (a) Each application for a certificate of authority shall 
48.22 	be in a form prescribed by the commissioner and verified by an officer or authorized 
48.23 	representative of the applicant. Each application shall include the following in addition to 
48.24 	information described in the criteria in subdivisions 2 and subdivision 3:
48.25 	(1) for health information organizations only, a copy of the basic organizational document, 
48.26 	if any, of the applicant and of each major participating entity, such as the articles of 
48.27 	incorporation, or other applicable documents, and all amendments to it;
48.28 	(2) for health information organizations only, a list of the names, addresses, and official 
48.29 	positions of the following:
48.30 	(i) all members of the board of directors or equivalent governing body, and the principal 
48.31 	officers and, if applicable, shareholders of the applicant organization; and
49.1 	(ii) all members of the board of directors or equivalent governing body, and the principal 
49.2 	officers of each major participating entity and, if applicable, each shareholder beneficially 
49.3 	owning more than ten percent of any voting stock of the major participating entity;
49.4 	(3) for health information organizations only, the name and address of each participating 
49.5 	entity and the agreed-upon duration of each contract or agreement if applicable;
49.6 	(4) a copy of each standard agreement or contract intended to bind the participating 
49.7 	entities and the health information exchange service provider organization. Contractual 
49.8 	provisions shall be consistent with the purposes of this section, in regard to the services to 
49.9 	be performed under the standard agreement or contract, the manner in which payment for 
49.10 	services is determined, the nature and extent of responsibilities to be retained by the health 
49.11 	information organization, and contractual termination provisions;
49.12 	(5) a statement generally describing the health information exchange service provider
49.13 	organization, its health information exchange contracts, facilities, and personnel, including 
49.14 	a statement describing the manner in which the applicant proposes to provide participants 
49.15 	with comprehensive health information exchange services;
49.16 	(6) a statement reasonably describing the geographic area or areas to be served and the 
49.17 	type or types of participants to be served;
49.18 	(7) a description of the complaint procedures to be used as required under this section;
49.19 	(8) a description of the mechanism by which participating entities will have an opportunity 
49.20 	to participate in matters of policy and operation;
49.21 	(9) a copy of any pertinent agreements between the health information organization and 
49.22 	insurers, including liability insurers, demonstrating coverage is in place;
49.23 	(10) a copy of the conflict of interest policy that applies to all members of the board of 
49.24 	directors or equivalent governing body and the principal officers of the health information 
49.25 	organization; and
49.26 	(11) other information as the commissioner may reasonably require to be provided.
49.27 	(b) Within 45 days after the receipt of the application for a certificate of authority, the 
49.28 	commissioner shall determine whether or not the application submitted meets the 
49.29 	requirements for completion in paragraph (a), and notify the applicant of any further 
49.30 	information required for the application to be processed.
49.31 	(c) Within 90 days after the receipt of a complete application for a certificate of authority, 
49.32 	the commissioner shall issue a certificate of authority to the applicant if the commissioner 
50.1 	determines that the applicant meets the minimum criteria requirements of subdivision 2 for 
50.2 	health data intermediaries or subdivision 3 for health information organizations. If the 
50.3 	commissioner determines that the applicant is not qualified, the commissioner shall notify 
50.4 	the applicant and specify the reasons for disqualification.
50.5 	(d) Upon being granted a certificate of authority to operate as a state-certified health 
50.6 	information organization or state-certified health data intermediary, the organization must 
50.7 	operate in compliance with the provisions of this section. Noncompliance may result in the 
50.8 	imposition of a fine or the suspension or revocation of the certificate of authority according 
50.9 	to section 62J.4982.
50.10 		Subd. 5.Reciprocal agreements between health information exchange entities
50.11 	organizations. (a) Reciprocal agreements between two health information organizations 
50.12 	or between a health information organization and a health data intermediary must include 
50.13 	a fair and equitable model for charges between the entities that:
50.14 	(1) does not impede the secure transmission of clinical transactions;
50.15 	(2) does not charge a fee for the exchange of meaningful use transactions transmitted 
50.16 	according to nationally recognized standards where no additional value-added service is 
50.17 	rendered to the sending or receiving health information organization or health data 
50.18 	intermediary either directly or on behalf of the client;
50.19 	(3) is consistent with fair market value and proportionately reflects the value-added 
50.20 	services accessed as a result of the agreement; and
50.21 	(4) prevents health care stakeholders from being charged multiple times for the same 
50.22 	service.
50.23 	(b) Reciprocal agreements must include comparable quality of service standards that 
50.24 	ensure equitable levels of services.
50.25 	(c) Reciprocal agreements are subject to review and approval by the commissioner.
50.26 	(d) Nothing in this section precludes a state-certified health information organization or 
50.27 	state-certified health data intermediary from entering into contractual agreements for the 
50.28 	provision of value-added services beyond meaningful use transactions.

50.29 	Sec. 4. Minnesota Statutes 2020, section 62J.4982, is amended to read:
50.30 	62J.4982 ENFORCEMENT AUTHORITY; COMPLIANCE.
50.31 		Subdivision 1.Penalties and enforcement. (a) The commissioner may, for any violation 
50.32 	of statute or rule applicable to a health information exchange service provider organization, 
51.1 	levy an administrative penalty in an amount up to $25,000 for each violation. In determining 
51.2 	the level of an administrative penalty, the commissioner shall consider the following factors:
51.3 	(1) the number of participating entities affected by the violation;
51.4 	(2) the effect of the violation on participating entities' access to health information 
51.5 	exchange services;
51.6 	(3) if only one participating entity is affected, the effect of the violation on the patients 
51.7 	of that entity;
51.8 	(4) whether the violation is an isolated incident or part of a pattern of violations;
51.9 	(5) the economic benefits derived by the health information organization or a health data 
51.10 	intermediary by virtue of the violation;
51.11 	(6) whether the violation hindered or facilitated an individual's ability to obtain health 
51.12 	care;
51.13 	(7) whether the violation was intentional;
51.14 	(8) whether the violation was beyond the direct control of the health information exchange 
51.15 	service provider organization;
51.16 	(9) any history of prior compliance with the provisions of this section, including 
51.17 	violations;
51.18 	(10) whether and to what extent the health information exchange service provider
51.19 	organization attempted to correct previous violations;
51.20 	(11) how the health information exchange service provider organization responded to 
51.21 	technical assistance from the commissioner provided in the context of a compliance effort; 
51.22 	and
51.23 	(12) the financial condition of the health information exchange service provider
51.24 	organization including, but not limited to, whether the health information exchange service 
51.25 	provider organization had financial difficulties that affected its ability to comply or whether 
51.26 	the imposition of an administrative monetary penalty would jeopardize the ability of the 
51.27 	health information exchange service provider organization to continue to deliver health 
51.28 	information exchange services.
51.29 	The commissioner shall give reasonable notice in writing to the health information 
51.30 	exchange service provider organization of the intent to levy the penalty and the reasons for 
51.31 	it. A health information exchange service provider organization may have 15 days within 
51.32 	which to contest whether the facts found constitute a violation of sections 62J.4981 and 
52.1 	62J.4982, according to the contested case and judicial review provisions of sections 14.57
52.2 	to 14.69.
52.3 	(b) If the commissioner has reason to believe that a violation of section 62J.4981 or 
52.4 	62J.4982 has occurred or is likely, the commissioner may confer with the persons involved 
52.5 	before commencing action under subdivision 2. The commissioner may notify the health 
52.6 	information exchange service provider organization and the representatives, or other persons 
52.7 	who appear to be involved in the suspected violation, to arrange a voluntary conference 
52.8 	with the alleged violators or their authorized representatives. The purpose of the conference 
52.9 	is to attempt to learn the facts about the suspected violation and, if it appears that a violation 
52.10 	has occurred or is threatened, to find a way to correct or prevent it. The conference is not 
52.11 	governed by any formal procedural requirements, and may be conducted as the commissioner 
52.12 	considers appropriate.
52.13 	(c) The commissioner may issue an order directing a health information exchange service 
52.14 	provider organization or a representative of a health information exchange service provider
52.15 	organization to cease and desist from engaging in any act or practice in violation of sections 
52.16 	62J.4981 and 62J.4982.
52.17 	(d) Within 20 days after service of the order to cease and desist, a health information 
52.18 	exchange service provider organization may contest whether the facts found constitute a 
52.19 	violation of sections 62J.4981 and 62J.4982 according to the contested case and judicial 
52.20 	review provisions of sections 14.57 to 14.69.
52.21 	(e) In the event of noncompliance with a cease and desist order issued under this 
52.22 	subdivision, the commissioner may institute a proceeding to obtain injunctive relief or other 
52.23 	appropriate relief in Ramsey County District Court.
52.24 		Subd. 2.Suspension or revocation of certificates of authority. (a) The commissioner 
52.25 	may suspend or revoke a certificate of authority issued to a health data intermediary or
52.26 	health information organization under section 62J.4981 if the commissioner finds that:
52.27 	(1) the health information exchange service provider organization is operating 
52.28 	significantly in contravention of its basic organizational document, or in a manner contrary 
52.29 	to that described in and reasonably inferred from any other information submitted under 
52.30 	section 62J.4981, unless amendments to the submissions have been filed with and approved 
52.31 	by the commissioner;
52.32 	(2) the health information exchange service provider organization is unable to fulfill its 
52.33 	obligations to furnish comprehensive health information exchange services as required 
52.34 	under its health information exchange contract;
53.1 	(3) the health information exchange service provider organization is no longer financially 
53.2 	solvent or may not reasonably be expected to meet its obligations to participating entities;
53.3 	(4) the health information exchange service provider organization has failed to implement 
53.4 	the complaint system in a manner designed to reasonably resolve valid complaints;
53.5 	(5) the health information exchange service provider organization, or any person acting 
53.6 	with its sanction, has advertised or merchandised its services in an untrue, misleading, 
53.7 	deceptive, or unfair manner;
53.8 	(6) the continued operation of the health information exchange service provider
53.9 	organization would be hazardous to its participating entities or the patients served by the 
53.10 	participating entities; or
53.11 	(7) the health information exchange service provider organization has otherwise failed 
53.12 	to substantially comply with section 62J.4981 or with any other statute or administrative 
53.13 	rule applicable to health information exchange service providers, or has submitted false 
53.14 	information in any report required under sections 62J.498 to 62J.4982.
53.15 	(b) A certificate of authority shall be suspended or revoked only after meeting the 
53.16 	requirements of subdivision 3.
53.17 	(c) If the certificate of authority of a health information exchange service provider
53.18 	organization is suspended, the health information exchange service provider organization
53.19 	shall not, during the period of suspension, enroll any additional participating entities, and 
53.20 	shall not engage in any advertising or solicitation.
53.21 	(d) If the certificate of authority of a health information exchange service provider
53.22 	organization is revoked, the organization shall proceed, immediately following the effective 
53.23 	date of the order of revocation, to wind up its affairs, and shall conduct no further business 
53.24 	except as necessary to the orderly conclusion of the affairs of the organization. The 
53.25 	organization shall engage in no further advertising or solicitation. The commissioner may, 
53.26 	by written order, permit further operation of the organization as the commissioner finds to 
53.27 	be in the best interest of participating entities, to the end that participating entities will be 
53.28 	given the greatest practical opportunity to access continuing health information exchange 
53.29 	services.
53.30 		Subd. 3.Denial, suspension, and revocation; administrative procedures. (a) When 
53.31 	the commissioner has cause to believe that grounds for the denial, suspension, or revocation 
53.32 	of a certificate of authority exist, the commissioner shall notify the health information 
54.1 	exchange service provider organization in writing stating the grounds for denial, suspension, 
54.2 	or revocation and setting a time within 20 days for a hearing on the matter.
54.3 	(b) After a hearing before the commissioner at which the health information exchange 
54.4 	service provider organization may respond to the grounds for denial, suspension, or 
54.5 	revocation, or upon the failure of the health information exchange service provider
54.6 	organization to appear at the hearing, the commissioner shall take action as deemed necessary 
54.7 	and shall issue written findings and mail them to the health information exchange service 
54.8 	provider organization.
54.9 	(c) If suspension, revocation, or administrative penalty is proposed according to this 
54.10 	section, the commissioner must deliver, or send by certified mail with return receipt 
54.11 	requested, to the health information exchange service provider organization written notice 
54.12 	of the commissioner's intent to impose a penalty. This notice of proposed determination 
54.13 	must include:
54.14 	(1) a reference to the statutory basis for the penalty;
54.15 	(2) a description of the findings of fact regarding the violations with respect to which 
54.16 	the penalty is proposed;
54.17 	(3) the nature and amount of the proposed penalty;
54.18 	(4) any circumstances described in subdivision 1, paragraph (a), that were considered 
54.19 	in determining the amount of the proposed penalty;
54.20 	(5) instructions for responding to the notice, including a statement of the health 
54.21 	information exchange service provider's organization's right to a contested case proceeding 
54.22 	and a statement that failure to request a contested case proceeding within 30 calendar days 
54.23 	permits the imposition of the proposed penalty; and
54.24 	(6) the address to which the contested case proceeding request must be sent.
54.25 		Subd. 4.Coordination.  The commissioner shall, to the extent possible, seek the advice 
54.26 	of the Minnesota e-Health Advisory Committee, in the review and update of criteria for the 
54.27 	certification and recertification of health information exchange service providers
54.28 	organizations when implementing sections 62J.498 to 62J.4982.
54.29 		Subd. 5.Fees and monetary penalties. (a) The commissioner shall assess fees on every 
54.30 	health information exchange service provider organization subject to sections 62J.4981 and 
54.31 	62J.4982 as follows:
55.1 	(1) filing an application for certificate of authority to operate as a health information 
55.2 	organization, $7,000; and
55.3 	(2) filing an application for certificate of authority to operate as a health data intermediary, 
55.4 	$7,000;
55.5 	(3) annual health information organization certificate fee, $7,000; and.
55.6 	(4) annual health data intermediary certificate fee, $7,000.
55.7 	(b) Fees collected under this section shall be deposited in the state treasury and credited 
55.8 	to the state government special revenue fund.
55.9 	(c) Administrative monetary penalties imposed under this subdivision shall be credited 
55.10 	to an account in the special revenue fund and are appropriated to the commissioner for the 
55.11 	purposes of sections 62J.498 to 62J.4982.

55.12 	Sec. 5. Minnesota Statutes 2020, section 62J.84, subdivision 3, is amended to read:
55.13 		Subd. 3.Prescription drug price increases reporting. (a) Beginning October 1, 2021
55.14 	January 1, 2022, a drug manufacturer must submit to the commissioner the information 
55.15 	described in paragraph (b) for each prescription drug for which the price was $100 or greater 
55.16 	for a 30-day supply or for a course of treatment lasting less than 30 days and:
55.17 	(1) for brand name drugs where there is an increase of ten percent or greater in the price 
55.18 	over the previous 12-month period or an increase of 16 percent or greater in the price over 
55.19 	the previous 24-month period; and
55.20 	(2) for generic drugs where there is an increase of 50 percent or greater in the price over 
55.21 	the previous 12-month period.
55.22 	(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to 
55.23 	the commissioner no later than 60 days after the price increase goes into effect, in the form 
55.24 	and manner prescribed by the commissioner, the following information, if applicable:
55.25 	(1) the name and price of the drug and the net increase, expressed as a percentage;
55.26 	(2) the factors that contributed to the price increase;
55.27 	(3) the name of any generic version of the prescription drug available on the market;
55.28 	(4) the introductory price of the prescription drug when it was approved for marketing 
55.29 	by the Food and Drug Administration and the net yearly increase, by calendar year, in the 
55.30 	price of the prescription drug during the previous five years;
56.1 	(5) the direct costs incurred by the manufacturer that are associated with the prescription 
56.2 	drug, listed separately:
56.3 	(i) to manufacture the prescription drug;
56.4 	(ii) to market the prescription drug, including advertising costs; and
56.5 	(iii) to distribute the prescription drug;
56.6 	(6) the total sales revenue for the prescription drug during the previous 12-month period;
56.7 	(7) the manufacturer's net profit attributable to the prescription drug during the previous 
56.8 	12-month period;
56.9 	(8) the total amount of financial assistance the manufacturer has provided through patient 
56.10 	prescription assistance programs, if applicable;
56.11 	(9) any agreement between a manufacturer and another entity contingent upon any delay 
56.12 	in offering to market a generic version of the prescription drug;
56.13 	(10) the patent expiration date of the prescription drug if it is under patent;
56.14 	(11) the name and location of the company that manufactured the drug; and
56.15 	(12) if a brand name prescription drug, the ten highest prices paid for the prescription 
56.16 	drug during the previous calendar year in any country other than the United States.
56.17 	(c) The manufacturer may submit any documentation necessary to support the information 
56.18 	reported under this subdivision.

56.19 	Sec. 6. Minnesota Statutes 2020, section 62J.84, subdivision 4, is amended to read:
56.20 		Subd. 4.New prescription drug price reporting. (a) Beginning October 1, 2021 January 
56.21 	1, 2022, no later than 60 days after a manufacturer introduces a new prescription drug for 
56.22 	sale in the United States that is a new brand name drug with a price that is greater than the 
56.23 	tier threshold established by the Centers for Medicare and Medicaid Services for specialty 
56.24 	drugs in the Medicare Part D program for a 30-day supply or a new generic or biosimilar 
56.25 	drug with a price that is greater than the tier threshold established by the Centers for Medicare 
56.26 	and Medicaid Services for specialty drugs in the Medicare Part D program for a 30-day 
56.27 	supply and is not at least 15 percent lower than the referenced brand name drug when the 
56.28 	generic or biosimilar drug is launched, the manufacturer must submit to the commissioner, 
56.29 	in the form and manner prescribed by the commissioner, the following information, if 
56.30 	applicable:
56.31 	(1) the price of the prescription drug;
57.1 	(2) whether the Food and Drug Administration granted the new prescription drug a 
57.2 	breakthrough therapy designation or a priority review;
57.3 	(3) the direct costs incurred by the manufacturer that are associated with the prescription 
57.4 	drug, listed separately:
57.5 	(i) to manufacture the prescription drug;
57.6 	(ii) to market the prescription drug, including advertising costs; and
57.7 	(iii) to distribute the prescription drug; and
57.8 	(4) the patent expiration date of the drug if it is under patent.
57.9 	(b) The manufacturer may submit documentation necessary to support the information 
57.10 	reported under this subdivision.

57.11 	Sec. 7. Minnesota Statutes 2020, section 62J.84, subdivision 5, is amended to read:
57.12 		Subd. 5.Newly acquired prescription drug price reporting. (a) Beginning October 
57.13 	1, 2021 January 1, 2022, the acquiring drug manufacturer must submit to the commissioner 
57.14 	the information described in paragraph (b) for each newly acquired prescription drug for 
57.15 	which the price was $100 or greater for a 30-day supply or for a course of treatment lasting 
57.16 	less than 30 days and:
57.17 	(1) for a newly acquired brand name drug where there is an increase of ten percent or 
57.18 	greater in the price over the previous 12-month period or an increase of 16 percent or greater 
57.19 	in price over the previous 24-month period; and
57.20 	(2) for a newly acquired generic drug where there is an increase of 50 percent or greater 
57.21 	in the price over the previous 12-month period.
57.22 	(b) For each of the drugs described in paragraph (a), the acquiring manufacturer shall 
57.23 	submit to the commissioner no later than 60 days after the acquiring manufacturer begins 
57.24 	to sell the newly acquired drug, in the form and manner prescribed by the commissioner, 
57.25 	the following information, if applicable:
57.26 	(1) the price of the prescription drug at the time of acquisition and in the calendar year 
57.27 	prior to acquisition;
57.28 	(2) the name of the company from which the prescription drug was acquired, the date 
57.29 	acquired, and the purchase price;
57.30 	(3) the year the prescription drug was introduced to market and the price of the 
57.31 	prescription drug at the time of introduction;
58.1 	(4) the price of the prescription drug for the previous five years;
58.2 	(5) any agreement between a manufacturer and another entity contingent upon any delay 
58.3 	in offering to market a generic version of the manufacturer's drug; and
58.4 	(6) the patent expiration date of the drug if it is under patent.
58.5 	(c) The manufacturer may submit any documentation necessary to support the information 
58.6 	reported under this subdivision.

58.7 	Sec. 8. Minnesota Statutes 2020, section 62J.84, subdivision 6, is amended to read:
58.8 		Subd. 6.Public posting of prescription drug price information. (a) The commissioner 
58.9 	shall post on the department's website, or may contract with a private entity or consortium 
58.10 	that satisfies the standards of section 62U.04, subdivision 6, to meet this requirement, the 
58.11 	following information:
58.12 	(1) a list of the prescription drugs reported under subdivisions 3, 4, and 5, and the 
58.13 	manufacturers of those prescription drugs; and
58.14 	(2) information reported to the commissioner under subdivisions 3, 4, and 5.
58.15 	(b) The information must be published in an easy-to-read format and in a manner that 
58.16 	identifies the information that is disclosed on a per-drug basis and must not be aggregated 
58.17 	in a manner that prevents the identification of the prescription drug.
58.18 	(c) The commissioner shall not post to the department's website or a private entity 
58.19 	contracting with the commissioner shall not post any information described in this section 
58.20 	if the information is not public data under section 13.02, subdivision 8a; or is trade secret 
58.21 	information under section 13.37, subdivision 1, paragraph (b); or is trade secret information 
58.22 	pursuant to the Defend Trade Secrets Act of 2016, United States Code, title 18, section 
58.23 	1836, as amended. If a manufacturer believes information should be withheld from public 
58.24 	disclosure pursuant to this paragraph, the manufacturer must clearly and specifically identify 
58.25 	that information and describe the legal basis in writing when the manufacturer submits the 
58.26 	information under this section. If the commissioner disagrees with the manufacturer's request 
58.27 	to withhold information from public disclosure, the commissioner shall provide the 
58.28 	manufacturer written notice that the information will be publicly posted 30 days after the 
58.29 	date of the notice.
58.30 	(d) If the commissioner withholds any information from public disclosure pursuant to 
58.31 	this subdivision, the commissioner shall post to the department's website a report describing 
59.1 	the nature of the information and the commissioner's basis for withholding the information 
59.2 	from disclosure.
59.3 	(e) To the extent the information required to be posted under this subdivision is collected 
59.4 	and made available to the public by another state, by the University of Minnesota, or through 
59.5 	an online drug pricing reference and analytical tool, the commissioner may reference the 
59.6 	availability of this drug price data from another source including, within existing 
59.7 	appropriations, creating the ability of the public to access the data from the source for 
59.8 	purposes of meeting the reporting requirements of this subdivision.

59.9 	Sec. 9. Minnesota Statutes 2020, section 62J.84, subdivision 9, is amended to read:
59.10 		Subd. 9.Legislative report. (a) No later than January 15 of each year, beginning January 
59.11 	15, 2022 May 15, 2022, and by January 15 of each year thereafter, the commissioner shall 
59.12 	report to the chairs and ranking minority members of the legislative committees with 
59.13 	jurisdiction over commerce and health and human services policy and finance on the 
59.14 	implementation of this section, including but not limited to the effectiveness in addressing 
59.15 	the following goals:
59.16 	(1) promoting transparency in pharmaceutical pricing for the state and other payers;
59.17 	(2) enhancing the understanding on pharmaceutical spending trends; and
59.18 	(3) assisting the state and other payers in the management of pharmaceutical costs.
59.19 	(b) The report must include a summary of the information submitted to the commissioner 
59.20 	under subdivisions 3, 4, and 5.

59.21 	Sec. 10. Minnesota Statutes 2020, section 144.05, is amended by adding a subdivision to 
59.22 	read:
59.23 		Subd. 7.Expiration of report mandates. (a) If the submission of a report by the 
59.24 	commissioner of health to the legislature is mandated by statute and the enabling legislation 
59.25 	does not include a date for the submission of a final report, the mandate to submit the report 
59.26 	shall expire in accordance with this section.
59.27 	(b) If the mandate requires the submission of an annual report and the mandate was 
59.28 	enacted before January 1, 2021, the mandate shall expire on January 1,2023. If the mandate 
59.29 	requires the submission of a biennial or less frequent report and the mandate was enacted 
59.30 	before January 1, 2021, the mandate shall expire on January 1, 2024.
60.1 	(c) Any reporting mandate enacted on or after January 1, 2021 shall expire three years 
60.2 	after the date of enactment if the mandate requires the submission of an annual report and 
60.3 	shall expire five years after the date of enactment if the mandate requires the submission 
60.4 	of a biennial or less frequent report, unless the enacting legislation provides for a different 
60.5 	expiration date.
60.6 	(d) The commissioner shall submit a list to the chairs and ranking minority members of 
60.7 	the legislative committee with jurisdiction over health by February 15 of each year, beginning 
60.8 	February 15, 2022, of all reports set to expire during the following calendar year in 
60.9 	accordance with this section.

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

60.11 	Sec. 11. Minnesota Statutes 2020, section 144.1205, subdivision 2, is amended to read:
60.12 		Subd. 2.Initial and annual fee. (a) A licensee must pay an initial fee that is equivalent 
60.13 	to the annual fee upon issuance of the initial license.
60.14 	(b) A licensee must pay an annual fee at least 60 days before the anniversary date of the 
60.15 	issuance of the license. The annual fee is as follows:

60.1760.16
	TYPE
		ANNUAL
LICENSE FEE
	
60.1960.18
	Academic broad scope - type A, B, or C
		$19,920
$25,896
		
60.20	Academic broad scope - type B
		19,920
		
60.21	Academic broad scope - type C
		19,920
		
60.22	Academic broad scope - type A, B, or C (4-8 locations)
		$31,075
		
60.23	Academic broad scope - type A, B, or C (9 or more locations)
		$36,254
		
60.2560.24
	Medical broad scope - type A
		19,920
$25,896
		
60.26	Medical broad scope- type A (4-8 locations)
		$31,075
		
60.27	Medical broad scope- type A (9 or more locations)
		$36,254
		
60.28	Medical institution - diagnostic and therapeutic
		3,680
		
60.29
60.30
60.31	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies
		$4,784
		
60.32
60.33
60.34	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies (4-8 locations)
		$5,740
		
60.35
60.36
60.37	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies (9 or more locations)
		$6,697
		
60.38	Medical institution - diagnostic (no written directives)
		3,680
		
61.1	Medical private practice - diagnostic and therapeutic
		3,680
		
61.2	Medical private practice - diagnostic (no written directives)
		3,680
		
61.3	Eye applicators
		3,680
		
61.4	Nuclear medical vans
		3,680
		
61.5	High dose rate afterloader
		3,680
		
61.6	Mobile high dose rate afterloader
		3,680
		
61.7	Medical therapy - other emerging technology
		3,680
		
61.961.8
	Teletherapy
		8,960
$11,648
		
61.1161.10
	Gamma knife
		8,960
$11,648
		
61.12	Veterinary medicine
		2,000 $2,600
		
61.13	In vitro testing lab
		2,000 $2,600
		
61.1561.14
	Nuclear pharmacy
		8,800
$11,440
		
61.16	Nuclear pharmacy (5 or more locations)
		$13,728
		
61.17	Radiopharmaceutical distribution (10 CFR 32.72)
		3,840 $4,992
		
61.18
61.19	Radiopharmaceutical processing and distribution (10 CFR 
32.72)
		8,800
$11,440
		
61.20
61.21	Radiopharmaceutical processing and distribution (10 CFR 
32.72) (5 or more locations)
		$13,728
		
61.22	Medical sealed sources - distribution (10 CFR 32.74)
		3,840 $4,992
		
61.23
61.24	Medical sealed sources - processing and distribution (10 CFR 
32.74)
		8,800
$11,440
		
61.25
61.26	Medical sealed sources - processing and distribution (10 CFR 
32.74) (5 or more locations)
		$13,728
		
61.27	Well logging - sealed sources
		3,760 $4,888
		
61.28
61.29	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other)
		2,000 $2,600
		
61.30	Measuring systems - portable gauge
		2,000
		
61.31
61.32	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other) (4-8 locations)
		$3,120
		
61.33
61.34	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other) (9 or more locations)
		$3,640
		
61.35	X-ray fluorescent analyzer
		1,520 $1,976
		
61.36	Measuring systems - gas chromatograph
		2,000
		
61.37	Measuring systems - other
		2,000
		
61.38
61.39	Broad scope Manufacturing and distribution - type A broad 
scope
		19,920
$25,896
		
61.40
61.41	Manufacturing and distribution - type A broad scope (4-8 
locations)
		$31,075
		
62.1
62.2	Manufacturing and distribution - type A broad scope (9 or more 
locations)
		$36,254
		
62.3
62.4	Broad scope Manufacturing and distribution - type B or C broad 
scope
		17,600
$22,880
		
62.5	Broad scope Manufacturing and distribution - type C
		17,600
		
62.6
62.7	Manufacturing and distribution - type B or C broad scope (4-8 
locations)
		$27,456
		
62.8
62.9	Manufacturing and distribution - type B or C broad scope (9 
or more locations)
		$32,032
		
62.10	Manufacturing and distribution - other
		5,280 $6,864
		
62.11	Manufacturing and distribution - other (4-8 locations)
		$8,236
		
62.12	Manufacturing and distribution - other (9 or more locations)
		$9,609
		
62.1462.13
	Nuclear laundry
		18,640
$24,232
		
62.15	Decontamination services
		4,960 $6,448
		
62.16	Leak test services only
		2,000 $2,600
		
62.17	Instrument calibration service only, less than 100 curies
		2,000 $2,600
		
62.18	Instrument calibration service only, 100 curies or more
		2,000
		
62.19	Service, maintenance, installation, source changes, etc.
		4,960 $6,448
		
62.20	Waste disposal service, prepackaged only
		6,000 $7,800
		
62.2262.21
	Waste disposal
		8,320
$10,816
		
62.23	Distribution - general licensed devices (sealed sources)
		1,760 $2,288
		
62.24	Distribution - general licensed material (unsealed sources)
		1,120 $1,456
		
62.2662.25
	Industrial radiography - fixed or temporary location
		9,840
$12,792
		
62.27	Industrial radiography - temporary job sites
		9,840
		
62.28
62.29	Industrial radiography - fixed or temporary location (5 or more 
locations)
		$16,629
		
62.30	Irradiators, self-shielding, less than 10,000 curies
		2,880 $3,744
		
62.31	Irradiators, other, less than 10,000 curies
		5,360 $6,968
		
62.32	Irradiators, self-shielding, 10,000 curies or more
		2,880
		
62.3462.33
	Research and development - type A, B, or C broad scope
		9,520
$12,376
		
62.35	Research and development - type B broad scope
		9,520
		
62.36	Research and development - type C broad scope
		9,520
		
62.37
62.38	Research and development - type A, B, or C broad scope (4-8 
locations)
		$14,851
		
62.39
62.40	Research and development - type A, B, or C broad scope (9 or 
more locations)
		$17,326
		
62.41	Research and development - other
		4,480 $5,824
		
62.42	Storage - no operations
		2,000 $2,600
		
63.1	Source material - shielding
		584 $759
		
63.2	Special nuclear material plutonium - neutron source in device
		3,680 $4,784
		
63.3
63.4	Pacemaker by-product and/or special nuclear material - medical 
(institution)
		3,680 $4,784
		
63.5
63.6	Pacemaker by-product and/or special nuclear material - 
manufacturing and distribution
		5,280 $6,864
		
63.7	Accelerator-produced radioactive material
		3,840 $4,992
		
63.8	Nonprofit educational institutions
		300 $500
		
63.9	General license registration
		150

63.10 	Sec. 12. Minnesota Statutes 2020, section 144.1205, subdivision 4, is amended to read:
63.11 		Subd. 4.Initial and renewal application fee. A licensee must pay an initial and a 
63.12 	renewal application fee as follows: according to this subdivision.

63.13	TYPE
	APPLICATION FEE
	
63.1563.14
	Academic broad scope - type A, B, or C
		$ 5,920
$6,808
		
63.16	Academic broad scope - type B
		5,920
		
63.17	Academic broad scope - type C
		5,920
		
63.18	Medical broad scope - type A
		3,920 $4,508
		
63.19
63.20
63.21	Medical - diagnostic, diagnostic and therapeutic, mobile nuclear 
medicine, eye applicators, high dose rate afterloaders, and 
medical therapy emerging technologies
		$1,748
		
63.22	Medical institution - diagnostic and therapeutic
		1,520
		
63.23	Medical institution - diagnostic (no written directives)
		1,520
		
63.24	Medical private practice - diagnostic and therapeutic
		1,520
		
63.25	Medical private practice - diagnostic (no written directives)
		1,520
		
63.26	Eye applicators
		1,520
		
63.27	Nuclear medical vans
		1,520
		
63.28	High dose rate afterloader
		1,520
		
63.29	Mobile high dose rate afterloader
		1,520
		
63.30	Medical therapy - other emerging technology
		1,520
		
63.31	Teletherapy
		5,520 $6,348
		
63.32	Gamma knife
		5,520 $6,348
		
63.33	Veterinary medicine
		960 $1,104
		
63.34	In vitro testing lab
		960 $1,104
		
63.35	Nuclear pharmacy
		4,880 $5,612
		
63.36	Radiopharmaceutical distribution (10 CFR 32.72)
		2,160 $2,484
		
63.37
63.38	Radiopharmaceutical processing and distribution (10 CFR 
32.72)
		4,880 $5,612
		
64.1	Medical sealed sources - distribution (10 CFR 32.74)
		2,160 $2,484
		
64.2
64.3	Medical sealed sources - processing and distribution (10 CFR 
32.74)
		4,880 $5,612
		
64.4	Well logging - sealed sources
		1,600 $1,840
		
64.5
64.6	Measuring systems - (fixed gauge, portable gauge, gas 
chromatograph, other)
		960 $1,104
		
64.7	Measuring systems - portable gauge
		960
		
64.8	X-ray fluorescent analyzer
		584 $671
		
64.9	Measuring systems - gas chromatograph
		960
		
64.10	Measuring systems - other
		960
		
64.11
64.12	Broad scope Manufacturing and distribution - type A, B, and 
C broad scope
		5,920 $6,854
		
64.13	Broad scope manufacturing and distribution - type B
		5,920
		
64.14	Broad scope manufacturing and distribution - type C
		5,920
		
64.15	Manufacturing and distribution - other
		2,320 $2,668
		
64.1764.16
	Nuclear laundry
		10,080
$11,592
		
64.18	Decontamination services
		2,640 $3,036
		
64.19	Leak test services only
		960 $1,104
		
64.20	Instrument calibration service only, less than 100 curies
		960 $1,104
		
64.21	Instrument calibration service only, 100 curies or more
		960
		
64.22	Service, maintenance, installation, source changes, etc.
		2,640 $3,036
		
64.23	Waste disposal service, prepackaged only
		2,240 $2,576
		
64.24	Waste disposal
		1,520 $1,748
		
64.25	Distribution - general licensed devices (sealed sources)
		880 $1,012
		
64.26	Distribution - general licensed material (unsealed sources)
		520 $598
		
64.27	Industrial radiography - fixed or temporary location
		2,640 $3,036
		
64.28	Industrial radiography - temporary job sites
		2,640
		
64.29	Irradiators, self-shielding, less than 10,000 curies
		1,440 $1,656
		
64.30	Irradiators, other, less than 10,000 curies
		2,960 $3,404
		
64.31	Irradiators, self-shielding, 10,000 curies or more
		1,440
		
64.32	Research and development - type A, B, or C broad scope
		4,960 $5,704
		
64.33	Research and development - type B broad scope
		4,960
		
64.34	Research and development - type C broad scope
		4,960
		
64.35	Research and development - other
		2,400 $2,760
		
64.36	Storage - no operations
		960 $1,104
		
64.37	Source material - shielding
		136 $156
		
64.38	Special nuclear material plutonium - neutron source in device
		1,200 $1,380
		
64.39
64.40	Pacemaker by-product and/or special nuclear material - medical 
(institution)
		1,200 $1,380
		
65.1
65.2	Pacemaker by-product and/or special nuclear material - 
manufacturing and distribution
		2,320 $2,668
		
65.3	Accelerator-produced radioactive material
		4,100 $4,715
		
65.4	Nonprofit educational institutions
		300 $345
		
65.5	General license registration
		0
		
65.6	Industrial radiographer certification
		150

65.7 	Sec. 13. Minnesota Statutes 2020, section 144.1205, subdivision 8, is amended to read:
65.8 		Subd. 8.Reciprocity fee. A licensee submitting an application for reciprocal recognition 
65.9 	of a materials license issued by another agreement state or the United States Nuclear 
65.10 	Regulatory Commission for a period of 180 days or less during a calendar year must pay 
65.11 	$1,200 $2,400. For a period of 181 days or more, the licensee must obtain a license under 
65.12 	subdivision 4.

65.13 	Sec. 14. Minnesota Statutes 2020, section 144.1205, subdivision 9, is amended to read:
65.14 		Subd. 9.Fees for license amendments. A licensee must pay a fee of $300 $600 to 
65.15 	amend a license as follows:
65.16 	(1) to amend a license requiring review including, but not limited to, addition of isotopes, 
65.17 	procedure changes, new authorized users, or a new radiation safety officer; andor
65.18 	(2) to amend a license requiring review and a site visit including, but not limited to, 
65.19 	facility move or addition of processes.

65.20 	Sec. 15. Minnesota Statutes 2020, section 144.1205, is amended by adding a subdivision 
65.21 	to read:
65.22 		Subd. 10.Fees for general license registrations. A person required to register generally 
65.23 	licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual 
65.24 	registration fee of $450.

65.25 	Sec. 16. Minnesota Statutes 2020, section 144.1481, subdivision 1, is amended to read:
65.26 		Subdivision 1.Establishment; membership. The commissioner of health shall establish 
65.27 	a 15-member 16-member Rural Health Advisory Committee. The committee shall consist 
65.28 	of the following members, all of whom must reside outside the seven-county metropolitan 
65.29 	area, as defined in section 473.121, subdivision 2:
65.30 	(1) two members from the house of representatives of the state of Minnesota, one from 
65.31 	the majority party and one from the minority party;
66.1 	(2) two members from the senate of the state of Minnesota, one from the majority party 
66.2 	and one from the minority party;
66.3 	(3) a volunteer member of an ambulance service based outside the seven-county 
66.4 	metropolitan area;
66.5 	(4) a representative of a hospital located outside the seven-county metropolitan area;
66.6 	(5) a representative of a nursing home located outside the seven-county metropolitan 
66.7 	area;
66.8 	(6) a medical doctor or doctor of osteopathic medicine licensed under chapter 147;
66.9 	(7) a dentist licensed under chapter 150A;
66.10 	(8) a midlevel practitioner;
66.11 	(8) (9) a registered nurse or licensed practical nurse;
66.12 	(9) (10) a licensed health care professional from an occupation not otherwise represented 
66.13 	on the committee;
66.14 	(10) (11) a representative of an institution of higher education located outside the 
66.15 	seven-county metropolitan area that provides training for rural health care providers; and
66.16 	(11) (12) three consumers, at least one of whom must be an advocate for persons who 
66.17 	are mentally ill or developmentally disabled.
66.18 	The commissioner will make recommendations for committee membership. Committee 
66.19 	members will be appointed by the governor. In making appointments, the governor shall 
66.20 	ensure that appointments provide geographic balance among those areas of the state outside 
66.21 	the seven-county metropolitan area. The chair of the committee shall be elected by the 
66.22 	members. The advisory committee is governed by section 15.059, except that the members 
66.23 	do not receive per diem compensation.

66.24 	Sec. 17. Minnesota Statutes 2020, section 144.1911, subdivision 6, is amended to read:
66.25 		Subd. 6.International medical graduate primary care residency grant program 
66.26 	and revolving account. (a) The commissioner shall award grants to support primary care 
66.27 	residency positions designated for Minnesota immigrant physicians who are willing to serve 
66.28 	in rural or underserved areas of the state. No grant shall exceed $150,000 per residency 
66.29 	position per year. Eligible primary care residency grant recipients include accredited family 
66.30 	medicine, general surgery, internal medicine, obstetrics and gynecology, psychiatry, and 
66.31 	pediatric residency programs. Eligible primary care residency programs shall apply to the 
67.1 	commissioner. Applications must include the number of anticipated residents to be funded 
67.2 	using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded to 
67.3 	grantees in a grant agreement do not lapse until the grant agreement expires. Before any 
67.4 	funds are distributed, a grant recipient shall provide the commissioner with the following:
67.5 	(1) a copy of the signed contract between the primary care residency program and the 
67.6 	participating international medical graduate;
67.7 	(2) certification that the participating international medical graduate has lived in 
67.8 	Minnesota for at least two years and is certified by the Educational Commission on Foreign 
67.9 	Medical Graduates. Residency programs may also require that participating international 
67.10 	medical graduates hold a Minnesota certificate of clinical readiness for residency, once the 
67.11 	certificates become available; and
67.12 	(3) verification that the participating international medical graduate has executed a 
67.13 	participant agreement pursuant to paragraph (b).
67.14 	(b) Upon acceptance by a participating residency program, international medical graduates 
67.15 	shall enter into an agreement with the commissioner to provide primary care for at least 
67.16 	five years in a rural or underserved area of Minnesota after graduating from the residency 
67.17 	program and make payments to the revolving international medical graduate residency 
67.18 	account for five years beginning in their second year of postresidency employment. 
67.19 	Participants shall pay $15,000 or ten percent of their annual compensation each year, 
67.20 	whichever is less.
67.21 	(c) A revolving international medical graduate residency account is established as an 
67.22 	account in the special revenue fund in the state treasury. The commissioner of management 
67.23 	and budget shall credit to the account appropriations, payments, and transfers to the account. 
67.24 	Earnings, such as interest, dividends, and any other earnings arising from fund assets, must 
67.25 	be credited to the account. Funds in the account are appropriated annually to the 
67.26 	commissioner to award grants and administer the grant program established in paragraph 
67.27 	(a). Notwithstanding any law to the contrary, any funds deposited in the account do not 
67.28 	expire. The commissioner may accept contributions to the account from private sector 
67.29 	entities subject to the following provisions:
67.30 	(1) the contributing entity may not specify the recipient or recipients of any grant issued 
67.31 	under this subdivision;
67.32 	(2) the commissioner shall make public the identity of any private contributor to the 
67.33 	account, as well as the amount of the contribution provided; and
68.1 	(3) a contributing entity may not specify that the recipient or recipients of any funds use 
68.2 	specific products or services, nor may the contributing entity imply that a contribution is 
68.3 	an endorsement of any specific product or service.

68.4 	Sec. 18. Minnesota Statutes 2020, section 144.223, is amended to read:
68.5 	144.223 REPORT OF MARRIAGE.
68.6 	Data relating to certificates of marriage registered shall be reported to the state registrar 
68.7 	by the local registrar or designee of the county board in each of the 87 registration districts 
68.8 	pursuant to the rules of the commissioner. The information in clause (1) necessary to compile 
68.9 	the report shall be furnished by the applicant prior to the issuance of the marriage license. 
68.10 	The report shall contain the following:
68.11 	(1) personal information on bride and groom:
68.12 	(i) name;
68.13 	(ii) residence;
68.14 	(iii) date and place of birth;
68.15 	(iv) race;
68.16 	(v) (iv) if previously married, how terminated; and
68.17 	(vi) (v) signature of applicant, date signed, and Social Security number; and
68.18 	(2) information concerning the marriage:
68.19 	(i) date of marriage;
68.20 	(ii) place of marriage; and
68.21 	(iii) civil or religious ceremony.

68.22 	Sec. 19. Minnesota Statutes 2020, section 144.225, subdivision 7, is amended to read:
68.23 		Subd. 7.Certified birth or death record. (a) The state registrar or local issuance office 
68.24 	shall issue a certified birth or death record or a statement of no vital record found to an 
68.25 	individual upon the individual's proper completion of an attestation provided by the 
68.26 	commissioner and payment of the required fee:
68.27 	(1) to a person who has a tangible interest in the requested vital record. A person who 
68.28 	has a tangible interest is:
68.29 	(i) the subject of the vital record;
69.1 	(ii) a child of the subject;
69.2 	(iii) the spouse of the subject;
69.3 	(iv) a parent of the subject;
69.4 	(v) the grandparent or grandchild of the subject;
69.5 	(vi) if the requested record is a death record, a sibling of the subject;
69.6 	(vii) the party responsible for filing the vital record;
69.7 	(viii) (vii) the legal custodian, guardian or conservator, or health care agent of the subject;
69.8 	(ix) (viii) a personal representative, by sworn affidavit of the fact that the certified copy 
69.9 	is required for administration of the estate;
69.10 	(x) (ix) a successor of the subject, as defined in section 524.1-201, if the subject is 
69.11 	deceased, by sworn affidavit of the fact that the certified copy is required for administration 
69.12 	of the estate;
69.13 	(xi) (x) if the requested record is a death record, a trustee of a trust by sworn affidavit 
69.14 	of the fact that the certified copy is needed for the proper administration of the trust;
69.15 	(xii) (xi) a person or entity who demonstrates that a certified vital record is necessary 
69.16 	for the determination or protection of a personal or property right, pursuant to rules adopted 
69.17 	by the commissioner; or
69.18 	(xiii) (xii) an adoption agency in order to complete confidential postadoption searches 
69.19 	as required by section 259.83;
69.20 	(2) to any local, state, tribal, or federal governmental agency upon request if the certified 
69.21 	vital record is necessary for the governmental agency to perform its authorized duties;
69.22 	(3) to an attorney representing the subject of the vital record or another person listed in 
69.23 	clause (1), upon evidence of the attorney's license;
69.24 	(4) pursuant to a court order issued by a court of competent jurisdiction. For purposes 
69.25 	of this section, a subpoena does not constitute a court order; or
69.26 	(5) to a representative authorized by a person under clauses (1) to (4).
69.27 	(b) The state registrar or local issuance office shall also issue a certified death record to 
69.28 	an individual described in paragraph (a), clause (1), items (ii) to (viii) (xi), if, on behalf of 
69.29 	the individual, a licensed mortician furnishes the registrar with a properly completed 
69.30 	attestation in the form provided by the commissioner within 180 days of the time of death 
70.1 	of the subject of the death record. This paragraph is not subject to the requirements specified 
70.2 	in Minnesota Rules, part 4601.2600, subpart 5, item B.

70.3 	Sec. 20. Minnesota Statutes 2020, section 144G.84, is amended to read:
70.4 	144G.84 SERVICES FOR RESIDENTS WITH DEMENTIA.
70.5 	(a) In addition to the minimum services required in section 144G.41, an assisted living 
70.6 	facility with dementia care must also provide the following services:
70.7 	(1) assistance with activities of daily living that address the needs of each resident with 
70.8 	dementia due to cognitive or physical limitations. These services must meet or be in addition 
70.9 	to the requirements in the licensing rules for the facility. Services must be provided in a 
70.10 	person-centered manner that promotes resident choice, dignity, and sustains the resident's 
70.11 	abilities;
70.12 	(2) nonpharmacological practices that are person-centered and evidence-informed;
70.13 	(3) services to prepare and educate persons living with dementia and their legal and 
70.14 	designated representatives about transitions in care and ensuring complete, timely 
70.15 	communication between, across, and within settings; and
70.16 	(4) services that provide residents with choices for meaningful engagement with other 
70.17 	facility residents and the broader community.
70.18 	(b) Each resident must be evaluated for activities according to the licensing rules of the 
70.19 	facility. In addition, the evaluation must address the following:
70.20 	(1) past and current interests;
70.21 	(2) current abilities and skills;
70.22 	(3) emotional and social needs and patterns;
70.23 	(4) physical abilities and limitations;
70.24 	(5) adaptations necessary for the resident to participate; and
70.25 	(6) identification of activities for behavioral interventions.
70.26 	(c) An individualized activity plan must be developed for each resident based on their 
70.27 	activity evaluation. The plan must reflect the resident's activity preferences and needs.
70.28 	(d) A selection of daily structured and non-structured activities must be provided and 
70.29 	included on the resident's activity service or care plan as appropriate. Daily activity options 
70.30 	based on resident evaluation may include but are not limited to:
71.1 	(1) occupation or chore related tasks;
71.2 	(2) scheduled and planned events such as entertainment or outings;
71.3 	(3) spontaneous activities for enjoyment or those that may help defuse a behavior;
71.4 	(4) one-to-one activities that encourage positive relationships between residents and 
71.5 	staff such as telling a life story, reminiscing, or playing music;
71.6 	(5) spiritual, creative, and intellectual activities;
71.7 	(6) sensory stimulation activities;
71.8 	(7) physical activities that enhance or maintain a resident's ability to ambulate or move; 
71.9 	and
71.10 	(8) a resident's individualized activity plan for regular outdoor activities activity.
71.11 	(e) Behavioral symptoms that negatively impact the resident and others in the assisted 
71.12 	living facility with dementia care must be evaluated and included on the service or care 
71.13 	plan. The staff must initiate and coordinate outside consultation or acute care when indicated.
71.14 	(f) Support must be offered to family and other significant relationships on a regularly 
71.15 	scheduled basis but not less than quarterly.
71.16 	(g) Access to secured outdoor space and walkways that allow residents to enter and 
71.17 	return without staff assistance must be provided. Existing housing with services 
71.18 	establishments registered under chapter 144D prior to August 1, 2021, that obtain an assisted 
71.19 	living facility license must provide residents with regular access to outdoor space. A licensee 
71.20 	with new construction on or after August 1, 2021, or a new licensee that was not previously 
71.21 	registered under chapter 144D prior to August 1, 2021, must provide regular access to 
71.22 	secured outdoor space on the premises of the facility. A resident's access to outdoor space 
71.23 	must be in accordance with the resident's documented care plan.

71.24 	EFFECTIVE DATE. This section is effective August 1, 2021.

71.25 	Sec. 21. [145.87] HOME VISITING FOR PREGNANT WOMEN AND FAMILIES 
71.26 	WITH YOUNG CHILDREN.
71.27 		Subdivision 1.Definitions. (a) The terms defined in this subdivision apply to this section 
71.28 	and have the meanings given them.
71.29 	(b) "Evidence-based home visiting program" means a program that:
71.30 	(1) is based on a clear, consistent program or model that is research-based and grounded 
71.31 	in relevant, empirically based knowledge;
72.1 	(2) is linked to program-determined outcomes and is associated with a national 
72.2 	organization, institution of higher education, or national or state public health institute;
72.3 	(3) has comprehensive home visitation standards that ensure high-quality service delivery 
72.4 	and continuous quality improvement;
72.5 	(4) has demonstrated significant, sustained positive outcomes; and
72.6 	(5) either:
72.7 	(i) has been evaluated using rigorous randomized controlled research designs and the 
72.8 	evaluation results have been published in a peer-reviewed journal; or
72.9 	(ii) is based on quasi-experimental research using two or more separate, comparable 
72.10 	client samples.
72.11 	(c) "Evidence-informed home visiting program" means a program that:
72.12 	(1) has data or evidence demonstrating effectiveness at achieving positive outcomes for 
72.13 	pregnant women or young children; and
72.14 	(2) either:
72.15 	(i) has an active evaluation of the program; or
72.16 	(ii) has a plan and timeline for an active evaluation of the program to be conducted.
72.17 	(d) "Health equity" means every individual has a fair opportunity to attain the individual's 
72.18 	full health potential and no individual is disadvantaged from achieving this potential.
72.19 	(e) "Promising practice home visiting program" means a program that has shown 
72.20 	improvement toward achieving positive outcomes for pregnant women or young children.
72.21 		Subd. 2.Grants for home visiting programs. (a) The commissioner of health shall 
72.22 	award grants to community health boards, nonprofit organizations, and Tribal nations to 
72.23 	start up, sustain, or expand voluntary home visiting programs serving pregnant women or 
72.24 	families with young children. Home visiting programs supported under this section shall 
72.25 	provide voluntary home visits by early childhood professionals or health professionals, 
72.26 	including but not limited to nurses, social workers, early childhood educators, and trained 
72.27 	paraprofessionals. Grant money shall be used to:
72.28 	(1) establish, sustain, or expand evidence-based, evidence-informed, or promising practice 
72.29 	home visiting programs that address health equity and utilize community-driven health 
72.30 	strategies;
73.1 	(2) serve families with young children or pregnant women who have high needs or are 
73.2 	high-risk, including but not limited to a family with low income, a parent or pregnant woman 
73.3 	with a mental illness or a substance use disorder, or a parent or pregnant woman experiencing 
73.4 	housing instability or domestic abuse; and
73.5 	(3) improve program outcomes in two or more of the following areas:
73.6 	(i) maternal and newborn health;
73.7 	(ii) school readiness and achievement;
73.8 	(iii) family economic self-sufficiency;
73.9 	(iv) coordination and referral for other community resources and supports;
73.10 	(v) reduction in child injuries, abuse, or neglect; or
73.11 	(vi) reduction in crime or domestic violence.
73.12 	(b) Grants awarded to evidence-informed and promising practice home visiting programs 
73.13 	must include money to evaluate program outcomes for up to four of the areas listed in 
73.14 	paragraph (a), clause (3).
73.15 		Subd. 3.Grant prioritization. (a) In awarding grants, the commissioner shall give 
73.16 	priority to community health boards, nonprofit organizations, and Tribal nations seeking to 
73.17 	expand home visiting services with community or regional partnerships.
73.18 	(b) The commissioner shall allocate at least 75 percent of the grant money awarded each 
73.19 	grant cycle to evidence-based home visiting programs that address health equity and up to 
73.20 	25 percent of the grant money awarded each grant cycle to evidence-informed or promising 
73.21 	practice home visiting programs that address health equity and utilize community-driven 
73.22 	health strategies.
73.23 		Subd. 4.Administrative costs. The commissioner may use up to seven percent of the 
73.24 	annual appropriation under this section to provide training and technical assistance and to 
73.25 	administer and evaluate the program. The commissioner may contract for training, 
73.26 	capacity-building support for grantees or potential grantees, technical assistance, and 
73.27 	evaluation support.
73.28 		Subd. 5.Use of state general fund appropriations. Appropriations dedicated to 
73.29 	establishing, sustaining, or expanding evidence-based home visiting programs shall, for 
73.30 	grants awarded on or after July 1, 2021, be awarded according to this section. This section 
73.31 	shall not govern grant awards of federal funds for home visiting programs and shall not 
74.1 	govern grant awards using state general fund appropriations dedicated to establishing or 
74.2 	expanding nurse-family partnership home visiting programs.

74.3 	Sec. 22. Minnesota Statutes 2020, section 145.893, subdivision 1, is amended to read:
74.4 		Subdivision 1.Vouchers Food benefits. An eligible individual shall receive vouchers
74.5 	food benefits for the purchase of specified nutritional supplements in type and quantity 
74.6 	approved by the commissioner. Alternate forms of delivery may be developed by the 
74.7 	commissioner in appropriate cases.

74.8 	Sec. 23. Minnesota Statutes 2020, section 145.894, is amended to read:
74.9 	145.894 STATE COMMISSIONER OF HEALTH; DUTIES, RESPONSIBILITIES.
74.10 	The commissioner of health shall:
74.11 	(1) develop a comprehensive state plan for the delivery of nutritional supplements to 
74.12 	pregnant and lactating women, infants, and children;
74.13 	(2) contract with existing local public or private nonprofit organizations for the 
74.14 	administration of the nutritional supplement program;
74.15 	(3) develop and implement a public education program promoting the provisions of 
74.16 	sections 145.891 to 145.897, and provide for the delivery of individual and family nutrition 
74.17 	education and counseling at project sites. The education programs must include a campaign 
74.18 	to promote breast feeding;
74.19 	(4) develop in cooperation with other agencies and vendors a uniform state voucherfood 
74.20 	benefit system for the delivery of nutritional supplements;
74.21 	(5) authorize local health agencies to issue vouchers bimonthly food benefits trimonthly
74.22 	to some or all eligible individuals served by the agency, provided the agency demonstrates 
74.23 	that the federal minimum requirements for providing nutrition education will continue to 
74.24 	be met and that the quality of nutrition education and health services provided by the agency 
74.25 	will not be adversely impacted;
74.26 	(6) investigate and implement a system to reduce the cost of nutritional supplements 
74.27 	and maintain ongoing negotiations with nonparticipating manufacturers and suppliers to 
74.28 	maximize cost savings;
74.29 	(7) develop, analyze, and evaluate the health aspects of the nutritional supplement 
74.30 	program and establish nutritional guidelines for the program;
75.1 	(8) apply for, administer, and annually expend at least 99 percent of available federal 
75.2 	or private funds;
75.3 	(9) aggressively market services to eligible individuals by conducting ongoing outreach 
75.4 	activities and by coordinating with and providing marketing materials and technical assistance 
75.5 	to local human services and community service agencies and nonprofit service providers;
75.6 	(10) determine, on July 1 of each year, the number of pregnant women participating in 
75.7 	each special supplemental food program for women, infants, and children (WIC) and, in 
75.8 	1986, 1987, and 1988, at the commissioner's discretion, designate a different food program 
75.9 	deliverer if the current deliverer fails to increase the participation of pregnant women in the 
75.10 	program by at least ten percent over the previous year's participation rate;
75.11 	(11) promulgate all rules necessary to carry out the provisions of sections 145.891 to 
75.12 	145.897; and
75.13 	(12) ensure that any state appropriation to supplement the federal program is spent 
75.14 	consistent with federal requirements.

75.15 	Sec. 24. Minnesota Statutes 2020, section 145.897, is amended to read:
75.16 	145.897 VOUCHERS FOOD BENEFITS.
75.17 	Vouchers Food benefits issued pursuant to sections 145.891 to 145.897 shall be only 
75.18 	for the purchase of those foods determined by the commissioner United States Department 
75.19 	of Agriculture to be desirable nutritional supplements for pregnant and lactating women, 
75.20 	infants and children. These foods shall include, but not be limited to, iron fortified infant 
75.21 	formula, vegetable or fruit juices, cereal, milk, cheese, and eggs.

75.22 	Sec. 25. Minnesota Statutes 2020, section 145.899, is amended to read:
75.23 	145.899 WIC VOUCHERS FOOD BENEFITS FOR ORGANICS.
75.24 	Vouchers Food benefits for the special supplemental nutrition program for women, 
75.25 	infants, and children (WIC) may be used to purchase cost-neutral organic WIC allowable 
75.26 	food. The commissioner of health shall regularly evaluate the list of WIC allowable food 
75.27 	in accordance with federal requirements and shall add to the list any organic WIC allowable 
75.28 	foods determined to be cost-neutral.

75.29 	Sec. 26. [145A.145] NURSE-FAMILY PARTNERSHIP PROGRAMS.
75.30 	(a) The commissioner of health shall award expansion grants to community health boards 
75.31 	and tribal nations to expand existing nurse-family partnership programs. Grant funds must 
76.1 	be used to start up, expand, or sustain nurse-family partnership programs in the county, 
76.2 	reservation, or region to serve families in accordance with the Nurse-Family Partnership 
76.3 	Service Office nurse-family partnership model. The commissioner shall award grants to 
76.4 	community health boards, nonprofit organizations, or tribal nations in metropolitan and 
76.5 	rural areas of the state.
76.6 	(b) Priority for all grants shall be given to nurse-family partnership programs that provide 
76.7 	services through a Minnesota health care program-enrolled provider that accepts medical 
76.8 	assistance. Priority for grants to rural areas shall be given to community health boards, 
76.9 	nonprofit organizations, and tribal nations that start up, expand, or sustain services within 
76.10 	regional partnerships that provide the nurse-family partnership program.
76.11 	(c) Funding available under this section may only be used to supplement, not to replace, 
76.12 	funds being used for nurse-family partnership home visiting services as of June 30, 2015.

76.13 	Sec. 27. Minnesota Statutes 2020, section 151.72, subdivision 5, is amended to read:
76.14 		Subd. 5.Labeling requirements. (a) A product regulated under this section must bear 
76.15 	a label that contains, at a minimum:
76.16 	(1) the name, location, contact phone number, and website of the manufacturer of the 
76.17 	product;
76.18 	(2) the name and address of the independent, accredited laboratory used by the 
76.19 	manufacturer to test the product; and
76.20 	(3) an accurate statement of the amount or percentage of cannabinoids found in each 
76.21 	unit of the product meant to be consumed; and or
76.22 	(4) instead of the information required in clauses (1) to (3), a scannable bar code or QR 
76.23 	code that links to the manufacturer's website.
76.24 	The label must also include a statement stating that this product does not claim to diagnose, 
76.25 	treat, cure, or prevent any disease and has not been evaluated or approved by the United 
76.26 	States Food and Drug Administration (FDA) unless the product has been so approved.
76.27 	(b) The information required to be on the label must be prominently and conspicuously 
76.28 	placed and in terms that can be easily read and understood by the consumer.
76.29 	(c) The label must not contain any claim that the product may be used or is effective for 
76.30 	the prevention, treatment, or cure of a disease or that it may be used to alter the structure 
76.31 	or function of human or animal bodies, unless the claim has been approved by the FDA.

77.1 	Sec. 28. Minnesota Statutes 2020, section 152.22, is amended by adding a subdivision to 
77.2 	read:
77.3 		Subd. 5c.Hemp processor. "Hemp processor" means a person or business licensed by 
77.4 	the commissioner of agriculture under chapter 18K to convert raw hemp into a product.

77.5 	Sec. 29. Minnesota Statutes 2020, section 152.22, subdivision 6, is amended to read:
77.6 		Subd. 6.Medical cannabis. (a) "Medical cannabis" means any species of the genus 
77.7 	cannabis plant, or any mixture or preparation of them, including whole plant extracts and 
77.8 	resins, and is delivered in the form of:
77.9 	(1) liquid, including, but not limited to, oil;
77.10 	(2) pill;
77.11 	(3) vaporized delivery method with use of liquid or oil but which does not require the 
77.12 	use of dried leaves or plant form; or;
77.13 	(4) combustion with use of dried raw cannabis; or
77.14 	(4) (5) any other method, excluding smoking, approved by the commissioner.
77.15 	(b) This definition includes any part of the genus cannabis plant prior to being processed 
77.16 	into a form allowed under paragraph (a), that is possessed by a person while that person is 
77.17 	engaged in employment duties necessary to carry out a requirement under sections 152.22 
77.18 	to 152.37 for a registered manufacturer or a laboratory under contract with a registered 
77.19 	manufacturer. This definition also includes any hemp acquired by a manufacturer by a hemp 
77.20 	grower as permitted under section 152.29, subdivision 1, paragraph (b).

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

77.28 	Sec. 30. Minnesota Statutes 2020, section 152.22, subdivision 11, is amended to read:
77.29 		Subd. 11.Registered designated caregiver. "Registered designated caregiver" means 
77.30 	a person who:
77.31 	(1) is at least 18 years old;
78.1 	(2) does not have a conviction for a disqualifying felony offense;
78.2 	(3) has been approved by the commissioner to assist a patient who has been identified 
78.3 	by a health care practitioner as developmentally or physically disabled and therefore requires 
78.4 	assistance in administering medical cannabis or obtaining medical cannabis from a 
78.5 	distribution facility due to the disability; and
78.6 	(4) is authorized by the commissioner to assist the patient with the use of medical 
78.7 	cannabis.

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

78.9 	Sec. 31. Minnesota Statutes 2020, section 152.23, is amended to read:
78.10 	152.23 LIMITATIONS.
78.11 	(a) Nothing in sections 152.22 to 152.37 permits any person to engage in and does not 
78.12 	prevent the imposition of any civil, criminal, or other penalties for:
78.13 	(1) undertaking any task under the influence of medical cannabis that would constitute 
78.14 	negligence or professional malpractice;
78.15 	(2) possessing or engaging in the use of medical cannabis:
78.16 	(i) on a school bus or van;
78.17 	(ii) on the grounds of any preschool or primary or secondary school;
78.18 	(iii) in any correctional facility; or
78.19 	(iv) on the grounds of any child care facility or home day care;
78.20 	(3) vaporizing or combusting medical cannabis pursuant to section 152.22, subdivision 
78.21 	6:
78.22 	(i) on any form of public transportation;
78.23 	(ii) where the vapor would be inhaled by a nonpatient minor child or where the smoke 
78.24 	would be inhaled by a minor child; or
78.25 	(iii) in any public place, including any indoor or outdoor area used by or open to the 
78.26 	general public or a place of employment as defined under section 144.413, subdivision 1b; 
78.27 	and
78.28 	(4) operating, navigating, or being in actual physical control of any motor vehicle, 
78.29 	aircraft, train, or motorboat, or working on transportation property, equipment, or facilities 
78.30 	while under the influence of medical cannabis.
79.1 	(b) Nothing in sections 152.22 to 152.37 require the medical assistance and 
79.2 	MinnesotaCare programs to reimburse an enrollee or a provider for costs associated with 
79.3 	the medical use of cannabis. Medical assistance and MinnesotaCare shall continue to provide 
79.4 	coverage for all services related to treatment of an enrollee's qualifying medical condition 
79.5 	if the service is covered under chapter 256B or 256L.

79.6 	Sec. 32. Minnesota Statutes 2020, section 152.26, is amended to read:
79.7 	152.26 RULEMAKING.
79.8 	(a) The commissioner may adopt rules to implement sections 152.22 to 152.37. Rules 
79.9 	for which notice is published in the State Register before January 1, 2015, may be adopted 
79.10 	using the process in section 14.389.
79.11 	(b) The commissioner may adopt or amend rules, using the procedure in section 14.386, 
79.12 	paragraph (a), to implement the addition of dried raw cannabis as an allowable form of 
79.13 	medical cannabis under section 152.22, subdivision 6, paragraph (a), clause (4). Section 
79.14 	14.386, paragraph (b), does not apply to these rules.

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

79.16 	Sec. 33. Minnesota Statutes 2020, section 152.27, subdivision 2, is amended to read:
79.17 		Subd. 2.Commissioner duties. (a) The commissioner shall:
79.18 	(1) give notice of the program to health care practitioners in the state who are eligible 
79.19 	to serve as health care practitioners and explain the purposes and requirements of the 
79.20 	program;
79.21 	(2) allow each health care practitioner who meets or agrees to meet the program's 
79.22 	requirements and who requests to participate, to be included in the registry program to 
79.23 	collect data for the patient registry;
79.24 	(3) provide explanatory information and assistance to each health care practitioner in 
79.25 	understanding the nature of therapeutic use of medical cannabis within program requirements;
79.26 	(4) create and provide a certification to be used by a health care practitioner for the 
79.27 	practitioner to certify whether a patient has been diagnosed with a qualifying medical 
79.28 	condition and include in the certification an option for the practitioner to certify whether 
79.29 	the patient, in the health care practitioner's medical opinion, is developmentally or physically 
79.30 	disabled and, as a result of that disability, the patient requires assistance in administering 
79.31 	medical cannabis or obtaining medical cannabis from a distribution facility;
80.1 	(5) supervise the participation of the health care practitioner in conducting patient 
80.2 	treatment and health records reporting in a manner that ensures stringent security and 
80.3 	record-keeping requirements and that prevents the unauthorized release of private data on 
80.4 	individuals as defined by section 13.02;
80.5 	(6) develop safety criteria for patients with a qualifying medical condition as a 
80.6 	requirement of the patient's participation in the program, to prevent the patient from 
80.7 	undertaking any task under the influence of medical cannabis that would constitute negligence 
80.8 	or professional malpractice on the part of the patient; and
80.9 	(7) conduct research and studies based on data from health records submitted to the 
80.10 	registry program and submit reports on intermediate or final research results to the legislature 
80.11 	and major scientific journals. The commissioner may contract with a third party to complete 
80.12 	the requirements of this clause. Any reports submitted must comply with section 152.28, 
80.13 	subdivision 2.
80.14 	(b) The commissioner may add a delivery method under section 152.22, subdivision 6, 
80.15 	or add, remove, or modify a qualifying medical condition under section 152.22, subdivision 
80.16 	14, upon a petition from a member of the public or the task force on medical cannabis 
80.17 	therapeutic research or as directed by law. The commissioner shall evaluate all petitions to 
80.18 	add a qualifying medical condition or to remove or modify an existing qualifying medical 
80.19 	condition submitted by the task force on medical cannabis therapeutic research or as directed 
80.20 	by law and shall may make the addition, removal, or modification if the commissioner 
80.21 	determines the addition, removal, or modification is warranted based on the best available 
80.22 	evidence and research. If the commissioner wishes to add a delivery method under section 
80.23 	152.22, subdivision 6, or add or remove a qualifying medical condition under section 152.22, 
80.24 	subdivision 14, the commissioner must notify the chairs and ranking minority members of 
80.25 	the legislative policy committees having jurisdiction over health and public safety of the 
80.26 	addition or removal and the reasons for its addition or removal, including any written 
80.27 	comments received by the commissioner from the public and any guidance received from 
80.28 	the task force on medical cannabis research, by January 15 of the year in which the 
80.29 	commissioner wishes to make the change. The change shall be effective on August 1 of that 
80.30 	year, unless the legislature by law provides otherwise.

80.31 	Sec. 34. Minnesota Statutes 2020, section 152.27, subdivision 3, is amended to read:
80.32 		Subd. 3.Patient application. (a) The commissioner shall develop a patient application 
80.33 	for enrollment into the registry program. The application shall be available to the patient 
81.1 	and given to health care practitioners in the state who are eligible to serve as health care 
81.2 	practitioners. The application must include:
81.3 	(1) the name, mailing address, and date of birth of the patient;
81.4 	(2) the name, mailing address, and telephone number of the patient's health care 
81.5 	practitioner;
81.6 	(3) the name, mailing address, and date of birth of the patient's designated caregiver, if 
81.7 	any, or the patient's parent, legal guardian, or spouse if the parent, legal guardian, or spouse 
81.8 	will be acting as a caregiver;
81.9 	(4) a copy of the certification from the patient's health care practitioner that is dated 
81.10 	within 90 days prior to submitting the application which that certifies that the patient has 
81.11 	been diagnosed with a qualifying medical condition and, if applicable, that, in the health 
81.12 	care practitioner's medical opinion, the patient is developmentally or physically disabled 
81.13 	and, as a result of that disability, the patient requires assistance in administering medical 
81.14 	cannabis or obtaining medical cannabis from a distribution facility; and
81.15 	(5) all other signed affidavits and enrollment forms required by the commissioner under 
81.16 	sections 152.22 to 152.37, including, but not limited to, the disclosure form required under 
81.17 	paragraph (c).
81.18 	(b) The commissioner shall require a patient to resubmit a copy of the certification from 
81.19 	the patient's health care practitioner on a yearly basis and shall require that the recertification 
81.20 	be dated within 90 days of submission.
81.21 	(c) The commissioner shall develop a disclosure form and require, as a condition of 
81.22 	enrollment, all patients to sign a copy of the disclosure. The disclosure must include:
81.23 	(1) a statement that, notwithstanding any law to the contrary, the commissioner, or an 
81.24 	employee of any state agency, may not be held civilly or criminally liable for any injury, 
81.25 	loss of property, personal injury, or death caused by any act or omission while acting within 
81.26 	the scope of office or employment under sections 152.22 to 152.37; and
81.27 	(2) the patient's acknowledgment that enrollment in the patient registry program is 
81.28 	conditional on the patient's agreement to meet all of the requirements of sections 152.22 to 
81.29 	152.37.

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

82.1 	Sec. 35. Minnesota Statutes 2020, section 152.27, subdivision 4, is amended to read:
82.2 		Subd. 4.Registered designated caregiver. (a) The commissioner shall register a 
82.3 	designated caregiver for a patient if the patient's health care practitioner has certified that 
82.4 	the patient, in the health care practitioner's medical opinion, is developmentally or physically 
82.5 	disabled and, as a result of that disability, the patient requires assistance in administering 
82.6 	medical cannabis or obtaining medical cannabis from a distribution facility and the caregiver 
82.7 	has agreed, in writing, to be the patient's designated caregiver. As a condition of registration 
82.8 	as a designated caregiver, the commissioner shall require the person to:
82.9 	(1) be at least 18 years of age;
82.10 	(2) agree to only possess the patient's medical cannabis for purposes of assisting the 
82.11 	patient; and
82.12 	(3) agree that if the application is approved, the person will not be a registered designated 
82.13 	caregiver for more than one patient, unless the six registered patients at one time. Patients 
82.14 	who reside in the same residence shall count as one patient.
82.15 	(b) The commissioner shall conduct a criminal background check on the designated 
82.16 	caregiver prior to registration to ensure that the person does not have a conviction for a 
82.17 	disqualifying felony offense. Any cost of the background check shall be paid by the person 
82.18 	seeking registration as a designated caregiver. A designated caregiver must have the criminal 
82.19 	background check renewed every two years.
82.20 	(c) Nothing in sections 152.22 to 152.37 shall be construed to prevent a person registered 
82.21 	as a designated caregiver from also being enrolled in the registry program as a patient and 
82.22 	possessing and using medical cannabis as a patient.

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

82.24 	Sec. 36. Minnesota Statutes 2020, section 152.28, subdivision 1, is amended to read:
82.25 		Subdivision 1.Health care practitioner duties. (a) Prior to a patient's enrollment in 
82.26 	the registry program, a health care practitioner shall:
82.27 	(1) determine, in the health care practitioner's medical judgment, whether a patient suffers 
82.28 	from a qualifying medical condition, and, if so determined, provide the patient with a 
82.29 	certification of that diagnosis;
82.30 	(2) determine whether a patient is developmentally or physically disabled and, as a result 
82.31 	of that disability, the patient requires assistance in administering medical cannabis or 
83.1 	obtaining medical cannabis from a distribution facility, and, if so determined, include that 
83.2 	determination on the patient's certification of diagnosis;
83.3 	(3) advise patients, registered designated caregivers, and parents, legal guardians, or 
83.4 	spouses who are acting as caregivers of the existence of any nonprofit patient support groups 
83.5 	or organizations;
83.6 	(4) (3) provide explanatory information from the commissioner to patients with qualifying 
83.7 	medical conditions, including disclosure to all patients about the experimental nature of 
83.8 	therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the 
83.9 	proposed treatment; the application and other materials from the commissioner; and provide 
83.10 	patients with the Tennessen warning as required by section 13.04, subdivision 2; and
83.11 	(5) (4) agree to continue treatment of the patient's qualifying medical condition and 
83.12 	report medical findings to the commissioner.
83.13 	(b) Upon notification from the commissioner of the patient's enrollment in the registry 
83.14 	program, the health care practitioner shall:
83.15 	(1) participate in the patient registry reporting system under the guidance and supervision 
83.16 	of the commissioner;
83.17 	(2) report health records of the patient throughout the ongoing treatment of the patient 
83.18 	to the commissioner in a manner determined by the commissioner and in accordance with 
83.19 	subdivision 2;
83.20 	(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying 
83.21 	medical condition and, if so, issue the patient a new certification of that diagnosis; and
83.22 	(4) otherwise comply with all requirements developed by the commissioner.
83.23 	(c) A health care practitioner may conduct a patient assessment to issue a recertification 
83.24 	as required under paragraph (b), clause (3), via telemedicine as defined under section 
83.25 	62A.671, subdivision 9.
83.26 	(d) Nothing in this section requires a health care practitioner to participate in the registry 
83.27 	program.

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

83.29 	Sec. 37. Minnesota Statutes 2020, section 152.29, subdivision 1, is amended to read:
83.30 		Subdivision 1.Manufacturer; requirements. (a) A manufacturer may operate eight 
83.31 	distribution facilities, which may include the manufacturer's single location for cultivation, 
84.1 	harvesting, manufacturing, packaging, and processing but is not required to include that 
84.2 	location. The commissioner shall designate the geographical service areas to be served by 
84.3 	each manufacturer based on geographical need throughout the state to improve patient 
84.4 	access. A manufacturer shall not have more than two distribution facilities in each 
84.5 	geographical service area assigned to the manufacturer by the commissioner. A manufacturer 
84.6 	shall operate only one location where all cultivation, harvesting, manufacturing, packaging, 
84.7 	and processing of medical cannabis shall be conducted. This location may be one of the 
84.8 	manufacturer's distribution facility sites. The additional distribution facilities may dispense 
84.9 	medical cannabis and medical cannabis products but may not contain any medical cannabis 
84.10 	in a form other than those forms allowed under section 152.22, subdivision 6, and the 
84.11 	manufacturer shall not conduct any cultivation, harvesting, manufacturing, packaging, or 
84.12 	processing at the other distribution facility sites. Any distribution facility operated by the 
84.13 	manufacturer is subject to all of the requirements applying to the manufacturer under sections 
84.14 	152.22 to 152.37, including, but not limited to, security and distribution requirements.
84.15 	(b) A manufacturer may acquire hemp grown in this state from a hemp grower, and may 
84.16 	acquire hemp products produced by a hemp processor. A manufacturer may manufacture 
84.17 	or process hemp and hemp products into an allowable form of medical cannabis under 
84.18 	section 152.22, subdivision 6. Hemp and hemp products acquired by a manufacturer under 
84.19 	this paragraph is are subject to the same quality control program, security and testing 
84.20 	requirements, and other requirements that apply to medical cannabis under sections 152.22
84.21 	to 152.37 and Minnesota Rules, chapter 4770.
84.22 	(c) A medical cannabis manufacturer shall contract with a laboratory approved by the 
84.23 	commissioner, subject to any additional requirements set by the commissioner, for purposes 
84.24 	of testing medical cannabis manufactured or hemp or hemp products acquired by the medical 
84.25 	cannabis manufacturer as to content, contamination, and consistency to verify the medical 
84.26 	cannabis meets the requirements of section 152.22, subdivision 6. The cost of laboratory 
84.27 	testing shall be paid by the manufacturer.
84.28 	(d) The operating documents of a manufacturer must include:
84.29 	(1) procedures for the oversight of the manufacturer and procedures to ensure accurate 
84.30 	record keeping;
84.31 	(2) procedures for the implementation of appropriate security measures to deter and 
84.32 	prevent the theft of medical cannabis and unauthorized entrance into areas containing medical 
84.33 	cannabis; and
85.1 	(3) procedures for the delivery and transportation of hemp between hemp growers and 
85.2 	manufacturers and for the delivery and transportation of hemp products between hemp 
85.3 	processors and manufacturers.
85.4 	(e) A manufacturer shall implement security requirements, including requirements for 
85.5 	the delivery and transportation of hemp and hemp products, protection of each location by 
85.6 	a fully operational security alarm system, facility access controls, perimeter intrusion 
85.7 	detection systems, and a personnel identification system.
85.8 	(f) A manufacturer shall not share office space with, refer patients to a health care 
85.9 	practitioner, or have any financial relationship with a health care practitioner.
85.10 	(g) A manufacturer shall not permit any person to consume medical cannabis on the 
85.11 	property of the manufacturer.
85.12 	(h) A manufacturer is subject to reasonable inspection by the commissioner.
85.13 	(i) For purposes of sections 152.22 to 152.37, a medical cannabis manufacturer is not 
85.14 	subject to the Board of Pharmacy licensure or regulatory requirements under chapter 151.
85.15 	(j) A medical cannabis manufacturer may not employ any person who is under 21 years 
85.16 	of age or who has been convicted of a disqualifying felony offense. An employee of a 
85.17 	medical cannabis manufacturer must submit a completed criminal history records check 
85.18 	consent form, a full set of classifiable fingerprints, and the required fees for submission to 
85.19 	the Bureau of Criminal Apprehension before an employee may begin working with the 
85.20 	manufacturer. The bureau must conduct a Minnesota criminal history records check and 
85.21 	the superintendent is authorized to exchange the fingerprints with the Federal Bureau of 
85.22 	Investigation to obtain the applicant's national criminal history record information. The 
85.23 	bureau shall return the results of the Minnesota and federal criminal history records checks 
85.24 	to the commissioner.
85.25 	(k) A manufacturer may not operate in any location, whether for distribution or 
85.26 	cultivation, harvesting, manufacturing, packaging, or processing, within 1,000 feet of a 
85.27 	public or private school existing before the date of the manufacturer's registration with the 
85.28 	commissioner.
85.29 	(l) A manufacturer shall comply with reasonable restrictions set by the commissioner 
85.30 	relating to signage, marketing, display, and advertising of medical cannabis.
85.31 	(m) Before a manufacturer acquires hemp from a hemp grower or hemp products from 
85.32 	a hemp processor, the manufacturer must verify that the hemp grower or hemp processor 
85.33 	has a valid license issued by the commissioner of agriculture under chapter 18K.
86.1 	(n) Until a state-centralized, seed-to-sale system is implemented that can track a specific 
86.2 	medical cannabis plant from cultivation through testing and point of sale, the commissioner 
86.3 	shall conduct at least one unannounced inspection per year of each manufacturer that includes 
86.4 	inspection of:
86.5 	(1) business operations;
86.6 	(2) physical locations of the manufacturer's manufacturing facility and distribution 
86.7 	facilities;
86.8 	(3) financial information and inventory documentation, including laboratory testing 
86.9 	results; and
86.10 	(4) physical and electronic security alarm systems.

86.11 	Sec. 38. Minnesota Statutes 2020, section 152.29, subdivision 3, is amended to read:
86.12 		Subd. 3.Manufacturer; distribution. (a) A manufacturer shall require that employees 
86.13 	licensed as pharmacists pursuant to chapter 151 be the only employees to give final approval 
86.14 	for the distribution of medical cannabis to a patient. A manufacturer may transport medical 
86.15 	cannabis or medical cannabis products that have been cultivated, harvested, manufactured, 
86.16 	packaged, and processed by that manufacturer to another registered manufacturer for the 
86.17 	other manufacturer to distribute.
86.18 	(b) A manufacturer may distribute medical cannabis products, whether or not the products 
86.19 	have been manufactured by that manufacturer.
86.20 	(c) Prior to distribution of any medical cannabis, the manufacturer shall:
86.21 	(1) verify that the manufacturer has received the registry verification from the 
86.22 	commissioner for that individual patient;
86.23 	(2) verify that the person requesting the distribution of medical cannabis is the patient, 
86.24 	the patient's registered designated caregiver, or the patient's parent, legal guardian, or spouse 
86.25 	listed in the registry verification using the procedures described in section 152.11, subdivision 
86.26 	2d;
86.27 	(3) assign a tracking number to any medical cannabis distributed from the manufacturer;
86.28 	(4) ensure that any employee of the manufacturer licensed as a pharmacist pursuant to 
86.29 	chapter 151 has consulted with the patient to determine the proper dosage for the individual 
86.30 	patient after reviewing the ranges of chemical compositions of the medical cannabis and 
86.31 	the ranges of proper dosages reported by the commissioner. For purposes of this clause, a 
86.32 	consultation may be conducted remotely using a by secure videoconference, telephone, or 
87.1 	other remote means, so long as the employee providing the consultation is able to confirm 
87.2 	the identity of the patient, the consultation occurs while the patient is at a distribution facility,
87.3 	and the consultation adheres to patient privacy requirements that apply to health care services 
87.4 	delivered through telemedicine. A pharmacist consultation under this clause is not required 
87.5 	when a manufacturer is distributing medical cannabis to a patient according to a 
87.6 	patient-specific dosage plan established with that manufacturer and is not modifying the 
87.7 	dosage or product being distributed under that plan and the medical cannabis is distributed 
87.8 	by a pharmacy technician;
87.9 	(5) properly package medical cannabis in compliance with the United States Poison 
87.10 	Prevention Packing Act regarding child-resistant packaging and exemptions for packaging 
87.11 	for elderly patients, and label distributed medical cannabis with a list of all active ingredients 
87.12 	and individually identifying information, including:
87.13 	(i) the patient's name and date of birth;
87.14 	(ii) the name and date of birth of the patient's registered designated caregiver or, if listed 
87.15 	on the registry verification, the name of the patient's parent or legal guardian, if applicable;
87.16 	(iii) the patient's registry identification number;
87.17 	(iv) the chemical composition of the medical cannabis; and
87.18 	(v) the dosage; and
87.19 	(6) ensure that the medical cannabis distributed contains a maximum of a 90-day supply 
87.20 	of the dosage determined for that patient.
87.21 	(d) A manufacturer shall require any employee of the manufacturer who is transporting 
87.22 	medical cannabis or medical cannabis products to a distribution facility or to another 
87.23 	registered manufacturer to carry identification showing that the person is an employee of 
87.24 	the manufacturer.
87.25 	(e) A manufacturer shall distribute medical cannabis in dried raw cannabis form only 
87.26 	to a patient age 21 or older, or to the registered designated caregiver, parent, legal guardian, 
87.27 	or spouse of a patient age 21 or older.

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

88.3 	Sec. 39. Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to 
88.4 	read:
88.5 		Subd. 3b.Distribution to recipient in a motor vehicle. A manufacturer may distribute 
88.6 	medical cannabis to a patient, registered designated caregiver, or parent, legal guardian, or 
88.7 	spouse of a patient who is at the distribution facility but remains in a motor vehicle, provided:
88.8 	(1) distribution facility staff receive payment and distribute medical cannabis in a 
88.9 	designated zone that is as close as feasible to the front door of the distribution facility;
88.10 	(2) the manufacturer ensures that the receipt of payment and distribution of medical 
88.11 	cannabis are visually recorded by a closed-circuit television surveillance camera at the 
88.12 	distribution facility and provides any other necessary security safeguards;
88.13 	(3) the manufacturer does not store medical cannabis outside a restricted access area at 
88.14 	the distribution facility, and distribution facility staff transport medical cannabis from a 
88.15 	restricted access area at the distribution facility to the designated zone for distribution only 
88.16 	after confirming that the patient, designated caregiver, or parent, guardian, or spouse has 
88.17 	arrived in the designated zone;
88.18 	(4) the payment and distribution of medical cannabis take place only after a pharmacist 
88.19 	consultation takes place, if required under subdivision 3, paragraph (c), clause (4);
88.20 	(5) immediately following distribution of medical cannabis, distribution facility staff 
88.21 	enter the transaction in the state medical cannabis registry information technology database; 
88.22 	and
88.23 	(6) immediately following distribution of medical cannabis, distribution facility staff 
88.24 	take the payment received into the distribution facility.

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

88.26 	Sec. 40. Minnesota Statutes 2020, section 152.29, is amended by adding a subdivision to 
88.27 	read:
88.28 		Subd. 3c.Disposal of medical cannabis plant root balls. Notwithstanding Minnesota 
88.29 	Rules, part 4770.1200, subpart 2, item C, a manufacturer is not required to grind root balls 
88.30 	of medical cannabis plants or incorporate them with a greater quantity of nonconsumable 
88.31 	solid waste before transporting root balls to another location for disposal. For purposes of 
89.1 	this subdivision, "root ball" means a compact mass of roots formed by a plant and any 
89.2 	attached growing medium.

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

89.4 	Sec. 41. Minnesota Statutes 2020, section 152.31, is amended to read:
89.5 	152.31 DATA PRACTICES.
89.6 	(a) Government data in patient files maintained by the commissioner and the health care 
89.7 	practitioner, and data submitted to or by a medical cannabis manufacturer, are private data 
89.8 	on individuals, as defined in section 13.02, subdivision 12, or nonpublic data, as defined in 
89.9 	section 13.02, subdivision 9, but may be used for purposes of complying with chapter 13 
89.10 	and complying with a request from the legislative auditor or the state auditor in the 
89.11 	performance of official duties. The provisions of section 13.05, subdivision 11, apply to a 
89.12 	registration agreement entered between the commissioner and a medical cannabis 
89.13 	manufacturer under section 152.25.
89.14 	(b) Not public data maintained by the commissioner may not be used for any purpose 
89.15 	not provided for in sections 152.22 to 152.37, and may not be combined or linked in any 
89.16 	manner with any other list, dataset, or database.
89.17 	(c) The commissioner may execute data sharing arrangements with the commissioner 
89.18 	of agriculture to verify licensing, inspection, and compliance information related to hemp 
89.19 	growers and hemp processors under chapter 18K.

89.20 	Sec. 42. Minnesota Statutes 2020, section 157.22, is amended to read:
89.21 	157.22 EXEMPTIONS.
89.22 	This chapter does not apply to:
89.23 	(1) interstate carriers under the supervision of the United States Department of Health 
89.24 	and Human Services;
89.25 	(2) weddings, fellowship meals, or funerals conducted by a faith-based organization 
89.26 	using any building constructed and primarily used for religious worship or education;
89.27 	(3) any building owned, operated, and used by a college or university in accordance 
89.28 	with health regulations promulgated by the college or university under chapter 14;
89.29 	(4) any person, firm, or corporation whose principal mode of business is licensed under 
89.30 	sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food or beverage 
89.31 	establishment; provided that the holding of any license pursuant to sections 28A.04 and 
90.1 	28A.05 shall not exempt any person, firm, or corporation from the applicable provisions of 
90.2 	this chapter or the rules of the state commissioner of health relating to food and beverage 
90.3 	service establishments;
90.4 	(5) family day care homes and group family day care homes governed by sections 
90.5 	245A.01 to 245A.16;
90.6 	(6) nonprofit senior citizen centers for the sale of home-baked goods;
90.7 	(7) fraternal, sportsman, or patriotic organizations that are tax exempt under section 
90.8 	501(c)(3), 501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue 
90.9 	Code of 1986, or organizations related to, affiliated with, or supported by such fraternal, 
90.10 	sportsman, or patriotic organizations for events held in the building or on the grounds of 
90.11 	the organization and at which home-prepared food is donated by organization members for 
90.12 	sale at the events, provided:
90.13 	(i) the event is not a circus, carnival, or fair;
90.14 	(ii) the organization controls the admission of persons to the event, the event agenda, or 
90.15 	both; and
90.16 	(iii) the organization's licensed kitchen is not used in any manner for the event;
90.17 	(8) food not prepared at an establishment and brought in by individuals attending a 
90.18 	potluck event for consumption at the potluck event. An organization sponsoring a potluck 
90.19 	event under this clause may advertise the potluck event to the public through any means. 
90.20 	Individuals who are not members of an organization sponsoring a potluck event under this 
90.21 	clause may attend the potluck event and consume the food at the event. Licensed food 
90.22 	establishments other than schools cannot be sponsors of potluck events. A school may 
90.23 	sponsor and hold potluck events in areas of the school other than the school's kitchen, 
90.24 	provided that the school's kitchen is not used in any manner for the potluck event. For 
90.25 	purposes of this clause, "school" means a public school as defined in section 120A.05, 
90.26 	subdivisions 9, 11, 13, and 17, or a nonpublic school, church, or religious organization at 
90.27 	which a child is provided with instruction in compliance with sections 120A.22 and 120A.24. 
90.28 	Potluck event food shall not be brought into a licensed food establishment kitchen;
90.29 	(9) a home school in which a child is provided instruction at home;
90.30 	(10) school concession stands serving commercially prepared, nonpotentially hazardous 
90.31 	foods, as defined in Minnesota Rules, chapter 4626;
91.1 	(11) group residential facilities of ten or fewer beds licensed by the commissioner of 
91.2 	human services under Minnesota Rules, chapter 2960, provided the facility employs or 
91.3 	contracts with a certified food manager under Minnesota Rules, part 4626.2015;
91.4 	(12) food served at fund-raisers or community events conducted in the building or on 
91.5 	the grounds of a faith-based organization, provided that a certified food manager, or a 
91.6 	volunteer trained in a food safety course, trains the food preparation workers in safe food 
91.7 	handling practices. This exemption does not apply to faith-based organizations at the state 
91.8 	agricultural society or county fairs or to faith-based organizations that choose to apply for 
91.9 	a license;
91.10 	(12) food served at fund-raisers, community events or fellowship meals conducted in 
91.11 	the building or on the grounds of a faith-based organization, provided that a certified food 
91.12 	manager or volunteer trained in a food safety course, trains the food preparation workers 
91.13 	in safe food handling practices. Food prepared during these events is allowed to be made 
91.14 	available for curbside pickup or delivered to members of the faith-based organization or 
91.15 	the community in which the faith-based organization serves. This exemption does not apply 
91.16 	to faith-based organizations at the state agricultural society or county fairs or to faith-based 
91.17 	organizations that choose to apply for a license;
91.18 	(13) food service events conducted following a disaster for purposes of feeding disaster 
91.19 	relief staff and volunteers serving commercially prepared, nonpotentially hazardous foods, 
91.20 	as defined in Minnesota Rules, chapter 4626;
91.21 	(14) chili or soup served at a chili or soup cook-off fund-raiser conducted by a 
91.22 	community-based nonprofit organization, provided:
91.23 	(i) the municipality where the event is located approves the event;
91.24 	(ii) the sponsoring organization must develop food safety rules and ensure that participants 
91.25 	follow these rules; and
91.26 	(iii) if the food is not prepared in a kitchen that is licensed or inspected, a visible sign 
91.27 	or placard must be posted that states: "These products are homemade and not subject to 
91.28 	state inspection."
91.29 	Foods exempt under this clause must be labeled to accurately reflect the name and 
91.30 	address of the person preparing the foods; and
91.31 	(15) a special event food stand or a seasonal temporary food stand provided:
91.32 	(i) the stand is located on private property with the permission of the property owner;
92.1 	(ii) the stand has gross receipts or contributions of $1,000 or less in a calendar year; and
92.2 	(iii) the operator of the stand posts a sign or placard at the site that states "The products 
92.3 	sold at this stand are not subject to state inspection or regulation." if the stand offers for sale 
92.4 	potentially hazardous food as defined in Minnesota Rules, part 4626.0020, subpart 62.

92.5 	Sec. 43. Minnesota Statutes 2020, section 256.98, subdivision 1, is amended to read:
92.6 		Subdivision 1.Wrongfully obtaining assistance. (a) A person who commits any of the 
92.7 	following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897, 
92.8 	the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program 
92.9 	formerly codified in sections 256.72 to 256.871, chapter 256B, 256D, 256I, 256J, 256K, or 
92.10 	256L, child care assistance programs, and emergency assistance programs under section 
92.11 	256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses 
92.12 	(1) to (5):
92.13 	(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a 
92.14 	willfully false statement or representation, by intentional concealment of any material fact, 
92.15 	or by impersonation or other fraudulent device, assistance or the continued receipt of 
92.16 	assistance, to include child care assistance or vouchers food benefits produced according 
92.17 	to sections 145.891 to 145.897 and MinnesotaCare services according to sections 256.9365, 
92.18 	256.94, and 256L.01 to 256L.15, to which the person is not entitled or assistance greater 
92.19 	than that to which the person is entitled;
92.20 	(2) knowingly aids or abets in buying or in any way disposing of the property of a 
92.21 	recipient or applicant of assistance without the consent of the county agency; or
92.22 	(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments 
92.23 	to which the individual is not entitled as a provider of subsidized child care, or by furnishing 
92.24 	or concurring in a willfully false claim for child care assistance.
92.25 	(b) The continued receipt of assistance to which the person is not entitled or greater than 
92.26 	that to which the person is entitled as a result of any of the acts, failure to act, or concealment 
92.27 	described in this subdivision shall be deemed to be continuing offenses from the date that 
92.28 	the first act or failure to act occurred.

92.29 	Sec. 44. Minnesota Statutes 2020, section 326.71, subdivision 4, is amended to read:
92.30 		Subd. 4.Asbestos-related work. "Asbestos-related work" means the enclosure, removal, 
92.31 	or encapsulation of asbestos-containing material in a quantity that meets or exceeds 260 
92.32 	linear feet of friable asbestos-containing material on pipes, 160 square feet of friable 
93.1 	asbestos-containing material on other facility components, or, if linear feet or square feet 
93.2 	cannot be measured, a total of 35 cubic feet of friable asbestos-containing material on or 
93.3 	off all facility components in one facility. In the case of single or multifamily residences, 
93.4 	"asbestos-related work" also means the enclosure, removal, or encapsulation of greater than 
93.5 	ten but less than 260 linear feet of friable asbestos-containing material on pipes, greater 
93.6 	than six but less than 160 square feet of friable asbestos-containing material on other facility 
93.7 	components, or, if linear feet or square feet cannot be measured, greater than one cubic foot 
93.8 	but less than 35 cubic feet of friable asbestos-containing material on or off all facility 
93.9 	components in one facility. This provision excludes asbestos-containing floor tiles and 
93.10 	sheeting, roofing materials, siding, and all ceilings with asbestos-containing material in 
93.11 	single family residences and buildings with no more than four dwelling units.
93.12 	Asbestos-related work includes asbestos abatement area preparation; enclosure, removal, 
93.13 	or encapsulation operations; and an air quality monitoring specified in rule to assure that 
93.14 	the abatement and adjacent areas are not contaminated with asbestos fibers during the project 
93.15 	and after completion.
93.16 	For purposes of this subdivision, the quantity of asbestos containingasbestos-containing
93.17 	material applies separately for every project.

93.18 	Sec. 45. Minnesota Statutes 2020, section 326.75, subdivision 1, is amended to read:
93.19 		Subdivision 1.Licensing fee. A person required to be licensed under section 326.72
93.20 	shall, before receipt of the license and before causing asbestos-related work to be performed, 
93.21 	pay the commissioner an annual license fee of $100 $105.

93.22 	Sec. 46. Minnesota Statutes 2020, section 326.75, subdivision 2, is amended to read:
93.23 		Subd. 2.Certification fee. An individual required to be certified as an asbestos worker 
93.24 	or asbestos site supervisor under section 326.73, subdivision 1, shall pay the commissioner 
93.25 	a certification fee of $50 $52.50 before the issuance of the certificate. The commissioner 
93.26 	may establish by rule fees required before the issuance of An individual required to be 
93.27 	certified as an asbestos inspector, asbestos management planner, andor asbestos project 
93.28 	designer certificates required under section 326.73, subdivisions 2, 3, and 4, shall pay the 
93.29 	commissioner a certification fee of $105 before the issuance of the certificate.

93.30 	Sec. 47. Minnesota Statutes 2020, section 326.75, subdivision 3, is amended to read:
93.31 		Subd. 3.Permit fee. Five calendar days before beginning asbestos-related work, a person 
93.32 	shall pay a project permit fee to the commissioner equal to one two percent of the total costs 
94.1 	of the asbestos-related work. For asbestos-related work performed in single or multifamily 
94.2 	residences, of greater than ten but less than 260 linear feet of asbestos-containing material 
94.3 	on pipes, or greater than six but less than 160 square feet of asbestos-containing material 
94.4 	on other facility components, a person shall pay a project permit fee of $35 to the 
94.5 	commissioner.

94.6 	Sec. 48. Laws 2008, chapter 364, section 17, is amended to read:
94.7 	Sec. 17. APPROPRIATIONS.
 94.8 	(a) $261,000 is appropriated from the state government special revenue fund to the 
94.9 	commissioner of health for the purposes of this act for fiscal year 2009. Base level funding 
94.10 	for this appropriation shall be $77,000 for fiscal years beginning on or after July 1, 2009.
94.11 	(b) Of the appropriation in paragraph (a), $116,000 in fiscal year 2009 is for the study 
94.12 	and report required in section 12, $145,000 in fiscal year 2009 shall be transferred to the 
94.13 	general fund, and $77,000 shall be transferred for each fiscal year beginning on or after July 
94.14 	1, 2009.
94.15 	(c) (a) $145,000 is appropriated from the general fund to the commissioner of human 
94.16 	services for fiscal year 2009 for the actuarial and other department costs associated with 
94.17 	additional reporting requirements for health plans and county-based purchasing plans. Base 
94.18 	level funding for this appropriation for fiscal years beginning on or after July 1, 2009, shall 
94.19 	be $135,000 each year.
94.20 	(d) (b) $96,000 is appropriated from the general fund to the commissioner of human 
94.21 	services for fiscal year 2009 for the study authorized in section 11, clause (3). This 
94.22 	appropriation is onetime.

94.23 	EFFECTIVE DATE. This section is effective July 1, 2021.

94.24 	Sec. 49. Laws 2019, First Special Session chapter 9, article 14, section 3, as amended by 
94.25 	Laws 2019, First Special Session chapter 12, section 6, is amended to read:

94.26	Sec. 3. COMMISSIONER OF HEALTH

94.2894.27
	Subdivision 1.Total Appropriation
 	$
	231,829,000
	$
	236,188,000
233,584,000

94.29	Appropriations by Fund
	
94.30		2020
	2021
	
94.3294.31
	General
	124,381,000
	126,276,000
125,881,000
	
95.1
95.2	State Government 
Special Revenue
	58,450,000
	61,367,000
59,158,000
	
95.3	Health Care Access
	37,285,000
	36,832,000
	
95.4	Federal TANF
	11,713,000
	11,713,000
	
95.5 	The amounts that may be spent for each 
95.6 	purpose are specified in the following 
95.7 	subdivisions.

95.8	Subd. 2.Health Improvement

95.9	Appropriations by Fund
	
95.1195.10
	General
	94,980,000
	96,117,000
95,722,000
	
95.12
95.13	State Government 
Special Revenue
	7,614,000
	7,558,000
6,924,000
	
95.14	Health Care Access
	37,285,000
	36,832,000
	
95.15	Federal TANF
	11,713,000
	11,713,000
	
95.16 	(a) TANF Appropriations. (1) $3,579,000 in 
95.17 	fiscal year 2020 and $3,579,000 in fiscal year 
95.18 	2021 are from the TANF fund for home 
95.19 	visiting and nutritional services under 
95.20 	Minnesota Statutes, section 145.882, 
95.21 	subdivision 7, clauses (6) and (7). Funds must 
95.22 	be distributed to community health boards 
95.23 	according to Minnesota Statutes, section 
95.24 	145A.131, subdivision 1;
95.25 	(2) $2,000,000 in fiscal year 2020 and 
95.26 	$2,000,000 in fiscal year 2021 are from the 
95.27 	TANF fund for decreasing racial and ethnic 
95.28 	disparities in infant mortality rates under 
95.29 	Minnesota Statutes, section 145.928, 
95.30 	subdivision 7;
95.31 	(3) $4,978,000 in fiscal year 2020 and 
95.32 	$4,978,000 in fiscal year 2021 are from the 
95.33 	TANF fund for the family home visiting grant 
95.34 	program under Minnesota Statutes, section 
95.35 	145A.17. $4,000,000 of the funding in each 
95.36 	fiscal year must be distributed to community 
96.1 	health boards according to Minnesota Statutes, 
96.2 	section 145A.131, subdivision 1. $978,000 of 
96.3 	the funding in each fiscal year must be 
96.4 	distributed to tribal governments according to 
96.5 	Minnesota Statutes, section 145A.14, 
96.6 	subdivision 2a;
96.7 	(4) $1,156,000 in fiscal year 2020 and 
96.8 	$1,156,000 in fiscal year 2021 are from the 
96.9 	TANF fund for family planning grants under 
96.10 	Minnesota Statutes, section 145.925; and
96.11 	(5) The commissioner may use up to 6.23 
96.12 	percent of the amounts appropriated from the 
96.13 	TANF fund each year to conduct the ongoing 
96.14 	evaluations required under Minnesota Statutes, 
96.15 	section 145A.17, subdivision 7, and training 
96.16 	and technical assistance as required under 
96.17 	Minnesota Statutes, section 145A.17, 
96.18 	subdivisions 4 and 5.
96.19 	(b) TANF Carryforward. Any unexpended 
96.20 	balance of the TANF appropriation in the first 
96.21 	year of the biennium does not cancel but is 
96.22 	available for the second year.
96.23 	(c) Comprehensive Suicide Prevention.
96.24 	$2,730,000 in fiscal year 2020 and $2,730,000 
96.25 	in fiscal year 2021 are from the general fund 
96.26 	for a comprehensive, community-based suicide 
96.27 	prevention strategy. The funds are allocated 
96.28 	as follows:
96.29 	(1) $955,000 in fiscal year 2020 and $955,000 
96.30 	in fiscal year 2021 are for community-based 
96.31 	suicide prevention grants authorized in 
96.32 	Minnesota Statutes, section 145.56, 
96.33 	subdivision 2. Specific emphasis must be 
96.34 	placed on those communities with the greatest 
97.1 	disparities. The base for this appropriation is 
97.2 	$1,291,000 in fiscal year 2022 and $1,291,000 
97.3 	in fiscal year 2023;
97.4 	(2) $683,000 in fiscal year 2020 and $683,000 
97.5 	in fiscal year 2021 are to support 
97.6 	evidence-based training for educators and 
97.7 	school staff and purchase suicide prevention 
97.8 	curriculum for student use statewide, as 
97.9 	authorized in Minnesota Statutes, section 
97.10 	145.56, subdivision 2. The base for this 
97.11 	appropriation is $913,000 in fiscal year 2022 
97.12 	and $913,000 in fiscal year 2023;
97.13 	(3) $137,000 in fiscal year 2020 and $137,000 
97.14 	in fiscal year 2021 are to implement the Zero 
97.15 	Suicide framework with up to 20 behavioral 
97.16 	and health care organizations each year to treat 
97.17 	individuals at risk for suicide and support 
97.18 	those individuals across systems of care upon 
97.19 	discharge. The base for this appropriation is 
97.20 	$205,000 in fiscal year 2022 and $205,000 in 
97.21 	fiscal year 2023;
97.22 	(4) $955,000 in fiscal year 2020 and $955,000 
97.23 	in fiscal year 2021 are to develop and fund a 
97.24 	Minnesota-based network of National Suicide 
97.25 	Prevention Lifeline, providing statewide 
97.26 	coverage. The base for this appropriation is 
97.27 	$1,321,000 in fiscal year 2022 and $1,321,000 
97.28 	in fiscal year 2023; and
97.29 	(5) the commissioner may retain up to 18.23 
97.30 	percent of the appropriation under this 
97.31 	paragraph to administer the comprehensive 
97.32 	suicide prevention strategy.
97.33 	(d) Statewide Tobacco Cessation. $1,598,000 
97.34 	in fiscal year 2020 and $2,748,000 in fiscal 
98.1 	year 2021 are from the general fund for 
98.2 	statewide tobacco cessation services under 
98.3 	Minnesota Statutes, section 144.397. The base 
98.4 	for this appropriation is $2,878,000 in fiscal 
98.5 	year 2022 and $2,878,000 in fiscal year 2023.
98.6 	(e) Health Care Access Survey. $225,000 in 
98.7 	fiscal year 2020 and $225,000 in fiscal year 
98.8 	2021 are from the health care access fund to 
98.9 	continue and improve the Minnesota Health 
98.10 	Care Access Survey. These appropriations 
98.11 	may be used in either year of the biennium.
98.12 	(f) Community Solutions for Healthy Child 
98.13 	Development Grant Program. $1,000,000 
98.14 	in fiscal year 2020 and $1,000,000 in fiscal 
98.15 	year 2021 are for the community solutions for 
98.16 	healthy child development grant program to 
98.17 	promote health and racial equity for young 
98.18 	children and their families under article 11, 
98.19 	section 107. The commissioner may use up to 
98.20 	23.5 percent of the total appropriation for 
98.21 	administration. The base for this appropriation 
98.22 	is $1,000,000 in fiscal year 2022, $1,000,000 
98.23 	in fiscal year 2023, and $0 in fiscal year 2024.
98.24 	(g) Domestic Violence and Sexual Assault 
98.25 	Prevention Program. $375,000 in fiscal year 
98.26 	2020 and $375,000 in fiscal year 2021 are 
98.27 	from the general fund for the domestic 
98.28 	violence and sexual assault prevention 
98.29 	program under article 11, section 108. This is 
98.30 	a onetime appropriation.
98.31 	(h) Skin Lightening Products Public 
98.32 	Awareness Grant Program. $100,000 in 
98.33 	fiscal year 2020 and $100,000 in fiscal year 
98.34 	2021 are from the general fund for a skin 
98.35 	lightening products public awareness and 
99.1 	education grant program. This is a onetime 
99.2 	appropriation.
99.3 	(i) Cannabinoid Products Workgroup.
99.4 	$8,000 in fiscal year 2020 is from the state 
99.5 	government special revenue fund for the 
99.6 	cannabinoid products workgroup. This is a 
99.7 	onetime appropriation.
99.8 	(j) Base Level Adjustments. The general fund 
99.9 	base is $96,742,000 in fiscal year 2022 and 
99.10 	$96,742,000 in fiscal year 2023. The health 
99.11 	care access fund base is $37,432,000 in fiscal 
99.12 	year 2022 and $36,832,000 in fiscal year 2023.

99.13	Subd. 3.Health Protection

99.14	Appropriations by Fund
	
99.15	General
	18,803,000
	19,774,000
	
99.16
99.17	State Government 
Special Revenue
	50,836,000
	53,809,000
52,234,000
	
99.18 	(a) Public Health Laboratory Equipment.
99.19 	$840,000 in fiscal year 2020 and $655,000 in 
99.20 	fiscal year 2021 are from the general fund for 
99.21 	equipment for the public health laboratory. 
99.22 	This is a onetime appropriation and is 
99.23 	available until June 30, 2023.
99.24 	(b) Base Level Adjustment. The general fund 
99.25 	base is $19,119,000 in fiscal year 2022 and 
99.26 	$19,119,000 in fiscal year 2023. The state 
99.27 	government special revenue fund base is 
99.28 	$53,782,000 in fiscal year 2022 and 
99.29 	$53,782,000 in fiscal year 2023.

99.30	Subd. 4.Health Operations
 		10,598,000
		10,385,000
	
99.31 	Base Level Adjustment. The general fund 
99.32 	base is $10,912,000 in fiscal year 2022 and 
99.33 	$10,912,000 in fiscal year 2023.

100.1 	EFFECTIVE DATE. This section is effective the day following final enactment and 
100.2 	the reductions in subdivisions 1 to 3 are onetime reductions.

100.3 	Sec. 50. Laws 2020, Seventh Special Session chapter 1, article 6, section 12, subdivision 
100.4 	4, is amended to read:
100.5 		Subd. 4.Housing with services establishment registration; conversion to an assisted 
100.6 	living facility license.  (a) Housing with services establishments registered under chapter 
100.7 	144D, providing home care services according to chapter 144A to at least one resident, and 
100.8 	intending to provide assisted living services on or after August 1, 2021, must submit an 
100.9 	application for an assisted living facility license in accordance with section 144G.12 no 
100.10 	later than June 1, 2021. The commissioner shall consider the application in accordance with 
100.11 	section 144G.16 144G.15.
100.12 	(b) Notwithstanding the housing with services contract requirements identified in section 
100.13 	144D.04, any existing housing with services establishment registered under chapter 144D 
100.14 	that does not intend to convert its registration to an assisted living facility license under this 
100.15 	chapter must provide written notice to its residents at least 60 days before the expiration of 
100.16 	its registration, or no later than May 31, 2021, whichever is earlier. The notice must:
100.17 	(1) state that the housing with services establishment does not intend to convert to an 
100.18 	assisted living facility;
100.19 	(2) include the date when the housing with services establishment will no longer provide 
100.20 	housing with services;
100.21 	(3) include the name, e-mail address, and phone number of the individual associated 
100.22 	with the housing with services establishment that the recipient of home care services may 
100.23 	contact to discuss the notice;
100.24 	(4) include the contact information consisting of the phone number, e-mail address, 
100.25 	mailing address, and website for the Office of Ombudsman for Long-Term Care and the 
100.26 	Office of Ombudsman for Mental Health and Developmental Disabilities; and
100.27 	(5) for residents who receive home and community-based waiver services under section 
100.28 	256B.49 and chapter 256S, also be provided to the resident's case manager at the same time 
100.29 	that it is provided to the resident.
100.30 	(c) A housing with services registrant that obtains an assisted living facility license, but 
100.31 	does so under a different business name as a result of reincorporation, and continues to 
100.32 	provide services to the recipient, is not subject to the 60-day notice required under paragraph 
101.1 	(b). However, the provider must otherwise provide notice to the recipient as required under 
101.2 	sections 144D.04 and 144D.045, as applicable, and section 144D.09.
101.3 	(d) All registered housing with services establishments providing assisted living under 
101.4 	sections 144G.01 to 144G.07 prior to August 1, 2021, must have an assisted living facility 
101.5 	license under this chapter.
101.6 	(e) Effective August 1, 2021, any housing with services establishment registered under 
101.7 	chapter 144D that has not converted its registration to an assisted living facility license 
101.8 	under this chapter is prohibited from providing assisted living services.

101.9 	EFFECTIVE DATE. This section is effective retroactively from December 17, 2020.

101.10 	Sec. 51. DIRECTION TO MODIFY MARRIAGE LICENSE APPLICATIONS.
 101.11 	A local registrar or a designee of the county board shall delete from the county's marriage 
101.12 	license application any space or other manner in which the applicant is required to specify 
101.13 	the applicant's race.

101.14 	ARTICLE 4
101.15 	HEALTH-RELATED LICENSING BOARDS

101.16 	Section 1. Minnesota Statutes 2020, section 151.01, subdivision 29, is amended to read:
101.17 		Subd. 29.Legend Medical gas. "Legend Medical gas" means a liquid or gaseous 
101.18 	substance used for medical purposes and that is required by federal law to be dispensed 
101.19 	only pursuant to the prescription of a licensed practitioner any gas or liquid manufactured 
101.20 	or stored in a liquefied, nonliquefied, or cryogenic state that:
101.21 	(1) has a chemical or physical action in or on the human body or animals or is used in 
101.22 	conjunction with medical gas equipment; and
101.23 	(2) is intended to be used for the diagnosis, cure, mitigation, treatment, or prevention of 
101.24 	disease.

101.25 	Sec. 2. Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to 
101.26 	read:
101.27 		Subd. 29a.Medical gas manufacturer. "Medical gas manufacturer" means any person:
101.28 	(1) originally manufacturing a medical gas by chemical reaction, physical separation, 
101.29 	compression of atmospheric air, purification, or other means;
102.1 	(2) filling a medical gas into a dispensing container via gas to gas, liquid to gas, or liquid 
102.2 	to liquid processes;
102.3 	(3) combining two or more medical gases into a container to form a medically appropriate 
102.4 	mixture; or
102.5 	(4) filling a medical gas via liquid to liquid into a final use container at the point of use.

102.6 	Sec. 3. Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to 
102.7 	read:
102.8 		Subd. 29b.Medical gas wholesaler. "Medical gas wholesaler" means any person who 
102.9 	sells a medical gas to another business or entity for the purpose of reselling or providing 
102.10 	that medical gas to the ultimate consumer or patient.

102.11 	Sec. 4. Minnesota Statutes 2020, section 151.01, is amended by adding a subdivision to 
102.12 	read:
102.13 		Subd. 29c.Medical gas dispenser. "Medical gas dispenser" means any person, other 
102.14 	than a licensed practitioner or pharmacy, who sells or provides a medical gas directly to the 
102.15 	ultimate consumer or patient via a valid prescription.

102.16 	Sec. 5. [151.191] LICENSING MEDICAL GAS FACILITIES; FEES; 
102.17 	PROHIBITIONS.
102.18 		Subdivision 1.Medical gas manufacturers; requirements. (a) No person shall act as 
102.19 	a medical gas manufacturer without first obtaining a license from the board and paying any 
102.20 	applicable fee specified in section 151.065.
102.21 	(b) Application for a medical gas manufacturer license under this section must be made 
102.22 	in a manner specified by the board.
102.23 	(c) A license must not be issued or renewed for a medical gas manufacturer unless the 
102.24 	applicant agrees to operate in a manner prescribed by federal and state law and according 
102.25 	to Minnesota Rules.
102.26 	(d) A license must not be issued or renewed for a medical gas manufacturer that is 
102.27 	required to be licensed or registered by the state in which it is physically located unless the 
102.28 	applicant supplies the board with proof of licensure or registration. The board may establish 
102.29 	standards for the licensure of a medical gas manufacturer that is not required to be licensed 
102.30 	or registered by the state in which it is physically located.
103.1 	(e) The board must require a separate license for each facility located within the state at 
103.2 	which medical gas manufacturing occurs and for each facility located outside of the state 
103.3 	at which medical gases that are shipped into the state are manufactured.
103.4 	(f) Prior to the issuance of an initial or renewed license for a medical gas manufacturing 
103.5 	facility, the board may require the facility to pass an inspection conducted by an authorized 
103.6 	representative of the board. In the case of a medical gas manufacturing facility located 
103.7 	outside of the state, the board may require the applicant to pay the cost of the inspection, 
103.8 	in addition to the license fee in section 151.065, unless the applicant furnishes the board 
103.9 	with a report, issued by the appropriate regulatory agency of the state in which the facility 
103.10 	is located, of an inspection that has occurred within the 24 months immediately preceding 
103.11 	receipt of the license application by the board. The board may deny licensure unless the 
103.12 	applicant submits documentation satisfactory to the board that any deficiencies noted in an 
103.13 	inspection report have been corrected.
103.14 	(g) A duly licensed medical gas manufacturing facility may also wholesale or dispense 
103.15 	any medical gas that is manufactured by the licensed facility, or manufactured or wholesaled 
103.16 	by another properly licensed medical gas facility, without also obtaining a medical gas 
103.17 	wholesaler license or medical gas dispenser registration.
103.18 	(h) The filling of a medical gas into a final use container, at the point of use and by liquid 
103.19 	to liquid transfer, is permitted as long as the facility used as the base of operations is duly 
103.20 	licensed as a medical gas manufacturer.
103.21 		Subd. 2.Medical gas wholesalers; requirements. (a) No person shall act as a medical 
103.22 	gas wholesaler without first obtaining a license from the board and paying any applicable 
103.23 	fee specified in section 151.065.
103.24 	(b) Application for a medical gas wholesaler license under this section must be made in 
103.25 	a manner specified by the board.
103.26 	(c) A license must not be issued or renewed for a medical gas wholesaler unless the 
103.27 	applicant agrees to operate in a manner prescribed by federal and state law and according 
103.28 	to Minnesota Rules.
103.29 	(d) A license must not be issued or renewed for a medical gas wholesaler that is required 
103.30 	to be licensed or registered by the state in which it is physically located unless the applicant 
103.31 	supplies the board with proof of licensure or registration. The board may establish standards 
103.32 	for the licensure of a medical gas wholesaler that is not required to be licensed or registered 
103.33 	by the state in which it is physically located.
104.1 	(e) The board must require a separate license for each facility located within the state at 
104.2 	which medical gas wholesaling occurs and for each facility located outside of the state from 
104.3 	which medical gases that are shipped into the state are wholesaled.
104.4 	(f) Prior to the issuance of an initial or renewed license for a medical gas wholesaling 
104.5 	facility, the board may require the facility to pass an inspection conducted by an authorized 
104.6 	representative of the board. In the case of a medical gas wholesaling facility located outside 
104.7 	of the state, the board may require the applicant to pay the cost of the inspection, in addition 
104.8 	to the license fee in section 151.065, unless the applicant furnishes the board with a report, 
104.9 	issued by the appropriate regulatory agency of the state in which the facility is located, of 
104.10 	an inspection that has occurred within the 24 months immediately preceding receipt of the 
104.11 	license application by the board. The board may deny licensure unless the applicant submits 
104.12 	documentation satisfactory to the board that any deficiencies noted in an inspection report 
104.13 	have been corrected.
104.14 	(g) A duly licensed medical gas wholesaling facility may also dispense any medical gas 
104.15 	that is manufactured or wholesaled by another properly licensed medical gas facility.
104.16 		Subd. 3.Medical gas dispensers; requirements. (a) A person or establishment not 
104.17 	licensed as a pharmacy, practitioner, medical gas manufacturer, or medical gas dispenser 
104.18 	must not engage in the dispensing of medical gases without first obtaining a registration 
104.19 	from the board and paying the applicable fee specified in section 151.065. The registration 
104.20 	must be displayed in a conspicuous place in the business for which it is issued and expires 
104.21 	on the date set by the board.
104.22 	(b) Application for a medical gas dispenser registration under this section must be made 
104.23 	in a manner specified by the board.
104.24 	(c) A registration must not be issued or renewed for a medical gas dispenser located 
104.25 	within the state unless the applicant agrees to operate in a manner prescribed by federal and 
104.26 	state law and according to the rules adopted by the board. A license must not be issued for 
104.27 	a medical gas dispenser located outside of the state unless the applicant agrees to operate 
104.28 	in a manner prescribed by federal law and, when dispensing medical gases for residents of 
104.29 	this state, the laws of this state and Minnesota Rules.
104.30 	(d) A registration must not be issued or renewed for a medical gas dispenser that is 
104.31 	required to be licensed or registered by the state in which it is physically located unless the 
104.32 	applicant supplies the board with proof of the licensure or registration. The board may 
104.33 	establish standards for the registration of a medical gas dispenser that is not required to be 
104.34 	licensed or registered by the state in which it is physically located.
105.1 	(e) The board must require a separate registration for each medical gas dispenser located 
105.2 	within the state and for each facility located outside of the state from which medical gases 
105.3 	are dispensed to residents of this state.
105.4 	(f) Prior to the issuance of an initial or renewed registration for a medical gas dispenser, 
105.5 	the board may require the medical gas dispenser to pass an inspection conducted by an 
105.6 	authorized representative of the board. In the case of a medical gas dispenser located outside 
105.7 	of the state, the board may require the applicant to pay the cost of the inspection, in addition 
105.8 	to the license fee in section 151.065, unless the applicant furnishes the board with a report, 
105.9 	issued by the appropriate regulatory agency of the state in which the facility is located, of 
105.10 	an inspection that has occurred within the 24 months immediately preceding receipt of the 
105.11 	license application by the board. The board may deny licensure unless the applicant submits 
105.12 	documentation satisfactory to the board that any deficiencies noted in an inspection report 
105.13 	have been corrected.
105.14 	(g) A facility holding a medical gas dispenser registration must not engage in the 
105.15 	manufacturing or wholesaling of medical gases, except that a medical gas dispenser may 
105.16 	transfer medical gases from one of its duly registered facilities to other duly registered 
105.17 	medical gas manufacturing, wholesaling, or dispensing facilities owned or operated by that 
105.18 	same company, without requiring a medical gas wholesaler license.

105.19 	Sec. 6. REPEALER.
 105.20 	Minnesota Statutes 2020, section 151.19, subdivision 3, is repealed.

105.21 	ARTICLE 5
105.22 	PRESCRIPTION DRUGS

105.23 	Section 1. Minnesota Statutes 2020, section 62W.11, is amended to read:
105.24 	62W.11 GAG CLAUSE PROHIBITION.
105.25 	(a) No contract between a pharmacy benefit manager or health carrier and a pharmacy 
105.26 	or pharmacist shall prohibit, restrict, or penalize a pharmacy or pharmacist from disclosing 
105.27 	to an enrollee any health care information that the pharmacy or pharmacist deems appropriate 
105.28 	regarding the nature of treatment; the risks or alternatives; the availability of alternative 
105.29 	therapies, consultations, or tests; the decision of utilization reviewers or similar persons to 
105.30 	authorize or deny services; the process that is used to authorize or deny health care services 
105.31 	or benefits; or information on financial incentives and structures used by the health carrier 
105.32 	or pharmacy benefit manager.
106.1 	(b) A pharmacy or pharmacist must provide to an enrollee information regarding the 
106.2 	enrollee's total cost for each prescription drug dispensed where part or all of the cost of the 
106.3 	prescription is being paid or reimbursed by the employer-sponsored plan or by a health 
106.4 	carrier or pharmacy benefit manager, in accordance with section 151.214, subdivision 1.
106.5 	(c) A pharmacy benefit manager or health carrier must not prohibit a pharmacist or 
106.6 	pharmacy from discussing information regarding the total cost for pharmacy services for a 
106.7 	prescription drug, including the patient's co-payment amount and, the pharmacy's own usual 
106.8 	and customary price of for the prescription drug, the pharmacy's acquisition cost for the 
106.9 	prescription drug, and the amount the pharmacy is being reimbursed by the pharmacy benefit 
106.10 	manager or health carrier for the prescription drug.
106.11 	(d) A pharmacy benefit manager must not prohibit a pharmacist or pharmacy from 
106.12 	discussing with a health carrier the amount the pharmacy is being paid or reimbursed for a 
106.13 	prescription drug by the pharmacy benefit manager or the pharmacy's acquisition cost for 
106.14 	a prescription drug.
106.15 	(d) (e) A pharmacy benefit manager or health carrier must not prohibit a pharmacist or 
106.16 	pharmacy from discussing the availability of any therapeutically equivalent alternative 
106.17 	prescription drugs or alternative methods for purchasing the prescription drug, including 
106.18 	but not limited to paying out-of-pocket the pharmacy's usual and customary price when that 
106.19 	amount is less expensive to the enrollee than the amount the enrollee is required to pay for 
106.20 	the prescription drug under the enrollee's health plan.

106.21 	Sec. 2. Minnesota Statutes 2020, section 151.555, subdivision 1, is amended to read:
106.22 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in this 
106.23 	subdivision have the meanings given.
106.24 	(b) "Central repository" means a wholesale distributor that meets the requirements under 
106.25 	subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this 
106.26 	section.
106.27 	(c) "Distribute" means to deliver, other than by administering or dispensing.
106.28 	(d) "Donor" means:
106.29 	(1) a health care facility as defined in this subdivision;
106.30 	(2) a skilled nursing facility licensed under chapter 144A;
106.31 	(3) an assisted living facility registered under chapter 144D where there is centralized 
106.32 	storage of drugs and 24-hour on-site licensed nursing coverage provided seven days a week;
107.1 	(4) a pharmacy licensed under section 151.19, and located either in the state or outside 
107.2 	the state;
107.3 	(5) a drug wholesaler licensed under section 151.47;
107.4 	(6) a drug manufacturer licensed under section 151.252; or
107.5 	(7) an individual at least 18 years of age, provided that the drug or medical supply that 
107.6 	is donated was obtained legally and meets the requirements of this section for donation.
107.7 	(e) "Drug" means any prescription drug that has been approved for medical use in the 
107.8 	United States, is listed in the United States Pharmacopoeia or National Formulary, and 
107.9 	meets the criteria established under this section for donation; or any over-the-counter 
107.10 	medication that meets the criteria established under this section for donation. This definition 
107.11 	includes cancer drugs and antirejection drugs, but does not include controlled substances, 
107.12 	as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed 
107.13 	to a patient registered with the drug's manufacturer in accordance with federal Food and 
107.14 	Drug Administration requirements.
107.15 	(f) "Health care facility" means:
107.16 	(1) a physician's office or health care clinic where licensed practitioners provide health 
107.17 	care to patients;
107.18 	(2) a hospital licensed under section 144.50;
107.19 	(3) a pharmacy licensed under section 151.19 and located in Minnesota; or
107.20 	(4) a nonprofit community clinic, including a federally qualified health center; a rural 
107.21 	health clinic; public health clinic; or other community clinic that provides health care utilizing 
107.22 	a sliding fee scale to patients who are low-income, uninsured, or underinsured.
107.23 	(g) "Local repository" means a health care facility that elects to accept donated drugs 
107.24 	and medical supplies and meets the requirements of subdivision 4.
107.25 	(h) "Medical supplies" or "supplies" means any prescription and nonprescription medical 
107.26 	supplies needed to administer a prescription drug.
107.27 	(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is 
107.28 	sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or 
107.29 	unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose 
107.30 	packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules, 
107.31 	part 6800.3750.
108.1 	(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that 
108.2 	it does not include a veterinarian.

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

108.4 	Sec. 3. Minnesota Statutes 2020, section 151.555, subdivision 7, is amended to read:
108.5 		Subd. 7.Standards and procedures for inspecting and storing donated prescription 
108.6 	drugs and supplies. (a) A pharmacist or authorized practitioner who is employed by or 
108.7 	under contract with the central repository or a local repository shall inspect all donated 
108.8 	prescription drugs and supplies before the drug or supply is dispensed to determine, to the 
108.9 	extent reasonably possible in the professional judgment of the pharmacist or practitioner, 
108.10 	that the drug or supply is not adulterated or misbranded, has not been tampered with, is safe 
108.11 	and suitable for dispensing, has not been subject to a recall, and meets the requirements for 
108.12 	donation. The pharmacist or practitioner who inspects the drugs or supplies shall sign an 
108.13 	inspection record stating that the requirements for donation have been met. If a local 
108.14 	repository receives drugs and supplies from the central repository, the local repository does 
108.15 	not need to reinspect the drugs and supplies.
108.16 	(b) The central repository and local repositories shall store donated drugs and supplies 
108.17 	in a secure storage area under environmental conditions appropriate for the drug or supply 
108.18 	being stored. Donated drugs and supplies may not be stored with nondonated inventory. If 
108.19 	donated drugs or supplies are not inspected immediately upon receipt, a repository must 
108.20 	quarantine the donated drugs or supplies separately from all dispensing stock until the 
108.21 	donated drugs or supplies have been inspected and (1) approved for dispensing under the 
108.22 	program; (2) disposed of pursuant to paragraph (c); or (3) returned to the donor pursuant to 
108.23 	paragraph (d).
108.24 	(c) The central repository and local repositories shall dispose of all prescription drugs 
108.25 	and medical supplies that are not suitable for donation in compliance with applicable federal 
108.26 	and state statutes, regulations, and rules concerning hazardous waste.
108.27 	(d) In the event that controlled substances or prescription drugs that can only be dispensed 
108.28 	to a patient registered with the drug's manufacturer are shipped or delivered to a central or 
108.29 	local repository for donation, the shipment delivery must be documented by the repository 
108.30 	and returned immediately to the donor or the donor's representative that provided the drugs.
108.31 	(e) Each repository must develop drug and medical supply recall policies and procedures. 
108.32 	If a repository receives a recall notification, the repository shall destroy all of the drug or 
108.33 	medical supply in its inventory that is the subject of the recall and complete a record of 
109.1 	destruction form in accordance with paragraph (f). If a drug or medical supply that is the 
109.2 	subject of a Class I or Class II recall has been dispensed, the repository shall immediately 
109.3 	notify the recipient of the recalled drug or medical supply. A drug that potentially is subject 
109.4 	to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug 
109.5 	is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.
109.6 	(f) A record of destruction of donated drugs and supplies that are not dispensed under 
109.7 	subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation 
109.8 	shall be maintained by the repository for at least five two years. For each drug or supply 
109.9 	destroyed, the record shall include the following information:
109.10 	(1) the date of destruction;
109.11 	(2) the name, strength, and quantity of the drug destroyed; and
109.12 	(3) the name of the person or firm that destroyed the drug.

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

109.14 	Sec. 4. Minnesota Statutes 2020, section 151.555, subdivision 11, is amended to read:
109.15 		Subd. 11.Forms and record-keeping requirements. (a) The following forms developed 
109.16 	for the administration of this program shall be utilized by the participants of the program 
109.17 	and shall be available on the board's website:
109.18 	(1) intake application form described under subdivision 5;
109.19 	(2) local repository participation form described under subdivision 4;
109.20 	(3) local repository withdrawal form described under subdivision 4;
109.21 	(4) drug repository donor form described under subdivision 6;
109.22 	(5) record of destruction form described under subdivision 7; and
109.23 	(6) drug repository recipient form described under subdivision 8.
109.24 	(b) All records, including drug inventory, inspection, and disposal of donated prescription 
109.25 	drugs and medical supplies, must be maintained by a repository for a minimum of five two
109.26 	years. Records required as part of this program must be maintained pursuant to all applicable 
109.27 	practice acts.
109.28 	(c) Data collected by the drug repository program from all local repositories shall be 
109.29 	submitted quarterly or upon request to the central repository. Data collected may consist of 
109.30 	the information, records, and forms required to be collected under this section.
110.1 	(d) The central repository shall submit reports to the board as required by the contract 
110.2 	or upon request of the board.

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

110.4 	Sec. 5. Minnesota Statutes 2020, section 151.555, is amended by adding a subdivision to 
110.5 	read:
110.6 		Subd. 14.Cooperation. The central repository, as approved by the Board of Pharmacy, 
110.7 	may enter into an agreement with another state that has an established drug repository or 
110.8 	drug donation program if the other state's program includes regulations to ensure the purity, 
110.9 	integrity, and safety of the drugs and supplies donated, to permit the central repository to 
110.10 	offer to another state program inventory that is not needed by a Minnesota resident and to 
110.11 	accept inventory from another state program to be distributed to local repositories and 
110.12 	dispensed to Minnesota residents in accordance with this program.

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

110.14 	ARTICLE 6
110.15 	HEALTH INSURANCE

110.16 	Section 1. [62Q.097] REQUIREMENTS FOR TIMELY PROVIDER 
110.17 	CREDENTIALING.
110.18 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
110.19 	(b) "Clean application for provider credentialing" or "clean application" means an 
110.20 	application for provider credentialing submitted by a health care provider to a health plan 
110.21 	company that is complete, is in the format required by the health plan company, and includes 
110.22 	all information and substantiation required by the health plan company and does not require 
110.23 	evaluation of any identified potential quality or safety concern.
110.24 	(c) "Provider credentialing" means the process undertaken by a health plan company to 
110.25 	evaluate and approve a health care provider's education, training, residency, licenses, 
110.26 	certifications, and history of significant quality or safety concerns in order to approve the 
110.27 	health care provider to provide health care services to patients at a clinic or facility.
110.28 		Subd. 2.Time limit for credentialing determination. A health plan company that 
110.29 	receives an application for provider credentialing must:
110.30 	(1) if the application is determined to be a clean application for provider credentialing 
110.31 	and if the health care provider submitting the application or the clinic or facility at which 
111.1 	the health care provider provides services requests the information, affirm that the health 
111.2 	care provider's application is a clean application and notify the health care provider or clinic 
111.3 	or facility of the date by which the health plan company will make a determination on the 
111.4 	health care provider's application;
111.5 	(2) if the application is determined not to be a clean application, inform the health care 
111.6 	provider of the application's deficiencies or missing information or substantiation within 
111.7 	three business days after the health plan company determines the application is not a clean 
111.8 	application; and
111.9 	(3) make a determination on the health care provider's clean application within 45 days 
111.10 	after receiving the clean application unless the health plan company identifies a substantive 
111.11 	quality or safety concern in the course of provider credentialing that requires further 
111.12 	investigation. Upon notice to the health care provider, clinic, or facility, the health plan 
111.13 	company is allowed 30 additional days to investigate any quality or safety concerns.

111.14 	EFFECTIVE DATE. This section applies to applications for provider credentialing 
111.15 	submitted to a health plan company on or after January 1, 2022.

111.16 	ARTICLE 7
111.17 	TELEHEALTH

111.18 	Section 1. Minnesota Statutes 2020, section 256J.08, subdivision 21, is amended to read:
111.19 		Subd. 21.Date of application. "Date of application" means the date on which the county 
111.20 	agency receives an applicant's signed application as a signed written application, an 
111.21 	application submitted by telephone, or an application submitted through Internet telepresence.

111.22 	Sec. 2. Minnesota Statutes 2020, section 256J.09, subdivision 3, is amended to read:
111.23 		Subd. 3.Submitting application form. (a) A county agency must offer, in person or 
111.24 	by mail, the application forms prescribed by the commissioner as soon as a person makes 
111.25 	a written or oral inquiry. At that time, the county agency must:
111.26 	(1) inform the person that assistance begins with on the date that the signed application 
111.27 	is received by the county agency either as a signed written application; an application 
111.28 	submitted by telephone; or an application submitted through Internet telepresence; or on 
111.29 	the date that all eligibility criteria are met, whichever is later;
111.30 	(2) inform a person that the person may submit the application by telephone or through 
111.31 	Internet telepresence;
112.1 	(3) inform a person that when the person submits the application by telephone or through 
112.2 	Internet telepresence, the county agency must receive a signed written application within 
112.3 	30 days of the date that the person submitted the application by telephone or through Internet 
112.4 	telepresence;
112.5 	(2) (4) inform the person that any delay in submitting the application will reduce the 
112.6 	amount of assistance paid for the month of application;
112.7 	(3) (5) inform a person that the person may submit the application before an interview;
112.8 	(4) (6) explain the information that will be verified during the application process by 
112.9 	the county agency as provided in section 256J.32;
112.10 	(5) (7) inform a person about the county agency's average application processing time 
112.11 	and explain how the application will be processed under subdivision 5;
112.12 	(6) (8) explain how to contact the county agency if a person's application information 
112.13 	changes and how to withdraw the application;
112.14 	(7) (9) inform a person that the next step in the application process is an interview and 
112.15 	what a person must do if the application is approved including, but not limited to, attending 
112.16 	orientation under section 256J.45 and complying with employment and training services 
112.17 	requirements in sections 256J.515 to 256J.57;
112.18 	(8) (10) inform the person that the an interview must be conducted. The interview may 
112.19 	be conducted face-to-face in the county office or at a location mutually agreed upon, through 
112.20 	Internet telepresence, or at a location mutually agreed upon by telephone;
112.21 	(9) inform a person who has received MFIP or DWP in the past 12 months of the option 
112.22 	to have a face-to-face, Internet telepresence, or telephone interview;
112.23 	(10) (11) explain the child care and transportation services that are available under 
112.24 	paragraph (c) to enable caregivers to attend the interview, screening, and orientation; and
112.25 	(11) (12) identify any language barriers and arrange for translation assistance during 
112.26 	appointments, including, but not limited to, screening under subdivision 3a, orientation 
112.27 	under section 256J.45, and assessment under section 256J.521.
112.28 	(b) Upon receipt of a signed application, the county agency must stamp the date of receipt 
112.29 	on the face of the application. The county agency must process the application within the 
112.30 	time period required under subdivision 5. An applicant may withdraw the application at 
112.31 	any time by giving written or oral notice to the county agency. The county agency must 
112.32 	issue a written notice confirming the withdrawal. The notice must inform the applicant of 
113.1 	the county agency's understanding that the applicant has withdrawn the application and no 
113.2 	longer wants to pursue it. When, within ten days of the date of the agency's notice, an 
113.3 	applicant informs a county agency, in writing, that the applicant does not wish to withdraw 
113.4 	the application, the county agency must reinstate the application and finish processing the 
113.5 	application.
113.6 	(c) Upon a participant's request, the county agency must arrange for transportation and 
113.7 	child care or reimburse the participant for transportation and child care expenses necessary 
113.8 	to enable participants to attend the screening under subdivision 3a and orientation under 
113.9 	section 256J.45.

113.10 	Sec. 3. Minnesota Statutes 2020, section 256J.45, subdivision 1, is amended to read:
113.11 		Subdivision 1.County agency to provide orientation. A county agency must provide 
113.12 	a face-to-face an orientation to each MFIP caregiver unless the caregiver is:
113.13 	(1) a single parent, or one parent in a two-parent family, employed at least 35 hours per 
113.14 	week; or
113.15 	(2) a second parent in a two-parent family who is employed for 20 or more hours per 
113.16 	week provided the first parent is employed at least 35 hours per week.
113.17 	The county agency must inform caregivers who are not exempt under clause (1) or (2) that 
113.18 	failure to attend the orientation is considered an occurrence of noncompliance with program 
113.19 	requirements, and will result in the imposition of a sanction under section 256J.46. If the 
113.20 	client complies with the orientation requirement prior to the first day of the month in which 
113.21 	the grant reduction is proposed to occur, the orientation sanction shall be lifted.

113.22 	Sec. 4. Minnesota Statutes 2020, section 256J.95, subdivision 5, is amended to read:
113.23 		Subd. 5.Submitting application form. The eligibility date for the diversionary work 
113.24 	program begins with on the date that the signed combined application form (CAF) is received 
113.25 	by the county agency either as a signed written application; an application submitted by 
113.26 	telephone; or an application submitted through Internet telepresence; or on the date that 
113.27 	diversionary work program eligibility criteria are met, whichever is later. The county agency 
113.28 	must inform an applicant that when the applicant submits the application by telephone or 
113.29 	through Internet telepresence, the county agency must receive a signed written application 
113.30 	within 30 days of the date that the applicant submitted the application by telephone or 
113.31 	through Internet telepresence. The county agency must inform the applicant that any delay 
113.32 	in submitting the application will reduce the benefits paid for the month of application. The 
114.1 	county agency must inform a person that an application may be submitted before the person 
114.2 	has an interview appointment. Upon receipt of a signed application, the county agency must 
114.3 	stamp the date of receipt on the face of the application. The applicant may withdraw the 
114.4 	application at any time prior to approval by giving written or oral notice to the county 
114.5 	agency. The county agency must follow the notice requirements in section 256J.09, 
114.6 	subdivision 3, when issuing a notice confirming the withdrawal.

114.7 	ARTICLE 8
114.8 	ECONOMIC SUPPORTS

114.9 	Section 1. Minnesota Statutes 2020, section 256E.34, subdivision 1, is amended to read:
114.10 		Subdivision 1.Distribution of appropriation. The commissioner must distribute funds 
114.11 	appropriated to the commissioner by law for that purpose to Hunger Solutions, a statewide 
114.12 	association of food shelves organized as a nonprofit corporation as defined under section 
114.13 	501(c)(3) of the Internal Revenue Code of 1986, to distribute to qualifying food shelves. A 
114.14 	food shelf qualifies under this section if:
114.15 	(1) it is a nonprofit corporation, or is affiliated with a nonprofit corporation, as defined 
114.16 	in section 501(c)(3) of the Internal Revenue Code of 1986 or a federally recognized Tribal 
114.17 	nation;
114.18 	(2) it distributes standard food orders without charge to needy individuals. The standard 
114.19 	food order must consist of at least a two-day supply or six pounds per person of nutritionally 
114.20 	balanced food items;
114.21 	(3) it does not limit food distributions to individuals of a particular religious affiliation, 
114.22 	race, or other criteria unrelated to need or to requirements necessary to administration of a 
114.23 	fair and orderly distribution system;
114.24 	(4) it does not use the money received or the food distribution program to foster or 
114.25 	advance religious or political views; and
114.26 	(5) it has a stable address and directly serves individuals.

114.27 	EFFECTIVE DATE. This section is effective July 1, 2021.

114.28 	Sec. 2. Minnesota Statutes 2020, section 256J.30, subdivision 8, is amended to read:
114.29 		Subd. 8.Late MFIP household report forms. (a) Paragraphs (b) to (e) apply to the 
114.30 	reporting requirements in subdivision 7.
115.1 	(b) When the county agency receives an incomplete MFIP household report form, the 
115.2 	county agency must immediately return the incomplete form and clearly state what the 
115.3 	caregiver must do for the form to be complete contact the caregiver by phone or in writing 
115.4 	to acquire the necessary information to complete the form.
115.5 	(c) The automated eligibility system must send a notice of proposed termination of 
115.6 	assistance to the assistance unit if a complete MFIP household report form is not received 
115.7 	by a county agency. The automated notice must be mailed to the caregiver by approximately 
115.8 	the 16th of the month. When a caregiver submits an incomplete form on or after the date a 
115.9 	notice of proposed termination has been sent, the termination is valid unless the caregiver 
115.10 	submits a complete form before the end of the month.
115.11 	(d) An assistance unit required to submit an MFIP household report form is considered 
115.12 	to have continued its application for assistance if a complete MFIP household report form 
115.13 	is received within a calendar month after the month in which the form was due and assistance 
115.14 	shall be paid for the period beginning with the first day of that calendar month.
115.15 	(e) A county agency must allow good cause exemptions from the reporting requirements 
115.16 	under subdivision 5 when any of the following factors cause a caregiver to fail to provide 
115.17 	the county agency with a completed MFIP household report form before the end of the 
115.18 	month in which the form is due:
115.19 	(1) an employer delays completion of employment verification;
115.20 	(2) a county agency does not help a caregiver complete the MFIP household report form 
115.21 	when the caregiver asks for help;
115.22 	(3) a caregiver does not receive an MFIP household report form due to mistake on the 
115.23 	part of the department or the county agency or due to a reported change in address;
115.24 	(4) a caregiver is ill, or physically or mentally incapacitated; or
115.25 	(5) some other circumstance occurs that a caregiver could not avoid with reasonable 
115.26 	care which prevents the caregiver from providing a completed MFIP household report form 
115.27 	before the end of the month in which the form is due.

115.28 	EFFECTIVE DATE. This section is effective July 1, 2021.

115.29 	Sec. 3. Minnesota Statutes 2020, section 256J.626, subdivision 1, is amended to read:
115.30 		Subdivision 1.Consolidated fund. The consolidated fund is established to support 
115.31 	counties and tribes in meeting their duties under this chapter. Counties and tribes must use 
115.32 	funds from the consolidated fund to develop programs and services that are designed to 
116.1 	improve participant outcomes as measured in section 256J.751, subdivision 2. Counties and 
116.2 	tribes that administer MFIP eligibility may use the funds for any allowable expenditures 
116.3 	under subdivision 2, including case management. Tribes that do not administer MFIP 
116.4 	eligibility may use the funds for any allowable expenditures under subdivision 2, including 
116.5 	case management, except those in subdivision 2, paragraph (a), clauses (1) and (6). All 
116.6 	payments made through the MFIP consolidated fund to support a caregiver's pursuit of 
116.7 	greater economic stability does not count when determining a family's available income.

116.8 	EFFECTIVE DATE. This section is effective July 1, 2021.

116.9 	ARTICLE 9
116.10 	CHILD PROTECTION

116.11 	Section 1. Minnesota Statutes 2020, section 256N.02, subdivision 16, is amended to read:
116.12 		Subd. 16.Permanent legal and physical custody. "Permanent legal and physical 
116.13 	custody" means: (1) a full transfer of permanent legal and physical custody of a child ordered 
116.14 	by a Minnesota juvenile court under section 260C.515, subdivision 4, to a relative ordered 
116.15 	by a Minnesota juvenile court under section 260C.515, subdivision 4, who is not the child's 
116.16 	parent as defined in section 260C.007, subdivision 25; or (2) for a child under jurisdiction 
116.17 	of a tribal court, a judicial determination under a similar provision in tribal code which 
116.18 	means that a relative will assume the duty and authority to provide care, control, and 
116.19 	protection of a child who is residing in foster care, and to make decisions regarding the 
116.20 	child's education, health care, and general welfare until adulthood. To establish eligibility 
116.21 	for Northstar kinship assistance, permanent legal and physical custody does not include 
116.22 	joint legal custody, joint physical custody, or joint legal and joint physical custody of a child 
116.23 	shared by the child's parent and relative custodian.

116.24 	Sec. 2. Minnesota Statutes 2020, section 256N.02, subdivision 17, is amended to read:
116.25 		Subd. 17.Reassessment. "Reassessment" means an update of a previous assessment 
116.26 	through the process under section 256N.24 for a child who has been continuously eligible 
116.27 	for Northstar Care for Children, or when a child identified as an at-risk child (Level A) 
116.28 	under guardianship or adoption assistance has manifested the disability upon which eligibility 
116.29 	for the agreement was based according to section 256N.25, subdivision 3, paragraph (b). 
116.30 	A reassessment may be used to update an initial assessment, a special assessment, or a 
116.31 	previous reassessment.

117.1 	Sec. 3. Minnesota Statutes 2020, section 256N.22, subdivision 1, is amended to read:
117.2 		Subdivision 1.General eligibility requirements. (a) To be eligible for Northstar kinship 
117.3 	assistance under this section, there must be a judicial determination under section 260C.515, 
117.4 	subdivision 4, that a transfer of permanent legal and physical custody to a relative who is 
117.5 	not the child's parent is in the child's best interest. For a child under jurisdiction of a tribal 
117.6 	court, a judicial determination under a similar provision in tribal code indicating that a 
117.7 	relative will assume the duty and authority to provide care, control, and protection of a child 
117.8 	who is residing in foster care, and to make decisions regarding the child's education, health 
117.9 	care, and general welfare until adulthood, and that this is in the child's best interest is 
117.10 	considered equivalent. A child whose parent shares legal, physical, or legal and physical 
117.11 	custody of the child with a relative custodian is not eligible for Northstar kinship assistance. 
117.12 	Additionally, a child must:
117.13 	(1) have been removed from the child's home pursuant to a voluntary placement 
117.14 	agreement or court order;
117.15 	(2)(i) have resided with the prospective relative custodian who has been a licensed child 
117.16 	foster parent for at least six consecutive months; or
117.17 	(ii) have received from the commissioner an exemption from the requirement in item 
117.18 	(i) that the prospective relative custodian has been a licensed child foster parent for at least 
117.19 	six consecutive months, based on a determination that:
117.20 	(A) an expedited move to permanency is in the child's best interest;
117.21 	(B) expedited permanency cannot be completed without provision of Northstar kinship 
117.22 	assistance;
117.23 	(C) the prospective relative custodian is uniquely qualified to meet the child's needs, as 
117.24 	defined in section 260C.212, subdivision 2, on a permanent basis;
117.25 	(D) the child and prospective relative custodian meet the eligibility requirements of this 
117.26 	section; and
117.27 	(E) efforts were made by the legally responsible agency to place the child with the 
117.28 	prospective relative custodian as a licensed child foster parent for six consecutive months 
117.29 	before permanency, or an explanation why these efforts were not in the child's best interests;
117.30 	(3) meet the agency determinations regarding permanency requirements in subdivision 
117.31 	2;
117.32 	(4) meet the applicable citizenship and immigration requirements in subdivision 3;
118.1 	(5) have been consulted regarding the proposed transfer of permanent legal and physical 
118.2 	custody to a relative, if the child is at least 14 years of age or is expected to attain 14 years 
118.3 	of age prior to the transfer of permanent legal and physical custody; and
118.4 	(6) have a written, binding agreement under section 256N.25 among the caregiver or 
118.5 	caregivers, the financially responsible agency, and the commissioner established prior to 
118.6 	transfer of permanent legal and physical custody.
118.7 	(b) In addition to the requirements in paragraph (a), the child's prospective relative 
118.8 	custodian or custodians must meet the applicable background study requirements in 
118.9 	subdivision 4.
118.10 	(c) To be eligible for title IV-E Northstar kinship assistance, a child must also meet any 
118.11 	additional criteria in section 473(d) of the Social Security Act. The sibling of a child who 
118.12 	meets the criteria for title IV-E Northstar kinship assistance in section 473(d) of the Social 
118.13 	Security Act is eligible for title IV-E Northstar kinship assistance if the child and sibling 
118.14 	are placed with the same prospective relative custodian or custodians, and the legally 
118.15 	responsible agency, relatives, and commissioner agree on the appropriateness of the 
118.16 	arrangement for the sibling. A child who meets all eligibility criteria except those specific 
118.17 	to title IV-E Northstar kinship assistance is entitled to Northstar kinship assistance paid 
118.18 	through funds other than title IV-E.

118.19 	Sec. 4. Minnesota Statutes 2020, section 256N.23, subdivision 2, is amended to read:
118.20 		Subd. 2.Special needs determination. (a) A child is considered a child with special 
118.21 	needs under this section if the requirements in paragraphs (b) to (g) are met.
118.22 	(b) There must be a determination that the child must not or should not be returned to 
118.23 	the home of the child's parents as evidenced by:
118.24 	(1) a court-ordered termination of parental rights;
118.25 	(2) a petition to terminate parental rights;
118.26 	(3) consent of the child's parent to adoption accepted by the court under chapter 260C
118.27 	or, in the case of a child receiving Northstar kinship assistance payments under section 
118.28 	256N.22, consent of the child's parent to the child's adoption executed under chapter 259;
118.29 	(4) in circumstances when tribal law permits the child to be adopted without a termination 
118.30 	of parental rights, a judicial determination by a tribal court indicating the valid reason why 
118.31 	the child cannot or should not return home;
119.1 	(5) a voluntary relinquishment under section 259.25or 259.47 or, if relinquishment 
119.2 	occurred in another state, the applicable laws in that state; or
119.3 	(6) the death of the legal parent or parents if the child has two legal parents.
119.4 	(c) There exists a specific factor or condition of which it is reasonable to conclude that 
119.5 	the child cannot be placed with adoptive parents without providing adoption assistance as 
119.6 	evidenced by:
119.7 	(1) a determination by the Social Security Administration that the child meets all medical 
119.8 	or disability requirements of title XVI of the Social Security Act with respect to eligibility 
119.9 	for Supplemental Security Income benefits;
119.10 	(2) a documented physical, mental, emotional, or behavioral disability not covered under 
119.11 	clause (1);
119.12 	(3) a member of a sibling group being adopted at the same time by the same parent;
119.13 	(4) an adoptive placement in the home of a parent who previously adopted a sibling for 
119.14 	whom they receive adoption assistance; or
119.15 	(5) documentation that the child is an at-risk child.
119.16 	(d) A reasonable but unsuccessful effort must have been made to place the child with 
119.17 	adoptive parents without providing adoption assistance as evidenced by:
119.18 	(1) a documented search for an appropriate adoptive placement; or
119.19 	(2) a determination by the commissioner that a search under clause (1) is not in the best 
119.20 	interests of the child.
119.21 	(e) The requirement for a documented search for an appropriate adoptive placement 
119.22 	under paragraph (d), including the registration of the child with the state adoption exchange 
119.23 	and other recruitment methods under paragraph (f), must be waived if:
119.24 	(1) the child is being adopted by a relative and it is determined by the child-placing 
119.25 	agency that adoption by the relative is in the best interests of the child;
119.26 	(2) the child is being adopted by a foster parent with whom the child has developed 
119.27 	significant emotional ties while in the foster parent's care as a foster child and it is determined 
119.28 	by the child-placing agency that adoption by the foster parent is in the best interests of the 
119.29 	child; or
120.1 	(3) the child is being adopted by a parent that previously adopted a sibling of the child, 
120.2 	and it is determined by the child-placing agency that adoption by this parent is in the best 
120.3 	interests of the child.
120.4 	For an Indian child covered by the Indian Child Welfare Act, a waiver must not be 
120.5 	granted unless the child-placing agency has complied with the placement preferences required 
120.6 	by the Indian Child Welfare Act, United States Code, title 25, section 1915(a).
120.7 	(f) To meet the requirement of a documented search for an appropriate adoptive placement 
120.8 	under paragraph (d), clause (1), the child-placing agency minimally must:
120.9 	(1) conduct a relative search as required by section 260C.221 and give consideration to 
120.10 	placement with a relative, as required by section 260C.212, subdivision 2;
120.11 	(2) comply with the placement preferences required by the Indian Child Welfare Act 
120.12 	when the Indian Child Welfare Act, United States Code, title 25, section 1915(a), applies;
120.13 	(3) locate prospective adoptive families by registering the child on the state adoption 
120.14 	exchange, as required under section 259.75; and
120.15 	(4) if registration with the state adoption exchange does not result in the identification 
120.16 	of an appropriate adoptive placement, the agency must employ additional recruitment 
120.17 	methods prescribed by the commissioner.
120.18 	(g) Once the legally responsible agency has determined that placement with an identified 
120.19 	parent is in the child's best interests and made full written disclosure about the child's social 
120.20 	and medical history, the agency must ask the prospective adoptive parent if the prospective 
120.21 	adoptive parent is willing to adopt the child without receiving adoption assistance under 
120.22 	this section. If the identified parent is either unwilling or unable to adopt the child without 
120.23 	adoption assistance, the legally responsible agency must provide documentation as prescribed 
120.24 	by the commissioner to fulfill the requirement to make a reasonable effort to place the child 
120.25 	without adoption assistance. If the identified parent is willing to adopt the child without 
120.26 	adoption assistance, the parent must provide a written statement to this effect to the legally 
120.27 	responsible agency and the statement must be maintained in the permanent adoption record 
120.28 	of the legally responsible agency. For children under guardianship of the commissioner, 
120.29 	the legally responsible agency shall submit a copy of this statement to the commissioner to 
120.30 	be maintained in the permanent adoption record.

120.31 	Sec. 5. Minnesota Statutes 2020, section 256N.23, subdivision 6, is amended to read:
120.32 		Subd. 6.Exclusions. The commissioner must not enter into an adoption assistance 
120.33 	agreement with the following individuals:
121.1 	(1) a child's biological parent or stepparent;
121.2 	(2) a child's relative under section 260C.007, subdivision 26b or 27, with whom the 
121.3 	child resided immediately prior to child welfare involvement unless:
121.4 	(i) the child was in the custody of a Minnesota county or tribal agency pursuant to an 
121.5 	order under chapter 260C or equivalent provisions of tribal code and the agency had 
121.6 	placement and care responsibility for permanency planning for the child; and
121.7 	(ii) the child is under guardianship of the commissioner of human services according to 
121.8 	the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota tribal 
121.9 	court after termination of parental rights, suspension of parental rights, or a finding by the 
121.10 	tribal court that the child cannot safely return to the care of the parent;
121.11 	(3) an individual adopting a child who is the subject of a direct adoptive placement under 
121.12 	section 259.47 or the equivalent in tribal code;
121.13 	(4) a child's legal custodian or guardian who is now adopting the child, except for a 
121.14 	relative custodian as defined in section 256N.02, subdivision 19, who is currently receiving 
121.15 	Northstar kinship assistance benefits on behalf of the child; or
121.16 	(5) an individual who is adopting a child who is not a citizen or resident of the United 
121.17 	States and was either adopted in another country or brought to the United States for the 
121.18 	purposes of adoption.

121.19 	Sec. 6. Minnesota Statutes 2020, section 256N.24, subdivision 1, is amended to read:
121.20 		Subdivision 1.Assessment. (a) Each child eligible under sections 256N.21, 256N.22, 
121.21 	and 256N.23, must be assessed to determine the benefits the child may receive under section 
121.22 	256N.26, in accordance with the assessment tool, process, and requirements specified in 
121.23 	subdivision 2.
121.24 	(b) If an agency applies the emergency foster care rate for initial placement under section 
121.25 	256N.26, the agency may wait up to 30 days to complete the initial assessment.
121.26 	(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic 
121.27 	level, level B, or one of ten supplemental difficulty of care levels, levels C to L.
121.28 	(d) An assessment must not be completed for:
121.29 	(1) a child eligible for Northstar kinship assistance under section 256N.22 or adoption 
121.30 	assistance under section 256N.23 who is determined to be an at-risk child. A child under 
121.31 	this clause must be assigned level A under section 256N.26, subdivision 1; and
122.1 	(2) a child transitioning into Northstar Care for Children under section 256N.28, 
122.2 	subdivision 7, unless the commissioner determines an assessment is appropriate.

122.3 	Sec. 7. Minnesota Statutes 2020, section 256N.24, subdivision 8, is amended to read:
122.4 		Subd. 8.Completing the special assessment. (a) The special assessment must be 
122.5 	completed in consultation with the child's caregiver. Face-to-face contact with the caregiver 
122.6 	is not required to complete the special assessment.
122.7 	(b) If a new special assessment is required prior to the effective date of the Northstar 
122.8 	kinship assistance agreement, it must be completed by the financially responsible agency, 
122.9 	in consultation with the legally responsible agency if different. If the prospective relative 
122.10 	custodian is unable or unwilling to cooperate with the special assessment process, the child 
122.11 	shall be assigned the basic level, level B under section 256N.26, subdivision 3, unless the 
122.12 	child is known to be an at-risk child, in which case, the child shall be assigned level A under 
122.13 	section 256N.26, subdivision 1.
122.14 	(c) If a special assessment is required prior to the effective date of the adoption assistance 
122.15 	agreement, it must be completed by the financially responsible agency, in consultation with 
122.16 	the legally responsible agency if different. If there is no financially responsible agency, the 
122.17 	special assessment must be completed by the agency designated by the commissioner. If 
122.18 	the prospective adoptive parent is unable or unwilling to cooperate with the special 
122.19 	assessment process, the child must be assigned the basic level, level B under section 256N.26, 
122.20 	subdivision 3, unless the child is known to be an at-risk child, in which case, the child shall 
122.21 	be assigned level A under section 256N.26, subdivision 1.
122.22 	(d) Notice to the prospective relative custodians or prospective adoptive parents must 
122.23 	be provided as specified in subdivision 13.

122.24 	Sec. 8. Minnesota Statutes 2020, section 256N.24, subdivision 11, is amended to read:
122.25 		Subd. 11.Completion of reassessment. (a) The reassessment must be completed in 
122.26 	consultation with the child's caregiver. Face-to-face contact with the caregiver is not required 
122.27 	to complete the reassessment.
122.28 	(b) For foster children eligible under section 256N.21, reassessments must be completed 
122.29 	by the financially responsible agency, in consultation with the legally responsible agency 
122.30 	if different.
122.31 	(c) If reassessment is required after the effective date of the Northstar kinship assistance 
122.32 	agreement, the reassessment must be completed by the financially responsible agency.
123.1 	(d) If a reassessment is required after the effective date of the adoption assistance 
123.2 	agreement, it must be completed by the financially responsible agency or, if there is no 
123.3 	financially responsible agency, the agency designated by the commissioner.
123.4 	(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment, the 
123.5 	child must be assessed at level B under section 256N.26, subdivision 3, unless the child has 
123.6 	an a Northstar adoption assistance or Northstar kinship assistance agreement in place and 
123.7 	is known to be an at-risk child, in which case the child must be assessed at level A under 
123.8 	section 256N.26, subdivision 1.

123.9 	Sec. 9. Minnesota Statutes 2020, section 256N.24, subdivision 12, is amended to read:
123.10 		Subd. 12.Approval of initial assessments, special assessments, and reassessments. (a) 
123.11 	Any agency completing initial assessments, special assessments, or reassessments must 
123.12 	designate one or more supervisors or other staff to examine and approve assessments 
123.13 	completed by others in the agency under subdivision 2. The person approving an assessment 
123.14 	must not be the case manager or staff member completing that assessment.
123.15 	(b) In cases where a special assessment or reassessment for guardian Northstar kinship
123.16 	assistance and adoption assistance is required under subdivision 8 or 11, the commissioner 
123.17 	shall review and approve the assessment as part of the eligibility determination process 
123.18 	outlined in section 256N.22, subdivision 7, for Northstar kinship assistance, or section 
123.19 	256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum 
123.20 	for of the negotiated agreement amount under section 256N.25.
123.21 	(c) The new rate is effective the calendar month that the assessment is approved, or the 
123.22 	effective date of the agreement, whichever is later.

123.23 	Sec. 10. Minnesota Statutes 2020, section 256N.24, subdivision 14, is amended to read:
123.24 		Subd. 14.Assessment tool determines rate of benefits. The assessment tool established 
123.25 	by the commissioner in subdivision 2 determines the monthly benefit level for children in 
123.26 	foster care. The monthly payment for guardian Northstar kinship assistance or adoption 
123.27 	assistance may be negotiated up to the monthly benefit level under foster care for those 
123.28 	children eligible for a payment under section 256N.26, subdivision 1.

123.29 	Sec. 11. Minnesota Statutes 2020, section 256N.25, subdivision 1, is amended to read:
123.30 		Subdivision 1.Agreement; Northstar kinship assistance; adoption assistance. (a) In 
123.31 	order to receive Northstar kinship assistance or adoption assistance benefits on behalf of 
123.32 	an eligible child, a written, binding agreement between the caregiver or caregivers, the 
124.1 	financially responsible agency, or, if there is no financially responsible agency, the agency 
124.2 	designated by the commissioner, and the commissioner must be established prior to 
124.3 	finalization of the adoption or a transfer of permanent legal and physical custody. The 
124.4 	agreement must be negotiated with the caregiver or caregivers under subdivision 2 and 
124.5 	renegotiated under subdivision 3, if applicable.
124.6 	(b) The agreement must be on a form approved by the commissioner and must specify 
124.7 	the following:
124.8 	(1) duration of the agreement;
124.9 	(2) the nature and amount of any payment, services, and assistance to be provided under 
124.10 	such agreement;
124.11 	(3) the child's eligibility for Medicaid services;
124.12 	(4) the terms of the payment, including any child care portion as specified in section 
124.13 	256N.24, subdivision 3;
124.14 	(5) eligibility for reimbursement of nonrecurring expenses associated with adopting or 
124.15 	obtaining permanent legal and physical custody of the child, to the extent that the total cost 
124.16 	does not exceed $2,000 per child pursuant to subdivision 1a;
124.17 	(6) that the agreement must remain in effect regardless of the state of which the adoptive 
124.18 	parents or relative custodians are residents at any given time;
124.19 	(7) provisions for modification of the terms of the agreement, including renegotiation 
124.20 	of the agreement;
124.21 	(8) the effective date of the agreement; and
124.22 	(9) the successor relative custodian or custodians for Northstar kinship assistance, when 
124.23 	applicable. The successor relative custodian or custodians may be added or changed by 
124.24 	mutual agreement under subdivision 3.
124.25 	(c) The caregivers, the commissioner, and the financially responsible agency, or, if there 
124.26 	is no financially responsible agency, the agency designated by the commissioner, must sign 
124.27 	the agreement. A copy of the signed agreement must be given to each party. Once signed 
124.28 	by all parties, the commissioner shall maintain the official record of the agreement.
124.29 	(d) The effective date of the Northstar kinship assistance agreement must be the date of 
124.30 	the court order that transfers permanent legal and physical custody to the relative. The 
124.31 	effective date of the adoption assistance agreement is the date of the finalized adoption 
124.32 	decree.
125.1 	(e) Termination or disruption of the preadoptive placement or the foster care placement 
125.2 	prior to assignment of custody makes the agreement with that caregiver void.

125.3 	EFFECTIVE DATE. This section is effective August 1, 2021.

125.4 	Sec. 12. Minnesota Statutes 2020, section 256N.25, is amended by adding a subdivision 
125.5 	to read:
125.6 		Subd. 1a.Reimbursement of nonrecurring expenses. (a) The commissioner of human 
125.7 	services must reimburse a relative custodian with a fully executed Northstar kinship assistance 
125.8 	benefit agreement for costs that the relative custodian incurs while seeking permanent legal 
125.9 	and physical custody of a child who is the subject of a Northstar kinship assistance benefit 
125.10 	agreement. The commissioner must reimburse a relative custodian for expenses that are 
125.11 	reasonable and necessary that the relative incurs during the transfer of permanent legal and 
125.12 	physical custody of a child to the relative custodian, subject to a maximum of $2,000. To 
125.13 	be eligible for reimbursement, the expenses must directly relate to the legal transfer of 
125.14 	permanent legal and physical custody of the child to the relative custodian, must not have 
125.15 	been incurred by the relative custodian in violation of state or federal law, and must not 
125.16 	have been reimbursed from other sources or funds. The relative custodian must submit 
125.17 	reimbursement requests to the commissioner within 21 months of the date of the child's 
125.18 	finalized transfer of permanent legal and physical custody, and the relative custodian must 
125.19 	follow all requirements and procedures that the commissioner prescribes.
125.20 	(b) The commissioner of human services must reimburse an adoptive parent for costs 
125.21 	that the adoptive parent incurs in an adoption of a child with special needs according to 
125.22 	section 256N.23, subdivision 2. The commissioner must reimburse an adoptive parent for 
125.23 	expenses that are reasonable and necessary for the adoption of the child to occur, subject 
125.24 	to a maximum of $2,000. To be eligible for reimbursement, the expenses must directly relate 
125.25 	to the legal adoption of the child, must not have been incurred by the adoptive parent in 
125.26 	violation of state or federal law, and must not have been reimbursed from other sources or 
125.27 	funds.
125.28 	(1) Children who have special needs but who are not citizens or residents of the United 
125.29 	States and were either adopted in another country or brought to this country for the purposes 
125.30 	of adoption are categorically ineligible for the reimbursement program in this section, except 
125.31 	when the child meets the eligibility criteria in this section after the dissolution of the child's 
125.32 	international adoption.
125.33 	(2) An adoptive parent, in consultation with the responsible child-placing agency, may 
125.34 	request reimbursement of nonrecurring adoption expenses by submitting a complete 
126.1 	application to the commissioner that follows the commissioner's requirements and procedures 
126.2 	on forms that the commissioner prescribes.
126.3 	(3) The commissioner must determine a child's eligibility for adoption expense 
126.4 	reimbursement under title IV-E of the Social Security Act, United States Code, title 42, 
126.5 	sections 670 to 679c. If the commissioner determines that a child is eligible, the commissioner 
126.6 	of human services must fully execute the agreement for nonrecurring adoption expense 
126.7 	reimbursement by signing the agreement. For a child to be eligible, the commissioner must 
126.8 	have fully executed the agreement for nonrecurring adoption expense reimbursement prior 
126.9 	to finalizing a child's adoption.
126.10 	(4) An adoptive parent who has a fully executed Northstar adoption assistance agreement 
126.11 	is not required to submit a separate application for reimbursement of nonrecurring adoption 
126.12 	expenses for the child who is the subject of the Northstar adoption assistance agreement.
126.13 	(5) If the commissioner has determined the child to be eligible, the adoptive parent must 
126.14 	submit reimbursement requests to the commissioner within 21 months of the date of the 
126.15 	child's adoption decree, and the adoptive parent must follow requirements and procedures 
126.16 	that the commissioner prescribes.

126.17 	EFFECTIVE DATE. This section is effective August 1, 2021.

126.18 	Sec. 13. Minnesota Statutes 2020, section 259.22, subdivision 4, is amended to read:
126.19 		Subd. 4.Time for filing petition. A petition shall be filed not later than 12 months after 
126.20 	a child is placed in a prospective adoptive home. If a petition is not filed by that time, the 
126.21 	agency that placed the child, or, in a direct adoptive placement, the agency that is supervising 
126.22 	the placement shall file with the district court in the county where the prospective adoptive 
126.23 	parent resides a motion for an order and a report recommending one of the following:
126.24 	(1) that the time for filing a petition be extended because of the child's special needs as 
126.25 	defined under title IV-E of the Social Security Act, United States Code, title 42, section 
126.26 	673;
126.27 	(2) that, based on a written plan for completing filing of the petition, including a specific 
126.28 	timeline, to which the prospective adoptive parents have agreed, the time for filing a petition 
126.29 	be extended long enough to complete the plan because such an extension is in the best 
126.30 	interests of the child and additional time is needed for the child to adjust to the adoptive 
126.31 	home; or
126.32 	(3) that the child be removed from the prospective adoptive home.
127.1 	The prospective adoptive parent must reimburse an agency for the cost of preparing and 
127.2 	filing the motion and report under this section, unless the costs are reimbursed by the 
127.3 	commissioner under section 259.73 or 259A.70 256N.25, subdivision 1a.

127.4 	EFFECTIVE DATE. This section is effective August 1, 2021.

127.5 	Sec. 14. Minnesota Statutes 2020, section 259.35, subdivision 1, is amended to read:
127.6 		Subdivision 1.Parental responsibilities. Prior to commencing an investigation of the 
127.7 	suitability of proposed adoptive parents, a child-placing agency shall give the individuals 
127.8 	the following written notice in all capital letters at least one-eighth inch high:
127.9 	"Minnesota Statutes, section 259.59, provides that upon legally adopting a child, adoptive 
127.10 	parents assume all the rights and responsibilities of birth parents. The responsibilities include 
127.11 	providing for the child's financial support and caring for health, emotional, and behavioral 
127.12 	problems. Except for subsidized adoptions under Minnesota Statutes, chapter 259A 256N, 
127.13 	or any other provisions of law that expressly apply to adoptive parents and children, adoptive 
127.14 	parents are not eligible for state or federal financial subsidies besides those that a birth 
127.15 	parent would be eligible to receive for a child. Adoptive parents may not terminate their 
127.16 	parental rights to a legally adopted child for a reason that would not apply to a birth parent 
127.17 	seeking to terminate rights to a child. An individual who takes guardianship of a child for 
127.18 	the purpose of adopting the child shall, upon taking guardianship from the child's country 
127.19 	of origin, assume all the rights and responsibilities of birth and adoptive parents as stated 
127.20 	in this paragraph."

127.21 	Sec. 15. Minnesota Statutes 2020, section 259.73, is amended to read:
127.22 	259.73 REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.
127.23 	An individual may apply for reimbursement for costs incurred in an adoption of a child 
127.24 	with special needs under section 259A.70 256N.25, subdivision 1a.

127.25 	EFFECTIVE DATE. This section is effective August 1, 2021.

127.26 	ARTICLE 10
127.27 	CHILD PROTECTION POLICY

127.28 	Section 1. Minnesota Statutes 2020, section 245.4885, subdivision 1, is amended to read:
127.29 		Subdivision 1.Admission criteria. (a) Prior to admission or placement, except in the 
127.30 	case of an emergency, all children referred for treatment of severe emotional disturbance 
127.31 	in a treatment foster care setting, residential treatment facility, or informally admitted to a 
128.1 	regional treatment center shall undergo an assessment to determine the appropriate level of 
128.2 	care if public funds are used to pay for the child's services.
128.3 	(b) The responsible social services agency shall determine the appropriate level of care 
128.4 	for a child when county-controlled funds are used to pay for the child's services or placement 
128.5 	in a qualified residential treatment facility under chapter 260C and licensed by the 
128.6 	commissioner under chapter 245A. In accordance with section 260C.157, a juvenile treatment 
128.7 	screening team shall conduct a screening of a child before the team may recommend whether 
128.8 	to place a child in a qualified residential treatment program as defined in section 260C.007, 
128.9 	subdivision 26d. When a social services agency does not have responsibility for a child's 
128.10 	placement and the child is enrolled in a prepaid health program under section 256B.69, the 
128.11 	enrolled child's contracted health plan must determine the appropriate level of care for the 
128.12 	child. When Indian Health Services funds or funds of a tribally owned facility funded under 
128.13 	the Indian Self-Determination and Education Assistance Act, Public Law 93-638, are to be 
128.14 	used for a child, the Indian Health Services or 638 tribal health facility must determine the 
128.15 	appropriate level of care for the child. When more than one entity bears responsibility for
128.16 	a child's coverage, the entities shall coordinate level of care determination activities for the 
128.17 	child to the extent possible.
128.18 	(c) The responsible social services agency must make the child's level of care 
128.19 	determination available to the child's juvenile treatment screening team, as permitted under 
128.20 	chapter 13. The level of care determination shall inform the juvenile treatment screening 
128.21 	team process and the assessment in section 260C.704 when considering whether to place 
128.22 	the child in a qualified residential treatment program. When the responsible social services 
128.23 	agency is not involved in determining a child's placement, the child's level of care 
128.24 	determination shall determine whether the proposed treatment:
128.25 	(1) is necessary;
128.26 	(2) is appropriate to the child's individual treatment needs;
128.27 	(3) cannot be effectively provided in the child's home; and
128.28 	(4) provides a length of stay as short as possible consistent with the individual child's 
128.29 	need needs.
128.30 	(d) When a level of care determination is conducted, the responsible social services 
128.31 	agency or other entity may not determine that a screening of a child under section 260C.157
128.32 	or referral or admission to a treatment foster care setting or residential treatment facility is 
128.33 	not appropriate solely because services were not first provided to the child in a less restrictive 
128.34 	setting and the child failed to make progress toward or meet treatment goals in the less 
129.1 	restrictive setting. The level of care determination must be based on a diagnostic assessment
129.2 	of a child that includes a functional assessment which evaluates the child's family, school, 
129.3 	and community living situations; and an assessment of the child's need for care out of the 
129.4 	home using a validated tool which assesses a child's functional status and assigns an 
129.5 	appropriate level of care to the child. The validated tool must be approved by the 
129.6 	commissioner of human services and may be the validated tool approved for the child's 
129.7 	assessment under section 260C.704 if the juvenile treatment screening team recommended 
129.8 	placement of the child in a qualified residential treatment program. If a diagnostic assessment 
129.9 	including a functional assessment has been completed by a mental health professional within 
129.10 	the past 180 days, a new diagnostic assessment need not be completed unless in the opinion 
129.11 	of the current treating mental health professional the child's mental health status has changed 
129.12 	markedly since the assessment was completed. The child's parent shall be notified if an 
129.13 	assessment will not be completed and of the reasons. A copy of the notice shall be placed 
129.14 	in the child's file. Recommendations developed as part of the level of care determination 
129.15 	process shall include specific community services needed by the child and, if appropriate, 
129.16 	the child's family, and shall indicate whether or not these services are available and accessible 
129.17 	to the child and the child's family.
129.18 	(e) During the level of care determination process, the child, child's family, or child's 
129.19 	legal representative, as appropriate, must be informed of the child's eligibility for case 
129.20 	management services and family community support services and that an individual family 
129.21 	community support plan is being developed by the case manager, if assigned.
129.22 	(f) When the responsible social services agency has authority, the agency must engage 
129.23 	the child's parents in case planning under sections 260C.212 and 260C.708 and chapter 
129.24 	260D unless a court terminates the parent's rights or court orders restrict the parent from 
129.25 	participating in case planning, visitation, or parental responsibilities.
129.26 	(g) The level of care determination, and placement decision, and recommendations for 
129.27 	mental health services must be documented in the child's record, as required in chapter
129.28 	chapters260C and 260D.

129.29 	EFFECTIVE DATE. This section is effective September 30, 2021.

129.30 	Sec. 2. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
129.31 	read:
129.32 		Subd. 3c.At risk of becoming a victim of sex trafficking or commercial sexual 
129.33 	exploitation. For the purposes of section 245A.25, a youth who is "at risk of becoming a 
130.1 	victim of sex trafficking or commercial sexual exploitation" means a youth who meets the 
130.2 	criteria established by the commissioner of human services for this purpose.

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

130.4 	Sec. 3. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
130.5 	read:
130.6 		Subd. 4a.Children's residential facility. "Children's residential facility" means a 
130.7 	residential program licensed under this chapter or chapter 241 according to the applicable 
130.8 	standards in Minnesota Rules, parts 2960.0010 to 2960.0710.

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

130.10 	Sec. 4. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
130.11 	read:
130.12 		Subd. 6d.Foster family setting. "Foster family setting" has the meaning given in 
130.13 	Minnesota Rules, part 2960.3010, subpart 23, and includes settings licensed by the 
130.14 	commissioner of human services or the commissioner of corrections.

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

130.16 	Sec. 5. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
130.17 	read:
130.18 		Subd. 6e.Foster residence setting. "Foster residence setting" has the meaning given 
130.19 	in Minnesota Rules, part 2960.3010, subpart 26, and includes settings licensed by the 
130.20 	commissioner of human services or the commissioner of corrections.

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

130.22 	Sec. 6. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
130.23 	read:
130.24 		Subd. 18a.Trauma. For the purposes of section 245A.25, "trauma" means an event, 
130.25 	series of events, or set of circumstances experienced by an individual as physically or 
130.26 	emotionally harmful or life-threatening and has lasting adverse effects on the individual's 
130.27 	functioning and mental, physical, social, emotional, or spiritual well-being. Trauma includes 
130.28 	the cumulative emotional or psychological harm of group traumatic experiences transmitted 
130.29 	across generations within a community that are often associated with racial and ethnic 
130.30 	population groups that have suffered major intergenerational losses.

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

131.2 	Sec. 7. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
131.3 	read:
131.4 		Subd. 23.Victim of sex trafficking or commercial sexual exploitation. For the purposes 
131.5 	of section 245A.25, "victim of sex trafficking or commercial sexual exploitation" means a 
131.6 	person who meets the definitions in section 260C.007, subdivision 31, clauses (4) and (5).

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

131.8 	Sec. 8. Minnesota Statutes 2020, section 245A.02, is amended by adding a subdivision to 
131.9 	read:
131.10 		Subd. 24.Youth. For the purposes of section 245A.25, "youth" means a child as defined 
131.11 	in section 260C.007, subdivision 4, and includes individuals under 21 years of age who are 
131.12 	in foster care pursuant to section 260C.451.

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

131.14 	Sec. 9. Minnesota Statutes 2020, section 245A.041, is amended by adding a subdivision 
131.15 	to read:
131.16 		Subd. 5.First date of working in a facility or setting; documentation 
131.17 	requirements. Children's residential facility and foster residence setting license holders 
131.18 	must document the first date that a person who is a background study subject begins working 
131.19 	in the license holder's facility or setting. If the license holder does not maintain documentation 
131.20 	of each background study subject's first date of working in the facility or setting in the 
131.21 	license holder's personnel files, the license holder must provide documentation to the 
131.22 	commissioner that contains the first date that each background study subject began working 
131.23 	in the license holder's program upon the commissioner's request.

131.24 	EFFECTIVE DATE. This section is effective August 1, 2021.

131.25 	Sec. 10. [245A.25] RESIDENTIAL PROGRAM CERTIFICATIONS FOR 
131.26 	COMPLIANCE WITH THE FAMILY FIRST PREVENTION SERVICES ACT.
131.27 		Subdivision 1.Certification scope and applicability. (a) This section establishes the 
131.28 	requirements that a children's residential facility or child foster residence setting must meet 
131.29 	to be certified for the purposes of Title IV-E funding requirements as:
131.30 	(1) a qualified residential treatment program;
132.1 	(2) a residential setting specializing in providing care and supportive services for youth 
132.2 	who have been or are at risk of becoming victims of sex trafficking or commercial sexual 
132.3 	exploitation;
132.4 	(3) a residential setting specializing in providing prenatal, postpartum, or parenting 
132.5 	support for youth; or
132.6 	(4) a supervised independent living setting for youth who are 18 years of age or older.
132.7 	(b) This section does not apply to a foster family setting in which the license holder 
132.8 	resides in the foster home.
132.9 	(c) Children's residential facilities licensed as detention settings according to Minnesota 
132.10 	Rules, parts 2960.0230 to 2960.0290, or secure programs according to Minnesota Rules, 
132.11 	parts 2960.0300 to 2960.0420, may not be certified under this section.
132.12 	(d) For purposes of this section, "license holder" means an individual, organization, or 
132.13 	government entity that was issued a children's residential facility or foster residence setting 
132.14 	license by the commissioner of human services under this chapter or by the commissioner 
132.15 	of corrections under chapter 241.
132.16 	(e) Certifications issued under this section for foster residence settings may only be 
132.17 	issued by the commissioner of human services and are not delegated to county or private 
132.18 	licensing agencies under section 245A.16.
132.19 		Subd. 2.Program certification types and requests for certification. (a) By July 1, 
132.20 	2021, the commissioner of human services must offer certifications to license holders for 
132.21 	the following types of programs:
132.22 	(1) qualified residential treatment programs;
132.23 	(2) residential settings specializing in providing care and supportive services for youth 
132.24 	who have been or are at risk of becoming victims of sex trafficking or commercial sexual 
132.25 	exploitation;
132.26 	(3) residential settings specializing in providing prenatal, postpartum, or parenting 
132.27 	support for youth; and
132.28 	(4) supervised independent living settings for youth who are 18 years of age or older.
132.29 	(b) An applicant or license holder must submit a request for certification under this 
132.30 	section on a form and in a manner prescribed by the commissioner of human services. The 
132.31 	decision of the commissioner of human services to grant or deny a certification request is 
132.32 	final and not subject to appeal under chapter 14.
133.1 		Subd. 3.Trauma-informed care. (a) Programs certified under subdivision 4 or 5 must 
133.2 	provide services to a person according to a trauma-informed model of care that meets the 
133.3 	requirements of this subdivision, except that programs certified under subdivision 5 are not 
133.4 	required to meet the requirements of paragraph (e).
133.5 	(b) For the purposes of this section, "trauma-informed care" means care that:
133.6 	(1) acknowledges the effects of trauma on a person receiving services and on the person's 
133.7 	family;
133.8 	(2) modifies services to respond to the effects of trauma on the person receiving services;
133.9 	(3) emphasizes skill and strength-building rather than symptom management; and
133.10 	(4) focuses on the physical and psychological safety of the person receiving services 
133.11 	and the person's family.
133.12 	(c) The license holder must have a process for identifying the signs and symptoms of 
133.13 	trauma in a youth and must address the youth's needs related to trauma. This process must 
133.14 	include:
133.15 	(1) screening for trauma by completing a trauma-specific screening tool with each youth 
133.16 	upon the youth's admission or obtaining the results of a trauma-specific screening tool that 
133.17 	was completed with the youth within 30 days prior to the youth's admission to the program; 
133.18 	and
133.19 	(2) ensuring that trauma-based interventions targeting specific trauma-related symptoms 
133.20 	are available to each youth when needed to assist the youth in obtaining services. For 
133.21 	qualified residential treatment programs, this must include the provision of services in 
133.22 	paragraph (e).
133.23 	(d) The license holder must develop and provide services to each youth according to the 
133.24 	principles of trauma-informed care including:
133.25 	(1) recognizing the impact of trauma on a youth when determining the youth's service 
133.26 	needs and providing services to the youth;
133.27 	(2) allowing each youth to participate in reviewing and developing the youth's 
133.28 	individualized treatment or service plan;
133.29 	(3) providing services to each youth that are person-centered and culturally responsive; 
133.30 	and
133.31 	(4) adjusting services for each youth to address additional needs of the youth.
134.1 	(e) In addition to the other requirements of this subdivision, qualified residential treatment 
134.2 	programs must use a trauma-based treatment model that includes:
134.3 	(1) assessing each youth to determine if the youth needs trauma-specific treatment 
134.4 	interventions;
134.5 	(2) identifying in each youth's treatment plan how the program will provide 
134.6 	trauma-specific treatment interventions to the youth;
134.7 	(3) providing trauma-specific treatment interventions to a youth that target the youth's 
134.8 	specific trauma-related symptoms; and
134.9 	(4) training all clinical staff of the program on trauma-specific treatment interventions.
134.10 	(f) At the license holder's program, the license holder must provide a physical, social, 
134.11 	and emotional environment that:
134.12 	(1) promotes the physical and psychological safety of each youth;
134.13 	(2) avoids aspects that may be retraumatizing;
134.14 	(3) responds to trauma experienced by each youth and the youth's other needs; and
134.15 	(4) includes designated spaces that are available to each youth for engaging in sensory 
134.16 	and self-soothing activities.
134.17 	(g) The license holder must base the program's policies and procedures on 
134.18 	trauma-informed principles. In the program's policies and procedures, the license holder 
134.19 	must:
134.20 	(1) describe how the program provides services according to a trauma-informed model 
134.21 	of care;
134.22 	(2) describe how the program's environment fulfills the requirements of paragraph (f);
134.23 	(3) prohibit the use of aversive consequences for a youth's violation of program rules 
134.24 	or any other reason;
134.25 	(4) describe the process for how the license holder incorporates trauma-informed 
134.26 	principles and practices into the organizational culture of the license holder's program; and
134.27 	(5) if the program is certified to use restrictive procedures under Minnesota Rules, part 
134.28 	2960.0710, describe how the program uses restrictive procedures only when necessary for 
134.29 	a youth in a manner that addresses the youth's history of trauma and avoids causing the 
134.30 	youth additional trauma.
135.1 	(h) Prior to allowing a staff person to have direct contact, as defined in section 245C.02, 
135.2 	subdivision 11, with a youth and annually thereafter, the license holder must train each staff 
135.3 	person about:
135.4 	(1) concepts of trauma-informed care and how to provide services to each youth according 
135.5 	to these concepts; and
135.6 	(2) impacts of each youth's culture, race, gender, and sexual orientation on the youth's 
135.7 	behavioral health and traumatic experiences.
135.8 		Subd. 4.Qualified residential treatment programs; certification requirements. (a) 
135.9 	To be certified as a qualified residential treatment program, a license holder must meet:
135.10 	(1) the definition of a qualified residential treatment program in section 260C.007, 
135.11 	subdivision 26d;
135.12 	(2) the requirements for providing trauma-informed care and using a trauma-based 
135.13 	treatment model in subdivision 3; and
135.14 	(3) the requirements of this subdivision.
135.15 	(b) For each youth placed in the license holder's program, the license holder must 
135.16 	collaborate with the responsible social services agency and other appropriate parties to 
135.17 	implement the youth's out-of-home placement plan and the youth's short-term and long-term 
135.18 	mental health and behavioral health goals in the assessment required by sections 260C.212, 
135.19 	subdivision 1; 260C.704; and 260C.708.
135.20 	(c) A qualified residential treatment program must use a trauma-based treatment model 
135.21 	that meets all of the requirements of subdivision 3 that is designed to address the needs, 
135.22 	including clinical needs, of youth with serious emotional or behavioral disorders or 
135.23 	disturbances. The license holder must develop, document, and review a treatment plan for 
135.24 	each youth according to the requirements of Minnesota Rules, parts 2960.0180, subpart 2, 
135.25 	item B; and 2960.0190, subpart 2.
135.26 	(d) The following types of staff must be on-site according to the program's treatment 
135.27 	model and must be available 24 hours a day and seven days a week to provide care within 
135.28 	the scope of their practice:
135.29 	(1) a registered nurse or licensed practical nurse licensed by the Minnesota Board of 
135.30 	Nursing to practice professional nursing or practical nursing as defined in section 148.171, 
135.31 	subdivisions 14 and 15; and
135.32 	(2) other licensed clinical staff to meet each youth's clinical needs.
136.1 	(e) A qualified residential treatment program must be accredited by one of the following 
136.2 	independent, not-for-profit organizations:
136.3 	(1) the Commission on Accreditation of Rehabilitation Facilities (CARF);
136.4 	(2) the Joint Commission;
136.5 	(3) the Council on Accreditation (COA); or
136.6 	(4) another independent, not-for-profit accrediting organization approved by the Secretary 
136.7 	of the United States Department of Health and Human Services.
136.8 	(f) The license holder must facilitate participation of a youth's family members in the 
136.9 	youth's treatment program, consistent with the youth's best interests and according to the 
136.10 	youth's out-of-home placement plan required by sections 260C.212, subdivision 1; and 
136.11 	260C.708.
136.12 	(g) The license holder must contact and facilitate outreach to each youth's family 
136.13 	members, including the youth's siblings, and must document outreach to the youth's family 
136.14 	members in the youth's file, including the contact method and each family member's contact 
136.15 	information. In the youth's file, the license holder must record and maintain the contact 
136.16 	information for all known biological family members and fictive kin of the youth.
136.17 	(h) The license holder must document in the youth's file how the program integrates 
136.18 	family members into the treatment process for the youth, including after the youth's discharge 
136.19 	from the program, and how the program maintains the youth's connections to the youth's 
136.20 	siblings.
136.21 	(i) The program must provide discharge planning and family-based aftercare support to 
136.22 	each youth for at least six months after the youth's discharge from the program. When 
136.23 	providing aftercare to a youth, the program must have monthly contact with the youth and 
136.24 	the youth's caregivers to promote the youth's engagement in aftercare services and to regularly 
136.25 	evaluate the family's needs. The program's monthly contact with the youth may be 
136.26 	face-to-face, by telephone, or virtual.
136.27 	(j) The license holder must maintain a service delivery plan that describes how the 
136.28 	program provides services according to the requirements in paragraphs (b) to (i).
136.29 		Subd. 5.Residential settings specializing in providing care and supportive services 
136.30 	for youth who have been or are at risk of becoming victims of sex trafficking or 
136.31 	commercial sexual exploitation; certification requirements. (a) To be certified as a 
136.32 	residential setting specializing in providing care and supportive services for youth who have 
137.1 	been or are at risk of becoming victims of sex trafficking or commercial sexual exploitation, 
137.2 	a license holder must meet the requirements of this subdivision.
137.3 	(b) Settings certified according to this subdivision are exempt from the requirements of 
137.4 	section 245A.04, subdivision 11, paragraph (b).
137.5 	(c) The program must use a trauma-informed model of care that meets all of the applicable 
137.6 	requirements of subdivision 3, and that is designed to address the needs, including emotional 
137.7 	and mental health needs, of youth who have been or are at risk of becoming victims of sex 
137.8 	trafficking or commercial sexual exploitation.
137.9 	(d) The program must provide high-quality care and supportive services for youth who 
137.10 	have been or are at risk of becoming victims of sex trafficking or commercial sexual 
137.11 	exploitation and must:
137.12 	(1) offer a safe setting to each youth designed to prevent ongoing and future trafficking 
137.13 	of the youth;
137.14 	(2) provide equitable, culturally responsive, and individualized services to each youth;
137.15 	(3) assist each youth with accessing medical, mental health, legal, advocacy, and family 
137.16 	services based on the youth's individual needs;
137.17 	(4) provide each youth with relevant educational, life skills, and employment supports 
137.18 	based on the youth's individual needs;
137.19 	(5) offer a trafficking prevention education curriculum and provide support for each 
137.20 	youth at risk of future sex trafficking or commercial sexual exploitation; and
137.21 	(6) engage with the discharge planning process for each youth and the youth's family.
137.22 	(e) The license holder must maintain a service delivery plan that describes how the 
137.23 	program provides services according to the requirements in paragraphs (c) and (d).
137.24 	(f) The license holder must ensure that each staff person who has direct contact, as 
137.25 	defined in section 245C.02, subdivision 11, with a youth served by the license holder's 
137.26 	program completes a human trafficking training approved by the Department of Human 
137.27 	Services' Children and Family Services Administration before the staff person has direct 
137.28 	contact with a youth served by the program and annually thereafter. For programs certified 
137.29 	prior to January 1, 2022, the license holder must ensure that each staff person at the license 
137.30 	holder's program completes the initial training by January 1, 2022.
137.31 		Subd. 6.Residential settings specializing in providing prenatal, postpartum, or 
137.32 	parenting supports for youth; certification requirements. (a) To be certified as a 
138.1 	residential setting specializing in providing prenatal, postpartum, or parenting supports for 
138.2 	youth, a license holder must meet the requirements of this subdivision.
138.3 	(b) The license holder must collaborate with the responsible social services agency and 
138.4 	other appropriate parties to implement each youth's out-of-home placement plan required 
138.5 	by section 260C.212, subdivision 1.
138.6 	(c) The license holder must specialize in providing prenatal, postpartum, or parenting 
138.7 	supports for youth and must:
138.8 	(1) provide equitable, culturally responsive, and individualized services to each youth;
138.9 	(2) assist each youth with accessing postpartum services during the same period of time 
138.10 	that a woman is considered pregnant for the purposes of medical assistance eligibility under 
138.11 	section 256B.055, subdivision 6, including providing each youth with:
138.12 	(i) sexual and reproductive health services and education; and
138.13 	(ii) a postpartum mental health assessment and follow-up services; and
138.14 	(3) discharge planning that includes the youth and the youth's family.
138.15 	(d) On or before the date of a child's initial physical presence at the facility, the license 
138.16 	holder must provide education to the child's parent related to safe bathing and reducing the 
138.17 	risk of sudden unexpected infant death and abusive head trauma from shaking infants and 
138.18 	young children. The license holder must use the educational material developed by the 
138.19 	commissioner of human services to comply with this requirement. At a minimum, the 
138.20 	education must address:
138.21 	(1) instruction that: (i) a child or infant should never be left unattended around water; 
138.22 	(ii) a tub should be filled with only two to four inches of water for infants; and (iii) an infant 
138.23 	should never be put into a tub when the water is running; and
138.24 	(2) the risk factors related to sudden unexpected infant death and abusive head trauma 
138.25 	from shaking infants and young children and means of reducing the risks, including the 
138.26 	safety precautions identified in section 245A.1435 and the risks of co-sleeping.
138.27 	The license holder must document the parent's receipt of the education and keep the 
138.28 	documentation in the parent's file. The documentation must indicate whether the parent 
138.29 	agrees to comply with the safeguards described in this paragraph. If the parent refuses to 
138.30 	comply, program staff must provide additional education to the parent as described in the 
138.31 	parental supervision plan. The parental supervision plan must include the intervention, 
139.1 	frequency, and staff responsible for the duration of the parent's participation in the program 
139.2 	or until the parent agrees to comply with the safeguards described in this paragraph.
139.3 	(e) On or before the date of a child's initial physical presence at the facility, the license 
139.4 	holder must document the parent's capacity to meet the health and safety needs of the child 
139.5 	while on the facility premises considering the following factors:
139.6 	(1) the parent's physical and mental health;
139.7 	(2) the parent being under the influence of drugs, alcohol, medications, or other chemicals;
139.8 	(3) the child's physical and mental health; and
139.9 	(4) any other information available to the license holder indicating that the parent may 
139.10 	not be able to adequately care for the child.
139.11 	(f) The license holder must have written procedures specifying the actions that staff shall 
139.12 	take if a parent is or becomes unable to adequately care for the parent's child.
139.13 	(g) If the parent refuses to comply with the safeguards described in paragraph (d) or is 
139.14 	unable to adequately care for the child, the license holder must develop a parental supervision 
139.15 	plan in conjunction with the parent. The plan must account for any factors in paragraph (e) 
139.16 	that contribute to the parent's inability to adequately care for the child. The plan must be 
139.17 	dated and signed by the staff person who completed the plan.
139.18 	(h) The license holder must have written procedures addressing whether the program 
139.19 	permits a parent to arrange for supervision of the parent's child by another youth in the 
139.20 	program. If permitted, the facility must have a procedure that requires staff approval of the 
139.21 	supervision arrangement before the supervision by the nonparental youth occurs. The 
139.22 	procedure for approval must include an assessment of the nonparental youth's capacity to 
139.23 	assume the supervisory responsibilities using the criteria in paragraph (e). The license holder 
139.24 	must document the license holder's approval of the supervisory arrangement and the 
139.25 	assessment of the nonparental youth's capacity to supervise the child and must keep this 
139.26 	documentation in the file of the parent whose child is being supervised by the nonparental 
139.27 	youth.
139.28 	(i) The license holder must maintain a service delivery plan that describes how the 
139.29 	program provides services according to paragraphs (b) to (h).
139.30 		Subd. 7.Supervised independent living settings for youth 18 years of age or older; 
139.31 	certification requirements. (a) To be certified as a supervised independent living setting 
139.32 	for youth who are 18 years of age or older, a license holder must meet the requirements of 
139.33 	this subdivision.
140.1 	(b) A license holder must provide training, counseling, instruction, supervision, and 
140.2 	assistance for independent living, according to the needs of the youth being served.
140.3 	(c) A license holder may provide services to assist the youth with locating housing, 
140.4 	money management, meal preparation, shopping, health care, transportation, and any other 
140.5 	support services necessary to meet the youth's needs and improve the youth's ability to 
140.6 	conduct such tasks independently.
140.7 	(d) The service plan for the youth must contain an objective of independent living skills.
140.8 	(e) The license holder must maintain a service delivery plan that describes how the 
140.9 	program provides services according to paragraphs (b) to (d).
140.10 		Subd. 8.Monitoring and inspections. (a) For a program licensed by the commissioner 
140.11 	of human services, the commissioner of human services may review a program's compliance 
140.12 	with certification requirements by conducting an inspection, a licensing review, or an 
140.13 	investigation of the program. The commissioner may issue a correction order to the license 
140.14 	holder for a program's noncompliance with the certification requirements of this section. 
140.15 	For a program licensed by the commissioner of human services, a license holder must make 
140.16 	a request for reconsideration of a correction order according to section 245A.06, subdivision 
140.17 	2.
140.18 	(b) For a program licensed by the commissioner of corrections, the commissioner of 
140.19 	human services may review the program's compliance with the requirements for a certification 
140.20 	issued under this section biennially and may issue a correction order identifying the program's 
140.21 	noncompliance with the requirements of this section. The correction order must state the 
140.22 	following:
140.23 	(1) the conditions that constitute a violation of a law or rule;
140.24 	(2) the specific law or rule violated; and
140.25 	(3) the time allowed for the program to correct each violation.
140.26 	(c) For a program licensed by the commissioner of corrections, if a license holder believes 
140.27 	that there are errors in the correction order of the commissioner of human services, the 
140.28 	license holder may ask the Department of Human Services to reconsider the parts of the 
140.29 	correction order that the license holder alleges are in error. To submit a request for 
140.30 	reconsideration, the license holder must send a written request for reconsideration by United 
140.31 	States mail to the commissioner of human services. The request for reconsideration must 
140.32 	be postmarked within 20 calendar days of the date that the correction order was received 
140.33 	by the license holder and must:
141.1 	(1) specify the parts of the correction order that are alleged to be in error;
141.2 	(2) explain why the parts of the correction order are in error; and
141.3 	(3) include documentation to support the allegation of error.
141.4 	A request for reconsideration does not stay any provisions or requirements of the correction 
141.5 	order. The commissioner of human services' disposition of a request for reconsideration is 
141.6 	final and not subject to appeal under chapter 14.
141.7 	(d) Nothing in this subdivision prohibits the commissioner of human services from 
141.8 	decertifying a license holder according to subdivision 9 prior to issuing a correction order.
141.9 		Subd. 9.Decertification. (a) The commissioner of human services may rescind a 
141.10 	certification issued under this section if a license holder fails to comply with the certification 
141.11 	requirements in this section.
141.12 	(b) The license holder may request reconsideration of a decertification by notifying the 
141.13 	commissioner of human services by certified mail or personal service. The license holder 
141.14 	must request reconsideration of a decertification in writing. If the license holder sends the 
141.15 	request for reconsideration of a decertification by certified mail, the license holder must 
141.16 	send the request by United States mail to the commissioner of human services and the 
141.17 	request must be postmarked within 20 calendar days after the license holder received the 
141.18 	notice of decertification. If the license holder requests reconsideration of a decertification 
141.19 	by personal service, the request for reconsideration must be received by the commissioner 
141.20 	of human services within 20 calendar days after the license holder received the notice of 
141.21 	decertification. When submitting a request for reconsideration of a decertification, the license 
141.22 	holder must submit a written argument or evidence in support of the request for 
141.23 	reconsideration.
141.24 	(c) The commissioner of human services' disposition of a request for reconsideration is 
141.25 	final and not subject to appeal under chapter 14.
141.26 		Subd. 10.Variances. The commissioner of human services may grant variances to the 
141.27 	requirements in this section that do not affect a youth's health or safety or compliance with 
141.28 	federal requirements for Title IV-E funding if the conditions in section 245A.04, subdivision 
141.29 	9, are met.

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

142.1 	Sec. 11. Minnesota Statutes 2020, section 256.01, subdivision 14b, is amended to read:
142.2 		Subd. 14b.American Indian child welfare projects. (a) The commissioner of human 
142.3 	services may authorize projects to initiate tribal delivery of child welfare services to American 
142.4 	Indian children and their parents and custodians living on the reservation. The commissioner 
142.5 	has authority to solicit and determine which tribes may participate in a project. Grants may 
142.6 	be issued to Minnesota Indian tribes to support the projects. The commissioner may waive 
142.7 	existing state rules as needed to accomplish the projects. The commissioner may authorize 
142.8 	projects to use alternative methods of (1) screening, investigating, and assessing reports of 
142.9 	child maltreatment, and (2) administrative reconsideration, administrative appeal, and 
142.10 	judicial appeal of maltreatment determinations, provided the alternative methods used by 
142.11 	the projects comply with the provisions of section 256.045 and chapter 260E that deal with 
142.12 	the rights of individuals who are the subjects of reports or investigations, including notice 
142.13 	and appeal rights and data practices requirements. The commissioner shall only authorize 
142.14 	alternative methods that comply with the public policy under section 260E.01. The 
142.15 	commissioner may seek any federal approval necessary to carry out the projects as well as 
142.16 	seek and use any funds available to the commissioner, including use of federal funds, 
142.17 	foundation funds, existing grant funds, and other funds. The commissioner is authorized to 
142.18 	advance state funds as necessary to operate the projects. Federal reimbursement applicable 
142.19 	to the projects is appropriated to the commissioner for the purposes of the projects. The 
142.20 	projects must be required to address responsibility for safety, permanency, and well-being 
142.21 	of children.
142.22 	(b) For the purposes of this section, "American Indian child" means a person under 21 
142.23 	years old and who is a tribal member or eligible for membership in one of the tribes chosen 
142.24 	for a project under this subdivision and who is residing on the reservation of that tribe.
142.25 	(c) In order to qualify for an American Indian child welfare project, a tribe must:
142.26 	(1) be one of the existing tribes with reservation land in Minnesota;
142.27 	(2) have a tribal court with jurisdiction over child custody proceedings;
142.28 	(3) have a substantial number of children for whom determinations of maltreatment have 
142.29 	occurred;
142.30 	(4)(i) have capacity to respond to reports of abuse and neglect under chapter 260E; or 
142.31 	(ii) have codified the tribe's screening, investigation, and assessment of reports of child 
142.32 	maltreatment procedures, if authorized to use an alternative method by the commissioner 
142.33 	under paragraph (a);
143.1 	(5) provide a wide range of services to families in need of child welfare services; and
143.2 	(6) have a tribal-state title IV-E agreement in effect; and
143.3 	(7) enter into host Tribal contracts pursuant to section 256.0112, subdivision 6.
143.4 	(d) Grants awarded under this section may be used for the nonfederal costs of providing 
143.5 	child welfare services to American Indian children on the tribe's reservation, including costs 
143.6 	associated with:
143.7 	(1) assessment and prevention of child abuse and neglect;
143.8 	(2) family preservation;
143.9 	(3) facilitative, supportive, and reunification services;
143.10 	(4) out-of-home placement for children removed from the home for child protective 
143.11 	purposes; and
143.12 	(5) other activities and services approved by the commissioner that further the goals of 
143.13 	providing safety, permanency, and well-being of American Indian children.
143.14 	(e) When a tribe has initiated a project and has been approved by the commissioner to 
143.15 	assume child welfare responsibilities for American Indian children of that tribe under this 
143.16 	section, the affected county social service agency is relieved of responsibility for responding 
143.17 	to reports of abuse and neglect under chapter 260E for those children during the time within 
143.18 	which the tribal project is in effect and funded. The commissioner shall work with tribes 
143.19 	and affected counties to develop procedures for data collection, evaluation, and clarification 
143.20 	of ongoing role and financial responsibilities of the county and tribe for child welfare services 
143.21 	prior to initiation of the project. Children who have not been identified by the tribe as 
143.22 	participating in the project shall remain the responsibility of the county. Nothing in this 
143.23 	section shall alter responsibilities of the county for law enforcement or court services.
143.24 	(f) Participating tribes may conduct children's mental health screenings under section 
143.25 	245.4874, subdivision 1, paragraph (a), clause (12), for children who are eligible for the 
143.26 	initiative and living on the reservation and who meet one of the following criteria:
143.27 	(1) the child must be receiving child protective services;
143.28 	(2) the child must be in foster care; or
143.29 	(3) the child's parents must have had parental rights suspended or terminated.
144.1 	Tribes may access reimbursement from available state funds for conducting the screenings. 
144.2 	Nothing in this section shall alter responsibilities of the county for providing services under 
144.3 	section 245.487.
144.4 	(g) Participating tribes may establish a local child mortality review panel. In establishing 
144.5 	a local child mortality review panel, the tribe agrees to conduct local child mortality reviews 
144.6 	for child deaths or near-fatalities occurring on the reservation under subdivision 12. Tribes 
144.7 	with established child mortality review panels shall have access to nonpublic data and shall 
144.8 	protect nonpublic data under subdivision 12, paragraphs (c) to (e). The tribe shall provide 
144.9 	written notice to the commissioner and affected counties when a local child mortality review 
144.10 	panel has been established and shall provide data upon request of the commissioner for 
144.11 	purposes of sharing nonpublic data with members of the state child mortality review panel 
144.12 	in connection to an individual case.
144.13 	(h) The commissioner shall collect information on outcomes relating to child safety, 
144.14 	permanency, and well-being of American Indian children who are served in the projects. 
144.15 	Participating tribes must provide information to the state in a format and completeness 
144.16 	deemed acceptable by the state to meet state and federal reporting requirements.
144.17 	(i) In consultation with the White Earth Band, the commissioner shall develop and submit 
144.18 	to the chairs and ranking minority members of the legislative committees with jurisdiction 
144.19 	over health and human services a plan to transfer legal responsibility for providing child 
144.20 	protective services to White Earth Band member children residing in Hennepin County to 
144.21 	the White Earth Band. The plan shall include a financing proposal, definitions of key terms, 
144.22 	statutory amendments required, and other provisions required to implement the plan. The 
144.23 	commissioner shall submit the plan by January 15, 2012.

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

144.25 	Sec. 12. Minnesota Statutes 2020, section 256.0112, subdivision 6, is amended to read:
144.26 		Subd. 6.Contracting within and across county lines; lead county contracts; lead 
144.27 	Tribal contracts. Paragraphs (a) to (e) govern contracting within and across county lines 
144.28 	and lead county contracts. Paragraphs (a) to (e) govern contracting within and across 
144.29 	reservation boundaries and lead Tribal contracts for initiative tribes under section 256.01, 
144.30 	subdivision 14b. For purposes of this subdivision, "local agency" includes a tribe or a county 
144.31 	agency.
144.32 	(a) Once a local agency and an approved vendor execute a contract that meets the 
144.33 	requirements of this subdivision, the contract governs all other purchases of service from 
145.1 	the vendor by all other local agencies for the term of the contract. The local agency that 
145.2 	negotiated and entered into the contract becomes the lead tribe or county for the contract.
145.3 	(b) When the local agency in the county or reservation where a vendor is located wants 
145.4 	to purchase services from that vendor and the vendor has no contract with the local agency 
145.5 	or any other tribe or county, the local agency must negotiate and execute a contract with 
145.6 	the vendor.
145.7 	(c) When a local agency in one county wants to purchase services from a vendor located 
145.8 	in another county or reservation, it must notify the local agency in the county or reservation
145.9 	where the vendor is located. Within 30 days of being notified, the local agency in the vendor's 
145.10 	county or reservation must:
145.11 	(1) if it has a contract with the vendor, send a copy to the inquiring local agency;
145.12 	(2) if there is a contract with the vendor for which another local agency is the lead tribe 
145.13 	or county, identify the lead tribe or county to the inquiring agency; or
145.14 	(3) if no local agency has a contract with the vendor, inform the inquiring agency whether 
145.15 	it will negotiate a contract and become the lead tribe or county. If the agency where the 
145.16 	vendor is located will not negotiate a contract with the vendor because of concerns related 
145.17 	to clients' health and safety, the agency must share those concerns with the inquiring local
145.18 	agency.
145.19 	(d) If the local agency in the county where the vendor is located declines to negotiate a 
145.20 	contract with the vendor or fails to respond within 30 days of receiving the notification 
145.21 	under paragraph (c), the inquiring agency is authorized to negotiate a contract and must 
145.22 	notify the local agency that declined or failed to respond.
145.23 	(e) When the inquiring county local agency under paragraph (d) becomes the lead tribe 
145.24 	or county for a contract and the contract expires and needs to be renegotiated, that tribe or 
145.25 	county must again follow the requirements under paragraph (c) and notify the local agency 
145.26 	where the vendor is located. The local agency where the vendor is located has the option 
145.27 	of becoming the lead tribe or county for the new contract. If the local agency does not 
145.28 	exercise the option, paragraph (d) applies.
145.29 	(f) This subdivision does not affect the requirement to seek county concurrence under 
145.30 	section 256B.092, subdivision 8a, when the services are to be purchased for a person with 
145.31 	a developmental disability or under section 245.4711, subdivision 3, when the services to 
145.32 	be purchased are for an adult with serious and persistent mental illness.

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

146.1 	Sec. 13. Minnesota Statutes 2020, section 256.741, is amended by adding a subdivision 
146.2 	to read:
146.3 		Subd. 12a.Appeals of good cause determinations. According to section 256.045, an 
146.4 	individual may appeal the determination or redetermination of good cause under this section. 
146.5 	To initiate an appeal of a good cause determination or redetermination, the individual must 
146.6 	make a request for a state agency hearing in writing within 30 calendar days after the date 
146.7 	that a notice of denial for good cause is mailed or otherwise transmitted to the individual. 
146.8 	Until a human services judge issues a decision under section 256.0451, subdivision 22, the 
146.9 	child support agency shall cease all child support enforcement efforts and shall not report 
146.10 	the individual's noncooperation to public assistance agencies.

146.11 	Sec. 14. Minnesota Statutes 2020, section 256.741, is amended by adding a subdivision 
146.12 	to read:
146.13 		Subd. 12b.Reporting noncooperation. The public authority may issue a notice of the 
146.14 	individual's noncooperation to each public assistance agency providing public assistance 
146.15 	to the individual if:
146.16 	(1) 30 calendar days have passed since the later of the initial county denial or the date 
146.17 	of the denial following the state agency hearing; or
146.18 	(2) the individual has not cooperated with the child support agency as required in 
146.19 	subdivision 5.

146.20 	Sec. 15. Minnesota Statutes 2020, section 259.241, is amended to read:
146.21 	259.241 ADULT ADOPTION.
146.22 	(a) Any adult person may be adopted, regardless of the adult person's residence. A 
146.23 	resident of Minnesota may petition the court of record having jurisdiction of adoption 
146.24 	proceedings to adopt an individual who has reached the age of 18 years or older.
146.25 	(b) The consent of the person to be adopted shall be the only consent necessary, according 
146.26 	to section 259.24. The consent of an adult in the adult person's own adoption is invalid if 
146.27 	the adult is considered to be a vulnerable adult under section 626.5572, subdivision 21, or 
146.28 	if the person consenting to the adoption is determined not competent to give consent.
146.29 	(c) Notwithstanding paragraph (b), a person in extended foster care under section 
146.30 	260C.451 may consent to the person's own adoption as long as the court with jurisdiction 
146.31 	finds the person competent to give consent.
147.1 	(c) (d) The decree of adoption establishes a parent-child relationship between the adopting 
147.2 	parent or parents and the person adopted, including the right to inherit, and also terminates 
147.3 	the parental rights and sibling relationship between the adopted person and the adopted 
147.4 	person's birth parents and siblings according to section 259.59.
147.5 	(d) (e) If the adopted person requests a change of name, the adoption decree shall order 
147.6 	the name change.

147.7 	Sec. 16. Minnesota Statutes 2020, section 259.53, subdivision 4, is amended to read:
147.8 		Subd. 4.Preadoption residence. No petition shall be granted under this chapter until 
147.9 	the child shall have has lived for three months in the proposed adoptive home, subject to a 
147.10 	right of visitation by the commissioner or an agency or their authorized representatives.

147.11 	Sec. 17. Minnesota Statutes 2020, section 259.75, subdivision 5, is amended to read:
147.12 		Subd. 5.Withdrawal of registration. A child's registration shall be withdrawn when 
147.13 	the exchange service has been notified in writing by the local social service agency or the 
147.14 	licensed child-placing agency that the child has been placed in an adoptive home or, has 
147.15 	died, or is no longer under the guardianship of the commissioner and is no longer seeking 
147.16 	an adoptive home.

147.17 	Sec. 18. Minnesota Statutes 2020, section 259.75, subdivision 6, is amended to read:
147.18 		Subd. 6.Periodic review of status. (a) The exchange service commissioner shall 
147.19 	semiannually check review the state adoption exchange status of listed children for whom 
147.20 	inquiries have been received identified under subdivision 2, including a child whose 
147.21 	registration was withdrawn pursuant to subdivision 5. The commissioner may determine 
147.22 	that a child who is unregistered, or whose registration has been deferred, must be registered 
147.23 	and require the authorized child-placing agency to register the child with the state adoption 
147.24 	exchange within ten working days of the commissioner's determination.
147.25 	(b) Periodic checks reviews shall be made by the service commissioner to determine the 
147.26 	progress toward adoption of those children and the status of children registered but never 
147.27 	listed in the exchange book because of placement in an adoptive home prior to or at the 
147.28 	time of registration state adoption exchange.

148.1 	Sec. 19. Minnesota Statutes 2020, section 259.75, subdivision 9, is amended to read:
148.2 		Subd. 9.Rules; staff. The commissioner of human services shall make rules as necessary 
148.3 	to administer this section and shall employ necessary staff to carry out the purposes of this 
148.4 	section. The commissioner may contract for services to carry out the purposes of this section.

148.5 	Sec. 20. Minnesota Statutes 2020, section 259.83, subdivision 1a, is amended to read:
148.6 		Subd. 1a.Social and medical history. (a) If a person aged 19 years and over who was 
148.7 	adopted on or after August 1, 1994, or the adoptive parent requests the detailed nonidentifying 
148.8 	social and medical history of the adopted person's birth family that was provided at the time 
148.9 	of the adoption, agencies must provide the information to the adopted person or adoptive 
148.10 	parent on the applicable form required under section sections 259.43 and 260C.212, 
148.11 	subdivision 15.
148.12 	(b) If an adopted person aged 19 years and over or the adoptive parent requests the 
148.13 	agency to contact the adopted person's birth parents to request current nonidentifying social 
148.14 	and medical history of the adopted person's birth family, agencies must use the applicable
148.15 	form required under section sections 259.43 and 260C.212, subdivision 15, when obtaining 
148.16 	the information for the adopted person or adoptive parent.

148.17 	Sec. 21. Minnesota Statutes 2020, section 259A.75, subdivision 1, is amended to read:
148.18 		Subdivision 1.General information. (a) Subject to the procedures required by the 
148.19 	commissioner and the provisions of this section, a Minnesota county or Tribal agency shall 
148.20 	receive a reimbursement from the commissioner equal to 100 percent of the reasonable and 
148.21 	appropriate cost for contracted adoption placement services identified for a specific child 
148.22 	that are not reimbursed under other federal or state funding sources.
148.23 	(b) The commissioner may spend up to $16,000 for each purchase of service contract. 
148.24 	Only one contract per child per adoptive placement is permitted. Funds encumbered and 
148.25 	obligated under the contract for the child remain available until the terms of the contract 
148.26 	are fulfilled or the contract is terminated.
148.27 	(c) The commissioner shall set aside an amount not to exceed five percent of the total 
148.28 	amount of the fiscal year appropriation from the state for the adoption assistance program 
148.29 	to reimburse a Minnesota county or tribal social services placing agency for child-specific 
148.30 	adoption placement services. When adoption assistance payments for children's needs exceed 
148.31 	95 percent of the total amount of the fiscal year appropriation from the state for the adoption 
149.1 	assistance program, the amount of reimbursement available to placing agencies for adoption 
149.2 	services is reduced correspondingly.

149.3 	Sec. 22. Minnesota Statutes 2020, section 259A.75, subdivision 2, is amended to read:
149.4 		Subd. 2.Purchase of service contract child eligibility criteria. (a) A child who is the 
149.5 	subject of a purchase of service contract must:
149.6 	(1) have the goal of adoption, which may include an adoption in accordance with tribal 
149.7 	law;
149.8 	(2) be under the guardianship of the commissioner of human services or be a ward of 
149.9 	tribal court pursuant to section 260.755, subdivision 20; and
149.10 	(3) meet all of the special needs criteria according to section 259A.10, subdivision 2
149.11 	256N.23, subdivision 2.
149.12 	(b) A child under the guardianship of the commissioner must have an identified adoptive 
149.13 	parent and a fully executed adoption placement agreement according to section 260C.613, 
149.14 	subdivision 1, paragraph (a).

149.15 	Sec. 23. Minnesota Statutes 2020, section 259A.75, subdivision 3, is amended to read:
149.16 		Subd. 3.Agency eligibility criteria. (a) A Minnesota county or Tribal social services 
149.17 	agency shall receive reimbursement for child-specific adoption placement services for an 
149.18 	eligible child that it purchases from a private adoption agency licensed in Minnesota or any 
149.19 	other state or tribal social services agency.
149.20 	(b) Reimbursement for adoption services is available only for services provided prior 
149.21 	to the date of the adoption decree.

149.22 	Sec. 24. Minnesota Statutes 2020, section 259A.75, subdivision 4, is amended to read:
149.23 		Subd. 4.Application and eligibility determination. (a) A Minnesota county or Tribal
149.24 	social services agency may request reimbursement of costs for adoption placement services 
149.25 	by submitting a complete purchase of service application, according to the requirements 
149.26 	and procedures and on forms prescribed by the commissioner.
149.27 	(b) The commissioner shall determine eligibility for reimbursement of adoption placement 
149.28 	services. If determined eligible, the commissioner of human services shall sign the purchase 
149.29 	of service agreement, making this a fully executed contract. No reimbursement under this 
149.30 	section shall be made to an agency for services provided prior to the fully executed contract.
150.1 	(c) Separate purchase of service agreements shall be made, and separate records 
150.2 	maintained, on each child. Only one agreement per child per adoptive placement is permitted. 
150.3 	For siblings who are placed together, services shall be planned and provided to best maximize 
150.4 	efficiency of the contracted hours.

150.5 	Sec. 25. Minnesota Statutes 2020, section 260C.007, subdivision 22a, is amended to read:
150.6 		Subd. 22a.Licensed residential family-based substance use disorder treatment 
150.7 	program. "Licensed residential family-based substance use disorder treatment program" 
150.8 	means a residential treatment facility that provides the parent or guardian with parenting 
150.9 	skills training, parent education, or individual and family counseling, under an organizational 
150.10 	structure and treatment framework that involves understanding, recognizing, and responding 
150.11 	to the effects of all types of trauma according to recognized principles of a trauma-informed 
150.12 	approach and trauma-specific interventions to address the consequences of trauma and 
150.13 	facilitate healing. The residential program must be licensed by the Department of Human 
150.14 	Services under chapter chapters245A and sections 245G.01 to 245G.16, 245G.19, and 
150.15 	245G.21 245G or Tribally licensed or approved as a residential substance use disorder 
150.16 	treatment program specializing in the treatment of clients with children.

150.17 	Sec. 26. Minnesota Statutes 2020, section 260C.007, subdivision 26c, is amended to read:
150.18 		Subd. 26c.Qualified individual. (a) "Qualified individual" means a trained culturally 
150.19 	competent professional or licensed clinician, including a mental health professional under 
150.20 	section 245.4871, subdivision 27, who is notqualified to conduct the assessment approved 
150.21 	by the commissioner. The qualified individual must not be an employee of the responsible 
150.22 	social services agency and who is notor an individual connected to or affiliated with any 
150.23 	placement setting in which a responsible social services agency has placed children.
150.24 	(b) When the Indian Child Welfare Act of 1978, United States Code, title 25, sections 
150.25 	1901 to 1963, applies to a child, the county must contact the child's tribe without delay to 
150.26 	give the tribe the option to designate a qualified individual who is a trained culturally 
150.27 	competent professional or licensed clinician, including a mental health professional under 
150.28 	section 245.4871, subdivision 27, who is not employed by the responsible social services 
150.29 	agency and who is not connected to or affiliated with any placement setting in which a 
150.30 	responsible social services agency has placed children. Only a federal waiver that 
150.31 	demonstrates maintained objectivity may allow a responsible social services agency employee 
150.32 	or Tribal employee affiliated with any placement setting in which the responsible social 
150.33 	services agency has placed children to be designated the qualified individual.

151.1 	Sec. 27. Minnesota Statutes 2020, section 260C.007, subdivision 31, is amended to read:
151.2 		Subd. 31.Sexually exploited youth. "Sexually exploited youth" means an individual 
151.3 	who:
151.4 	(1) is alleged to have engaged in conduct which would, if committed by an adult, violate 
151.5 	any federal, state, or local law relating to being hired, offering to be hired, or agreeing to 
151.6 	be hired by another individual to engage in sexual penetration or sexual conduct;
151.7 	(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345, 
151.8 	609.3451, 609.3453, 609.352, 617.246, or 617.247;
151.9 	(3) is a victim of a crime described in United States Code, title 18, section 2260; 2421; 
151.10 	2422; 2423; 2425; 2425A; or 2256; or
151.11 	(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.; or
151.12 	(5) is a victim of commercial sexual exploitation as defined in United States Code, title 
151.13 	22, section 7102(11)(A) and (12).

151.14 	EFFECTIVE DATE. This section is effective September 30, 2021.

151.15 	Sec. 28. Minnesota Statutes 2020, section 260C.157, subdivision 3, is amended to read:
151.16 		Subd. 3.Juvenile treatment screening team. (a) The responsible social services agency 
151.17 	shall establish a juvenile treatment screening team to conduct screenings under this chapter
151.18 	and chapter 260D,and section 245.487, subdivision 3, for a child to receive treatment for 
151.19 	an emotional disturbance, a developmental disability, or related condition in a residential 
151.20 	treatment facility licensed by the commissioner of human services under chapter 245A, or 
151.21 	licensed or approved by a tribe. A screening team is not required for a child to be in: (1) a 
151.22 	residential facility specializing in prenatal, postpartum, or parenting support; (2) a facility 
151.23 	specializing in high-quality residential care and supportive services to children and youth 
151.24 	who are have been or are at risk of becoming victims ofsex-traffickingsex trafficking 
151.25 	victims or are at risk of becoming sex-trafficking victims or commercial sexual exploitation; 
151.26 	(3) supervised settings for youth who are 18 years old of age or older and living 
151.27 	independently; or (4) a licensed residential family-based treatment facility for substance 
151.28 	abuse consistent with section 260C.190. Screenings are also not required when a child must 
151.29 	be placed in a facility due to an emotional crisis or other mental health emergency.
151.30 	(b) The responsible social services agency shall conduct screenings within 15 days of a 
151.31 	request for a screening, unless the screening is for the purpose of residential treatment and 
151.32 	the child is enrolled in a prepaid health program under section 256B.69, in which case the 
152.1 	agency shall conduct the screening within ten working days of a request. The responsible 
152.2 	social services agency shall convene the juvenile treatment screening team, which may be 
152.3 	constituted under section 245.4885 or 256B.092 or Minnesota Rules, parts 9530.6600 to 
152.4 	9530.6655. The team shall consist of social workers; persons with expertise in the treatment 
152.5 	of juveniles who are emotionally disableddisturbed, chemically dependent, or have a 
152.6 	developmental disability; and the child's parent, guardian, or permanent legal custodian. 
152.7 	The team may include the child's relatives as defined in section 260C.007, subdivisions 26b
152.8 	and 27, the child's foster care provider, and professionals who are a resource to the child's 
152.9 	family such as teachers, medical or mental health providers, and clergy, as appropriate, 
152.10 	consistent with the family and permanency team as defined in section 260C.007, subdivision 
152.11 	16a. Prior to forming the team, the responsible social services agency must consult with the 
152.12 	child's parents, the child if the child is age 14 or older, the child's parents, and, if applicable, 
152.13 	the child's tribe to obtain recommendations regarding which individuals to include on the 
152.14 	team and to ensure that the team is family-centered and will act in the child's best interest
152.15 	interests. If the child, child's parents, or legal guardians raise concerns about specific relatives 
152.16 	or professionals, the team should not include those individuals. This provision does not 
152.17 	apply to paragraph (c).
152.18 	(c) If the agency provides notice to tribes under section 260.761, and the child screened 
152.19 	is an Indian child, the responsible social services agency must make a rigorous and concerted 
152.20 	effort to include a designated representative of the Indian child's tribe on the juvenile 
152.21 	treatment screening team, unless the child's tribal authority declines to appoint a 
152.22 	representative. The Indian child's tribe may delegate its authority to represent the child to 
152.23 	any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12. 
152.24 	The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections 
152.25 	1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to 
152.26 	260.835, apply to this section.
152.27 	(d) If the court, prior to, or as part of, a final disposition or other court order, proposes 
152.28 	to place a child with an emotional disturbance or developmental disability or related condition 
152.29 	in residential treatment, the responsible social services agency must conduct a screening. 
152.30 	If the team recommends treating the child in a qualified residential treatment program, the 
152.31 	agency must follow the requirements of sections 260C.70 to 260C.714.
152.32 	The court shall ascertain whether the child is an Indian child and shall notify the 
152.33 	responsible social services agency and, if the child is an Indian child, shall notify the Indian 
152.34 	child's tribe as paragraph (c) requires.
153.1 	(e) When the responsible social services agency is responsible for placing and caring 
153.2 	for the child and the screening team recommends placing a child in a qualified residential 
153.3 	treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1) 
153.4 	begin the assessment and processes required in section 260C.704 without delay; and (2) 
153.5 	conduct a relative search according to section 260C.221 to assemble the child's family and 
153.6 	permanency team under section 260C.706. Prior to notifying relatives regarding the family 
153.7 	and permanency team, the responsible social services agency must consult with the child's 
153.8 	parent or legal guardian, the child if the child is age 14 or older, the child's parents and, if 
153.9 	applicable, the child's tribe to ensure that the agency is providing notice to individuals who 
153.10 	will act in the child's best interestinterests. The child and the child's parents may identify 
153.11 	a culturally competent qualified individual to complete the child's assessment. The agency 
153.12 	shall make efforts to refer the assessment to the identified qualified individual. The 
153.13 	assessment may not be delayed for the purpose of having the assessment completed by a 
153.14 	specific qualified individual.
153.15 	(f) When a screening team determines that a child does not need treatment in a qualified 
153.16 	residential treatment program, the screening team must:
153.17 	(1) document the services and supports that will prevent the child's foster care placement 
153.18 	and will support the child remaining at home;
153.19 	(2) document the services and supports that the agency will arrange to place the child 
153.20 	in a family foster home; or
153.21 	(3) document the services and supports that the agency has provided in any other setting.
153.22 	(g) When the Indian child's tribe or tribal health care services provider or Indian Health 
153.23 	Services provider proposes to place a child for the primary purpose of treatment for an 
153.24 	emotional disturbance, a developmental disability, or co-occurring emotional disturbance 
153.25 	and chemical dependency, the Indian child's tribe or the tribe delegated by the child's tribe 
153.26 	shall submit necessary documentation to the county juvenile treatment screening team, 
153.27 	which must invite the Indian child's tribe to designate a representative to the screening team.
153.28 	(h) The responsible social services agency must conduct and document the screening in 
153.29 	a format approved by the commissioner of human services.

153.30 	EFFECTIVE DATE. This section is effective September 30, 2021.

153.31 	Sec. 29. Minnesota Statutes 2020, section 260C.212, subdivision 1, is amended to read:
153.32 		Subdivision 1.Out-of-home placement; plan. (a) An out-of-home placement plan shall 
153.33 	be prepared within 30 days after any child is placed in foster care by court order or a 
154.1 	voluntary placement agreement between the responsible social services agency and the 
154.2 	child's parent pursuant to section 260C.227 or chapter 260D.
154.3 	(b) An out-of-home placement plan means a written document which is prepared by the 
154.4 	responsible social services agency jointly with the parent or parents or guardian of the child 
154.5 	and in consultation with the child's guardian ad litem, the child's tribe, if the child is an 
154.6 	Indian child, the child's foster parent or representative of the foster care facility, and, where 
154.7 	appropriate, the child. When a child is age 14 or older, the child may include two other 
154.8 	individuals on the team preparing the child's out-of-home placement plan. The child may 
154.9 	select one member of the case planning team to be designated as the child's advisor and to 
154.10 	advocate with respect to the application of the reasonable and prudent parenting standards. 
154.11 	The responsible social services agency may reject an individual selected by the child if the 
154.12 	agency has good cause to believe that the individual would not act in the best interest of the 
154.13 	child. For a child in voluntary foster care for treatment under chapter 260D, preparation of 
154.14 	the out-of-home placement plan shall additionally include the child's mental health treatment 
154.15 	provider. For a child 18 years of age or older, the responsible social services agency shall 
154.16 	involve the child and the child's parents as appropriate. As appropriate, the plan shall be:
154.17 	(1) submitted to the court for approval under section 260C.178, subdivision 7;
154.18 	(2) ordered by the court, either as presented or modified after hearing, under section 
154.19 	260C.178, subdivision 7, or 260C.201, subdivision 6; and
154.20 	(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem, 
154.21 	a representative of the child's tribe, the responsible social services agency, and, if possible, 
154.22 	the child.
154.23 	(c) The out-of-home placement plan shall be explained to all persons involved in its 
154.24 	implementation, including the child who has signed the plan, and shall set forth:
154.25 	(1) a description of the foster care home or facility selected, including how the 
154.26 	out-of-home placement plan is designed to achieve a safe placement for the child in the 
154.27 	least restrictive, most family-like, setting available which is in close proximity to the home 
154.28 	of the parent or parents or guardian of the child when the case plan goal is reunification, 
154.29 	and how the placement is consistent with the best interests and special needs of the child 
154.30 	according to the factors under subdivision 2, paragraph (b);
154.31 	(2) the specific reasons for the placement of the child in foster care, and when 
154.32 	reunification is the plan, a description of the problems or conditions in the home of the 
154.33 	parent or parents which necessitated removal of the child from home and the changes the 
154.34 	parent or parents must make for the child to safely return home;
155.1 	(3) a description of the services offered and provided to prevent removal of the child 
155.2 	from the home and to reunify the family including:
155.3 	(i) the specific actions to be taken by the parent or parents of the child to eliminate or 
155.4 	correct the problems or conditions identified in clause (2), and the time period during which 
155.5 	the actions are to be taken; and
155.6 	(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to 
155.7 	achieve a safe and stable home for the child including social and other supportive services 
155.8 	to be provided or offered to the parent or parents or guardian of the child, the child, and the 
155.9 	residential facility during the period the child is in the residential facility;
155.10 	(4) a description of any services or resources that were requested by the child or the 
155.11 	child's parent, guardian, foster parent, or custodian since the date of the child's placement 
155.12 	in the residential facility, and whether those services or resources were provided and if not, 
155.13 	the basis for the denial of the services or resources;
155.14 	(5) the visitation plan for the parent or parents or guardian, other relatives as defined in 
155.15 	section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not 
155.16 	placed together in foster care, and whether visitation is consistent with the best interest of 
155.17 	the child, during the period the child is in foster care;
155.18 	(6) when a child cannot return to or be in the care of either parent, documentation of 
155.19 	steps to finalize adoption as the permanency plan for the child through reasonable efforts 
155.20 	to place the child for adoption. At a minimum, the documentation must include consideration 
155.21 	of whether adoption is in the best interests of the child, child-specific recruitment efforts 
155.22 	such as relative search and the use of state, regional, and national adoption exchanges to 
155.23 	facilitate orderly and timely placements in and outside of the state. A copy of this 
155.24 	documentation shall be provided to the court in the review required under section 260C.317, 
155.25 	subdivision 3, paragraph (b);
155.26 	(7) when a child cannot return to or be in the care of either parent, documentation of 
155.27 	steps to finalize the transfer of permanent legal and physical custody to a relative as the 
155.28 	permanency plan for the child. This documentation must support the requirements of the 
155.29 	kinship placement agreement under section 256N.22 and must include the reasonable efforts 
155.30 	used to determine that it is not appropriate for the child to return home or be adopted, and 
155.31 	reasons why permanent placement with a relative through a Northstar kinship assistance 
155.32 	arrangement is in the child's best interest; how the child meets the eligibility requirements 
155.33 	for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's 
155.34 	relative foster parent and reasons why the relative foster parent chose not to pursue adoption, 
156.1 	if applicable; and agency efforts to discuss with the child's parent or parents the permanent 
156.2 	transfer of permanent legal and physical custody or the reasons why these efforts were not 
156.3 	made;
156.4 	(8) efforts to ensure the child's educational stability while in foster care for a child who 
156.5 	attained the minimum age for compulsory school attendance under state law and is enrolled 
156.6 	full time in elementary or secondary school, or instructed in elementary or secondary 
156.7 	education at home, or instructed in an independent study elementary or secondary program, 
156.8 	or incapable of attending school on a full-time basis due to a medical condition that is 
156.9 	documented and supported by regularly updated information in the child's case plan. 
156.10 	Educational stability efforts include:
156.11 	(i) efforts to ensure that the child remains in the same school in which the child was 
156.12 	enrolled prior to placement or upon the child's move from one placement to another, including 
156.13 	efforts to work with the local education authorities to ensure the child's educational stability 
156.14 	and attendance; or
156.15 	(ii) if it is not in the child's best interest to remain in the same school that the child was 
156.16 	enrolled in prior to placement or move from one placement to another, efforts to ensure 
156.17 	immediate and appropriate enrollment for the child in a new school;
156.18 	(9) the educational records of the child including the most recent information available 
156.19 	regarding:
156.20 	(i) the names and addresses of the child's educational providers;
156.21 	(ii) the child's grade level performance;
156.22 	(iii) the child's school record;
156.23 	(iv) a statement about how the child's placement in foster care takes into account 
156.24 	proximity to the school in which the child is enrolled at the time of placement; and
156.25 	(v) any other relevant educational information;
156.26 	(10) the efforts by the responsible social services agency to ensure the oversight and 
156.27 	continuity of health care services for the foster child, including:
156.28 	(i) the plan to schedule the child's initial health screens;
156.29 	(ii) how the child's known medical problems and identified needs from the screens, 
156.30 	including any known communicable diseases, as defined in section 144.4172, subdivision 
156.31 	2, shall be monitored and treated while the child is in foster care;
157.1 	(iii) how the child's medical information shall be updated and shared, including the 
157.2 	child's immunizations;
157.3 	(iv) who is responsible to coordinate and respond to the child's health care needs, 
157.4 	including the role of the parent, the agency, and the foster parent;
157.5 	(v) who is responsible for oversight of the child's prescription medications;
157.6 	(vi) how physicians or other appropriate medical and nonmedical professionals shall be 
157.7 	consulted and involved in assessing the health and well-being of the child and determine 
157.8 	the appropriate medical treatment for the child; and
157.9 	(vii) the responsibility to ensure that the child has access to medical care through either 
157.10 	medical insurance or medical assistance;
157.11 	(11) the health records of the child including information available regarding:
157.12 	(i) the names and addresses of the child's health care and dental care providers;
157.13 	(ii) a record of the child's immunizations;
157.14 	(iii) the child's known medical problems, including any known communicable diseases 
157.15 	as defined in section 144.4172, subdivision 2;
157.16 	(iv) the child's medications; and
157.17 	(v) any other relevant health care information such as the child's eligibility for medical 
157.18 	insurance or medical assistance;
157.19 	(12) an independent living plan for a child 14 years of age or older, developed in 
157.20 	consultation with the child. The child may select one member of the case planning team to 
157.21 	be designated as the child's advisor and to advocate with respect to the application of the 
157.22 	reasonable and prudent parenting standards in subdivision 14. The plan should include, but 
157.23 	not be limited to, the following objectives:
157.24 	(i) educational, vocational, or employment planning;
157.25 	(ii) health care planning and medical coverage;
157.26 	(iii) transportation including, where appropriate, assisting the child in obtaining a driver's 
157.27 	license;
157.28 	(iv) money management, including the responsibility of the responsible social services 
157.29 	agency to ensure that the child annually receives, at no cost to the child, a consumer report 
157.30 	as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies 
157.31 	in the report;
158.1 	(v) planning for housing;
158.2 	(vi) social and recreational skills;
158.3 	(vii) establishing and maintaining connections with the child's family and community; 
158.4 	and
158.5 	(viii) regular opportunities to engage in age-appropriate or developmentally appropriate 
158.6 	activities typical for the child's age group, taking into consideration the capacities of the 
158.7 	individual child;
158.8 	(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic 
158.9 	and assessment information, specific services relating to meeting the mental health care 
158.10 	needs of the child, and treatment outcomes;
158.11 	(14) for a child 14 years of age or older, a signed acknowledgment that describes the 
158.12 	child's rights regarding education, health care, visitation, safety and protection from 
158.13 	exploitation, and court participation; receipt of the documents identified in section 260C.452; 
158.14 	and receipt of an annual credit report. The acknowledgment shall state that the rights were 
158.15 	explained in an age-appropriate manner to the child; and
158.16 	(15) for a child placed in a qualified residential treatment program, the plan must include 
158.17 	the requirements in section 260C.708.
158.18 	(d) The parent or parents or guardian and the child each shall have the right to legal 
158.19 	counsel in the preparation of the case plan and shall be informed of the right at the time of 
158.20 	placement of the child. The child shall also have the right to a guardian ad litem. If unable 
158.21 	to employ counsel from their own resources, the court shall appoint counsel upon the request 
158.22 	of the parent or parents or the child or the child's legal guardian. The parent or parents may 
158.23 	also receive assistance from any person or social services agency in preparation of the case 
158.24 	plan.
158.25 	After the plan has been agreed upon by the parties involved or approved or ordered by 
158.26 	the court, the foster parents shall be fully informed of the provisions of the case plan and 
158.27 	shall be provided a copy of the plan.
158.28 	Upon the child's discharge from foster care, the responsible social services agency must 
158.29 	provide the child's parent, adoptive parent, or permanent legal and physical custodian, as 
158.30 	appropriate, and the child, if appropriate, must be provided the child is 14 years of age or 
158.31 	older, with a current copy of the child's health and education record. If a child meets the 
158.32 	conditions in subdivision 15, paragraph (b), the agency must also provide the child with the 
158.33 	child's social and medical history. The responsible social services agency may give a copy 
159.1 	of the child's health and education record and social and medical history to a child who is 
159.2 	younger than 14 years of age, if it is appropriate and if subdivision 15, paragraph (b), applies.

159.3 	Sec. 30. Minnesota Statutes 2020, section 260C.212, subdivision 1a, is amended to read:
159.4 		Subd. 1a.Out-of-home placement plan update. (a) Within 30 days of placing the child 
159.5 	in foster care, the agency must file the child's initial out-of-home placement plan with the 
159.6 	court. After filing the child's initial out-of-home placement plan, the agency shall update 
159.7 	and file the child's out-of-home placement plan with the court as follows:
159.8 	(1) when the agency moves a child to a different foster care setting, the agency shall 
159.9 	inform the court within 30 days of the child's placement change or court-ordered trial home 
159.10 	visit. The agency must file the child's updated out-of-home placement plan with the court 
159.11 	at the next required review hearing;
159.12 	(2) when the agency places a child in a qualified residential treatment program as defined 
159.13 	in section 260C.007, subdivision 26d, or moves a child from one qualified residential 
159.14 	treatment program to a different qualified residential treatment program, the agency must 
159.15 	update the child's out-of-home placement plan within 60 days. To meet the requirements 
159.16 	of section 260C.708, the agency must file the child's out-of-home placement plan with the 
159.17 	court as part of the 60-day hearing and along with the agency's report seeking the court's 
159.18 	approval of the child's placement at a qualified residential treatment program under section 
159.19 	260C.71. After the court issues an order, the agency must update the child's out-of-home 
159.20 	placement plan after the court hearing to document the court's approval or disapproval of 
159.21 	the child's placement in a qualified residential treatment program;
159.22 	(3) when the agency places a child with the child's parent in a licensed residential 
159.23 	family-based substance use disorder treatment program under section 260C.190, the agency 
159.24 	must identify the treatment program where the child will be placed in the child's out-of-home 
159.25 	placement plan prior to the child's placement. The agency must file the child's out-of-home 
159.26 	placement plan with the court at the next required review hearing; and
159.27 	(4) under sections 260C.227 and 260C.521, the agency must update the child's
159.28 	out-of-home placement plan and file the child's out-of-home placement plan with the court.
159.29 	(b) When none of the items in paragraph (a) apply, the agency must update the child's
159.30 	out-of-home placement plan no later than 180 days after the child's initial placement and 
159.31 	every six months thereafter, consistent with section 260C.203, paragraph (a).

159.32 	EFFECTIVE DATE. This section is effective September 30, 2021.

160.1 	Sec. 31. Minnesota Statutes 2020, section 260C.212, subdivision 2, is amended to read:
160.2 		Subd. 2.Placement decisions based on best interests of the child. (a) The policy of 
160.3 	the state of Minnesota is to ensure that the child's best interests are met by requiring an 
160.4 	individualized determination of the needs of the child and of how the selected placement 
160.5 	will serve the needs of the child being placed. The authorized child-placing agency shall 
160.6 	place a child, released by court order or by voluntary release by the parent or parents, in a 
160.7 	family foster home selected by considering placement with relatives and important friends 
160.8 	in the following order:
160.9 	(1) with an individual who is related to the child by blood, marriage, or adoption, 
160.10 	including the legal parent, guardian, or custodian of the child's siblings; or
160.11 	(2) with an individual who is an important friend with whom the child has resided or 
160.12 	had significant contact.
160.13 	For an Indian child, the agency shall follow the order of placement preferences in the Indian 
160.14 	Child Welfare Act of 1978, United States Code, title 25, section 1915.
160.15 	(b) Among the factors the agency shall consider in determining the needs of the child 
160.16 	are the following:
160.17 	(1) the child's current functioning and behaviors;
160.18 	(2) the medical needs of the child;
160.19 	(3) the educational needs of the child;
160.20 	(4) the developmental needs of the child;
160.21 	(5) the child's history and past experience;
160.22 	(6) the child's religious and cultural needs;
160.23 	(7) the child's connection with a community, school, and faith community;
160.24 	(8) the child's interests and talents;
160.25 	(9) the child's relationship to current caretakers, parents, siblings, and relatives;
160.26 	(10) the reasonable preference of the child, if the court, or the child-placing agency in 
160.27 	the case of a voluntary placement, deems the child to be of sufficient age to express 
160.28 	preferences; and
160.29 	(11) for an Indian child, the best interests of an Indian child as defined in section 260.755, 
160.30 	subdivision 2a.
161.1 	(c) Placement of a child cannot be delayed or denied based on race, color, or national 
161.2 	origin of the foster parent or the child.
161.3 	(d) Siblings should be placed together for foster care and adoption at the earliest possible 
161.4 	time unless it is documented that a joint placement would be contrary to the safety or 
161.5 	well-being of any of the siblings or unless it is not possible after reasonable efforts by the 
161.6 	responsible social services agency. In cases where siblings cannot be placed together, the 
161.7 	agency is required to provide frequent visitation or other ongoing interaction between 
161.8 	siblings unless the agency documents that the interaction would be contrary to the safety 
161.9 	or well-being of any of the siblings.
161.10 	(e) Except for emergency placement as provided for in section 245A.035, the following 
161.11 	requirements must be satisfied before the approval of a foster or adoptive placement in a 
161.12 	related or unrelated home: (1) a completed background study under section 245C.08; and 
161.13 	(2) a completed review of the written home study required under section 260C.215, 
161.14 	subdivision 4, clause (5), or 260C.611, to assess the capacity of the prospective foster or 
161.15 	adoptive parent to ensure the placement will meet the needs of the individual child.
161.16 	(f) The agency must determine whether colocation with a parent who is receiving services 
161.17 	in a licensed residential family-based substance use disorder treatment program is in the 
161.18 	child's best interests according to paragraph (b) and include that determination in the child's 
161.19 	case plan under subdivision 1. The agency may consider additional factors not identified 
161.20 	in paragraph (b). The agency's determination must be documented in the child's case plan 
161.21 	before the child is colocated with a parent.
161.22 	(g) The agency must establish a juvenile treatment screening team under section 260C.157
161.23 	to determine whether it is necessary and appropriate to recommend placing a child in a 
161.24 	qualified residential treatment program, as defined in section 260C.007, subdivision 26d.

161.25 	Sec. 32. Minnesota Statutes 2020, section 260C.212, subdivision 13, is amended to read:
161.26 		Subd. 13.Protecting missing and runaway children and youth at risk of sex 
161.27 	trafficking or commercial sexual exploitation. (a) The local social services agency shall 
161.28 	expeditiously locate any child missing from foster care.
161.29 	(b) The local social services agency shall report immediately, but no later than 24 hours, 
161.30 	after receiving information on a missing or abducted child to the local law enforcement 
161.31 	agency for entry into the National Crime Information Center (NCIC) database of the Federal 
161.32 	Bureau of Investigation, and to the National Center for Missing and Exploited Children.
162.1 	(c) The local social services agency shall not discharge a child from foster care or close 
162.2 	the social services case until diligent efforts have been exhausted to locate the child and the 
162.3 	court terminates the agency's jurisdiction.
162.4 	(d) The local social services agency shall determine the primary factors that contributed 
162.5 	to the child's running away or otherwise being absent from care and, to the extent possible 
162.6 	and appropriate, respond to those factors in current and subsequent placements.
162.7 	(e) The local social services agency shall determine what the child experienced while 
162.8 	absent from care, including screening the child to determine if the child is a possible sex 
162.9 	trafficking or commercial sexual exploitation victim as defined in section 609.321, 
162.10 	subdivision 7b 260C.007, subdivision 31.
162.11 	(f) The local social services agency shall report immediately, but no later than 24 hours, 
162.12 	to the local law enforcement agency any reasonable cause to believe a child is, or is at risk 
162.13 	of being, a sex trafficking or commercial sexual exploitation victim.
162.14 	(g) The local social services agency shall determine appropriate services as described 
162.15 	in section 145.4717 with respect to any child for whom the local social services agency has 
162.16 	responsibility for placement, care, or supervision when the local social services agency has 
162.17 	reasonable cause to believe that the child is, or is at risk of being, a sex trafficking or 
162.18 	commercial sexual exploitation victim.

162.19 	EFFECTIVE DATE. This section is effective September 30, 2021.

162.20 	Sec. 33. Minnesota Statutes 2020, section 260C.212, is amended by adding a subdivision 
162.21 	to read:
162.22 		Subd. 15.Social and medical history. (a) The responsible social services agency must 
162.23 	complete each child's social and medical history using forms developed by the commissioner. 
162.24 	The responsible social services agency must work with each child's birth family, foster 
162.25 	family, medical and treatment providers, and school to ensure that there is a detailed and 
162.26 	up-to-date social and medical history of the child on forms provided by the commissioner.
162.27 	(b) If the child continues to be in placement out of the home of the parent or guardian 
162.28 	from whom the child was removed, reasonable efforts by the responsible social services 
162.29 	agency to complete the child's social and medical history must begin no later than the child's 
162.30 	permanency progress review hearing required under section 260C.204 or six months after 
162.31 	the child's placement in foster care, whichever occurs earlier.
162.32 	(c) In a child's social and medical history, the responsible social services agency must 
162.33 	include background information and health history specific to the child, the child's birth 
163.1 	parents, and the child's other birth relatives. Applicable background and health information 
163.2 	about the child includes the child's current health condition, behavior, and demeanor; 
163.3 	placement history; education history; sibling information; and birth, medical, dental, and 
163.4 	immunization information. Redacted copies of pertinent records, assessments, and evaluations 
163.5 	must be attached to the child's social and medical history. Applicable background information 
163.6 	about the child's birth parents and other birth relatives includes general background 
163.7 	information; education and employment history; physical health and mental health history; 
163.8 	and reasons for the child's placement.

163.9 	Sec. 34. Minnesota Statutes 2020, section 260C.219, subdivision 5, is amended to read:
163.10 		Subd. 5.Children reaching age of majority; copies of records. Regardless of whether
163.11 	a child is under state guardianship or not, if a child leaves foster care by reason of having 
163.12 	attained the age of majority under state law, the child must be given at no cost a copy of 
163.13 	the child's social and medical history, as defined described in section 259.43, 260C.212, 
163.14 	subdivision 15, including the child's health and education report.

163.15 	Sec. 35. Minnesota Statutes 2020, section 260C.4412, is amended to read:
163.16 	260C.4412 PAYMENT FOR RESIDENTIAL PLACEMENTS.
163.17 	(a) When a child is placed in a foster care group residential setting under Minnesota 
163.18 	Rules, parts 2960.0020 to 2960.0710, a foster residence licensed under chapter 245A that 
163.19 	meets the standards of Minnesota Rules, parts 2960.3200 to 2960.3230, or a children's 
163.20 	residential facility licensed or approved by a tribe, foster care maintenance payments must 
163.21 	be made on behalf of the child to cover the cost of providing food, clothing, shelter, daily 
163.22 	supervision, school supplies, child's personal incidentals and supports, reasonable travel for 
163.23 	visitation, or other transportation needs associated with the items listed. Daily supervision 
163.24 	in the group residential setting includes routine day-to-day direction and arrangements to 
163.25 	ensure the well-being and safety of the child. It may also include reasonable costs of 
163.26 	administration and operation of the facility.
163.27 	(b) The commissioner of human services shall specify the title IV-E administrative 
163.28 	procedures under section 256.82 for each of the following residential program settings:
163.29 	(1) residential programs licensed under chapter 245A or licensed by a tribe, including:
163.30 	(i) qualified residential treatment programs as defined in section 260C.007, subdivision 
163.31 	26d;
164.1 	(ii) program settings specializing in providing prenatal, postpartum, or parenting supports 
164.2 	for youth; and
164.3 	(iii) program settings providing high-quality residential care and supportive services to 
164.4 	children and youth who are, or are at risk of becoming, sex trafficking victims;
164.5 	(2) licensed residential family-based substance use disorder treatment programs as 
164.6 	defined in section 260C.007, subdivision 22a; and
164.7 	(3) supervised settings in which a foster child age 18 or older may live independently, 
164.8 	consistent with section 260C.451.
164.9 	(c) A lead contract under section 256.0112, subdivision 6, is not required to establish 
164.10 	the foster care maintenance payment in paragraph (a) for foster residence settings licensed 
164.11 	under chapter 245A that meet the standards of Minnesota Rules, parts 2960.3200 to 
164.12 	2960.3230. The foster care maintenance payment for these settings must be consistent with 
164.13 	section 256N.26, subdivision 3, and subject to the annual revision as specified in section 
164.14 	256N.26, subdivision 9.

164.15 	EFFECTIVE DATE. This section is effective for placements made in licensed residential 
164.16 	settings after September 30, 2021.

164.17 	Sec. 36. Minnesota Statutes 2020, section 260C.452, is amended to read:
164.18 	260C.452 SUCCESSFUL TRANSITION TO ADULTHOOD.
164.19 		Subdivision 1.Scope; purpose. (a) For purposes of this section, "youth" means a person 
164.20 	who is at least 14 years of age and under 23 years of age.
164.21 	(b) This section pertains to a child youth who:
164.22 	(1) is in foster care and is 14 years of age or older, including a youth who is under the 
164.23 	guardianship of the commissioner of human services, or who;
164.24 	(2) has a permanency disposition of permanent custody to the agency, or who;
164.25 	(3) will leave foster care at 18 to 21 years of age. when the youth is 18 years of age or 
164.26 	older and under 21 years of age;
164.27 	(4) has left foster care due to adoption when the youth was 16 years of age or older;
164.28 	(5) has left foster care due to a transfer of permanent legal and physical custody to a 
164.29 	relative, or Tribal equivalent, when the youth was 16 years of age or older; or
164.30 	(6) was reunified with the youth's primary caretaker when the youth was 14 years of age 
164.31 	or older and under 18 years of age.
165.1 	(c) The purpose of this section is to provide support to each youth who is transitioning 
165.2 	to adulthood by providing services to the youth in the areas of:
165.3 	(1) education;
165.4 	(2) employment;
165.5 	(3) daily living skills such as financial literacy training and driving instruction, preventive 
165.6 	health activities including promoting abstinence from substance use and smoking, and 
165.7 	nutrition education and pregnancy prevention;
165.8 	(4) forming meaningful, permanent connections with caring adults;
165.9 	(5) engaging in age-appropriate and developmentally appropriate activities under section 
165.10 	260C.212, subdivision 14, and positive youth development;
165.11 	(6) financial, housing, counseling, and other services to assist a youth over 18 years of 
165.12 	age in achieving self-sufficiency and accepting personal responsibility for the transition 
165.13 	from adolescence to adulthood; and
165.14 	(7) making vouchers available for education and training.
165.15 	(d) The responsible social services agency may provide support and case management 
165.16 	services to a youth as defined in paragraph (a) until the youth reaches 23 years of age. 
165.17 	According to section 260C.451, a youth's placement in a foster care setting will end when 
165.18 	the youth reaches 21 years of age.
165.19 		Subd. 1a.Case management services. Case management services include the 
165.20 	responsibility for planning, coordinating, authorizing, monitoring, and evaluating services 
165.21 	for a youth and shall be provided to a youth by the responsible social services agency or 
165.22 	the contracted agency. Case management services include the out-of-home placement plan 
165.23 	under section 260C.212, subdivision 1, when the youth is in out-of-home placement.
165.24 		Subd. 2.Independent living plan. When the child youth is 14 years of age or older and 
165.25 	is receiving support from the responsible social services agency under this section, the 
165.26 	responsible social services agency, in consultation with the child youth, shall complete the
165.27 	youth's independent living plan according to section 260C.212, subdivision 1, paragraph 
165.28 	(c), clause (12), regardless of the youth's current placement status.
165.29 		Subd. 3.Notification. Six months before the child is expected to be discharged from 
165.30 	foster care, the responsible social services agency shall provide written notice to the child 
165.31 	regarding the right to continued access to services for certain children in foster care past 18 
165.32 	years of age and of the right to appeal a denial of social services under section 256.045.
166.1 		Subd. 4.Administrative or court review of placements. (a) When the child youth is 
166.2 	14 years of age or older, the court, in consultation with the child youth, shall review the
166.3 	youth's independent living plan according to section 260C.203, paragraph (d).
166.4 	(b) The responsible social services agency shall file a copy of the notification required 
166.5 	in subdivision 3 of foster care benefits for a youth who is 18 years of age or older according 
166.6 	to section 260C.451, subdivision 1, with the court. If the responsible social services agency 
166.7 	does not file the notice by the time the child youth is 17-1/2 years of age, the court shall 
166.8 	require the responsible social services agency to file the notice.
166.9 	(c) When a youth is 18 years of age or older, the court shall ensure that the responsible 
166.10 	social services agency assists the child youth in obtaining the following documents before 
166.11 	the child youth leaves foster care: a Social Security card; an official or certified copy of the 
166.12 	child's youth's birth certificate; a state identification card or driver's license, tribal enrollment 
166.13 	identification card, green card, or school visa; health insurance information; the child's
166.14 	youth's school, medical, and dental records; a contact list of the child's youth's medical, 
166.15 	dental, and mental health providers; and contact information for the child's youth's siblings, 
166.16 	if the siblings are in foster care.
166.17 	(d) For a child youth who will be discharged from foster care at 18 years of age or older 
166.18 	because the youth is not eligible for extended foster care benefits or chooses to leave foster 
166.19 	care, the responsible social services agency must develop a personalized transition plan as 
166.20 	directed by the child youth during the 90-day180-day period immediately prior to the 
166.21 	expected date of discharge. The transition plan must be as detailed as the child youth elects 
166.22 	and include specific options, including but not limited to:
166.23 	(1) affordable housing with necessary supports that does not include a homeless shelter;
166.24 	(2) health insurance, including eligibility for medical assistance as defined in section 
166.25 	256B.055, subdivision 17;
166.26 	(3) education, including application to the Education and Training Voucher Program;
166.27 	(4) local opportunities for mentors and continuing support services, including the Healthy 
166.28 	Transitions and Homeless Prevention program, if available;
166.29 	(5) workforce supports and employment services;
166.30 	(6) a copy of the child's youth's consumer credit report as defined in section 13C.001
166.31 	and assistance in interpreting and resolving any inaccuracies in the report, at no cost to the 
166.32 	child youth;
167.1 	(7) information on executing a health care directive under chapter 145C and on the 
167.2 	importance of designating another individual to make health care decisions on behalf of the 
167.3 	child youth if the child youth becomes unable to participate in decisions;
167.4 	(8) appropriate contact information through 21 years of age if the child youth needs 
167.5 	information or help dealing with a crisis situation; and
167.6 	(9) official documentation that the youth was previously in foster care.
167.7 		Subd. 5.Notice of termination of foster care social services. (a) When Before a child
167.8 	youth who is 18 years of age or older leaves foster care at 18 years of age or older, the 
167.9 	responsible social services agency shall give the child youth written notice that foster care 
167.10 	shall terminate 30 days from the date that the notice is sent by the agency according to 
167.11 	section 260C.451, subdivision 8.
167.12 	(b) The child or the child's guardian ad litem may file a motion asking the court to review 
167.13 	the responsible social services agency's determination within 15 days of receiving the notice. 
167.14 	The child shall not be discharged from foster care until the motion is heard. The responsible 
167.15 	social services agency shall work with the child to transition out of foster care.
167.16 	(c) The written notice of termination of benefits shall be on a form prescribed by the 
167.17 	commissioner and shall give notice of the right to have the responsible social services 
167.18 	agency's determination reviewed by the court under this section or sections 260C.203, 
167.19 	260C.317, and 260C.515, subdivision 5 or 6. A copy of the termination notice shall be sent 
167.20 	to the child and the child's attorney, if any, the foster care provider, the child's guardian ad 
167.21 	litem, and the court. The responsible social services agency is not responsible for paying 
167.22 	foster care benefits for any period of time after the child leaves foster care.
167.23 	(b) Before case management services will end for a youth who is at least 18 years of 
167.24 	age and under 23 years of age, the responsible social services agency shall give the youth: 
167.25 	(1) written notice that case management services for the youth shall terminate; and (2) 
167.26 	written notice that the youth has the right to appeal the termination of case management 
167.27 	services under section 256.045, subdivision 3, by responding in writing within ten days of 
167.28 	the date that the agency mailed the notice. The termination notice must include information 
167.29 	about services for which the youth is eligible and how to access the services.

167.30 	EFFECTIVE DATE. This section is effective July 1, 2021.

168.1 	Sec. 37. Minnesota Statutes 2020, section 260C.503, subdivision 2, is amended to read:
168.2 		Subd. 2.Termination of parental rights. (a) The responsible social services agency 
168.3 	must ask the county attorney to immediately file a termination of parental rights petition 
168.4 	when:
168.5 	(1) the child has been subjected to egregious harm as defined in section 260C.007, 
168.6 	subdivision 14;
168.7 	(2) the child is determined to be the sibling of a child who was subjected to egregious 
168.8 	harm;
168.9 	(3) the child is an abandoned infant as defined in section 260C.301, subdivision 2, 
168.10 	paragraph (a), clause (2);
168.11 	(4) the child's parent has lost parental rights to another child through an order involuntarily 
168.12 	terminating the parent's rights;
168.13 	(5) the parent has committed sexual abuse as defined in section 260E.03, against the 
168.14 	child or another child of the parent;
168.15 	(6) the parent has committed an offense that requires registration as a predatory offender 
168.16 	under section 243.166, subdivision 1b, paragraph (a) or (b); or
168.17 	(7) another child of the parent is the subject of an order involuntarily transferring 
168.18 	permanent legal and physical custody of the child to a relative under this chapter or a similar 
168.19 	law of another jurisdiction;
168.20 	The county attorney shall file a termination of parental rights petition unless the conditions 
168.21 	of paragraph (d) are met.
168.22 	(b) When the termination of parental rights petition is filed under this subdivision, the 
168.23 	responsible social services agency shall identify, recruit, and approve an adoptive family 
168.24 	for the child. If a termination of parental rights petition has been filed by another party, the 
168.25 	responsible social services agency shall be joined as a party to the petition.
168.26 	(c) If criminal charges have been filed against a parent arising out of the conduct alleged 
168.27 	to constitute egregious harm, the county attorney shall determine which matter should 
168.28 	proceed to trial first, consistent with the best interests of the child and subject to the 
168.29 	defendant's right to a speedy trial.
168.30 	(d) The requirement of paragraph (a) does not apply if the responsible social services 
168.31 	agency and the county attorney determine and file with the court:
169.1 	(1) a petition for transfer of permanent legal and physical custody to a relative under 
169.2 	sections 260C.505 and 260C.515, subdivision 3 4, including a determination that adoption 
169.3 	is not in the child's best interests and that transfer of permanent legal and physical custody 
169.4 	is in the child's best interests; or
169.5 	(2) a petition under section 260C.141 alleging the child, and where appropriate, the 
169.6 	child's siblings, to be in need of protection or services accompanied by a case plan prepared 
169.7 	by the responsible social services agency documenting a compelling reason why filing a 
169.8 	termination of parental rights petition would not be in the best interests of the child.

169.9 	Sec. 38. Minnesota Statutes 2020, section 260C.515, subdivision 3, is amended to read:
169.10 		Subd. 3.Guardianship; commissioner. The court may issue an order that the child is 
169.11 	under the guardianship to of the commissioner of human services under the following 
169.12 	procedures and conditions:
169.13 	(1) there is an identified prospective adoptive parent agreed to by the responsible social 
169.14 	services agency having that has legal custody of the child pursuant to court order under this 
169.15 	chapter and that prospective adoptive parent has agreed to adopt the child;
169.16 	(2) the court accepts the parent's voluntary consent to adopt in writing on a form 
169.17 	prescribed by the commissioner, executed before two competent witnesses and confirmed 
169.18 	by the consenting parent before the court or executed before the court. The consent shall 
169.19 	contain notice that consent given under this chapter:
169.20 	(i) is irrevocable upon acceptance by the court unless fraud is established and an order 
169.21 	is issued permitting revocation as stated in clause (9) unless the matter is governed by the 
169.22 	Indian Child Welfare Act, United States Code, title 25, section 1913(c); and
169.23 	(ii) will result in an order that the child is under the guardianship of the commissioner 
169.24 	of human services;
169.25 	(3) a consent executed and acknowledged outside of this state, either in accordance with 
169.26 	the law of this state or in accordance with the law of the place where executed, is valid;
169.27 	(4) the court must review the matter at least every 90 days under section 260C.317;
169.28 	(5) a consent to adopt under this subdivision vests guardianship of the child with the 
169.29 	commissioner of human services and makes the child a ward of the commissioner of human 
169.30 	services under section 260C.325;
169.31 	(6) the court must forward to the commissioner a copy of the consent to adopt, together 
169.32 	with a certified copy of the order transferring guardianship to the commissioner;
170.1 	(7) if an adoption is not finalized by the identified prospective adoptive parent within 
170.2 	six months of the execution of the consent to adopt under this clause, the responsible social 
170.3 	services agency shall pursue adoptive placement in another home unless the court finds in 
170.4 	a hearing under section 260C.317 that the failure to finalize is not due to either an action 
170.5 	or a failure to act by the prospective adoptive parent;
170.6 	(8) notwithstanding clause (7), the responsible social services agency must pursue 
170.7 	adoptive placement in another home as soon as the agency determines that finalization of 
170.8 	the adoption with the identified prospective adoptive parent is not possible, that the identified 
170.9 	prospective adoptive parent is not willing to adopt the child, or that the identified prospective 
170.10 	adoptive parent is not cooperative in completing the steps necessary to finalize the adoption. 
170.11 	The court may order a termination of parental rights under subdivision 2; and
170.12 	(9) unless otherwise required by the Indian Child Welfare Act, United States Code, title 
170.13 	25, section 1913(c), a consent to adopt executed under this section shall be irrevocable upon 
170.14 	acceptance by the court except upon order permitting revocation issued by the same court 
170.15 	after written findings that consent was obtained by fraud.

170.16 	Sec. 39. Minnesota Statutes 2020, section 260C.605, subdivision 1, is amended to read:
170.17 		Subdivision 1.Requirements. (a) Reasonable efforts to finalize the adoption of a child 
170.18 	under the guardianship of the commissioner shall be made by the responsible social services 
170.19 	agency responsible for permanency planning for the child.
170.20 	(b) Reasonable efforts to make a placement in a home according to the placement 
170.21 	considerations under section 260C.212, subdivision 2, with a relative or foster parent who 
170.22 	will commit to being the permanent resource for the child in the event the child cannot be 
170.23 	reunified with a parent are required under section 260.012 and may be made concurrently 
170.24 	with reasonable, or if the child is an Indian child, active efforts to reunify the child with the 
170.25 	parent.
170.26 	(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the 
170.27 	child is in foster care under this chapter, but not later than the hearing required under section 
170.28 	260C.204.
170.29 	(d) Reasonable efforts to finalize the adoption of the child include:
170.30 	(1) using age-appropriate engagement strategies to plan for adoption with the child;
170.31 	(2) identifying an appropriate prospective adoptive parent for the child by updating the 
170.32 	child's identified needs using the factors in section 260C.212, subdivision 2;
171.1 	(3) making an adoptive placement that meets the child's needs by:
171.2 	(i) completing or updating the relative search required under section 260C.221 and giving 
171.3 	notice of the need for an adoptive home for the child to:
171.4 	(A) relatives who have kept the agency or the court apprised of their whereabouts and 
171.5 	who have indicated an interest in adopting the child; or
171.6 	(B) relatives of the child who are located in an updated search;
171.7 	(ii) an updated search is required whenever:
171.8 	(A) there is no identified prospective adoptive placement for the child notwithstanding 
171.9 	a finding by the court that the agency made diligent efforts under section 260C.221, in a 
171.10 	hearing required under section 260C.202;
171.11 	(B) the child is removed from the home of an adopting parent; or
171.12 	(C) the court determines a relative search by the agency is in the best interests of the 
171.13 	child;
171.14 	(iii) engaging the child's foster parent and the child's relatives identified as an adoptive 
171.15 	resource during the search conducted under section 260C.221, to commit to being the 
171.16 	prospective adoptive parent of the child; or
171.17 	(iv) when there is no identified prospective adoptive parent:
171.18 	(A) registering the child on the state adoption exchange as required in section 259.75 
171.19 	unless the agency documents to the court an exception to placing the child on the state 
171.20 	adoption exchange reported to the commissioner;
171.21 	(B) reviewing all families with approved adoption home studies associated with the 
171.22 	responsible social services agency;
171.23 	(C) presenting the child to adoption agencies and adoption personnel who may assist 
171.24 	with finding an adoptive home for the child;
171.25 	(D) using newspapers and other media to promote the particular child;
171.26 	(E) using a private agency under grant contract with the commissioner to provide adoption 
171.27 	services for intensive child-specific recruitment efforts; and
171.28 	(F) making any other efforts or using any other resources reasonably calculated to identify 
171.29 	a prospective adoption parent for the child;
171.30 	(4) updating and completing the social and medical history required under sections 
171.31 	259.43 260C.212, subdivision 15, and 260C.609;
172.1 	(5) making, and keeping updated, appropriate referrals required by section 260.851, the 
172.2 	Interstate Compact on the Placement of Children;
172.3 	(6) giving notice regarding the responsibilities of an adoptive parent to any prospective 
172.4 	adoptive parent as required under section 259.35;
172.5 	(7) offering the adopting parent the opportunity to apply for or decline adoption assistance 
172.6 	under chapter 259A 256N;
172.7 	(8) certifying the child for adoption assistance, assessing the amount of adoption 
172.8 	assistance, and ascertaining the status of the commissioner's decision on the level of payment 
172.9 	if the adopting parent has applied for adoption assistance;
172.10 	(9) placing the child with siblings. If the child is not placed with siblings, the agency 
172.11 	must document reasonable efforts to place the siblings together, as well as the reason for 
172.12 	separation. The agency may not cease reasonable efforts to place siblings together for final 
172.13 	adoption until the court finds further reasonable efforts would be futile or that placement 
172.14 	together for purposes of adoption is not in the best interests of one of the siblings; and
172.15 	(10) working with the adopting parent to file a petition to adopt the child and with the 
172.16 	court administrator to obtain a timely hearing to finalize the adoption.

172.17 	Sec. 40. Minnesota Statutes 2020, section 260C.607, subdivision 6, is amended to read:
172.18 		Subd. 6.Motion and hearing to order adoptive placement. (a) At any time after the 
172.19 	district court orders the child under the guardianship of the commissioner of human services, 
172.20 	but not later than 30 days after receiving notice required under section 260C.613, subdivision 
172.21 	1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's 
172.22 	foster parent may file a motion for an order for adoptive placement of a child who is under 
172.23 	the guardianship of the commissioner if the relative or the child's foster parent:
172.24 	(1) has an adoption home study under section 259.41 approving the relative or foster 
172.25 	parent for adoption and has been a resident of Minnesota for at least six months before filing 
172.26 	the motion; the court may waive the residency requirement for the moving party if there is 
172.27 	a reasonable basis to do so; or
172.28 	(2) is not a resident of Minnesota, but has an approved adoption home study by an agency 
172.29 	licensed or approved to complete an adoption home study in the state of the individual's 
172.30 	residence and the study is filed with the motion for adoptive placement.
172.31 	(b) The motion shall be filed with the court conducting reviews of the child's progress 
172.32 	toward adoption under this section. The motion and supporting documents must make a 
173.1 	prima facie showing that the agency has been unreasonable in failing to make the requested 
173.2 	adoptive placement. The motion must be served according to the requirements for motions 
173.3 	under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all 
173.4 	individuals and entities listed in subdivision 2.
173.5 	(c) If the motion and supporting documents do not make a prima facie showing for the 
173.6 	court to determine whether the agency has been unreasonable in failing to make the requested 
173.7 	adoptive placement, the court shall dismiss the motion. If the court determines a prima facie 
173.8 	basis is made, the court shall set the matter for evidentiary hearing.
173.9 	(d) At the evidentiary hearing, the responsible social services agency shall proceed first 
173.10 	with evidence about the reason for not making the adoptive placement proposed by the 
173.11 	moving party. The moving party then has the burden of proving by a preponderance of the 
173.12 	evidence that the agency has been unreasonable in failing to make the adoptive placement.
173.13 	(e) At the conclusion of the evidentiary hearing, if the court finds that the agency has 
173.14 	been unreasonable in failing to make the adoptive placement and that the relative or the 
173.15 	child's foster parent is the most suitable adoptive home to meet the child's needs using the 
173.16 	factors in section 260C.212, subdivision 2, paragraph (b), the court may order the responsible 
173.17 	social services agency to make an adoptive placement in the home of the relative or the 
173.18 	child's foster parent.
173.19 	(f) If, in order to ensure that a timely adoption may occur, the court orders the responsible 
173.20 	social services agency to make an adoptive placement under this subdivision, the agency 
173.21 	shall:
173.22 	(1) make reasonable efforts to obtain a fully executed adoption placement agreement;
173.23 	(2) work with the moving party regarding eligibility for adoption assistance as required 
173.24 	under chapter 259A 256N; and
173.25 	(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval 
173.26 	of the adoptive placement through the Interstate Compact on the Placement of Children.
173.27 	(g) Denial or granting of a motion for an order for adoptive placement after an evidentiary 
173.28 	hearing is an order which may be appealed by the responsible social services agency, the 
173.29 	moving party, the child, when age ten or over, the child's guardian ad litem, and any 
173.30 	individual who had a fully executed adoption placement agreement regarding the child at 
173.31 	the time the motion was filed if the court's order has the effect of terminating the adoption 
173.32 	placement agreement. An appeal shall be conducted according to the requirements of the 
173.33 	Rules of Juvenile Protection Procedure.

174.1 	Sec. 41. Minnesota Statutes 2020, section 260C.609, is amended to read:
174.2 	260C.609 SOCIAL AND MEDICAL HISTORY.
174.3 	(a) The responsible social services agency shall work with the birth family of the child, 
174.4 	foster family, medical and treatment providers, and the child's school to ensure there is a 
174.5 	detailed, thorough, and currently up-to-date social and medical history of the child as required 
174.6 	under section 259.43 on the forms required by the commissioner.
174.7 	(b) When the child continues in foster care, the agency's reasonable efforts to complete 
174.8 	the history shall begin no later than the permanency progress review hearing required under 
174.9 	section 260C.204 or six months after the child's placement in foster care.
174.10 	(c) (a) The responsible social services agency shall thoroughly discuss the child's history 
174.11 	with the adopting prospective adoptive parent of the child and shall give a redacted copy 
174.12 	of the report of the child's social and medical history as described in section 260C.212, 
174.13 	subdivision 15, including redacted attachments, to the adopting prospective adoptive parent.
174.14 	If the prospective adoptive parent does not pursue adoption of the child, the prospective 
174.15 	adoptive parent must return the child's social and medical history and redacted attachments 
174.16 	to the agency. The responsible social services agency may give a redacted copy of the child's 
174.17 	social and medical history may also be given to the child, as appropriate according to section 
174.18 	260C.212, subdivision 1.
174.19 	(d) (b) The report shall not include information that identifies birth relatives. Redacted 
174.20 	copies of all of the child's relevant evaluations, assessments, and records must be attached 
174.21 	to the social and medical history.
174.22 	(c) The agency must submit the child's social and medical history to the Department of 
174.23 	Human Services at the time that the agency submits the child's adoption placement agreement. 
174.24 	Pursuant to section 260C.623, subdivision 4, the child's social and medical history must be 
174.25 	submitted to the court at the time the adoption petition is filed with the court.

174.26 	Sec. 42. Minnesota Statutes 2020, section 260C.615, is amended to read:
174.27 	260C.615 DUTIES OF COMMISSIONER.
174.28 		Subdivision 1.Duties. (a) For any child who is under the guardianship of the 
174.29 	commissioner, the commissioner has the exclusive rights to consent to:
174.30 	(1) the medical care plan for the treatment of a child who is at imminent risk of death 
174.31 	or who has a chronic disease that, in a physician's judgment, will result in the child's death 
174.32 	in the near future including a physician's order not to resuscitate or intubate the child; and
175.1 	(2) the child donating a part of the child's body to another person while the child is living; 
175.2 	the decision to donate a body part under this clause shall take into consideration the child's 
175.3 	wishes and the child's culture.
175.4 	(b) In addition to the exclusive rights under paragraph (a), the commissioner has a duty 
175.5 	to:
175.6 	(1) process any complete and accurate request for home study and placement through 
175.7 	the Interstate Compact on the Placement of Children under section 260.851;
175.8 	(2) process any complete and accurate application for adoption assistance forwarded by 
175.9 	the responsible social services agency according to chapter 259A 256N;
175.10 	(3) complete the execution of review and process an adoption placement agreement 
175.11 	forwarded to the commissioner by the responsible social services agency and return it to 
175.12 	the agency in a timely fashion; and
175.13 	(4) maintain records as required in chapter 259.
175.14 		Subd. 2.Duties not reserved. All duties, obligations, and consents not specifically 
175.15 	reserved to the commissioner in this section are delegated to the responsible social services 
175.16 	agency, subject to supervision by the commissioner under section 393.07.

175.17 	Sec. 43. Minnesota Statutes 2020, section 260C.704, is amended to read:
175.18 	260C.704 REQUIREMENTS FOR THE QUALIFIED INDIVIDUAL'S 
175.19 	ASSESSMENT OF THE CHILD FOR PLACEMENT IN A QUALIFIED 
175.20 	RESIDENTIAL TREATMENT PROGRAM.
175.21 	(a) A qualified individual must complete an assessment of the child prior to or within
175.22 	30 days of the child's placement in a qualified residential treatment program in a format 
175.23 	approved by the commissioner of human services, andunless, due to a crisis, the child must 
175.24 	immediately be placed in a qualified residential treatment program. When a child must 
175.25 	immediately be placed in a qualified residential treatment program without an assessment, 
175.26 	the qualified individual must complete the child's assessment within 30 days of the child's 
175.27 	placement. The qualified individual must:
175.28 	(1) assess the child's needs and strengths, using an age-appropriate, evidence-based, 
175.29 	validated, functional assessment approved by the commissioner of human services;
175.30 	(2) determine whether the child's needs can be met by the child's family members or 
175.31 	through placement in a family foster home; or, if not, determine which residential setting 
176.1 	would provide the child with the most effective and appropriate level of care to the child 
176.2 	in the least restrictive environment;
176.3 	(3) develop a list of short- and long-term mental and behavioral health goals for the 
176.4 	child; and
176.5 	(4) work with the child's family and permanency team using culturally competent 
176.6 	practices.
176.7 	If a level of care determination was conducted under section 245.4885, that information 
176.8 	must be shared with the qualified individual and the juvenile treatment screening team.
176.9 	(b) The child and the child's parents, when appropriate, may request that a specific 
176.10 	culturally competent qualified individual complete the child's assessment. The agency shall 
176.11 	make efforts to refer the child to the identified qualified individual to complete the 
176.12 	assessment. The assessment must not be delayed for a specific qualified individual to 
176.13 	complete the assessment.
176.14 	(c) The qualified individual must provide the assessment, when complete, to the 
176.15 	responsible social services agency, the child's parents or legal guardians, the guardian ad 
176.16 	litem, and the court. If the assessment recommends placement of the child in a qualified 
176.17 	residential treatment facility, the agency must distribute the assessment to the child's parent 
176.18 	or legal guardian and file the assessment with the court report as required in section 260C.71, 
176.19 	subdivision 2. If the assessment does not recommend placement in a qualified residential 
176.20 	treatment facility, the agency must provide a copy of the assessment to the parents or legal 
176.21 	guardians and the guardian ad litem and file the assessment determination with the court at 
176.22 	the next required hearing as required in section 260C.71, subdivision 5. If court rules and 
176.23 	chapter 13 permit disclosure of the results of the child's assessment, the agency may share 
176.24 	the results of the child's assessment with the child's foster care provider, other members of 
176.25 	the child's family, and the family and permanency team. The agency must not share the 
176.26 	child's private medical data with the family and permanency team unless: (1) chapter 13
176.27 	permits the agency to disclose the child's private medical data to the family and permanency 
176.28 	team; or (2) the child's parent has authorized the agency to disclose the child's private medical 
176.29 	data to the family and permanency team.
176.30 	(d) For an Indian child, the assessment of the child must follow the order of placement 
176.31 	preferences in the Indian Child Welfare Act of 1978, United States Code, title 25, section 
176.32 	1915.
176.33 	(e) In the assessment determination, the qualified individual must specify in writing:
177.1 	(1) the reasons why the child's needs cannot be met by the child's family or in a family 
177.2 	foster home. A shortage of family foster homes is not an acceptable reason for determining 
177.3 	that a family foster home cannot meet a child's needs;
177.4 	(2) why the recommended placement in a qualified residential treatment program will 
177.5 	provide the child with the most effective and appropriate level of care to meet the child's 
177.6 	needs in the least restrictive environment possible and how placing the child at the treatment 
177.7 	program is consistent with the short-term and long-term goals of the child's permanency 
177.8 	plan; and
177.9 	(3) if the qualified individual's placement recommendation is not the placement setting 
177.10 	that the parent, family and permanency team, child, or tribe prefer, the qualified individual 
177.11 	must identify the reasons why the qualified individual does not recommend the parent's, 
177.12 	family and permanency team's, child's, or tribe's placement preferences. The out-of-home 
177.13 	placement plan under section 260C.708 must also include reasons why the qualified 
177.14 	individual did not recommend the preferences of the parents, family and permanency team, 
177.15 	child, or tribe.
177.16 	(f) If the qualified individual determines that the child's family or a family foster home 
177.17 	or other less restrictive placement may meet the child's needs, the agency must move the 
177.18 	child out of the qualified residential treatment program and transition the child to a less 
177.19 	restrictive setting within 30 days of the determination. If the responsible social services 
177.20 	agency has placement authority of the child, the agency must make a plan for the child's 
177.21 	placement according to section 260C.212, subdivision 2. The agency must file the child's 
177.22 	assessment determination with the court at the next required hearing.
177.23 	(g) If the qualified individual recommends placing the child in a qualified residential 
177.24 	treatment program and if the responsible social services agency has placement authority of 
177.25 	the child, the agency shall make referrals to appropriate qualified residential treatment 
177.26 	programs and, upon acceptance by an appropriate program, place the child in an approved 
177.27 	or certified qualified residential treatment program.

177.28 	EFFECTIVE DATE. This section is effective September 30, 2021.

177.29 	Sec. 44. Minnesota Statutes 2020, section 260C.706, is amended to read:
177.30 	260C.706 FAMILY AND PERMANENCY TEAM REQUIREMENTS.
177.31 	(a) When the responsible social services agency's juvenile treatment screening team, as 
177.32 	defined in section 260C.157, recommends placing the child in a qualified residential treatment 
177.33 	program, the agency must assemble a family and permanency team within ten days.
178.1 	(1) The team must include all appropriate biological family members, the child's parents, 
178.2 	legal guardians or custodians, foster care providers, and relatives as defined in section 
178.3 	260C.007, subdivisions 26c 26b and 27, and professionals, as appropriate, who are a resource 
178.4 	to the child's family, such as teachers, medical or mental health providers, or clergy.
178.5 	(2) When a child is placed in foster care prior to the qualified residential treatment 
178.6 	program, the agency shall include relatives responding to the relative search notice as 
178.7 	required under section 260C.221 on this team, unless the juvenile court finds that contacting 
178.8 	a specific relative would endangerpresent a safety or health risk to the parent, guardian, 
178.9 	child, sibling, or any other family member.
178.10 	(3) When a qualified residential treatment program is the child's initial placement setting, 
178.11 	the responsible social services agency must engage with the child and the child's parents to 
178.12 	determine the appropriate family and permanency team members.
178.13 	(4) When the permanency goal is to reunify the child with the child's parent or legal 
178.14 	guardian, the purpose of the relative search and focus of the family and permanency team 
178.15 	is to preserve family relationships and identify and develop supports for the child and parents.
178.16 	(5) The responsible agency must make a good faith effort to identify and assemble all 
178.17 	appropriate individuals to be part of the child's family and permanency team and request 
178.18 	input from the parents regarding relative search efforts consistent with section 260C.221. 
178.19 	The out-of-home placement plan in section 260C.708 must include all contact information 
178.20 	for the team members, as well as contact information for family members or relatives who 
178.21 	are not a part of the family and permanency team.
178.22 	(6) If the child is age 14 or older, the team must include members of the family and 
178.23 	permanency team that the child selects in accordance with section 260C.212, subdivision 
178.24 	1, paragraph (b).
178.25 	(7) Consistent with section 260C.221, a responsible social services agency may disclose 
178.26 	relevant and appropriate private data about the child to relatives in order for the relatives 
178.27 	to participate in caring and planning for the child's placement.
178.28 	(8) If the child is an Indian child under section 260.751, the responsible social services 
178.29 	agency must make active efforts to include the child's tribal representative on the family 
178.30 	and permanency team.
178.31 	(b) The family and permanency team shall meet regarding the assessment required under 
178.32 	section 260C.704 to determine whether it is necessary and appropriate to place the child in 
179.1 	a qualified residential treatment program and to participate in case planning under section 
179.2 	260C.708.
179.3 	(c) When reunification of the child with the child's parent or legal guardian is the 
179.4 	permanency plan, the family and permanency team shall support the parent-child relationship 
179.5 	by recognizing the parent's legal authority, consulting with the parent regarding ongoing 
179.6 	planning for the child, and assisting the parent with visiting and contacting the child.
179.7 	(d) When the agency's permanency plan is to transfer the child's permanent legal and 
179.8 	physical custody to a relative or for the child's adoption, the team shall:
179.9 	(1) coordinate with the proposed guardian to provide the child with educational services, 
179.10 	medical care, and dental care;
179.11 	(2) coordinate with the proposed guardian, the agency, and the foster care facility to 
179.12 	meet the child's treatment needs after the child is placed in a permanent placement with the 
179.13 	proposed guardian;
179.14 	(3) plan to meet the child's need for safety, stability, and connection with the child's 
179.15 	family and community after the child is placed in a permanent placement with the proposed 
179.16 	guardian; and
179.17 	(4) in the case of an Indian child, communicate with the child's tribe to identify necessary 
179.18 	and appropriate services for the child, transition planning for the child, the child's treatment 
179.19 	needs, and how to maintain the child's connections to the child's community, family, and 
179.20 	tribe.
179.21 	(e) The agency shall invite the family and permanency team to participate in case planning 
179.22 	and the agency shall give the team notice of court reviews under sections 260C.152 and 
179.23 	260C.221 until: (1) the child is reunited with the child's parents; or (2) the child's foster care 
179.24 	placement ends and the child is in a permanent placement.

179.25 	EFFECTIVE DATE. This section is effective September 30, 2021.

179.26 	Sec. 45. Minnesota Statutes 2020, section 260C.708, is amended to read:
179.27 	260C.708 OUT-OF-HOME PLACEMENT PLAN FOR QUALIFIED 
179.28 	RESIDENTIAL TREATMENT PROGRAM PLACEMENTS.
179.29 	(a) When the responsible social services agency places a child in a qualified residential 
179.30 	treatment program as defined in section 260C.007, subdivision 26d, the out-of-home 
179.31 	placement plan must include:
179.32 	(1) the case plan requirements in section 260.212, subdivision 1 260C.212;
180.1 	(2) the reasonable and good faith efforts of the responsible social services agency to 
180.2 	identify and include all of the individuals required to be on the child's family and permanency 
180.3 	team under section 260C.007;
180.4 	(3) all contact information for members of the child's family and permanency team and 
180.5 	for other relatives who are not part of the family and permanency team;
180.6 	(4) evidence that the agency scheduled meetings of the family and permanency team, 
180.7 	including meetings relating to the assessment required under section 260C.704, at a time 
180.8 	and place convenient for the family;
180.9 	(5) evidence that the family and permanency team is involved in the assessment required 
180.10 	under section 260C.704 to determine the appropriateness of the child's placement in a 
180.11 	qualified residential treatment program;
180.12 	(6) the family and permanency team's placement preferences for the child in the 
180.13 	assessment required under section 260C.704. When making a decision about the child's 
180.14 	placement preferences, the family and permanency team must recognize:
180.15 	(i) that the agency should place a child with the child's siblings unless a court finds that 
180.16 	placing a child with the child's siblings is not possible due to a child's specialized placement 
180.17 	needs or is otherwise contrary to the child's best interests; and
180.18 	(ii) that the agency should place an Indian child according to the requirements of the 
180.19 	Indian Child Welfare Act, the Minnesota Family Preservation Act under sections 260.751 
180.20 	to 260.835, and section 260C.193, subdivision 3, paragraph (g);
180.21 	(5) (7) when reunification of the child with the child's parent or legal guardian is the 
180.22 	agency's goal, evidence demonstrating that the parent or legal guardian provided input about 
180.23 	the members of the family and permanency team under section 260C.706;
180.24 	(6) (8) when the agency's permanency goal is to reunify the child with the child's parent 
180.25 	or legal guardian, the out-of-home placement plan must identify services and supports that 
180.26 	maintain the parent-child relationship and the parent's legal authority, decision-making, and 
180.27 	responsibility for ongoing planning for the child. In addition, the agency must assist the 
180.28 	parent with visiting and contacting the child;
180.29 	(7) (9) when the agency's permanency goal is to transfer permanent legal and physical 
180.30 	custody of the child to a proposed guardian or to finalize the child's adoption, the case plan 
180.31 	must document the agency's steps to transfer permanent legal and physical custody of the 
180.32 	child or finalize adoption, as required in section 260C.212, subdivision 1, paragraph (c), 
180.33 	clauses (6) and (7); and
181.1 	(8) (10) the qualified individual's recommendation regarding the child's placement in a 
181.2 	qualified residential treatment program and the court approval or disapproval of the placement 
181.3 	as required in section 260C.71.
181.4 	(b) If the placement preferences of the family and permanency team, child, and tribe, if 
181.5 	applicable, are not consistent with the placement setting that the qualified individual 
181.6 	recommends, the case plan must include the reasons why the qualified individual did not 
181.7 	recommend following the preferences of the family and permanency team, child, and the 
181.8 	tribe.
181.9 	(c) The agency must file the out-of-home placement plan with the court as part of the 
181.10 	60-day hearing court order under section 260C.71.

181.11 	EFFECTIVE DATE. This section is effective September 30, 2021.

181.12 	Sec. 46. Minnesota Statutes 2020, section 260C.71, is amended to read:
181.13 	260C.71 COURT APPROVAL REQUIREMENTS.
181.14 		Subdivision 1.Judicial review. When the responsible social services agency has legal 
181.15 	authority to place a child at a qualified residential treatment facility under section 260C.007, 
181.16 	subdivision 21a, and the child's assessment under section 260C.704 recommends placing 
181.17 	the child in a qualified residential treatment facility, the agency shall place the child at a 
181.18 	qualified residential facility. Within 60 days of placing the child at a qualified residential 
181.19 	treatment facility, the agency must obtain a court order finding that the child's placement 
181.20 	is appropriate and meets the child's individualized needs.
181.21 		Subd. 2.Qualified residential treatment program; agency report to court. (a) The 
181.22 	responsible social services agency shall file a written report with the court after receiving 
181.23 	the qualified individual's assessment as specified in section 260C.704 prior to the child's 
181.24 	placement or within 35 days of the date of the child's placement in a qualified residential 
181.25 	treatment facility. The written report shall contain or have attached:
181.26 	(1) the child's name, date of birth, race, gender, and current address;
181.27 	(2) the names, races, dates of birth, residence, and post office address of the child's 
181.28 	parents or legal custodian, or guardian;
181.29 	(3) the name and address of the qualified residential treatment program, including a 
181.30 	chief administrator of the facility;
181.31 	(4) a statement of the facts that necessitated the child's foster care placement;
182.1 	(5) the child's out-of-home placement plan under section 260C.212, subdivision 1, 
182.2 	including the requirements in section 260C.708;
182.3 	(6) if the child is placed in an out-of-state qualified residential treatment program, the 
182.4 	compelling reasons why the child's needs cannot be met by an in-state placement;
182.5 	(7) the qualified individual's assessment of the child under section 260C.704, paragraph 
182.6 	(c), in a format approved by the commissioner;
182.7 	(8) if, at the time required for the report under this subdivision, the child's parent or legal 
182.8 	guardian, a child who is ten years of age or older, the family and permanency team, or a 
182.9 	tribe disagrees with the recommended qualified residential treatment program placement, 
182.10 	information regarding the disagreement and to the extent possible, the basis for the 
182.11 	disagreement in the report; and
182.12 	(9) any other information that the responsible social services agency, child's parent, legal 
182.13 	custodian or guardian, child, or, in the case of an Indian child, tribe would like the court to 
182.14 	consider.
182.15 	(b) The agency shall file the written report under paragraph (a) with the court and serve 
182.16 	on the parties a request for a hearing or a court order without a hearing.
182.17 	(c) The agency must inform the child's parent or legal guardian and a child who is ten 
182.18 	years of age or older of the court review requirements of this section and the child and child's 
182.19 	parent's or legal guardian's right to submit information to the court:
182.20 	(1) the agency must inform the child's parent or legal guardian and a child who is ten 
182.21 	years of age or older of the reporting date and the date by which the agency must receive 
182.22 	information from the child and child's parent so that the agency is able to submit the report 
182.23 	required by this subdivision to the court;
182.24 	(2) the agency must inform the child's parent or legal guardian, and a child who is ten 
182.25 	years of age or older that the court will hold a hearing upon the request of the child or the 
182.26 	child's parent; and
182.27 	(3) the agency must inform the child's parent or legal guardian, and a child who is ten 
182.28 	years of age or older that they have the right to request a hearing and the right to present 
182.29 	information to the court for the court's review under this subdivision.
182.30 		Subd. 3.Court hearing. (a) The court shall hold a hearing when a party or a child who 
182.31 	is ten years of age or older requests a hearing.
183.1 	(b) In all other circumstances, the court has the discretion to hold a hearing or issue an 
183.2 	order without a hearing.
183.3 		Subd. 4.Court findings and order. (a) Within 60 days from the beginning of each 
183.4 	placement in a qualified residential treatment program when the qualified individual's 
183.5 	assessment of the child recommends placing the child in a qualified residential treatment 
183.6 	program, the court must consider the qualified individual's assessment of the child under 
183.7 	section 260C.704 and issue an order to:
183.8 	(1) consider the qualified individual's assessment of whether it is necessary and 
183.9 	appropriate to place the child in a qualified residential treatment program under section 
183.10 	260C.704;
183.11 	(2) (1) determine whether a family foster home can meet the child's needs, whether it is 
183.12 	necessary and appropriate to place a child in a qualified residential treatment program that 
183.13 	is the least restrictive environment possible, and whether the child's placement is consistent 
183.14 	with the child's short and long term goals as specified in the permanency plan; and
183.15 	(3) (2) approve or disapprove of the child's placement.
183.16 	(b) In the out-of-home placement plan, the agency must document the court's approval 
183.17 	or disapproval of the placement, as specified in section 260C.708. If the court disapproves 
183.18 	of the child's placement in a qualified residential treatment program, the responsible social 
183.19 	services agency shall: (1) remove the child from the qualified residential treatment program 
183.20 	within 30 days of the court's order; and (2) make a plan for the child's placement that is 
183.21 	consistent with the child's best interests under section 260C.212, subdivision 2.
183.22 		Subd. 5.Court review and approval not required. When the responsible social services 
183.23 	agency has legal authority to place a child under section 260C.007, subdivision 21a, and 
183.24 	the qualified individual's assessment of the child does not recommend placing the child in 
183.25 	a qualified residential treatment program, the court is not required to hold a hearing and the 
183.26 	court is not required to issue an order. Pursuant to section 260C.704, paragraph (f), the 
183.27 	responsible social services agency shall make a plan for the child's placement consistent 
183.28 	with the child's best interests under section 260C.212, subdivision 2. The agency must file 
183.29 	the agency's assessment determination for the child with the court at the next required 
183.30 	hearing.

183.31 	EFFECTIVE DATE. This section is effective September 30, 2021.

184.1 	Sec. 47. Minnesota Statutes 2020, section 260C.712, is amended to read:
184.2 	260C.712 ONGOING REVIEWS AND PERMANENCY HEARING 
184.3 	REQUIREMENTS.
184.4 	As long as a child remains placed in a qualified residential treatment program, the 
184.5 	responsible social services agency shall submit evidence at each administrative review under 
184.6 	section 260C.203; each court review under sections 260C.202, 260C.203, and260C.204, 
184.7 	260D.06, 260D.07, and 260D.08; and each permanency hearing under section 260C.515, 
184.8 	260C.519, or260C.521, or 260D.07 that:
184.9 	(1) demonstrates that an ongoing assessment of the strengths and needs of the child 
184.10 	continues to support the determination that the child's needs cannot be met through placement 
184.11 	in a family foster home;
184.12 	(2) demonstrates that the placement of the child in a qualified residential treatment 
184.13 	program provides the most effective and appropriate level of care for the child in the least 
184.14 	restrictive environment;
184.15 	(3) demonstrates how the placement is consistent with the short-term and long-term 
184.16 	goals for the child, as specified in the child's permanency plan;
184.17 	(4) documents how the child's specific treatment or service needs will be met in the 
184.18 	placement;
184.19 	(5) documents the length of time that the agency expects the child to need treatment or 
184.20 	services; and
184.21 	(6) documents the responsible social services agency's efforts to prepare the child to 
184.22 	return home or to be placed with a fit and willing relative, legal guardian, adoptive parent, 
184.23 	or foster family.; and
184.24 	(7) if the child is placed in a qualified residential treatment program out-of-state, 
184.25 	documents the compelling reasons for placing the child out-of-state, and the reasons that 
184.26 	the child's needs cannot be met by an in-state placement.

184.27 	EFFECTIVE DATE. This section is effective September 30, 2021.

185.1 	Sec. 48. Minnesota Statutes 2020, section 260C.714, is amended to read:
185.2 	260C.714 REVIEW OF EXTENDED QUALIFIED RESIDENTIAL TREATMENT 
185.3 	PROGRAM PLACEMENTS.
185.4 	(a) When a responsible social services agency places a child in a qualified residential 
185.5 	treatment program for more than 12 consecutive months or 18 nonconsecutive months or, 
185.6 	in the case of a child who is under 13 years of age, for more than six consecutive or 
185.7 	nonconsecutive months, the agency must submit: (1) the signed approval by the county 
185.8 	social services director of the responsible social services agency; and (2) the evidence 
185.9 	supporting the child's placement at the most recent court review or permanency hearing 
185.10 	under section 260C.712, paragraph (b).
185.11 	(b) The commissioner shall specify the procedures and requirements for the agency's 
185.12 	review and approval of a child's extended qualified residential treatment program placement. 
185.13 	The commissioner may consult with counties, tribes, child-placing agencies, mental health 
185.14 	providers, licensed facilities, the child, the child's parents, and the family and permanency 
185.15 	team members to develop case plan requirements and engage in periodic reviews of the 
185.16 	case plan.

185.17 	EFFECTIVE DATE. This section is effective September 30, 2021.

185.18 	Sec. 49. Minnesota Statutes 2020, section 260D.01, is amended to read:
185.19 	260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
185.20 	(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for 
185.21 	treatment" provisions of the Juvenile Court Act.
185.22 	(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary 
185.23 	foster care for treatment upon the filing of a report or petition required under this chapter. 
185.24 	All obligations of the responsible social services agency to a child and family in foster care 
185.25 	contained in chapter 260C not inconsistent with this chapter are also obligations of the 
185.26 	agency with regard to a child in foster care for treatment under this chapter.
185.27 	(c) This chapter shall be construed consistently with the mission of the children's mental 
185.28 	health service system as set out in section 245.487, subdivision 3, and the duties of an agency 
185.29 	under sections 256B.092 and 260C.157 and Minnesota Rules, parts 9525.0004 to 9525.0016, 
185.30 	to meet the needs of a child with a developmental disability or related condition. This 
185.31 	chapter:
186.1 	(1) establishes voluntary foster care through a voluntary foster care agreement as the 
186.2 	means for an agency and a parent to provide needed treatment when the child must be in 
186.3 	foster care to receive necessary treatment for an emotional disturbance or developmental 
186.4 	disability or related condition;
186.5 	(2) establishes court review requirements for a child in voluntary foster care for treatment 
186.6 	due to emotional disturbance or developmental disability or a related condition;
186.7 	(3) establishes the ongoing responsibility of the parent as legal custodian to visit the 
186.8 	child, to plan together with the agency for the child's treatment needs, to be available and 
186.9 	accessible to the agency to make treatment decisions, and to obtain necessary medical, 
186.10 	dental, and other care for the child; and
186.11 	(4) applies to voluntary foster care when the child's parent and the agency agree that the 
186.12 	child's treatment needs require foster care either:
186.13 	(i) due to a level of care determination by the agency's screening team informed by the
186.14 	child's diagnostic and functional assessment under section 245.4885; or
186.15 	(ii) due to a determination regarding the level of services needed by the child by the 
186.16 	responsible social services' services agency's screening team under section 256B.092, and 
186.17 	Minnesota Rules, parts 9525.0004 to 9525.0016.; and
186.18 	(5) includes the requirements for a child's placement in sections 260C.70 to 260C.714, 
186.19 	when the juvenile treatment screening team recommends placing a child in a qualified 
186.20 	residential treatment program, except as modified by this chapter.
186.21 	(d) This chapter does not apply when there is a current determination under chapter 
186.22 	260E that the child requires child protective services or when the child is in foster care for 
186.23 	any reason other than treatment for the child's emotional disturbance or developmental 
186.24 	disability or related condition. When there is a determination under chapter 260E that the 
186.25 	child requires child protective services based on an assessment that there are safety and risk 
186.26 	issues for the child that have not been mitigated through the parent's engagement in services 
186.27 	or otherwise, or when the child is in foster care for any reason other than the child's emotional 
186.28 	disturbance or developmental disability or related condition, the provisions of chapter 260C
186.29 	apply.
186.30 	(e) The paramount consideration in all proceedings concerning a child in voluntary foster 
186.31 	care for treatment is the safety, health, and the best interests of the child. The purpose of 
186.32 	this chapter is:
187.1 	(1) to ensure that a child with a disability is provided the services necessary to treat or 
187.2 	ameliorate the symptoms of the child's disability;
187.3 	(2) to preserve and strengthen the child's family ties whenever possible and in the child's 
187.4 	best interests, approving the child's placement away from the child's parents only when the 
187.5 	child's need for care or treatment requires it out-of-home placement and the child cannot 
187.6 	be maintained in the home of the parent; and
187.7 	(3) to ensure that the child's parent retains legal custody of the child and associated 
187.8 	decision-making authority unless the child's parent willfully fails or is unable to make 
187.9 	decisions that meet the child's safety, health, and best interests. The court may not find that 
187.10 	the parent willfully fails or is unable to make decisions that meet the child's needs solely 
187.11 	because the parent disagrees with the agency's choice of foster care facility, unless the 
187.12 	agency files a petition under chapter 260C, and establishes by clear and convincing evidence 
187.13 	that the child is in need of protection or services.
187.14 	(f) The legal parent-child relationship shall be supported under this chapter by maintaining 
187.15 	the parent's legal authority and responsibility for ongoing planning for the child and by the 
187.16 	agency's assisting the parent, where when necessary, to exercise the parent's ongoing right 
187.17 	and obligation to visit or to have reasonable contact with the child. Ongoing planning means:
187.18 	(1) actively participating in the planning and provision of educational services, medical, 
187.19 	and dental care for the child;
187.20 	(2) actively planning and participating with the agency and the foster care facility for 
187.21 	the child's treatment needs; and
187.22 	(3) planning to meet the child's need for safety, stability, and permanency, and the child's 
187.23 	need to stay connected to the child's family and community.;
187.24 	(4) engaging with the responsible social services agency to ensure that the family and 
187.25 	permanency team under section 260C.706 consists of appropriate family members. For 
187.26 	purposes of voluntary placement of a child in foster care for treatment under chapter 260D, 
187.27 	prior to forming the child's family and permanency team, the responsible social services 
187.28 	agency must consult with the child's parent or legal guardian, the child if the child is 14 
187.29 	years of age or older, and, if applicable, the child's tribe to obtain recommendations regarding 
187.30 	which individuals to include on the team and to ensure that the team is family-centered and 
187.31 	will act in the child's best interests. If the child, child's parents, or legal guardians raise 
187.32 	concerns about specific relatives or professionals, the team should not include those 
187.33 	individuals unless the individual is a treating professional or an important connection to the 
187.34 	youth as outlined in the case or crisis plan; and
188.1 	(5) for a voluntary placement under this chapter in a qualified residential treatment 
188.2 	program, as defined in section 260C.007, subdivision 26d, for purposes of engaging in a 
188.3 	relative search as provided in section 260C.221, the county agency must consult with the 
188.4 	child's parent or legal guardian, the child if the child is 14 years of age or older, and, if 
188.5 	applicable, the child's tribe to obtain recommendations regarding which adult relatives the 
188.6 	county agency should notify. If the child, child's parents, or legal guardians raise concerns 
188.7 	about specific relatives, the county agency should not notify those relatives.
188.8 	(g) The provisions of section 260.012 to ensure placement prevention, family 
188.9 	reunification, and all active and reasonable effort requirements of that section apply. This 
188.10 	chapter shall be construed consistently with the requirements of the Indian Child Welfare 
188.11 	Act of 1978, United States Code, title 25, section 1901, et al., and the provisions of the 
188.12 	Minnesota Indian Family Preservation Act, sections 260.751 to 260.835.

188.13 	EFFECTIVE DATE. This section is effective September 30, 2021.

188.14 	Sec. 50. Minnesota Statutes 2020, section 260D.05, is amended to read:
188.15 	260D.05 ADMINISTRATIVE REVIEW OF CHILD IN VOLUNTARY FOSTER 
188.16 	CARE FOR TREATMENT.
188.17 	The administrative reviews required under section 260C.203 must be conducted for a 
188.18 	child in voluntary foster care for treatment, except that the initial administrative review 
188.19 	must take place prior to the submission of the report to the court required under section 
188.20 	260D.06, subdivision 2. When a child is placed in a qualified residential treatment program 
188.21 	as defined in section 260C.007, subdivision 26d, the responsible social services agency 
188.22 	must submit evidence to the court as specified in section 260C.712.

188.23 	EFFECTIVE DATE. This section is effective September 30, 2021.

188.24 	Sec. 51. Minnesota Statutes 2020, section 260D.06, subdivision 2, is amended to read:
188.25 		Subd. 2.Agency report to court; court review. The agency shall obtain judicial review 
188.26 	by reporting to the court according to the following procedures:
188.27 	(a) A written report shall be forwarded to the court within 165 days of the date of the 
188.28 	voluntary placement agreement. The written report shall contain or have attached:
188.29 	(1) a statement of facts that necessitate the child's foster care placement;
188.30 	(2) the child's name, date of birth, race, gender, and current address;
189.1 	(3) the names, race, date of birth, residence, and post office addresses of the child's 
189.2 	parents or legal custodian;
189.3 	(4) a statement regarding the child's eligibility for membership or enrollment in an Indian 
189.4 	tribe and the agency's compliance with applicable provisions of sections 260.751 to 260.835;
189.5 	(5) the names and addresses of the foster parents or chief administrator of the facility in 
189.6 	which the child is placed, if the child is not in a family foster home or group home;
189.7 	(6) a copy of the out-of-home placement plan required under section 260C.212, 
189.8 	subdivision 1;
189.9 	(7) a written summary of the proceedings of any administrative review required under 
189.10 	section 260C.203; and
189.11 	(8) evidence as specified in section 260C.712 when a child is placed in a qualified 
189.12 	residential treatment program as defined in section 260C.007, subdivision 26d; and
189.13 	(9) any other information the agency, parent or legal custodian, the child or the foster 
189.14 	parent, or other residential facility wants the court to consider.
189.15 	(b) In the case of a child in placement due to emotional disturbance, the written report 
189.16 	shall include as an attachment, the child's individual treatment plan developed by the child's 
189.17 	treatment professional, as provided in section 245.4871, subdivision 21, or the child's 
189.18 	standard written plan, as provided in section 125A.023, subdivision 3, paragraph (e).
189.19 	(c) In the case of a child in placement due to developmental disability or a related 
189.20 	condition, the written report shall include as an attachment, the child's individual service 
189.21 	plan, as provided in section 256B.092, subdivision 1b; the child's individual program plan, 
189.22 	as provided in Minnesota Rules, part 9525.0004, subpart 11; the child's waiver care plan; 
189.23 	or the child's standard written plan, as provided in section 125A.023, subdivision 3, paragraph 
189.24 	(e).
189.25 	(d) The agency must inform the child, age 12 or older, the child's parent, and the foster 
189.26 	parent or foster care facility of the reporting and court review requirements of this section 
189.27 	and of their right to submit information to the court:
189.28 	(1) if the child or the child's parent or the foster care provider wants to send information 
189.29 	to the court, the agency shall advise those persons of the reporting date and the date by 
189.30 	which the agency must receive the information they want forwarded to the court so the 
189.31 	agency is timely able submit it with the agency's report required under this subdivision;
190.1 	(2) the agency must also inform the child, age 12 or older, the child's parent, and the 
190.2 	foster care facility that they have the right to be heard in person by the court and how to 
190.3 	exercise that right;
190.4 	(3) the agency must also inform the child, age 12 or older, the child's parent, and the 
190.5 	foster care provider that an in-court hearing will be held if requested by the child, the parent, 
190.6 	or the foster care provider; and
190.7 	(4) if, at the time required for the report under this section, a child, age 12 or older, 
190.8 	disagrees about the foster care facility or services provided under the out-of-home placement 
190.9 	plan required under section 260C.212, subdivision 1, the agency shall include information 
190.10 	regarding the child's disagreement, and to the extent possible, the basis for the child's 
190.11 	disagreement in the report required under this section.
190.12 	(e) After receiving the required report, the court has jurisdiction to make the following 
190.13 	determinations and must do so within ten days of receiving the forwarded report, whether 
190.14 	a hearing is requested:
190.15 	(1) whether the voluntary foster care arrangement is in the child's best interests;
190.16 	(2) whether the parent and agency are appropriately planning for the child; and
190.17 	(3) in the case of a child age 12 or older, who disagrees with the foster care facility or 
190.18 	services provided under the out-of-home placement plan, whether it is appropriate to appoint 
190.19 	counsel and a guardian ad litem for the child using standards and procedures under section 
190.20 	260C.163.
190.21 	(f) Unless requested by a parent, representative of the foster care facility, or the child, 
190.22 	no in-court hearing is required in order for the court to make findings and issue an order as 
190.23 	required in paragraph (e).
190.24 	(g) If the court finds the voluntary foster care arrangement is in the child's best interests 
190.25 	and that the agency and parent are appropriately planning for the child, the court shall issue 
190.26 	an order containing explicit, individualized findings to support its determination. The 
190.27 	individualized findings shall be based on the agency's written report and other materials 
190.28 	submitted to the court. The court may make this determination notwithstanding the child's 
190.29 	disagreement, if any, reported under paragraph (d).
190.30 	(h) The court shall send a copy of the order to the county attorney, the agency, parent, 
190.31 	child, age 12 or older, and the foster parent or foster care facility.
191.1 	(i) The court shall also send the parent, the child, age 12 or older, the foster parent, or 
191.2 	representative of the foster care facility notice of the permanency review hearing required 
191.3 	under section 260D.07, paragraph (e).
191.4 	(j) If the court finds continuing the voluntary foster care arrangement is not in the child's 
191.5 	best interests or that the agency or the parent are not appropriately planning for the child, 
191.6 	the court shall notify the agency, the parent, the foster parent or foster care facility, the child, 
191.7 	age 12 or older, and the county attorney of the court's determinations and the basis for the 
191.8 	court's determinations. In this case, the court shall set the matter for hearing and appoint a 
191.9 	guardian ad litem for the child under section 260C.163, subdivision 5.

191.10 	EFFECTIVE DATE. This section is effective September 30, 2021.

191.11 	Sec. 52. Minnesota Statutes 2020, section 260D.07, is amended to read:
191.12 	260D.07 REQUIRED PERMANENCY REVIEW HEARING.
191.13 	(a) When the court has found that the voluntary arrangement is in the child's best interests 
191.14 	and that the agency and parent are appropriately planning for the child pursuant to the report 
191.15 	submitted under section 260D.06, and the child continues in voluntary foster care as defined 
191.16 	in section 260D.02, subdivision 10, for 13 months from the date of the voluntary foster care 
191.17 	agreement, or has been in placement for 15 of the last 22 months, the agency must:
191.18 	(1) terminate the voluntary foster care agreement and return the child home; or
191.19 	(2) determine whether there are compelling reasons to continue the voluntary foster care 
191.20 	arrangement and, if the agency determines there are compelling reasons, seek judicial 
191.21 	approval of its determination; or
191.22 	(3) file a petition for the termination of parental rights.
191.23 	(b) When the agency is asking for the court's approval of its determination that there are 
191.24 	compelling reasons to continue the child in the voluntary foster care arrangement, the agency 
191.25 	shall file a "Petition for Permanency Review Regarding a Child in Voluntary Foster Care 
191.26 	for Treatment" and ask the court to proceed under this section.
191.27 	(c) The "Petition for Permanency Review Regarding a Child in Voluntary Foster Care 
191.28 	for Treatment" shall be drafted or approved by the county attorney and be under oath. The 
191.29 	petition shall include:
191.30 	(1) the date of the voluntary placement agreement;
191.31 	(2) whether the petition is due to the child's developmental disability or emotional 
191.32 	disturbance;
192.1 	(3) the plan for the ongoing care of the child and the parent's participation in the plan;
192.2 	(4) a description of the parent's visitation and contact with the child;
192.3 	(5) the date of the court finding that the foster care placement was in the best interests 
192.4 	of the child, if required under section 260D.06, or the date the agency filed the motion under 
192.5 	section 260D.09, paragraph (b);
192.6 	(6) the agency's reasonable efforts to finalize the permanent plan for the child, including 
192.7 	returning the child to the care of the child's family; and
192.8 	(7) a citation to this chapter as the basis for the petition.; and
192.9 	(8) evidence as specified in section 260C.712 when a child is placed in a qualified 
192.10 	residential treatment program as defined in section 260C.007, subdivision 26d.
192.11 	(d) An updated copy of the out-of-home placement plan required under section 260C.212, 
192.12 	subdivision 1, shall be filed with the petition.
192.13 	(e) The court shall set the date for the permanency review hearing no later than 14 months 
192.14 	after the child has been in placement or within 30 days of the petition filing date when the 
192.15 	child has been in placement 15 of the last 22 months. The court shall serve the petition 
192.16 	together with a notice of hearing by United States mail on the parent, the child age 12 or 
192.17 	older, the child's guardian ad litem, if one has been appointed, the agency, the county 
192.18 	attorney, and counsel for any party.
192.19 	(f) The court shall conduct the permanency review hearing on the petition no later than 
192.20 	14 months after the date of the voluntary placement agreement, within 30 days of the filing 
192.21 	of the petition when the child has been in placement 15 of the last 22 months, or within 15 
192.22 	days of a motion to terminate jurisdiction and to dismiss an order for foster care under 
192.23 	chapter 260C, as provided in section 260D.09, paragraph (b).
192.24 	(g) At the permanency review hearing, the court shall:
192.25 	(1) inquire of the parent if the parent has reviewed the "Petition for Permanency Review 
192.26 	Regarding a Child in Voluntary Foster Care for Treatment," whether the petition is accurate, 
192.27 	and whether the parent agrees to the continued voluntary foster care arrangement as being 
192.28 	in the child's best interests;
192.29 	(2) inquire of the parent if the parent is satisfied with the agency's reasonable efforts to 
192.30 	finalize the permanent plan for the child, including whether there are services available and 
192.31 	accessible to the parent that might allow the child to safely be with the child's family;
192.32 	(3) inquire of the parent if the parent consents to the court entering an order that:
193.1 	(i) approves the responsible agency's reasonable efforts to finalize the permanent plan 
193.2 	for the child, which includes ongoing future planning for the safety, health, and best interests 
193.3 	of the child; and
193.4 	(ii) approves the responsible agency's determination that there are compelling reasons 
193.5 	why the continued voluntary foster care arrangement is in the child's best interests; and
193.6 	(4) inquire of the child's guardian ad litem and any other party whether the guardian or 
193.7 	the party agrees that:
193.8 	(i) the court should approve the responsible agency's reasonable efforts to finalize the 
193.9 	permanent plan for the child, which includes ongoing and future planning for the safety, 
193.10 	health, and best interests of the child; and
193.11 	(ii) the court should approve of the responsible agency's determination that there are 
193.12 	compelling reasons why the continued voluntary foster care arrangement is in the child's 
193.13 	best interests.
193.14 	(h) At a permanency review hearing under this section, the court may take the following 
193.15 	actions based on the contents of the sworn petition and the consent of the parent:
193.16 	(1) approve the agency's compelling reasons that the voluntary foster care arrangement 
193.17 	is in the best interests of the child; and
193.18 	(2) find that the agency has made reasonable efforts to finalize the permanent plan for 
193.19 	the child.
193.20 	(i) A child, age 12 or older, may object to the agency's request that the court approve its 
193.21 	compelling reasons for the continued voluntary arrangement and may be heard on the reasons 
193.22 	for the objection. Notwithstanding the child's objection, the court may approve the agency's 
193.23 	compelling reasons and the voluntary arrangement.
193.24 	(j) If the court does not approve the voluntary arrangement after hearing from the child 
193.25 	or the child's guardian ad litem, the court shall dismiss the petition. In this case, either:
193.26 	(1) the child must be returned to the care of the parent; or
193.27 	(2) the agency must file a petition under section 260C.141, asking for appropriate relief 
193.28 	under sections 260C.301 or 260C.503 to 260C.521.
193.29 	(k) When the court approves the agency's compelling reasons for the child to continue 
193.30 	in voluntary foster care for treatment, and finds that the agency has made reasonable efforts 
193.31 	to finalize a permanent plan for the child, the court shall approve the continued voluntary 
194.1 	foster care arrangement, and continue the matter under the court's jurisdiction for the purposes 
194.2 	of reviewing the child's placement every 12 months while the child is in foster care.
194.3 	(l) A finding that the court approves the continued voluntary placement means the agency 
194.4 	has continued legal authority to place the child while a voluntary placement agreement 
194.5 	remains in effect. The parent or the agency may terminate a voluntary agreement as provided 
194.6 	in section 260D.10. Termination of a voluntary foster care placement of an Indian child is 
194.7 	governed by section 260.765, subdivision 4.

194.8 	EFFECTIVE DATE. This section is effective September 30, 2021.

194.9 	Sec. 53. Minnesota Statutes 2020, section 260D.08, is amended to read:
194.10 	260D.08 ANNUAL REVIEW.
194.11 	(a) After the court conducts a permanency review hearing under section 260D.07, the 
194.12 	matter must be returned to the court for further review of the responsible social services 
194.13 	reasonable efforts to finalize the permanent plan for the child and the child's foster care 
194.14 	placement at least every 12 months while the child is in foster care. The court shall give 
194.15 	notice to the parent and child, age 12 or older, and the foster parents of the continued review 
194.16 	requirements under this section at the permanency review hearing.
194.17 	(b) Every 12 months, the court shall determine whether the agency made reasonable 
194.18 	efforts to finalize the permanency plan for the child, which means the exercise of due 
194.19 	diligence by the agency to:
194.20 	(1) ensure that the agreement for voluntary foster care is the most appropriate legal 
194.21 	arrangement to meet the child's safety, health, and best interests and to conduct a genuine 
194.22 	examination of whether there is another permanency disposition order under chapter 260C, 
194.23 	including returning the child home, that would better serve the child's need for a stable and 
194.24 	permanent home;
194.25 	(2) engage and support the parent in continued involvement in planning and decision 
194.26 	making for the needs of the child;
194.27 	(3) strengthen the child's ties to the parent, relatives, and community;
194.28 	(4) implement the out-of-home placement plan required under section 260C.212, 
194.29 	subdivision 1, and ensure that the plan requires the provision of appropriate services to 
194.30 	address the physical health, mental health, and educational needs of the child; and
195.1 	(5) submit evidence to the court as specified in section 260C.712 when a child is placed 
195.2 	in a qualified residential treatment program setting as defined in section 260C.007, 
195.3 	subdivision 26d; and
195.4 	(5) (6) ensure appropriate planning for the child's safe, permanent, and independent 
195.5 	living arrangement after the child's 18th birthday.

195.6 	EFFECTIVE DATE. This section is effective September 30, 2021.

195.7 	Sec. 54. Minnesota Statutes 2020, section 260D.14, is amended to read:
195.8 	260D.14 SUCCESSFUL TRANSITION TO ADULTHOOD FOR CHILDREN
195.9 	YOUTH IN VOLUNTARY PLACEMENT.
195.10 		Subdivision 1.Case planning. When the child a youth is 14 years of age or older, the 
195.11 	responsible social services agency shall ensure that a child youth in foster care under this 
195.12 	chapter is provided with the case plan requirements in section 260C.212, subdivisions 1
195.13 	and 14.
195.14 		Subd. 2.Notification. The responsible social services agency shall provide a youth with
195.15 	written notice of the right to continued access to services for certain children in foster care 
195.16 	past 18 years of age under section 260C.452, subdivision 3 foster care benefits that a youth 
195.17 	who is 18 years of age or older may continue to receive according to section 260C.451, 
195.18 	subdivision 1, and of the right to appeal a denial of social services under section 256.045. 
195.19 	The notice must be provided to the child youth six months before the child's youth's 18th 
195.20 	birthday.
195.21 		Subd. 3.Administrative or court reviews. When the child a youth is 17 14 years of 
195.22 	age or older, the administrative review or court hearing must include a review of the 
195.23 	responsible social services agency's support for the child's youth's successful transition to 
195.24 	adulthood as required in section 260C.452, subdivision 4.

195.25 	EFFECTIVE DATE. This section is effective July 1, 2021.

195.26 	Sec. 55. Minnesota Statutes 2020, section 260E.20, subdivision 2, is amended to read:
195.27 		Subd. 2.Face-to-face contact. (a) Upon receipt of a screened in report, the local welfare 
195.28 	agency shall conduct a face-to-face contact with the child reported to be maltreated and 
195.29 	with the child's primary caregiver sufficient to complete a safety assessment and ensure the 
195.30 	immediate safety of the child.
196.1 	(b) The face-to-face contact with the child and primary caregiver shall occur immediately 
196.2 	if sexual abuse or substantial child endangerment is alleged and within five calendar days 
196.3 	for all other reports. If the alleged offender was not already interviewed as the primary 
196.4 	caregiver, the local welfare agency shall also conduct a face-to-face interview with the 
196.5 	alleged offender in the early stages of the assessment or investigation. Face-to-face contact 
196.6 	with the child and primary caregiver in response to a report alleging sexual abuse or 
196.7 	substantial child endangerment may be postponed for no more than five calendar days if 
196.8 	the child is residing in a location that is confirmed to restrict contact with the alleged offender 
196.9 	as established in guidelines issued by the commissioner, or if the local welfare agency is 
196.10 	pursuing a court order for the child's caregiver to produce the child for questioning under 
196.11 	section 260E.22, subdivision 5.
196.12 	(c) At the initial contact with the alleged offender, the local welfare agency or the agency 
196.13 	responsible for assessing or investigating the report must inform the alleged offender of the 
196.14 	complaints or allegations made against the individual in a manner consistent with laws 
196.15 	protecting the rights of the person who made the report. The interview with the alleged 
196.16 	offender may be postponed if it would jeopardize an active law enforcement investigation.
196.17 	(d) The local welfare agency or the agency responsible for assessing or investigating 
196.18 	the report must provide the alleged offender with an opportunity to make a statement. The 
196.19 	alleged offender may submit supporting documentation relevant to the assessment or 
196.20 	investigation.

196.21 	Sec. 56. Minnesota Statutes 2020, section 260E.31, subdivision 1, is amended to read:
196.22 		Subdivision 1.Reports required. (a) Except as provided in paragraph (b), a person 
196.23 	mandated to report under this chapter shall immediately report to the local welfare agency 
196.24 	if the person knows or has reason to believe that a woman is pregnant and has used a 
196.25 	controlled substance for a nonmedical purpose during the pregnancy, including but not 
196.26 	limited to tetrahydrocannabinol, or has consumed alcoholic beverages during the pregnancy 
196.27 	in any way that is habitual or excessive.
196.28 	(b) A health care professional or a social service professional who is mandated to report 
196.29 	under this chapter is exempt from reporting under paragraph (a) a woman's use or 
196.30 	consumption of tetrahydrocannabinol or alcoholic beverages during pregnancy if the 
196.31 	professional is providing or collaborating with other professionals to provide the woman 
196.32 	with prenatal care, postpartum care, or other health care services, including care of the 
196.33 	woman's infant. If the woman does not continue to receive regular prenatal or postpartum 
197.1 	care, after the woman's health care professional has made attempts to contact the woman, 
197.2 	then the professional is required to report under paragraph (a).
197.3 	(c) Any person may make a voluntary report if the person knows or has reason to believe 
197.4 	that a woman is pregnant and has used a controlled substance for a nonmedical purpose 
197.5 	during the pregnancy, including but not limited to tetrahydrocannabinol, or has consumed 
197.6 	alcoholic beverages during the pregnancy in any way that is habitual or excessive.
197.7 	(d) An oral report shall be made immediately by telephone or otherwise. An oral report 
197.8 	made by a person required to report shall be followed within 72 hours, exclusive of weekends 
197.9 	and holidays, by a report in writing to the local welfare agency. Any report shall be of 
197.10 	sufficient content to identify the pregnant woman, the nature and extent of the use, if known, 
197.11 	and the name and address of the reporter. The local welfare agency shall accept a report 
197.12 	made under paragraph (c) notwithstanding refusal by a voluntary reporter to provide the 
197.13 	reporter's name or address as long as the report is otherwise sufficient.
197.14 	(e) For purposes of this section, "prenatal care" means the comprehensive package of 
197.15 	medical and psychological support provided throughout the pregnancy.

197.16 	Sec. 57. Minnesota Statutes 2020, section 260E.33, is amended by adding a subdivision 
197.17 	to read:
197.18 		Subd. 6a.Notification of contested case hearing. When an appeal of a lead investigative 
197.19 	agency determination results in a contested case hearing under chapter 245A or 245C, the 
197.20 	administrative law judge shall notify the parent, legal custodian, or guardian of the child 
197.21 	who is the subject of the maltreatment determination. The notice must be sent by certified 
197.22 	mail and inform the parent, legal custodian, or guardian of the child of the right to file a 
197.23 	signed written statement in the proceedings and the right to attend and participate in the 
197.24 	hearing. The parent, legal custodian, or guardian of the child may file a written statement 
197.25 	with the administrative law judge hearing the case no later than five business days before 
197.26 	commencement of the hearing. The administrative law judge shall include the written 
197.27 	statement in the hearing record and consider the statement in deciding the appeal. The lead 
197.28 	investigative agency shall provide to the administrative law judge the address of the parent, 
197.29 	legal custodian, or guardian of the child. If the lead investigative agency is not reasonably 
197.30 	able to determine the address of the parent, legal custodian, or guardian of the child, the 
197.31 	administrative law judge is not required to send a hearing notice under this subdivision.

198.1 	Sec. 58. Minnesota Statutes 2020, section 260E.36, is amended by adding a subdivision 
198.2 	to read:
198.3 		Subd. 1a.Sex trafficking and sexual exploitation training requirement. As required 
198.4 	by the Child Abuse Prevention and Treatment Act amendments through Public Law 114-22 
198.5 	and to implement Public Law 115-123, all child protection social workers and social services 
198.6 	staff who have responsibility for child protective duties under this chapter or chapter 260C 
198.7 	shall complete training implemented by the commissioner of human services regarding sex 
198.8 	trafficking and sexual exploitation of children and youth.

198.9 	EFFECTIVE DATE. This section is effective July 1, 2021.

198.10 	Sec. 59. Minnesota Statutes 2020, section 518.157, subdivision 1, is amended to read:
198.11 		Subdivision 1.Implementation; administration. (a) By January 1, 1998, the chief 
198.12 	judge of each judicial district or a designee shall implement one or more parent education 
198.13 	programs within the judicial district for the purpose of educating parents about the impact 
198.14 	that divorce, the restructuring of families, and judicial proceedings have upon children and 
198.15 	families; methods for preventing parenting time conflicts; and dispute resolution options. 
198.16 	The chief judge of each judicial district or a designee may require that children attend a 
198.17 	separate education program designed to deal with the impact of divorce upon children as 
198.18 	part of the parent education program. Each parent education program must enable persons 
198.19 	to have timely and reasonable access to education sessions.
198.20 	(b) The chief judge of each judicial district shall ensure that the judicial district's website 
198.21 	includes information on the parent education program or programs required under this 
198.22 	section.

198.23 	Sec. 60. Minnesota Statutes 2020, section 518.157, subdivision 3, is amended to read:
198.24 		Subd. 3.Attendance. (a) In a proceeding under this chapter where the parties have not 
198.25 	agreed to custody or a parenting time is contested schedule, the court shall order the parents 
198.26 	of a minor child shall attendto attend or take online a minimum of eight hours in an 
198.27 	orientation and education program that meets the minimum standards promulgated by the 
198.28 	Minnesota Supreme Court.
198.29 	(b) In all other proceedings involving custody, support, or parenting time the court may 
198.30 	order the parents of a minor child to attend a parent education program.
198.31 	(c) The program shall provide the court with names of persons who fail to attend the 
198.32 	parent education program as ordered by the court. Persons who are separated or contemplating 
199.1 	involvement in a dissolution, paternity, custody, or parenting time proceeding may attend 
199.2 	a parent education program without a court order.
199.3 	(d) Unless otherwise ordered by the court, participation in a parent education program 
199.4 	must begin before an initial case management conference and within 30 days after the first 
199.5 	filing with the court or as soon as practicable after that time based on the reasonable 
199.6 	availability of classes for the program for the parent. Parent education programs must offer 
199.7 	an opportunity to participate at all phases of a pending or postdecree proceeding.
199.8 	(e) Upon request of a party and a showing of good cause, the court may excuse the party 
199.9 	from attending the program. If past or present domestic abuse, as defined in chapter 518B, 
199.10 	is alleged, the court shall not require the parties to attend the same parent education sessions 
199.11 	and shall enter an order setting forth the manner in which the parties may safely participate 
199.12 	in the program.
199.13 	(f) Before an initial case management conference for a proceeding under this chapter 
199.14 	where the parties have not agreed to custody or parenting time, the court shall notify the 
199.15 	parties of their option to resolve disagreements, including the development of a parenting 
199.16 	plan, through the use of private mediation.

199.17 	Sec. 61. Minnesota Statutes 2020, section 518.68, subdivision 2, is amended to read:
199.18 		Subd. 2.Contents.  The required notices must be substantially as follows:
199.19 	IMPORTANT NOTICE
199.20 	1. PAYMENTS TO PUBLIC AGENCY
199.21 	According to Minnesota Statutes, section 518A.50, payments ordered for maintenance 
199.22 	and support must be paid to the public agency responsible for child support enforcement 
199.23 	as long as the person entitled to receive the payments is receiving or has applied for 
199.24 	public assistance or has applied for support and maintenance collection services. MAIL 
199.25 	PAYMENTS TO:
199.26 	2. DEPRIVING ANOTHER OF CUSTODIAL OR PARENTAL RIGHTS -- A FELONY
199.27 	A person may be charged with a felony who conceals a minor child or takes, obtains, 
199.28 	retains, or fails to return a minor child from or to the child's parent (or person with 
199.29 	custodial or visitation rights), according to Minnesota Statutes, section 609.26. A copy 
199.30 	of that section is available from any district court clerk.
199.31 	3. NONSUPPORT OF A SPOUSE OR CHILD -- CRIMINAL PENALTIES
200.1 	A person who fails to pay court-ordered child support or maintenance may be charged 
200.2 	with a crime, which may include misdemeanor, gross misdemeanor, or felony charges, 
200.3 	according to Minnesota Statutes, section 609.375. A copy of that section is available 
200.4 	from any district court clerk.
200.5 	4. RULES OF SUPPORT, MAINTENANCE, PARENTING TIME
200.6 	(a) Payment of support or spousal maintenance is to be as ordered, and the giving of 
200.7 	gifts or making purchases of food, clothing, and the like will not fulfill the obligation.
200.8 	(b) Payment of support must be made as it becomes due, and failure to secure or denial 
200.9 	of parenting time is NOT an excuse for nonpayment, but the aggrieved party must seek 
200.10 	relief through a proper motion filed with the court.
200.11 	(c) Nonpayment of support is not grounds to deny parenting time. The party entitled to 
200.12 	receive support may apply for support and collection services, file a contempt motion, 
200.13 	or obtain a judgment as provided in Minnesota Statutes, section 548.091.
200.14 	(d) The payment of support or spousal maintenance takes priority over payment of debts 
200.15 	and other obligations.
200.16 	(e) A party who accepts additional obligations of support does so with the full knowledge 
200.17 	of the party's prior obligation under this proceeding.
200.18 	(f) Child support or maintenance is based on annual income, and it is the responsibility 
200.19 	of a person with seasonal employment to budget income so that payments are made 
200.20 	throughout the year as ordered.
200.21 	(g) Reasonable parenting time guidelines are contained in Appendix B, which is available 
200.22 	from the court administrator.
200.23 	(h) The nonpayment of support may be enforced through the denial of student grants; 
200.24 	interception of state and federal tax refunds; suspension of driver's, recreational, and 
200.25 	occupational licenses; referral to the department of revenue or private collection agencies; 
200.26 	seizure of assets, including bank accounts and other assets held by financial institutions; 
200.27 	reporting to credit bureaus; interest charging, income withholding, and contempt 
200.28 	proceedings; and other enforcement methods allowed by law.
200.29 	(i) The public authority may suspend or resume collection of the amount allocated for 
200.30 	child care expenses if the conditions of Minnesota Statutes, section 518A.40, subdivision 
200.31 	4, are met.
201.1 	(j) The public authority may remove or resume a medical support offset if the conditions 
201.2 	of Minnesota Statutes, section 518A.41, subdivision 16, are met.
201.3 	(k) The public authority may suspend or resume interest charging on child support 
201.4 	judgments if the conditions of Minnesota Statutes, section 548.091, subdivision 1a, are met.
201.5 	5. MODIFYING CHILD SUPPORT
201.6 	If either the obligor or obligee is laid off from employment or receives a pay reduction, 
201.7 	child support may be modified, increased, or decreased. Any modification will only take 
201.8 	effect when it is ordered by the court, and will only relate back to the time that a motion 
201.9 	is filed. Either the obligor or obligee may file a motion to modify child support, and may 
201.10 	request the public agency for help. UNTIL A MOTION IS FILED, THE CHILD 
201.11 	SUPPORT OBLIGATION WILL CONTINUE AT THE CURRENT LEVEL. THE 
201.12 	COURT IS NOT PERMITTED TO REDUCE SUPPORT RETROACTIVELY.
201.13 	6. PARENTAL RIGHTS FROM MINNESOTA STATUTES, SECTION 518.17, 
201.14 	SUBDIVISION 3
201.15 	Unless otherwise provided by the Court:
201.16 	(a) Each party has the right of access to, and to receive copies of, school, medical, dental, 
201.17 	religious training, and other important records and information about the minor children. 
201.18 	Each party has the right of access to information regarding health or dental insurance 
201.19 	available to the minor children. Presentation of a copy of this order to the custodian of 
201.20 	a record or other information about the minor children constitutes sufficient authorization 
201.21 	for the release of the record or information to the requesting party.
201.22 	(b) Each party shall keep the other informed as to the name and address of the school 
201.23 	of attendance of the minor children. Each party has the right to be informed by school 
201.24 	officials about the children's welfare, educational progress and status, and to attend 
201.25 	school and parent teacher conferences. The school is not required to hold a separate 
201.26 	conference for each party.
201.27 	(c) In case of an accident or serious illness of a minor child, each party shall notify the 
201.28 	other party of the accident or illness, and the name of the health care provider and the 
201.29 	place of treatment.
201.30 	(d) Each party has the right of reasonable access and telephone contact with the minor 
201.31 	children.
201.32 	7. WAGE AND INCOME DEDUCTION OF SUPPORT AND MAINTENANCE
202.1 	Child support and/or spousal maintenance may be withheld from income, with or without 
202.2 	notice to the person obligated to pay, when the conditions of Minnesota Statutes, section 
202.3 	518A.53 have been met. A copy of those sections is available from any district court 
202.4 	clerk.
202.5 	8. CHANGE OF ADDRESS OR RESIDENCE
202.6 	Unless otherwise ordered, each party shall notify the other party, the court, and the public 
202.7 	authority responsible for collection, if applicable, of the following information within 
202.8 	ten days of any change: the residential and mailing address, telephone number, driver's 
202.9 	license number, Social Security number, and name, address, and telephone number of 
202.10 	the employer.
202.11 	9. COST OF LIVING INCREASE OF SUPPORT AND MAINTENANCE
202.12 	Basic support and/or spousal maintenance may be adjusted every two years based upon 
202.13 	a change in the cost of living (using Department of Labor Consumer Price Index .........., 
202.14 	unless otherwise specified in this order) when the conditions of Minnesota Statutes, 
202.15 	section 518A.75, are met. Cost of living increases are compounded. A copy of Minnesota 
202.16 	Statutes, section 518A.75, and forms necessary to request or contest a cost of living 
202.17 	increase are available from any district court clerk.
202.18 	10. JUDGMENTS FOR UNPAID SUPPORT
202.19 	If a person fails to make a child support payment, the payment owed becomes a judgment 
202.20 	against the person responsible to make the payment by operation of law on or after the 
202.21 	date the payment is due, and the person entitled to receive the payment or the public 
202.22 	agency may obtain entry and docketing of the judgment WITHOUT NOTICE to the 
202.23 	person responsible to make the payment under Minnesota Statutes, section 548.091. 
202.24 	Interest begins to accrue on a payment or installment of child support whenever the 
202.25 	unpaid amount due is greater than the current support due, according to Minnesota 
202.26 	Statutes, section 548.091, subdivision 1a.
202.27 	11. JUDGMENTS FOR UNPAID MAINTENANCE
202.28 	(a) A judgment for unpaid spousal maintenance may be entered when the conditions of 
202.29 	Minnesota Statutes, section 548.091, are met. A copy of that section is available from 
202.30 	any district court clerk.
202.31 	(b) The public authority is not responsible for calculating interest on any judgment for 
202.32 	unpaid spousal maintenance. When providing services in IV-D cases, as defined in 
202.33 	Minnesota Statutes, section 518A.26, subdivision 10, the public authority will only 
203.1 	collect interest on spousal maintenance if spousal maintenance is reduced to a sum 
203.2 	certain judgment.
203.3 	12. ATTORNEY FEES AND COLLECTION COSTS FOR ENFORCEMENT OF CHILD 
203.4 	SUPPORT
203.5 	A judgment for attorney fees and other collection costs incurred in enforcing a child 
203.6 	support order will be entered against the person responsible to pay support when the 
203.7 	conditions of Minnesota Statutes, section 518A.735, are met. A copy of Minnesota 
203.8 	Statutes, sections 518.14 and 518A.735 and forms necessary to request or contest these 
203.9 	attorney fees and collection costs are available from any district court clerk.
203.10 	13. PARENTING TIME EXPEDITOR PROCESS
203.11 	On request of either party or on its own motion, the court may appoint a parenting time 
203.12 	expeditor to resolve parenting time disputes under Minnesota Statutes, section 518.1751. 
203.13 	A copy of that section and a description of the expeditor process is available from any 
203.14 	district court clerk.
203.15 	14. PARENTING TIME REMEDIES AND PENALTIES
203.16 	Remedies and penalties for the wrongful denial of parenting time are available under 
203.17 	Minnesota Statutes, section 518.175, subdivision 6. These include compensatory parenting 
203.18 	time; civil penalties; bond requirements; contempt; and reversal of custody. A copy of 
203.19 	that subdivision and forms for requesting relief are available from any district court 
203.20 	clerk.

203.21 	EFFECTIVE DATE. This section is effective August 1, 2022.

203.22 	Sec. 62. Minnesota Statutes 2020, section 518A.29, is amended to read:
203.23 	518A.29 CALCULATION OF GROSS INCOME.
203.24 	(a) Subject to the exclusions and deductions in this section, gross income includes any 
203.25 	form of periodic payment to an individual, including, but not limited to, salaries, wages, 
203.26 	commissions, self-employment income under section 518A.30, workers' compensation, 
203.27 	unemployment benefits, annuity payments, military and naval retirement, pension and 
203.28 	disability payments, spousal maintenance received under a previous order or the current 
203.29 	proceeding, Social Security or veterans benefits provided for a joint child under section 
203.30 	518A.31, and potential income under section 518A.32. Salaries, wages, commissions, or 
203.31 	other compensation paid by third parties shall be based upon gross income before 
203.32 	participation in an employer-sponsored benefit plan that allows an employee to pay for a 
204.1 	benefit or expense using pretax dollars, such as flexible spending plans and health savings 
204.2 	accounts. No deductions shall be allowed for contributions to pensions, 401-K, IRA, or 
204.3 	other retirement benefits.
204.4 	(b) Gross income does not include compensation received by a party for employment 
204.5 	in excess of a 40-hour work week, provided that:
204.6 	(1) child support is ordered in an amount at least equal to the guideline amount based 
204.7 	on gross income not excluded under this clause; and
204.8 	(2) the party demonstrates, and the court finds, that:
204.9 	(i) the excess employment began after the filing of the petition for dissolution or legal 
204.10 	separation or a petition related to custody, parenting time, or support;
204.11 	(ii) the excess employment reflects an increase in the work schedule or hours worked 
204.12 	over that of the two years immediately preceding the filing of the petition;
204.13 	(iii) the excess employment is voluntary and not a condition of employment;
204.14 	(iv) the excess employment is in the nature of additional, part-time or overtime 
204.15 	employment compensable by the hour or fraction of an hour; and
204.16 	(v) the party's compensation structure has not been changed for the purpose of affecting 
204.17 	a support or maintenance obligation.
204.18 	(c) Expense reimbursements or in-kind payments received by a parent in the course of 
204.19 	employment, self-employment, or operation of a business shall be counted as income if 
204.20 	they reduce personal living expenses.
204.21 	(d) Gross income may be calculated on either an annual or monthly basis. Weekly income 
204.22 	shall be translated to monthly income by multiplying the weekly income by 4.33.
204.23 	(e) Gross income does not include a child support payment received by a party. It is a 
204.24 	rebuttable presumption that adoption assistance payments, Northstar kinship assistance 
204.25 	payments, and foster care subsidies are not gross income.
204.26 	(f) Gross income does not include the income of the obligor's spouse and the obligee's 
204.27 	spouse.
204.28 	(g) Child support or Spousal maintenance payments ordered by a court for a nonjoint 
204.29 	child or former spouse or ordered payable to the other party as part of the current proceeding 
204.30 	are deducted from other periodic payments received by a party for purposes of determining 
204.31 	gross income.
205.1 	(h) Gross income does not include public assistance benefits received under section 
205.2 	256.741 or other forms of public assistance based on need.

205.3 	EFFECTIVE DATE. This section is effective January 1, 2023.

205.4 	Sec. 63. Minnesota Statutes 2020, section 518A.33, is amended to read:
205.5 	518A.33 DEDUCTION FROM INCOME FOR NONJOINT CHILDREN.
205.6 	(a) When either or both parents are legally responsible for a nonjoint child, a deduction 
205.7 	for this obligation shall be calculated under this section if:.
205.8 	(1) the nonjoint child primarily resides in the parent's household; and
205.9 	(2) the parent is not obligated to pay basic child support for the nonjoint child to the 
205.10 	other parent or a legal custodian of the child under an existing child support order.
205.11 	(b) The court shall use the guidelines under section 518A.35 to determine the basic child 
205.12 	support obligation for the nonjoint child or children by using the gross income of the parent 
205.13 	for whom the deduction is being calculated and the number of nonjoint children primarily 
205.14 	residing in the parent's household. If the number of nonjoint children to be used for the 
205.15 	determination is greater than two, the determination must be made using the number two 
205.16 	instead of the greater number. Court-ordered child support for a nonjoint child shall be 
205.17 	deducted from the payor's gross income.
205.18 	(c) The deduction for nonjoint children is 50 percent of the guideline amount determined 
205.19 	under paragraph (b). When a parent is legally responsible for a nonjoint child and the parent 
205.20 	is not obligated to pay basic child support for the nonjoint child to the other parent or a legal 
205.21 	custodian under an existing child support order, a deduction shall be calculated. The court 
205.22 	shall use the basic support guideline table under section 518A.35 to determine this deduction 
205.23 	by using the gross income of the parent for whom the deduction is being calculated, minus 
205.24 	any deduction under paragraph (b) and the number of eligible nonjoint children, up to six 
205.25 	children. The deduction for nonjoint children is 75 percent of the guideline amount 
205.26 	determined under this paragraph.

205.27 	EFFECTIVE DATE. This section is effective January 1, 2023.

205.28 	Sec. 64. Minnesota Statutes 2020, section 518A.35, subdivision 1, is amended to read:
205.29 		Subdivision 1.Determination of support obligation. (a) The guideline in this section 
205.30 	is a rebuttable presumption and shall be used in any judicial or administrative proceeding 
205.31 	to establish or modify a support obligation under this chapter.
206.1 	(b) The basic child support obligation shall be determined by referencing the guideline 
206.2 	for the appropriate number of joint children and the combined parental income for 
206.3 	determining child support of the parents.
206.4 	(c) If a child is not in the custody of either parent and a support order is sought against 
206.5 	one or both parents, the basic child support obligation shall be determined by referencing 
206.6 	the guideline for the appropriate number of joint children, and the parent's individual parental 
206.7 	income for determining child support, not the combined parental incomes for determining 
206.8 	child support of the parents. Unless a parent has court-ordered parenting time, the parenting 
206.9 	expense adjustment formula under section 518A.34 must not be applied.
206.10 	(d) If a child is in custody of either parentnot residing with the parent that has 
206.11 	court-ordered or statutory custody and a support order is sought by the public authority
206.12 	under section 256.87 against one or both parents, unless the parent against whom the support 
206.13 	order is sought has court-ordered parenting time, the basic support obligation must be 
206.14 	determined by referencing the guideline for the appropriate number of joint children and 
206.15 	the parent's individual income without application of the parenting expense adjustment 
206.16 	formula under section 518A.34.
206.17 	(e) For combined parental incomes for determining child support exceeding $15,000
206.18 	$20,000 per month, the presumed basic child support obligations shall be as for parents 
206.19 	with combined parental income for determining child support of $15,000 $20,000 per month. 
206.20 	A basic child support obligation in excess of this level may be demonstrated for those reasons 
206.21 	set forth in section 518A.43.

206.22 	EFFECTIVE DATE. This section is effective January 1, 2023.

206.23 	Sec. 65. Minnesota Statutes 2020, section 518A.35, subdivision 2, is amended to read:
206.24 		Subd. 2.Basic support; guideline. Unless otherwise agreed to by the parents and 
206.25 	approved by the court, when establishing basic support, the court must order that basic 
206.26 	support be divided between the parents based on their proportionate share of the parents' 
206.27 	combined monthly parental income for determining child support (PICS). Basic support 
206.28 	must be computed using the following guideline:

206.29	Combined Parental
	Number of Children
	
206.30
206.31
206.32	Income for 
Determining Child 
Support
	One
	Two
	Three
	Four
	Five
	Six
	
206.33
206.34	$0- $799
$1,399
	$50
	$50
$60
	$75
$70
	$75
$80
	$100
$90
	$100
	
206.35	800- 899
	80
	129
	149
	173
	201
	233
	
207.1	900- 999
	90
	145
	167
	194
	226
	262
	
207.2	1,000- 1,099
	116
	161
	186
	216
	251
	291
	
207.3	1,100- 1,199
	145
	205
	237
	275
	320
	370
	
207.4	1,200- 1,299
	177
	254
	294
	341
	396
	459
	
207.5	1,300- 1,399
	212
	309
	356
	414
	480
	557
	
207.7207.6
	1,400- 1,499
	251
60
	368
75
	425
85
	493
100
	573
110
	664
120
	
207.9207.8
	1,500- 1,599
	292
75
	433
90
	500
105
	580
125
	673
135
	780
145
	
207.11207.10
	1,600- 1,699
	337
90
	502
110
	580
130
	673
150
	781
160
	905
170
	
207.13207.12
	1,700- 1,799
	385
110
	577
130
	666
155
	773
175
	897
185
	1,040
195
	
207.15207.14
	1,800- 1,899
	436
130
	657
150
	758
180
	880
200
	1,021
210
	1,183
220
	
207.17207.16
	1,900- 1,999
	490
150
	742
175
	856
205
	994
235
	1,152
245
	1,336
255
	
207.19207.18
	2,000- 2,099
	516
170
	832
200
	960
235
	1,114
270
	1,292
285
	1,498
295
	
207.21207.20
	2,100- 2,199
	528
190
	851
225
	981
265
	1,139
305
	1,320
325
	1,531
335
	
207.23207.22
	2,200- 2,299
	538
215
	867
255
	1,000
300
	1,160
345
	1,346
367
	1,561
379
	
207.25207.24
	2,300- 2,399
	546
240
	881
285
	1,016
335
	1,179
385
	1,367
409
	1,586
423
	
207.27207.26
	2,400- 2,499
	554
265
	893
315
	1,029
370
	1,195
425
	1,385
451
	1,608
467
	
207.29207.28
	2,500- 2,599
	560
290
	903
350
	1,040
408
	1,208
465
	1,400
493
	1,625
511
	
207.31207.30
	2,600- 2,699
	570
315
	920
385
	1,060
446
	1,230
505
	1,426
535
	1,655
555
	
207.33207.32
	2,700- 2,799
	580
340
	936
420
	1,078
484
	1,251
545
	1,450
577
	1,683
599
	
207.35207.34
	2,800- 2,899
	589
365
	950
455
	1,094
522
	1,270
585
	1,472
619
	1,707
643
	
207.37207.36
	2,900- 2,999
	596
390
	963
490
	1,109
560
	1,287
625
	1,492
661
	1,730
687
	
207.39207.38
	3,000- 3,099
	603
415
	975
525
	1,122
598
	1,302
665
	1,509
703
	1,749
731
	
207.41207.40
	3,100- 3,199
	613
440
	991
560
	1,141
636
	1,324
705
	1,535
745
	1,779
775
	
207.43207.42
	3,200- 3,299
	623
465
	1,007
595
	1,158
674
	1,344
745
	1,558
787
	1,807
819
	
207.45207.44
	3,300- 3,399
	636
485
	1,021
630
	1,175
712
	1,363
785
	1,581
829
	1,833
863
	
208.2208.1
	3,400- 3,499
	650
505
	1,034
665
	1,190
750
	1,380
825
	1,601
871
	1,857
907
	
208.4208.3
	3,500- 3,599
	664
525
	1,047
695
	1,204
784
	1,397
861
	1,621
910
	1,880
948
	
208.6208.5
	3,600- 3,699
	677
545
	1,062
725
	1,223
818
	1,418
897
	1,646
949
	1,909
989
	
208.8208.7
	3,700- 3,799
	691
565
	1,077
755
	1,240
852
	1,439
933
	1,670
988
	1,937
1,030
	
208.10208.9	3,800- 3,899
	705
585
	1,081
785
	1,257
886
	1,459
969
	1,693
1,027
	1,963
1,071
	
208.12208.11
	3,900- 3,999
	719
605
	1,104
815
	1,273
920
	1,478
1,005
	1,715
1,065
	1,988
1,111
	
208.14208.13
	4,000- 4,099
	732
625
	1,116
845
	1,288
954
	1,496
1,041
	1,736
1,103
	2,012
1,151
	
208.16208.15
	4,100- 4,199
	746
645
	1,132
875
	1,305
988
	1,516
1,077
	1,759
1,142
	2,039
1,191
	
208.18208.17
	4,200- 4,299
	760
665
	1,147
905
	1,322
1,022
	1,536
1,113
	1,781
1,180
	2,064
1,230
	
208.20208.19
	4,300- 4,399
	774
685
	1,161
935
	1,338
1,056
	1,554
1,149
	1,802
1,218
	2,088
1,269
	
208.22208.21
	4,400- 4,499
	787
705
	1,175
965
	1,353
1,090
	1,572
1,185
	1,822
1,256
	2,111
1,308
	
208.24208.23
	4,500- 4,599
	801
724
	1,184
993
	1,368
1,122
	1,589
1,219
	1,841
1,292
	2,133
1,345
	
208.26208.25
	4,600- 4,699
	808
743
	1,200
1,021
	1,386
1,154
	1,608
1,253
	1,864
1,328
	2,160
1,382
	
208.28208.27
	4,700- 4,799
	814
762
	1,215
1,049
	1,402
1,186
	1,627
1,287
	1,887
1,364
	2,186
1,419
	
208.30208.29
	4,800- 4,899
	820
781
	1,231
1,077
	1,419
1,218
	1,645
1,321
	1,908
1,400
	2,212
1,456
	
208.32208.31
	4,900- 4,999
	825
800
	1,246
1,105
	1,435
1,250
	1,663
1,354
	1,930
1,435
	2,236
1,493
	
208.34208.33
	5,000- 5,099
	831
818
	1,260
1,132
	1,450
1,281
	1,680
1,387
	1,950
1,470
	2,260
1,529
	
208.36208.35
	5,100- 5,199
	837
835
	1,275
1,159
	1,468
1,312
	1,701
1,420
	1,975
1,505
	2,289
1,565
	
208.38208.37
	5,200- 5,299
	843
852
	1,290
1,186
	1,485
1,343
	1,722
1,453
	1,999
1,540
	2,317
1,601
	
208.40208.39
	5,300- 5,399
	849
869
	1,304
1,213
	1,502
1,374
	1,743
1,486
	2,022
1,575
	2,345
1,638
	
208.42208.41
	5,400- 5,499
	854
886
	1,318
1,240
	1,518
1,405
	1,763
1,519
	2,046
1,610
	2,372
1,674
	
208.44208.43
	5,500- 5,599
	860
903
	1,331
1,264
	1,535
1,434
	1,782
1,550
	2,068
1,643
	2,398
1,708
	
208.46208.45
	5,600- 5,699
	866
920
	1,346
1,288
	1,551
1,463
	1,801
1,581
	2,090
1,676
	2,424
1,743
	
209.2209.1
	5,700- 5,799
	873
937
	1,357
1,312
	1,568
1,492
	1,819
1,612
	2,111
1,709
	2,449
1,777
	
209.4209.3
	5,800- 5,899
	881
954
	1,376
1,336
	1,583
1,521
	1,837
1,643
	2,132
1,742
	2,473
1,811
	
209.6209.5
	5,900- 5,999
	888
971
	1,390
1,360
	1,599
1,550
	1,855
1,674
	2,152
1,775
	2,497
1,846
	
209.8209.7
	6,000- 6,099
	895
988
	1,404
1,383
	1,604
1,577
	1,872
1,703
	2,172
1,805
	2,520
1,877
	
209.10209.9	6,100- 6,199
	902
993
	1,419
1,391
	1,631
1,586
	1,892
1,713
	2,195
1,815
	2,546
1,887
	
209.12209.11
	6,200- 6,299
	909
999
	1,433
1,399
	1,645
1,594
	1,912
1,722
	2,217
1,825
	2,572
1,898
	
209.14209.13
	6,300- 6,399
	916
1,005
	1,448
1,406
	1,664
1,603
	1,932
1,732
	2,239
1,836
	2,597
1,909
	
209.16209.15
	6,400- 6,499
	923
1,010
	1,462
1,414
	1,682
1,612
	1,951
1,741
	2,260
1,846
	2,621
1,920
	
209.18209.17
	6,500- 6,599
	930
1,016
	1,476
1,422
	1,697
1,621
	1,970
1,751
	2,282
1,856
	2,646
1,931
	
209.20209.19
	6,600- 6,699
	936
1,021
	1,490
1,430
	1,713
1,630
	1,989
1,761
	2,305
1,866
	2,673
1,941
	
209.22209.21
	6,700- 6,799
	943
1,027
	1,505
1,438
	1,730
1,639
	2,009
1,770
	2,328
1,876
	2,700
1,951
	
209.24209.23
	6,800- 6,899
	950
1,032
	1,519
1,445
	1,746
1,648
	2,028
1,780
	2,350
1,887
	2,727
1,962
	
209.26209.25
	6,900- 6,999
	957
1,038
	1,533
1,453
	1,762
1,657
	2,047
1,790
	2,379
1,897
	2,747
1,973
	
209.28209.27
	7,000- 7,099
	963
1,044
	1,547
1,462
	1,778
1,666
	2,065
1,800
	2,394
1,908
	2,753
1,984
	
209.30209.29
	7,100- 7,199
	970
1,050
	1,561
1,470
	1,795
1,676
	2,085
1,810
	2,417
1,918
	2,758
1,995
	
209.32209.31
	7,200- 7,299
	974
1,056
	1,574
1,479
	1,812
1,686
	2,104
1,821
	2,439
1,930
	2,764
2,007
	
209.34209.33
	7,300- 7,399
	980
1,063
	1,587
1,488
	1,828
1,696
	2,123
1,832
	2,462
1,942
	2,769
2,019
	
209.36209.35
	7,400- 7,499
	989
1,069
	1,600
1,496
	1,844
1,706
	2,142
1,843
	2,483
1,953
	2,775
2,032
	
209.38209.37
	7,500- 7,599
	998
1,075
	1,613
1,505
	1,860
1,716
	2,160
1,854
	2,505
1,965
	2,781
2,043
	
209.40209.39
	7,600- 7,699
	1,006
1,081
	1,628
1,514
	1,877
1,725
	2,180
1,863
	2,528
1,975
	2,803
2,054
	
209.42209.41
	7,700- 7,799
	1,015
1,087
	1,643
1,522
	1,894
1,735
	2,199
1,874
	2,550
1,986
	2,833
2,066
	
209.44209.43
	7,800- 7,899
	1,023
1,093
	1,658
1,531
	1,911
1,745
	2,218
1,885
	2,572
1,998
	2,864
2,078
	
209.46209.45
	7,900- 7,999
	1,032
1,099
	1,673
1,540
	1,928
1,755
	2,237
1,896
	2,594
2,009
	2,894
2,090
	
210.2210.1
	8,000- 8,099
	1,040
1,106
	1,688
1,548
	1,944
1,765
	2,256
1,907
	2,616
2,021
	2,925
2,102
	
210.4210.3
	8,100- 8,199
	1,048
1,112
	1,703
1,557
	1,960
1,775
	2,274
1,917
	2,637
2,032
	2,955
2,114
	
210.6210.5
	8,200- 8,299
	1,056
1,118
	1,717
1,566
	1,976
1,785
	2,293
1,928
	2,658
2,044
	2,985
2,126
	
210.8210.7
	8,300 -8,399
	1,064
1,124
	1,731
1,574
	1,992
1,795
	2,311
1,939
	2,679
2,055
	3,016
2,137
	
210.10210.9	8,400- 8,499
	1,072
1,131
	1,746
1,583
	2,008
1,804
	2,328
1,949
	2,700
2,066
	3,046
2,149
	
210.12210.11
	8,500- 8,599
	1,080
1,137
	1,760
1,592
	2,023
1,814
	2,346
1,960
	2,720
2,078
	3,077
2,161
	
210.14210.13
	8,600- 8,699
	1,092
1,143
	1,780
1,600
	2,047
1,824
	2,374
1,970
	2,752
2,089
	3,107
2,173
	
210.16210.15
	8,700- 8,799
	1,105
1,149
	1,801
1,609
	2,071
1,834
	2,401
1,981
	2,784
2,100
	3,138
2,185
	
210.18210.17
	8,800- 8,899
	1,118
1,155
	1,822
1,618
	2,094
1,844
	2,429
1,992
	2,816
2,112
	3,168
2,197
	
210.20210.19
	8,900- 8,999
	1,130
1,162
	1,842
1,626
	2,118
1,854
	2,456
2,003
	2,848
2,124
	3,199
2,209
	
210.22210.21
	9,000- 9,099
	1,143
1,168
	1,863
1,635
	2,142
1,864
	2,484
2,014
	2,880
2,135
	3,223
2,221
	
210.24210.23
	9,100- 9,199
	1,156
1,174
	1,884
1,644
	2,166
1,874
	2,512
2,024
	2,912
2,146
	3,243
2,232
	
210.26210.25
	9,200- 9,299
	1,168
1,180
	1,904
1,652
	2,190
1,884
	2,539
2,035
	2,944
2,158
	3,263
2,244
	
210.28210.27
	9,300- 9,399
	1,181
1,186
	1,925
1,661
	2,213
1,893
	2,567
2,045
	2,976
2,168
	3,284
2,255
	
210.30210.29
	9,400- 9,499
	1,194
1,193
	1,946
1,670
	2,237
1,903
	2,594
2,056
	3,008
2,179
	3,304
2,267
	
210.32210.31
	9,500- 9,599
	1,207
1,199
	1,967
1,678
	2,261
1,913
	2,622
2,066
	3,031
2,190
	3,324
2,278
	
210.34210.33
	9,600- 9,699
	1,219
1,205
	1,987
1,687
	2,285
1,923
	2,650
2,077
	3,050
2,202
	3,345
2,290
	
210.36210.35
	9,700- 9,799
	1,232
1,211
	2,008
1,696
	2,309
1,933
	2,677
2,088
	3,069
2,214
	3,365
2,302
	
210.38210.37
	9,800- 9,899
	1,245
1,217
	2,029
1,704
	2,332
1,943
	2,705
2,099
	3,087
2,225
	3,385
2,314
	
210.40210.39
	9,900- 9,999
	1,257
1,224
	2,049
1,713
	2,356
1,953
	2,732
2,110
	3,106
2,237
	3,406
2,326
	
210.42210.41
	10,000-10,099
	1,270
1,230
	2,070
1,722
	2,380
1,963
	2,760
2,121
	3,125
2,248
	3,426
2,338
	
210.44210.43
	10,100-10,199
	1,283
1,236
	2,091
1,730
	2,404
1,973
	2,788
2,131
	3,144
2,259
	3,446
2,350
	
210.46210.45
	10,200-10,299
	1,295
1,242
	2,111
1,739
	2,428
1,983
	2,815
2,142
	3,162
2,270
	3,467
2,361
	
211.2211.1
	10,300-10,399
	1,308
1,248
	2,132
1,748
	2,451
1,992
	2,843
2,152
	3,181
2,281
	3,487
2,373
	
211.4211.3
	10,400-10,499
	1,321
1,254
	2,153
1,756
	2,475
2,002
	2,870
2,163
	3,200
2,292
	3,507
2,384
	
211.6211.5
	10,500-10,599
	1,334
1,261
	2,174
1,765
	2,499
2,012
	2,898
2,173
	3,218
2,304
	3,528
2,396
	
211.8211.7
	10,600-10,699
	1,346
1,267
	2,194
1,774
	2,523
2,022
	2,921
2,184
	3,237
2,316
	3,548
2,409
	
211.10211.9	10,700-10,799
	1,359
1,273
	2,215
1,782
	2,547
2,032
	2,938
2,195
	3,256
2,327
	3,568
2,420
	
211.12211.11
	10,800-10,899
	1,372
1,279
	2,236
1,791
	2,570
2,042
	2,955
2,206
	3,274
2,338
	3,589
2,432
	
211.14211.13
	10,900-10,999
	1,384
1,285
	2,256
1,800
	2,594
2,052
	2,972
2,217
	3,293
2,349
	3,609
2,444
	
211.16211.15
	11,000-11,099
	1,397
1,292
	2,277
1,808
	2,618
2,061
	2,989
2,226
	3,312
2,360
	3,629
2,455
	
211.18211.17
	11,100-11,199
	1,410
1,298
	2,294
1,817
	2,642
2,071
	3,006
2,237
	3,331
2,372
	3,649
2,467
	
211.20211.19
	11,200-11,299
	1,422
1,304
	2,306
1,826
	2,666
2,081
	3,023
2,248
	3,349
2,384
	3,667
2,479
	
211.22211.21
	11,300-11,399
	1,435
1,310
	2,319
1,834
	2,689
2,091
	3,040
2,259
	3,366
2,395
	3,686
2,491
	
211.24211.23
	11,400-11,499
	1,448
1,316
	2,331
1,843
	2,713
2,101
	3,055
2,270
	3,383
2,406
	3,705
2,503
	
211.26211.25
	11,500-11,599
	1,461
1,323
	2,344
1,852
	2,735
2,111
	3,071
2,280
	3,400
2,417
	3,723
2,514
	
211.28211.27
	11,600-11,699
	1,473
1,329
	2,356
1,860
	2,748
2,121
	3,087
2,291
	3,417
2,428
	3,742
2,526
	
211.30211.29
	11,700-11,799
	1,486
1,335
	2,367
1,869
	2,762
2,131
	3,102
2,302
	3,435
2,439
	3,761
2,537
	
211.32211.31
	11,800-11,899
	1,499
1,341
	2,378
1,878
	2,775
2,141
	3,116
2,313
	3,452
2,451
	3,780
2,549
	
211.34211.33
	11,900-11,999
	1,511
1,347
	2,389
1,886
	2,788
2,150
	3,131
2,323
	3,469
2,463
	3,798
2,561
	
211.36211.35
	12,000-12,099
	1,524
1,354
	2,401
1,895
	2,801
2,160
	3,146
2,333
	3,485
2,474
	3,817
2,573
	
211.38211.37
	12,100-12,199
	1,537
1,360
	2,412
1,904
	2,814
2,170
	3,160
2,344
	3,501
2,485
	3,836
2,585
	
211.40211.39
	12,200-12,299
	1,549
1,366
	2,423
1,912
	2,828
2,180
	3,175
2,355
	3,517
2,497
	3,854
2,597
	
211.42211.41
	12,300-12,399
	1,562
1,372
	2,434
1,921
	2,841
2,190
	3,190
2,366
	3,534
2,509
	3,871
2,609
	
211.44211.43
	12,400-12,499
	1,575
1,378
	2,445
1,930
	2,854
2,200
	3,205
2,377
	3,550
2,520
	3,889
2,621
	
211.46211.45
	12,500-12,599
	1,588
1,385
	2,456
1,938
	2,867
2,210
	3,219
2,387
	3,566
2,531
	3,907
2,633
	
212.2212.1
	12,600-12,699
	1,600
1,391
	2,467
1,947
	2,880
2,220
	3,234
2,397
	3,582
2,542
	3,924
2,644
	
212.4212.3
	12,700-12,799
	1,613
1,397
	2,478
1,956
	2,894
2,230
	3,249
2,408
	3,598
2,553
	3,942
2,656
	
212.6212.5
	12,800-12,899
	1,626
1,403
	2,489
1,964
	2,907
2,240
	3,264
2,419
	3,615
2,565
	3,960
2,668
	
212.8212.7
	12,900-12,999
	1,638
1,409
	2,500
1,973
	2,920
2,250
	3,278
2,430
	3,631
2,576
	3,977
2,680
	
212.10212.9	13,000-13,099
	1,651
1,416
	2,512
1,982
	2,933
2,259
	3,293
2,440
	3,647
2,587
	3,995
2,691
	
212.12212.11
	13,100-13,199
	1,664
1,422
	2,523
1,990
	2,946
2,269
	3,308
2,451
	3,663
2,599
	4,012
2,703
	
212.14212.13
	13,200-13,299
	1,676
1,428
	2,534
1,999
	2,960
2,279
	3,322
2,462
	3,679
2,610
	4,030
2,715
	
212.16212.15
	13,300-13,399
	1,689
1,434
	2,545
2,008
	2,973
2,289
	3,337
2,473
	3,696
2,622
	4,048
2,727
	
212.18212.17
	13,400-13,499
	1,702
1,440
	2,556
2,016
	2,986
2,299
	3,352
2,484
	3,712
2,633
	4,065
2,739
	
212.20212.19
	13,500-13,599
	1,715
1,446
	2,567
2,025
	2,999
2,309
	3,367
2,494
	3,728
2,644
	4,083
2,751
	
212.22212.21
	13,600-13,699
	1,727
1,453
	2,578
2,034
	3,012
2,318
	3,381
2,504
	3,744
2,655
	4,100
2,762
	
212.24212.23
	13,700-13,799
	1,740
1,459
	2,589
2,042
	3,026
2,328
	3,396
2,515
	3,760
2,666
	4,118
2,773
	
212.26212.25
	13,800-13,899
	1,753
1,465
	2,600
2,051
	3,039
2,338
	3,411
2,526
	3,777
2,677
	4,136
2,784
	
212.28212.27
	13,900-13,999
	1,765
1,471
	2,611
2,060
	3,052
2,348
	3,425
2,537
	3,793
2,688
	4,153
2,795
	
212.30212.29
	14,000-14,099
	1,778
1,477
	2,623
2,068
	3,065
2,358
	3,440
2,547
	3,809
2,699
	4,171
2,807
	
212.32212.31
	14,100-14,199
	1,791
1,484
	2,634
2,077
	3,078
2,368
	3,455
2,558
	3,825
2,711
	4,189
2,819
	
212.34212.33
	14,200-14,299
	1,803
1,490
	2,645
2,086
	3,092
2,378
	3,470
2,569
	3,841
2,722
	4,206
2,831
	
212.36212.35
	14,300-14,399
	1,816
1,496
	2,656
2,094
	3,105
2,388
	3,484
2,580
	3,858
2,734
	4,224
2,843
	
212.38212.37
	14,400-14,499
	1,829
1,502
	2,667
2,103
	3,118
2,398
	3,499
2,590
	3,874
2,746
	4,239
2,855
	
212.40212.39
	14,500-14,599
	1,842
1,508
	2,678
2,111
	3,131
2,407
	3,514
2,600
	3,889
2,757
	4,253
2,867
	
212.42212.41
	14,600-14,699
	1,854
1,515
	2,689
2,120
	3,144
2,417
	3,529
2,611
	3,902
2,768
	4,268
2,879
	
212.44212.43
	14,700-14,799
	1,864
1,521
	2,700
2,129
	3,158
2,427
	3,541
2,622
	3,916
2,780
	4,282
2,891
	
212.46212.45
	14,800-14,899
	1,872
1,527
	2,711
2,138
	3,170
2,437
	3,553
2,633
	3,929
2,792
	4,297
2,903
	
213.2213.1
	14,900-14,999
	1,879
1,533
	2,722
2,146
	3,181
2,447
	3,565
2,643
	3,942
2,802
	4,311
2,914
	
213.3
213.4
213.5
213.6	15,000, or the 
amount in effect 
under subd. 4
-15,099
	1,883
1,539
	2,727
2,155
	3,186
2,457
	3,571
2,654
	3,949
2,813
	4,319
2,926
	
213.7	15,100-15,199
	1,545
	2,163
	2,466
	2,664
	2,825
	2,937
	
213.8	15,200-15,299
	1,551
	2,171
	2,476
	2,675
	2,836
	2,949
	
213.9	15,300-15,399
	1,557
	2,180
	2,486
	2,685
	2,847
	2,961
	
213.10	15,400-15,499
	1,563
	2,188
	2,495
	2,695
	2,858
	2,973
	
213.11	15,500-15,599
	1,569
	2,197
	2,505
	2,706
	2,869
	2,985
	
213.12	15,600-15,699
	1,575
	2,205
	2,514
	2,716
	2,880
	2,996
	
213.13	15,700-15,799
	1,581
	2,214
	2,524
	2,727
	2,891
	3,008
	
213.14	15,800-15,899
	1,587
	2,222
	2,534
	2,737
	2,902
	3,019
	
213.15	15,900-15,999
	1,593
	2,230
	2,543
	2,747
	2,913
	3,030
	
213.16	16,000-16,099
	1,599
	2,239
	2,553
	2,758
	2,924
	3,042
	
213.17	16,100-16,199
	1,605
	2,247
	2,562
	2,768
	2,935
	3,053
	
213.18	16,200-16,299
	1,611
	2,256
	2,572
	2,779
	2,946
	3,065
	
213.19	16,300-16,399
	1,617
	2,264
	2,582
	2,789
	2,957
	3,076
	
213.20	16,400-16,499
	1,623
	2,272
	2,591
	2,799
	2,968
	3,088
	
213.21	16,500-16,599
	1,629
	2,281
	2,601
	2,810
	2,979
	3,099
	
213.22	16,600-16,699
	1,635
	2,289
	2,610
	2,820
	2,990
	3,110
	
213.23	16,700-16,799
	1,641
	2,298
	2,620
	2,830
	3,001
	3,121
	
213.24	16,800-16,899
	1,647
	2,306
	2,629
	2,840
	3,011
	3,132
	
213.25	16,900-16,999
	1,653
	2,315
	2,639
	2,851
	3,022
	3,143
	
213.26	17,000-17,099
	1,659
	2,323
	2,649
	2,861
	3,033
	3,155
	
213.27	17,100-17,199
	1,665
	2,331
	2,658
	2,871
	3,044
	3,167
	
213.28	17,200-17,299
	1,671
	2,340
	2,668
	2,882
	3,055
	3,178
	
213.29	17,300-17,399
	1,677
	2,348
	2,677
	2,892
	3,066
	3,189
	
213.30	17,400-17,499
	1,683
	2,357
	2,687
	2,902
	3,077
	3,201
	
213.31	17,500-17,599
	1,689
	2,365
	2,696
	2,912
	3,088
	3,212
	
213.32	17,600-17,699
	1,695
	2,373
	2,705
	2,922
	3,098
	3,223
	
213.33	17,700-17,799
	1,701
	2,382
	2,715
	2,932
	3,109
	3,234
	
213.34	17,800-17,899
	1,707
	2,390
	2,724
	2,942
	3,119
	3,245
	
213.35	17,900-17,999
	1,713
	2,399
	2,734
	2,953
	3,130
	3,256
	
213.36	18,000-18,099
	1,719
	2,407
	2,744
	2,963
	3,141
	3,268
	
213.37	18,100-18,199
	1,725
	2,415
	2,753
	2,973
	3,152
	3,279
	
213.38	18,200-18,299
	1,731
	2,424
	2,763
	2,984
	3,163
	3,290
	
213.39	18,300-18,399
	1,737
	2,432
	2,772
	2,994
	3,174
	3,301
	
214.1	18,400-18,499
	1,743
	2,441
	2,782
	3,004
	3,185
	3,313
	
214.2	18,500-18,599
	1,749
	2,449
	2,791
	3,014
	3,196
	3,324
	
214.3	18,600-18,699
	1,755
	2,457
	2,801
	3,024
	3,206
	3,335
	
214.4	18,700-18,799
	1,761
	2,466
	2,811
	3,035
	3,217
	3,346
	
214.5	18,800-18,899
	1,767
	2,474
	2,820
	3,045
	3,227
	3,357
	
214.6	18,900-18,999
	1,773
	2,483
	2,830
	3,056
	3,238
	3,368
	
214.7	19,000-19,099
	1,779
	2,491
	2,840
	3,066
	3,249
	3,380
	
214.8	19,100-19,199
	1,785
	2,499
	2,849
	3,076
	3,260
	3,392
	
214.9	19,200-19,299
	1,791
	2,508
	2,859
	3,087
	3,271
	3,403
	
214.10	19,300-19,399
	1,797
	2,516
	2,868
	3,097
	3,282
	3,414
	
214.11	19,400-19,499
	1,803
	2,525
	2,878
	3,107
	3,293
	3,426
	
214.12	19,500-19,599
	1,809
	2,533
	2,887
	3,117
	3,304
	3,437
	
214.13	19,600-19,699
	1,815
	2,541
	2,896
	3,127
	3,315
	3,448
	
214.14	19,700-19,799
	1,821
	2,550
	2,906
	3,138
	3,326
	3,459
	
214.15	19,800-19,899
	1,827
	2,558
	2,915
	3,148
	3,337
	3,470
	
214.16	19,900-19,999
	1,833
	2,567
	2,925
	3,159
	3,348
	3,481
	
214.17
214.18
214.19
214.20	20,000 and over or 
the amount in 
effect under 
subdivision 4
	1,839
	2,575
	2,935
	3,170
	3,359
	3,492

214.21 	EFFECTIVE DATE. This section is effective January 1, 2023.

214.22 	Sec. 66. Minnesota Statutes 2020, section 518A.39, subdivision 7, is amended to read:
214.23 		Subd. 7.Child care exception. Child care support must be based on the actual child 
214.24 	care expenses. The court may provide that a decrease in the amount of the child care based 
214.25 	on a decrease in the actual child care expenses is effective as of the date the expense is 
214.26 	decreased. Under section 518A.40, subdivision 4, paragraph (d), a decrease in the amount 
214.27 	of child care support shall be effective as of the date the expenses terminated unless otherwise 
214.28 	found by the court.

214.29 	Sec. 67. Minnesota Statutes 2020, section 518A.40, is amended by adding a subdivision 
214.30 	to read:
214.31 		Subd. 3a.Child care cost information. (a) Upon the request of the obligor when child 
214.32 	care support is ordered to be paid, unless there is a protective or restraining order issued by 
214.33 	the court regarding one of the parties or on behalf of a joint child, or the obligee is a 
214.34 	participant in the Safe at Home program:
215.1 	(1) the obligee must give the child care provider the name and address of the obligor 
215.2 	and must give the obligor the name, address, and telephone number of the child care provider;
215.3 	(2) by February 1 of each year, the obligee must provide the obligor with verification 
215.4 	from the child care provider that indicates the total child care expenses paid for the previous 
215.5 	year; and
215.6 	(3) when there is a change in the child care provider, the type of child care provider, or 
215.7 	the age group of the child, the obligee must provide updated information to the obligor 
215.8 	within 30 calendar days. If the obligee fails to provide the annual verification from the 
215.9 	provider or updated information, the obligor may request the verification from the provider.
215.10 	(b) When the obligee is no longer incurring child care expenses, the obligee must notify 
215.11 	the obligor, and the public authority if it provides child support services, that the child care 
215.12 	expenses ended and on which date. If the public authority is providing services, the public 
215.13 	authority must follow the procedure outlined in subdivision 4.

215.14 	Sec. 68. Minnesota Statutes 2020, section 518A.40, subdivision 4, is amended to read:
215.15 		Subd. 4.Change in child care. (a) When a court order provides for child care expenses, 
215.16 	and child care support is not assigned under section 256.741, the public authority, if the 
215.17 	public authority provides child support enforcement services, may suspend collecting the 
215.18 	amount allocated for child care expenses when either party informs the public authority that 
215.19 	no child care costs expenses are being incurred and:
215.20 	(1) the public authority verifies the accuracy of the information with the obligee; or
215.21 	(2) the obligee fails to respond within 30 days of the date of a written request from the 
215.22 	public authority for information regarding child care costs. A written or oral response from 
215.23 	the obligee that child care costs are being incurred is sufficient for the public authority to 
215.24 	continue collecting child care expenses.
215.25 	The suspension is effective as of the first day of the month following the date that the public 
215.26 	authority either verified the information with the obligee or the obligee failed to respond.
215.27 	The public authority will resume collecting child care expenses when either party provides 
215.28 	information that child care costs are incurred, or when a child care support assignment takes 
215.29 	effect under section 256.741, subdivision 4. The resumption is effective as of the first day 
215.30 	of the month after the date that the public authority received the information.
215.31 	(b) If the parties provide conflicting information to the public authority regarding whether 
215.32 	child care expenses are being incurred, the public authority will continue or resume collecting 
216.1 	child care expenses. Either party, by motion to the court, may challenge the suspension, 
216.2 	continuation, or resumption of the collection of child care expenses under this subdivision. 
216.3 	If the public authority suspends collection activities for the amount allocated for child care 
216.4 	expenses, all other provisions of the court order remain in effect.
216.5 	(c) In cases where there is a substantial increase or decrease in child care expenses, the 
216.6 	parties may modify the order under section 518A.39.
216.7 	(d) In cases where child care expenses have terminated, the parties may modify the order 
216.8 	under section 518A.39.
216.9 	(e) When the public authority is providing child support services, the parties may contact 
216.10 	the public authority about the option of a stipulation to modify or terminate the child care 
216.11 	support amount.

216.12 	Sec. 69. Minnesota Statutes 2020, section 518A.42, is amended to read:
216.13 	518A.42 ABILITY TO PAY; SELF-SUPPORT ADJUSTMENT.
216.14 		Subdivision 1.Ability to pay. (a) It is a rebuttable presumption that a child support 
216.15 	order should not exceed the obligor's ability to pay. To determine the amount of child support 
216.16 	the obligor has the ability to pay, the court shall follow the procedure set out in this section.
216.17 	(b) The court shall calculate the obligor's income available for support by subtracting a 
216.18 	monthly self-support reserve equal to 120 percent of the federal poverty guidelines for one 
216.19 	person from the obligor's gross income parental income for determining child support (PICS). 
216.20 	If the obligor's income available for support calculated under this paragraph is equal to or 
216.21 	greater than the obligor's support obligation calculated under section 518A.34, the court 
216.22 	shall order child support under section 518A.34.
216.23 	(c) If the obligor's income available for support calculated under paragraph (b) is more 
216.24 	than the minimum support amount under subdivision 2, but less than the guideline amount 
216.25 	under section 518A.34, then the court shall apply a reduction to the child support obligation 
216.26 	in the following order, until the support order is equal to the obligor's income available for 
216.27 	support:
216.28 	(1) medical support obligation;
216.29 	(2) child care support obligation; and
216.30 	(3) basic support obligation.
216.31 	(d) If the obligor's income available for support calculated under paragraph (b) is equal 
216.32 	to or less than the minimum support amount under subdivision 2 or if the obligor's gross 
217.1 	income is less than 120 percent of the federal poverty guidelines for one person, the minimum 
217.2 	support amount under subdivision 2 applies.
217.3 		Subd. 2.Minimum basic support amount. (a) If the basic support amount applies, the 
217.4 	court must order the following amount as the minimum basic support obligation:
217.5 	(1) for one or two children child, the obligor's basic support obligation is $50 per month;
217.6 	(2) for two children, the obligor's basic support obligation is $60 per month;
217.7 	(3) for three or four children, the obligor's basic support obligation is $75 $70 per month; 
217.8 	and
217.9 	(4) for four children, the obligor's basic support obligation is $80 per month;
217.10 	(3) (5) for five or more children, the obligor's basic support obligation is $100 $90 per 
217.11 	month.; and
217.12 	(6) for six or more children, the obligor's basic support obligation is $100 per month.
217.13 	(b) If the court orders the obligor to pay the minimum basic support amount under this 
217.14 	subdivision, the obligor is presumed unable to pay child care support and medical support.
217.15 	If the court finds the obligor receives no income and completely lacks the ability to earn 
217.16 	income, the minimum basic support amount under this subdivision does not apply.
217.17 		Subd. 3.Exception. (a) This section does not apply to an obligor who is incarcerated.
217.18 	(b) If the court finds the obligor receives no income and completely lacks the ability to 
217.19 	earn income, the minimum basic support amount under this subdivision does not apply.
217.20 	(c) If the obligor's basic support amount is reduced below the minimum basic support 
217.21 	amount due to the application of the parenting expense adjustment, the minimum basic 
217.22 	support amount under this subdivision does not apply and the lesser amount is the guideline 
217.23 	basic support.

217.24 	EFFECTIVE DATE. This section is effective January 1, 2023.

217.25 	Sec. 70. Minnesota Statutes 2020, section 518A.43, is amended by adding a subdivision 
217.26 	to read:
217.27 		Subd. 1b.Increase in income of custodial parent. In a modification of support under 
217.28 	section 518A.39, the court may deviate from the presumptive child support obligation under 
217.29 	section 518A.34 when the only change in circumstances is an increase to the custodial 
217.30 	parent's income and:
218.1 	(1) the basic support increases;
218.2 	(2) the parties' combined gross income is $6,000 or less; or
218.3 	(3) the obligor's income is $2,000 or less.

218.4 	EFFECTIVE DATE. This section is effective January 1, 2023.

218.5 	Sec. 71. Minnesota Statutes 2020, section 518A.685, is amended to read:
218.6 	518A.685 CONSUMER REPORTING AGENCY; REPORTING ARREARS.
218.7 	(a) If a public authority determines that an obligor has not paid the current monthly 
218.8 	support obligation plus any required arrearage payment for three months, the public authority 
218.9 	must may report this information to a consumer reporting agency.
218.10 	(b) Before reporting that an obligor is in arrears for court-ordered child support, the 
218.11 	public authority must:
218.12 	(1) provide written notice to the obligor that the public authority intends to report the 
218.13 	arrears to a consumer reporting agency; and
218.14 	(2) mail the written notice to the obligor's last known mailing address at least 30 days 
218.15 	before the public authority reports the arrears to a consumer reporting agency.
218.16 	(c) The obligor may, within 21 days of receipt of the notice, do the following to prevent 
218.17 	the public authority from reporting the arrears to a consumer reporting agency:
218.18 	(1) pay the arrears in full; or
218.19 	(2) request an administrative review. An administrative review is limited to issues of 
218.20 	mistaken identity, a pending legal action involving the arrears, or an incorrect arrears 
218.21 	balance.; or
218.22 	(3) enter into a written payment agreement pursuant to section 518A.69 that is approved 
218.23 	by a court, a child support magistrate, or the public authority responsible for child support 
218.24 	enforcement.
218.25 	(d) A public authority that reports arrearage information under this section must make 
218.26 	monthly reports to a consumer reporting agency. The monthly report must be consistent 
218.27 	with credit reporting industry standards for child support.
218.28 	(e) For purposes of this section, "consumer reporting agency" has the meaning given in 
218.29 	section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f).

218.30 	EFFECTIVE DATE. This section is effective January 1, 2023.

219.1 	Sec. 72. [518A.80] MOTION TO TRANSFER TO TRIBAL COURT.
219.2 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in this 
219.3 	subdivision have the meanings given.
219.4 	(b) "Case participant" means a person who is a party to the case.
219.5 	(c) "District court" means a district court of the state of Minnesota.
219.6 	(d) "Party" means a person or entity named or admitted as a party or seeking to be 
219.7 	admitted as a party in the district court action, including the county IV-D agency, regardless 
219.8 	of whether the person or entity is named in the caption.
219.9 	(e) "Tribal court" means a tribal court of a federally recognized Indian tribe located in 
219.10 	Minnesota that is receiving funding from the federal government to operate a child support 
219.11 	program under United States Code, title 42, chapter 7, subchapter IV, part D, sections 654 
219.12 	to 669b.
219.13 	(f) "Tribal IV-D agency" has the meaning given in Code of Federal Regulations, title 
219.14 	45, part 309.05.
219.15 	(g) "Title IV-D child support case" has the meaning given in section 518A.26, subdivision 
219.16 	10.
219.17 		Subd. 2.Actions eligible for transfer. Under this section, a postjudgment child support, 
219.18 	custody, or parenting time action is eligible for transfer to a Tribal court. This section does 
219.19 	not apply to a child protection action or a dissolution action involving a child.
219.20 		Subd. 3.Motion to transfer. (a) A party's or Tribal IV-D agency's motion to transfer a 
219.21 	child support, custody, or parenting time action to a Tribal court shall include:
219.22 	(1) the address of each case participant;
219.23 	(2) the Tribal affiliation of each case participant, if applicable;
219.24 	(3) the name, Tribal affiliation if applicable, and date of birth of each living minor or 
219.25 	dependent child of a case participant who is subject to the action; and
219.26 	(4) the legal and factual basis for the court to find that the district court and a Tribal 
219.27 	court have concurrent jurisdiction in the case.
219.28 	(b) A party or Tribal IV-D agency bringing a motion to transfer a child support, custody, 
219.29 	or parenting time action to a Tribal court must file the motion with the district court and 
219.30 	serve the required documents on each party and the Tribal IV-D agency, regardless of 
219.31 	whether the Tribal IV-D agency is a party to the action.
220.1 	(c) A party's or Tribal IV-D agency's motion to transfer a child support, custody, or 
220.2 	parenting time action to a Tribal court must be accompanied by an affidavit setting forth 
220.3 	facts in support of the motion.
220.4 	(d) When a party other than the Tribal IV-D agency has filed a motion to transfer a child 
220.5 	support, custody, or parenting time action to a Tribal court, an affidavit of the Tribal IV-D 
220.6 	agency stating whether the Tribal IV-D agency provides services to a party must be filed 
220.7 	and served on each party within 15 days from the date of service of the motion to transfer 
220.8 	the action.
220.9 		Subd. 4.Order to transfer to Tribal court. (a) Unless a district court holds a hearing 
220.10 	under subdivision 6, upon motion of a party or a Tribal IV-D agency, a district court must 
220.11 	transfer a postjudgment child support, custody, or parenting time action to a Tribal court 
220.12 	when the district court finds that:
220.13 	(1) the district court and Tribal court have concurrent jurisdiction of the action;
220.14 	(2) a case participant in the action is receiving services from the Tribal IV-D agency; 
220.15 	and
220.16 	(3) no party or Tribal IV-D agency files and serves a timely objection to transferring the 
220.17 	action to a Tribal court.
220.18 	(b) When the district court finds that each requirement of this subdivision is satisfied, 
220.19 	the district court is not required to hold a hearing on the motion to transfer the action to a 
220.20 	Tribal court. The district court's order transferring the action to a Tribal court must include 
220.21 	written findings that describe how each requirement of this subdivision is met.
220.22 		Subd. 5.Objection to motion to transfer. (a) To object to a motion to transfer a child 
220.23 	support, custody, or parenting time action to a Tribal court, a party or Tribal IV-D agency 
220.24 	must file with the court and serve on each party and the Tribal IV-D agency a responsive 
220.25 	motion objecting to the motion to transfer within 30 days of the motion to transfer's date of 
220.26 	service.
220.27 	(b) If a party or Tribal IV-D agency files with the district court and properly serves a 
220.28 	timely objection to the motion to transfer a child support, custody, or parenting time action 
220.29 	to a Tribal court, the district court must hold a hearing on the motion.
220.30 		Subd. 6.Hearing. If a district court holds a hearing under this section, the district court 
220.31 	must evaluate and make written findings about all relevant factors, including:
220.32 	(1) whether an issue requires interpretation of Tribal law, including the Tribal constitution, 
220.33 	statutes, bylaws, ordinances, resolutions, treaties, or case law;
221.1 	(2) whether the action involves Tribal traditional or cultural matters;
221.2 	(3) whether the tribe is a party to the action;
221.3 	(4) whether Tribal sovereignty, jurisdiction, or territory is an issue in the action;
221.4 	(5) the Tribal membership status of each case participant in the action;
221.5 	(6) where the claim arises that forms the basis of the action;
221.6 	(7) the location of the residence of each case participant in the action and each child 
221.7 	who is a subject of the action;
221.8 	(8) whether the parties have by contract chosen a forum or the law to be applied in the 
221.9 	event of a dispute;
221.10 	(9) the timing of any motion to transfer the action to a Tribal court, each party's 
221.11 	expenditure of time and resources, the court's expenditure of time and resources, and the 
221.12 	district court's scheduling order;
221.13 	(10) which court will hear and decide the action more expeditiously;
221.14 	(11) the burden on each party if the court transfers the action to a Tribal court, including 
221.15 	costs, access to and admissibility of evidence, and matters of procedure; and
221.16 	(12) any other factor that the court determines to be relevant.
221.17 		Subd. 7.Future exercise of jurisdiction. Nothing in this section shall be construed to 
221.18 	limit the district court's exercise of jurisdiction when the Tribal court waives jurisdiction, 
221.19 	transfers the action back to district court, or otherwise declines to exercise jurisdiction over 
221.20 	the action.
221.21 		Subd. 8.Transfer to Red Lake Nation Tribal Court. When a party or Tribal IV-D 
221.22 	agency brings a motion to transfer a child support, custody, or parenting time action to the 
221.23 	Red Lake Nation Tribal Court, the court must transfer the action to the Red Lake Nation 
221.24 	Tribal Court if the case participants and child resided within the boundaries of the Red Lake 
221.25 	Reservation for six months preceding the motion to transfer the action to the Red Lake 
221.26 	Nation Tribal Court.

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

221.28 	Sec. 73. Minnesota Statutes 2020, section 548.091, subdivision 1a, is amended to read:
221.29 		Subd. 1a.Child support judgment by operation of law. (a) Any payment or installment 
221.30 	of support required by a judgment or decree of dissolution or legal separation, determination 
221.31 	of parentage, an order under chapter 518C, an order under section 256.87, or an order under 
222.1 	section 260B.331 or 260C.331, that is not paid or withheld from the obligor's income as 
222.2 	required under section 518A.53, or which is ordered as child support by judgment, decree, 
222.3 	or order by a court in any other state, is a judgment by operation of law on and after the 
222.4 	date it is due, is entitled to full faith and credit in this state and any other state, and shall be 
222.5 	entered and docketed by the court administrator on the filing of affidavits as provided in 
222.6 	subdivision 2a. Except as otherwise provided by paragraphs (b) and (e), interest accrues 
222.7 	from the date the unpaid amount due is greater than the current support due at the annual 
222.8 	rate provided in section 549.09, subdivision 1, not to exceed an annual rate of 18 percent.
222.9 	A payment or installment of support that becomes a judgment by operation of law between 
222.10 	the date on which a party served notice of a motion for modification under section 518A.39, 
222.11 	subdivision 2, and the date of the court's order on modification may be modified under that 
222.12 	subdivision. Beginning August 1, 2022, interest does not accrue on a past, current, or future 
222.13 	judgment for child support, confinement and pregnancy expenses, or genetic testing fees.
222.14 	(b) Notwithstanding the provisions of section 549.09, upon motion to the court and upon 
222.15 	proof by the obligor of 12 consecutive months of complete and timely payments of both 
222.16 	current support and court-ordered paybacks of a child support debt or arrearage, the court 
222.17 	may order interest on the remaining debt or arrearage to stop accruing. Timely payments 
222.18 	are those made in the month in which they are due. If, after that time, the obligor fails to 
222.19 	make complete and timely payments of both current support and court-ordered paybacks 
222.20 	of child support debt or arrearage, the public authority or the obligee may move the court 
222.21 	for the reinstatement of interest as of the month in which the obligor ceased making complete 
222.22 	and timely payments.
222.23 	The court shall provide copies of all orders issued under this section to the public 
222.24 	authority. The state court administrator shall prepare and make available to the court and 
222.25 	the parties forms to be submitted by the parties in support of a motion under this paragraph.
222.26 	(c) Notwithstanding the provisions of section 549.09, upon motion to the court, the court 
222.27 	may order interest on a child support debt or arrearage to stop accruing where the court 
222.28 	finds that the obligor is:
222.29 	(1) unable to pay support because of a significant physical or mental disability;
222.30 	(2) a recipient of Supplemental Security Income (SSI), Title II Older Americans Survivor's 
222.31 	Disability Insurance (OASDI), other disability benefits, or public assistance based upon 
222.32 	need; or
223.1 	(3) institutionalized or incarcerated for at least 30 days for an offense other than 
223.2 	nonsupport of the child or children involved, and is otherwise financially unable to pay 
223.3 	support.
223.4 	(d) If the conditions in paragraph (c) no longer exist, upon motion to the court, the court 
223.5 	may order interest accrual to resume retroactively from the date of service of the motion to 
223.6 	resume the accrual of interest.
223.7 	(e) Notwithstanding section 549.09, the public authority must suspend the charging of 
223.8 	interest when:
223.9 	(1) the obligor makes a request to the public authority that the public authority suspend 
223.10 	the charging of interest;
223.11 	(2) the public authority provides full IV-D child support services; and
223.12 	(3) the obligor has made, through the public authority, 12 consecutive months of complete 
223.13 	and timely payments of both current support and court-ordered paybacks of a child support 
223.14 	debt or arrearage.
223.15 	Timely payments are those made in the month in which they are due.
223.16 	Interest charging must be suspended on the first of the month following the date of the 
223.17 	written notice of the public authority's action to suspend the charging of interest. If, after 
223.18 	interest charging has been suspended, the obligor fails to make complete and timely payments 
223.19 	of both current support and court-ordered paybacks of child support debt or arrearage, the 
223.20 	public authority may resume the charging of interest as of the first day of the month in which 
223.21 	the obligor ceased making complete and timely payments.
223.22 	The public authority must provide written notice to the parties of the public authority's 
223.23 	action to suspend or resume the charging of interest. The notice must inform the parties of 
223.24 	the right to request a hearing to contest the public authority's action. The notice must be 
223.25 	sent by first class mail to the parties' last known addresses.
223.26 	A party may contest the public authority's action to suspend or resume the charging of 
223.27 	interest if the party makes a written request for a hearing within 30 days of the date of written 
223.28 	notice. If a party makes a timely request for a hearing, the public authority must schedule 
223.29 	a hearing and send written notice of the hearing to the parties by mail to the parties' last 
223.30 	known addresses at least 14 days before the hearing. The hearing must be conducted in 
223.31 	district court or in the expedited child support process if section 484.702 applies. The district 
223.32 	court or child support magistrate must determine whether suspending or resuming the interest 
223.33 	charging is appropriate and, if appropriate, the effective date.

224.1 	EFFECTIVE DATE. This section is effective August 1, 2022.

224.2 	Sec. 74. Minnesota Statutes 2020, section 548.091, subdivision 2a, is amended to read:
224.3 		Subd. 2a.Entry and docketing of child support judgment. (a) On or after the date an 
224.4 	unpaid amount becomes a judgment by operation of law under subdivision 1a, the obligee 
224.5 	or the public authority may file with the court administrator:
224.6 	(1) a statement identifying, or a copy of, the judgment or decree of dissolution or legal 
224.7 	separation, determination of parentage, order under chapter 518B or 518C, an order under 
224.8 	section 256.87, an order under section 260B.331 or 260C.331, or judgment, decree, or order 
224.9 	for child support by a court in any other state, which provides for periodic installments of 
224.10 	child support, or a judgment or notice of attorney fees and collection costs under section 
224.11 	518A.735;
224.12 	(2) an affidavit of default. The affidavit of default must state the full name, occupation, 
224.13 	place of residence, and last known post office address of the obligor, the name of the obligee, 
224.14 	the date or dates payment was due and not received and judgment was obtained by operation 
224.15 	of law, the total amount of the judgments to be entered and docketed; and
224.16 	(3) an affidavit of service of a notice of intent to enter and docket judgment and to recover 
224.17 	attorney fees and collection costs on the obligor, in person or by first class mail at the 
224.18 	obligor's last known post office address. Service is completed upon mailing in the manner 
224.19 	designated. Where applicable, a notice of interstate lien in the form promulgated under 
224.20 	United States Code, title 42, section 652(a), is sufficient to satisfy the requirements of clauses 
224.21 	(1) and (2).
224.22 	(b) A judgment entered and docketed under this subdivision has the same effect and is 
224.23 	subject to the same procedures, defenses, and proceedings as any other judgment in district 
224.24 	court, and may be enforced or satisfied in the same manner as judgments under section 
224.25 	548.09, except as otherwise provided.
224.26 	(c) A judgment entered and docketed under this subdivision is not subject to interest 
224.27 	charging or accrual.

224.28 	EFFECTIVE DATE. This section is effective August 1, 2022.

224.29 	Sec. 75. Minnesota Statutes 2020, section 548.091, subdivision 3b, is amended to read:
224.30 		Subd. 3b.Child support judgment administrative renewals. Child support judgments 
224.31 	may be renewed by service of notice upon the debtor. Service must be by first class mail at 
224.32 	the last known address of the debtor, with service deemed complete upon mailing in the 
225.1 	manner designated, or in the manner provided for the service of civil process. Upon the 
225.2 	filing of the notice and proof of service, the court administrator shall administratively renew 
225.3 	the judgment for child support without any additional filing fee in the same court file as the 
225.4 	original child support judgment. The judgment must be renewed in an amount equal to the 
225.5 	unpaid principal plus the accrued unpaid interest accrued prior to August 1, 2022. Child 
225.6 	support judgments may be renewed multiple times until paid.

225.7 	EFFECTIVE DATE. This section is effective August 1, 2022.

225.8 	Sec. 76. Minnesota Statutes 2020, section 548.091, subdivision 9, is amended to read:
225.9 		Subd. 9.Payoff statement. The public authority shall issue to the obligor, attorneys, 
225.10 	lenders, and closers, or their agents, a payoff statement setting forth conclusively the amount 
225.11 	necessary to satisfy the lien. Payoff statements must be issued within three business days 
225.12 	after receipt of a request by mail, personal delivery, telefacsimile, or electronic mail 
225.13 	transmission, and must be delivered to the requester by telefacsimile or electronic mail 
225.14 	transmission if requested and if appropriate technology is available to the public authority.
225.15 	If the payoff statement includes amounts for unpaid maintenance, the statement shall specify 
225.16 	that the public authority does not calculate accrued interest and that an interest balance in 
225.17 	addition to the payoff statement may be owed.

225.18 	EFFECTIVE DATE. This section is effective August 1, 2022.

225.19 	Sec. 77. Minnesota Statutes 2020, section 548.091, subdivision 10, is amended to read:
225.20 		Subd. 10.Release of lien. Upon payment of the child support amount due, the public 
225.21 	authority shall execute and deliver a satisfaction of the judgment lien within five business 
225.22 	days. The public authority is not responsible for satisfaction of judgments for unpaid 
225.23 	maintenance.

225.24 	EFFECTIVE DATE. This section is effective August 1, 2022.

225.25 	Sec. 78. Minnesota Statutes 2020, section 549.09, subdivision 1, is amended to read:
225.26 		Subdivision 1.When owed; rate. (a) When a judgment or award is for the recovery of 
225.27 	money, including a judgment for the recovery of taxes, interest from the time of the verdict, 
225.28 	award, or report until judgment is finally entered shall be computed by the court administrator 
225.29 	or arbitrator as provided in paragraph (c) and added to the judgment or award.
225.30 	(b) Except as otherwise provided by contract or allowed by law, preverdict, preaward, 
225.31 	or prereport interest on pecuniary damages shall be computed as provided in paragraph (c) 
226.1 	from the time of the commencement of the action or a demand for arbitration, or the time 
226.2 	of a written notice of claim, whichever occurs first, except as provided herein. The action 
226.3 	must be commenced within two years of a written notice of claim for interest to begin to 
226.4 	accrue from the time of the notice of claim. If either party serves a written offer of settlement, 
226.5 	the other party may serve a written acceptance or a written counteroffer within 30 days. 
226.6 	After that time, interest on the judgment or award shall be calculated by the judge or arbitrator 
226.7 	in the following manner. The prevailing party shall receive interest on any judgment or 
226.8 	award from the time of commencement of the action or a demand for arbitration, or the time 
226.9 	of a written notice of claim, or as to special damages from the time when special damages 
226.10 	were incurred, if later, until the time of verdict, award, or report only if the amount of its 
226.11 	offer is closer to the judgment or award than the amount of the opposing party's offer. If 
226.12 	the amount of the losing party's offer was closer to the judgment or award than the prevailing 
226.13 	party's offer, the prevailing party shall receive interest only on the amount of the settlement 
226.14 	offer or the judgment or award, whichever is less, and only from the time of commencement 
226.15 	of the action or a demand for arbitration, or the time of a written notice of claim, or as to 
226.16 	special damages from when the special damages were incurred, if later, until the time the 
226.17 	settlement offer was made. Subsequent offers and counteroffers supersede the legal effect 
226.18 	of earlier offers and counteroffers. For the purposes of clause (2), the amount of settlement 
226.19 	offer must be allocated between past and future damages in the same proportion as determined 
226.20 	by the trier of fact. Except as otherwise provided by contract or allowed by law, preverdict, 
226.21 	preaward, or prereport interest shall not be awarded on the following:
226.22 	(1) judgments, awards, or benefits in workers' compensation cases, but not including 
226.23 	third-party actions;
226.24 	(2) judgments or awards for future damages;
226.25 	(3) punitive damages, fines, or other damages that are noncompensatory in nature;
226.26 	(4) judgments or awards not in excess of the amount specified in section 491A.01; and
226.27 	(5) that portion of any verdict, award, or report which is founded upon interest, or costs, 
226.28 	disbursements, attorney fees, or other similar items added by the court or arbitrator.
226.29 	(c)(1)(i) For a judgment or award of $50,000 or less or a judgment or award for or against 
226.30 	the state or a political subdivision of the state, regardless of the amount, or a judgment or 
226.31 	award in a family court action, except for a child support judgment, regardless of the amount, 
226.32 	the interest shall be computed as simple interest per annum. The rate of interest shall be 
226.33 	based on the secondary market yield of one year United States Treasury bills, calculated on 
226.34 	a bank discount basis as provided in this section.
227.1 	On or before the 20th day of December of each year the state court administrator shall 
227.2 	determine the rate from the one-year constant maturity treasury yield for the most recent 
227.3 	calendar month, reported on a monthly basis in the latest statistical release of the board of 
227.4 	governors of the Federal Reserve System. This yield, rounded to the nearest one percent, 
227.5 	or four percent, whichever is greater, shall be the annual interest rate during the succeeding 
227.6 	calendar year. The state court administrator shall communicate the interest rates to the court 
227.7 	administrators and sheriffs for use in computing the interest on verdicts and shall make the 
227.8 	interest rates available to arbitrators.
227.9 	This item applies to any section that references section 549.09 by citation for the purposes 
227.10 	of computing an interest rate on any amount owed to or by the state or a political subdivision 
227.11 	of the state, regardless of the amount.
227.12 	(ii) The court, in a family court action, may order a lower interest rate or no interest rate 
227.13 	if the parties agree or if the court makes findings explaining why application of a lower 
227.14 	interest rate or no interest rate is necessary to avoid causing an unfair hardship to the debtor. 
227.15 	This item does not apply to child support or spousal maintenance judgments subject to 
227.16 	section 548.091.
227.17 	(2) For a judgment or award over $50,000, other than a judgment or award for or against 
227.18 	the state or a political subdivision of the state or a judgment or award in a family court 
227.19 	action, the interest rate shall be ten percent per year until paid.
227.20 	(3) When a judgment creditor, or the judgment creditor's attorney or agent, has received 
227.21 	a payment after entry of judgment, whether the payment is made voluntarily by or on behalf 
227.22 	of the judgment debtor, or is collected by legal process other than execution levy where a 
227.23 	proper return has been filed with the court administrator, the judgment creditor, or the 
227.24 	judgment creditor's attorney, before applying to the court administrator for an execution 
227.25 	shall file with the court administrator an affidavit of partial satisfaction. The affidavit must 
227.26 	state the dates and amounts of payments made upon the judgment after the most recent 
227.27 	affidavit of partial satisfaction filed, if any; the part of each payment that is applied to taxable 
227.28 	disbursements and to accrued interest and to the unpaid principal balance of the judgment; 
227.29 	and the accrued, but the unpaid interest owing, if any, after application of each payment.
227.30 	(4) Beginning August 1, 2022, interest shall not accrue on past, current, or future child 
227.31 	support judgments.
227.32 	(d) This section does not apply to arbitrations between employers and employees under 
227.33 	chapter 179 or 179A. An arbitrator is neither required to nor prohibited from awarding 
227.34 	interest under chapter 179 or under section 179A.16 for essential employees.
228.1 	(e) For purposes of this subdivision:
228.2 	(1) "state" includes a department, board, agency, commission, court, or other entity in 
228.3 	the executive, legislative, or judicial branch of the state; and
228.4 	(2) "political subdivision" includes a town, statutory or home rule charter city, county, 
228.5 	school district, or any other political subdivision of the state.

228.6 	EFFECTIVE DATE. This section is effective August 1, 2022.

228.7 	Sec. 79. DIRECTION TO THE COMMISSIONER; QUALIFIED RESIDENTIAL 
228.8 	TREATMENT TRANSITION SUPPORTS.
 228.9 	The commissioner of human services shall consult with stakeholders to develop policies 
228.10 	regarding aftercare supports for the transition of a child from a qualified residential treatment 
228.11 	program, as defined in Minnesota Statutes, section 260C.007, subdivision 26d, to 
228.12 	reunification with the child's parent or legal guardian, including potential placement in a 
228.13 	less restrictive setting prior to reunification that aligns with the child's permanency plan and 
228.14 	person-centered support plan, when applicable. The policies must be consistent with 
228.15 	Minnesota Rules, part 2960.0190, and Minnesota Statutes, section 245A.25, subdivision 4, 
228.16 	paragraph (i), and address the coordination of the qualified residential treatment program 
228.17 	discharge planning and aftercare supports where needed, the county social services case 
228.18 	plan, and services from community-based providers, to maintain the child's progress with 
228.19 	behavioral health goals in the child's treatment plan. The commissioner must complete 
228.20 	development of the policy guidance by December 31, 2022.

228.21 	Sec. 80. REVISOR INSTRUCTION.
 228.22 	The revisor of statutes shall place the following first grade headnote in Minnesota 
228.23 	Statutes, chapter 260C, preceding Minnesota Statutes, sections 260C.70 to 260C.714: 
228.24 	PLACEMENT OF CHILDREN IN QUALIFIED RESIDENTIAL TREATMENT.

228.25 	ARTICLE 11
228.26 	BEHAVIORAL HEALTH

228.27 	Section 1. Minnesota Statutes 2020, section 245.735, subdivision 3, is amended to read:
228.28 		Subd. 3.Certified community behavioral health clinics. (a) The commissioner shall 
228.29 	establish a state certification process for certified community behavioral health clinics 
228.30 	(CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified under this 
228.31 	section to be eligible for reimbursement under medical assistance, without service area 
229.1 	limits based on geographic area or region. The commissioner shall consult with CCBHC 
229.2 	stakeholders before establishing and implementing changes in the certification process and 
229.3 	requirements. Entities that choose to be CCBHCs must:
229.4 	(1) comply with the CCBHC criteria published by the United States Department of 
229.5 	Health and Human Services;
229.6 	(1) comply with state licensing requirements and other requirements issued by the 
229.7 	commissioner;
229.8 	(2) employ or contract for clinic staff who have backgrounds in diverse disciplines, 
229.9 	including licensed mental health professionals and licensed alcohol and drug counselors, 
229.10 	and staff who are culturally and linguistically trained to meet the needs of the population 
229.11 	the clinic serves;
229.12 	(3) ensure that clinic services are available and accessible to individuals and families of 
229.13 	all ages and genders and that crisis management services are available 24 hours per day;
229.14 	(4) establish fees for clinic services for individuals who are not enrolled in medical 
229.15 	assistance using a sliding fee scale that ensures that services to patients are not denied or 
229.16 	limited due to an individual's inability to pay for services;
229.17 	(5) comply with quality assurance reporting requirements and other reporting 
229.18 	requirements, including any required reporting of encounter data, clinical outcomes data, 
229.19 	and quality data;
229.20 	(6) provide crisis mental health and substance use services, withdrawal management 
229.21 	services, emergency crisis intervention services, and stabilization services through existing 
229.22 	mobile crisis services; screening, assessment, and diagnosis services, including risk 
229.23 	assessments and level of care determinations; person- and family-centered treatment planning; 
229.24 	outpatient mental health and substance use services; targeted case management; psychiatric 
229.25 	rehabilitation services; peer support and counselor services and family support services; 
229.26 	and intensive community-based mental health services, including mental health services 
229.27 	for members of the armed forces and veterans;. CCBHCs must directly provide the majority 
229.28 	of these services to enrollees, but may coordinate some services with another entity through 
229.29 	a collaboration or agreement, pursuant to paragraph (b);
229.30 	(7) provide coordination of care across settings and providers to ensure seamless 
229.31 	transitions for individuals being served across the full spectrum of health services, including 
229.32 	acute, chronic, and behavioral needs. Care coordination may be accomplished through 
229.33 	partnerships or formal contracts with:
230.1 	(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified 
230.2 	health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or 
230.3 	community-based mental health providers; and
230.4 	(ii) other community services, supports, and providers, including schools, child welfare 
230.5 	agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally 
230.6 	licensed health care and mental health facilities, urban Indian health clinics, Department of 
230.7 	Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals, 
230.8 	and hospital outpatient clinics;
230.9 	(8) be certified as mental health clinics under section 245.69, subdivision 2;
230.10 	(9) comply with standards established by the commissioner relating to mental health 
230.11 	services in Minnesota Rules, parts 9505.0370 to 9505.0372 CCBHC screenings, assessments, 
230.12 	and evaluations;
230.13 	(10) be licensed to provide substance use disorder treatment under chapter 245G;
230.14 	(11) be certified to provide children's therapeutic services and supports under section 
230.15 	256B.0943;
230.16 	(12) be certified to provide adult rehabilitative mental health services under section 
230.17 	256B.0623;
230.18 	(13) be enrolled to provide mental health crisis response services under sections 
230.19 	256B.0624 and 256B.0944;
230.20 	(14) be enrolled to provide mental health targeted case management under section 
230.21 	256B.0625, subdivision 20;
230.22 	(15) comply with standards relating to mental health case management in Minnesota 
230.23 	Rules, parts 9520.0900 to 9520.0926;
230.24 	(16) provide services that comply with the evidence-based practices described in 
230.25 	paragraph (e); and
230.26 	(17) comply with standards relating to peer services under sections 256B.0615, 
230.27 	256B.0616, and 245G.07, subdivision 1, paragraph (a), clause (5), as applicable when peer 
230.28 	services are provided.
230.29 	(b) If an entity a certified CCBHC is unable to provide one or more of the services listed 
230.30 	in paragraph (a), clauses (6) to (17), the commissioner may certify the entity as a CCBHC, 
230.31 	if the entity has a current may contract with another entity that has the required authority 
230.32 	to provide that service and that meets federal CCBHC the following criteria as a designated 
231.1 	collaborating organization, or, to the extent allowed by the federal CCBHC criteria, the 
231.2 	commissioner may approve a referral arrangement. The CCBHC must meet federal 
231.3 	requirements regarding the type and scope of services to be provided directly by the CCBHC.:
231.4 	(1) the entity has a formal agreement with the CCBHC to furnish one or more of the 
231.5 	services under paragraph (a), clause (6);
231.6 	(2) the entity provides assurances that it will provide services according to CCBHC 
231.7 	service standards and provider requirements;
231.8 	(3) the entity agrees that the CCBHC is responsible for coordinating care and has clinical 
231.9 	and financial responsibility for the services that the entity provides under the agreement; 
231.10 	and
231.11 	(4) the entity meets any additional requirements issued by the commissioner.
231.12 	(c) Notwithstanding any other law that requires a county contract or other form of county 
231.13 	approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets 
231.14 	CCBHC requirements may receive the prospective payment under section 256B.0625, 
231.15 	subdivision 5m, for those services without a county contract or county approval. As part of 
231.16 	the certification process in paragraph (a), the commissioner shall require a letter of support 
231.17 	from the CCBHC's host county confirming that the CCBHC and the county or counties it 
231.18 	serves have an ongoing relationship to facilitate access and continuity of care, especially 
231.19 	for individuals who are uninsured or who may go on and off medical assistance.
231.20 	(d) When the standards listed in paragraph (a) or other applicable standards conflict or 
231.21 	address similar issues in duplicative or incompatible ways, the commissioner may grant 
231.22 	variances to state requirements if the variances do not conflict with federal requirements
231.23 	for services reimbursed under medical assistance. If standards overlap, the commissioner 
231.24 	may substitute all or a part of a licensure or certification that is substantially the same as 
231.25 	another licensure or certification. The commissioner shall consult with stakeholders, as 
231.26 	described in subdivision 4, before granting variances under this provision. For the CCBHC 
231.27 	that is certified but not approved for prospective payment under section 256B.0625, 
231.28 	subdivision 5m, the commissioner may grant a variance under this paragraph if the variance 
231.29 	does not increase the state share of costs.
231.30 	(e) The commissioner shall issue a list of required evidence-based practices to be 
231.31 	delivered by CCBHCs, and may also provide a list of recommended evidence-based practices. 
231.32 	The commissioner may update the list to reflect advances in outcomes research and medical 
231.33 	services for persons living with mental illnesses or substance use disorders. The commissioner 
231.34 	shall take into consideration the adequacy of evidence to support the efficacy of the practice, 
232.1 	the quality of workforce available, and the current availability of the practice in the state. 
232.2 	At least 30 days before issuing the initial list and any revisions, the commissioner shall 
232.3 	provide stakeholders with an opportunity to comment.
232.4 	(f) The commissioner shall recertify CCBHCs at least every three years. The 
232.5 	commissioner shall establish a process for decertification and shall require corrective action, 
232.6 	medical assistance repayment, or decertification of a CCBHC that no longer meets the 
232.7 	requirements in this section or that fails to meet the standards provided by the commissioner 
232.8 	in the application and certification process.

232.9 	EFFECTIVE DATE. This section is effective July 1, 2021, or upon federal approval, 
232.10 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
232.11 	when federal approval is obtained or denied.

232.12 	Sec. 2. Minnesota Statutes 2020, section 245.735, subdivision 5, is amended to read:
232.13 		Subd. 5.Information systems support. The commissioner and the state chief information 
232.14 	officer shall provide information systems support to the projects as necessary to comply 
232.15 	with state and federal requirements.

232.16 	Sec. 3. Minnesota Statutes 2020, section 245.735, is amended by adding a subdivision to 
232.17 	read:
232.18 		Subd. 6.Demonstration entities. The commissioner may operate the demonstration 
232.19 	program established by section 223 of the Protecting Access to Medicare Act if federal 
232.20 	funding for the demonstration program remains available from the United States Department 
232.21 	of Health and Human Services. To the extent practicable, the commissioner shall align the 
232.22 	requirements of the demonstration program with the requirements under this section for 
232.23 	CCBHCs receiving medical assistance reimbursement. A CCBHC may not apply to 
232.24 	participate as a billing provider in both the CCBHC federal demonstration and the benefit 
232.25 	for CCBHCs under the medical assistance program.

232.26 	Sec. 4. Minnesota Statutes 2020, section 256B.0625, subdivision 5m, is amended to read:
232.27 		Subd. 5m.Certified community behavioral health clinic services. (a) Medical 
232.28 	assistance covers certified community behavioral health clinic (CCBHC) services that meet 
232.29 	the requirements of section 245.735, subdivision 3.
232.30 	(b) The commissioner shall establish standards and methodologies for areimburse 
232.31 	CCBHCs on a per-visit basis under the prospective payment system for medical assistance 
232.32 	payments for services delivered by a CCBHC, in accordance with guidance issued by the 
233.1 	Centers for Medicare and Medicaid Services as described in paragraph (c). The commissioner 
233.2 	shall include a quality bonus incentive payment in the prospective payment system based 
233.3 	on federal criteriaas described in paragraph (e). There is no county share for medical 
233.4 	assistance services when reimbursed through the CCBHC prospective payment system.
233.5 	(c) Unless otherwise indicated in applicable federal requirements, the prospective payment 
233.6 	system must continue to be based on the federal instructions issued for the federal section 
233.7 	223 CCBHC demonstration, except: The commissioner shall ensure that the prospective 
233.8 	payment system for CCBHC payments under medical assistance meets the following 
233.9 	requirements:
233.10 	(1) the prospective payment rate shall be a provider-specific rate calculated for each 
233.11 	CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable 
233.12 	costs for CCBHCs divided by the total annual number of CCBHC visits. For calculating 
233.13 	the payment rate, total annual visits include visits covered by medical assistance and visits 
233.14 	not covered by medical assistance. Allowable costs include but are not limited to the salaries 
233.15 	and benefits of medical assistance providers; the cost of CCBHC services provided under 
233.16 	section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as 
233.17 	insurance or supplies needed to provide CCBHC services;
233.18 	(2) payment shall be limited to one payment per day per medical assistance enrollee for 
233.19 	each CCBHC visit eligible for reimbursement. A CCBHC visit is eligible for reimbursement 
233.20 	if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph 
233.21 	(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or 
233.22 	licensed agency employed by or under contract with a CCBHC;
233.23 	(3) new payment rates set by the commissioner for newly certified CCBHCs under 
233.24 	section 245.735, subdivision 3, shall be based on rates for established CCBHCs with a 
233.25 	similar scope of services. If no comparable CCBHC exists, the commissioner shall establish 
233.26 	a clinic-specific rate using audited historical cost report data adjusted for the estimated cost 
233.27 	of delivering CCBHC services, including the estimated cost of providing the full scope of 
233.28 	services and the projected change in visits resulting from the change in scope;
233.29 	(1) (4) the commissioner shall rebase CCBHC rates at least once every three years and 
233.30 	no less than 12 months following an initial rate or a rate change due to a change in the scope 
233.31 	of services;
233.32 	(2) (5) the commissioner shall provide for a 60-day appeals process after notice of the 
233.33 	results of the rebasing;
234.1 	(3) the prohibition against inclusion of new facilities in the demonstration does not apply 
234.2 	after the demonstration ends;
234.3 	(4) (6) the prospective payment rate under this section does not apply to services rendered 
234.4 	by CCBHCs to individuals who are dually eligible for Medicare and medical assistance 
234.5 	when Medicare is the primary payer for the service. An entity that receives a prospective 
234.6 	payment system rate that overlaps with the CCBHC rate is not eligible for the CCBHC rate;
234.7 	(5) (7) payments for CCBHC services to individuals enrolled in managed care shall be 
234.8 	coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall 
234.9 	complete the phase-out of CCBHC wrap payments within 60 days of the implementation 
234.10 	of the prospective payment system in the Medicaid Management Information System 
234.11 	(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments 
234.12 	due made payable to CCBHCs no later than 18 months thereafter;
234.13 	(6) initial prospective payment rates for CCBHCs certified after July 1, 2019, shall be 
234.14 	based on rates for comparable CCBHCs. If no comparable provider exists, the commissioner 
234.15 	shall compute a CCBHC-specific rate based upon the CCBHC's audited costs adjusted for 
234.16 	changes in the scope of services;
234.17 	(7) (8) the prospective payment rate for each CCBHC shall be adjusted annuallyupdated 
234.18 	by trending each provider-specific rate by the Medicare Economic Index as defined for the 
234.19 	federal section 223 CCBHC demonstration for primary care services. This update shall 
234.20 	occur each year in between rebasing periods determined by the commissioner in accordance 
234.21 	with clause (4). CCBHCs must provide data on costs and visits to the state annually using 
234.22 	the CCBHC cost report established by the commissioner; and
234.23 	(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of 
234.24 	services when such changes are expected to result in an adjustment to the CCBHC payment 
234.25 	rate by 2.5 percent or more. The CCBHC must provide the commissioner with information 
234.26 	regarding the changes in the scope of services, including the estimated cost of providing 
234.27 	the new or modified services and any projected increase or decrease in the number of visits 
234.28 	resulting from the change. Rate adjustments for changes in scope shall occur no more than 
234.29 	once per year in between rebasing periods per CCBHC and are effective on the date of the 
234.30 	annual CCBHC rate update.
234.31 	(8) the commissioner shall seek federal approval for a CCBHC rate methodology that 
234.32 	allows for rate modifications based on changes in scope for an individual CCBHC, including 
234.33 	for changes to the type, intensity, or duration of services. Upon federal approval, a CCBHC 
234.34 	may submit a change of scope request to the commissioner if the change in scope would 
235.1 	result in a change of 2.5 percent or more in the prospective payment system rate currently 
235.2 	received by the CCBHC. CCBHC change of scope requests must be according to a format 
235.3 	and timeline to be determined by the commissioner in consultation with CCBHCs.
235.4 	(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC 
235.5 	providers at the prospective payment rate. The commissioner shall monitor the effect of 
235.6 	this requirement on the rate of access to the services delivered by CCBHC providers. If, for 
235.7 	any contract year, federal approval is not received for this paragraph, the commissioner 
235.8 	must adjust the capitation rates paid to managed care plans and county-based purchasing 
235.9 	plans for that contract year to reflect the removal of this provision. Contracts between 
235.10 	managed care plans and county-based purchasing plans and providers to whom this paragraph 
235.11 	applies must allow recovery of payments from those providers if capitation rates are adjusted 
235.12 	in accordance with this paragraph. Payment recoveries must not exceed the amount equal 
235.13 	to any increase in rates that results from this provision. This paragraph expires if federal 
235.14 	approval is not received for this paragraph at any time.
235.15 	(e) The commissioner shall implement a quality incentive payment program for CCBHCs 
235.16 	that meets the following requirements:
235.17 	(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric 
235.18 	thresholds for performance metrics established by the commissioner, in addition to payments 
235.19 	for which the CCBHC is eligible under the prospective payment system described in 
235.20 	paragraph (c);
235.21 	(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement 
235.22 	year to be eligible for incentive payments;
235.23 	(3) each CCBHC shall receive written notice of the criteria that must be met in order to 
235.24 	receive quality incentive payments at least 90 days prior to the measurement year; and
235.25 	(4) a CCBHC must provide the commissioner with data needed to determine incentive 
235.26 	payment eligibility within six months following the measurement year. The commissioner 
235.27 	shall notify CCBHC providers of their performance on the required measures and the 
235.28 	incentive payment amount within 12 months following the measurement year.
235.29 	(f) All claims to managed care plans for CCBHC services as provided under this section 
235.30 	shall be submitted directly to, and paid by, the commissioner on the dates specified no later 
235.31 	than January 1 of the following calendar year, if:
235.32 	(1) one or more managed care plans does not comply with the federal requirement for 
235.33 	payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42, 
236.1 	section 447.45(b), and the managed care plan does not resolve the payment issue within 30 
236.2 	days of noncompliance; and
236.3 	(2) the total amount of clean claims not paid in accordance with federal requirements 
236.4 	by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims 
236.5 	eligible for payment by managed care plans.
236.6 	If the conditions in this paragraph are met between January 1 and June 30 of a calendar 
236.7 	year, claims shall be submitted to and paid by the commissioner beginning on January 1 of 
236.8 	the following year. If the conditions in this paragraph are met between July 1 and December 
236.9 	31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning 
236.10 	on July 1 of the following year.

236.11 	EFFECTIVE DATE. This section is effective July 1, 2021, or upon federal approval, 
236.12 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
236.13 	when federal approval is obtained or denied.

236.14 	Sec. 5. Minnesota Statutes 2020, section 297E.02, subdivision 3, is amended to read:
236.15 		Subd. 3.Collection; disposition. (a) Taxes imposed by this section are due and payable 
236.16 	to the commissioner when the gambling tax return is required to be filed. Distributors must 
236.17 	file their monthly sales figures with the commissioner on a form prescribed by the 
236.18 	commissioner. Returns covering the taxes imposed under this section must be filed with 
236.19 	the commissioner on or before the 20th day of the month following the close of the previous 
236.20 	calendar month. The commissioner shall prescribe the content, format, and manner of returns 
236.21 	or other documents pursuant to section 270C.30. The proceeds, along with the revenue 
236.22 	received from all license fees and other fees under sections 349.11 to 349.191, 349.211, 
236.23 	and 349.213, must be paid to the commissioner of management and budget for deposit in 
236.24 	the general fund.
236.25 	(b) The sales tax imposed by chapter 297A on the sale of pull-tabs and tipboards by the 
236.26 	distributor is imposed on the retail sales price. The retail sale of pull-tabs or tipboards by 
236.27 	the organization is exempt from taxes imposed by chapter 297A and is exempt from all 
236.28 	local taxes and license fees except a fee authorized under section 349.16, subdivision 8.
236.29 	(c) One-half of one percent of the revenue deposited in the general fund under paragraph 
236.30 	(a), is appropriated to the commissioner of human services for the compulsive gambling 
236.31 	treatment program established under section 245.98. One-half of one percent of the revenue 
236.32 	deposited in the general fund under paragraph (a), is appropriated to the commissioner of 
236.33 	human services for a grant to the state affiliate recognized by the National Council on 
237.1 	Problem Gambling to increase public awareness of problem gambling, education and training 
237.2 	for individuals and organizations providing effective treatment services to problem gamblers 
237.3 	and their families, and research relating to problem gambling. Money appropriated by this 
237.4 	paragraph must supplement and must not replace existing state funding for these programs.
237.5 	(d) The commissioner of human services must provide to the state affiliate recognized 
237.6 	by the National Council on Problem Gambling a monthly statement of the amounts deposited 
237.7 	under paragraph (c). Beginning January 1, 2022, the commissioner of human services must 
237.8 	provide to the chairs and ranking minority members of the legislative committees with 
237.9 	jurisdiction over treatment for problem gambling and to the state affiliate recognized by the 
237.10 	National Council on Problem Gambling an annual reconciliation of the amounts deposited 
237.11 	under paragraph (c). The annual reconciliation under this paragraph must include the amount 
237.12 	allocated to the commissioner of human services for the compulsive gambling treatment 
237.13 	program established under section 245.98, and the amount allocated to the state affiliate 
237.14 	recognized by the National Council on Problem Gambling.

237.15 	Sec. 6. DIRECTION TO COMMISSIONERS OF HEALTH AND HUMAN 
237.16 	SERVICES; COMPULSIVE GAMBLING PROGRAMMING AND FUNDING.
 237.17 	By September 1, 2022, the commissioner of human services shall consult with the 
237.18 	commissioner of health and report to the chairs and ranking minority members of the 
237.19 	legislative committees with jurisdiction over health and human services with a 
237.20 	recommendation on whether the revenue appropriated to the commissioner of human services 
237.21 	for a grant to the state affiliate recognized by the National Council on Problem Gambling 
237.22 	under Minnesota Statutes, section 297E.02, subdivision 3, paragraph (c), is more properly 
237.23 	appropriated to and managed by an agency other than the Department of Human Services. 
237.24 	The commissioners shall also recommend whether the compulsive gambling treatment 
237.25 	program in Minnesota Statutes, section 245.98, should continue to be managed by the 
237.26 	Department of Human Services or be managed by another agency.

237.27 	Sec. 7. REVISOR INSTRUCTION.
 237.28 	The revisor of statutes shall replace "EXCELLENCE IN MENTAL HEALTH 
237.29 	DEMONSTRATION PROJECT" with "CERTIFIED COMMUNITY BEHAVIORAL 
237.30 	HEALTH CLINIC SERVICES" in the section headnote for Minnesota Statutes, section 
237.31 	245.735.

238.1 	Sec. 8. REPEALER.
 238.2 	Minnesota Statutes 2020, section 245.735, subdivisions 1, 2, and 4, are repealed.

238.3 	ARTICLE 12
238.4 	DISABILITY SERVICES AND 
238.5 	CONTINUING CARE FOR OLDER ADULTS

238.6 	Section 1. Minnesota Statutes 2020, section 256.9741, subdivision 1, is amended to read:
238.7 		Subdivision 1.Long-term care facility. "Long-term care facility" means a nursing home 
238.8 	licensed under sections 144A.02 to 144A.10; a boarding care home licensed under sections 
238.9 	144.50 to 144.56; an assisted living facility or an assisted living facility with dementia care 
238.10 	licensed under chapter 144G; or a licensed or registered residential setting that provides or 
238.11 	arranges for the provision of home care services; or a setting defined under section 144G.08, 
238.12 	subdivision 7, clauses (10) to (13), that provides or arranges for the provision of home care 
238.13 	services.

238.14 	EFFECTIVE DATE. This section is effective August 1, 2021.

238.15 	Sec. 2. Minnesota Statutes 2020, section 256B.0911, subdivision 3a, is amended to read:
238.16 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
238.17 	planning, or other assistance intended to support community-based living, including persons 
238.18 	who need assessment in order to determine waiver or alternative care program eligibility, 
238.19 	must be visited by a long-term care consultation team within 20 calendar days after the date 
238.20 	on which an assessment was requested or recommended. Upon statewide implementation 
238.21 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
238.22 	requesting personal care assistance services. The commissioner shall provide at least a 
238.23 	90-day notice to lead agencies prior to the effective date of this requirement. Face-to-face 
238.24 	assessments must be conducted according to paragraphs (b) to (i).
238.25 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
238.26 	assessors to conduct the assessment. For a person with complex health care needs, a public 
238.27 	health or registered nurse from the team must be consulted.
238.28 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
238.29 	be used to complete a comprehensive, conversation-based, person-centered assessment. 
238.30 	The assessment must include the health, psychological, functional, environmental, and 
238.31 	social needs of the individual necessary to develop a person-centered community support 
238.32 	plan that meets the individual's needs and preferences.
239.1 	(d) The assessment must be conducted by a certified assessor in a face-to-face 
239.2 	conversational interview with the person being assessed. The person's legal representative 
239.3 	must provide input during the assessment process and may do so remotely if requested. At 
239.4 	the request of the person, other individuals may participate in the assessment to provide 
239.5 	information on the needs, strengths, and preferences of the person necessary to develop a 
239.6 	community support plan that ensures the person's health and safety. Except for legal 
239.7 	representatives or family members invited by the person, persons participating in the 
239.8 	assessment may not be a provider of service or have any financial interest in the provision 
239.9 	of services. For persons who are to be assessed for elderly waiver customized living or adult 
239.10 	day services under chapter 256S, with the permission of the person being assessed or the 
239.11 	person's designated or legal representative, the client's current or proposed provider of 
239.12 	services may submit a copy of the provider's nursing assessment or written report outlining 
239.13 	its recommendations regarding the client's care needs. The person conducting the assessment 
239.14 	must notify the provider of the date by which this information is to be submitted. This 
239.15 	information shall be provided to the person conducting the assessment prior to the assessment. 
239.16 	For a person who is to be assessed for waiver services under section 256B.092 or 256B.49, 
239.17 	with the permission of the person being assessed or the person's designated legal 
239.18 	representative, the person's current provider of services may submit a written report outlining 
239.19 	recommendations regarding the person's care needs the person completed in consultation 
239.20 	with someone who is known to the person and has interaction with the person on a regular 
239.21 	basis. The provider must submit the report at least 60 days before the end of the person's 
239.22 	current service agreement. The certified assessor must consider the content of the submitted 
239.23 	report prior to finalizing the person's assessment or reassessment.
239.24 	(e) The certified assessor and the individual responsible for developing the coordinated 
239.25 	service and support plan must complete the community support plan and the coordinated 
239.26 	service and support plan no more than 60 calendar days from the assessment visit. The 
239.27 	person or the person's legal representative must be provided with a written community 
239.28 	support plan within the timelines established by the commissioner, regardless of whether 
239.29 	the person is eligible for Minnesota health care programs.
239.30 	(f) For a person being assessed for elderly waiver services under chapter 256S, a provider 
239.31 	who submitted information under paragraph (d) shall receive the final written community 
239.32 	support plan when available and the Residential Services Workbook.
239.33 	(g) The written community support plan must include:
239.34 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
240.1 	(2) the individual's options and choices to meet identified needs, including:
240.2 	(i) all available options for case management services and providers;
240.3 	(ii) all available options for employment services, settings, and providers;
240.4 	(iii) all available options for living arrangements;
240.5 	(iv) all available options for self-directed services and supports, including self-directed 
240.6 	budget options; and
240.7 	(v) service provided in a non-disability-specific setting;
240.8 	(3) identification of health and safety risks and how those risks will be addressed, 
240.9 	including personal risk management strategies;
240.10 	(4) referral information; and
240.11 	(5) informal caregiver supports, if applicable.
240.12 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
240.13 	(b), clause (1), the person or person's representative must also receive a copy of the home 
240.14 	care service plan developed by the certified assessor.
240.15 	(h) A person may request assistance in identifying community supports without 
240.16 	participating in a complete assessment. Upon a request for assistance identifying community 
240.17 	support, the person must be transferred or referred to long-term care options counseling 
240.18 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
240.19 	telephone assistance and follow up.
240.20 	(i) The person has the right to make the final decision:
240.21 	(1) between institutional placement and community placement after the recommendations 
240.22 	have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);
240.23 	(2) between community placement in a setting controlled by a provider and living 
240.24 	independently in a setting not controlled by a provider;
240.25 	(3) between day services and employment services; and
240.26 	(4) regarding available options for self-directed services and supports, including 
240.27 	self-directed funding options.
240.28 	(j) The lead agency must give the person receiving long-term care consultation services 
240.29 	or the person's legal representative, materials, and forms supplied by the commissioner 
240.30 	containing the following information:
241.1 	(1) written recommendations for community-based services and consumer-directed 
241.2 	options;
241.3 	(2) documentation that the most cost-effective alternatives available were offered to the 
241.4 	individual. For purposes of this clause, "cost-effective" means community services and 
241.5 	living arrangements that cost the same as or less than institutional care. For an individual 
241.6 	found to meet eligibility criteria for home and community-based service programs under 
241.7 	chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally 
241.8 	approved waiver plan for each program;
241.9 	(3) the need for and purpose of preadmission screening conducted by long-term care 
241.10 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
241.11 	nursing facility placement. If the individual selects nursing facility placement, the lead 
241.12 	agency shall forward information needed to complete the level of care determinations and 
241.13 	screening for developmental disability and mental illness collected during the assessment 
241.14 	to the long-term care options counselor using forms provided by the commissioner;
241.15 	(4) the role of long-term care consultation assessment and support planning in eligibility 
241.16 	determination for waiver and alternative care programs, and state plan home care, case 
241.17 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
241.18 	and (b);
241.19 	(5) information about Minnesota health care programs;
241.20 	(6) the person's freedom to accept or reject the recommendations of the team;
241.21 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
241.22 	Act, chapter 13;
241.23 	(8) the certified assessor's decision regarding the person's need for institutional level of 
241.24 	care as determined under criteria established in subdivision 4e and the certified assessor's 
241.25 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
241.26 	paragraphs (a), clause (6), and (b);
241.27 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
241.28 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
241.29 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
241.30 	or the lead agency's final decisions regarding public programs eligibility according to section 
241.31 	256.045, subdivision 3. The certified assessor must verbally communicate this appeal right 
241.32 	to the person and must visually point out where in the document the right to appeal is stated; 
241.33 	and
242.1 	(10) documentation that available options for employment services, independent living, 
242.2 	and self-directed services and supports were described to the individual.
242.3 	(k) Face-to-face assessment completed as part of an eligibility determination for multiple 
242.4 	programs for the alternative care, elderly waiver, developmental disabilities, community 
242.5 	access for disability inclusion, community alternative care, and brain injury waiver programs 
242.6 	under chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish 
242.7 	service eligibility for no more than 60 calendar days after the date of assessment.
242.8 	(l) The effective eligibility start date for programs in paragraph (k) can never be prior 
242.9 	to the date of assessment. If an assessment was completed more than 60 days before the 
242.10 	effective waiver or alternative care program eligibility start date, assessment and support 
242.11 	plan information must be updated and documented in the department's Medicaid Management 
242.12 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
242.13 	state plan services, the effective date of eligibility for programs included in paragraph (k) 
242.14 	cannot be prior to the date the most recent updated assessment is completed.
242.15 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
242.16 	assessment and documented in the department's Medicaid Management Information System 
242.17 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
242.18 	of the previous face-to-face assessment when all other eligibility requirements are met.
242.19 	(n) If a person who receives home and community-based waiver services under section 
242.20 	256B.0913, 256B.092, or 256B.49 or chapter 256S temporarily enters for 121 days or fewer 
242.21 	a hospital, institution of mental disease, nursing facility, intensive residential treatment 
242.22 	services program, transitional care unit, or inpatient substance use disorder treatment setting, 
242.23 	the person may return to the community with home and community-based waiver services 
242.24 	under the same waiver, without requiring an assessment or reassessment under this section, 
242.25 	unless the person's annual reassessment is otherwise due. Nothing in this paragraph shall 
242.26 	change annual long-term care consultation reassessment requirements, payment for 
242.27 	institutional or treatment services, medical assistance financial eligibility, or any other law.
242.28 	(n) (o) At the time of reassessment, the certified assessor shall assess each person 
242.29 	receiving waiver residential supports and services currently residing in a community 
242.30 	residential setting, licensed adult foster care home that is either not the primary residence 
242.31 	of the license holder or in which the license holder is not the primary caregiver, family adult 
242.32 	foster care residence, customized living setting, or supervised living facility to determine 
242.33 	if that person would prefer to be served in a community-living setting as defined in section 
242.34 	256B.49, subdivision 23, in a setting not controlled by a provider, or to receive integrated 
243.1 	community supports as described in section 245D.03, subdivision 1, paragraph (c), clause 
243.2 	(8). The certified assessor shall offer the person, through a person-centered planning process, 
243.3 	the option to receive alternative housing and service options.
243.4 	(o) (p) At the time of reassessment, the certified assessor shall assess each person 
243.5 	receiving waiver day services to determine if that person would prefer to receive employment 
243.6 	services as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). 
243.7 	The certified assessor shall describe to the person through a person-centered planning process 
243.8 	the option to receive employment services.
243.9 	(p) (q) At the time of reassessment, the certified assessor shall assess each person 
243.10 	receiving non-self-directed waiver services to determine if that person would prefer an 
243.11 	available service and setting option that would permit self-directed services and supports. 
243.12 	The certified assessor shall describe to the person through a person-centered planning process 
243.13 	the option to receive self-directed services and supports.

243.14 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
243.15 	shall notify the revisor of statutes when federal approval is obtained.

243.16 	Sec. 3. Minnesota Statutes 2020, section 256I.05, subdivision 1a, is amended to read:
243.17 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
243.18 	subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other 
243.19 	services necessary to provide room and board if the residence is licensed by or registered 
243.20 	by the Department of Health, or licensed by the Department of Human Services to provide 
243.21 	services in addition to room and board, and if the provider of services is not also concurrently 
243.22 	receiving funding for services for a recipient under a home and community-based waiver 
243.23 	under title XIX of the federal Social Security Act; or funding from the medical assistance 
243.24 	program under section 256B.0659, for personal care services for residents in the setting; or 
243.25 	residing in a setting which receives funding under section 245.73. If funding is available 
243.26 	for other necessary services through a home and community-based waiver, or personal care 
243.27 	services under section 256B.0659, then the housing support rate is limited to the rate set in 
243.28 	subdivision 1. Unless otherwise provided in law, in no case may the supplementary service 
243.29 	rate exceed $426.37. The registration and licensure requirement does not apply to 
243.30 	establishments which are exempt from state licensure because they are located on Indian 
243.31 	reservations and for which the tribe has prescribed health and safety requirements. Service 
243.32 	payments under this section may be prohibited under rules to prevent the supplanting of 
243.33 	federal funds with state funds. The commissioner shall pursue the feasibility of obtaining 
243.34 	the approval of the Secretary of Health and Human Services to provide home and 
244.1 	community-based waiver services under title XIX of the federal Social Security Act for 
244.2 	residents who are not eligible for an existing home and community-based waiver due to a 
244.3 	primary diagnosis of mental illness or chemical dependency and shall apply for a waiver if 
244.4 	it is determined to be cost-effective.
244.5 	(b) The commissioner is authorized to make cost-neutral transfers from the housing 
244.6 	support fund for beds under this section to other funding programs administered by the 
244.7 	department after consultation with the county or counties agency in which the affected beds 
244.8 	are located. The commissioner may also make cost-neutral transfers from the housing support 
244.9 	fund to county human service agencies for beds permanently removed from the housing 
244.10 	support census under a plan submitted by the county agency and approved by the 
244.11 	commissioner. The commissioner shall report the amount of any transfers under this provision 
244.12 	annually to the legislature.
244.13 	(c) Counties Agencies must not negotiate supplementary service rates with providers of 
244.14 	housing support that are licensed as board and lodging with special services and that do not 
244.15 	encourage a policy of sobriety on their premises and make referrals to available community 
244.16 	services for volunteer and employment opportunities for residents.

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

244.18 	Sec. 4. Minnesota Statutes 2020, section 256I.05, subdivision 11, is amended to read:
244.19 		Subd. 11.Transfer of emergency shelter funds. (a) The commissioner shall make a 
244.20 	cost-neutral transfer of funding from the housing support fund to county human service 
244.21 	agencies the agency for emergency shelter beds removed from the housing support census 
244.22 	under a biennial plan submitted by the county agency and approved by the commissioner. 
244.23 	The plan must describe: (1) anticipated and actual outcomes for persons experiencing 
244.24 	homelessness in emergency shelters; (2) improved efficiencies in administration; (3) 
244.25 	requirements for individual eligibility; and (4) plans for quality assurance monitoring and 
244.26 	quality assurance outcomes. The commissioner shall review the county agency plan to 
244.27 	monitor implementation and outcomes at least biennially, and more frequently if the 
244.28 	commissioner deems necessary.
244.29 	(b) The funding under paragraph (a) may be used for the provision of room and board 
244.30 	or supplemental services according to section 256I.03, subdivisions 2 and 8. Providers must 
244.31 	meet the requirements of section 256I.04, subdivisions 2a to 2f. Funding must be allocated 
244.32 	annually, and the room and board portion of the allocation shall be adjusted according to 
244.33 	the percentage change in the housing support room and board rate. The room and board 
244.34 	portion of the allocation shall be determined at the time of transfer. The commissioner or 
245.1 	county agency may return beds to the housing support fund with 180 days' notice, including 
245.2 	financial reconciliation.

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

245.4 	Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.
 245.5 	The Governor's Council on an Age-Friendly Minnesota, established in Executive Order 
245.6 	19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and 
245.7 	private partners' collaborative work on emergency preparedness, with a focus on older 
245.8 	adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic. 
245.9 	The Governor's Council on an Age-Friendly Minnesota is extended and expires October 1, 
245.10 	2022.

245.11 	Sec. 6. REVISOR INSTRUCTION.
 245.12 	(a) The revisor of statutes, in consultation with the Office of Senate Counsel, Research 
245.13 	and Fiscal Analysis, the Office of the House Research Department, and the commissioner 
245.14 	of human services, shall prepare legislation for the 2022 legislative session to recodify 
245.15 	Minnesota Statutes, sections 256.975, subdivisions 7 to 7d, and 256B.0911.
245.16 	(b) The revisor of statutes, in consultation with the Office of Senate Counsel, Research 
245.17 	and Fiscal Analysis, the Office of the House Research Department, and the commissioner 
245.18 	of human services, shall to the greatest extent practicable renumber as subdivisions the 
245.19 	paragraphs of Minnesota Statutes, section 256B.4914, prior to the publication of the 2021 
245.20 	Supplement of Minnesota Statutes, and shall without changing the meaning or effect of 
245.21 	these provisions minimize the use of internal cross-references, including by drafting new 
245.22 	technical definitions as substitutes for necessary cross-references or by other means 
245.23 	acceptable to the commissioner of human services.

245.24 	ARTICLE 13
245.25 	COMMUNITY SUPPORTS POLICY

245.26 	Section 1. Minnesota Statutes 2020, section 245.4874, subdivision 1, is amended to read:
245.27 		Subdivision 1.Duties of county board. (a) The county board must:
245.28 	(1) develop a system of affordable and locally available children's mental health services 
245.29 	according to sections 245.487 to 245.4889;
245.30 	(2) consider the assessment of unmet needs in the county as reported by the local 
245.31 	children's mental health advisory council under section 245.4875, subdivision 5, paragraph 
246.1 	(b), clause (3). The county shall provide, upon request of the local children's mental health 
246.2 	advisory council, readily available data to assist in the determination of unmet needs;
246.3 	(3) assure that parents and providers in the county receive information about how to 
246.4 	gain access to services provided according to sections 245.487 to 245.4889;
246.5 	(4) coordinate the delivery of children's mental health services with services provided 
246.6 	by social services, education, corrections, health, and vocational agencies to improve the 
246.7 	availability of mental health services to children and the cost-effectiveness of their delivery;
246.8 	(5) assure that mental health services delivered according to sections 245.487 to 245.4889
246.9 	are delivered expeditiously and are appropriate to the child's diagnostic assessment and 
246.10 	individual treatment plan;
246.11 	(6) provide for case management services to each child with severe emotional disturbance 
246.12 	according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 
246.13 	1, 3, and 5;
246.14 	(7) provide for screening of each child under section 245.4885 upon admission to a 
246.15 	residential treatment facility, acute care hospital inpatient treatment, or informal admission 
246.16 	to a regional treatment center;
246.17 	(8) prudently administer grants and purchase-of-service contracts that the county board 
246.18 	determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4889;
246.19 	(9) assure that mental health professionals, mental health practitioners, and case managers 
246.20 	employed by or under contract to the county to provide mental health services are qualified 
246.21 	under section 245.4871;
246.22 	(10) assure that children's mental health services are coordinated with adult mental health 
246.23 	services specified in sections 245.461 to 245.486 so that a continuum of mental health 
246.24 	services is available to serve persons with mental illness, regardless of the person's age;
246.25 	(11) assure that culturally competent mental health consultants are used as necessary to 
246.26 	assist the county board in assessing and providing appropriate treatment for children of 
246.27 	cultural or racial minority heritage; and
246.28 	(12) consistent with section 245.486, arrange for or provide a children's mental health 
246.29 	screening for:
246.30 	(i) a child receiving child protective services;
246.31 	(ii) a child in out-of-home placement;
246.32 	(iii) a child for whom parental rights have been terminated;
247.1 	(iv) a child found to be delinquent; or
247.2 	(v) a child found to have committed a juvenile petty offense for the third or subsequent 
247.3 	time.
247.4 	A children's mental health screening is not required when a screening or diagnostic 
247.5 	assessment has been performed within the previous 180 days, or the child is currently under 
247.6 	the care of a mental health professional.
247.7 	(b) When a child is receiving protective services or is in out-of-home placement, the 
247.8 	court or county agency must notify a parent or guardian whose parental rights have not been 
247.9 	terminated of the potential mental health screening and the option to prevent the screening 
247.10 	by notifying the court or county agency in writing.
247.11 	(c) When a child is found to be delinquent or a child is found to have committed a 
247.12 	juvenile petty offense for the third or subsequent time, the court or county agency must 
247.13 	obtain written informed consent from the parent or legal guardian before a screening is 
247.14 	conducted unless the court, notwithstanding the parent's failure to consent, determines that 
247.15 	the screening is in the child's best interest.
247.16 	(d) The screening shall be conducted with a screening instrument approved by the 
247.17 	commissioner of human services according to criteria that are updated and issued annually 
247.18 	to ensure that approved screening instruments are valid and useful for child welfare and 
247.19 	juvenile justice populations. Screenings shall be conducted by a mental health practitioner 
247.20 	as defined in section 245.4871, subdivision 26, or a probation officer or local social services 
247.21 	agency staff person who is trained in the use of the screening instrument. Training in the 
247.22 	use of the instrument shall include:
247.23 	(1) training in the administration of the instrument;
247.24 	(2) the interpretation of its validity given the child's current circumstances;
247.25 	(3) the state and federal data practices laws and confidentiality standards;
247.26 	(4) the parental consent requirement; and
247.27 	(5) providing respect for families and cultural values.
247.28 	If the screen indicates a need for assessment, the child's family, or if the family lacks 
247.29 	mental health insurance, the local social services agency, in consultation with the child's 
247.30 	family, shall have conducted a diagnostic assessment, including a functional assessment. 
247.31 	The administration of the screening shall safeguard the privacy of children receiving the 
247.32 	screening and their families and shall comply with the Minnesota Government Data Practices 
248.1 	Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of 
248.2 	1996, Public Law 104-191. Screening results shall be considered private dataand the 
248.3 	commissioner shall not collect individual screening results are classified as private data on 
248.4 	individuals, as defined by section 13.02, subdivision 12. The county board or Tribal nation 
248.5 	may provide the commissioner with access to the screening results for the purposes of 
248.6 	program evaluation and improvement.
248.7 	(e) When the county board refers clients to providers of children's therapeutic services 
248.8 	and supports under section 256B.0943, the county board must clearly identify the desired 
248.9 	services components not covered under section 256B.0943 and identify the reimbursement 
248.10 	source for those requested services, the method of payment, and the payment rate to the 
248.11 	provider.

248.12 	Sec. 2. Minnesota Statutes 2020, section 245.697, subdivision 1, is amended to read:
248.13 		Subdivision 1.Creation. (a) A State Advisory Council on Mental Health is created. The 
248.14 	council must have members appointed by the governor in accordance with federal 
248.15 	requirements. In making the appointments, the governor shall consider appropriate 
248.16 	representation of communities of color. The council must be composed of:
248.17 	(1) the assistant commissioner of mental health for the Department of Human Services 
248.18 	who oversees behavioral health policy;
248.19 	(2) a representative of the Department of Human Services responsible for the medical 
248.20 	assistance program;
248.21 	(3) a representative of the Department of Health;
248.22 	(3) (4) one member of each of the following professions:
248.23 	(i) psychiatry;
248.24 	(ii) psychology;
248.25 	(iii) social work;
248.26 	(iv) nursing;
248.27 	(v) marriage and family therapy; and
248.28 	(vi) professional clinical counseling;
248.29 	(4) (5) one representative from each of the following advocacy groups: Mental Health 
248.30 	Association of Minnesota, NAMI-MN, Mental Health Consumer/Survivor Network of 
249.1 	Minnesota, and Minnesota Disability Law Center, American Indian Mental Health Advisory 
249.2 	Council, and a consumer-run mental health advocacy group;
249.3 	(5) (6) providers of mental health services;
249.4 	(6) (7) consumers of mental health services;
249.5 	(7) (8) family members of persons with mental illnesses;
249.6 	(8) (9) legislators;
249.7 	(9) (10) social service agency directors;
249.8 	(10) (11) county commissioners; and
249.9 	(11) (12) other members reflecting a broad range of community interests, including 
249.10 	family physicians, or members as the United States Secretary of Health and Human Services 
249.11 	may prescribe by regulation or as may be selected by the governor.
249.12 	(b) The council shall select a chair. Terms, compensation, and removal of members and 
249.13 	filling of vacancies are governed by section 15.059. Notwithstanding provisions of section 
249.14 	15.059, the council and its subcommittee on children's mental health do not expire. The 
249.15 	commissioner of human services shall provide staff support and supplies to the council.

249.16 	Sec. 3. Minnesota Statutes 2020, section 252.43, is amended to read:
249.17 	252.43 COMMISSIONER'S DUTIES.
249.18 	(a) The commissioner shall supervise lead agencies' provision of day services to adults 
249.19 	with disabilities. The commissioner shall:
249.20 	(1) determine the need for day services programs under section sections256B.4914 and 
249.21 	252.41 to 252.46;
249.22 	(2) establish payment rates as provided under section 256B.4914;
249.23 	(3) adopt rules for the administration and provision of day services under sections 
249.24 	245A.01 to 245A.16,;252.28, subdivision 2,; or 252.41 to 252.46,; or Minnesota Rules, 
249.25 	parts 9525.1200 to 9525.1330;
249.26 	(4) enter into interagency agreements necessary to ensure effective coordination and 
249.27 	provision of day services;
249.28 	(5) monitor and evaluate the costs and effectiveness of day services; and
249.29 	(6) provide information and technical help to lead agencies and vendors in their 
249.30 	administration and provision of day services.
250.1 	(b) A determination of need in paragraph (a), clause (1), shall not be required for a 
250.2 	change in day service provider name or ownership.

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

250.4 	Sec. 4. Minnesota Statutes 2020, section 252A.01, subdivision 1, is amended to read:
250.5 		Subdivision 1.Policy. (a) It is the policy of the state of Minnesota to provide a 
250.6 	coordinated approach to the supervision, protection, and habilitation of its adult citizens 
250.7 	with a developmental disability. In furtherance of this policy, sections 252A.01 to 252A.21 
250.8 	are enacted to authorize the commissioner of human services to:
250.9 	(1) supervise those adult citizens with a developmental disability who are unable to fully 
250.10 	provide for their own needs and for whom no qualified person is willing and able to seek 
250.11 	guardianship or conservatorship under sections 524.5-101 to 524.5-502; and
250.12 	(2) protect adults with a developmental disability from violation of their human and civil 
250.13 	rights by assuring ensuring that they receive the full range of needed social, financial, 
250.14 	residential, and habilitative services to which they are lawfully entitled.
250.15 	(b) Public guardianship or conservatorship is the most restrictive form of guardianship 
250.16 	or conservatorship and should be imposed only when no other acceptable alternative is 
250.17 	available less restrictive alternatives have been attempted and determined to be insufficient 
250.18 	to meet the person's needs. Less restrictive alternatives include but are not limited to 
250.19 	supported decision making, community or residential services, or appointment of a health 
250.20 	care agent.

250.21 	Sec. 5. Minnesota Statutes 2020, section 252A.02, subdivision 2, is amended to read:
250.22 		Subd. 2.Person with a developmental disability. "Person with a developmental 
250.23 	disability" refers to any person age 18 or older who:
250.24 	(1) has been diagnosed as having significantly subaverage intellectual functioning existing 
250.25 	concurrently with demonstrated deficits in adaptive behavior such as to require supervision 
250.26 	and protection for the person's welfare or the public welfare. a developmental disability;
250.27 	(2) is impaired to the extent of lacking sufficient understanding or capacity to make 
250.28 	personal decisions; and
250.29 	(3) is unable to meet personal needs for medical care, nutrition, clothing, shelter, or 
250.30 	safety, even with appropriate technological and supported decision-making assistance.

251.1 	Sec. 6. Minnesota Statutes 2020, section 252A.02, subdivision 9, is amended to read:
251.2 		Subd. 9.Ward Person subject to public guardianship. "Ward" "Person subject to 
251.3 	public guardianship" means a person with a developmental disability for whom the court 
251.4 	has appointed a public guardian.

251.5 	Sec. 7. Minnesota Statutes 2020, section 252A.02, subdivision 11, is amended to read:
251.6 		Subd. 11.Interested person. "Interested person" means an interested responsible adult, 
251.7 	including, but not limited to, a public official, guardian, spouse, parent, adult sibling, legal 
251.8 	counsel, adult child, or next of kin of a person alleged to have a developmental disability.
251.9 	including but not limited to:
251.10 	(1) the person subject to guardianship, the protected person, or the respondent;
251.11 	(2) a nominated guardian or conservator;
251.12 	(3) a legal representative;
251.13 	(4) a spouse; a parent, including a stepparent; adult children, including adult stepchildren 
251.14 	of a living spouse; and siblings. If no such persons are living or can be located, the next of 
251.15 	kin of the person subject to public guardianship or the respondent is an interested person;
251.16 	(5) a representative of a state ombudsman's office or a federal protection and advocacy 
251.17 	program that has notified the commissioner or lead agency that it has a matter regarding 
251.18 	the protected person subject to guardianship, person subject to conservatorship, or respondent; 
251.19 	and
251.20 	(6) a health care agent or proxy appointed pursuant to a health care directive as defined 
251.21 	in section 145C.01, subdivision 5a; a living will under chapter 145B; or other similar 
251.22 	documentation executed in another state and enforceable under the laws of this state.

251.23 	Sec. 8. Minnesota Statutes 2020, section 252A.02, subdivision 12, is amended to read:
251.24 		Subd. 12.Comprehensive evaluation. (a) "Comprehensive evaluation" shall consist
251.25 	consists of:
251.26 	(1) a medical report on the health status and physical condition of the proposed ward,
251.27 	person subject to public guardianship prepared under the direction of a licensed physician 
251.28 	or advanced practice registered nurse;
251.29 	(2) a report on the proposed ward's intellectual capacity and functional abilities, specifying
251.30 	of the proposed person subject to public guardianship that specifies the tests and other data 
252.1 	used in reaching its conclusions, and is prepared by a psychologist who is qualified in the 
252.2 	diagnosis of developmental disability; and
252.3 	(3) a report from the case manager that includes:
252.4 	(i) the most current assessment of individual service needs as described in rules of the 
252.5 	commissioner;
252.6 	(ii) the most current individual service coordinated service and support plan under section 
252.7 	256B.092, subdivision 1b; and
252.8 	(iii) a description of contacts with and responses of near relatives of the proposed ward
252.9 	person subject to public guardianship notifying them the near relatives that a nomination 
252.10 	for public guardianship has been made and advising them the near relatives that they may 
252.11 	seek private guardianship.
252.12 	(b) Each report under paragraph (a), clause (3), shall contain recommendations as to the 
252.13 	amount of assistance and supervision required by the proposed ward person subject to public 
252.14 	guardianship to function as independently as possible in society. To be considered part of 
252.15 	the comprehensive evaluation, the reports must be completed no more than one year before 
252.16 	filing the petition under section 252A.05.

252.17 	Sec. 9. Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision to 
252.18 	read:
252.19 		Subd. 16.Protected person. "Protected person" means a person for whom a guardian 
252.20 	or conservator has been appointed or other protective order has been sought. A protected 
252.21 	person may be a minor.

252.22 	Sec. 10. Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision 
252.23 	to read:
252.24 		Subd. 17.Respondent. "Respondent" means an individual for whom the appointment 
252.25 	of a guardian or conservator or other protective order is sought.

252.26 	Sec. 11. Minnesota Statutes 2020, section 252A.02, is amended by adding a subdivision 
252.27 	to read:
252.28 		Subd. 18.Supported decision making. "Supported decision making" means assistance 
252.29 	to an individual with understanding the nature and consequences of personal and financial 
252.30 	decisions from one or more persons of the individual's choosing to enable the individual to 
253.1 	make the personal and financial decisions and, when consistent with the individual's wishes, 
253.2 	to communicate the individual's decisions.

253.3 	Sec. 12. Minnesota Statutes 2020, section 252A.03, subdivision 3, is amended to read:
253.4 		Subd. 3.Standard for acceptance. The commissioner shall accept the nomination if:
253.5 	the comprehensive evaluation concludes that:
253.6 	(1) the person alleged to have developmental disability is, in fact, developmentally 
253.7 	disabled; (1) the person's assessment confirms that they are a person with a developmental 
253.8 	disability under section 252A.02, subdivision 2;
253.9 	(2) the person is in need of the supervision and protection of a conservator or guardian; 
253.10 	and
253.11 	(3) no qualified person is willing to assume guardianship or conservatorship under 
253.12 	sections 524.5-101 to 524.5-502.; and
253.13 	(4) the person subject to public guardianship was included in the process prior to the 
253.14 	submission of the nomination.

253.15 	Sec. 13. Minnesota Statutes 2020, section 252A.03, subdivision 4, is amended to read:
253.16 		Subd. 4.Alternatives. (a) Public guardianship or conservatorship may be imposed only 
253.17 	when:
253.18 	(1) the person subject to guardianship is impaired to the extent of lacking sufficient 
253.19 	understanding or capacity to make personal decisions;
253.20 	(2) the person subject to guardianship is unable to meet personal needs for medical care, 
253.21 	nutrition, clothing, shelter, or safety, even with appropriate technological and supported 
253.22 	decision-making assistance; and
253.23 	(3) no acceptable, less restrictive form of guardianship or conservatorship is available.
253.24 	(b) The commissioner shall seek parents, near relatives, and other interested persons to 
253.25 	assume guardianship for persons with developmental disabilities who are currently under 
253.26 	public guardianship. If a person seeks to become a guardian or conservator, costs to the 
253.27 	person may be reimbursed under section 524.5-502. The commissioner must provide technical 
253.28 	assistance to parents, near relatives, and interested persons seeking to become guardians or 
253.29 	conservators.

254.1 	Sec. 14. Minnesota Statutes 2020, section 252A.04, subdivision 1, is amended to read:
254.2 		Subdivision 1.Local agency. Upon receipt of a written nomination, the commissioner 
254.3 	shall promptly order the local agency of the county in which the proposed ward person 
254.4 	subject to public guardianship resides to coordinate or arrange for a comprehensive evaluation 
254.5 	of the proposed ward person subject to public guardianship.

254.6 	Sec. 15. Minnesota Statutes 2020, section 252A.04, subdivision 2, is amended to read:
254.7 		Subd. 2.Medication; treatment. A proposed ward person subject to public guardianship
254.8 	who, at the time the comprehensive evaluation is to be performed, has been under medical 
254.9 	care shall not be so under the influence or so suffer the effects of drugs, medication, or other 
254.10 	treatment as to be hampered in the testing or evaluation process. When in the opinion of 
254.11 	the licensed physician or advanced practice registered nurse attending the proposed ward
254.12 	person subject to public guardianship, the discontinuance of medication or other treatment 
254.13 	is not in the proposed ward's best interest of the proposed person subject to public 
254.14 	guardianship, the physician or advanced practice registered nurse shall record a list of all 
254.15 	drugs, medication, or other treatment which that the proposed ward person subject to public 
254.16 	guardianship received 48 hours immediately prior to any examination, test, or interview 
254.17 	conducted in preparation for the comprehensive evaluation.

254.18 	Sec. 16. Minnesota Statutes 2020, section 252A.04, subdivision 4, is amended to read:
254.19 		Subd. 4.File. The comprehensive evaluation shall be kept on file at the Department of 
254.20 	Human Services and shall be open to the inspection of the proposed ward person subject to 
254.21 	public guardianship and such other persons as may be given permission permitted by the 
254.22 	commissioner.

254.23 	Sec. 17. Minnesota Statutes 2020, section 252A.05, is amended to read:
254.24 	252A.05 COMMISSIONER'S PETITION FOR APPOINTMENT AS PUBLIC 
254.25 	GUARDIAN OR PUBLIC CONSERVATOR.
254.26 	In every case in which the commissioner agrees to accept a nomination, the local agency, 
254.27 	within 20 working days of receipt of the commissioner's acceptance, shall petition on behalf 
254.28 	of the commissioner in the county or court of the county of residence of the person with a 
254.29 	developmental disability for appointment to act as public conservator or public guardian of 
254.30 	the person with a developmental disability.

255.1 	Sec. 18. Minnesota Statutes 2020, section 252A.06, subdivision 1, is amended to read:
255.2 		Subdivision 1.Who may file. The commissioner, the local agency, a person with a 
255.3 	developmental disability or any parent, spouse or relative of a person with a developmental 
255.4 	disability may file A verified petition alleging that the appointment of a public conservator 
255.5 	or public guardian is required may be filed by: the commissioner; the local agency; a person 
255.6 	with a developmental disability; or a parent, stepparent, spouse, or relative of a person with 
255.7 	a developmental disability.

255.8 	Sec. 19. Minnesota Statutes 2020, section 252A.06, subdivision 2, is amended to read:
255.9 		Subd. 2.Contents. The petition shall set forth:
255.10 	(1) the name and address of the petitioner, and, in the case of a petition brought by a 
255.11 	person other than the commissioner, whether the petitioner is a parent, spouse, or relative 
255.12 	of the proposed ward of the proposed person subject to guardianship;
255.13 	(2) whether the commissioner has accepted a nomination to act as public conservator 
255.14 	or public guardian;
255.15 	(3) the name, address, and date of birth of the proposed ward person subject to public 
255.16 	guardianship;
255.17 	(4) the names and addresses of the nearest relatives and spouse, if any, of the proposed 
255.18 	ward person subject to public guardianship;
255.19 	(5) the probable value and general character of the proposed ward's real and personal 
255.20 	property of the proposed person subject to public guardianship and the probable amount of 
255.21 	the proposed ward's debts of the proposed person subject to public guardianship; and
255.22 	(6) the facts supporting the establishment of public conservatorship or guardianship, 
255.23 	including that no family member or other qualified individual is willing to assume 
255.24 	guardianship or conservatorship responsibilities under sections 524.5-101 to 524.5-502; 
255.25 	and.
255.26 	(7) if conservatorship is requested, the powers the petitioner believes are necessary to 
255.27 	protect and supervise the proposed conservatee.

255.28 	Sec. 20. Minnesota Statutes 2020, section 252A.07, subdivision 1, is amended to read:
255.29 		Subdivision 1.With petition. When a petition is brought by the commissioner or local 
255.30 	agency, a copy of the comprehensive evaluation shall be filed with the petition. If a petition 
255.31 	is brought by a person other than the commissioner or local agency and a comprehensive 
256.1 	evaluation has been prepared within a year of the filing of the petition, the local agency 
256.2 	shall forward send a copy of the comprehensive evaluation to the court upon notice of the 
256.3 	filing of the petition. If a comprehensive evaluation has not been prepared within a year of 
256.4 	the filing of the petition, the local agency, upon notice of the filing of the petition, shall 
256.5 	arrange for a comprehensive evaluation to be prepared and forwarded provided to the court 
256.6 	within 90 days.

256.7 	Sec. 21. Minnesota Statutes 2020, section 252A.07, subdivision 2, is amended to read:
256.8 		Subd. 2.Copies. A copy of the comprehensive evaluation shall be made available by 
256.9 	the court to the proposed ward person subject to public guardianship, the proposed ward's
256.10 	counsel of the proposed person subject to public guardianship, the county attorney, the 
256.11 	attorney general, and the petitioner.

256.12 	Sec. 22. Minnesota Statutes 2020, section 252A.07, subdivision 3, is amended to read:
256.13 		Subd. 3.Evaluation required; exception. (a) No action for the appointment of a public 
256.14 	guardian may proceed to hearing unless a comprehensive evaluation has been first filed 
256.15 	with the court; provided, however, that an action may proceed and a guardian appointed.
256.16 	(b) Paragraph (a) does not apply if the director of the local agency responsible for 
256.17 	conducting the comprehensive evaluation has filed an affidavit that the proposed ward
256.18 	person subject to public guardianship refused to participate in the comprehensive evaluation 
256.19 	and the court finds on the basis of clear and convincing evidence that the proposed ward
256.20 	person subject to public guardianship is developmentally disabled and in need of the 
256.21 	supervision and protection of a guardian.

256.22 	Sec. 23. Minnesota Statutes 2020, section 252A.081, subdivision 2, is amended to read:
256.23 		Subd. 2.Service of notice. Service of notice on the ward person subject to public 
256.24 	guardianship or proposed ward person subject to public guardianship must be made by a 
256.25 	nonuniformed person or nonuniformed visitor. To the extent possible, the process server or 
256.26 	visitor person or visitor serving the notice shall explain the document's meaning to the 
256.27 	proposed ward person subject to public guardianship. In addition to the persons required to 
256.28 	be served under sections 524.5-113, 524.5-205, and 524.5-304, the mailed notice of the 
256.29 	hearing must be served on the commissioner, the local agency, and the county attorney.

257.1 	Sec. 24. Minnesota Statutes 2020, section 252A.081, subdivision 3, is amended to read:
257.2 		Subd. 3.Attorney. In place of the notice of attorney provisions in sections 524.5-205
257.3 	and 524.5-304, the notice must state that the court will appoint an attorney for the proposed 
257.4 	ward person subject to public guardianship unless an attorney is provided by other persons.

257.5 	Sec. 25. Minnesota Statutes 2020, section 252A.081, subdivision 5, is amended to read:
257.6 		Subd. 5.Defective notice of service. A defect in the service of notice or process, other 
257.7 	than personal service upon the proposed ward or conservatee person subject to public 
257.8 	guardianship or service upon the commissioner and local agency within the time allowed 
257.9 	and the form prescribed in this section and sections 524.5-113, 524.5-205, and 524.5-304, 
257.10 	does not invalidate any public guardianship or conservatorship proceedings.

257.11 	Sec. 26. Minnesota Statutes 2020, section 252A.09, subdivision 1, is amended to read:
257.12 		Subdivision 1.Attorney appointment. Upon the filing of the petition, the court shall 
257.13 	appoint an attorney for the proposed ward person subject to public guardianship, unless 
257.14 	such counsel is provided by others.

257.15 	Sec. 27. Minnesota Statutes 2020, section 252A.09, subdivision 2, is amended to read:
257.16 		Subd. 2.Representation. Counsel shall visit with and, to the extent possible, consult 
257.17 	with the proposed ward person subject to public guardianship prior to the hearing and shall 
257.18 	be given adequate time to prepare therefor for the hearing. Counsel shall be given the full 
257.19 	right of subpoena and shall be supplied with a copy of all documents filed with or issued 
257.20 	by the court.

257.21 	Sec. 28. Minnesota Statutes 2020, section 252A.101, subdivision 2, is amended to read:
257.22 		Subd. 2.Waiver of presence. The proposed ward person subject to public guardianship
257.23 	may waive the right to be present at the hearing only if the proposed ward person subject 
257.24 	to public guardianship has met with counsel and specifically waived the right to appear.

257.25 	Sec. 29. Minnesota Statutes 2020, section 252A.101, subdivision 3, is amended to read:
257.26 		Subd. 3.Medical care. If, at the time of the hearing, the proposed ward person subject 
257.27 	to public guardianship has been under medical care, the ward person subject to public 
257.28 	guardianship has the same rights regarding limitation on the use of drugs, medication, or 
257.29 	other treatment before the hearing that are available under section 252A.04, subdivision 2.

258.1 	Sec. 30. Minnesota Statutes 2020, section 252A.101, subdivision 5, is amended to read:
258.2 		Subd. 5.Findings. (a) In all cases the court shall make specific written findings of fact, 
258.3 	conclusions of law, and direct entry of an appropriate judgment or order. The court shall 
258.4 	order the appointment of the commissioner as guardian or conservator if it finds that:
258.5 	(1) the proposed ward or conservatee person subject to public guardianship is a person 
258.6 	with a developmental disability as defined in section 252A.02, subdivision 2;
258.7 	(2) the proposed ward or conservatee person subject to public guardianship is incapable 
258.8 	of exercising specific legal rights, which must be enumerated in its the court's findings;
258.9 	(3) the proposed ward or conservatee person subject to public guardianship is in need 
258.10 	of the supervision and protection of a public guardian or conservator; and
258.11 	(4) no appropriate alternatives to public guardianship or public conservatorship exist 
258.12 	that are less restrictive of the person's civil rights and liberties, such as appointing a private 
258.13 	guardian,or conservator supported decision maker, or health care agent; or arranging 
258.14 	residential or community services under sections 524.5-101 to 524.5-502.
258.15 	(b) The court shall grant the specific powers that are necessary for the commissioner to 
258.16 	act as public guardian or conservator on behalf of the ward or conservatee person subject 
258.17 	to public guardianship.

258.18 	Sec. 31. Minnesota Statutes 2020, section 252A.101, subdivision 6, is amended to read:
258.19 		Subd. 6.Notice of order; appeal. A copy of the order shall be served by mail upon the 
258.20 	ward or conservatee person subject to public guardianship and the ward's counsel of the 
258.21 	person subject to public guardianship. The order must be accompanied by a notice that 
258.22 	advises the ward or conservatee person subject to public guardianship of the right to appeal 
258.23 	the guardianship or conservatorship appointment within 30 days.

258.24 	Sec. 32. Minnesota Statutes 2020, section 252A.101, subdivision 7, is amended to read:
258.25 		Subd. 7.Letters of guardianship. (a) Letters of guardianship or conservatorship must 
258.26 	be issued by the court and contain:
258.27 	(1) the name, address, and telephone number of the ward or conservatee person subject 
258.28 	to public guardianship; and
258.29 	(2) the powers to be exercised on behalf of the ward or conservatee person subject to 
258.30 	public guardianship.
259.1 	(b) The letters under paragraph (a) must be served by mail upon the ward or conservatee
259.2 	person subject to public guardianship, the ward's counsel of the person subject to public 
259.3 	guardianship, the commissioner, and the local agency.

259.4 	Sec. 33. Minnesota Statutes 2020, section 252A.101, subdivision 8, is amended to read:
259.5 		Subd. 8.Dismissal. If upon the completion of the hearing and consideration of the record, 
259.6 	the court finds that the proposed ward person subject to public guardianship is not 
259.7 	developmentally disabled or is developmentally disabled but not in need of the supervision 
259.8 	and protection of a conservator or public guardian, it the court shall dismiss the application 
259.9 	and shall notify the proposed ward person subject to public guardianship, the ward's counsel
259.10 	of the person subject to public guardianship, and the petitioner of the court's findings.

259.11 	Sec. 34. Minnesota Statutes 2020, section 252A.111, subdivision 2, is amended to read:
259.12 		Subd. 2.Additional powers. In addition to the powers contained in sections 524.5-207
259.13 	and 524.5-313, the powers of a public guardian that the court may grant include:
259.14 	(1) the power to permit or withhold permission for the ward person subject to public 
259.15 	guardianship to marry;
259.16 	(2) the power to begin legal action or defend against legal action in the name of the ward
259.17 	person subject to public guardianship; and
259.18 	(3) the power to consent to the adoption of the ward person subject to public guardianship
259.19 	as provided in section 259.24.

259.20 	Sec. 35. Minnesota Statutes 2020, section 252A.111, subdivision 4, is amended to read:
259.21 		Subd. 4.Appointment of conservator. If the ward person subject to public guardianship
259.22 	has a personal estate beyond that which is necessary for the ward's personal and immediate 
259.23 	needs of the person subject to public guardianship, the commissioner shall determine whether 
259.24 	a conservator should be appointed. The commissioner shall consult with the parents, spouse, 
259.25 	or nearest relative of the ward person subject to public guardianship. The commissioner 
259.26 	may petition the court for the appointment of a private conservator of the ward person 
259.27 	subject to public guardianship. The commissioner cannot act as conservator for public wards
259.28 	persons subject to public guardianship or public protected persons.

260.1 	Sec. 36. Minnesota Statutes 2020, section 252A.111, subdivision 6, is amended to read:
260.2 		Subd. 6.Special duties. In exercising powers and duties under this chapter, the 
260.3 	commissioner shall:
260.4 	(1) maintain close contact with the ward person subject to public guardianship, visiting 
260.5 	at least twice a year;
260.6 	(2) protect and exercise the legal rights of the ward person subject to public guardianship;
260.7 	(3) take actions and make decisions on behalf of the ward person subject to public 
260.8 	guardianship that encourage and allow the maximum level of independent functioning in a 
260.9 	manner least restrictive of the ward's personal freedom of the person subject to public 
260.10 	guardianship consistent with the need for supervision and protection; and
260.11 	(4) permit and encourage maximum self-reliance on the part of the ward person subject 
260.12 	to public guardianship and permit and encourage input by the nearest relative of the ward
260.13 	person subject to public guardianship in planning and decision making on behalf of the 
260.14 	ward person subject to public guardianship.

260.15 	Sec. 37. Minnesota Statutes 2020, section 252A.12, is amended to read:
260.16 	252A.12 APPOINTMENT OF CONSERVATOR PUBLIC GUARDIAN NOT A 
260.17 	FINDING OF INCOMPETENCY.
260.18 	An appointment of the commissioner as conservator public guardian shall not constitute 
260.19 	a judicial finding that the person with a developmental disability is legally incompetent 
260.20 	except for the restrictions which that the conservatorship public guardianship places on the 
260.21 	conservatee person subject to public guardianship. The appointment of a conservator public 
260.22 	guardian shall not deprive the conservatee person subject to public guardianship of the right 
260.23 	to vote.

260.24 	Sec. 38. Minnesota Statutes 2020, section 252A.16, is amended to read:
260.25 	252A.16 ANNUAL REVIEW.
260.26 		Subdivision 1.Review required. The commissioner shall require an annual review of 
260.27 	the physical, mental, and social adjustment and progress of every ward and conservatee
260.28 	person subject to public guardianship. A copy of this review shall be kept on file at the 
260.29 	Department of Human Services and may be inspected by the ward or conservatee person 
260.30 	subject to public guardianship, the ward's or conservatee's parents, spouse, or relatives of 
260.31 	the person subject to public guardianship, and other persons who receive the permission of 
261.1 	the commissioner. The review shall contain information required under Minnesota Rules, 
261.2 	part 9525.3065, subpart 1.
261.3 		Subd. 2.Assessment of need for continued guardianship. The commissioner shall 
261.4 	annually review the legal status of each ward person subject to public guardianship in light 
261.5 	of the progress indicated in the annual review. If the commissioner determines the ward
261.6 	person subject to public guardianship is no longer in need of public guardianship or 
261.7 	conservatorship or is capable of functioning under a less restrictive conservatorship
261.8 	guardianship, the commissioner or local agency shall petition the court pursuant to section 
261.9 	252A.19 to restore the ward person subject to public guardianship to capacity or for a 
261.10 	modification of the court's previous order.

261.11 	Sec. 39. Minnesota Statutes 2020, section 252A.17, is amended to read:
261.12 	252A.17 EFFECT OF SUCCESSION IN OFFICE.
261.13 	The appointment by the court of the commissioner of human services as public 
261.14 	conservator or guardian shall be by the title of the commissioner's office. The authority of 
261.15 	the commissioner as public conservator or guardian shall cease upon the termination of the 
261.16 	commissioner's term of office and shall vest in a successor or successors in office without 
261.17 	further court proceedings.

261.18 	Sec. 40. Minnesota Statutes 2020, section 252A.19, subdivision 2, is amended to read:
261.19 		Subd. 2.Petition. The commissioner, ward person subject to public guardianship, or 
261.20 	any interested person may petition the appointing court or the court to which venue has 
261.21 	been transferred for an order to:
261.22 	(1) for an order to remove the guardianship or to;
261.23 	(2) for an order to limit or expand the powers of the guardianship or to;
261.24 	(3) for an order to appoint a guardian or conservator under sections 524.5-101 to 
261.25 	524.5-502or to;
261.26 	(4) for an order to restore the ward person subject to public guardianship or protected 
261.27 	person to full legal capacity or to;
261.28 	(5) to review de novo any decision made by the public guardian or public conservator
261.29 	for or on behalf of a ward person subject to public guardianship or protected person; or
261.30 	(6) for any other order as the court may deem just and equitable.

262.1 	Sec. 41. Minnesota Statutes 2020, section 252A.19, subdivision 4, is amended to read:
262.2 		Subd. 4.Comprehensive evaluation. The commissioner shall, at the court's request, 
262.3 	arrange for the preparation of a comprehensive evaluation of the ward person subject to 
262.4 	public guardianship or protected person.

262.5 	Sec. 42. Minnesota Statutes 2020, section 252A.19, subdivision 5, is amended to read:
262.6 		Subd. 5.Court order. Upon proof of the allegations of the petition the court shall enter 
262.7 	an order removing the guardianship or limiting or expanding the powers of the guardianship 
262.8 	or restoring the ward person subject to public guardianship or protected person to full legal 
262.9 	capacity or may enter such other order as the court may deem just and equitable.

262.10 	Sec. 43. Minnesota Statutes 2020, section 252A.19, subdivision 7, is amended to read:
262.11 		Subd. 7.Attorney general's role; commissioner's role. The attorney general may 
262.12 	appear and represent the commissioner in such proceedings. The commissioner shall support 
262.13 	or oppose the petition if the commissioner deems such action necessary for the protection 
262.14 	and supervision of the ward person subject to public guardianship or protected person.

262.15 	Sec. 44. Minnesota Statutes 2020, section 252A.19, subdivision 8, is amended to read:
262.16 		Subd. 8.Court appointed Court-appointed counsel. In all such proceedings, the 
262.17 	protected person or ward person subject to public guardianship shall be afforded an 
262.18 	opportunity to be represented by counsel, and if neither the protected person or ward person 
262.19 	subject to public guardianship nor others provide counsel the court shall appoint counsel to 
262.20 	represent the protected person or ward person subject to public guardianship.

262.21 	Sec. 45. Minnesota Statutes 2020, section 252A.20, is amended to read:
262.22 	252A.20 COSTS OF HEARINGS.
262.23 		Subdivision 1.Witness and attorney fees. In each proceeding under sections 252A.01 
262.24 	to 252A.21, the court shall allow and order paid to each witness subpoenaed the fees and 
262.25 	mileage prescribed by law; to each physician, advanced practice registered nurse, 
262.26 	psychologist, or social worker who assists in the preparation of the comprehensive evaluation 
262.27 	and who is not in the employ of employed by the local agency or the state Department of 
262.28 	Human Services, a reasonable sum for services and for travel; and to the ward's counsel of 
262.29 	the person subject to public guardianship, when appointed by the court, a reasonable sum 
262.30 	for travel and for each day or portion of a day actually employed in court or actually 
263.1 	consumed in preparing for the hearing. Upon order the county auditor shall issue a warrant 
263.2 	on the county treasurer for payment of the amount allowed.
263.3 		Subd. 2.Expenses. When the settlement of the ward person subject to public guardianship
263.4 	is found to be in another county, the court shall transmit to the county auditor a statement 
263.5 	of the expenses incurred pursuant to subdivision 1. The auditor shall transmit the statement 
263.6 	to the auditor of the county of the ward's settlement of the person subject to public 
263.7 	guardianship and this claim shall be paid as other claims against that county. If the auditor 
263.8 	to whom this claim is transmitted denies the claim, the auditor shall transmit it, together 
263.9 	with the objections thereto, to the commissioner, who shall determine the question of 
263.10 	settlement and certify findings to each auditor. If the claim is not paid within 30 days after 
263.11 	such certification, an action may be maintained thereon in the district court of the claimant 
263.12 	county.
263.13 		Subd. 3.Change of venue; cost of proceedings. Whenever venue of a proceeding has 
263.14 	been transferred under sections 252A.01 to 252A.21, the costs of such proceedings shall be 
263.15 	reimbursed to the county of the ward's settlement of the person subject to public guardianship 
263.16 	by the state.

263.17 	Sec. 46. Minnesota Statutes 2020, section 252A.21, subdivision 2, is amended to read:
263.18 		Subd. 2.Rules. The commissioner shall adopt rules to implement this chapter. The rules 
263.19 	must include standards for performance of guardianship or conservatorship duties including,
263.20 	but not limited to: twice a year visits with the ward person subject to public guardianship; 
263.21 	a requirement that the duties of guardianship or conservatorship and case management not 
263.22 	be performed by the same person; specific standards for action on "do not resuscitate" orders 
263.23 	as recommended by a physician, an advanced practice registered nurse, or a physician 
263.24 	assistant; sterilization requests; and the use of psychotropic medication and aversive 
263.25 	procedures.

263.26 	Sec. 47. Minnesota Statutes 2020, section 252A.21, subdivision 4, is amended to read:
263.27 		Subd. 4.Private guardianships and conservatorships. Nothing in sections 252A.01
263.28 	to 252A.21 shall impair the right of individuals to establish private guardianships or 
263.29 	conservatorships in accordance with applicable law.

263.30 	Sec. 48. Minnesota Statutes 2020, section 254B.03, subdivision 2, is amended to read:
263.31 		Subd. 2.Chemical dependency fund payment. (a) Payment from the chemical 
263.32 	dependency fund is limited to payments for services identified in section 254B.05, other 
264.1 	than detoxification licensed under Minnesota Rules, parts 9530.6510 to 9530.6590, that, if 
264.2 	located outside of federally recognized tribal lands, would be required to be licensed by the 
264.3 	commissioner as a chemical dependency treatment or rehabilitation program under sections 
264.4 	245A.01 to 245A.16, and services other than detoxification provided in another state that 
264.5 	would be required to be licensed as a chemical dependency program if the program were 
264.6 	in the state. Out of state vendors must also provide the commissioner with assurances that 
264.7 	the program complies substantially with state licensing requirements and possesses all 
264.8 	licenses and certifications required by the host state to provide chemical dependency 
264.9 	treatment. Vendors receiving payments from the chemical dependency fund must not require 
264.10 	co-payment from a recipient of benefits for services provided under this subdivision. The 
264.11 	vendor is prohibited from using the client's public benefits to offset the cost of services paid 
264.12 	under this section. The vendor shall not require the client to use public benefits for room 
264.13 	or board costs. This includes but is not limited to cash assistance benefits under chapters 
264.14 	119B, 256D, and 256J, or SNAP benefits. Retention of SNAP benefits is a right of a client 
264.15 	receiving services through the consolidated chemical dependency treatment fund or through 
264.16 	state contracted managed care entities. Payment from the chemical dependency fund shall 
264.17 	be made for necessary room and board costs provided by vendors meeting the criteria under 
264.18 	section 254B.05, subdivision 1a, or in a community hospital licensed by the commissioner 
264.19 	of health according to sections 144.50 to 144.56 to a client who is:
264.20 	(1) determined to meet the criteria for placement in a residential chemical dependency 
264.21 	treatment program according to rules adopted under section 254A.03, subdivision 3; and
264.22 	(2) concurrently receiving a chemical dependency treatment service in a program licensed 
264.23 	by the commissioner and reimbursed by the chemical dependency fund.
264.24 	(b) A county may, from its own resources, provide chemical dependency services for 
264.25 	which state payments are not made. A county may elect to use the same invoice procedures 
264.26 	and obtain the same state payment services as are used for chemical dependency services 
264.27 	for which state payments are made under this section if county payments are made to the 
264.28 	state in advance of state payments to vendors. When a county uses the state system for 
264.29 	payment, the commissioner shall make monthly billings to the county using the most recent 
264.30 	available information to determine the anticipated services for which payments will be made 
264.31 	in the coming month. Adjustment of any overestimate or underestimate based on actual 
264.32 	expenditures shall be made by the state agency by adjusting the estimate for any succeeding 
264.33 	month.
264.34 	(c) The commissioner shall coordinate chemical dependency services and determine 
264.35 	whether there is a need for any proposed expansion of chemical dependency treatment 
265.1 	services. The commissioner shall deny vendor certification to any provider that has not 
265.2 	received prior approval from the commissioner for the creation of new programs or the 
265.3 	expansion of existing program capacity. The commissioner shall consider the provider's 
265.4 	capacity to obtain clients from outside the state based on plans, agreements, and previous 
265.5 	utilization history, when determining the need for new treatment services.

265.6 	Sec. 49. Minnesota Statutes 2020, section 256B.051, subdivision 1, is amended to read:
265.7 		Subdivision 1.Purpose. Housing support stabilization services are established to provide 
265.8 	housing support stabilization services to an individual with a disability that limits the 
265.9 	individual's ability to obtain or maintain stable housing. The services support an individual's 
265.10 	transition to housing in the community and increase long-term stability in housing, to avoid 
265.11 	future periods of being at risk of homelessness or institutionalization.

265.12 	Sec. 50. Minnesota Statutes 2020, section 256B.051, subdivision 3, is amended to read:
265.13 		Subd. 3.Eligibility. An individual with a disability is eligible for housing support
265.14 	stabilization services if the individual:
265.15 	(1) is 18 years of age or older;
265.16 	(2) is enrolled in medical assistance;
265.17 	(3) has an assessment of functional need that determines a need for services due to 
265.18 	limitations caused by the individual's disability;
265.19 	(4) resides in or plans to transition to a community-based setting as defined in Code of 
265.20 	Federal Regulations, title 42, section 441.301 (c); and
265.21 	(5) has housing instability evidenced by:
265.22 	(i) being homeless or at-risk of homelessness;
265.23 	(ii) being in the process of transitioning from, or having transitioned in the past six 
265.24 	months from, an institution or licensed or registered setting;
265.25 	(iii) being eligible for waiver services under chapter 256S or section 256B.092 or 
265.26 	256B.49; or
265.27 	(iv) having been identified by a long-term care consultation under section 256B.0911 
265.28 	as at risk of institutionalization.

266.1 	Sec. 51. Minnesota Statutes 2020, section 256B.051, subdivision 5, is amended to read:
266.2 		Subd. 5.Housing support stabilization services. (a) Housing support stabilization
266.3 	services include housing transition services and housing and tenancy sustaining services.
266.4 	(b) Housing transition services are defined as:
266.5 	(1) tenant screening and housing assessment;
266.6 	(2) assistance with the housing search and application process;
266.7 	(3) identifying resources to cover onetime moving expenses;
266.8 	(4) ensuring a new living arrangement is safe and ready for move-in;
266.9 	(5) assisting in arranging for and supporting details of a move; and
266.10 	(6) developing a housing support crisis plan.
266.11 	(c) Housing and tenancy sustaining services include:
266.12 	(1) prevention and early identification of behaviors that may jeopardize continued stable 
266.13 	housing;
266.14 	(2) education and training on roles, rights, and responsibilities of the tenant and the 
266.15 	property manager;
266.16 	(3) coaching to develop and maintain key relationships with property managers and 
266.17 	neighbors;
266.18 	(4) advocacy and referral to community resources to prevent eviction when housing is 
266.19 	at risk;
266.20 	(5) assistance with housing recertification process;
266.21 	(6) coordination with the tenant to regularly review, update, and modify the housing 
266.22 	support and crisis plan; and
266.23 	(7) continuing training on being a good tenant, lease compliance, and household 
266.24 	management.
266.25 	(d) A housing support stabilization service may include person-centered planning for 
266.26 	people who are not eligible to receive person-centered planning through any other service, 
266.27 	if the person-centered planning is provided by a consultation service provider that is under 
266.28 	contract with the department and enrolled as a Minnesota health care program.

267.1 	Sec. 52. Minnesota Statutes 2020, section 256B.051, subdivision 6, is amended to read:
267.2 		Subd. 6.Provider qualifications and duties. A provider eligible for reimbursement 
267.3 	under this section shall:
267.4 	(1) enroll as a medical assistance Minnesota health care program provider and meet all 
267.5 	applicable provider standards and requirements;
267.6 	(2) demonstrate compliance with federal and state laws and policies for housing support
267.7 	stabilization services as determined by the commissioner;
267.8 	(3) comply with background study requirements under chapter 245C and maintain 
267.9 	documentation of background study requests and results; and
267.10 	(4) directly provide housing support stabilization services and not use a subcontractor 
267.11 	or reporting agent.; and
267.12 	(5) complete annual vulnerable adult training.

267.13 	Sec. 53. Minnesota Statutes 2020, section 256B.051, subdivision 7, is amended to read:
267.14 		Subd. 7.Housing support supplemental service rates. Supplemental service rates for 
267.15 	individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph 
267.16 	(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year 
267.17 	period. This reduction only applies to supplemental service rates for individuals eligible for 
267.18 	housing support stabilization services under this section.

267.19 	Sec. 54. Minnesota Statutes 2020, section 256B.051, is amended by adding a subdivision 
267.20 	to read:
267.21 		Subd. 8.Documentation requirements. (a) Documentation may be collected and 
267.22 	maintained electronically or in paper form by providers and must be produced upon request 
267.23 	by the commissioner.
267.24 	(b) Documentation of a delivered service must be in English and must be legible according 
267.25 	to the standard of a reasonable person.
267.26 	(c) If the service is reimbursed at an hourly or specified minute-based rate, each 
267.27 	documentation of the provision of a service, unless otherwise specified, must include:
267.28 	(1) the date the documentation occurred;
267.29 	(2) the day, month, and year the service was provided;
268.1 	(3) the start and stop times with a.m. and p.m. designations, except for person-centered 
268.2 	planning services described under subdivision 5, paragraph (d);
268.3 	(4) the service name or description of the service provided; and
268.4 	(5) the name, signature, and title, if any, of the provider of service. If the service is 
268.5 	provided by multiple staff members, the provider may designate a staff member responsible 
268.6 	for verifying services and completing the documentation required by this paragraph.

268.7 	Sec. 55. Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:
268.8 		Subd. 6.Service standards. The standards in this subdivision apply to intensive 
268.9 	nonresidential rehabilitative mental health services.
268.10 	(a) The treatment team must use team treatment, not an individual treatment model.
268.11 	(b) Services must be available at times that meet client needs.
268.12 	(c) Services must be age-appropriate and meet the specific needs of the client.
268.13 	(d) The initial functional assessment must be completed within ten days of intake and 
268.14 	updated at least every six months or prior to discharge from the service, whichever comes 
268.15 	first.
268.16 	(e) The treatment team must complete an individual treatment plan for each client and 
268.17 	the individual treatment plan must:
268.18 	(1) be based on the information in the client's diagnostic assessment and baselines;
268.19 	(2) identify goals and objectives of treatment, a treatment strategy, a schedule for 
268.20 	accomplishing treatment goals and objectives, and the individuals responsible for providing 
268.21 	treatment services and supports;
268.22 	(3) be developed after completion of the client's diagnostic assessment by a mental health 
268.23 	professional or clinical trainee and before the provision of children's therapeutic services 
268.24 	and supports;
268.25 	(4) be developed through a child-centered, family-driven, culturally appropriate planning 
268.26 	process, including allowing parents and guardians to observe or participate in individual 
268.27 	and family treatment services, assessments, and treatment planning;
268.28 	(5) be reviewed at least once every six months and revised to document treatment progress 
268.29 	on each treatment objective and next goals or, if progress is not documented, to document 
268.30 	changes in treatment;
269.1 	(6) be signed by the clinical supervisor and by the client or by the client's parent or other 
269.2 	person authorized by statute to consent to mental health services for the client. A client's 
269.3 	parent may approve the client's individual treatment plan by secure electronic signature or 
269.4 	by documented oral approval that is later verified by written signature;
269.5 	(7) be completed in consultation with the client's current therapist and key providers and 
269.6 	provide for ongoing consultation with the client's current therapist to ensure therapeutic 
269.7 	continuity and to facilitate the client's return to the community. For clients under the age of 
269.8 	18, the treatment team must consult with parents and guardians in developing the treatment 
269.9 	plan;
269.10 	(8) if a need for substance use disorder treatment is indicated by validated assessment:
269.11 	(i) identify goals, objectives, and strategies of substance use disorder treatment; develop 
269.12 	a schedule for accomplishing treatment goals and objectives; and identify the individuals 
269.13 	responsible for providing treatment services and supports;
269.14 	(ii) be reviewed at least once every 90 days and revised, if necessary;
269.15 	(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by 
269.16 	the client's parent or other person authorized by statute to consent to mental health treatment 
269.17 	and substance use disorder treatment for the client; and
269.18 	(10) provide for the client's transition out of intensive nonresidential rehabilitative mental 
269.19 	health services by defining the team's actions to assist the client and subsequent providers 
269.20 	in the transition to less intensive or "stepped down" services.
269.21 	(f) The treatment team shall actively and assertively engage the client's family members 
269.22 	and significant others by establishing communication and collaboration with the family and 
269.23 	significant others and educating the family and significant others about the client's mental 
269.24 	illness, symptom management, and the family's role in treatment, unless the team knows or 
269.25 	has reason to suspect that the client has suffered or faces a threat of suffering any physical 
269.26 	or mental injury, abuse, or neglect from a family member or significant other.
269.27 	(g) For a client age 18 or older, the treatment team may disclose to a family member, 
269.28 	other relative, or a close personal friend of the client, or other person identified by the client, 
269.29 	the protected health information directly relevant to such person's involvement with the 
269.30 	client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the 
269.31 	client is present, the treatment team shall obtain the client's agreement, provide the client 
269.32 	with an opportunity to object, or reasonably infer from the circumstances, based on the 
269.33 	exercise of professional judgment, that the client does not object. If the client is not present 
270.1 	or is unable, by incapacity or emergency circumstances, to agree or object, the treatment 
270.2 	team may, in the exercise of professional judgment, determine whether the disclosure is in 
270.3 	the best interests of the client and, if so, disclose only the protected health information that 
270.4 	is directly relevant to the family member's, relative's, friend's, or client-identified person's 
270.5 	involvement with the client's health care. The client may orally agree or object to the 
270.6 	disclosure and may prohibit or restrict disclosure to specific individuals.
270.7 	(h) The treatment team shall provide interventions to promote positive interpersonal 
270.8 	relationships.

270.9 	Sec. 56. Minnesota Statutes 2020, section 256B.4912, subdivision 13, is amended to read:
270.10 		Subd. 13.Waiver transportation documentation and billing requirements. (a) A 
270.11 	waiver transportation service must be a waiver transportation service that: (1) is not covered 
270.12 	by medical transportation under the Medicaid state plan; and (2) is not included as a 
270.13 	component of another waiver service.
270.14 	(b) In addition to the documentation requirements in subdivision 12, a waiver 
270.15 	transportation service provider must maintain:
270.16 	(1) odometer and other records pursuant to section 256B.0625, subdivision 17b, paragraph 
270.17 	(b), clause (3), sufficient to distinguish an individual trip with a specific vehicle and driver 
270.18 	for a waiver transportation service that is billed directly by the mile. A common carrier as 
270.19 	defined by Minnesota Rules, part 9505.0315, subpart 1, item B, or a publicly operated transit 
270.20 	system provider are exempt from this clause; and
270.21 	(2) documentation demonstrating that a vehicle and a driver meet the standards determined 
270.22 	by the Department of Human Services on vehicle and driver qualifications in section 
270.23 	256B.0625, subdivision 17, paragraph (c) transportation waiver service provider standards 
270.24 	and qualifications according to the federally approved waiver plan.

270.25 	Sec. 57. Minnesota Statutes 2020, section 256B.69, subdivision 5a, is amended to read:
270.26 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section and 
270.27 	section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner 
270.28 	may issue separate contracts with requirements specific to services to medical assistance 
270.29 	recipients age 65 and older.
270.30 	(b) A prepaid health plan providing covered health services for eligible persons pursuant 
270.31 	to chapters 256B and 256L is responsible for complying with the terms of its contract with 
270.32 	the commissioner. Requirements applicable to managed care programs under chapters 256B
271.1 	and 256L established after the effective date of a contract with the commissioner take effect 
271.2 	when the contract is next issued or renewed.
271.3 	(c) The commissioner shall withhold five percent of managed care plan payments under 
271.4 	this section and county-based purchasing plan payments under section 256B.692 for the 
271.5 	prepaid medical assistance program pending completion of performance targets. Each 
271.6 	performance target must be quantifiable, objective, measurable, and reasonably attainable, 
271.7 	except in the case of a performance target based on a federal or state law or rule. Criteria 
271.8 	for assessment of each performance target must be outlined in writing prior to the contract 
271.9 	effective date. Clinical or utilization performance targets and their related criteria must 
271.10 	consider evidence-based research and reasonable interventions when available or applicable 
271.11 	to the populations served, and must be developed with input from external clinical experts 
271.12 	and stakeholders, including managed care plans, county-based purchasing plans, and 
271.13 	providers. The managed care or county-based purchasing plan must demonstrate, to the 
271.14 	commissioner's satisfaction, that the data submitted regarding attainment of the performance 
271.15 	target is accurate. The commissioner shall periodically change the administrative measures 
271.16 	used as performance targets in order to improve plan performance across a broader range 
271.17 	of administrative services. The performance targets must include measurement of plan 
271.18 	efforts to contain spending on health care services and administrative activities. The 
271.19 	commissioner may adopt plan-specific performance targets that take into account factors 
271.20 	affecting only one plan, including characteristics of the plan's enrollee population. The 
271.21 	withheld funds must be returned no sooner than July of the following year if performance 
271.22 	targets in the contract are achieved. The commissioner may exclude special demonstration 
271.23 	projects under subdivision 23.
271.24 	(d) The commissioner shall require that managed care plans use the assessment and 
271.25 	authorization processes, forms, timelines, standards, documentation, and data reporting 
271.26 	requirements, protocols, billing processes, and policies consistent with medical assistance 
271.27 	fee-for-service or the Department of Human Services contract requirements for all personal 
271.28 	care assistance services under section 256B.0659 and community first services and supports 
271.29 	under section 256B.85.
271.30 	(e) Effective for services rendered on or after January 1, 2012, the commissioner shall 
271.31 	include as part of the performance targets described in paragraph (c) a reduction in the health 
271.32 	plan's emergency department utilization rate for medical assistance and MinnesotaCare 
271.33 	enrollees, as determined by the commissioner. For 2012, the reduction shall be based on 
271.34 	the health plan's utilization in 2009. To earn the return of the withhold each subsequent 
271.35 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
272.1 	reduction of no less than ten percent of the plan's emergency department utilization rate for 
272.2 	medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described 
272.3 	in subdivisions 23 and 28, compared to the previous measurement year until the final 
272.4 	performance target is reached. When measuring performance, the commissioner must 
272.5 	consider the difference in health risk in a managed care or county-based purchasing plan's 
272.6 	membership in the baseline year compared to the measurement year, and work with the 
272.7 	managed care or county-based purchasing plan to account for differences that they agree 
272.8 	are significant.
272.9 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
272.10 	the following calendar year if the managed care plan or county-based purchasing plan 
272.11 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
272.12 	was achieved. The commissioner shall structure the withhold so that the commissioner 
272.13 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
272.14 	in utilization less than the targeted amount.
272.15 	The withhold described in this paragraph shall continue for each consecutive contract 
272.16 	period until the plan's emergency room utilization rate for state health care program enrollees 
272.17 	is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance 
272.18 	and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the 
272.19 	health plans in meeting this performance target and shall accept payment withholds that 
272.20 	may be returned to the hospitals if the performance target is achieved.
272.21 	(f) Effective for services rendered on or after January 1, 2012, the commissioner shall 
272.22 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
272.23 	hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as 
272.24 	determined by the commissioner. To earn the return of the withhold each year, the managed 
272.25 	care plan or county-based purchasing plan must achieve a qualifying reduction of no less 
272.26 	than five percent of the plan's hospital admission rate for medical assistance and 
272.27 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
272.28 	28, compared to the previous calendar year until the final performance target is reached. 
272.29 	When measuring performance, the commissioner must consider the difference in health risk 
272.30 	in a managed care or county-based purchasing plan's membership in the baseline year 
272.31 	compared to the measurement year, and work with the managed care or county-based 
272.32 	purchasing plan to account for differences that they agree are significant.
272.33 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
272.34 	the following calendar year if the managed care plan or county-based purchasing plan 
272.35 	demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization 
273.1 	rate was achieved. The commissioner shall structure the withhold so that the commissioner 
273.2 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
273.3 	in utilization less than the targeted amount.
273.4 	The withhold described in this paragraph shall continue until there is a 25 percent 
273.5 	reduction in the hospital admission rate compared to the hospital admission rates in calendar 
273.6 	year 2011, as determined by the commissioner. The hospital admissions in this performance 
273.7 	target do not include the admissions applicable to the subsequent hospital admission 
273.8 	performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting 
273.9 	this performance target and shall accept payment withholds that may be returned to the 
273.10 	hospitals if the performance target is achieved.
273.11 	(g) Effective for services rendered on or after January 1, 2012, the commissioner shall 
273.12 	include as part of the performance targets described in paragraph (c) a reduction in the plan's 
273.13 	hospitalization admission rates for subsequent hospitalizations within 30 days of a previous 
273.14 	hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare 
273.15 	enrollees, as determined by the commissioner. To earn the return of the withhold each year, 
273.16 	the managed care plan or county-based purchasing plan must achieve a qualifying reduction 
273.17 	of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees, 
273.18 	excluding enrollees in programs described in subdivisions 23 and 28, of no less than five 
273.19 	percent compared to the previous calendar year until the final performance target is reached.
273.20 	The withheld funds must be returned no sooner than July 1 and no later than July 31 of 
273.21 	the following calendar year if the managed care plan or county-based purchasing plan 
273.22 	demonstrates to the satisfaction of the commissioner that a qualifying reduction in the 
273.23 	subsequent hospitalization rate was achieved. The commissioner shall structure the withhold 
273.24 	so that the commissioner returns a portion of the withheld funds in amounts commensurate 
273.25 	with achieved reductions in utilization less than the targeted amount.
273.26 	The withhold described in this paragraph must continue for each consecutive contract 
273.27 	period until the plan's subsequent hospitalization rate for medical assistance and 
273.28 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and 
273.29 	28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year 
273.30 	2011. Hospitals shall cooperate with the plans in meeting this performance target and shall 
273.31 	accept payment withholds that must be returned to the hospitals if the performance target 
273.32 	is achieved.
273.33 	(h) Effective for services rendered on or after January 1, 2013, through December 31, 
273.34 	2013, the commissioner shall withhold 4.5 percent of managed care plan payments under 
274.1 	this section and county-based purchasing plan payments under section 256B.692 for the 
274.2 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
274.3 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
274.4 	special demonstration projects under subdivision 23.
274.5 	(i) Effective for services rendered on or after January 1, 2014, the commissioner shall 
274.6 	withhold three percent of managed care plan payments under this section and county-based 
274.7 	purchasing plan payments under section 256B.692 for the prepaid medical assistance 
274.8 	program. The withheld funds must be returned no sooner than July 1 and no later than July 
274.9 	31 of the following year. The commissioner may exclude special demonstration projects 
274.10 	under subdivision 23.
274.11 	(j) A managed care plan or a county-based purchasing plan under section 256B.692 may 
274.12 	include as admitted assets under section 62D.044 any amount withheld under this section 
274.13 	that is reasonably expected to be returned.
274.14 	(k) Contracts between the commissioner and a prepaid health plan are exempt from the 
274.15 	set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and 
274.16 	7.
274.17 	(l) The return of the withhold under paragraphs (h) and (i) is not subject to the 
274.18 	requirements of paragraph (c).
274.19 	(m) Managed care plans and county-based purchasing plans shall maintain current and 
274.20 	fully executed agreements for all subcontractors, including bargaining groups, for 
274.21 	administrative services that are expensed to the state's public health care programs. 
274.22 	Subcontractor agreements determined to be material, as defined by the commissioner after 
274.23 	taking into account state contracting and relevant statutory requirements, must be in the 
274.24 	form of a written instrument or electronic document containing the elements of offer, 
274.25 	acceptance, consideration, payment terms, scope, duration of the contract, and how the 
274.26 	subcontractor services relate to state public health care programs. Upon request, the 
274.27 	commissioner shall have access to all subcontractor documentation under this paragraph. 
274.28 	Nothing in this paragraph shall allow release of information that is nonpublic data pursuant 
274.29 	to section 13.02.

274.30 	Sec. 58. Minnesota Statutes 2020, section 256B.85, subdivision 1, is amended to read:
274.31 		Subdivision 1.Basis and scope. (a) Upon federal approval, the commissioner shall 
274.32 	establish a state plan option for the provision of home and community-based personal 
274.33 	assistance service and supports called "community first services and supports (CFSS)."
275.1 	(b) CFSS is a participant-controlled method of selecting and providing services and 
275.2 	supports that allows the participant maximum control of the services and supports. 
275.3 	Participants may choose the degree to which they direct and manage their supports by 
275.4 	choosing to have a significant and meaningful role in the management of services and 
275.5 	supports including by directly employing support workers with the necessary supports to 
275.6 	perform that function.
275.7 	(c) CFSS is available statewide to eligible people to assist with accomplishing activities 
275.8 	of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related 
275.9 	procedures and tasks through hands-on assistance to accomplish the task or constant 
275.10 	supervision and cueing to accomplish the task; and to assist with acquiring, maintaining, 
275.11 	and enhancing the skills necessary to accomplish ADLs, IADLs, and health-related 
275.12 	procedures and tasks. CFSS allows payment for the participant for certain supports and 
275.13 	goods such as environmental modifications and technology that are intended to replace or 
275.14 	decrease the need for human assistance.
275.15 	(d) Upon federal approval, CFSS will replace the personal care assistance program under 
275.16 	sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
275.17 	(e) For the purposes of this section, notwithstanding the provisions of section 144A.43, 
275.18 	subdivision 3, supports purchased under CFSS are not considered home care services.

275.19 	Sec. 59. Minnesota Statutes 2020, section 256B.85, subdivision 2, is amended to read:
275.20 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
275.21 	subdivision have the meanings given.
275.22 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, dressing, 
275.23 	bathing, mobility, positioning, and transferring.:
275.24 	(1) dressing, including assistance with choosing, applying, and changing clothing and 
275.25 	applying special appliances, wraps, or clothing;
275.26 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
275.27 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail 
275.28 	care, except for recipients who are diabetic or have poor circulation;
275.29 	(3) bathing, including assistance with basic personal hygiene and skin care;
275.30 	(4) eating, including assistance with hand washing and applying orthotics required for 
275.31 	eating, transfers, or feeding;
276.1 	(5) transfers, including assistance with transferring the participant from one seating or 
276.2 	reclining area to another;
276.3 	(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility 
276.4 	does not include providing transportation for a participant;
276.5 	(7) positioning, including assistance with positioning or turning a participant for necessary 
276.6 	care and comfort; and
276.7 	(8) toileting, including assistance with bowel or bladder elimination and care, transfers, 
276.8 	mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing 
276.9 	the perineal area, inspection of the skin, and adjusting clothing.
276.10 	(c) "Agency-provider model" means a method of CFSS under which a qualified agency 
276.11 	provides services and supports through the agency's own employees and policies. The agency 
276.12 	must allow the participant to have a significant role in the selection and dismissal of support 
276.13 	workers of their choice for the delivery of their specific services and supports.
276.14 	(d) "Behavior" means a description of a need for services and supports used to determine 
276.15 	the home care rating and additional service units. The presence of Level I behavior is used 
276.16 	to determine the home care rating.
276.17 	(e) "Budget model" means a service delivery method of CFSS that allows the use of a 
276.18 	service budget and assistance from a financial management services (FMS) provider for a 
276.19 	participant to directly employ support workers and purchase supports and goods.
276.20 	(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that 
276.21 	has been ordered by a physician, advanced practice registered nurse, or physician's assistant 
276.22 	and is specified in a community support plan, including:
276.23 	(1) tube feedings requiring:
276.24 	(i) a gastrojejunostomy tube; or
276.25 	(ii) continuous tube feeding lasting longer than 12 hours per day;
276.26 	(2) wounds described as:
276.27 	(i) stage III or stage IV;
276.28 	(ii) multiple wounds;
276.29 	(iii) requiring sterile or clean dressing changes or a wound vac; or
276.30 	(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized 
276.31 	care;
277.1 	(3) parenteral therapy described as:
277.2 	(i) IV therapy more than two times per week lasting longer than four hours for each 
277.3 	treatment; or
277.4 	(ii) total parenteral nutrition (TPN) daily;
277.5 	(4) respiratory interventions, including:
277.6 	(i) oxygen required more than eight hours per day;
277.7 	(ii) respiratory vest more than one time per day;
277.8 	(iii) bronchial drainage treatments more than two times per day;
277.9 	(iv) sterile or clean suctioning more than six times per day;
277.10 	(v) dependence on another to apply respiratory ventilation augmentation devices such 
277.11 	as BiPAP and CPAP; and
277.12 	(vi) ventilator dependence under section 256B.0651;
277.13 	(5) insertion and maintenance of catheter, including:
277.14 	(i) sterile catheter changes more than one time per month;
277.15 	(ii) clean intermittent catheterization, and including self-catheterization more than six 
277.16 	times per day; or
277.17 	(iii) bladder irrigations;
277.18 	(6) bowel program more than two times per week requiring more than 30 minutes to 
277.19 	perform each time;
277.20 	(7) neurological intervention, including:
277.21 	(i) seizures more than two times per week and requiring significant physical assistance 
277.22 	to maintain safety; or
277.23 	(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse, 
277.24 	or physician's assistant and requiring specialized assistance from another on a daily basis; 
277.25 	and
277.26 	(8) other congenital or acquired diseases creating a need for significantly increased direct 
277.27 	hands-on assistance and interventions in six to eight activities of daily living.
277.28 	(g) "Community first services and supports" or "CFSS" means the assistance and supports 
277.29 	program under this section needed for accomplishing activities of daily living, instrumental 
277.30 	activities of daily living, and health-related tasks through hands-on assistance to accomplish 
278.1 	the task or constant supervision and cueing to accomplish the task, or the purchase of goods 
278.2 	as defined in subdivision 7, clause (3), that replace the need for human assistance.
278.3 	(h) "Community first services and supports service delivery plan" or "CFSS service 
278.4 	delivery plan" means a written document detailing the services and supports chosen by the 
278.5 	participant to meet assessed needs that are within the approved CFSS service authorization, 
278.6 	as determined in subdivision 8. Services and supports are based on the coordinated service 
278.7 	and support plan identified in section sections 256B.092, subdivision 1b, and256S.10.
278.8 	(i) "Consultation services" means a Minnesota health care program enrolled provider 
278.9 	organization that provides assistance to the participant in making informed choices about 
278.10 	CFSS services in general and self-directed tasks in particular, and in developing a 
278.11 	person-centered CFSS service delivery plan to achieve quality service outcomes.
278.12 	(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
278.13 	(k) "Dependency" in activities of daily living means a person requires hands-on assistance 
278.14 	or constant supervision and cueing to accomplish one or more of the activities of daily living 
278.15 	every day or on the days during the week that the activity is performed; however, a child 
278.16 	may must not be found to be dependent in an activity of daily living if, because of the child's 
278.17 	age, an adult would either perform the activity for the child or assist the child with the 
278.18 	activity and the assistance needed is the assistance appropriate for a typical child of the 
278.19 	same age.
278.20 	(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are 
278.21 	included in the CFSS service delivery plan through one of the home and community-based 
278.22 	services waivers and as approved and authorized under chapter 256S and sections 256B.092, 
278.23 	subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state 
278.24 	plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
278.25 	(m) "Financial management services provider" or "FMS provider" means a qualified 
278.26 	organization required for participants using the budget model under subdivision 13 that is 
278.27 	an enrolled provider with the department to provide vendor fiscal/employer agent financial 
278.28 	management services (FMS).
278.29 	(n) "Health-related procedures and tasks" means procedures and tasks related to the 
278.30 	specific assessed health needs of a participant that can be taught or assigned by a 
278.31 	state-licensed health care or mental health professional and performed by a support worker.
278.32 	(o) "Instrumental activities of daily living" means activities related to living independently 
278.33 	in the community, including but not limited to: meal planning, preparation, and cooking; 
279.1 	shopping for food, clothing, or other essential items; laundry; housecleaning; assistance 
279.2 	with medications; managing finances; communicating needs and preferences during activities; 
279.3 	arranging supports; and assistance with traveling around and participating in the community.
279.4 	(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 1a, paragraph 
279.5 	(e).
279.6 	(q) "Legal representative" means parent of a minor, a court-appointed guardian, or 
279.7 	another representative with legal authority to make decisions about services and supports 
279.8 	for the participant. Other representatives with legal authority to make decisions include but 
279.9 	are not limited to a health care agent or an attorney-in-fact authorized through a health care 
279.10 	directive or power of attorney.
279.11 	(r) "Level I behavior" means physical aggression toward towards self or others or 
279.12 	destruction of property that requires the immediate response of another person.
279.13 	(s) "Medication assistance" means providing verbal or visual reminders to take regularly 
279.14 	scheduled medication, and includes any of the following supports listed in clauses (1) to 
279.15 	(3) and other types of assistance, except that a support worker may must not determine 
279.16 	medication dose or time for medication or inject medications into veins, muscles, or skin:
279.17 	(1) under the direction of the participant or the participant's representative, bringing 
279.18 	medications to the participant including medications given through a nebulizer, opening a 
279.19 	container of previously set-up medications, emptying the container into the participant's 
279.20 	hand, opening and giving the medication in the original container to the participant, or 
279.21 	bringing to the participant liquids or food to accompany the medication;
279.22 	(2) organizing medications as directed by the participant or the participant's representative; 
279.23 	and
279.24 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
279.25 	(t) "Participant" means a person who is eligible for CFSS.
279.26 	(u) "Participant's representative" means a parent, family member, advocate, or other 
279.27 	adult authorized by the participant or participant's legal representative, if any, to serve as a 
279.28 	representative in connection with the provision of CFSS. This authorization must be in 
279.29 	writing or by another method that clearly indicates the participant's free choice and may be 
279.30 	withdrawn at any time. The participant's representative must have no financial interest in 
279.31 	the provision of any services included in the participant's CFSS service delivery plan and 
279.32 	must be capable of providing the support necessary to assist the participant in the use of 
279.33 	CFSS. If through the assessment process described in subdivision 5 a participant is 
280.1 	determined to be in need of a participant's representative, one must be selected. If the 
280.2 	participant is unable to assist in the selection of a participant's representative, the legal 
280.3 	representative shall appoint one. Two persons may be designated as a participant's 
280.4 	representative for reasons such as divided households and court-ordered custodies. Duties 
280.5 	of a participant's representatives may include:
280.6 	(1) being available while services are provided in a method agreed upon by the participant 
280.7 	or the participant's legal representative and documented in the participant's CFSS service 
280.8 	delivery plan;
280.9 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery plan is 
280.10 	being followed; and
280.11 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
280.12 	verification of the CFSS services.
280.13 	(v) "Person-centered planning process" means a process that is directed by the participant 
280.14 	to plan for CFSS services and supports.
280.15 	(w) "Service budget" means the authorized dollar amount used for the budget model or 
280.16 	for the purchase of goods.
280.17 	(x) "Shared services" means the provision of CFSS services by the same CFSS support 
280.18 	worker to two or three participants who voluntarily enter into an a written agreement to 
280.19 	receive services at the same time and, in the same setting by, and through the same employer
280.20 	agency-provider or FMS provider.
280.21 	(y) "Support worker" means a qualified and trained employee of the agency-provider 
280.22 	as required by subdivision 11b or of the participant employer under the budget model as 
280.23 	required by subdivision 14 who has direct contact with the participant and provides services 
280.24 	as specified within the participant's CFSS service delivery plan.
280.25 	(z) "Unit" means the increment of service based on hours or minutes identified in the 
280.26 	service agreement.
280.27 	(aa) "Vendor fiscal employer agent" means an agency that provides financial management 
280.28 	services.
280.29 	(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share 
280.30 	of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, 
280.31 	mileage reimbursement, health and dental insurance, life insurance, disability insurance, 
280.32 	long-term care insurance, uniform allowance, contributions to employee retirement accounts, 
280.33 	or other forms of employee compensation and benefits.
281.1 	(cc) "Worker training and development" means services provided according to subdivision 
281.2 	18a for developing workers' skills as required by the participant's individual CFSS service 
281.3 	delivery plan that are arranged for or provided by the agency-provider or purchased by the 
281.4 	participant employer. These services include training, education, direct observation and 
281.5 	supervision, and evaluation and coaching of job skills and tasks, including supervision of 
281.6 	health-related tasks or behavioral supports.

281.7 	Sec. 60. Minnesota Statutes 2020, section 256B.85, subdivision 3, is amended to read:
281.8 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the following:
281.9 	(1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056, 
281.10 	or 256B.057, subdivisions 5 and 9;
281.11 	(1) is determined eligible for medical assistance under this chapter, excluding those 
281.12 	under section 256B.057, subdivisions 3, 3a, 3b, and 4;
281.13 	(2) is a participant in the alternative care program under section 256B.0913;
281.14 	(3) is a waiver participant as defined under chapter 256S or section 256B.092, 256B.093, 
281.15 	or 256B.49; or
281.16 	(4) has medical services identified in a person's individualized education program and 
281.17 	is eligible for services as determined in section 256B.0625, subdivision 26.
281.18 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
281.19 	meet all of the following:
281.20 	(1) require assistance and be determined dependent in one activity of daily living or 
281.21 	Level I behavior based on assessment under section 256B.0911; and
281.22 	(2) is not a participant under a family support grant under section 252.32.
281.23 	(c) A pregnant woman eligible for medical assistance under section 256B.055, subdivision 
281.24 	6, is eligible for CFSS without federal financial participation if the woman: (1) is eligible 
281.25 	for CFSS under paragraphs (a) and (b); and (2) does not meet institutional level of care, as 
281.26 	determined under section 256B.0911.

281.27 	Sec. 61. Minnesota Statutes 2020, section 256B.85, subdivision 4, is amended to read:
281.28 		Subd. 4.Eligibility for other services. Selection of CFSS by a participant must not 
281.29 	restrict access to other medically necessary care and services furnished under the state plan 
281.30 	benefit or other services available through the alternative care program.

282.1 	Sec. 62. Minnesota Statutes 2020, section 256B.85, subdivision 5, is amended to read:
282.2 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
282.3 	(1) be conducted by a certified assessor according to the criteria established in section 
282.4 	256B.0911, subdivision 3a;
282.5 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there is 
282.6 	a significant change in the participant's condition or a change in the need for services and 
282.7 	supports, or at the request of the participant when the participant experiences a change in 
282.8 	condition or needs a change in the services or supports; and
282.9 	(3) be completed using the format established by the commissioner.
282.10 	(b) The results of the assessment and any recommendations and authorizations for CFSS 
282.11 	must be determined and communicated in writing by the lead agency's certified assessor as 
282.12 	defined in section 256B.0911 to the participant and the agency-provider or FMS provider 
282.13 	chosen by the participant or the participant's representative and chosen CFSS providers
282.14 	within 40 calendarten business days and must include the participant's right to appeal the 
282.15 	assessment under section 256.045, subdivision 3.
282.16 	(c) The lead agency assessor may authorize a temporary authorization for CFSS services 
282.17 	to be provided under the agency-provider model. The lead agency assessor may authorize 
282.18 	a temporary authorization for CFSS services to be provided under the agency-provider 
282.19 	model without using the assessment process described in this subdivision. Authorization 
282.20 	for a temporary level of CFSS services under the agency-provider model is limited to the 
282.21 	time specified by the commissioner, but shall not exceed 45 days. The level of services 
282.22 	authorized under this paragraph shall have no bearing on a future authorization. Participants 
282.23 	approved for a temporary authorization shall access the consultation service For CFSS 
282.24 	services needed beyond the 45-day temporary authorization, the lead agency must conduct 
282.25 	an assessment as described in this subdivision and participants must use consultation services
282.26 	to complete their orientation and selection of a service model.

282.27 	Sec. 63. Minnesota Statutes 2020, section 256B.85, subdivision 6, is amended to read:
282.28 		Subd. 6.Community first services and supports service delivery plan. (a) The CFSS 
282.29 	service delivery plan must be developed and evaluated through a person-centered planning 
282.30 	process by the participant, or the participant's representative or legal representative who 
282.31 	may be assisted by a consultation services provider. The CFSS service delivery plan must 
282.32 	reflect the services and supports that are important to the participant and for the participant 
282.33 	to meet the needs assessed by the certified assessor and identified in the coordinated service 
283.1 	and support plan identified in section sections 256B.092, subdivision 1b, and256S.10. The 
283.2 	CFSS service delivery plan must be reviewed by the participant, the consultation services 
283.3 	provider, and the agency-provider or FMS provider prior to starting services and at least 
283.4 	annually upon reassessment, or when there is a significant change in the participant's 
283.5 	condition, or a change in the need for services and supports.
283.6 	(b) The commissioner shall establish the format and criteria for the CFSS service delivery 
283.7 	plan.
283.8 	(c) The CFSS service delivery plan must be person-centered and:
283.9 	(1) specify the consultation services provider, agency-provider, or FMS provider selected 
283.10 	by the participant;
283.11 	(2) reflect the setting in which the participant resides that is chosen by the participant;
283.12 	(3) reflect the participant's strengths and preferences;
283.13 	(4) include the methods and supports used to address the needs as identified through an 
283.14 	assessment of functional needs;
283.15 	(5) include the participant's identified goals and desired outcomes;
283.16 	(6) reflect the services and supports, paid and unpaid, that will assist the participant to 
283.17 	achieve identified goals, including the costs of the services and supports, and the providers 
283.18 	of those services and supports, including natural supports;
283.19 	(7) identify the amount and frequency of face-to-face supports and amount and frequency 
283.20 	of remote supports and technology that will be used;
283.21 	(8) identify risk factors and measures in place to minimize them, including individualized 
283.22 	backup plans;
283.23 	(9) be understandable to the participant and the individuals providing support;
283.24 	(10) identify the individual or entity responsible for monitoring the plan;
283.25 	(11) be finalized and agreed to in writing by the participant and signed by all individuals 
283.26 	and providers responsible for its implementation;
283.27 	(12) be distributed to the participant and other people involved in the plan;
283.28 	(13) prevent the provision of unnecessary or inappropriate care;
283.29 	(14) include a detailed budget for expenditures for budget model participants or 
283.30 	participants under the agency-provider model if purchasing goods; and
284.1 	(15) include a plan for worker training and development provided according to 
284.2 	subdivision 18a detailing what service components will be used, when the service components 
284.3 	will be used, how they will be provided, and how these service components relate to the 
284.4 	participant's individual needs and CFSS support worker services.
284.5 	(d) The CFSS service delivery plan must describe the units or dollar amount available 
284.6 	to the participant. The total units of agency-provider services or the service budget amount 
284.7 	for the budget model include both annual totals and a monthly average amount that cover 
284.8 	the number of months of the service agreement. The amount used each month may vary, 
284.9 	but additional funds must not be provided above the annual service authorization amount, 
284.10 	determined according to subdivision 8, unless a change in condition is assessed and 
284.11 	authorized by the certified assessor and documented in the coordinated service and support 
284.12 	plan and CFSS service delivery plan.
284.13 	(e) In assisting with the development or modification of the CFSS service delivery plan 
284.14 	during the authorization time period, the consultation services provider shall:
284.15 	(1) consult with the FMS provider on the spending budget when applicable; and
284.16 	(2) consult with the participant or participant's representative, agency-provider, and case 
284.17 	manager/ or care coordinator.
284.18 	(f) The CFSS service delivery plan must be approved by the consultation services provider 
284.19 	for participants without a case manager or care coordinator who is responsible for authorizing 
284.20 	services. A case manager or care coordinator must approve the plan for a waiver or alternative 
284.21 	care program participant.

284.22 	Sec. 64. Minnesota Statutes 2020, section 256B.85, subdivision 7, is amended to read:
284.23 		Subd. 7.Community first services and supports; covered services.  Services and 
284.24 	supports covered under CFSS include:
284.25 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of 
284.26 	daily living (IADLs), and health-related procedures and tasks through hands-on assistance 
284.27 	to accomplish the task or constant supervision and cueing to accomplish the task;
284.28 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to 
284.29 	accomplish activities of daily living, instrumental activities of daily living, or health-related 
284.30 	tasks;
284.31 	(3) expenditures for items, services, supports, environmental modifications, or goods, 
284.32 	including assistive technology. These expenditures must:
285.1 	(i) relate to a need identified in a participant's CFSS service delivery plan; and
285.2 	(ii) increase independence or substitute for human assistance, to the extent that 
285.3 	expenditures would otherwise be made for human assistance for the participant's assessed 
285.4 	needs;
285.5 	(4) observation and redirection for behavior or symptoms where there is a need for 
285.6 	assistance;
285.7 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices, 
285.8 	to ensure continuity of the participant's services and supports;
285.9 	(6) services provided by a consultation services provider as defined under subdivision 
285.10 	17, that is under contract with the department and enrolled as a Minnesota health care 
285.11 	program provider;
285.12 	(7) services provided by an FMS provider as defined under subdivision 13a, that is an 
285.13 	enrolled provider with the department;
285.14 	(8) CFSS services provided by a support worker who is a parent, stepparent, or legal 
285.15 	guardian of a participant under age 18, or who is the participant's spouse. These support 
285.16 	workers shall not:
285.17 	(i) provide any medical assistance home and community-based services in excess of 40 
285.18 	hours per seven-day period regardless of the number of parents providing services, 
285.19 	combination of parents and spouses providing services, or number of children who receive 
285.20 	medical assistance services; and
285.21 	(ii) have a wage that exceeds the current rate for a CFSS support worker including the 
285.22 	wage, benefits, and payroll taxes; and
285.23 	(9) worker training and development services as described in subdivision 18a.

285.24 	Sec. 65. Minnesota Statutes 2020, section 256B.85, subdivision 8, is amended to read:
285.25 		Subd. 8.Determination of CFSS service authorization amount. (a) All community 
285.26 	first services and supports must be authorized by the commissioner or the commissioner's 
285.27 	designee before services begin. The authorization for CFSS must be completed as soon as 
285.28 	possible following an assessment but no later than 40 calendar days from the date of the 
285.29 	assessment.
285.30 	(b) The amount of CFSS authorized must be based on the participant's home care rating 
285.31 	described in paragraphs (d) and (e) and any additional service units for which the participant 
285.32 	qualifies as described in paragraph (f).
286.1 	(c) The home care rating shall be determined by the commissioner or the commissioner's 
286.2 	designee based on information submitted to the commissioner identifying the following for 
286.3 	a participant:
286.4 	(1) the total number of dependencies of activities of daily living;
286.5 	(2) the presence of complex health-related needs; and
286.6 	(3) the presence of Level I behavior.
286.7 	(d) The methodology to determine the total service units for CFSS for each home care 
286.8 	rating is based on the median paid units per day for each home care rating from fiscal year 
286.9 	2007 data for the PCA program.
286.10 	(e) Each home care rating is designated by the letters P through Z and EN and has the 
286.11 	following base number of service units assigned:
286.12 	(1) P home care rating requires Level I behavior or one to three dependencies in ADLs 
286.13 	and qualifies the person for five service units;
286.14 	(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs 
286.15 	and qualifies the person for six service units;
286.16 	(3) R home care rating requires a complex health-related need and one to three 
286.17 	dependencies in ADLs and qualifies the person for seven service units;
286.18 	(4) S home care rating requires four to six dependencies in ADLs and qualifies the person 
286.19 	for ten service units;
286.20 	(5) T home care rating requires four to six dependencies in ADLs and Level I behavior 
286.21 	and qualifies the person for 11 service units;
286.22 	(6) U home care rating requires four to six dependencies in ADLs and a complex 
286.23 	health-related need and qualifies the person for 14 service units;
286.24 	(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the 
286.25 	person for 17 service units;
286.26 	(8) W home care rating requires seven to eight dependencies in ADLs and Level I 
286.27 	behavior and qualifies the person for 20 service units;
286.28 	(9) Z home care rating requires seven to eight dependencies in ADLs and a complex 
286.29 	health-related need and qualifies the person for 30 service units; and
286.30 	(10) EN home care rating includes ventilator dependency as defined in section 256B.0651, 
286.31 	subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent 
287.1 	and the EN home care rating and utilize a combination of CFSS and home care nursing 
287.2 	services is limited to a total of 96 service units per day for those services in combination. 
287.3 	Additional units may be authorized when a person's assessment indicates a need for two 
287.4 	staff to perform activities. Additional time is limited to 16 service units per day.
287.5 	(f) Additional service units are provided through the assessment and identification of 
287.6 	the following:
287.7 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
287.8 	living;
287.9 	(2) 30 additional minutes per day for each complex health-related need; and
287.10 	(3) 30 additional minutes per day when the for each behavior under this clause that 
287.11 	requires assistance at least four times per week for one or more of the following behaviors:
287.12 	(i) level I behavior that requires the immediate response of another person;
287.13 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior; 
287.14 	or
287.15 	(iii) increased need for assistance for participants who are verbally aggressive or resistive 
287.16 	to care so that the time needed to perform activities of daily living is increased.
287.17 	(g) The service budget for budget model participants shall be based on:
287.18 	(1) assessed units as determined by the home care rating; and
287.19 	(2) an adjustment needed for administrative expenses.

287.20 	Sec. 66. Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision 
287.21 	to read:
287.22 		Subd. 8a.Authorization; exceptions. All CFSS services must be authorized by the 
287.23 	commissioner or the commissioner's designee as described in subdivision 8 except when:
287.24 	(1) the lead agency temporarily authorizes services in the agency-provider model as 
287.25 	described in subdivision 5, paragraph (c);
287.26 	(2) CFSS services in the agency-provider model were required to treat an emergency 
287.27 	medical condition that if not immediately treated could cause a participant serious physical 
287.28 	or mental disability, continuation of severe pain, or death. The CFSS agency provider must 
287.29 	request retroactive authorization from the lead agency no later than five working days after 
287.30 	providing the initial emergency service. The CFSS agency provider must be able to 
287.31 	substantiate the emergency through documentation such as reports, notes, and admission 
288.1 	or discharge histories. A lead agency must follow the authorization process in subdivision 
288.2 	5 after the lead agency receives the request for authorization from the agency provider;
288.3 	(3) the lead agency authorizes a temporary increase to the amount of services authorized 
288.4 	in the agency or budget model to accommodate the participant's temporary higher need for 
288.5 	services. Authorization for a temporary level of CFSS services is limited to the time specified 
288.6 	by the commissioner, but shall not exceed 45 days. The level of services authorized under 
288.7 	this clause shall have no bearing on a future authorization;
288.8 	(4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated, 
288.9 	and an authorization for CFSS services is completed based on the date of a current 
288.10 	assessment, eligibility, and request for authorization;
288.11 	(5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization 
288.12 	requests must be submitted by the provider within 20 working days of the notice of denial 
288.13 	or adjustment. A copy of the notice must be included with the request;
288.14 	(6) the commissioner has determined that a lead agency or state human services agency 
288.15 	has made an error; or
288.16 	(7) a participant enrolled in managed care experiences a temporary disenrollment from 
288.17 	a health plan, in which case the commissioner shall accept the current health plan 
288.18 	authorization for CFSS services for up to 60 days. The request must be received within the 
288.19 	first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after 
288.20 	the 60 days and before 90 days, the provider shall request an additional 30-day extension 
288.21 	of the current health plan authorization, for a total limit of 90 days from the time of 
288.22 	disenrollment.

288.23 	Sec. 67. Minnesota Statutes 2020, section 256B.85, subdivision 9, is amended to read:
288.24 		Subd. 9.Noncovered services. (a) Services or supports that are not eligible for payment 
288.25 	under this section include those that:
288.26 	(1) are not authorized by the certified assessor or included in the CFSS service delivery 
288.27 	plan;
288.28 	(2) are provided prior to the authorization of services and the approval of the CFSS 
288.29 	service delivery plan;
288.30 	(3) are duplicative of other paid services in the CFSS service delivery plan;
289.1 	(4) supplant natural unpaid supports that appropriately meet a need in the CFSS service 
289.2 	delivery plan, are provided voluntarily to the participant, and are selected by the participant 
289.3 	in lieu of other services and supports;
289.4 	(5) are not effective means to meet the participant's needs; and
289.5 	(6) are available through other funding sources, including, but not limited to, funding 
289.6 	through title IV-E of the Social Security Act.
289.7 	(b) Additional services, goods, or supports that are not covered include:
289.8 	(1) those that are not for the direct benefit of the participant, except that services for 
289.9 	caregivers such as training to improve the ability to provide CFSS are considered to directly 
289.10 	benefit the participant if chosen by the participant and approved in the support plan;
289.11 	(2) any fees incurred by the participant, such as Minnesota health care programs fees 
289.12 	and co-pays, legal fees, or costs related to advocate agencies;
289.13 	(3) insurance, except for insurance costs related to employee coverage;
289.14 	(4) room and board costs for the participant;
289.15 	(5) services, supports, or goods that are not related to the assessed needs;
289.16 	(6) special education and related services provided under the Individuals with Disabilities 
289.17 	Education Act and vocational rehabilitation services provided under the Rehabilitation Act 
289.18 	of 1973;
289.19 	(7) assistive technology devices and assistive technology services other than those for 
289.20 	back-up systems or mechanisms to ensure continuity of service and supports listed in 
289.21 	subdivision 7;
289.22 	(8) medical supplies and equipment covered under medical assistance;
289.23 	(9) environmental modifications, except as specified in subdivision 7;
289.24 	(10) expenses for travel, lodging, or meals related to training the participant or the 
289.25 	participant's representative or legal representative;
289.26 	(11) experimental treatments;
289.27 	(12) any service or good covered by other state plan services, including prescription and 
289.28 	over-the-counter medications, compounds, and solutions and related fees, including premiums 
289.29 	and co-payments;
289.30 	(13) membership dues or costs, except when the service is necessary and appropriate to 
289.31 	treat a health condition or to improve or maintain the adult participant's health condition. 
290.1 	The condition must be identified in the participant's CFSS service delivery plan and 
290.2 	monitored by a Minnesota health care program enrolled physician, advanced practice 
290.3 	registered nurse, or physician's assistant;
290.4 	(14) vacation expenses other than the cost of direct services;
290.5 	(15) vehicle maintenance or modifications not related to the disability, health condition, 
290.6 	or physical need;
290.7 	(16) tickets and related costs to attend sporting or other recreational or entertainment 
290.8 	events;
290.9 	(17) services provided and billed by a provider who is not an enrolled CFSS provider;
290.10 	(18) CFSS provided by a participant's representative or paid legal guardian;
290.11 	(19) services that are used solely as a child care or babysitting service;
290.12 	(20) services that are the responsibility or in the daily rate of a residential or program 
290.13 	license holder under the terms of a service agreement and administrative rules;
290.14 	(21) sterile procedures;
290.15 	(22) giving of injections into veins, muscles, or skin;
290.16 	(23) homemaker services that are not an integral part of the assessed CFSS service;
290.17 	(24) home maintenance or chore services;
290.18 	(25) home care services, including hospice services if elected by the participant, covered 
290.19 	by Medicare or any other insurance held by the participant;
290.20 	(26) services to other members of the participant's household;
290.21 	(27) services not specified as covered under medical assistance as CFSS;
290.22 	(28) application of restraints or implementation of deprivation procedures;
290.23 	(29) assessments by CFSS provider organizations or by independently enrolled registered 
290.24 	nurses;
290.25 	(30) services provided in lieu of legally required staffing in a residential or child care 
290.26 	setting; and
290.27 	(31) services provided by the residential or program a foster care license holder in a 
290.28 	residence for more than four participants. except when the home of the person receiving 
290.29 	services is the licensed foster care provider's primary residence;
291.1 	(32) services that are the responsibility of the foster care provider under the terms of the 
291.2 	foster care placement agreement, assessment under sections 256N.24 and 260C.4411, and 
291.3 	administrative rules under sections 256N.24 and 260C.4411;
291.4 	(33) services in a setting that has a licensed capacity greater than six, unless all conditions 
291.5 	for a variance under section 245A.04, subdivision 9a, are satisfied for a sibling, as defined 
291.6 	in section 260C.007, subdivision 32;
291.7 	(34) services from a provider who owns or otherwise controls the living arrangement, 
291.8 	except when the provider of services is related by blood, marriage, or adoption or when the 
291.9 	provider is a licensed foster care provider who is not prohibited from providing services 
291.10 	under clauses (31) to (33);
291.11 	(35) instrumental activities of daily living for children younger than 18 years of age, 
291.12 	except when immediate attention is needed for health or hygiene reasons integral to an 
291.13 	assessed need for assistance with activities of daily living, health-related procedures, and 
291.14 	tasks or behaviors; or
291.15 	(36) services provided to a resident of a nursing facility, hospital, intermediate care 
291.16 	facility, or health care facility licensed by the commissioner of health.

291.17 	Sec. 68. Minnesota Statutes 2020, section 256B.85, subdivision 10, is amended to read:
291.18 		Subd. 10.Agency-provider and FMS provider qualifications and duties. (a) 
291.19 	Agency-providers identified in subdivision 11 and FMS providers identified in subdivision 
291.20 	13a shall:
291.21 	(1) enroll as a medical assistance Minnesota health care programs provider and meet all 
291.22 	applicable provider standards and requirements including completion of required provider 
291.23 	training as determined by the commissioner;
291.24 	(2) demonstrate compliance with federal and state laws and policies for CFSS as 
291.25 	determined by the commissioner;
291.26 	(3) comply with background study requirements under chapter 245C and maintain 
291.27 	documentation of background study requests and results;
291.28 	(4) verify and maintain records of all services and expenditures by the participant, 
291.29 	including hours worked by support workers;
291.30 	(5) not engage in any agency-initiated direct contact or marketing in person, by telephone, 
291.31 	or other electronic means to potential participants, guardians, family members, or participants' 
291.32 	representatives;
292.1 	(6) directly provide services and not use a subcontractor or reporting agent;
292.2 	(7) meet the financial requirements established by the commissioner for financial 
292.3 	solvency;
292.4 	(8) have never had a lead agency contract or provider agreement discontinued due to 
292.5 	fraud, or have never had an owner, board member, or manager fail a state or FBI-based 
292.6 	criminal background check while enrolled or seeking enrollment as a Minnesota health care 
292.7 	programs provider; and
292.8 	(9) have an office located in Minnesota.
292.9 	(b) In conducting general duties, agency-providers and FMS providers shall:
292.10 	(1) pay support workers based upon actual hours of services provided;
292.11 	(2) pay for worker training and development services based upon actual hours of services 
292.12 	provided or the unit cost of the training session purchased;
292.13 	(3) withhold and pay all applicable federal and state payroll taxes;
292.14 	(4) make arrangements and pay unemployment insurance, taxes, workers' compensation, 
292.15 	liability insurance, and other benefits, if any;
292.16 	(5) enter into a written agreement with the participant, participant's representative, or 
292.17 	legal representative that assigns roles and responsibilities to be performed before services, 
292.18 	supports, or goods are provided and that meets the requirements of subdivisions 20a, 20b, 
292.19 	and 20c for agency-providers;
292.20 	(6) report maltreatment as required under section 626.557 and chapter 260E;
292.21 	(7) comply with the labor market reporting requirements described in section 256B.4912, 
292.22 	subdivision 1a;
292.23 	(8) comply with any data requests from the department consistent with the Minnesota 
292.24 	Government Data Practices Act under chapter 13; and
292.25 	(9) maintain documentation for the requirements under subdivision 16, paragraph (e), 
292.26 	clause (2), to qualify for an enhanced rate under this section.; and
292.27 	(10) request reassessments 60 days before the end of the current authorization for CFSS 
292.28 	on forms provided by the commissioner.

293.1 	Sec. 69. Minnesota Statutes 2020, section 256B.85, subdivision 11, is amended to read:
293.2 		Subd. 11.Agency-provider model. (a) The agency-provider model includes services 
293.3 	provided by support workers and staff providing worker training and development services 
293.4 	who are employed by an agency-provider that meets the criteria established by the 
293.5 	commissioner, including required training.
293.6 	(b) The agency-provider shall allow the participant to have a significant role in the 
293.7 	selection and dismissal of the support workers for the delivery of the services and supports 
293.8 	specified in the participant's CFSS service delivery plan. The agency must make a reasonable 
293.9 	effort to fulfill the participant's request for the participant's preferred support worker.
293.10 	(c) A participant may use authorized units of CFSS services as needed within a service 
293.11 	agreement that is not greater than 12 months. Using authorized units in a flexible manner 
293.12 	in either the agency-provider model or the budget model does not increase the total amount 
293.13 	of services and supports authorized for a participant or included in the participant's CFSS 
293.14 	service delivery plan.
293.15 	(d) A participant may share CFSS services. Two or three CFSS participants may share 
293.16 	services at the same time provided by the same support worker.
293.17 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated 
293.18 	by the medical assistance payment for CFSS for support worker wages and benefits, except 
293.19 	all of the revenue generated by a medical assistance rate increase due to a collective 
293.20 	bargaining agreement under section 179A.54 must be used for support worker wages and 
293.21 	benefits. The agency-provider must document how this requirement is being met. The 
293.22 	revenue generated by the worker training and development services and the reasonable costs 
293.23 	associated with the worker training and development services must not be used in making 
293.24 	this calculation.
293.25 	(f) The agency-provider model must be used by individuals participants who are restricted 
293.26 	by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 
293.27 	9505.2245.
293.28 	(g) Participants purchasing goods under this model, along with support worker services, 
293.29 	must:
293.30 	(1) specify the goods in the CFSS service delivery plan and detailed budget for 
293.31 	expenditures that must be approved by the consultation services provider, case manager, or 
293.32 	care coordinator; and
293.33 	(2) use the FMS provider for the billing and payment of such goods.

294.1 	Sec. 70. Minnesota Statutes 2020, section 256B.85, subdivision 11b, is amended to read:
294.2 		Subd. 11b.Agency-provider model; support worker competency. (a) The 
294.3 	agency-provider must ensure that support workers are competent to meet the participant's 
294.4 	assessed needs, goals, and additional requirements as written in the CFSS service delivery 
294.5 	plan. Within 30 days of any support worker beginning to provide services for a participant,
294.6 	The agency-provider must evaluate the competency of the support worker through direct 
294.7 	observation of the support worker's performance of the job functions in a setting where the 
294.8 	participant is using CFSS. within 30 days of:
294.9 	(1) any support worker beginning to provide services for a participant; or
294.10 	(2) any support worker beginning to provide shared services.
294.11 	(b) The agency-provider must verify and maintain evidence of support worker 
294.12 	competency, including documentation of the support worker's:
294.13 	(1) education and experience relevant to the job responsibilities assigned to the support 
294.14 	worker and the needs of the participant;
294.15 	(2) relevant training received from sources other than the agency-provider;
294.16 	(3) orientation and instruction to implement services and supports to participant needs 
294.17 	and preferences as identified in the CFSS service delivery plan; and
294.18 	(4) orientation and instruction delivered by an individual competent to perform, teach, 
294.19 	or assign the health-related tasks for tracheostomy suctioning and services to participants 
294.20 	on ventilator support, including equipment operation and maintenance; and
294.21 	(4) (5) periodic performance reviews completed by the agency-provider at least annually, 
294.22 	including any evaluations required under subdivision 11a, paragraph (a). If a support worker 
294.23 	is a minor, all evaluations of worker competency must be completed in person and in a 
294.24 	setting where the participant is using CFSS.
294.25 	(c) The agency-provider must develop a worker training and development plan with the 
294.26 	participant to ensure support worker competency. The worker training and development 
294.27 	plan must be updated when:
294.28 	(1) the support worker begins providing services;
294.29 	(2) the support worker begins providing shared services;
294.30 	(2) (3) there is any change in condition or a modification to the CFSS service delivery 
294.31 	plan; or
295.1 	(3) (4) a performance review indicates that additional training is needed.

295.2 	Sec. 71. Minnesota Statutes 2020, section 256B.85, subdivision 12, is amended to read:
295.3 		Subd. 12.Requirements for enrollment of CFSS agency-providers. (a) All CFSS 
295.4 	agency-providers must provide, at the time of enrollment, reenrollment, and revalidation 
295.5 	as a CFSS agency-provider in a format determined by the commissioner, information and 
295.6 	documentation that includes, but is not limited to, the following:
295.7 	(1) the CFSS agency-provider's current contact information including address, telephone 
295.8 	number, and e-mail address;
295.9 	(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's 
295.10 	Medicaid revenue in the previous calendar year is less than or equal to $300,000, the 
295.11 	agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid 
295.12 	revenue in the previous calendar year is greater than $300,000, the agency-provider must 
295.13 	purchase a surety bond of $100,000. The surety bond must be in a form approved by the 
295.14 	commissioner, must be renewed annually, and must allow for recovery of costs and fees in 
295.15 	pursuing a claim on the bond;
295.16 	(3) proof of fidelity bond coverage in the amount of $20,000 per provider location;
295.17 	(4) proof of workers' compensation insurance coverage;
295.18 	(5) proof of liability insurance;
295.19 	(6) a description copy of the CFSS agency-provider's organization organizational chart
295.20 	identifying the names and roles of all owners, managing employees, staff, board of directors, 
295.21 	and the additional documentation reporting any affiliations of the directors and owners to 
295.22 	other service providers;
295.23 	(7) a copy of proof that the CFSS agency-provider's agency-provider has written policies 
295.24 	and procedures including: hiring of employees; training requirements; service delivery; and 
295.25 	employee and consumer safety, including the process for notification and resolution of 
295.26 	participant grievances, incident response, identification and prevention of communicable 
295.27 	diseases, and employee misconduct;
295.28 	(8) copies of all other forms proof that the CFSS agency-provider uses in the course of 
295.29 	daily business including, but not limited to has all of the following forms and documents:
295.30 	(i) a copy of the CFSS agency-provider's time sheet; and
295.31 	(ii) a copy of the participant's individual CFSS service delivery plan;
296.1 	(9) a list of all training and classes that the CFSS agency-provider requires of its staff 
296.2 	providing CFSS services;
296.3 	(10) documentation that the CFSS agency-provider and staff have successfully completed 
296.4 	all the training required by this section;
296.5 	(11) documentation of the agency-provider's marketing practices;
296.6 	(12) disclosure of ownership, leasing, or management of all residential properties that 
296.7 	are used or could be used for providing home care services;
296.8 	(13) documentation that the agency-provider will use at least the following percentages 
296.9 	of revenue generated from the medical assistance rate paid for CFSS services for CFSS 
296.10 	support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except 
296.11 	100 percent of the revenue generated by a medical assistance rate increase due to a collective 
296.12 	bargaining agreement under section 179A.54 must be used for support worker wages and 
296.13 	benefits. The revenue generated by the worker training and development services and the 
296.14 	reasonable costs associated with the worker training and development services shall not be 
296.15 	used in making this calculation; and
296.16 	(14) documentation that the agency-provider does not burden participants' free exercise 
296.17 	of their right to choose service providers by requiring CFSS support workers to sign an 
296.18 	agreement not to work with any particular CFSS participant or for another CFSS 
296.19 	agency-provider after leaving the agency and that the agency is not taking action on any 
296.20 	such agreements or requirements regardless of the date signed.
296.21 	(b) CFSS agency-providers shall provide to the commissioner the information specified 
296.22 	in paragraph (a).
296.23 	(c) All CFSS agency-providers shall require all employees in management and 
296.24 	supervisory positions and owners of the agency who are active in the day-to-day management 
296.25 	and operations of the agency to complete mandatory training as determined by the 
296.26 	commissioner. Employees in management and supervisory positions and owners who are 
296.27 	active in the day-to-day operations of an agency who have completed the required training 
296.28 	as an employee with a CFSS agency-provider do not need to repeat the required training if 
296.29 	they are hired by another agency, if and they have completed the training within the past 
296.30 	three years. CFSS agency-provider billing staff shall complete training about CFSS program 
296.31 	financial management. Any new owners or employees in management and supervisory 
296.32 	positions involved in the day-to-day operations are required to complete mandatory training 
296.33 	as a requisite of working for the agency.
297.1 	(d) The commissioner shall send annual review notifications to agency-providers 30 
297.2 	days prior to renewal. The notification must:
297.3 	(1) list the materials and information the agency-provider is required to submit;
297.4 	(2) provide instructions on submitting information to the commissioner; and
297.5 	(3) provide a due date by which the commissioner must receive the requested information.
297.6 	Agency-providers shall submit all required documentation for annual review within 30 days 
297.7 	of notification from the commissioner. If an agency-provider fails to submit all the required 
297.8 	documentation, the commissioner may take action under subdivision 23a.
297.9 	(d) Agency-providers shall submit all required documentation in this section within 30 
297.10 	days of notification from the commissioner. If an agency-provider fails to submit all the 
297.11 	required documentation, the commissioner may take action under subdivision 23a.

297.12 	Sec. 72. Minnesota Statutes 2020, section 256B.85, subdivision 12b, is amended to read:
297.13 		Subd. 12b.CFSS agency-provider requirements; notice regarding termination of 
297.14 	services. (a) An agency-provider must provide written notice when it intends to terminate 
297.15 	services with a participant at least ten 30 calendar days before the proposed service 
297.16 	termination is to become effective, except in cases where:
297.17 	(1) the participant engages in conduct that significantly alters the terms of the CFSS 
297.18 	service delivery plan with the agency-provider;
297.19 	(2) the participant or other persons at the setting where services are being provided 
297.20 	engage in conduct that creates an imminent risk of harm to the support worker or other 
297.21 	agency-provider staff; or
297.22 	(3) an emergency or a significant change in the participant's condition occurs within a 
297.23 	24-hour period that results in the participant's service needs exceeding the participant's 
297.24 	identified needs in the current CFSS service delivery plan so that the agency-provider cannot 
297.25 	safely meet the participant's needs.
297.26 	(b) When a participant initiates a request to terminate CFSS services with the 
297.27 	agency-provider, the agency-provider must give the participant a written acknowledgement
297.28 	acknowledgment of the participant's service termination request that includes the date the 
297.29 	request was received by the agency-provider and the requested date of termination.
297.30 	(c) The agency-provider must participate in a coordinated transfer of the participant to 
297.31 	a new agency-provider to ensure continuity of care.

298.1 	Sec. 73. Minnesota Statutes 2020, section 256B.85, subdivision 13, is amended to read:
298.2 		Subd. 13.Budget model. (a) Under the budget model participants exercise responsibility 
298.3 	and control over the services and supports described and budgeted within the CFSS service 
298.4 	delivery plan. Participants must use services specified in subdivision 13a provided by an 
298.5 	FMS provider. Under this model, participants may use their approved service budget 
298.6 	allocation to:
298.7 	(1) directly employ support workers, and pay wages, federal and state payroll taxes, and 
298.8 	premiums for workers' compensation, liability, and health insurance coverage; and
298.9 	(2) obtain supports and goods as defined in subdivision 7.
298.10 	(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may 
298.11 	authorize a legal representative or participant's representative to do so on their behalf.
298.12 	(c) If two or more participants using the budget model live in the same household and 
298.13 	have the same support worker, the participants must use the same FMS provider.
298.14 	(d) If the FMS provider advises that there is a joint employer in the budget model, all 
298.15 	participants associated with that joint employer must use the same FMS provider.
298.16 	(c) (e) The commissioner shall disenroll or exclude participants from the budget model 
298.17 	and transfer them to the agency-provider model under, but not limited to, the following 
298.18 	circumstances:
298.19 	(1) when a participant has been restricted by the Minnesota restricted recipient program, 
298.20 	in which case the participant may be excluded for a specified time period under Minnesota 
298.21 	Rules, parts 9505.2160 to 9505.2245;
298.22 	(2) when a participant exits the budget model during the participant's service plan year. 
298.23 	Upon transfer, the participant shall not access the budget model for the remainder of that 
298.24 	service plan year; or
298.25 	(3) when the department determines that the participant or participant's representative 
298.26 	or legal representative is unable to fulfill the responsibilities under the budget model, as 
298.27 	specified in subdivision 14.
298.28 	(d) (f) A participant may appeal in writing to the department under section 256.045, 
298.29 	subdivision 3, to contest the department's decision under paragraph (c) (e), clause (3), to 
298.30 	disenroll or exclude the participant from the budget model.

299.1 	Sec. 74. Minnesota Statutes 2020, section 256B.85, subdivision 13a, is amended to read:
299.2 		Subd. 13a.Financial management services. (a) Services provided by an FMS provider 
299.3 	include but are not limited to: filing and payment of federal and state payroll taxes on behalf 
299.4 	of the participant; initiating and complying with background study requirements under 
299.5 	chapter 245C and maintaining documentation of background study requests and results; 
299.6 	billing for approved CFSS services with authorized funds; monitoring expenditures; 
299.7 	accounting for and disbursing CFSS funds; providing assistance in obtaining and filing for 
299.8 	liability, workers' compensation, and unemployment coverage; and providing participant 
299.9 	instruction and technical assistance to the participant in fulfilling employer-related 
299.10 	requirements in accordance with section 3504 of the Internal Revenue Code and related 
299.11 	regulations and interpretations, including Code of Federal Regulations, title 26, section 
299.12 	31.3504-1.
299.13 	(b) Agency-provider services shall not be provided by the FMS provider.
299.14 	(c) The FMS provider shall provide service functions as determined by the commissioner 
299.15 	for budget model participants that include but are not limited to:
299.16 	(1) assistance with the development of the detailed budget for expenditures portion of 
299.17 	the CFSS service delivery plan as requested by the consultation services provider or 
299.18 	participant;
299.19 	(2) data recording and reporting of participant spending;
299.20 	(3) other duties established by the department, including with respect to providing 
299.21 	assistance to the participant, participant's representative, or legal representative in performing 
299.22 	employer responsibilities regarding support workers. The support worker shall not be 
299.23 	considered the employee of the FMS provider; and
299.24 	(4) billing, payment, and accounting of approved expenditures for goods.
299.25 	(d) The FMS provider shall obtain an assurance statement from the participant employer 
299.26 	agreeing to follow state and federal regulations and CFSS policies regarding employment 
299.27 	of support workers.
299.28 	(e) The FMS provider shall:
299.29 	(1) not limit or restrict the participant's choice of service or support providers or service 
299.30 	delivery models consistent with any applicable state and federal requirements;
300.1 	(2) provide the participant, consultation services provider, and case manager or care 
300.2 	coordinator, if applicable, with a monthly written summary of the spending for services and 
300.3 	supports that were billed against the spending budget;
300.4 	(3) be knowledgeable of state and federal employment regulations, including those under 
300.5 	the Fair Labor Standards Act of 1938, and comply with the requirements under section 3504 
300.6 	of the Internal Revenue Code and related regulations and interpretations, including Code 
300.7 	of Federal Regulations, title 26, section 31.3504-1, regarding agency employer tax liability 
300.8 	for vendor fiscal/employer agent, and any requirements necessary to process employer and 
300.9 	employee deductions, provide appropriate and timely submission of employer tax liabilities, 
300.10 	and maintain documentation to support medical assistance claims;
300.11 	(4) have current and adequate liability insurance and bonding and sufficient cash flow 
300.12 	as determined by the commissioner and have on staff or under contract a certified public 
300.13 	accountant or an individual with a baccalaureate degree in accounting;
300.14 	(5) assume fiscal accountability for state funds designated for the program and be held 
300.15 	liable for any overpayments or violations of applicable statutes or rules, including but not 
300.16 	limited to the Minnesota False Claims Act, chapter 15C; and
300.17 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
300.18 	supports expenditures for any goods purchased and maintain time records of support workers. 
300.19 	The documentation and time records must be maintained for a minimum of five years from 
300.20 	the claim date and be available for audit or review upon request by the commissioner. Claims 
300.21 	submitted by the FMS provider to the commissioner for payment must correspond with 
300.22 	services, amounts, and time periods as authorized in the participant's service budget and 
300.23 	service plan and must contain specific identifying information as determined by the 
300.24 	commissioner.; and
300.25 	(7) provide written notice to the participant or the participant's representative at least 30 
300.26 	calendar days before a proposed service termination becomes effective.
300.27 	(f) The commissioner of human services shall:
300.28 	(1) establish rates and payment methodology for the FMS provider;
300.29 	(2) identify a process to ensure quality and performance standards for the FMS provider 
300.30 	and ensure statewide access to FMS providers; and
300.31 	(3) establish a uniform protocol for delivering and administering CFSS services to be 
300.32 	used by eligible FMS providers.

301.1 	Sec. 75. Minnesota Statutes 2020, section 256B.85, is amended by adding a subdivision 
301.2 	to read:
301.3 		Subd. 14a.Participant's representative responsibilities. (a) If a participant is unable 
301.4 	to direct the participant's own care, the participant must use a participant's representative 
301.5 	to receive CFSS services. A participant's representative is required if:
301.6 	(1) the person is under 18 years of age;
301.7 	(2) the person has a court-appointed guardian; or
301.8 	(3) an assessment according to section 256B.0659, subdivision 3a, determines that the 
301.9 	participant is in need of a participant's representative.
301.10 	(b) A participant's representative must:
301.11 	(1) be at least 18 years of age;
301.12 	(2) actively participate in planning and directing CFSS services;
301.13 	(3) have sufficient knowledge of the participant's circumstances to use CFSS services 
301.14 	consistent with the participant's health and safety needs identified in the participant's service 
301.15 	delivery plan;
301.16 	(4) not have a financial interest in the provision of any services included in the 
301.17 	participant's CFSS service delivery plan; and
301.18 	(5) be capable of providing the support necessary to assist the participant in the use of 
301.19 	CFSS services.
301.20 	(c) A participant's representative must not be the:
301.21 	(1) support worker;
301.22 	(2) worker training and development service provider;
301.23 	(3) agency-provider staff, unless related to the participant by blood, marriage, or adoption;
301.24 	(4) consultation service provider, unless related to the participant by blood, marriage, 
301.25 	or adoption;
301.26 	(5) FMS staff, unless related to the participant by blood, marriage, or adoption;
301.27 	(6) FMS owner or manager; or
301.28 	(7) lead agency staff acting as part of employment.
302.1 	(d) A licensed family foster parent who lives with the participant may be the participant's 
302.2 	representative if the family foster parent meets the other participant's representative 
302.3 	requirements.
302.4 	(e) There may be two persons designated as the participant's representative, including 
302.5 	instances of divided households and court-ordered custodies. Each person named as the 
302.6 	participant's representative must meet the program criteria and responsibilities.
302.7 	(f) The participant or the participant's legal representative shall appoint a participant's 
302.8 	representative. The participant's representative must be identified at the time of assessment 
302.9 	and listed on the participant's service agreement and CFSS service delivery plan.
302.10 	(g) A participant's representative must enter into a written agreement with an 
302.11 	agency-provider or FMS on a form determined by the commissioner and maintained in the 
302.12 	participant's file, to:
302.13 	(1) be available while care is provided using a method agreed upon by the participant 
302.14 	or the participant's legal representative and documented in the participant's service delivery 
302.15 	plan;
302.16 	(2) monitor CFSS services to ensure the participant's service delivery plan is followed;
302.17 	(3) review and sign support worker time sheets after services are provided to verify the 
302.18 	provision of services;
302.19 	(4) review and sign vendor paperwork to verify receipt of goods; and
302.20 	(5) in the budget model, review and sign documentation to verify worker training and 
302.21 	development expenditures.
302.22 	(h) A participant's representative may delegate responsibility to another adult who is not 
302.23 	the support worker during a temporary absence of at least 24 hours but not more than six 
302.24 	months. To delegate responsibility, the participant's representative must:
302.25 	(1) ensure that the delegate serving as the participant's representative satisfies the 
302.26 	requirements of the participant's representative;
302.27 	(2) ensure that the delegate performs the functions of the participant's representative;
302.28 	(3) communicate to the CFSS agency-provider or FMS provider about the need for a 
302.29 	delegate by updating the written agreement to include the name of the delegate and the 
302.30 	delegate's contact information; and
302.31 	(4) ensure that the delegate protects the participant's privacy according to federal and 
302.32 	state data privacy laws.
303.1 	(i) The designation of a participant's representative remains in place until:
303.2 	(1) the participant revokes the designation;
303.3 	(2) the participant's representative withdraws the designation or becomes unable to fulfill 
303.4 	the duties;
303.5 	(3) the legal authority to act as a participant's representative changes; or
303.6 	(4) the participant's representative is disqualified.
303.7 	(j) A lead agency may disqualify a participant's representative who engages in conduct 
303.8 	that creates an imminent risk of harm to the participant, the support workers, or other staff. 
303.9 	A participant's representative who fails to provide support required by the participant must 
303.10 	be referred to the common entry point.

303.11 	Sec. 76. Minnesota Statutes 2020, section 256B.85, subdivision 15, is amended to read:
303.12 		Subd. 15.Documentation of support services provided; time sheets. (a) CFSS services 
303.13 	provided to a participant by a support worker employed by either an agency-provider or the 
303.14 	participant employer must be documented daily by each support worker, on a time sheet. 
303.15 	Time sheets may be created, submitted, and maintained electronically. Time sheets must 
303.16 	be submitted by the support worker at least once per month to the:
303.17 	(1) agency-provider when the participant is using the agency-provider model. The 
303.18 	agency-provider must maintain a record of the time sheet and provide a copy of the time 
303.19 	sheet to the participant; or
303.20 	(2) participant and the participant's FMS provider when the participant is using the 
303.21 	budget model. The participant and the FMS provider must maintain a record of the time 
303.22 	sheet.
303.23 	(b) The documentation on the time sheet must correspond to the participant's assessed 
303.24 	needs within the scope of CFSS covered services. The accuracy of the time sheets must be 
303.25 	verified by the:
303.26 	(1) agency-provider when the participant is using the agency-provider model; or
303.27 	(2) participant employer and the participant's FMS provider when the participant is using 
303.28 	the budget model.
303.29 	(c) The time sheet must document the time the support worker provides services to the 
303.30 	participant. The following elements must be included in the time sheet:
303.31 	(1) the support worker's full name and individual provider number;
304.1 	(2) the agency-provider's name and telephone numbers, when responsible for the CFSS 
304.2 	service delivery plan;
304.3 	(3) the participant's full name;
304.4 	(4) the dates within the pay period established by the agency-provider or FMS provider, 
304.5 	including month, day, and year, and arrival and departure times with a.m. or p.m. notations 
304.6 	for days worked within the established pay period;
304.7 	(5) the covered services provided to the participant on each date of service;
304.8 	(6) a the signature line for of the participant or the participant's representative and a 
304.9 	statement that the participant's or participant's representative's signature is verification of 
304.10 	the time sheet's accuracy;
304.11 	(7) the personal signature of the support worker;
304.12 	(8) any shared care provided, if applicable;
304.13 	(9) a statement that it is a federal crime to provide false information on CFSS billings 
304.14 	for medical assistance payments; and
304.15 	(10) dates and location of participant stays in a hospital, care facility, or incarceration 
304.16 	occurring within the established pay period.

304.17 	Sec. 77. Minnesota Statutes 2020, section 256B.85, subdivision 17a, is amended to read:
304.18 		Subd. 17a.Consultation services provider qualifications and 
304.19 	requirements. Consultation services providers must meet the following qualifications and 
304.20 	requirements:
304.21 	(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4) 
304.22 	and (5);
304.23 	(2) are under contract with the department;
304.24 	(3) are not the FMS provider, the lead agency, or the CFSS or home and community-based 
304.25 	services waiver vendor or agency-provider to the participant;
304.26 	(4) meet the service standards as established by the commissioner;
304.27 	(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation 
304.28 	service provider's Medicaid revenue in the previous calendar year is less than or equal to 
304.29 	$300,000, the consultation service provider must purchase a surety bond of $50,000. If the 
304.30 	agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000, 
304.31 	the consultation service provider must purchase a surety bond of $100,000. The surety bond 
305.1 	must be in a form approved by the commissioner, must be renewed annually, and must 
305.2 	allow for recovery of costs and fees in pursuing a claim on the bond;
305.3 	(5) (6) employ lead professional staff with a minimum of threetwo years of experience 
305.4 	in providing services such as support planning, support broker, case management or care 
305.5 	coordination, or consultation services and consumer education to participants using a 
305.6 	self-directed program using FMS under medical assistance;
305.7 	(7) report maltreatment as required under chapter 260E and section 626.557;
305.8 	(6) (8) comply with medical assistance provider requirements;
305.9 	(7) (9) understand the CFSS program and its policies;
305.10 	(8) (10) are knowledgeable about self-directed principles and the application of the 
305.11 	person-centered planning process;
305.12 	(9) (11) have general knowledge of the FMS provider duties and the vendor 
305.13 	fiscal/employer agent model, including all applicable federal, state, and local laws and 
305.14 	regulations regarding tax, labor, employment, and liability and workers' compensation 
305.15 	coverage for household workers; and
305.16 	(10) (12) have all employees, including lead professional staff, staff in management and 
305.17 	supervisory positions, and owners of the agency who are active in the day-to-day management 
305.18 	and operations of the agency, complete training as specified in the contract with the 
305.19 	department.

305.20 	Sec. 78. Minnesota Statutes 2020, section 256B.85, subdivision 18a, is amended to read:
305.21 		Subd. 18a.Worker training and development services. (a) The commissioner shall 
305.22 	develop the scope of tasks and functions, service standards, and service limits for worker 
305.23 	training and development services.
305.24 	(b) Worker training and development costs are in addition to the participant's assessed 
305.25 	service units or service budget. Services provided according to this subdivision must:
305.26 	(1) help support workers obtain and expand the skills and knowledge necessary to ensure 
305.27 	competency in providing quality services as needed and defined in the participant's CFSS 
305.28 	service delivery plan and as required under subdivisions 11b and 14;
305.29 	(2) be provided or arranged for by the agency-provider under subdivision 11, or purchased 
305.30 	by the participant employer under the budget model as identified in subdivision 13; and
306.1 	(3) be delivered by an individual competent to perform, teach, or assign the tasks, 
306.2 	including health-related tasks, identified in the plan through education, training, and work 
306.3 	experience relevant to the person's assessed needs; and
306.4 	(3) (4) be described in the participant's CFSS service delivery plan and documented in 
306.5 	the participant's file.
306.6 	(c) Services covered under worker training and development shall include:
306.7 	(1) support worker training on the participant's individual assessed needs and condition, 
306.8 	provided individually or in a group setting by a skilled and knowledgeable trainer beyond 
306.9 	any training the participant or participant's representative provides;
306.10 	(2) tuition for professional classes and workshops for the participant's support workers 
306.11 	that relate to the participant's assessed needs and condition;
306.12 	(3) direct observation, monitoring, coaching, and documentation of support worker job 
306.13 	skills and tasks, beyond any training the participant or participant's representative provides, 
306.14 	including supervision of health-related tasks or behavioral supports that is conducted by an 
306.15 	appropriate professional based on the participant's assessed needs. These services must be 
306.16 	provided at the start of services or the start of a new support worker except as provided in 
306.17 	paragraph (d) and must be specified in the participant's CFSS service delivery plan; and
306.18 	(4) the activities to evaluate CFSS services and ensure support worker competency 
306.19 	described in subdivisions 11a and 11b.
306.20 	(d) The services in paragraph (c), clause (3), are not required to be provided for a new 
306.21 	support worker providing services for a participant due to staffing failures, unless the support 
306.22 	worker is expected to provide ongoing backup staffing coverage.
306.23 	(e) Worker training and development services shall not include:
306.24 	(1) general agency training, worker orientation, or training on CFSS self-directed models;
306.25 	(2) payment for preparation or development time for the trainer or presenter;
306.26 	(3) payment of the support worker's salary or compensation during the training;
306.27 	(4) training or supervision provided by the participant, the participant's support worker, 
306.28 	or the participant's informal supports, including the participant's representative; or
306.29 	(5) services in excess of 96 units the limit set by the commissioner per annual service 
306.30 	agreement, unless approved by the department.

307.1 	Sec. 79. Minnesota Statutes 2020, section 256B.85, subdivision 20b, is amended to read:
307.2 		Subd. 20b.Service-related rights under an agency-provider. A participant receiving 
307.3 	CFSS from an agency-provider has service-related rights to:
307.4 	(1) participate in and approve the initial development and ongoing modification and 
307.5 	evaluation of CFSS services provided to the participant;
307.6 	(2) refuse or terminate services and be informed of the consequences of refusing or 
307.7 	terminating services;
307.8 	(3) before services are initiated, be told the limits to the services available from the 
307.9 	agency-provider, including the agency-provider's knowledge, skill, and ability to meet the 
307.10 	participant's needs identified in the CFSS service delivery plan;
307.11 	(4) a coordinated transfer of services when there will be a change in the agency-provider;
307.12 	(5) before services are initiated, be told what the agency-provider charges for the services;
307.13 	(6) before services are initiated, be told to what extent payment may be expected from 
307.14 	health insurance, public programs, or other sources, if known; and what charges the 
307.15 	participant may be responsible for paying;
307.16 	(7) receive services from an individual who is competent and trained, who has 
307.17 	professional certification or licensure, as required, and who meets additional qualifications 
307.18 	identified in the participant's CFSS service delivery plan;
307.19 	(8) have the participant's preferences for support workers identified and documented, 
307.20 	and have those preferences met when possible; and
307.21 	(9) before services are initiated, be told the choices that are available from the 
307.22 	agency-provider for meeting the participant's assessed needs identified in the CFSS service 
307.23 	delivery plan, including but not limited to which support worker staff will be providing 
307.24 	services and, the proposed frequency and schedule of visits, and any agreements for shared 
307.25 	services.

307.26 	Sec. 80. Minnesota Statutes 2020, section 256B.85, subdivision 23, is amended to read:
307.27 		Subd. 23.Commissioner's access. (a) When the commissioner is investigating a possible 
307.28 	overpayment of Medicaid funds, the commissioner must be given immediate access without 
307.29 	prior notice to the agency-provider, consultation services provider, or FMS provider's office 
307.30 	during regular business hours and to documentation and records related to services provided 
307.31 	and submission of claims for services provided. Denying the commissioner access to records 
307.32 	is cause for immediate suspension of payment and terminating If the agency-provider's 
308.1 	enrollment or agency-provider, FMS provider's enrollment provider, or consultation services 
308.2 	provider denies the commissioner access to records, the provider's payment may be 
308.3 	immediately suspended or the provider's enrollment may be terminated according to section 
308.4 	256B.064or terminating the consultation services provider contract.
308.5 	(b) The commissioner has the authority to request proof of compliance with laws, rules, 
308.6 	and policies from agency-providers, consultation services providers, FMS providers, and 
308.7 	participants.
308.8 	(c) When relevant to an investigation conducted by the commissioner, the commissioner 
308.9 	must be given access to the business office, documents, and records of the agency-provider, 
308.10 	consultation services provider, or FMS provider, including records maintained in electronic 
308.11 	format; participants served by the program; and staff during regular business hours. The 
308.12 	commissioner must be given access without prior notice and as often as the commissioner 
308.13 	considers necessary if the commissioner is investigating an alleged violation of applicable 
308.14 	laws or rules. The commissioner may request and shall receive assistance from lead agencies 
308.15 	and other state, county, and municipal agencies and departments. The commissioner's access 
308.16 	includes being allowed to photocopy, photograph, and make audio and video recordings at 
308.17 	the commissioner's expense.

308.18 	Sec. 81. Minnesota Statutes 2020, section 256B.85, subdivision 23a, is amended to read:
308.19 		Subd. 23a.Sanctions; information for participants upon termination of services. (a) 
308.20 	The commissioner may withhold payment from the provider or suspend or terminate the 
308.21 	provider enrollment number if the provider fails to comply fully with applicable laws or 
308.22 	rules. The provider has the right to appeal the decision of the commissioner under section 
308.23 	256B.064.
308.24 	(b) Notwithstanding subdivision 13, paragraph (c), if a participant employer fails to 
308.25 	comply fully with applicable laws or rules, the commissioner may disenroll the participant 
308.26 	from the budget model. A participant may appeal in writing to the department under section 
308.27 	256.045, subdivision 3, to contest the department's decision to disenroll the participant from 
308.28 	the budget model.
308.29 	(c) Agency-providers of CFSS services or FMS providers must provide each participant 
308.30 	with a copy of participant protections in subdivision 20c at least 30 days prior to terminating 
308.31 	services to a participant, if the termination results from sanctions under this subdivision or 
308.32 	section 256B.064, such as a payment withhold or a suspension or termination of the provider 
308.33 	enrollment number. If a CFSS agency-provider or, FMS provider, or consultation services 
308.34 	provider determines it is unable to continue providing services to a participant because of 
309.1 	an action under this subdivision or section 256B.064, the agency-provider or, FMS provider, 
309.2 	or consultation services provider must notify the participant, the participant's representative, 
309.3 	and the commissioner 30 days prior to terminating services to the participant, and must 
309.4 	assist the commissioner and lead agency in supporting the participant in transitioning to 
309.5 	another CFSS agency-provider or, FMS provider, or consultation services provider of the 
309.6 	participant's choice.
309.7 	(d) In the event the commissioner withholds payment from a CFSS agency-provider or,
309.8 	FMS provider, or consultation services provider, or suspends or terminates a provider 
309.9 	enrollment number of a CFSS agency-provider or, FMS provider, or consultation services 
309.10 	provider under this subdivision or section 256B.064, the commissioner may inform the 
309.11 	Office of Ombudsman for Long-Term Care and the lead agencies for all participants with 
309.12 	active service agreements with the agency-provider or, FMS provider, or consultation 
309.13 	services provider. At the commissioner's request, the lead agencies must contact participants 
309.14 	to ensure that the participants are continuing to receive needed care, and that the participants 
309.15 	have been given free choice of agency-provider or, FMS provider, or consultation services 
309.16 	provider if they transfer to another CFSS agency-provider or, FMS provider, or consultation 
309.17 	services provider. In addition, the commissioner or the commissioner's delegate may directly 
309.18 	notify participants who receive care from the agency-provider or, FMS provider, or 
309.19 	consultation services provider that payments have been or will be withheld or that the 
309.20 	provider's participation in medical assistance has been or will be suspended or terminated, 
309.21 	if the commissioner determines that the notification is necessary to protect the welfare of 
309.22 	the participants.

309.23 	Sec. 82. Minnesota Statutes 2020, section 256L.03, subdivision 1, is amended to read:
309.24 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
309.25 	services reimbursed under chapter 256B, with the exception of special education services, 
309.26 	home care nursing services, adult dental care services other than services covered under 
309.27 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
309.28 	services, personal care assistance and case management services, community first services 
309.29 	and supports under Minnesota Statutes, section 256B.85, behavioral health home services 
309.30 	under section 256B.0757, housing stabilization services under section 256B.051, and nursing 
309.31 	home or intermediate care facilities services.
309.32 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare except 
309.33 	where the life of the female would be endangered or substantial and irreversible impairment 
310.1 	of a major bodily function would result if the fetus were carried to term; or where the 
310.2 	pregnancy is the result of rape or incest.
310.3 	(c) Covered health services shall be expanded as provided in this section.
310.4 	(d) For the purposes of covered health services under this section, "child" means an 
310.5 	individual younger than 19 years of age.

310.6 	Sec. 83. REVISOR INSTRUCTION.
 310.7 	(a) In Minnesota Statutes, sections 245A.191, paragraph (a); 245G.02, subdivision 3; 
310.8 	246.18, subdivision 2; 246.23, subdivision 2; 246.64, subdivision 3; 254A.03, subdivision 
310.9 	3; 254A.19, subdivision 4; 254B.03, subdivision 2; 254B.04, subdivision 1; 254B.05, 
310.10 	subdivisions 1a and 4; 254B.051; 254B.06, subdivision 1; 254B.12, subdivisions 1 and 2; 
310.11 	254B.13, subdivisions 2a and 5; 254B.14, subdivision 5; 256L.03, subdivision 2; and 295.53, 
310.12 	subdivision 1, the revisor of statutes must change the term "consolidated chemical 
310.13 	dependency treatment fund" or similar terms to "behavioral health fund." The revisor may 
310.14 	make grammatical changes related to the term change.
310.15 	(b) In Minnesota Statutes, sections 245C.03, subdivision 13, and 256B.051, the revisor 
310.16 	of statutes must change the term "housing support services" or similar terms to "housing 
310.17 	stabilization services." The revisor may make grammatical changes related to the term 
310.18 	change.
310.19 	(c) In Minnesota Statutes, section 245C.03, subdivision 10, the revisor of statutes must 
310.20 	change the term "group residential housing" to "housing support." The revisor may make 
310.21 	grammatical changes related to the term change.

310.22 	Sec. 84. REPEALER.
 310.23 	(a) Minnesota Statutes 2020, section 252.28, subdivisions 1 and 5, are repealed.
310.24 	(b) Minnesota Statutes 2020, sections 252A.02, subdivisions 8 and 10; and 252A.21, 
310.25 	subdivision 3, are repealed.

310.26 	EFFECTIVE DATE. Paragraph (a) is effective the day following final enactment. 
310.27 	Paragraph (b) is effective August 1, 2021.

311.1 	ARTICLE 14
311.2 	MISCELLANEOUS

311.3 	Section 1. [62A.082] NONDISCRIMINATION IN ACCESS TO TRANSPLANTS.
311.4 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
311.5 	the meanings given unless the context clearly requires otherwise.
311.6 	(b) "Disability" has the meaning given in section 363A.03, subdivision 12.
311.7 	(c) "Enrollee" means a natural person covered by a health plan or group health plan and 
311.8 	includes an insured, policy holder, subscriber, covered person, member, contract holder, or 
311.9 	certificate holder.
311.10 	(d) "Organ transplant" means the transplantation or transfusion of a part of a human 
311.11 	body into the body of another for the purpose of treating or curing a medical condition.
311.12 		Subd. 2.Transplant discrimination prohibited. A health plan or group health plan 
311.13 	that provides coverage for anatomical gifts, organ transplants, or related treatment and 
311.14 	services shall not:
311.15 	(1) deny coverage to an enrollee based on the enrollee's disability;
311.16 	(2) deny eligibility, or continued eligibility, to enroll or to renew coverage under the 
311.17 	terms of the health plan or group health plan solely for the purpose of avoiding the 
311.18 	requirements of this section;
311.19 	(3) penalize or otherwise reduce or limit the reimbursement of a health care provider, 
311.20 	or provide monetary or nonmonetary incentives to a health care provider, to induce the 
311.21 	provider to provide care to a patient in a manner inconsistent with this section; or
311.22 	(4) reduce or limit an enrollee's coverage benefits because of the enrollee's disability for 
311.23 	medical services and other services related to organ transplantation performed pursuant to 
311.24 	this section as determined in consultation with the enrollee's treating health care provider 
311.25 	and the enrollee.
311.26 		Subd. 3.Collective bargaining. In the case of a group health plan maintained pursuant 
311.27 	to one or more collective bargaining agreements between employee representatives and one 
311.28 	or more employers, any plan amendment made pursuant to a collective bargaining agreement 
311.29 	relating to the plan which amends the plan solely to conform to any requirement imposed 
311.30 	pursuant to this section shall not be treated as a termination of the collective bargaining 
311.31 	agreement.
312.1 		Subd. 4.Coverage limitation.  Nothing in this section shall be deemed to require a health 
312.2 	plan or group health plan to provide coverage for a medically inappropriate organ transplant.

312.3 	Sec. 2. [363A.50] NONDISCRIMINATION IN ACCESS TO TRANSPLANTS.
312.4 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
312.5 	the meanings given unless the context clearly requires otherwise.
312.6 	(b) "Anatomical gift" has the meaning given in section 525A.02, subdivision 4.
312.7 	(c) "Auxiliary aids and services" include, but are not limited to:
312.8 	(1) qualified interpreters or other effective methods of making aurally delivered materials 
312.9 	available to individuals with hearing impairments;
312.10 	(2) qualified readers, taped texts, texts in accessible electronic format, or other effective 
312.11 	methods of making visually delivered materials available to individuals with visual 
312.12 	impairments;
312.13 	(3) the provision of information in a format that is accessible for individuals with 
312.14 	cognitive, neurological, developmental, intellectual, or physical disabilities;
312.15 	(4) the provision of supported decision-making services; and
312.16 	(5) the acquisition or modification of equipment or devices.
312.17 	(d) "Covered entity" means:
312.18 	(1) any licensed provider of health care services, including licensed health care 
312.19 	practitioners, hospitals, nursing facilities, laboratories, intermediate care facilities, psychiatric 
312.20 	residential treatment facilities, institutions for individuals with intellectual or developmental 
312.21 	disabilities, and prison health centers; or
312.22 	(2) any entity responsible for matching anatomical gift donors to potential recipients.
312.23 	(e) "Disability" has the meaning given in section 363A.03, subdivision 12.
312.24 	(f) "Organ transplant" means the transplantation or infusion of a part of a human body 
312.25 	into the body of another for the purpose of treating or curing a medical condition.
312.26 	(g) "Qualified individual" means an individual who, with or without available support 
312.27 	networks, the provision of auxiliary aids and services, or reasonable modifications to policies 
312.28 	or practices, meets the essential eligibility requirements for the receipt of an anatomical 
312.29 	gift.
312.30 	(h) "Reasonable modifications" include, but are not limited to:
313.1 	(1) communication with individuals responsible for supporting an individual with 
313.2 	postsurgical and post-transplantation care, including medication; and
313.3 	(2) consideration of support networks available to the individual, including family, 
313.4 	friends, and home and community-based services, including home and community-based 
313.5 	services funded through Medicaid, Medicare, another health plan in which the individual 
313.6 	is enrolled, or any program or source of funding available to the individual, in determining 
313.7 	whether the individual is able to comply with post-transplant medical requirements.
313.8 	(i) "Supported decision making" has the meaning given in section 524.5-102, subdivision 
313.9 	16a.
313.10 		Subd. 2.Prohibition of discrimination. (a) A covered entity may not, on the basis of 
313.11 	a qualified individual's mental or physical disability:
313.12 	(1) deem an individual ineligible to receive an anatomical gift or organ transplant;
313.13 	(2) deny medical or related organ transplantation services, including evaluation, surgery, 
313.14 	counseling, and postoperative treatment and care;
313.15 	(3) refuse to refer the individual to a transplant center or other related specialist for the 
313.16 	purpose of evaluation or receipt of an anatomical gift or organ transplant;
313.17 	(4) refuse to place an individual on an organ transplant waiting list or place the individual 
313.18 	at a lower-priority position on the list than the position at which the individual would have 
313.19 	been placed if not for the individual's disability; or
313.20 	(5) decline insurance coverage for any procedure associated with the receipt of the 
313.21 	anatomical gift or organ transplant, including post-transplantation and postinfusion care.
313.22 	(b) Notwithstanding paragraph (a), a covered entity may take an individual's disability 
313.23 	into account when making treatment or coverage recommendations or decisions, solely to 
313.24 	the extent that the physical or mental disability has been found by a physician, following 
313.25 	an individualized evaluation of the potential recipient to be medically significant to the 
313.26 	provision of the anatomical gift or organ transplant. The provisions of this section may not 
313.27 	be deemed to require referrals or recommendations for, or the performance of, organ 
313.28 	transplants that are not medically appropriate given the individual's overall health condition.
313.29 	(c) If an individual has the necessary support system to assist the individual in complying 
313.30 	with post-transplant medical requirements, an individual's inability to independently comply 
313.31 	with those requirements may not be deemed to be medically significant for the purposes of 
313.32 	paragraph (b).
314.1 	(d) A covered entity must make reasonable modifications to policies, practices, or 
314.2 	procedures, when such modifications are necessary to make services such as 
314.3 	transplantation-related counseling, information, coverage, or treatment available to qualified 
314.4 	individuals with disabilities, unless the entity can demonstrate that making such modifications 
314.5 	would fundamentally alter the nature of such services.
314.6 	(e) A covered entity must take such steps as may be necessary to ensure that no qualified 
314.7 	individual with a disability is denied services such as transplantation-related counseling, 
314.8 	information, coverage, or treatment because of the absence of auxiliary aids and services, 
314.9 	unless the entity can demonstrate that taking such steps would fundamentally alter the nature 
314.10 	of the services being offered or result in an undue burden. A covered entity is not required 
314.11 	to provide supported decision-making services.
314.12 	(f) A covered entity must otherwise comply with the requirements of Titles II and III of 
314.13 	the Americans with Disabilities Act of 1990, the Americans with Disabilities Act 
314.14 	Amendments Act of 2008, and the Minnesota Human Rights Act.
314.15 	(g) The provisions of this section apply to each part of the organ transplant process.
314.16 		Subd. 3.Remedies. In addition to all other remedies available under this chapter, any 
314.17 	individual who has been subjected to discrimination in violation of this section may initiate 
314.18 	a civil action in a court of competent jurisdiction to enjoin violations of this section.

314.19 	ARTICLE 15
314.20 	MENTAL HEALTH UNIFORM SERVICE STANDARDS

314.21 	Section 1. [245I.01] PURPOSE AND CITATION.
314.22 		Subdivision 1.Citation. This chapter may be cited as the "Mental Health Uniform 
314.23 	Service Standards Act."
314.24 		Subd. 2.Purpose. In accordance with sections 245.461 and 245.487, the purpose of this 
314.25 	chapter is to create a system of mental health care that is unified, accountable, and 
314.26 	comprehensive, and to promote the recovery and resiliency of Minnesotans who have mental 
314.27 	illnesses. The state's public policy is to support Minnesotans' access to quality outpatient 
314.28 	and residential mental health services. Further, the state's public policy is to protect the 
314.29 	health and safety, rights, and well-being of Minnesotans receiving mental health services.

315.1 	Sec. 2. [245I.011] APPLICABILITY.
315.2 		Subdivision 1.License requirements. A license holder under this chapter must comply 
315.3 	with the requirements in chapters 245A, 245C, and 260E; section 626.557; and Minnesota 
315.4 	Rules, chapter 9544.
315.5 		Subd. 2.Variances. (a) The commissioner may grant a variance to an applicant, license 
315.6 	holder, or certification holder as long as the variance does not affect the staff qualifications 
315.7 	or the health or safety of any person in a licensed or certified program and the applicant, 
315.8 	license holder, or certification holder meets the following conditions:
315.9 	(1) an applicant, license holder, or certification holder must request the variance on a 
315.10 	form approved by the commissioner and in a manner prescribed by the commissioner;
315.11 	(2) the request for a variance must include the:
315.12 	(i) reasons that the applicant, license holder, or certification holder cannot comply with 
315.13 	a requirement as stated in the law; and
315.14 	(ii) alternative equivalent measures that the applicant, license holder, or certification 
315.15 	holder will follow to comply with the intent of the law; and
315.16 	(3) the request for a variance must state the period of time when the variance is requested.
315.17 	(b) The commissioner may grant a permanent variance when the conditions under which 
315.18 	the applicant, license holder, or certification holder requested the variance do not affect the 
315.19 	health or safety of any person whom the licensed or certified program serves, and when the 
315.20 	conditions of the variance do not compromise the qualifications of staff who provide services 
315.21 	to clients. A permanent variance expires when the conditions that warranted the variance 
315.22 	change in any way. Any applicant, license holder, or certification holder must inform the 
315.23 	commissioner of any changes to the conditions that warranted the permanent variance. If 
315.24 	an applicant, license holder, or certification holder fails to advise the commissioner of 
315.25 	changes to the conditions that warranted the variance, the commissioner must revoke the 
315.26 	permanent variance and may impose other sanctions under sections 245A.06 and 245A.07.
315.27 	(c) The commissioner's decision to grant or deny a variance request is final and not 
315.28 	subject to appeal under the provisions of chapter 14.
315.29 		Subd. 3.Certification required. (a) An individual, organization, or government entity 
315.30 	that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause 
315.31 	(19), and chooses to be identified as a certified mental health clinic must:
315.32 	(1) be a mental health clinic that is certified under section 245I.20;
316.1 	(2) comply with all of the responsibilities assigned to a license holder by this chapter 
316.2 	except subdivision 1; and
316.3 	(3) comply with all of the responsibilities assigned to a certification holder by chapter 
316.4 	245A.
316.5 	(b) An individual, organization, or government entity described by this subdivision must 
316.6 	obtain a criminal background study for each staff person or volunteer who provides direct 
316.7 	contact services to clients.
316.8 		Subd. 4.License required. An individual, organization, or government entity providing 
316.9 	intensive residential treatment services or residential crisis stabilization to adults must be 
316.10 	licensed under section 245I.23. An entity with an adult foster care license providing 
316.11 	residential crisis stabilization is exempt from licensure under section 245I.23.
316.12 		Subd. 5.Programs certified under chapter 256B. (a) An individual, organization, or 
316.13 	government entity certified under the following sections must comply with all of the 
316.14 	responsibilities assigned to a license holder under this chapter except subdivision 1:
316.15 	(1) an assertive community treatment provider under section 256B.0622, subdivision 
316.16 	3a;
316.17 	(2) an adult rehabilitative mental health services provider under section 256B.0623;
316.18 	(3) a mobile crisis team under section 256B.0624;
316.19 	(4) a children's therapeutic services and supports provider under section 256B.0943;
316.20 	(5) an intensive treatment in foster care provider under section 256B.0946; and
316.21 	(6) an intensive nonresidential rehabilitative mental health services provider under section 
316.22 	256B.0947.
316.23 	(b) An individual, organization, or government entity certified under the sections listed 
316.24 	in paragraph (a), clauses (1) to (6), must obtain a criminal background study for each staff 
316.25 	person and volunteer providing direct contact services to a client.

316.26 	Sec. 3. [245I.02] DEFINITIONS.
316.27 		Subdivision 1.Scope. For purposes of this chapter, the terms in this section have the 
316.28 	meanings given.
316.29 		Subd. 2.Approval. "Approval" means the documented review of, opportunity to request 
316.30 	changes to, and agreement with a treatment document. An individual may demonstrate 
316.31 	approval with a written signature, secure electronic signature, or documented oral approval.
317.1 		Subd. 3.Behavioral sciences or related fields. "Behavioral sciences or related fields" 
317.2 	means an education from an accredited college or university in social work, psychology, 
317.3 	sociology, community counseling, family social science, child development, child 
317.4 	psychology, community mental health, addiction counseling, counseling and guidance, 
317.5 	special education, nursing, and other similar fields approved by the commissioner.
317.6 		Subd. 4.Business day. "Business day" means a weekday on which government offices 
317.7 	are open for business. Business day does not include state or federal holidays, Saturdays, 
317.8 	or Sundays.
317.9 		Subd. 5.Case manager. "Case manager" means a client's case manager according to 
317.10 	section 256B.0596; 256B.0621; 256B.0625, subdivision 20; 256B.092, subdivision 1a; 
317.11 	256B.0924; 256B.093, subdivision 3a; 256B.094; or 256B.49.
317.12 		Subd. 6.Certified rehabilitation specialist. "Certified rehabilitation specialist" means 
317.13 	a staff person who meets the qualifications of section 245I.04, subdivision 8.
317.14 		Subd. 7.Child. "Child" means a client under the age of 18.
317.15 		Subd. 8.Client. "Client" means a person who is seeking or receiving services regulated 
317.16 	by this chapter. For the purpose of a client's consent to services, client includes a parent, 
317.17 	guardian, or other individual legally authorized to consent on behalf of a client to services.
317.18 		Subd. 9.Clinical trainee. "Clinical trainee" means a staff person who is qualified 
317.19 	according to section 245I.04, subdivision 6.
317.20 		Subd. 10.Commissioner. "Commissioner" means the commissioner of human services 
317.21 	or the commissioner's designee.
317.22 		Subd. 11.Co-occurring substance use disorder treatment. "Co-occurring substance 
317.23 	use disorder treatment" means the treatment of a person who has a co-occurring mental 
317.24 	illness and substance use disorder. Co-occurring substance use disorder treatment is 
317.25 	characterized by stage-wise comprehensive treatment, treatment goal setting, and flexibility 
317.26 	for clients at each stage of treatment. Co-occurring substance use disorder treatment includes 
317.27 	assessing and tracking each client's stage of change readiness and treatment using a treatment 
317.28 	approach based on a client's stage of change, such as motivational interviewing when working 
317.29 	with a client at an earlier stage of change readiness and a cognitive behavioral approach 
317.30 	and relapse prevention to work with a client at a later stage of change; and facilitating a 
317.31 	client's access to community supports.
317.32 		Subd. 12.Crisis plan. "Crisis plan" means a plan to prevent and de-escalate a client's 
317.33 	future crisis situation, with the goal of preventing future crises for the client and the client's 
318.1 	family and other natural supports. Crisis plan includes a crisis plan developed according to 
318.2 	section 245.4871, subdivision 9a.
318.3 		Subd. 13.Critical incident. "Critical incident" means an occurrence involving a client 
318.4 	that requires a license holder to respond in a manner that is not part of the license holder's 
318.5 	ordinary daily routine. Critical incident includes a client's suicide, attempted suicide, or 
318.6 	homicide; a client's death; an injury to a client or other person that is life-threatening or 
318.7 	requires medical treatment; a fire that requires a fire department's response; alleged 
318.8 	maltreatment of a client; an assault of a client; an assault by a client; or other situation that 
318.9 	requires a response by law enforcement, the fire department, an ambulance, or another 
318.10 	emergency response provider.
318.11 		Subd. 14.Diagnostic assessment. "Diagnostic assessment" means the evaluation and 
318.12 	report of a client's potential diagnoses that a mental health professional or clinical trainee 
318.13 	completes under section 245I.10, subdivisions 4 to 6.
318.14 		Subd. 15.Direct contact. "Direct contact" has the meaning given in section 245C.02, 
318.15 	subdivision 11.
318.16 		Subd. 16.Family and other natural supports. "Family and other natural supports" 
318.17 	means the people whom a client identifies as having a high degree of importance to the 
318.18 	client. Family and other natural supports also means people that the client identifies as being 
318.19 	important to the client's mental health treatment, regardless of whether the person is related 
318.20 	to the client or lives in the same household as the client.
318.21 		Subd. 17.Functional assessment. "Functional assessment" means the assessment of a 
318.22 	client's current level of functioning relative to functioning that is appropriate for someone 
318.23 	the client's age. For a client five years of age or younger, a functional assessment is the 
318.24 	Early Childhood Service Intensity Instrument (ESCII). For a client six to 17 years of age, 
318.25 	a functional assessment is the Child and Adolescent Service Intensity Instrument (CASII). 
318.26 	For a client 18 years of age or older, a functional assessment is the functional assessment 
318.27 	described in section 245I.10, subdivision 9.
318.28 		Subd. 18.Individual abuse prevention plan. "Individual abuse prevention plan" means 
318.29 	a plan according to section 245A.65, subdivision 2, paragraph (b), and section 626.557, 
318.30 	subdivision 14.
318.31 		Subd. 19.Level of care assessment. "Level of care assessment" means the level of care 
318.32 	decision support tool appropriate to the client's age. For a client five years of age or younger, 
318.33 	a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For 
318.34 	a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service 
319.1 	Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment 
319.2 	is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS).
319.3 		Subd. 20.License. "License" has the meaning given in section 245A.02, subdivision 8.
319.4 		Subd. 21.License holder. "License holder" has the meaning given in section 245A.02, 
319.5 	subdivision 9.
319.6 		Subd. 22.Licensed prescriber. "Licensed prescriber" means an individual who is 
319.7 	authorized to prescribe legend drugs under section 151.37.
319.8 		Subd. 23.Mental health behavioral aide. "Mental health behavioral aide" means a 
319.9 	staff person who is qualified under section 245I.04, subdivision 16.
319.10 		Subd. 24.Mental health certified family peer specialist. "Mental health certified 
319.11 	family peer specialist" means a staff person who is qualified under section 245I.04, 
319.12 	subdivision 12.
319.13 		Subd. 25.Mental health certified peer specialist. "Mental health certified peer 
319.14 	specialist" means a staff person who is qualified under section 245I.04, subdivision 10.
319.15 		Subd. 26.Mental health practitioner. "Mental health practitioner" means a staff person 
319.16 	who is qualified under section 245I.04, subdivision 4.
319.17 		Subd. 27.Mental health professional. "Mental health professional" means a staff person 
319.18 	who is qualified under section 245I.04, subdivision 2.
319.19 		Subd. 28.Mental health rehabilitation worker. "Mental health rehabilitation worker" 
319.20 	means a staff person who is qualified under section 245I.04, subdivision 14.
319.21 		Subd. 29.Mental illness. "Mental illness" means any of the conditions included in the 
319.22 	most recent editions of the DC: 0-5 Diagnostic Classification of Mental Health and 
319.23 	Development Disorders of Infancy and Early Childhood published by Zero to Three or the 
319.24 	Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric 
319.25 	Association.
319.26 		Subd. 30.Organization. "Organization" has the meaning given in section 245A.02, 
319.27 	subdivision 10c.
319.28 		Subd. 31.Personnel file. "Personnel file" means a set of records under section 245I.07, 
319.29 	paragraph (a). Personnel files excludes information related to a person's employment that 
319.30 	is not included in section 245I.07.
319.31 		Subd. 32.Registered nurse. "Registered nurse" means a staff person who is qualified 
319.32 	under section 148.171, subdivision 20.
320.1 		Subd. 33.Rehabilitative mental health services. "Rehabilitative mental health services" 
320.2 	means mental health services provided to an adult client that enable the client to develop 
320.3 	and achieve psychiatric stability, social competencies, personal and emotional adjustment, 
320.4 	independent living skills, family roles, and community skills when symptoms of mental 
320.5 	illness has impaired any of the client's abilities in these areas.
320.6 		Subd. 34.Residential program. "Residential program" has the meaning given in section 
320.7 	245A.02, subdivision 14.
320.8 		Subd. 35.Signature. "Signature" means a written signature or an electronic signature 
320.9 	defined in section 325L.02, paragraph (h).
320.10 		Subd. 36.Staff person. "Staff person" means an individual who works under a license 
320.11 	holder's direction or under a contract with a license holder. Staff person includes an intern, 
320.12 	consultant, contractor, individual who works part-time, and an individual who does not 
320.13 	provide direct contact services to clients. Staff person includes a volunteer who provides 
320.14 	treatment services to a client or a volunteer whom the license holder regards as a staff person 
320.15 	for the purpose of meeting staffing or service delivery requirements. A staff person must 
320.16 	be 18 years of age or older.
320.17 		Subd. 37.Strengths. "Strengths" means a person's inner characteristics, virtues, external 
320.18 	relationships, activities, and connections to resources that contribute to a client's resilience 
320.19 	and core competencies. A person can build on strengths to support recovery.
320.20 		Subd. 38.Trauma. "Trauma" means an event, series of events, or set of circumstances 
320.21 	that is experienced by an individual as physically or emotionally harmful or life-threatening 
320.22 	that has lasting adverse effects on the individual's functioning and mental, physical, social, 
320.23 	emotional, or spiritual well-being. Trauma includes group traumatic experiences. Group 
320.24 	traumatic experiences are emotional or psychological harm that a group experiences. Group 
320.25 	traumatic experiences can be transmitted across generations within a community and are 
320.26 	often associated with racial and ethnic population groups who suffer major intergenerational 
320.27 	losses.
320.28 		Subd. 39.Treatment plan. "Treatment plan" means services that a license holder 
320.29 	formulates to respond to a client's needs and goals. A treatment plan includes individual 
320.30 	treatment plans under section 245I.10, subdivisions 7 and 8; initial treatment plans under 
320.31 	section 245I.23, subdivision 7; and crisis treatment plans under sections 245I.23, subdivision 
320.32 	8, and 256B.0624, subdivision 11.
321.1 		Subd. 40.Treatment supervision. "Treatment supervision" means a mental health 
321.2 	professional's or certified rehabilitation specialist's oversight, direction, and evaluation of 
321.3 	a staff person providing services to a client according to section 245I.06.
321.4 		Subd. 41.Volunteer. "Volunteer" means an individual who, under the direction of the 
321.5 	license holder, provides services to or facilitates an activity for a client without compensation.

321.6 	Sec. 4. [245I.03] REQUIRED POLICIES AND PROCEDURES.
321.7 		Subdivision 1.Generally. A license holder must establish, enforce, and maintain policies 
321.8 	and procedures to comply with the requirements of this chapter and chapters 245A, 245C, 
321.9 	and 260E; sections 626.557 and 626.5572; and Minnesota Rules, chapter 9544. The license 
321.10 	holder must make all policies and procedures available in writing to each staff person. The 
321.11 	license holder must complete and document a review of policies and procedures every two 
321.12 	years and update policies and procedures as necessary. Each policy and procedure must 
321.13 	identify the date that it was initiated and the dates of all revisions. The license holder must 
321.14 	clearly communicate any policy and procedural change to each staff person and provide 
321.15 	necessary training to each staff person to implement any policy and procedural change.
321.16 		Subd. 2.Health and safety. A license holder must have policies and procedures to 
321.17 	ensure the health and safety of each staff person and client during the provision of services, 
321.18 	including policies and procedures for services based in community settings.
321.19 		Subd. 3.Client rights. A license holder must have policies and procedures to ensure 
321.20 	that each staff person complies with the client rights and protections requirements in section 
321.21 	245I.12.
321.22 		Subd. 4.Behavioral emergencies. (a) A license holder must have procedures that each 
321.23 	staff person follows when responding to a client who exhibits behavior that threatens the 
321.24 	immediate safety of the client or others. A license holder's behavioral emergency procedures 
321.25 	must incorporate person-centered planning and trauma-informed care.
321.26 	(b) A license holder's behavioral emergency procedures must include:
321.27 	(1) a plan designed to prevent the client from inflicting self-harm and harming others;
321.28 	(2) contact information for emergency resources that a staff person must use when the 
321.29 	license holder's behavioral emergency procedures are unsuccessful in controlling a client's 
321.30 	behavior;
321.31 	(3) the types of behavioral emergency procedures that a staff person may use;
322.1 	(4) the specific circumstances under which the program may use behavioral emergency 
322.2 	procedures; and
322.3 	(5) the staff persons whom the license holder authorizes to implement behavioral 
322.4 	emergency procedures.
322.5 	(c) The license holder's behavioral emergency procedures must not include secluding 
322.6 	or restraining a client except as allowed under section 245.8261.
322.7 	(d) Staff persons must not use behavioral emergency procedures to enforce program 
322.8 	rules or for the convenience of staff persons. Behavioral emergency procedures must not 
322.9 	be part of any client's treatment plan. A staff person may not use behavioral emergency 
322.10 	procedures except in response to a client's current behavior that threatens the immediate 
322.11 	safety of the client or others.
322.12 		Subd. 5.Health services and medications. If a license holder is licensed as a residential 
322.13 	program, stores or administers client medications, or observes clients self-administer 
322.14 	medications, the license holder must ensure that a staff person who is a registered nurse or 
322.15 	licensed prescriber reviews and approves of the license holder's policies and procedures to 
322.16 	comply with the health services and medications requirements in section 245I.11, the training 
322.17 	requirements in section 245I.05, subdivision 6, and the documentation requirements in 
322.18 	section 245I.08, subdivision 5.
322.19 		Subd. 6.Reporting maltreatment. A license holder must have policies and procedures 
322.20 	for reporting a staff person's suspected maltreatment, abuse, or neglect of a client according 
322.21 	to chapter 260E and section 626.557.
322.22 		Subd. 7.Critical incidents. If a license holder is licensed as a residential program, the 
322.23 	license holder must have policies and procedures for reporting and maintaining records of 
322.24 	critical incidents according to section 245I.13.
322.25 		Subd. 8.Personnel. A license holder must have personnel policies and procedures that:
322.26 	(1) include a chart or description of the organizational structure of the program that 
322.27 	indicates positions and lines of authority;
322.28 	(2) ensure that it will not adversely affect a staff person's retention, promotion, job 
322.29 	assignment, or pay when a staff person communicates in good faith with the Department 
322.30 	of Human Services, the Office of Ombudsman for Mental Health and Developmental 
322.31 	Disabilities, the Department of Health, a health-related licensing board, a law enforcement 
322.32 	agency, or a local agency investigating a complaint regarding a client's rights, health, or 
322.33 	safety;
323.1 	(3) prohibit a staff person from having sexual contact with a client in violation of chapter 
323.2 	604, sections 609.344 or 609.345;
323.3 	(4) prohibit a staff person from neglecting, abusing, or maltreating a client as described 
323.4 	in chapter 260E and sections 626.557 and 626.5572;
323.5 	(5) include the drug and alcohol policy described in section 245A.04, subdivision 1, 
323.6 	paragraph (c);
323.7 	(6) describe the process for disciplinary action, suspension, or dismissal of a staff person 
323.8 	for violating a policy provision described in clauses (3) to (5);
323.9 	(7) describe the license holder's response to a staff person who violates other program 
323.10 	policies or who has a behavioral problem that interferes with providing treatment services 
323.11 	to clients; and
323.12 	(8) describe each staff person's position that includes the staff person's responsibilities, 
323.13 	authority to execute the responsibilities, and qualifications for the position.
323.14 		Subd. 9.Volunteers. A license holder must have policies and procedures for using 
323.15 	volunteers, including when a license holder must submit a background study for a volunteer, 
323.16 	and the specific tasks that a volunteer may perform.
323.17 		Subd. 10.Data privacy. (a) A license holder must have policies and procedures that 
323.18 	comply with all applicable state and federal law. A license holder's use of electronic record 
323.19 	keeping or electronic signatures does not alter a license holder's obligations to comply with 
323.20 	applicable state and federal law.
323.21 	(b) A license holder must have policies and procedures for a staff person to promptly 
323.22 	document a client's revocation of consent to disclose the client's health record. The license 
323.23 	holder must verify that the license holder has permission to disclose a client's health record 
323.24 	before releasing any client data.

323.25 	Sec. 5. [245I.04] PROVIDER QUALIFICATIONS AND SCOPE OF PRACTICE.
323.26 		Subdivision 1.Tribal providers. For purposes of this section, a Tribal entity may 
323.27 	credential an individual according to section 256B.02, subdivision 7, paragraphs (b) and 
323.28 	(c).
323.29 		Subd. 2.Mental health professional qualifications. The following individuals may 
323.30 	provide services to a client as a mental health professional:
323.31 	(1) a registered nurse who is licensed under sections 148.171 to 148.285 and is certified 
323.32 	as a: (i) clinical nurse specialist in child or adolescent, family, or adult psychiatric and 
324.1 	mental health nursing by a national certification organization; or (ii) nurse practitioner in 
324.2 	adult or family psychiatric and mental health nursing by a national nurse certification 
324.3 	organization;
324.4 	(2) a licensed independent clinical social worker as defined in section 148E.050, 
324.5 	subdivision 5;
324.6 	(3) a psychologist licensed by the Board of Psychology under sections 148.88 to 148.98;
324.7 	(4) a physician licensed under chapter 147 if the physician is: (i) certified by the American 
324.8 	Board of Psychiatry and Neurology; (ii) certified by the American Osteopathic Board of 
324.9 	Neurology and Psychiatry; or (iii) eligible for board certification in psychiatry;
324.10 	(5) a marriage and family therapist licensed under sections 148B.29 to 148B.392; or
324.11 	(6) a licensed professional clinical counselor licensed under section 148B.5301.
324.12 		Subd. 3.Mental health professional scope of practice. A mental health professional 
324.13 	must maintain a valid license with the mental health professional's governing health-related 
324.14 	licensing board and must only provide services to a client within the scope of practice 
324.15 	determined by the applicable health-related licensing board.
324.16 		Subd. 4.Mental health practitioner qualifications. (a) An individual who is qualified 
324.17 	in at least one of the ways described in paragraph (b) to (d) may serve as a mental health 
324.18 	practitioner.
324.19 	(b) An individual is qualified as a mental health practitioner through relevant coursework 
324.20 	if the individual completes at least 30 semester hours or 45 quarter hours in behavioral 
324.21 	sciences or related fields and:
324.22 	(1) has at least 2,000 hours of experience providing services to individuals with:
324.23 	(i) a mental illness or a substance use disorder; or
324.24 	(ii) a traumatic brain injury or a developmental disability, and completes the additional 
324.25 	training described in section 245I.05, subdivision 3, paragraph (c), before providing direct 
324.26 	contact services to a client;
324.27 	(2) is fluent in the non-English language of the ethnic group to which at least 50 percent 
324.28 	of the individual's clients belong, and completes the additional training described in section 
324.29 	245I.05, subdivision 3, paragraph (c), before providing direct contact services to a client;
324.30 	(3) is working in a day treatment program under section 256B.0671, subdivision 3, or 
324.31 	256B.0943; or
325.1 	(4) has completed a practicum or internship that (i) required direct interaction with adult 
325.2 	clients or child clients, and (ii) was focused on behavioral sciences or related fields.
325.3 	(c) An individual is qualified as a mental health practitioner through work experience 
325.4 	if the individual:
325.5 	(1) has at least 4,000 hours of experience in the delivery of services to individuals with:
325.6 	(i) a mental illness or a substance use disorder; or
325.7 	(ii) a traumatic brain injury or a developmental disability, and completes the additional 
325.8 	training described in section 245I.05, subdivision 3, paragraph (c), before providing direct 
325.9 	contact services to clients; or
325.10 	(2) receives treatment supervision at least once per week until meeting the requirement 
325.11 	in clause (1) of 4,000 hours of experience and has at least 2,000 hours of experience providing 
325.12 	services to individuals with:
325.13 	(i) a mental illness or a substance use disorder; or
325.14 	(ii) a traumatic brain injury or a developmental disability, and completes the additional 
325.15 	training described in section 245I.05, subdivision 3, paragraph (c), before providing direct 
325.16 	contact services to clients.
325.17 	(d) An individual is qualified as a mental health practitioner if the individual has a 
325.18 	master's or other graduate degree in behavioral sciences or related fields.
325.19 		Subd. 5.Mental health practitioner scope of practice. (a) A mental health practitioner 
325.20 	under the treatment supervision of a mental health professional or certified rehabilitation 
325.21 	specialist may provide an adult client with client education, rehabilitative mental health 
325.22 	services, functional assessments, level of care assessments, and treatment plans. A mental 
325.23 	health practitioner under the treatment supervision of a mental health professional may 
325.24 	provide skill-building services to a child client and complete treatment plans for a child 
325.25 	client.
325.26 	(b) A mental health practitioner must not provide treatment supervision to other staff 
325.27 	persons. A mental health practitioner may provide direction to mental health rehabilitation 
325.28 	workers and mental health behavioral aides.
325.29 	(c) A mental health practitioner who provides services to clients according to section 
325.30 	256B.0624 or 256B.0944 may perform crisis assessments and interventions for a client.
325.31 		Subd. 6.Clinical trainee qualifications. (a) A clinical trainee is a staff person who: (1) 
325.32 	is enrolled in an accredited graduate program of study to prepare the staff person for 
326.1 	independent licensure as a mental health professional and who is participating in a practicum 
326.2 	or internship with the license holder through the individual's graduate program; or (2) has 
326.3 	completed an accredited graduate program of study to prepare the staff person for independent 
326.4 	licensure as a mental health professional and who is in compliance with the requirements 
326.5 	of the applicable health-related licensing board, including requirements for supervised 
326.6 	practice.
326.7 	(b) A clinical trainee is responsible for notifying and applying to a health-related licensing 
326.8 	board to ensure that the trainee meets the requirements of the health-related licensing board. 
326.9 	As permitted by a health-related licensing board, treatment supervision under this chapter 
326.10 	may be integrated into a plan to meet the supervisory requirements of the health-related 
326.11 	licensing board but does not supersede those requirements.
326.12 		Subd. 7.Clinical trainee scope of practice. (a) A clinical trainee under the treatment 
326.13 	supervision of a mental health professional may provide a client with psychotherapy, client 
326.14 	education, rehabilitative mental health services, diagnostic assessments, functional 
326.15 	assessments, level of care assessments, and treatment plans.
326.16 	(b) A clinical trainee must not provide treatment supervision to other staff persons. A 
326.17 	clinical trainee may provide direction to mental health behavioral aides and mental health 
326.18 	rehabilitation workers.
326.19 	(c) A psychological clinical trainee under the treatment supervision of a psychologist 
326.20 	may perform psychological testing of clients.
326.21 	(d) A clinical trainee must not provide services to clients that violate any practice act of 
326.22 	a health-related licensing board, including failure to obtain licensure if licensure is required.
326.23 		Subd. 8.Certified rehabilitation specialist qualifications. A certified rehabilitation 
326.24 	specialist must have:
326.25 	(1) a master's degree from an accredited college or university in behavioral sciences or 
326.26 	related fields;
326.27 	(2) at least 4,000 hours of post-master's supervised experience providing mental health 
326.28 	services to clients; and
326.29 	(3) a valid national certification as a certified rehabilitation counselor or certified 
326.30 	psychosocial rehabilitation practitioner.
326.31 		Subd. 9.Certified rehabilitation specialist scope of practice. (a) A certified 
326.32 	rehabilitation specialist may provide an adult client with client education, rehabilitative 
327.1 	mental health services, functional assessments, level of care assessments, and treatment 
327.2 	plans.
327.3 	(b) A certified rehabilitation specialist may provide treatment supervision to a mental 
327.4 	health certified peer specialist, mental health practitioner, and mental health rehabilitation 
327.5 	worker.
327.6 		Subd. 10.Mental health certified peer specialist qualifications. A mental health 
327.7 	certified peer specialist must:
327.8 	(1) have been diagnosed with a mental illness;
327.9 	(2) be a current or former mental health services client; and
327.10 	(3) have a valid certification as a mental health certified peer specialist under section 
327.11 	256B.0615.
327.12 		Subd. 11.Mental health certified peer specialist scope of practice. A mental health 
327.13 	certified peer specialist under the treatment supervision of a mental health professional or 
327.14 	certified rehabilitation specialist must:
327.15 	(1) provide individualized peer support to each client;
327.16 	(2) promote a client's recovery goals, self-sufficiency, self-advocacy, and development 
327.17 	of natural supports; and
327.18 	(3) support a client's maintenance of skills that the client has learned from other services.
327.19 		Subd. 12.Mental health certified family peer specialist qualifications. A mental 
327.20 	health certified family peer specialist must:
327.21 	(1) have raised or be currently raising a child with a mental illness;
327.22 	(2) have experience navigating the children's mental health system; and
327.23 	(3) have a valid certification as a mental health certified family peer specialist under 
327.24 	section 256B.0616.
327.25 		Subd. 13.Mental health certified family peer specialist scope of practice. A mental 
327.26 	health certified family peer specialist under the treatment supervision of a mental health 
327.27 	professional must provide services to increase the child's ability to function in the child's 
327.28 	home, school, and community. The mental health certified family peer specialist must:
327.29 	(1) provide family peer support to build on a client's family's strengths and help the 
327.30 	family achieve desired outcomes;
328.1 	(2) provide nonadversarial advocacy to a child client and the child's family that 
328.2 	encourages partnership and promotes the child's positive change and growth;
328.3 	(3) support families in advocating for culturally appropriate services for a child in each 
328.4 	treatment setting;
328.5 	(4) promote resiliency, self-advocacy, and development of natural supports;
328.6 	(5) support maintenance of skills learned from other services;
328.7 	(6) establish and lead parent support groups;
328.8 	(7) assist parents in developing coping and problem-solving skills; and
328.9 	(8) educate parents about mental illnesses and community resources, including resources 
328.10 	that connect parents with similar experiences to one another.
328.11 		Subd. 14.Mental health rehabilitation worker qualifications. (a) A mental health 
328.12 	rehabilitation worker must:
328.13 	(1) have a high school diploma or equivalent; and
328.14 	(2) meet one of the following qualification requirements:
328.15 	(i) be fluent in the non-English language or competent in the culture of the ethnic group 
328.16 	to which at least 20 percent of the mental health rehabilitation worker's clients belong;
328.17 	(ii) have an associate of arts degree;
328.18 	(iii) have two years of full-time postsecondary education or a total of 15 semester hours 
328.19 	or 23 quarter hours in behavioral sciences or related fields;
328.20 	(iv) be a registered nurse;
328.21 	(v) have, within the previous ten years, three years of personal life experience with 
328.22 	mental illness;
328.23 	(vi) have, within the previous ten years, three years of life experience as a primary 
328.24 	caregiver to an adult with a mental illness, traumatic brain injury, substance use disorder, 
328.25 	or developmental disability; or
328.26 	(vii) have, within the previous ten years, 2,000 hours of work experience providing 
328.27 	health and human services to individuals.
328.28 	(b) A mental health rehabilitation worker who is scheduled as an overnight staff person 
328.29 	and works alone is exempt from the additional qualification requirements in paragraph (a), 
328.30 	clause (2).
329.1 		Subd. 15.Mental health rehabilitation worker scope of practice. A mental health 
329.2 	rehabilitation worker under the treatment supervision of a mental health professional or 
329.3 	certified rehabilitation specialist may provide rehabilitative mental health services to an 
329.4 	adult client according to the client's treatment plan.
329.5 		Subd. 16.Mental health behavioral aide qualifications. (a) A level 1 mental health 
329.6 	behavioral aide must have: (1) a high school diploma or equivalent; or (2) two years of 
329.7 	experience as a primary caregiver to a child with mental illness within the previous ten 
329.8 	years.
329.9 	(b) A level 2 mental health behavioral aide must: (1) have an associate or bachelor's 
329.10 	degree; or (2) be certified by a program under section 256B.0943, subdivision 8a.
329.11 		Subd. 17.Mental health behavioral aide scope of practice. While under the treatment 
329.12 	supervision of a mental health professional, a mental health behavioral aide may practice 
329.13 	psychosocial skills with a child client according to the child's treatment plan and individual 
329.14 	behavior plan that a mental health professional, clinical trainee, or mental health practitioner 
329.15 	has previously taught to the child.

329.16 	Sec. 6. [245I.05] TRAINING REQUIRED.
329.17 		Subdivision 1.Training plan. A license holder must develop a training plan to ensure 
329.18 	that staff persons receive ongoing training according to this section. The training plan must 
329.19 	include:
329.20 	(1) a formal process to evaluate the training needs of each staff person. An annual 
329.21 	performance evaluation of a staff person satisfies this requirement;
329.22 	(2) a description of how the license holder conducts ongoing training of each staff person, 
329.23 	including whether ongoing training is based on a staff person's hire date or a specified annual 
329.24 	cycle determined by the program;
329.25 	(3) a description of how the license holder verifies and documents each staff person's 
329.26 	previous training experience. A license holder may consider a staff person to have met a 
329.27 	training requirement in subdivision 3, paragraph (d) or (e), if the staff person has received 
329.28 	equivalent postsecondary education in the previous four years or training experience in the 
329.29 	previous two years; and
329.30 	(4) a description of how the license holder determines when a staff person needs 
329.31 	additional training, including when the license holder will provide additional training.
330.1 		Subd. 2.Documentation of training. (a) The license holder must provide training to 
330.2 	each staff person according to the training plan and must document that the license holder 
330.3 	provided the training to each staff person. The license holder must document the following 
330.4 	information for each staff person's training:
330.5 	(1) the topics of the training;
330.6 	(2) the name of the trainee;
330.7 	(3) the name and credentials of the trainer;
330.8 	(4) the license holder's method of evaluating the trainee's competency upon completion 
330.9 	of training;
330.10 	(5) the date of the training; and
330.11 	(6) the length of training in hours and minutes.
330.12 	(b) Documentation of a staff person's continuing education credit accepted by the 
330.13 	governing health-related licensing board is sufficient to document training for purposes of 
330.14 	this subdivision.
330.15 		Subd. 3.Initial training. (a) A staff person must receive training about:
330.16 	(1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and
330.17 	(2) the maltreatment of minor reporting requirements and definitions in chapter 260E 
330.18 	within 72 hours of first providing direct contact services to a client.
330.19 	(b) Before providing direct contact services to a client, a staff person must receive training 
330.20 	about:
330.21 	(1) client rights and protections under section 245I.12;
330.22 	(2) the Minnesota Health Records Act, including client confidentiality, family engagement 
330.23 	under section 144.294, and client privacy;
330.24 	(3) emergency procedures that the staff person must follow when responding to a fire, 
330.25 	inclement weather, a report of a missing person, and a behavioral or medical emergency;
330.26 	(4) specific activities and job functions for which the staff person is responsible, including 
330.27 	the license holder's program policies and procedures applicable to the staff person's position;
330.28 	(5) professional boundaries that the staff person must maintain; and
331.1 	(6) specific needs of each client to whom the staff person will be providing direct contact 
331.2 	services, including each client's developmental status, cognitive functioning, physical and 
331.3 	mental abilities.
331.4 	(c) Before providing direct contact services to a client, a mental health rehabilitation 
331.5 	worker, mental health behavioral aide, or mental health practitioner qualified under section 
331.6 	245I.04, subdivision 4, must receive 30 hours of training about:
331.7 	(1) mental illnesses;
331.8 	(2) client recovery and resiliency;
331.9 	(3) mental health de-escalation techniques;
331.10 	(4) co-occurring mental illness and substance use disorders; and
331.11 	(5) psychotropic medications and medication side effects.
331.12 	(d) Within 90 days of first providing direct contact services to an adult client, a clinical 
331.13 	trainee, mental health practitioner, mental health certified peer specialist, or mental health 
331.14 	rehabilitation worker must receive training about:
331.15 	(1) trauma-informed care and secondary trauma;
331.16 	(2) person-centered individual treatment plans, including seeking partnerships with 
331.17 	family and other natural supports;
331.18 	(3) co-occurring substance use disorders; and
331.19 	(4) culturally responsive treatment practices.
331.20 	(e) Within 90 days of first providing direct contact services to a child client, a clinical 
331.21 	trainee, mental health practitioner, mental health certified family peer specialist, mental 
331.22 	health certified peer specialist, or mental health behavioral aide must receive training about 
331.23 	the topics in clauses (1) to (5). This training must address the developmental characteristics 
331.24 	of each child served by the license holder and address the needs of each child in the context 
331.25 	of the child's family, support system, and culture. Training topics must include:
331.26 	(1) trauma-informed care and secondary trauma, including adverse childhood experiences 
331.27 	(ACEs);
331.28 	(2) family-centered treatment plan development, including seeking partnership with a 
331.29 	child client's family and other natural supports;
331.30 	(3) mental illness and co-occurring substance use disorders in family systems;
331.31 	(4) culturally responsive treatment practices; and
332.1 	(5) child development, including cognitive functioning, and physical and mental abilities.
332.2 	(f) For a mental health behavioral aide, the training under paragraph (e) must include 
332.3 	parent team training using a curriculum approved by the commissioner.
332.4 		Subd. 4.Ongoing training. (a) A license holder must ensure that staff persons who 
332.5 	provide direct contact services to clients receive annual training about the topics in 
332.6 	subdivision 3, paragraphs (a) and (b), clauses (1) to (3).
332.7 	(b) A license holder must ensure that each staff person who is qualified under section 
332.8 	245I.04 who is not a mental health professional receives 30 hours of training every two 
332.9 	years. The training topics must be based on the program's needs and the staff person's areas 
332.10 	of competency.
332.11 		Subd. 5.Additional training for medication administration. (a) Prior to administering 
332.12 	medications to a client under delegated authority or observing a client self-administer 
332.13 	medications, a staff person who is not a licensed prescriber, registered nurse, or licensed 
332.14 	practical nurse qualified under section 148.171, subdivision 8, must receive training about 
332.15 	psychotropic medications, side effects, and medication management.
332.16 	(b) Prior to administering medications to a client under delegated authority, a staff person 
332.17 	must successfully complete a:
332.18 	(1) medication administration training program for unlicensed personnel through an 
332.19 	accredited Minnesota postsecondary educational institution with completion of the course 
332.20 	documented in writing and placed in the staff person's personnel file; or
332.21 	(2) formalized training program taught by a registered nurse or licensed prescriber that 
332.22 	is offered by the license holder. A staff person's successful completion of the formalized 
332.23 	training program must include direct observation of the staff person to determine the staff 
332.24 	person's areas of competency.

332.25 	Sec. 7. [245I.06] TREATMENT SUPERVISION.
332.26 		Subdivision 1.Generally. (a) A license holder must ensure that a mental health 
332.27 	professional or certified rehabilitation specialist provides treatment supervision to each staff 
332.28 	person who provides services to a client and who is not a mental health professional or 
332.29 	certified rehabilitation specialist. When providing treatment supervision, a treatment 
332.30 	supervisor must follow a staff person's written treatment supervision plan.
333.1 	(b) Treatment supervision must focus on each client's treatment needs and the ability of 
333.2 	the staff person under treatment supervision to provide services to each client, including 
333.3 	the following topics related to the staff person's current caseload:
333.4 	(1) a review and evaluation of the interventions that the staff person delivers to each 
333.5 	client;
333.6 	(2) instruction on alternative strategies if a client is not achieving treatment goals;
333.7 	(3) a review and evaluation of each client's assessments, treatment plans, and progress 
333.8 	notes for accuracy and appropriateness;
333.9 	(4) instruction on the cultural norms or values of the clients and communities that the 
333.10 	license holder serves and the impact that a client's culture has on providing treatment;
333.11 	(5) evaluation of and feedback regarding a direct service staff person's areas of 
333.12 	competency; and
333.13 	(6) coaching, teaching, and practicing skills with a staff person.
333.14 	(c) A treatment supervisor must provide treatment supervision to a staff person using 
333.15 	methods that allow for immediate feedback, including in-person, telephone, and interactive 
333.16 	video supervision.
333.17 	(d) A treatment supervisor's responsibility for a staff person receiving treatment 
333.18 	supervision is limited to the services provided by the associated license holder. If a staff 
333.19 	person receiving treatment supervision is employed by multiple license holders, each license 
333.20 	holder is responsible for providing treatment supervision related to the treatment of the 
333.21 	license holder's clients.
333.22 		Subd. 2.Treatment supervision planning. (a) A treatment supervisor and the staff 
333.23 	person supervised by the treatment supervisor must develop a written treatment supervision 
333.24 	plan. The license holder must ensure that a new staff person's treatment supervision plan is 
333.25 	completed and implemented by a treatment supervisor and the new staff person within 30 
333.26 	days of the new staff person's first day of employment. The license holder must review and 
333.27 	update each staff person's treatment supervision plan annually.
333.28 	(b) Each staff person's treatment supervision plan must include:
333.29 	(1) the name and qualifications of the staff person receiving treatment supervision;
333.30 	(2) the names and licensures of the treatment supervisors who are supervising the staff 
333.31 	person;
334.1 	(3) how frequently the treatment supervisors must provide treatment supervision to the 
334.2 	staff person; and
334.3 	(4) the staff person's authorized scope of practice, including a description of the client 
334.4 	population that the staff person serves, and a description of the treatment methods and 
334.5 	modalities that the staff person may use to provide services to clients.
334.6 		Subd. 3.Treatment supervision and direct observation of mental health 
334.7 	rehabilitation workers and mental health behavioral aides. (a) A mental health behavioral 
334.8 	aide or a mental health rehabilitation worker must receive direct observation from a mental 
334.9 	health professional, clinical trainee, certified rehabilitation specialist, or mental health 
334.10 	practitioner while the mental health behavioral aide or mental health rehabilitation worker 
334.11 	provides treatment services to clients, no less than twice per month for the first six months 
334.12 	of employment and once per month thereafter. The staff person performing the direct 
334.13 	observation must approve of the progress note for the observed treatment service.
334.14 	(b) For a mental health rehabilitation worker qualified under section 245I.04, subdivision 
334.15 	14, paragraph (a), clause (2), item (i), treatment supervision in the first 2,000 hours of work 
334.16 	must at a minimum consist of:
334.17 	(1) monthly individual supervision; and
334.18 	(2) direct observation twice per month.

334.19 	Sec. 8. [245I.07] PERSONNEL FILES.
334.20 	(a) For each staff person, a license holder must maintain a personnel file that includes:
334.21 	(1) verification of the staff person's qualifications required for the position including 
334.22 	training, education, practicum or internship agreement, licensure, and any other required 
334.23 	qualifications;
334.24 	(2) documentation related to the staff person's background study;
334.25 	(3) the hiring date of the staff person;
334.26 	(4) a description of the staff person's job responsibilities with the license holder;
334.27 	(5) the date that the staff person's specific duties and responsibilities became effective, 
334.28 	including the date that the staff person began having direct contact with clients;
334.29 	(6) documentation of the staff person's training as required by section 245I.05, subdivision 
334.30 	2;
335.1 	(7) a verification copy of license renewals that the staff person completed during the 
335.2 	staff person's employment;
335.3 	(8) annual job performance evaluations; and
335.4 	(9) if applicable, the staff person's alleged and substantiated violations of the license 
335.5 	holder's policies under section 245I.03, subdivision 8, clauses (3) to (7), and the license 
335.6 	holder's response.
335.7 	(b) The license holder must ensure that all personnel files are readily accessible for the 
335.8 	commissioner's review. The license holder is not required to keep personnel files in a single 
335.9 	location.

335.10 	Sec. 9. [245I.08] DOCUMENTATION STANDARDS.
335.11 		Subdivision 1.Generally. A license holder must ensure that all documentation required 
335.12 	by this chapter complies with this section.
335.13 		Subd. 2.Documentation standards. A license holder must ensure that all documentation 
335.14 	required by this chapter:
335.15 	(1) is legible;
335.16 	(2) identifies the applicable client and staff person on each page; and
335.17 	(3) is signed and dated by the staff persons who provided services to the client or 
335.18 	completed the documentation, including the staff persons' credentials.
335.19 		Subd. 3.Documenting approval. A license holder must ensure that all diagnostic 
335.20 	assessments, functional assessments, level of care assessments, and treatment plans completed 
335.21 	by a clinical trainee or mental health practitioner contain documentation of approval by a 
335.22 	treatment supervisor within five business days of initial completion by the staff person under 
335.23 	treatment supervision.
335.24 		Subd. 4.Progress notes. A license holder must use a progress note to document each 
335.25 	occurrence of a mental health service that a staff person provides to a client. A progress 
335.26 	note must include the following:
335.27 	(1) the type of service;
335.28 	(2) the date of service;
335.29 	(3) the start and stop time of the service unless the license holder is licensed as a 
335.30 	residential program;
335.31 	(4) the location of the service;
336.1 	(5) the scope of the service, including: (i) the targeted goal and objective; (ii) the 
336.2 	intervention that the staff person provided to the client and the methods that the staff person 
336.3 	used; (iii) the client's response to the intervention; (iv) the staff person's plan to take future 
336.4 	actions, including changes in treatment that the staff person will implement if the intervention 
336.5 	was ineffective; and (v) the service modality;
336.6 	(6) the signature, printed name, and credentials of the staff person who provided the 
336.7 	service to the client;
336.8 	(7) the mental health provider travel documentation required by section 256B.0625, if 
336.9 	applicable; and
336.10 	(8) significant observations by the staff person, if applicable, including: (i) the client's 
336.11 	current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with 
336.12 	or referrals to other professionals, family, or significant others; and (iv) changes in the 
336.13 	client's mental or physical symptoms.
336.14 		Subd. 5.Medication administration record. If a license holder administers or observes 
336.15 	a client self-administer medications, the license holder must maintain a medication 
336.16 	administration record for each client that contains the following, as applicable:
336.17 	(1) the client's date of birth;
336.18 	(2) the client's allergies;
336.19 	(3) all medication orders for the client, including client-specific orders for 
336.20 	over-the-counter medications and approved condition-specific protocols;
336.21 	(4) the name of each ordered medication, date of each medication's expiration, each 
336.22 	medication's dosage frequency, method of administration, and time;
336.23 	(5) the licensed prescriber's name and telephone number;
336.24 	(6) the date of initiation;
336.25 	(7) the signature, printed name, and credentials of the staff person who administered the 
336.26 	medication or observed the client self-administer the medication; and
336.27 	(8) the reason that the license holder did not administer the client's prescribed medication 
336.28 	or observe the client self-administer the client's prescribed medication.

336.29 	Sec. 10. [245I.09] CLIENT FILES.
336.30 		Subdivision 1.Generally. (a) A license holder must maintain a file for each client that 
336.31 	contains the client's current and accurate records. The license holder must store each client 
337.1 	file on the premises where the license holder provides or coordinates services for the client. 
337.2 	The license holder must ensure that all client files are readily accessible for the 
337.3 	commissioner's review. The license holder is not required to keep client files in a single 
337.4 	location.
337.5 	(b) The license holder must protect client records against loss, tampering, or unauthorized 
337.6 	disclosure of confidential client data according to the Minnesota Government Data Practices 
337.7 	Act, chapter 13; the privacy provisions of the Minnesota health care programs provider 
337.8 	agreement; the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 
337.9 	Public Law 104-191; and the Minnesota Health Records Act, sections 144.291 to 144.298.
337.10 		Subd. 2.Record retention. A license holder must retain client records of a discharged 
337.11 	client for a minimum of five years from the date of the client's discharge. A license holder 
337.12 	who ceases to provide treatment services to a client must retain the client's records for a 
337.13 	minimum of five years from the date that the license holder stopped providing services to 
337.14 	the client and must notify the commissioner of the location of the client records and the 
337.15 	name of the individual responsible for storing and maintaining the client records.
337.16 		Subd. 3.Contents. A license holder must retain a clear and complete record of the 
337.17 	information that the license holder receives regarding a client, and of the services that the 
337.18 	license holder provides to the client. If applicable, each client's file must include the following 
337.19 	information:
337.20 	(1) the client's screenings, assessments, and testing;
337.21 	(2) the client's treatment plans and reviews of the client's treatment plan;
337.22 	(3) the client's individual abuse prevention plans;
337.23 	(4) the client's health care directive under section 145C.01, subdivision 5a, and the 
337.24 	client's emergency contacts;
337.25 	(5) the client's crisis plans;
337.26 	(6) the client's consents for releases of information and documentation of the client's 
337.27 	releases of information;
337.28 	(7) the client's significant medical and health-related information;
337.29 	(8) a record of each communication that a staff person has with the client's other mental 
337.30 	health providers and persons interested in the client, including the client's case manager, 
337.31 	family members, primary caregiver, legal representatives, court representatives, 
337.32 	representatives from the correctional system, or school administration;
338.1 	(9) written information by the client that the client requests to include in the client's file; 
338.2 	and
338.3 	(10) the date of the client's discharge from the license holder's program, the reason that 
338.4 	the license holder discontinued services for the client, and the client's discharge summaries.

338.5 	Sec. 11. [245I.10] ASSESSMENT AND TREATMENT PLANNING.
338.6 		Subdivision 1.Definitions. (a) "Diagnostic formulation" means a written analysis and 
338.7 	explanation of a client's clinical assessment to develop a hypothesis about the cause and 
338.8 	nature of a client's presenting problems and to identify the most suitable approach for treating 
338.9 	the client.
338.10 	(b) "Responsivity factors" means the factors other than the diagnostic formulation that 
338.11 	may modify a client's treatment needs. This includes a client's learning style, abilities, 
338.12 	cognitive functioning, cultural background, and personal circumstances. When documenting 
338.13 	a client's responsivity factors a mental health professional or clinical trainee must include 
338.14 	an analysis of how a client's strengths are reflected in the license holder's plan to deliver 
338.15 	services to the client.
338.16 		Subd. 2.Generally. (a) A license holder must use a client's diagnostic assessment or 
338.17 	crisis assessment to determine a client's eligibility for mental health services, except as 
338.18 	provided in this section.
338.19 	(b) Prior to completing a client's initial diagnostic assessment, a license holder may 
338.20 	provide a client with the following services:
338.21 	(1) an explanation of findings;
338.22 	(2) neuropsychological testing, neuropsychological assessment, and psychological 
338.23 	testing;
338.24 	(3) any combination of psychotherapy sessions, family psychotherapy sessions, and 
338.25 	family psychoeducation sessions not to exceed three sessions;
338.26 	(4) crisis assessment services according to section 256B.0624; and
338.27 	(5) ten days of intensive residential treatment services according to the assessment and 
338.28 	treatment planning standards in section 245.23, subdivision 7.
338.29 	(c) Based on the client's needs that a crisis assessment identifies under section 256B.0624, 
338.30 	a license holder may provide a client with the following services:
339.1 	(1) crisis intervention and stabilization services under section 245I.23 or 256B.0624; 
339.2 	and
339.3 	(2) any combination of psychotherapy sessions, group psychotherapy sessions, family 
339.4 	psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions 
339.5 	within a 12-month period without prior authorization.
339.6 	(d) Based on the client's needs in the client's brief diagnostic assessment, a license holder 
339.7 	may provide a client with any combination of psychotherapy sessions, group psychotherapy 
339.8 	sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed 
339.9 	ten sessions within a 12-month period without prior authorization for any new client or for 
339.10 	an existing client who the license holder projects will need fewer than ten sessions during 
339.11 	the next 12 months.
339.12 	(e) Based on the client's needs that a hospital's medical history and presentation 
339.13 	examination identifies, a license holder may provide a client with:
339.14 	(1) any combination of psychotherapy sessions, group psychotherapy sessions, family 
339.15 	psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions 
339.16 	within a 12-month period without prior authorization for any new client or for an existing 
339.17 	client who the license holder projects will need fewer than ten sessions during the next 12 
339.18 	months; and
339.19 	(2) up to five days of day treatment services or partial hospitalization.
339.20 	(f) A license holder must complete a new standard diagnostic assessment of a client:
339.21 	(1) when the client requires services of a greater number or intensity than the services 
339.22 	that paragraphs (b) to (e) describe;
339.23 	(2) at least annually following the client's initial diagnostic assessment if the client needs 
339.24 	additional mental health services and the client does not meet the criteria for a brief 
339.25 	assessment;
339.26 	(3) when the client's mental health condition has changed markedly since the client's 
339.27 	most recent diagnostic assessment; or
339.28 	(4) when the client's current mental health condition does not meet the criteria of the 
339.29 	client's current diagnosis.
339.30 	(g) For an existing client, the license holder must ensure that a new standard diagnostic 
339.31 	assessment includes a written update containing all significant new or changed information 
339.32 	about the client, and an update regarding what information has not significantly changed, 
340.1 	including a discussion with the client about changes in the client's life situation, functioning, 
340.2 	presenting problems, and progress with achieving treatment goals since the client's last 
340.3 	diagnostic assessment was completed.
340.4 		Subd. 3.Continuity of services. (a) For any client with a diagnostic assessment 
340.5 	completed under Minnesota Rules, parts 9505.0370 to 9505.0372, before the effective date 
340.6 	of this section, the diagnostic assessment is valid for authorizing the client's treatment and 
340.7 	billing for one calendar year after the date that the assessment was completed.
340.8 	(b) For any client with an individual treatment plan completed under section 256B.0622, 
340.9 	256B.0623, 256B.0943, 256B.0946, or 256B.0947 or Minnesota Rules, parts 9505.0370 to 
340.10 	9505.0372, the client's treatment plan is valid for authorizing treatment and billing until the 
340.11 	treatment plan's expiration date.
340.12 	(c) This subdivision expires July 1, 2023.
340.13 		Subd. 4.Diagnostic assessment. A client's diagnostic assessment must: (1) identify at 
340.14 	least one mental health diagnosis for which the client meets the diagnostic criteria and 
340.15 	recommend mental health services to develop the client's mental health services and treatment 
340.16 	plan; or (2) include a finding that the client does not meet the criteria for a mental health 
340.17 	disorder.
340.18 		Subd. 5.Brief diagnostic assessment; required elements. (a) Only a mental health 
340.19 	professional or clinical trainee may complete a brief diagnostic assessment of a client. A 
340.20 	license holder may only use a brief diagnostic assessment for a client who is six years of 
340.21 	age or older.
340.22 	(b) When conducting a brief diagnostic assessment of a client, the assessor must complete 
340.23 	a face-to-face interview with the client and a written evaluation of the client. The assessor 
340.24 	must gather and document initial components of the client's standard diagnostic assessment, 
340.25 	including the client's:
340.26 	(1) age;
340.27 	(2) description of symptoms, including the reason for the client's referral;
340.28 	(3) history of mental health treatment;
340.29 	(4) cultural influences on the client; and
340.30 	(5) mental status examination.
340.31 	(c) Based on the initial components of the assessment, the assessor must develop a 
340.32 	provisional diagnostic formulation about the client. The assessor may use the client's 
341.1 	provisional diagnostic formulation to address the client's immediate needs and presenting 
341.2 	problems.
341.3 	(d) A mental health professional or clinical trainee may use treatment sessions with the 
341.4 	client authorized by a brief diagnostic assessment to gather additional information about 
341.5 	the client to complete the client's standard diagnostic assessment if the number of sessions 
341.6 	will exceed the coverage limits in subdivision 2.
341.7 		Subd. 6.Standard diagnostic assessment; required elements. (a) Only a mental health 
341.8 	professional or a clinical trainee may complete a standard diagnostic assessment of a client. 
341.9 	A standard diagnostic assessment of a client must include a face-to-face interview with a 
341.10 	client and a written evaluation of the client. The assessor must complete a client's standard 
341.11 	diagnostic assessment within the client's cultural context.
341.12 	(b) When completing a standard diagnostic assessment of a client, the assessor must 
341.13 	gather and document information about the client's current life situation, including the 
341.14 	following information:
341.15 	(1) the client's age;
341.16 	(2) the client's current living situation, including the client's housing status and household 
341.17 	members;
341.18 	(3) the status of the client's basic needs;
341.19 	(4) the client's education level and employment status;
341.20 	(5) the client's current medications;
341.21 	(6) any immediate risks to the client's health and safety;
341.22 	(7) the client's perceptions of the client's condition;
341.23 	(8) the client's description of the client's symptoms, including the reason for the client's 
341.24 	referral;
341.25 	(9) the client's history of mental health treatment; and
341.26 	(10) cultural influences on the client.
341.27 	(c) If the assessor cannot obtain the information that this subdivision requires without 
341.28 	retraumatizing the client or harming the client's willingness to engage in treatment, the 
341.29 	assessor must identify which topics will require further assessment during the course of the 
341.30 	client's treatment. The assessor must gather and document information related to the following 
341.31 	topics:
342.1 	(1) the client's relationship with the client's family and other significant personal 
342.2 	relationships, including the client's evaluation of the quality of each relationship;
342.3 	(2) the client's strengths and resources, including the extent and quality of the client's 
342.4 	social networks;
342.5 	(3) important developmental incidents in the client's life;
342.6 	(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;
342.7 	(5) the client's history of or exposure to alcohol and drug usage and treatment; and
342.8 	(6) the client's health history and the client's family health history, including the client's 
342.9 	physical, chemical, and mental health history.
342.10 	(d) When completing a standard diagnostic assessment of a client, an assessor must use 
342.11 	a recognized diagnostic framework.
342.12 	(1) When completing a standard diagnostic assessment of a client who is five years of 
342.13 	age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic 
342.14 	Classification of Mental Health and Development Disorders of Infancy and Early Childhood 
342.15 	published by Zero to Three.
342.16 	(2) When completing a standard diagnostic assessment of a client who is six years of 
342.17 	age or older, the assessor must use the current edition of the Diagnostic and Statistical 
342.18 	Manual of Mental Disorders published by the American Psychiatric Association.
342.19 	(3) When completing a standard diagnostic assessment of a client who is five years of 
342.20 	age or younger, an assessor must administer the Early Childhood Service Intensity Instrument 
342.21 	(ECSII) to the client and include the results in the client's assessment.
342.22 	(4) When completing a standard diagnostic assessment of a client who is six to 17 years 
342.23 	of age, an assessor must administer the Child and Adolescent Service Intensity Instrument 
342.24 	(CASII) to the client and include the results in the client's assessment.
342.25 	(5) When completing a standard diagnostic assessment of a client who is 18 years of 
342.26 	age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria 
342.27 	in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders 
342.28 	published by the American Psychiatric Association to screen and assess the client for a 
342.29 	substance use disorder.
342.30 	(e) When completing a standard diagnostic assessment of a client, the assessor must 
342.31 	include and document the following components of the assessment:
342.32 	(1) the client's mental status examination;
343.1 	(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources; 
343.2 	vulnerabilities; safety needs, including client information that supports the assessor's findings 
343.3 	after applying a recognized diagnostic framework from paragraph (d); and any differential 
343.4 	diagnosis of the client;
343.5 	(3) an explanation of: (i) how the assessor diagnosed the client using the information 
343.6 	from the client's interview, assessment, psychological testing, and collateral information 
343.7 	about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths; 
343.8 	and (v) the client's responsivity factors.
343.9 	(f) When completing a standard diagnostic assessment of a client, the assessor must 
343.10 	consult the client and the client's family about which services that the client and the family 
343.11 	prefer to treat the client. The assessor must make referrals for the client as to services required 
343.12 	by law.
343.13 		Subd. 7.Individual treatment plan. A license holder must follow each client's written 
343.14 	individual treatment plan when providing services to the client with the following exceptions:
343.15 	(1) services that do not require that a license holder completes a standard diagnostic 
343.16 	assessment of a client before providing services to the client;
343.17 	(2) when developing a service plan; and
343.18 	(3) when a client re-engages in services under subdivision 8, paragraph (b).
343.19 		Subd. 8.Individual treatment plan; required elements. (a) After completing a client's 
343.20 	diagnostic assessment and before providing services to the client, the license holder must 
343.21 	complete the client's individual treatment plan. The license holder must:
343.22 	(1) base the client's individual treatment plan on the client's diagnostic assessment and 
343.23 	baseline measurements;
343.24 	(2) for a child client, use a child-centered, family-driven, and culturally appropriate 
343.25 	planning process that allows the child's parents and guardians to observe and participate in 
343.26 	the child's individual and family treatment services, assessments, and treatment planning;
343.27 	(3) for an adult client, use a person-centered, culturally appropriate planning process 
343.28 	that allows the client's family and other natural supports to observe and participate in the 
343.29 	client's treatment services, assessments, and treatment planning;
343.30 	(4) identify the client's treatment goals, measureable treatment objectives, a schedule 
343.31 	for accomplishing the client's treatment goals and objectives, a treatment strategy, and the 
344.1 	individuals responsible for providing treatment services and supports to the client. The 
344.2 	license holder must have a treatment strategy to engage the client in treatment if the client:
344.3 	(i) has a history of not engaging in treatment; and
344.4 	(ii) is ordered by a court to participate in treatment services or to take neuroleptic 
344.5 	medications;
344.6 	(5) identify the participants involved in the client's treatment planning. The client must 
344.7 	be a participant in the client's treatment planning. If applicable, the license holder must 
344.8 	document the reasons that the license holder did not involve the client's family or other 
344.9 	natural supports in the client's treatment planning;
344.10 	(6) review the client's individual treatment plan every 180 days and update the client's 
344.11 	individual treatment plan with the client's treatment progress, new treatment objectives and 
344.12 	goals or, if the client has not made treatment progress, changes in the license holder's 
344.13 	approach to treatment; and
344.14 	(7) ensure that the client approves of the client's individual treatment plan unless a court 
344.15 	orders the client's treatment plan under chapter 253B.
344.16 	(b) If the client disagrees with the client's treatment plan, the license holder must 
344.17 	document in the client file the reasons why the client does not agree with the treatment plan. 
344.18 	If the license holder cannot obtain the client's approval of the treatment plan, a mental health 
344.19 	professional must make efforts to obtain approval from a person who is authorized to consent 
344.20 	on the client's behalf within 30 days after the client's previous individual treatment plan 
344.21 	expired. A license holder may not deny a client service during this time period solely because 
344.22 	the license holder could not obtain the client's approval of the client's individual treatment 
344.23 	plan. A license holder may continue to bill for the client's otherwise eligible services when 
344.24 	the client re-engages in services.
344.25 		Subd. 9.Functional assessment; required elements. When a license holder is 
344.26 	completing a functional assessment for an adult client, the license holder must:
344.27 	(1) complete a functional assessment of the client after completing the client's diagnostic 
344.28 	assessment;
344.29 	(2) use a collaborative process that allows the client and the client's family and other 
344.30 	natural supports, the client's referral sources, and the client's providers to provide information 
344.31 	about how the client's symptoms of mental illness impact the client's functioning;
344.32 	(3) if applicable, document the reasons that the license holder did not contact the client's 
344.33 	family and other natural supports;
345.1 	(4) assess and document how the client's symptoms of mental illness impact the client's 
345.2 	functioning in the following areas:
345.3 	(i) the client's mental health symptoms;
345.4 	(ii) the client's mental health service needs;
345.5 	(iii) the client's substance use;
345.6 	(iv) the client's vocational and educational functioning;
345.7 	(v) the client's social functioning, including the use of leisure time;
345.8 	(vi) the client's interpersonal functioning, including relationships with the client's family 
345.9 	and other natural supports;
345.10 	(vii) the client's ability to provide self-care and live independently;
345.11 	(viii) the client's medical and dental health;
345.12 	(ix) the client's financial assistance needs; and
345.13 	(x) the client's housing and transportation needs;
345.14 	(5) include a narrative summarizing the client's strengths, resources, and all areas of 
345.15 	functional impairment;
345.16 	(6) complete the client's functional assessment before the client's initial individual 
345.17 	treatment plan unless a service specifies otherwise; and
345.18 	(7) update the client's functional assessment with the client's current functioning whenever 
345.19 	there is a significant change in the client's functioning or at least every 180 days, unless a 
345.20 	service specifies otherwise.

345.21 	Sec. 12. [245I.11] HEALTH SERVICES AND MEDICATIONS.
345.22 		Subdivision 1.Generally. If a license holder is licensed as a residential program, stores 
345.23 	or administers client medications, or observes clients self-administer medications, the license 
345.24 	holder must ensure that a staff person who is a registered nurse or licensed prescriber is 
345.25 	responsible for overseeing storage and administration of client medications and observing 
345.26 	as a client self-administers medications, including training according to section 245I.05, 
345.27 	subdivision 6, and documenting the occurrence according to section 245I.08, subdivision 
345.28 	5.
345.29 		Subd. 2.Health services. If a license holder is licensed as a residential program, the 
345.30 	license holder must:
346.1 	(1) ensure that a client is screened for health issues within 72 hours of the client's 
346.2 	admission;
346.3 	(2) monitor the physical health needs of each client on an ongoing basis;
346.4 	(3) offer referrals to clients and coordinate each client's care with psychiatric and medical 
346.5 	services;
346.6 	(4) identify circumstances in which a staff person must notify a registered nurse or 
346.7 	licensed prescriber of any of a client's health concerns and the process for providing 
346.8 	notification of client health concerns; and
346.9 	(5) identify the circumstances in which the license holder must obtain medical care for 
346.10 	a client and the process for obtaining medical care for a client.
346.11 		Subd. 3.Storing and accounting for medications. (a) If a license holder stores client 
346.12 	medications, the license holder must:
346.13 	(1) store client medications in original containers in a locked location;
346.14 	(2) store refrigerated client medications in special trays or containers that are separate 
346.15 	from food;
346.16 	(3) store client medications marked "for external use only" in a compartment that is 
346.17 	separate from other client medications;
346.18 	(4) store Schedule II to IV drugs listed in section 152.02, subdivisions 3 to 5, in a 
346.19 	compartment that is locked separately from other medications;
346.20 	(5) ensure that only authorized staff persons have access to stored client medications;
346.21 	(6) follow a documentation procedure on each shift to account for all scheduled drugs; 
346.22 	and
346.23 	(7) record each incident when a staff person accepts a supply of client medications and 
346.24 	destroy discontinued, outdated, or deteriorated client medications.
346.25 	(b) If a license holder is licensed as a residential program, the license holder must allow 
346.26 	clients who self-administer medications to keep a private medication supply. The license 
346.27 	holder must ensure that the client stores all private medication in a locked container in the 
346.28 	client's private living area, unless the private medication supply poses a health and safety 
346.29 	risk to any clients. A client must not maintain a private medication supply of a prescription 
346.30 	medication without a written medication order from a licensed prescriber and a prescription 
346.31 	label that includes the client's name.
347.1 		Subd. 4.Medication orders. (a) If a license holder stores, prescribes, or administers 
347.2 	medications or observes a client self-administer medications, the license holder must:
347.3 	(1) ensure that a licensed prescriber writes all orders to accept, administer, or discontinue 
347.4 	client medications;
347.5 	(2) accept nonwritten orders to administer client medications in emergency circumstances 
347.6 	only;
347.7 	(3) establish a timeline and process for obtaining a written order with the licensed 
347.8 	prescriber's signature when the license holder accepts a nonwritten order to administer client 
347.9 	medications;
347.10 	(4) obtain prescription medication renewals from a licensed prescriber for each client 
347.11 	every 90 days for psychotropic medications and annually for all other medications; and
347.12 	(5) maintain the client's right to privacy and dignity.
347.13 	(b) If a license holder employs a licensed prescriber, the license holder must inform the 
347.14 	client about potential medication effects and side effects and obtain and document the client's 
347.15 	informed consent before the licensed prescriber prescribes a medication.
347.16 		Subd. 5.Medication administration. If a license holder is licensed as a residential 
347.17 	program, the license holder must:
347.18 	(1) assess and document each client's ability to self-administer medication. In the 
347.19 	assessment, the license holder must evaluate the client's ability to: (i) comply with prescribed 
347.20 	medication regimens; and (ii) store the client's medications safely and in a manner that 
347.21 	protects other individuals in the facility. Through the assessment process, the license holder 
347.22 	must assist the client in developing the skills necessary to safely self-administer medication;
347.23 	(2) monitor the effectiveness of medications, side effects of medications, and adverse 
347.24 	reactions to medications for each client. The license holder must address and document any 
347.25 	concerns about a client's medications;
347.26 	(3) ensure that no staff person or client gives a legend drug supply for one client to 
347.27 	another client;
347.28 	(4) have policies and procedures for: (i) keeping a record of each client's medication 
347.29 	orders; (ii) keeping a record of any incident of deferring a client's medications; (iii) 
347.30 	documenting any incident when a client's medication is omitted; and (iv) documenting when 
347.31 	a client refuses to take medications as prescribed; and
348.1 	(5) document and track medication errors, document whether the license holder notified 
348.2 	anyone about the medication error, determine if the license holder must take any follow-up 
348.3 	actions, and identify the staff persons who are responsible for taking follow-up actions.

348.4 	Sec. 13. [245I.12] CLIENT RIGHTS AND PROTECTIONS.
348.5 		Subdivision 1.Client rights. A license holder must ensure that all clients have the 
348.6 	following rights:
348.7 	(1) the rights listed in the health care bill of rights in section 144.651;
348.8 	(2) the right to be free from discrimination based on age, race, color, creed, religion, 
348.9 	national origin, gender, marital status, disability, sexual orientation, and status with regard 
348.10 	to public assistance. The license holder must follow all applicable state and federal laws 
348.11 	including the Minnesota Human Rights Act, chapter 363A; and
348.12 	(3) the right to be informed prior to a photograph or audio or video recording being made 
348.13 	of the client. The client has the right to refuse to allow any recording or photograph of the 
348.14 	client that is not for the purposes of identification or supervision by the license holder.
348.15 		Subd. 2.Restrictions to client rights. If the license holder restricts a client's right, the 
348.16 	license holder must document in the client file a mental health professional's approval of 
348.17 	the restriction and the reasons for the restriction.
348.18 		Subd. 3.Notice of rights. The license holder must give a copy of the client's rights 
348.19 	according to this section to each client on the day of the client's admission. The license 
348.20 	holder must document that the license holder gave a copy of the client's rights to each client 
348.21 	on the day of the client's admission according to this section. The license holder must post 
348.22 	a copy of the client rights in an area visible or accessible to all clients. The license holder 
348.23 	must include the client rights in Minnesota Rules, chapter 9544, for applicable clients.
348.24 		Subd. 4.Client property. (a) The license holder must meet the requirements of section 
348.25 	245A.04, subdivision 13.
348.26 	(b) If the license holder is unable to obtain a client's signature acknowledging the receipt 
348.27 	or disbursement of the client's funds or property required by section 245A.04, subdivision 
348.28 	13, paragraph (c), clause (1), two staff persons must sign documentation acknowledging 
348.29 	that the staff persons witnessed the client's receipt or disbursement of the client's funds or 
348.30 	property.
348.31 	(c) The license holder must return all of the client's funds and other property to the client 
348.32 	except for the following items:
349.1 	(1) illicit drugs, drug paraphernalia, and drug containers that are subject to forfeiture 
349.2 	under section 609.5316. The license holder must give illicit drugs, drug paraphernalia, and 
349.3 	drug containers to a local law enforcement agency or destroy the items; and
349.4 	(2) weapons, explosives, and other property that may cause serious harm to the client 
349.5 	or others. The license holder may give a client's weapons and explosives to a local law 
349.6 	enforcement agency. The license holder must notify the client that a local law enforcement 
349.7 	agency has the client's property and that the client has the right to reclaim the property if 
349.8 	the client has a legal right to possess the item.
349.9 	(d) If a client leaves the license holder's program but abandons the client's funds or 
349.10 	property, the license holder must retain and store the client's funds or property, including 
349.11 	medications, for a minimum of 30 days after the client's discharge from the program.
349.12 		Subd. 5.Client grievances. (a) The license holder must have a grievance procedure 
349.13 	that:
349.14 	(1) describes to clients how the license holder will meet the requirements in this 
349.15 	subdivision; and
349.16 	(2) contains the current public contact information of the Department of Human Services, 
349.17 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
349.18 	Disabilities; the Department of Health, Office of Health Facilities Complaints; and all 
349.19 	applicable health-related licensing boards.
349.20 	(b) On the day of each client's admission, the license holder must explain the grievance 
349.21 	procedure to the client.
349.22 	(c) The license holder must:
349.23 	(1) post the grievance procedure in a place visible to clients and provide a copy of the 
349.24 	grievance procedure upon request;
349.25 	(2) allow clients, former clients, and their authorized representatives to submit a grievance 
349.26 	to the license holder;
349.27 	(3) within three business days of receiving a client's grievance, acknowledge in writing 
349.28 	that the license holder received the client's grievance. If applicable, the license holder must 
349.29 	include a notice of the client's separate appeal rights for a managed care organization's 
349.30 	reduction, termination, or denial of a covered service;
350.1 	(4) within 15 business days of receiving a client's grievance, provide a written final 
350.2 	response to the client's grievance containing the license holder's official response to the 
350.3 	grievance; and
350.4 	(5) allow the client to bring a grievance to the person with the highest level of authority 
350.5 	in the program.

350.6 	Sec. 14. [245I.13] CRITICAL INCIDENTS.
350.7 	If a license holder is licensed as a residential program, the license holder must report all 
350.8 	critical incidents to the commissioner within ten days of learning of the incident on a form 
350.9 	approved by the commissioner. The license holder must keep a record of critical incidents 
350.10 	in a central location that is readily accessible to the commissioner for review upon the 
350.11 	commissioner's request for a minimum of two licensing periods.

350.12 	Sec. 15. [245I.20] MENTAL HEALTH CLINIC.
350.13 		Subdivision 1.Purpose. Certified mental health clinics provide clinical services for the 
350.14 	treatment of mental illnesses with a treatment team that reflects multiple disciplines and 
350.15 	areas of expertise.
350.16 		Subd. 2.Definitions. (a) "Clinical services" means services provided to a client to 
350.17 	diagnose, describe, predict, and explain the client's status relative to a condition or problem 
350.18 	as described in the: (1) current edition of the Diagnostic and Statistical Manual of Mental 
350.19 	Disorders published by the American Psychiatric Association; or (2) current edition of the 
350.20 	DC: 0-5 Diagnostic Classification of Mental Health and Development Disorders of Infancy 
350.21 	and Early Childhood published by Zero to Three. Where necessary, clinical services includes 
350.22 	services to treat a client to reduce the client's impairment due to the client's condition. 
350.23 	Clinical services also includes individual treatment planning, case review, record-keeping 
350.24 	required for a client's treatment, and treatment supervision. For the purposes of this section, 
350.25 	clinical services excludes services delivered to a client under a separate license and services 
350.26 	listed under section 245I.011, subdivision 5.
350.27 	(b) "Competent" means having professional education, training, continuing education, 
350.28 	consultation, supervision, experience, or a combination thereof necessary to demonstrate 
350.29 	sufficient knowledge of and proficiency in a specific clinical service.
350.30 	(c) "Discipline" means a branch of professional knowledge or skill acquired through a 
350.31 	specific course of study, training, and supervised practice. Discipline is usually documented 
350.32 	by a specific educational degree, licensure, or certification of proficiency. Examples of the 
351.1 	mental health disciplines include but are not limited to psychiatry, psychology, clinical 
351.2 	social work, marriage and family therapy, clinical counseling, and psychiatric nursing.
351.3 	(d) "Treatment team" means the mental health professionals, mental health practitioners, 
351.4 	and clinical trainees who provide clinical services to clients.
351.5 		Subd. 3.Organizational structure. (a) A mental health clinic location must be an entire 
351.6 	facility or a clearly identified unit within a facility that is administratively and clinically 
351.7 	separate from the rest of the facility. The mental health clinic location may provide services 
351.8 	other than clinical services to clients, including medical services, substance use disorder 
351.9 	services, social services, training, and education.
351.10 	(b) The certification holder must notify the commissioner of all mental health clinic 
351.11 	locations. If there is more than one mental health clinic location, the certification holder 
351.12 	must designate one location as the main location and all of the other locations as satellite 
351.13 	locations. The main location as a unit and the clinic as a whole must comply with the 
351.14 	minimum staffing standards in subdivision 4.
351.15 	(c) The certification holder must ensure that each satellite location:
351.16 	(1) adheres to the same policies and procedures as the main location;
351.17 	(2) provides treatment team members with face-to-face or telephone access to a mental 
351.18 	health professional for the purposes of supervision whenever the satellite location is open. 
351.19 	The certification holder must maintain a schedule of the mental health professionals who 
351.20 	will be available and the contact information for each available mental health professional. 
351.21 	The schedule must be current and readily available to treatment team members; and
351.22 	(3) enables clients to access all of the mental health clinic's clinical services and treatment 
351.23 	team members, as needed.
351.24 		Subd. 4.Minimum staffing standards. (a) A certification holder's treatment team must 
351.25 	consist of at least four mental health professionals. At least two of the mental health 
351.26 	professionals must be employed by or under contract with the mental health clinic for a 
351.27 	minimum of 35 hours per week each. Each of the two mental health professionals must 
351.28 	specialize in a different mental health discipline.
351.29 	(b) The treatment team must include:
351.30 	(1) a physician qualified as a mental health professional according to section 245I.04, 
351.31 	subdivision 2, clause (4), or a nurse qualified as a mental health professional according to 
351.32 	section 245I.04, subdivision 2, clause (1); and
352.1 	(2) a psychologist qualified as a mental health professional according to section 245I.04, 
352.2 	subdivision 2, clause (3).
352.3 	(c) The staff persons fulfilling the requirement in paragraph (b) must provide clinical 
352.4 	services at least:
352.5 	(1) eight hours every two weeks if the mental health clinic has over 25.0 full-time 
352.6 	equivalent treatment team members;
352.7 	(2) eight hours each month if the mental health clinic has 15.1 to 25.0 full-time equivalent 
352.8 	treatment team members;
352.9 	(3) four hours each month if the mental health clinic has 5.1 to 15.0 full-time equivalent 
352.10 	treatment team members; or
352.11 	(4) two hours each month if the mental health clinic has 2.0 to 5.0 full-time equivalent 
352.12 	treatment team members or only provides in-home services to clients.
352.13 	(d) The certification holder must maintain a record that demonstrates compliance with 
352.14 	this subdivision.
352.15 		Subd. 5.Treatment supervision specified. (a) A mental health professional must remain 
352.16 	responsible for each client's case. The certification holder must document the name of the 
352.17 	mental health professional responsible for each case and the dates that the mental health 
352.18 	professional is responsible for the client's case from beginning date to end date. The 
352.19 	certification holder must assign each client's case for assessment, diagnosis, and treatment 
352.20 	services to a treatment team member who is competent in the assigned clinical service, the 
352.21 	recommended treatment strategy, and in treating the client's characteristics.
352.22 	(b) Treatment supervision of mental health practitioners and clinical trainees required 
352.23 	by section 245I.06 must include case reviews as described in this paragraph. Every two 
352.24 	months, a mental health professional must complete a case review of each client assigned 
352.25 	to the mental health professional when the client is receiving clinical services from a mental 
352.26 	health practitioner or clinical trainee. The case review must include a consultation process 
352.27 	that thoroughly examines the client's condition and treatment, including: (1) a review of the 
352.28 	client's reason for seeking treatment, diagnoses and assessments, and the individual treatment 
352.29 	plan; (2) a review of the appropriateness, duration, and outcome of treatment provided to 
352.30 	the client; and (3) treatment recommendations.
352.31 		Subd. 6.Additional policy and procedure requirements. (a) In addition to the policies 
352.32 	and procedures required by section 245I.03, the certification holder must establish, enforce, 
352.33 	and maintain the policies and procedures required by this subdivision.
353.1 	(b) The certification holder must have a clinical evaluation procedure to identify and 
353.2 	document each treatment team member's areas of competence.
353.3 	(c) The certification holder must have policies and procedures for client intake and case 
353.4 	assignment that:
353.5 	(1) outline the client intake process;
353.6 	(2) describe how the mental health clinic determines the appropriateness of accepting a 
353.7 	client into treatment by reviewing the client's condition and need for treatment, the clinical 
353.8 	services that the mental health clinic offers to clients, and other available resources; and
353.9 	(3) contain a process for assigning a client's case to a mental health professional who is 
353.10 	responsible for the client's case and other treatment team members.
353.11 		Subd. 7.Referrals. If necessary treatment for a client or treatment desired by a client 
353.12 	is not available at the mental health clinic, the certification holder must facilitate appropriate 
353.13 	referrals for the client. When making a referral for a client, the treatment team member must 
353.14 	document a discussion with the client that includes: (1) the reason for the client's referral; 
353.15 	(2) potential treatment resources for the client; and (3) the client's response to receiving a 
353.16 	referral.
353.17 		Subd. 8.Emergency service. For the certification holder's telephone numbers that clients 
353.18 	regularly access, the certification holder must include the contact information for the area's 
353.19 	mental health crisis services as part of the certification holder's message when a live operator 
353.20 	is not available to answer clients' calls.
353.21 		Subd. 9.Quality assurance and improvement plan. (a) At a minimum, a certification 
353.22 	holder must develop a written quality assurance and improvement plan that includes a plan 
353.23 	for:
353.24 	(1) encouraging ongoing consultation among members of the treatment team;
353.25 	(2) obtaining and evaluating feedback about services from clients, family and other 
353.26 	natural supports, referral sources, and staff persons;
353.27 	(3) measuring and evaluating client outcomes;
353.28 	(4) reviewing client suicide deaths and suicide attempts;
353.29 	(5) examining the quality of clinical service delivery to clients; and
353.30 	(6) self-monitoring of compliance with this chapter.
354.1 	(b) At least annually, the certification holder must review, evaluate, and update the 
354.2 	quality assurance and improvement plan. The review must: (1) include documentation of 
354.3 	the actions that the certification holder will take as a result of information obtained from 
354.4 	monitoring activities in the plan; and (2) establish goals for improved service delivery to 
354.5 	clients for the next year.
354.6 		Subd. 10.Application procedures. (a) The applicant for certification must submit any 
354.7 	documents that the commissioner requires on forms approved by the commissioner.
354.8 	(b) Upon submitting an application for certification, an applicant must pay the application 
354.9 	fee required by section 245A.10, subdivision 3.
354.10 	(c) The commissioner must act on an application within 90 working days of receiving 
354.11 	a completed application.
354.12 	(d) When the commissioner receives an application for initial certification that is 
354.13 	incomplete because the applicant failed to submit required documents or is deficient because 
354.14 	the submitted documents do not meet certification requirements, the commissioner must 
354.15 	provide the applicant with written notice that the application is incomplete or deficient. In 
354.16 	the notice, the commissioner must identify the particular documents that are missing or 
354.17 	deficient and give the applicant 45 days to submit a second application that is complete. An 
354.18 	applicant's failure to submit a complete application within 45 days after receiving notice 
354.19 	from the commissioner is a basis for certification denial.
354.20 	(e) The commissioner must give notice of a denial to an applicant when the commissioner 
354.21 	has made the decision to deny the certification application. In the notice of denial, the 
354.22 	commissioner must state the reasons for the denial in plain language. The commissioner 
354.23 	must send or deliver the notice of denial to an applicant by certified mail or personal service. 
354.24 	In the notice of denial, the commissioner must state the reasons that the commissioner denied 
354.25 	the application and must inform the applicant of the applicant's right to request a contested 
354.26 	case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The 
354.27 	applicant may appeal the denial by notifying the commissioner in writing by certified mail 
354.28 	or personal service. If mailed, the appeal must be postmarked and sent to the commissioner 
354.29 	within 20 calendar days after the applicant received the notice of denial. If an applicant 
354.30 	delivers an appeal by personal service, the commissioner must receive the appeal within 20 
354.31 	calendar days after the applicant received the notice of denial.
354.32 		Subd. 11.Commissioner's right of access. (a) When the commissioner is exercising 
354.33 	the powers conferred to the commissioner by this chapter, if the mental health clinic is in 
355.1 	operation and the information is relevant to the commissioner's inspection or investigation, 
355.2 	the certification holder must provide the commissioner access to:
355.3 	(1) the physical facility and grounds where the program is located;
355.4 	(2) documentation and records, including electronically maintained records;
355.5 	(3) clients served by the mental health clinic;
355.6 	(4) staff persons of the mental health clinic; and
355.7 	(5) personnel records of current and former staff of the mental health clinic.
355.8 	(b) The certification holder must provide the commissioner with access to the facility 
355.9 	and grounds, documentation and records, clients, and staff without prior notice and as often 
355.10 	as the commissioner considers necessary if the commissioner is investigating alleged 
355.11 	maltreatment or a violation of a law or rule, or conducting an inspection. When conducting 
355.12 	an inspection, the commissioner may request and must receive assistance from other state, 
355.13 	county, and municipal governmental agencies and departments. The applicant or certification 
355.14 	holder must allow the commissioner, at the commissioner's expense, to photocopy, 
355.15 	photograph, and make audio and video recordings during an inspection.
355.16 		Subd. 12.Monitoring and inspections. (a) The commissioner may conduct a certification 
355.17 	review of the certified mental health clinic every two years to determine the certification 
355.18 	holder's compliance with applicable rules and statutes.
355.19 	(b) The commissioner must offer the certification holder a choice of dates for an 
355.20 	announced certification review. A certification review must occur during the clinic's normal 
355.21 	working hours.
355.22 	(c) The commissioner must make the results of certification reviews and the results of 
355.23 	investigations that result in a correction order publicly available on the department's website.
355.24 		Subd. 13.Correction orders. (a) If the applicant or certification holder fails to comply 
355.25 	with a law or rule, the commissioner may issue a correction order. The correction order 
355.26 	must state:
355.27 	(1) the condition that constitutes a violation of the law or rule;
355.28 	(2) the specific law or rule that the applicant or certification holder has violated; and
355.29 	(3) the time that the applicant or certification holder is allowed to correct each violation.
355.30 	(b) If the applicant or certification holder believes that the commissioner's correction 
355.31 	order is erroneous, the applicant or certification holder may ask the commissioner to 
356.1 	reconsider the part of the correction order that is allegedly erroneous. An applicant or 
356.2 	certification holder must make a request for reconsideration in writing. The request must 
356.3 	be postmarked and sent to the commissioner within 20 calendar days after the applicant or 
356.4 	certification holder received the correction order; and the request must:
356.5 	(1) specify the part of the correction order that is allegedly erroneous;
356.6 	(2) explain why the specified part is erroneous; and
356.7 	(3) include documentation to support the allegation of error.
356.8 	(c) A request for reconsideration does not stay any provision or requirement of the 
356.9 	correction order. The commissioner's disposition of a request for reconsideration is final 
356.10 	and not subject to appeal.
356.11 	(d) If the commissioner finds that the applicant or certification holder failed to correct 
356.12 	the violation specified in the correction order, the commissioner may decertify the certified 
356.13 	mental health clinic according to subdivision 14.
356.14 	(e) Nothing in this subdivision prohibits the commissioner from decertifying a mental 
356.15 	health clinic according to subdivision 14.
356.16 		Subd. 14.Decertification. (a) The commissioner may decertify a mental health clinic 
356.17 	if a certification holder:
356.18 	(1) failed to comply with an applicable law or rule; or
356.19 	(2) knowingly withheld relevant information from or gave false or misleading information 
356.20 	to the commissioner in connection with an application for certification, during an 
356.21 	investigation, or regarding compliance with applicable laws or rules.
356.22 	(b) When considering decertification of a mental health clinic, the commissioner must 
356.23 	consider the nature, chronicity, or severity of the violation of law or rule and the effect of 
356.24 	the violation on the health, safety, or rights of clients.
356.25 	(c) If the commissioner decertifies a mental health clinic, the order of decertification 
356.26 	must inform the certification holder of the right to have a contested case hearing under 
356.27 	chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The certification holder 
356.28 	may appeal the decertification. The certification holder must appeal a decertification in 
356.29 	writing and send or deliver the appeal to the commissioner by certified mail or personal 
356.30 	service. If the certification holder mails the appeal, the appeal must be postmarked and sent 
356.31 	to the commissioner within ten calendar days after the certification holder receives the order 
356.32 	of decertification. If the certification holder delivers an appeal by personal service, the 
357.1 	commissioner must receive the appeal within ten calendar days after the certification holder 
357.2 	received the order. If a certification holder submits a timely appeal of an order of 
357.3 	decertification, the certification holder may continue to operate the program until the 
357.4 	commissioner issues a final order on the decertification.
357.5 	(d) If the commissioner decertifies a mental health clinic pursuant to paragraph (a), 
357.6 	clause (1), based on a determination that the mental health clinic was responsible for 
357.7 	maltreatment, and if the certification holder appeals the decertification according to paragraph 
357.8 	(c), and appeals the maltreatment determination under section 260E.33, the final 
357.9 	decertification determination is stayed until the commissioner issues a final decision regarding 
357.10 	the maltreatment appeal.
357.11 		Subd. 15.Transfer prohibited. A certification issued under this section is only valid 
357.12 	for the premises and the individual, organization, or government entity identified by the 
357.13 	commissioner on the certification. A certification is not transferable or assignable.
357.14 		Subd. 16.Notifications required and noncompliance. (a) A certification holder must 
357.15 	notify the commissioner, in a manner prescribed by the commissioner, and obtain the 
357.16 	commissioner's approval before making any change to the name of the certification holder 
357.17 	or the location of the mental health clinic.
357.18 	(b) Changes in mental health clinic organization, staffing, treatment, or quality assurance 
357.19 	procedures that affect the ability of the certification holder to comply with the minimum 
357.20 	standards of this section must be reported in writing by the certification holder to the 
357.21 	commissioner within 15 days of the occurrence. Review of the change must be conducted 
357.22 	by the commissioner. A certification holder with changes resulting in noncompliance in 
357.23 	minimum standards must receive written notice and may have up to 180 days to correct the 
357.24 	areas of noncompliance before being decertified. Interim procedures to resolve the 
357.25 	noncompliance on a temporary basis must be developed and submitted in writing to the 
357.26 	commissioner for approval within 30 days of the commissioner's determination of the 
357.27 	noncompliance. Not reporting an occurrence of a change that results in noncompliance 
357.28 	within 15 days, failure to develop an approved interim procedure within 30 days of the 
357.29 	determination of the noncompliance, or nonresolution of the noncompliance within 180 
357.30 	days will result in immediate decertification.
357.31 	(c) The mental health clinic may be required to submit written information to the 
357.32 	department to document that the mental health clinic has maintained compliance with this 
357.33 	section and mental health clinic procedures.

358.1 	Sec. 16. [245I.23] INTENSIVE RESIDENTIAL TREATMENT SERVICES AND 
358.2 	RESIDENTIAL CRISIS STABILIZATION.
358.3 		Subdivision 1.Purpose. (a) Intensive residential treatment services is a community-based 
358.4 	medically monitored level of care for an adult client that uses established rehabilitative 
358.5 	principles to promote a client's recovery and to develop and achieve psychiatric stability, 
358.6 	personal and emotional adjustment, self-sufficiency, and other skills that help a client 
358.7 	transition to a more independent setting.
358.8 	(b) Residential crisis stabilization provides structure and support to an adult client in a 
358.9 	community living environment when a client has experienced a mental health crisis and 
358.10 	needs short-term services to ensure that the client can safely return to the client's home or 
358.11 	precrisis living environment with additional services and supports identified in the client's 
358.12 	crisis assessment.
358.13 		Subd. 2.Definitions. (a) "Program location" means a set of rooms that are each physically 
358.14 	self-contained and have defining walls extending from floor to ceiling. Program location 
358.15 	includes bedrooms, living rooms or lounge areas, bathrooms, and connecting areas.
358.16 	(b) "Treatment team" means a group of staff persons who provide intensive residential 
358.17 	treatment services or residential crisis stabilization to clients. The treatment team includes 
358.18 	mental health professionals, mental health practitioners, clinical trainees, certified 
358.19 	rehabilitation specialists, mental health rehabilitation workers, and mental health certified 
358.20 	peer specialists.
358.21 		Subd. 3.Treatment services description. The license holder must describe in writing 
358.22 	all treatment services that the license holder provides. The license holder must have the 
358.23 	description readily available for the commissioner upon the commissioner's request.
358.24 		Subd. 4.Required intensive residential treatment services. (a) On a daily basis, the 
358.25 	license holder must follow a client's treatment plan to provide intensive residential treatment 
358.26 	services to the client to improve the client's functioning.
358.27 	(b) The license holder must offer and have the capacity to directly provide the following 
358.28 	treatment services to each client:
358.29 	(1) rehabilitative mental health services;
358.30 	(2) crisis prevention planning to assist a client with:
358.31 	(i) identifying and addressing patterns in the client's history and experience of the client's 
358.32 	mental illness; and
359.1 	(ii) developing crisis prevention strategies that include de-escalation strategies that have 
359.2 	been effective for the client in the past;
359.3 	(3) health services and administering medication;
359.4 	(4) co-occurring substance use disorder treatment;
359.5 	(5) engaging the client's family and other natural supports in the client's treatment and 
359.6 	educating the client's family and other natural supports to strengthen the client's social and 
359.7 	family relationships; and
359.8 	(6) making referrals for the client to other service providers in the community and 
359.9 	supporting the client's transition from intensive residential treatment services to another 
359.10 	setting.
359.11 	(c) The license holder must include Illness Management and Recovery (IMR), Enhanced 
359.12 	Illness Management and Recovery (E-IMR), or other similar interventions in the license 
359.13 	holder's programming as approved by the commissioner.
359.14 		Subd. 5.Required residential crisis stabilization services. (a) On a daily basis, the 
359.15 	license holder must follow a client's individual crisis treatment plan to provide services to 
359.16 	the client in residential crisis stabilization to improve the client's functioning.
359.17 	(b) The license holder must offer and have the capacity to directly provide the following 
359.18 	treatment services to the client:
359.19 	(1) crisis stabilization services as described in section 256B.0624, subdivision 7;
359.20 	(2) rehabilitative mental health services;
359.21 	(3) health services and administering the client's medications; and
359.22 	(4) making referrals for the client to other service providers in the community and 
359.23 	supporting the client's transition from residential crisis stabilization to another setting.
359.24 		Subd. 6.Optional treatment services. (a) If the license holder offers additional treatment 
359.25 	services to a client, the treatment service must be:
359.26 	(1) approved by the commissioner; and
359.27 	(2)(i) a mental health evidence-based practice that the federal Department of Health and 
359.28 	Human Services Substance Abuse and Mental Health Service Administration has adopted;
359.29 	(ii) a nationally recognized mental health service that substantial research has validated 
359.30 	as effective in helping individuals with serious mental illness achieve treatment goals; or
360.1 	(iii) developed under state-sponsored research of publicly funded mental health programs 
360.2 	and validated to be effective for individuals, families, and communities.
360.3 	(b) Before providing an optional treatment service to a client, the license holder must 
360.4 	provide adequate training to a staff person about providing the optional treatment service 
360.5 	to a client.
360.6 		Subd. 7.Intensive residential treatment services assessment and treatment 
360.7 	planning. (a) Within 12 hours of a client's admission, the license holder must evaluate and 
360.8 	document the client's immediate needs, including the client's:
360.9 	(1) health and safety, including the client's need for crisis assistance;
360.10 	(2) responsibilities for children, family and other natural supports, and employers; and
360.11 	(3) housing and legal issues.
360.12 	(b) Within 24 hours of the client's admission, the license holder must complete an initial 
360.13 	treatment plan for the client. The license holder must:
360.14 	(1) base the client's initial treatment plan on the client's referral information and an 
360.15 	assessment of the client's immediate needs;
360.16 	(2) consider crisis assistance strategies that have been effective for the client in the past;
360.17 	(3) identify the client's initial treatment goals, measurable treatment objectives, and 
360.18 	specific interventions that the license holder will use to help the client engage in treatment;
360.19 	(4) identify the participants involved in the client's treatment planning. The client must 
360.20 	be a participant; and
360.21 	(5) ensure that a treatment supervisor approves of the client's initial treatment plan if a 
360.22 	mental health practitioner or clinical trainee completes the client's treatment plan, 
360.23 	notwithstanding section 245I.08, subdivision 3.
360.24 	(c) According to section 245A.65, subdivision 2, paragraph (b), the license holder must 
360.25 	complete an individual abuse prevention plan as part of a client's initial treatment plan.
360.26 	(d) Within five days of the client's admission and again within 60 days after the client's 
360.27 	admission, the license holder must complete a level of care assessment of the client. If the 
360.28 	license holder determines that a client does not need a medically monitored level of service, 
360.29 	a treatment supervisor must document how the client's admission to and continued services 
360.30 	in intensive residential treatment services are medically necessary for the client.
361.1 	(e) Within ten days of a client's admission, the license holder must complete or review 
361.2 	and update the client's standard diagnostic assessment.
361.3 	(f) Within ten days of a client's admission, the license holder must complete the client's 
361.4 	individual treatment plan, notwithstanding section 245I.10, subdivision 8. Within 40 days 
361.5 	after the client's admission and again within 70 days after the client's admission, the license 
361.6 	holder must update the client's individual treatment plan. The license holder must focus the 
361.7 	client's treatment planning on preparing the client for a successful transition from intensive 
361.8 	residential treatment services to another setting. In addition to the required elements of an 
361.9 	individual treatment plan under section 245I.10, subdivision 8, the license holder must 
361.10 	identify the following information in the client's individual treatment plan: (1) the client's 
361.11 	referrals and resources for the client's health and safety; and (2) the staff persons who are 
361.12 	responsible for following up with the client's referrals and resources. If the client does not 
361.13 	receive a referral or resource that the client needs, the license holder must document the 
361.14 	reason that the license holder did not make the referral or did not connect the client to a 
361.15 	particular resource. The license holder is responsible for determining whether additional 
361.16 	follow-up is required on behalf of the client.
361.17 	(g) Within 30 days of the client's admission, the license holder must complete a functional 
361.18 	assessment of the client. Within 60 days after the client's admission, the license holder must 
361.19 	update the client's functional assessment to include any changes in the client's functioning 
361.20 	and symptoms.
361.21 	(h) For a client with a current substance use disorder diagnosis and for a client whose 
361.22 	substance use disorder screening in the client's standard diagnostic assessment indicates the 
361.23 	possibility that the client has a substance use disorder, the license holder must complete a 
361.24 	written assessment of the client's substance use within 30 days of the client's admission. In 
361.25 	the substance use assessment, the license holder must: (1) evaluate the client's history of 
361.26 	substance use, relapses, and hospitalizations related to substance use; (2) assess the effects 
361.27 	of the client's substance use on the client's relationships including with family member and 
361.28 	others; (3) identify financial problems, health issues, housing instability, and unemployment; 
361.29 	(4) assess the client's legal problems, past and pending incarceration, violence, and 
361.30 	victimization; and (5) evaluate the client's suicide attempts, noncompliance with taking 
361.31 	prescribed medications, and noncompliance with psychosocial treatment.
361.32 	(i) On a weekly basis, a mental health professional or certified rehabilitation specialist 
361.33 	must review each client's treatment plan and individual abuse prevention plan. The license 
361.34 	holder must document in the client's file each weekly review of the client's treatment plan 
361.35 	and individual abuse prevention plan.
362.1 		Subd. 8.Residential crisis stabilization assessment and treatment planning. (a) 
362.2 	Within 12 hours of a client's admission, the license holder must evaluate the client and 
362.3 	document the client's immediate needs, including the client's:
362.4 	(1) health and safety, including the client's need for crisis assistance;
362.5 	(2) responsibilities for children, family and other natural supports, and employers; and
362.6 	(3) housing and legal issues.
362.7 	(b) Within 24 hours of a client's admission, the license holder must complete a crisis 
362.8 	treatment plan for the client under section 256B.0624, subdivision 11. The license holder 
362.9 	must base the client's crisis treatment plan on the client's referral information and an 
362.10 	assessment of the client's immediate needs.
362.11 	(c) Section 245A.65, subdivision 2, paragraph (b), requires the license holder to complete 
362.12 	an individual abuse prevention plan for a client as part of the client's crisis treatment plan.
362.13 		Subd. 9.Key staff positions. (a) The license holder must have a staff person assigned 
362.14 	to each of the following key staff positions at all times:
362.15 	(1) a program director who qualifies as a mental health practitioner. The license holder 
362.16 	must designate the program director as responsible for all aspects of the operation of the 
362.17 	program and the program's compliance with all applicable requirements. The program 
362.18 	director must know and understand the implications of this chapter; chapters 245A, 245C, 
362.19 	and 260E; sections 626.557 and 626.5572; Minnesota Rules, chapter 9544; and all other 
362.20 	applicable requirements. The license holder must document in the program director's 
362.21 	personnel file how the program director demonstrates knowledge of these requirements. 
362.22 	The program director may also serve as the treatment director of the program, if qualified;
362.23 	(2) a treatment director who qualifies as a mental health professional. The treatment 
362.24 	director must be responsible for overseeing treatment services for clients and the treatment 
362.25 	supervision of all staff persons; and
362.26 	(3) a registered nurse who qualifies as a mental health practitioner. The registered nurse 
362.27 	must:
362.28 	(i) work at the program location a minimum of eight hours per week;
362.29 	(ii) provide monitoring and supervision of staff persons as defined in section 148.171, 
362.30 	subdivisions 8a and 23;
362.31 	(iii) be responsible for the review and approval of health service and medication policies 
362.32 	and procedures under section 245I.03, subdivision 5; and
363.1 	(iv) oversee the license holder's provision of health services to clients, medication storage, 
363.2 	and medication administration to clients.
363.3 	(b) Within five business days of a change in a key staff position, the license holder must 
363.4 	notify the commissioner of the staffing change. The license holder must notify the 
363.5 	commissioner of the staffing change on a form approved by the commissioner and include 
363.6 	the name of the staff person now assigned to the key staff position and the staff person's 
363.7 	qualifications.
363.8 		Subd. 10.Minimum treatment team staffing levels and ratios. (a) The license holder 
363.9 	must maintain a treatment team staffing level sufficient to:
363.10 	(1) provide continuous daily coverage of all shifts;
363.11 	(2) follow each client's treatment plan and meet each client's needs as identified in the 
363.12 	client's treatment plan;
363.13 	(3) implement program requirements; and
363.14 	(4) safely monitor and guide the activities of each client, taking into account the client's 
363.15 	level of behavioral and psychiatric stability, cultural needs, and vulnerabilities.
363.16 	(b) The license holder must ensure that treatment team members:
363.17 	(1) remain awake during all work hours; and
363.18 	(2) are available to monitor and guide the activities of each client whenever clients are 
363.19 	present in the program.
363.20 	(c) On each shift, the license holder must maintain a treatment team staffing ratio of at 
363.21 	least one treatment team member to nine clients. If the license holder is serving nine or 
363.22 	fewer clients, at least one treatment team member on the day shift must be a mental health 
363.23 	professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner. 
363.24 	If the license holder is serving more than nine clients, at least one of the treatment team 
363.25 	members working during both the day and evening shifts must be a mental health 
363.26 	professional, clinical trainee, certified rehabilitation specialist, or mental health practitioner.
363.27 	(d) If the license holder provides residential crisis stabilization to clients and is serving 
363.28 	at least one client in residential crisis stabilization and more than four clients in residential 
363.29 	crisis stabilization and intensive residential treatment services, the license holder must 
363.30 	maintain a treatment team staffing ratio on each shift of at least two treatment team members 
363.31 	during the client's first 48 hours in residential crisis stabilization.
364.1 		Subd. 11.Shift exchange. A license holder must ensure that treatment team members 
364.2 	working on different shifts exchange information about a client as necessary to effectively 
364.3 	care for the client and to follow and update a client's treatment plan and individual abuse 
364.4 	prevention plan.
364.5 		Subd. 12.Daily documentation. (a) For each day that a client is present in the program, 
364.6 	the license holder must provide a daily summary in the client's file that includes observations 
364.7 	about the client's behavior and symptoms, including any critical incidents in which the client 
364.8 	was involved.
364.9 	(b) For each day that a client is not present in the program, the license holder must 
364.10 	document the reason for a client's absence in the client's file.
364.11 		Subd. 13.Access to a mental health professional, clinical trainee, certified 
364.12 	rehabilitation specialist, or mental health practitioner. Treatment team members must 
364.13 	have access in person or by telephone to a mental health professional, clinical trainee, 
364.14 	certified rehabilitation specialist, or mental health practitioner within 30 minutes. The license 
364.15 	holder must maintain a schedule of mental health professionals, clinical trainees, certified 
364.16 	rehabilitation specialists, or mental health practitioners who will be available and contact 
364.17 	information to reach them. The license holder must keep the schedule current and make the 
364.18 	schedule readily available to treatment team members.
364.19 		Subd. 14.Weekly team meetings. (a) The license holder must hold weekly team meetings 
364.20 	and ancillary meetings according to this subdivision.
364.21 	(b) A mental health professional or certified rehabilitation specialist must hold at least 
364.22 	one team meeting each calendar week and be physically present at the team meeting. All 
364.23 	treatment team members, including treatment team members who work on a part-time or 
364.24 	intermittent basis, must participate in a minimum of one team meeting during each calendar 
364.25 	week when the treatment team member is working for the license holder. The license holder 
364.26 	must document all weekly team meetings, including the names of meeting attendees.
364.27 	(c) If a treatment team member cannot participate in a weekly team meeting, the treatment 
364.28 	team member must participate in an ancillary meeting. A mental health professional, certified 
364.29 	rehabilitation specialist, clinical trainee, or mental health practitioner who participated in 
364.30 	the most recent weekly team meeting may lead the ancillary meeting. During the ancillary 
364.31 	meeting, the treatment team member leading the ancillary meeting must review the 
364.32 	information that was shared at the most recent weekly team meeting, including revisions 
364.33 	to client treatment plans and other information that the treatment supervisors exchanged 
365.1 	with treatment team members. The license holder must document all ancillary meetings, 
365.2 	including the names of meeting attendees.
365.3 		Subd. 15.Intensive residential treatment services admission criteria. (a) An eligible 
365.4 	client for intensive residential treatment services is an individual who:
365.5 	(1) is age 18 or older;
365.6 	(2) is diagnosed with a mental illness;
365.7 	(3) because of a mental illness, has a substantial disability and functional impairment 
365.8 	in three or more areas listed in section 245I.10, subdivision 9, clause (4), that markedly 
365.9 	reduce the individual's self-sufficiency;
365.10 	(4) has one or more of the following: a history of recurring or prolonged inpatient 
365.11 	hospitalizations during the past year, significant independent living instability, homelessness, 
365.12 	or very frequent use of mental health and related services with poor outcomes for the 
365.13 	individual; and
365.14 	(5) in the written opinion of a mental health professional, needs mental health services 
365.15 	that available community-based services cannot provide, or is likely to experience a mental 
365.16 	health crisis or require a more restrictive setting if the individual does not receive intensive 
365.17 	rehabilitative mental health services.
365.18 	(b) The license holder must not limit or restrict intensive residential treatment services 
365.19 	to a client based solely on:
365.20 	(1) the client's substance use;
365.21 	(2) the county in which the client resides; or
365.22 	(3) whether the client elects to receive other services for which the client may be eligible, 
365.23 	including case management services.
365.24 	(c) This subdivision does not prohibit the license holder from restricting admissions of 
365.25 	individuals who present an imminent risk of harm or danger to themselves or others.
365.26 		Subd. 16.Residential crisis stabilization services admission criteria. An eligible client 
365.27 	for residential crisis stabilization is an individual who is age 18 or older and meets the 
365.28 	eligibility criteria in section 256B.0624, subdivision 3.
365.29 		Subd. 17.Admissions referrals and determinations. (a) The license holder must 
365.30 	identify the information that the license holder needs to make a determination about a 
365.31 	person's admission referral.
366.1 	(b) The license holder must:
366.2 	(1) always be available to receive referral information about a person seeking admission 
366.3 	to the license holder's program;
366.4 	(2) respond to the referral source within eight hours of receiving a referral and, within 
366.5 	eight hours, communicate with the referral source about what information the license holder 
366.6 	needs to make a determination concerning the person's admission;
366.7 	(3) consider the license holder's staffing ratio and the areas of treatment team members' 
366.8 	competency when determining whether the license holder is able to meet the needs of a 
366.9 	person seeking admission; and
366.10 	(4) determine whether to admit a person within 72 hours of receiving all necessary 
366.11 	information from the referral source.
366.12 		Subd. 18.Discharge standards. (a) When a license holder discharges a client from a 
366.13 	program, the license holder must categorize the discharge as a successful discharge, 
366.14 	program-initiated discharge, or non-program-initiated discharge according to the criteria in 
366.15 	this subdivision. The license holder must meet the standards associated with the type of 
366.16 	discharge according to this subdivision.
366.17 	(b) To successfully discharge a client from a program, the license holder must ensure 
366.18 	that the following criteria are met:
366.19 	(1) the client must substantially meet the client's documented treatment plan goals and 
366.20 	objectives;
366.21 	(2) the client must complete discharge planning with the treatment team; and
366.22 	(3) the client and treatment team must arrange for the client to receive continuing care 
366.23 	at a less intensive level of care after discharge.
366.24 	(c) Prior to successfully discharging a client from a program, the license holder must 
366.25 	complete the client's discharge summary and provide the client with a copy of the client's 
366.26 	discharge summary in plain language that includes:
366.27 	(1) a brief review of the client's problems and strengths during the period that the license 
366.28 	holder provided services to the client;
366.29 	(2) the client's response to the client's treatment plan;
366.30 	(3) the goals and objectives that the license holder recommends that the client addresses 
366.31 	during the first three months following the client's discharge from the program;
367.1 	(4) the recommended actions, supports, and services that will assist the client with a 
367.2 	successful transition from the program to another setting;
367.3 	(5) the client's crisis plan; and
367.4 	(6) the client's forwarding address and telephone number.
367.5 	(d) For a non-program-initiated discharge of a client from a program, the following 
367.6 	criteria must be met:
367.7 	(1)(i) the client has withdrawn the client's consent for treatment; (ii) the license holder 
367.8 	has determined that the client has the capacity to make an informed decision; and (iii) the 
367.9 	client does not meet the criteria for an emergency hold under section 253B.051, subdivision 
367.10 	2;
367.11 	(2) the client has left the program against staff person advice;
367.12 	(3) an entity with legal authority to remove the client has decided to remove the client 
367.13 	from the program; or
367.14 	(4) a source of payment for the services is no longer available.
367.15 	(e) Within ten days of a non-program-initiated discharge of a client from a program, the 
367.16 	license holder must complete the client's discharge summary in plain language that includes:
367.17 	(1) the reasons for the client's discharge;
367.18 	(2) a description of attempts by staff persons to enable the client to continue treatment 
367.19 	or to consent to treatment; and
367.20 	(3) recommended actions, supports, and services that will assist the client with a 
367.21 	successful transition from the program to another setting.
367.22 	(f) For a program-initiated discharge of a client from a program, the following criteria 
367.23 	must be met:
367.24 	(1) the client is competent but has not participated in treatment or has not followed the 
367.25 	program rules and regulations and the client has not participated to such a degree that the 
367.26 	program's level of care is ineffective or unsafe for the client, despite multiple, documented 
367.27 	attempts that the license holder has made to address the client's lack of participation in 
367.28 	treatment;
367.29 	(2) the client has not made progress toward the client's treatment goals and objectives 
367.30 	despite the license holder's persistent efforts to engage the client in treatment, and the license 
367.31 	holder has no reasonable expectation that the client will make progress at the program's 
368.1 	level of care nor does the client require the program's level of care to maintain the current 
368.2 	level of functioning;
368.3 	(3) a court order or the client's legal status requires the client to participate in the program 
368.4 	but the client has left the program against staff person advice; or
368.5 	(4) the client meets criteria for a more intensive level of care and a more intensive level 
368.6 	of care is available to the client.
368.7 	(g) Prior to a program-initiated discharge of a client from a program, the license holder 
368.8 	must consult the client, the client's family and other natural supports, and the client's case 
368.9 	manager, if applicable, to review the issues involved in the program's decision to discharge 
368.10 	the client from the program. During the discharge review process, which must not exceed 
368.11 	five working days, the license holder must determine whether the license holder, treatment 
368.12 	team, and any interested persons can develop additional strategies to resolve the issues 
368.13 	leading to the client's discharge and to permit the client to have an opportunity to continue 
368.14 	receiving services from the license holder. The license holder may temporarily remove a 
368.15 	client from the program facility during the five-day discharge review period. The license 
368.16 	holder must document the client's discharge review in the client's file.
368.17 	(h) Prior to a program-initiated discharge of a client from the program, the license holder 
368.18 	must complete the client's discharge summary and provide the client with a copy of the 
368.19 	discharge summary in plain language that includes:
368.20 	(1) the reasons for the client's discharge;
368.21 	(2) the alternatives to discharge that the license holder considered or attempted to 
368.22 	implement;
368.23 	(3) the names of each individual who is involved in the decision to discharge the client 
368.24 	and a description of each individual's involvement; and
368.25 	(4) recommended actions, supports, and services that will assist the client with a 
368.26 	successful transition from the program to another setting.
368.27 		Subd. 19.Program facility. (a) The license holder must be licensed or certified as a 
368.28 	board and lodging facility, supervised living facility, or a boarding care home by the 
368.29 	Department of Health.
368.30 	(b) The license holder must have a capacity of five to 16 beds and the program must not 
368.31 	be declared as an institution for mental disease.
369.1 	(c) The license holder must furnish each program location to meet the psychological, 
369.2 	emotional, and developmental needs of clients.
369.3 	(d) The license holder must provide one living room or lounge area per program location. 
369.4 	There must be space available to provide services according to each client's treatment plan, 
369.5 	such as an area for learning recreation time skills and areas for learning independent living 
369.6 	skills, such as laundering clothes and preparing meals.
369.7 	(e) The license holder must ensure that each program location allows each client to have 
369.8 	privacy. Each client must have privacy during assessment interviews and counseling sessions. 
369.9 	Each client must have a space designated for the client to see outside visitors at the program 
369.10 	facility.
369.11 		Subd. 20.Physical separation of services. If the license holder offers services to 
369.12 	individuals who are not receiving intensive residential treatment services or residential 
369.13 	stabilization at the program location, the license holder must inform the commissioner and 
369.14 	submit a plan for approval to the commissioner about how and when the license holder will 
369.15 	provide services. The license holder must only provide services to clients who are not 
369.16 	receiving intensive residential treatment services or residential crisis stabilization in an area 
369.17 	that is physically separated from the area in which the license holder provides clients with 
369.18 	intensive residential treatment services or residential crisis stabilization.
369.19 		Subd. 21.Dividing staff time between locations. A license holder must obtain approval 
369.20 	from the commissioner prior to providing intensive residential treatment services or 
369.21 	residential crisis stabilization to clients in more than one program location under one license 
369.22 	and dividing one staff person's time between program locations during the same work period.
369.23 		Subd. 22.Additional policy and procedure requirements. (a) In addition to the policies 
369.24 	and procedures in section 245I.03, the license holder must establish, enforce, and maintain 
369.25 	the policies and procedures in this subdivision.
369.26 	(b) The license holder must have policies and procedures for receiving referrals and 
369.27 	making admissions determinations about referred persons under subdivisions 14 to 16.
369.28 	(c) The license holder must have policies and procedures for discharging clients under 
369.29 	subdivision 17. In the policies and procedures, the license holder must identify the staff 
369.30 	persons who are authorized to discharge clients from the program.
369.31 		Subd. 23.Quality assurance and improvement plan. (a) A license holder must develop 
369.32 	a written quality assurance and improvement plan that includes a plan to:
369.33 	(1) encourage ongoing consultation between members of the treatment team;
370.1 	(2) obtain and evaluate feedback about services from clients, family and other natural 
370.2 	supports, referral sources, and staff persons;
370.3 	(3) measure and evaluate client outcomes in the program;
370.4 	(4) review critical incidents in the program;
370.5 	(5) examine the quality of clinical services in the program; and
370.6 	(6) self-monitor the license holder's compliance with this chapter.
370.7 	(b) At least annually, the license holder must review, evaluate, and update the license 
370.8 	holder's quality assurance and improvement plan. The license holder's review must:
370.9 	(1) document the actions that the license holder will take in response to the information 
370.10 	that the license holder obtains from the monitoring activities in the plan; and
370.11 	(2) establish goals for improving the license holder's services to clients during the next 
370.12 	year.
370.13 		Subd. 24.Application. When an applicant requests licensure to provide intensive 
370.14 	residential treatment services, residential crisis stabilization, or both to clients, the applicant 
370.15 	must submit, on forms that the commissioner provides, any documents that the commissioner 
370.16 	requires.

370.17 	Sec. 17. [256B.0671] COVERED MENTAL HEALTH SERVICES.
370.18 		Subdivision 1.Definitions. (a) "Clinical trainee" means a staff person who is qualified 
370.19 	under section 245I.04, subdivision 6.
370.20 	(b) "Mental health practitioner" means a staff person who is qualified under section 
370.21 	245I.04, subdivision 4.
370.22 	(c) "Mental health professional" means a staff person who is qualified under section 
370.23 	245I.04, subdivision 2.
370.24 		Subd. 2.Generally. (a) An individual, organization, or government entity providing 
370.25 	mental health services to a client under this section must obtain a criminal background study 
370.26 	of each staff person or volunteer who is providing direct contact services to a client.
370.27 	(b) An individual, organization, or government entity providing mental health services 
370.28 	to a client under this section must comply with all responsibilities that chapter 245I assigns 
370.29 	to a license holder, except section 245I.011, subdivision 1, unless all of the individual's, 
370.30 	organization's, or government entity's treatment staff are qualified as mental health 
370.31 	professionals.
371.1 	(c) An individual, organization, or government entity providing mental health services 
371.2 	to a client under this section must comply with the following requirements if all of the 
371.3 	license holder's treatment staff are qualified as mental health professionals:
371.4 	(1) provider qualifications and scopes of practice under section 245I.04;
371.5 	(2) maintaining and updating personnel files under section 245I.07;
371.6 	(3) documenting under section 245I.08;
371.7 	(4) maintaining and updating client files under section 245I.09;
371.8 	(5) completing client assessments and treatment planning under section 245I.10;
371.9 	(6) providing clients with health services and medications under section 245I.11; and
371.10 	(7) respecting and enforcing client rights under section 245I.12.
371.11 		Subd. 3.Adult day treatment services. (a) Subject to federal approval, medical 
371.12 	assistance covers adult day treatment (ADT) services that are provided under contract with 
371.13 	the county board. Adult day treatment payment is subject to the conditions in paragraphs 
371.14 	(b) to (e). The provider must make reasonable and good faith efforts to report individual 
371.15 	client outcomes to the commissioner using instruments, protocols, and forms approved by 
371.16 	the commissioner.
371.17 	(b) Adult day treatment is an intensive psychotherapeutic treatment to reduce or relieve 
371.18 	the effects of mental illness on a client to enable the client to benefit from a lower level of 
371.19 	care and to live and function more independently in the community. Adult day treatment 
371.20 	services must be provided to a client to stabilize the client's mental health and to improve 
371.21 	the client's independent living and socialization skills. Adult day treatment must consist of 
371.22 	at least one hour of group psychotherapy and must include group time focused on 
371.23 	rehabilitative interventions or other therapeutic services that a multidisciplinary team provides 
371.24 	to each client. Adult day treatment services are not a part of inpatient or residential treatment 
371.25 	services. The following providers may apply to become adult day treatment providers:
371.26 	(1) a hospital accredited by the Joint Commission on Accreditation of Health 
371.27 	Organizations and licensed under sections 144.50 to 144.55;
371.28 	(2) a community mental health center under section 256B.0625, subdivision 5; or
371.29 	(3) an entity that is under contract with the county board to operate a program that meets 
371.30 	the requirements of section 245.4712, subdivision 2, and Minnesota Rules, parts 9505.0170 
371.31 	to 9505.0475.
371.32 	(c) An adult day treatment (ADT) services provider must:
372.1 	(1) ensure that the commissioner has approved of the organization as an adult day 
372.2 	treatment provider organization;
372.3 	(2) ensure that a multidisciplinary team provides ADT services to a group of clients. A 
372.4 	mental health professional must supervise each multidisciplinary staff person who provides 
372.5 	ADT services;
372.6 	(3) make ADT services available to the client at least two days a week for at least three 
372.7 	consecutive hours per day. ADT services may be longer than three hours per day, but medical 
372.8 	assistance may not reimburse a provider for more than 15 hours per week;
372.9 	(4) provide ADT services to each client that includes group psychotherapy by a mental 
372.10 	health professional or clinical trainee and daily rehabilitative interventions by a mental 
372.11 	health professional, clinical trainee, or mental health practitioner; and
372.12 	(5) include ADT services in the client's individual treatment plan, when appropriate. 
372.13 	The adult day treatment provider must:
372.14 	(i) complete a functional assessment of each client under section 245I.10, subdivision 
372.15 	9;
372.16 	(ii) notwithstanding section 245I.10, subdivision 8, review the client's progress and 
372.17 	update the individual treatment plan at least every 90 days until the client is discharged 
372.18 	from the program; and
372.19 	(iii) include a discharge plan for the client in the client's individual treatment plan.
372.20 	(d) To be eligible for adult day treatment, a client must:
372.21 	(1) be 18 years of age or older;
372.22 	(2) not reside in a nursing facility, hospital, institute of mental disease, or state-operated 
372.23 	treatment center unless the client has an active discharge plan that indicates a move to an 
372.24 	independent living setting within 180 days;
372.25 	(3) have the capacity to engage in rehabilitative programming, skills activities, and 
372.26 	psychotherapy in the structured, therapeutic setting of an adult day treatment program and 
372.27 	demonstrate measurable improvements in functioning resulting from participation in the 
372.28 	adult day treatment program;
372.29 	(4) have a level of care assessment under section 245I.02, subdivision 19, recommending 
372.30 	that the client participate in services with the level of intensity and duration of an adult day 
372.31 	treatment program; and
373.1 	(5) have the recommendation of a mental health professional for adult day treatment 
373.2 	services. The mental health professional must find that adult day treatment services are 
373.3 	medically necessary for the client.
373.4 	(e) Medical assistance does not cover the following services as adult day treatment 
373.5 	services:
373.6 	(1) services that are primarily recreational or that are provided in a setting that is not 
373.7 	under medical supervision, including sports activities, exercise groups, craft hours, leisure 
373.8 	time, social hours, meal or snack time, trips to community activities, and tours;
373.9 	(2) social or educational services that do not have or cannot reasonably be expected to 
373.10 	have a therapeutic outcome related to the client's mental illness;
373.11 	(3) consultations with other providers or service agency staff persons about the care or 
373.12 	progress of a client;
373.13 	(4) prevention or education programs that are provided to the community;
373.14 	(5) day treatment for clients with a primary diagnosis of a substance use disorder;
373.15 	(6) day treatment provided in the client's home;
373.16 	(7) psychotherapy for more than two hours per day; and
373.17 	(8) participation in meal preparation and eating that is not part of a clinical treatment 
373.18 	plan to address the client's eating disorder.
373.19 		Subd. 4.Explanation of findings. (a) Subject to federal approval, medical assistance 
373.20 	covers an explanation of findings that a mental health professional or clinical trainee provides 
373.21 	when the provider has obtained the authorization from the client or the client's representative 
373.22 	to release the information.
373.23 	(b) A mental health professional or clinical trainee provides an explanation of findings 
373.24 	to assist the client or related parties in understanding the results of the client's testing or 
373.25 	diagnostic assessment and the client's mental illness, and provides professional insight that 
373.26 	the client or related parties need to carry out a client's treatment plan. Related parties may 
373.27 	include the client's family and other natural supports and other service providers working 
373.28 	with the client.
373.29 	(c) An explanation of findings is not paid for separately when a mental health professional 
373.30 	or clinical trainee explains the results of psychological testing or a diagnostic assessment 
373.31 	to the client or the client's representative as part of the client's psychological testing or a 
373.32 	diagnostic assessment.
374.1 		Subd. 5.Family psychoeducation services. (a) Subject to federal approval, medical 
374.2 	assistance covers family psychoeducation services provided to a child up to age 21 with a 
374.3 	diagnosed mental health condition when identified in the child's individual treatment plan 
374.4 	and provided by a mental health professional or a clinical trainee who has determined it 
374.5 	medically necessary to involve family members in the child's care.
374.6 	(b) "Family psychoeducation services" means information or demonstration provided 
374.7 	to an individual or family as part of an individual, family, multifamily group, or peer group 
374.8 	session to explain, educate, and support the child and family in understanding a child's 
374.9 	symptoms of mental illness, the impact on the child's development, and needed components 
374.10 	of treatment and skill development so that the individual, family, or group can help the child 
374.11 	to prevent relapse, prevent the acquisition of comorbid disorders, and achieve optimal mental 
374.12 	health and long-term resilience.
374.13 		Subd. 6.Dialectical behavior therapy. (a) Subject to federal approval, medical assistance 
374.14 	covers intensive mental health outpatient treatment for dialectical behavior therapy for 
374.15 	adults. A dialectical behavior therapy provider must make reasonable and good faith efforts 
374.16 	to report individual client outcomes to the commissioner using instruments and protocols 
374.17 	that are approved by the commissioner.
374.18 	(b) "Dialectical behavior therapy" means an evidence-based treatment approach that a 
374.19 	mental health professional or clinical trainee provides to a client or a group of clients in an 
374.20 	intensive outpatient treatment program using a combination of individualized rehabilitative 
374.21 	and psychotherapeutic interventions. A dialectical behavior therapy program involves: 
374.22 	individual dialectical behavior therapy, group skills training, telephone coaching, and team 
374.23 	consultation meetings.
374.24 	(c) To be eligible for dialectical behavior therapy, a client must:
374.25 	(1) be 18 years of age or older;
374.26 	(2) have mental health needs that available community-based services cannot meet or 
374.27 	that the client must receive concurrently with other community-based services;
374.28 	(3) have either:
374.29 	(i) a diagnosis of borderline personality disorder; or
374.30 	(ii) multiple mental health diagnoses, exhibit behaviors characterized by impulsivity or 
374.31 	intentional self-harm, and be at significant risk of death, morbidity, disability, or severe 
374.32 	dysfunction in multiple areas of the client's life;
375.1 	(4) be cognitively capable of participating in dialectical behavior therapy as an intensive 
375.2 	therapy program and be able and willing to follow program policies and rules to ensure the 
375.3 	safety of the client and others; and
375.4 	(5) be at significant risk of one or more of the following if the client does not receive 
375.5 	dialectical behavior therapy:
375.6 	(i) having a mental health crisis;
375.7 	(ii) requiring a more restrictive setting such as hospitalization;
375.8 	(iii) decompensating; or
375.9 	(iv) engaging in intentional self-harm behavior.
375.10 	(d) Individual dialectical behavior therapy combines individualized rehabilitative and 
375.11 	psychotherapeutic interventions to treat a client's suicidal and other dysfunctional behaviors 
375.12 	and to reinforce a client's use of adaptive skillful behaviors. A mental health professional 
375.13 	or clinical trainee must provide individual dialectical behavior therapy to a client. A mental 
375.14 	health professional or clinical trainee providing dialectical behavior therapy to a client must:
375.15 	(1) identify, prioritize, and sequence the client's behavioral targets;
375.16 	(2) treat the client's behavioral targets;
375.17 	(3) assist the client in applying dialectical behavior therapy skills to the client's natural 
375.18 	environment through telephone coaching outside of treatment sessions;
375.19 	(4) measure the client's progress toward dialectical behavior therapy targets;
375.20 	(5) help the client manage mental health crises and life-threatening behaviors; and
375.21 	(6) help the client learn and apply effective behaviors when working with other treatment 
375.22 	providers.
375.23 	(e) Group skills training combines individualized psychotherapeutic and psychiatric 
375.24 	rehabilitative interventions conducted in a group setting to reduce the client's suicidal and 
375.25 	other dysfunctional coping behaviors and restore function. Group skills training must teach 
375.26 	the client adaptive skills in the following areas: (1) mindfulness; (2) interpersonal 
375.27 	effectiveness; (3) emotional regulation; and (4) distress tolerance.
375.28 	(f) Group skills training must be provided by two mental health professionals or by a 
375.29 	mental health professional co-facilitating with a clinical trainee or a mental health practitioner. 
375.30 	Individual skills training must be provided by a mental health professional, a clinical trainee, 
375.31 	or a mental health practitioner.
376.1 	(g) Before a program provides dialectical behavior therapy to a client, the commissioner 
376.2 	must certify the program as a dialectical behavior therapy provider. To qualify for 
376.3 	certification as a dialectical behavior therapy provider, a provider must:
376.4 	(1) allow the commissioner to inspect the provider's program;
376.5 	(2) provide evidence to the commissioner that the program's policies, procedures, and 
376.6 	practices meet the requirements of this subdivision and chapter 245I;
376.7 	(3) be enrolled as a MHCP provider; and
376.8 	(4) have a manual that outlines the program's policies, procedures, and practices that 
376.9 	meet the requirements of this subdivision.
376.10 		Subd. 7.Mental health clinical care consultation. (a) Subject to federal approval, 
376.11 	medical assistance covers clinical care consultation for a person up to age 21 who is 
376.12 	diagnosed with a complex mental health condition or a mental health condition that co-occurs 
376.13 	with other complex and chronic conditions, when described in the person's individual 
376.14 	treatment plan and provided by a mental health professional or a clinical trainee.
376.15 	(b) "Clinical care consultation" means communication from a treating mental health 
376.16 	professional to other providers or educators not under the treatment supervision of the 
376.17 	treating mental health professional who are working with the same client to inform, inquire, 
376.18 	and instruct regarding the client's symptoms; strategies for effective engagement, care, and 
376.19 	intervention needs; and treatment expectations across service settings and to direct and 
376.20 	coordinate clinical service components provided to the client and family.
376.21 		Subd. 8.Neuropsychological assessment. (a) Subject to federal approval, medical 
376.22 	assistance covers a client's neuropsychological assessment.
376.23 	(b) Neuropsychological assessment" means a specialized clinical assessment of the 
376.24 	client's underlying cognitive abilities related to thinking, reasoning, and judgment that is 
376.25 	conducted by a qualified neuropsychologist. A neuropsychological assessment must include 
376.26 	a face-to-face interview with the client, interpretation of the test results, and preparation 
376.27 	and completion of a report.
376.28 	(c) A client is eligible for a neuropsychological assessment if the client meets at least 
376.29 	one of the following criteria:
376.30 	(1) the client has a known or strongly suspected brain disorder based on the client's 
376.31 	medical history or the client's prior neurological evaluation, including a history of significant 
376.32 	head trauma, brain tumor, stroke, seizure disorder, multiple sclerosis, neurodegenerative 
376.33 	disorder, significant exposure to neurotoxins, central nervous system infection, metabolic 
377.1 	or toxic encephalopathy, fetal alcohol syndrome, or congenital malformation of the brain; 
377.2 	or
377.3 	(2) the client has cognitive or behavioral symptoms that suggest that the client has an 
377.4 	organic condition that cannot be readily attributed to functional psychopathology or suspected 
377.5 	neuropsychological impairment in addition to functional psychopathology. The client's 
377.6 	symptoms may include:
377.7 	(i) having a poor memory or impaired problem solving;
377.8 	(ii) experiencing change in mental status evidenced by lethargy, confusion, or 
377.9 	disorientation;
377.10 	(iii) experiencing a deteriorating level of functioning;
377.11 	(iv) displaying a marked change in behavior or personality;
377.12 	(v) in a child or an adolescent, having significant delays in acquiring academic skill or 
377.13 	poor attention relative to peers;
377.14 	(vi) in a child or an adolescent, having reached a significant plateau in expected 
377.15 	development of cognitive, social, emotional, or physical functioning relative to peers; and
377.16 	(vii) in a child or an adolescent, significant inability to develop expected knowledge, 
377.17 	skills, or abilities to adapt to new or changing cognitive, social, emotional, or physical 
377.18 	demands.
377.19 	(d) The neuropsychological assessment must be completed by a neuropsychologist who:
377.20 	(1) was awarded a diploma by the American Board of Clinical Neuropsychology, the 
377.21 	American Board of Professional Neuropsychology, or the American Board of Pediatric 
377.22 	Neuropsychology;
377.23 	(2) earned a doctoral degree in psychology from an accredited university training program 
377.24 	and:
377.25 	(i) completed an internship or its equivalent in a clinically relevant area of professional 
377.26 	psychology;
377.27 	(ii) completed the equivalent of two full-time years of experience and specialized training, 
377.28 	at least one of which is at the postdoctoral level, supervised by a clinical neuropsychologist 
377.29 	in the study and practice of clinical neuropsychology and related neurosciences; and
377.30 	(iii) holds a current license to practice psychology independently according to sections 
377.31 	144.88 to 144.98;
378.1 	(3) is licensed or credentialed by another state's board of psychology examiners in the 
378.2 	specialty of neuropsychology using requirements equivalent to requirements specified by 
378.3 	one of the boards named in clause (1); or
378.4 	(4) was approved by the commissioner as an eligible provider of neuropsychological 
378.5 	assessments prior to December 31, 2010.
378.6 		Subd. 9.Neuropsychological testing. (a) Subject to federal approval, medical assistance 
378.7 	covers neuropsychological testing for clients.
378.8 	(b) "Neuropsychological testing" means administering standardized tests and measures 
378.9 	designed to evaluate the client's ability to attend to, process, interpret, comprehend, 
378.10 	communicate, learn, and recall information and use problem solving and judgment.
378.11 	(c) Medical assistance covers neuropsychological testing of a client when the client:
378.12 	(1) has a significant mental status change that is not a result of a metabolic disorder and 
378.13 	that has failed to respond to treatment;
378.14 	(2) is a child or adolescent with a significant plateau in expected development of 
378.15 	cognitive, social, emotional, or physical function relative to peers;
378.16 	(3) is a child or adolescent with a significant inability to develop expected knowledge, 
378.17 	skills, or abilities to adapt to new or changing cognitive, social, physical, or emotional 
378.18 	demands; or
378.19 	(4) has a significant behavioral change, memory loss, or suspected neuropsychological 
378.20 	impairment in addition to functional psychopathology, or other organic brain injury or one 
378.21 	of the following:
378.22 	(i) traumatic brain injury;
378.23 	(ii) stroke;
378.24 	(iii) brain tumor;
378.25 	(iv) substance use disorder;
378.26 	(v) cerebral anoxic or hypoxic episode;
378.27 	(vi) central nervous system infection or other infectious disease;
378.28 	(vii) neoplasms or vascular injury of the central nervous system;
378.29 	(viii) neurodegenerative disorders;
378.30 	(ix) demyelinating disease;
379.1 	(x) extrapyramidal disease;
379.2 	(xi) exposure to systemic or intrathecal agents or cranial radiation known to be associated 
379.3 	with cerebral dysfunction;
379.4 	(xii) systemic medical conditions known to be associated with cerebral dysfunction, 
379.5 	including renal disease, hepatic encephalopathy, cardiac anomaly, sickle cell disease, and 
379.6 	related hematologic anomalies, and autoimmune disorders, including lupus, erythematosus, 
379.7 	or celiac disease;
379.8 	(xiii) congenital genetic or metabolic disorders known to be associated with cerebral 
379.9 	dysfunction, including phenylketonuria, craniofacial syndromes, or congenital hydrocephalus;
379.10 	(xiv) severe or prolonged nutrition or malabsorption syndromes; or
379.11 	(xv) a condition presenting in a manner difficult for a clinician to distinguish between 
379.12 	the neurocognitive effects of a neurogenic syndrome, including dementia or encephalopathy; 
379.13 	and a major depressive disorder when adequate treatment for major depressive disorder has 
379.14 	not improved the client's neurocognitive functioning; or another disorder, including autism, 
379.15 	selective mutism, anxiety disorder, or reactive attachment disorder.
379.16 	(d) Neuropsychological testing must be administered or clinically supervised by a 
379.17 	qualified neuropsychologist under subdivision 8, paragraph (c).
379.18 	(e) Medical assistance does not cover neuropsychological testing of a client when the 
379.19 	testing is:
379.20 	(1) primarily for educational purposes;
379.21 	(2) primarily for vocational counseling or training;
379.22 	(3) for personnel or employment testing;
379.23 	(4) a routine battery of psychological tests given to the client at the client's inpatient 
379.24 	admission or during a client's continued inpatient stay; or
379.25 	(5) for legal or forensic purposes.
379.26 		Subd. 10.Psychological testing. (a) Subject to federal approval, medical assistance 
379.27 	covers psychological testing of a client.
379.28 	(b) "Psychological testing" means the use of tests or other psychometric instruments to 
379.29 	determine the status of a client's mental, intellectual, and emotional functioning.
379.30 	(c) The psychological testing must:
380.1 	(1) be administered or supervised by a licensed psychologist qualified under section 
380.2 	245I.04, subdivision 2, clause (3), who is competent in the area of psychological testing; 
380.3 	and
380.4 	(2) be validated in a face-to-face interview between the client and a licensed psychologist 
380.5 	or a clinical trainee in psychology under the treatment supervision of a licensed psychologist 
380.6 	under section 245I.06.
380.7 	(d) A licensed psychologist must supervise the administration, scoring, and interpretation 
380.8 	of a client's psychological tests when a clinical psychology trainee, technician, psychometrist, 
380.9 	or psychological assistant or a computer-assisted psychological testing program completes 
380.10 	the psychological testing of the client. The report resulting from the psychological testing 
380.11 	must be signed by the licensed psychologist who conducts the face-to-face interview with 
380.12 	the client. The licensed psychologist or a staff person who is under treatment supervision 
380.13 	must place the client's psychological testing report in the client's record and release one 
380.14 	copy of the report to the client and additional copies to individuals authorized by the client 
380.15 	to receive the report.
380.16 		Subd. 11.Psychotherapy. (a) Subject to federal approval, medical assistance covers 
380.17 	psychotherapy for a client.
380.18 	(b) "Psychotherapy" means treatment of a client with mental illness that applies to the 
380.19 	most appropriate psychological, psychiatric, psychosocial, or interpersonal method that 
380.20 	conforms to prevailing community standards of professional practice to meet the mental 
380.21 	health needs of the client. Medical assistance covers psychotherapy if a mental health 
380.22 	professional or a clinical trainee provides psychotherapy to a client.
380.23 	(c) "Individual psychotherapy" means psychotherapy that a mental health professional 
380.24 	or clinical trainee designs for a client.
380.25 	(d) "Family psychotherapy" means psychotherapy that a mental health professional or 
380.26 	clinical trainee designs for a client and one or more of the client's family members or primary 
380.27 	caregiver whose participation is necessary to accomplish the client's treatment goals. Family 
380.28 	members or primary caregivers participating in a therapy session do not need to be eligible 
380.29 	for medical assistance for medical assistance to cover family psychotherapy. For purposes 
380.30 	of this paragraph, "primary caregiver whose participation is necessary to accomplish the 
380.31 	client's treatment goals" excludes shift or facility staff persons who work at the client's 
380.32 	residence. Medical assistance payments for family psychotherapy are limited to face-to-face 
380.33 	sessions during which the client is present throughout the session, unless the mental health 
380.34 	professional or clinical trainee believes that the client's exclusion from the family 
381.1 	psychotherapy session is necessary to meet the goals of the client's individual treatment 
381.2 	plan. If the client is excluded from a family psychotherapy session, a mental health 
381.3 	professional or clinical trainee must document the reason for the client's exclusion and the 
381.4 	length of time that the client is excluded. The mental health professional must also document 
381.5 	any reason that a member of the client's family is excluded from a psychotherapy session.
381.6 	(e) Group psychotherapy is appropriate for a client who, because of the nature of the 
381.7 	client's emotional, behavioral, or social dysfunctions, can benefit from treatment in a group 
381.8 	setting. For a group of three to eight clients, at least one mental health professional or clinical 
381.9 	trainee must provide psychotherapy to the group. For a group of nine to 12 clients, a team 
381.10 	of at least two mental health professionals or two clinical trainees or one mental health 
381.11 	professional and one clinical trainee must provide psychotherapy to the group. Medical 
381.12 	assistance will cover group psychotherapy for a group of no more than 12 persons.
381.13 	(f) A multiple-family group psychotherapy session is eligible for medical assistance if 
381.14 	a mental health professional or clinical trainee designs the psychotherapy session for at least 
381.15 	two but not more than five families. A mental health professional or clinical trainee must 
381.16 	design multiple-family group psychotherapy sessions to meet the treatment needs of each 
381.17 	client. If the client is excluded from a psychotherapy session, the mental health professional 
381.18 	or clinical trainee must document the reason for the client's exclusion and the length of time 
381.19 	that the client was excluded. The mental health professional or clinical trainee must document 
381.20 	any reason that a member of the client's family was excluded from a psychotherapy session.
381.21 		Subd. 12.Partial hospitalization. (a) Subject to federal approval, medical assistance 
381.22 	covers a client's partial hospitalization.
381.23 	(b) "Partial hospitalization" means a provider's time-limited, structured program of 
381.24 	psychotherapy and other therapeutic services, as defined in United States Code, title 42, 
381.25 	chapter 7, subchapter XVIII, part E, section 1395x(ff), that a multidisciplinary staff person 
381.26 	provides in an outpatient hospital facility or community mental health center that meets 
381.27 	Medicare requirements to provide partial hospitalization services to a client.
381.28 	(c) Partial hospitalization is an appropriate alternative to inpatient hospitalization for a 
381.29 	client who is experiencing an acute episode of mental illness who meets the criteria for an 
381.30 	inpatient hospital admission under Minnesota Rules, part 9505.0520, subpart 1, and who 
381.31 	has family and community resources that support the client's residence in the community. 
381.32 	Partial hospitalization consists of multiple intensive short-term therapeutic services for a 
381.33 	client that a multidisciplinary staff person provides to a client to treat the client's mental 
381.34 	illness.
382.1 		Subd. 13.Diagnostic assessments. Subject to federal approval, medical assistance covers 
382.2 	a client's diagnostic assessments that a mental health professional or clinical trainee completes 
382.3 	under section 245I.10.

382.4 	Sec. 18. DIRECTION TO COMMISSIONER; SINGLE COMPREHENSIVE 
382.5 	LICENSE STRUCTURE.
 382.6 	The commissioner of human services, in consultation with stakeholders including 
382.7 	counties, tribes, managed care organizations, provider organizations, advocacy groups, and 
382.8 	clients and clients' families, shall develop recommendations to develop a single 
382.9 	comprehensive licensing structure for mental health service programs, including outpatient 
382.10 	and residential services for adults and children. The recommendations must prioritize 
382.11 	program integrity, the welfare of clients and clients' families, improved integration of mental 
382.12 	health and substance use disorder services, and the reduction of administrative burden on 
382.13 	providers.

382.14 	Sec. 19. EFFECTIVE DATE.
 382.15 	This article is effective July 1, 2022, or upon federal approval, whichever is later. The 
382.16 	commissioner of human services shall notify the revisor of statutes when federal approval 
382.17 	is obtained.

382.18 	ARTICLE 16
382.19 	CRISIS RESPONSE SERVICES

382.20 	Section 1. Minnesota Statutes 2020, section 245.469, subdivision 1, is amended to read:
382.21 		Subdivision 1.Availability of emergency services. By July 1, 1988,(a) County boards 
382.22 	must provide or contract for enough emergency services within the county to meet the needs 
382.23 	of adults, children, and families in the county who are experiencing an emotional crisis or 
382.24 	mental illness. Clients may be required to pay a fee according to section 245.481.Emergency 
382.25 	service providers must not delay the timely provision of emergency services to a client 
382.26 	because of the unwillingness or inability of the client to pay for services. Emergency services 
382.27 	must include assessment, crisis intervention, and appropriate case disposition. Emergency 
382.28 	services must:
382.29 	(1) promote the safety and emotional stability of adults with mental illness or emotional 
382.30 	crises each client;
383.1 	(2) minimize further deterioration of adults with mental illness or emotional crises each 
383.2 	client;
383.3 	(3) help adults with mental illness or emotional crises each client to obtain ongoing care 
383.4 	and treatment; and
383.5 	(4) prevent placement in settings that are more intensive, costly, or restrictive than 
383.6 	necessary and appropriate to meet client needs.; and
383.7 	(5) provide support, psychoeducation, and referrals to each client's family members, 
383.8 	service providers, and other third parties on behalf of the client in need of emergency 
383.9 	services.
383.10 	(b) If a county provides engagement services under section 253B.041, the county's 
383.11 	emergency service providers must refer clients to engagement services when the client 
383.12 	meets the criteria for engagement services.

383.13 	Sec. 2. Minnesota Statutes 2020, section 245.469, subdivision 2, is amended to read:
383.14 		Subd. 2.Specific requirements. (a) The county board shall require that all service 
383.15 	providers of emergency services to adults with mental illness provide immediate direct 
383.16 	access to a mental health professional during regular business hours. For evenings, weekends, 
383.17 	and holidays, the service may be by direct toll-free telephone access to a mental health 
383.18 	professional, a clinical trainee, or mental health practitioner, or until January 1, 1991, a 
383.19 	designated person with training in human services who receives clinical supervision from 
383.20 	a mental health professional.
383.21 	(b) The commissioner may waive the requirement in paragraph (a) that the evening, 
383.22 	weekend, and holiday service be provided by a mental health professional, clinical trainee,
383.23 	or mental health practitioner after January 1, 1991, if the county documents that:
383.24 	(1) mental health professionals, clinical trainees, or mental health practitioners are 
383.25 	unavailable to provide this service;
383.26 	(2) services are provided by a designated person with training in human services who 
383.27 	receives clinical treatment supervision from a mental health professional; and
383.28 	(3) the service provider is not also the provider of fire and public safety emergency 
383.29 	services.
383.30 	(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the 
383.31 	evening, weekend, and holiday service not be provided by the provider of fire and public 
383.32 	safety emergency services if:
384.1 	(1) every person who will be providing the first telephone contact has received at least 
384.2 	eight hours of training on emergency mental health services reviewed by the state advisory 
384.3 	council on mental health and then approved by the commissioner;
384.4 	(2) every person who will be providing the first telephone contact will annually receive 
384.5 	at least four hours of continued training on emergency mental health services reviewed by 
384.6 	the state advisory council on mental health and then approved by the commissioner;
384.7 	(3) the local social service agency has provided public education about available 
384.8 	emergency mental health services and can assure potential users of emergency services that 
384.9 	their calls will be handled appropriately;
384.10 	(4) the local social service agency agrees to provide the commissioner with accurate 
384.11 	data on the number of emergency mental health service calls received;
384.12 	(5) the local social service agency agrees to monitor the frequency and quality of 
384.13 	emergency services; and
384.14 	(6) the local social service agency describes how it will comply with paragraph (d).
384.15 	(d) Whenever emergency service during nonbusiness hours is provided by anyone other 
384.16 	than a mental health professional, a mental health professional must be available on call for 
384.17 	an emergency assessment and crisis intervention services, and must be available for at least 
384.18 	telephone consultation within 30 minutes.

384.19 	Sec. 3. Minnesota Statutes 2020, section 245.4879, subdivision 1, is amended to read:
384.20 		Subdivision 1.Availability of emergency services. County boards must provide or 
384.21 	contract for enough mental health emergency services within the county to meet the needs 
384.22 	of children, and children's families when clinically appropriate, in the county who are 
384.23 	experiencing an emotional crisis or emotional disturbance. The county board shall ensure 
384.24 	that parents, providers, and county residents are informed about when and how to access 
384.25 	emergency mental health services for children. A child or the child's parent may be required 
384.26 	to pay a fee according to section 245.481. Emergency service providers shall not delay the 
384.27 	timely provision of emergency service because of delays in determining this fee or because 
384.28 	of the unwillingness or inability of the parent to pay the fee. Emergency services must 
384.29 	include assessment, crisis intervention, and appropriate case disposition. Emergency services 
384.30 	must: according to section 245.469.
384.31 	(1) promote the safety and emotional stability of children with emotional disturbances 
384.32 	or emotional crises;
385.1 	(2) minimize further deterioration of the child with emotional disturbance or emotional 
385.2 	crisis;
385.3 	(3) help each child with an emotional disturbance or emotional crisis to obtain ongoing 
385.4 	care and treatment; and
385.5 	(4) prevent placement in settings that are more intensive, costly, or restrictive than 
385.6 	necessary and appropriate to meet the child's needs.

385.7 	Sec. 4. Minnesota Statutes 2020, section 256B.0624, is amended to read:
385.8 	256B.0624 ADULT CRISIS RESPONSE SERVICES COVERED.
385.9 		Subdivision 1.Scope. Medical assistance covers adult mental health crisis response 
385.10 	services as defined in subdivision 2, paragraphs (c) to (e),(a) Subject to federal approval, 
385.11 	if provided to a recipient as defined in subdivision 3 and provided by a qualified provider 
385.12 	entity as defined in this section and by a qualified individual provider working within the 
385.13 	provider's scope of practice and as defined in this subdivision and identified in the recipient's 
385.14 	individual crisis treatment plan as defined in subdivision 11 and if determined to be medically 
385.15 	necessary medical assistance covers medically necessary crisis response services when the 
385.16 	services are provided according to the standards in this section.
385.17 	(b) Subject to federal approval, medical assistance covers medically necessary residential 
385.18 	crisis stabilization for adults when the services are provided by an entity licensed under and 
385.19 	meeting the standards in section 245I.23 or an entity with an adult foster care license meeting 
385.20 	the standards in this section.
385.21 	(c) The provider entity must make reasonable and good faith efforts to report individual 
385.22 	client outcomes to the commissioner using instruments and protocols approved by the 
385.23 	commissioner.
385.24 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
385.25 	given them.
385.26 	(a) "Mental health crisis" is an adult behavioral, emotional, or psychiatric situation 
385.27 	which, but for the provision of crisis response services, would likely result in significantly 
385.28 	reduced levels of functioning in primary activities of daily living, or in an emergency 
385.29 	situation, or in the placement of the recipient in a more restrictive setting, including, but 
385.30 	not limited to, inpatient hospitalization.
386.1 	(b) "Mental health emergency" is an adult behavioral, emotional, or psychiatric situation 
386.2 	which causes an immediate need for mental health services and is consistent with section 
386.3 	62Q.55.
386.4 	A mental health crisis or emergency is determined for medical assistance service 
386.5 	reimbursement by a physician, a mental health professional, or crisis mental health 
386.6 	practitioner with input from the recipient whenever possible.
386.7 	(a) "Certified rehabilitation specialist" means a staff person who is qualified under section 
386.8 	245I.04, subdivision 8.
386.9 	(b) "Clinical trainee" means a staff person who is qualified under section 245I.04, 
386.10 	subdivision 6.
386.11 	(c) "Mental health Crisis assessment" means an immediate face-to-face assessment by 
386.12 	a physician, a mental health professional, or mental health practitioner under the clinical 
386.13 	supervision of a mental health professional, following a screening that suggests that the 
386.14 	adult may be experiencing a mental health crisis or mental health emergency situation. It 
386.15 	includes, when feasible, assessing whether the person might be willing to voluntarily accept 
386.16 	treatment, determining whether the person has an advance directive, and obtaining 
386.17 	information and history from involved family members or caretakers a qualified member 
386.18 	of a crisis team, as described in subdivision 6a.
386.19 	(d) "Mental health mobile Crisis intervention services" means face-to-face, short-term 
386.20 	intensive mental health services initiated during a mental health crisis or mental health 
386.21 	emergency to help the recipient cope with immediate stressors, identify and utilize available 
386.22 	resources and strengths, engage in voluntary treatment, and begin to return to the recipient's 
386.23 	baseline level of functioning. The services, including screening and treatment plan 
386.24 	recommendations, must be culturally and linguistically appropriate.
386.25 	(1) This service is provided on site by a mobile crisis intervention team outside of an 
386.26 	inpatient hospital setting. Mental health mobile crisis intervention services must be available 
386.27 	24 hours a day, seven days a week.
386.28 	(2) The initial screening must consider other available services to determine which 
386.29 	service intervention would best address the recipient's needs and circumstances.
386.30 	(3) The mobile crisis intervention team must be available to meet promptly face-to-face 
386.31 	with a person in mental health crisis or emergency in a community setting or hospital 
386.32 	emergency room.
387.1 	(4) The intervention must consist of a mental health crisis assessment and a crisis 
387.2 	treatment plan.
387.3 	(5) The team must be available to individuals who are experiencing a co-occurring 
387.4 	substance use disorder, who do not need the level of care provided in a detoxification facility.
387.5 	(6) The treatment plan must include recommendations for any needed crisis stabilization 
387.6 	services for the recipient, including engagement in treatment planning and family 
387.7 	psychoeducation.
387.8 	(e) "Crisis screening" means a screening of a client's potential mental health crisis 
387.9 	situation under subdivision 6.
387.10 	(e) (f) "Mental health Crisis stabilization services" means individualized mental health 
387.11 	services provided to a recipient following crisis intervention services which are designed 
387.12 	to restore the recipient to the recipient's prior functional level. Mental health Crisis 
387.13 	stabilization services may be provided in the recipient's home, the home of a family member 
387.14 	or friend of the recipient, another community setting, or a short-term supervised, licensed 
387.15 	residential program, or an emergency department. Mental health crisis stabilization does 
387.16 	not include partial hospitalization or day treatment. Mental health Crisis stabilization services 
387.17 	includes family psychoeducation.
387.18 	(g) "Crisis team" means the staff of a provider entity who are supervised and prepared 
387.19 	to provide mobile crisis services to a client in a potential mental health crisis situation.
387.20 	(h) "Mental health certified family peer specialist" means a staff person who is qualified 
387.21 	under section 245I.04, subdivision 12.
387.22 	(i) "Mental health certified peer specialist" means a staff person who is qualified under 
387.23 	section 245I.04, subdivision 10.
387.24 	(j) "Mental health crisis" is a behavioral, emotional, or psychiatric situation that, without 
387.25 	the provision of crisis response services, would likely result in significantly reducing the 
387.26 	recipient's levels of functioning in primary activities of daily living, in an emergency situation 
387.27 	under section 62Q.55, or in the placement of the recipient in a more restrictive setting, 
387.28 	including but not limited to inpatient hospitalization.
387.29 	(k) "Mental health practitioner" means a staff person who is qualified under section 
387.30 	245I.04, subdivision 4.
387.31 	(l) "Mental health professional" means a staff person who is qualified under section 
387.32 	245I.04, subdivision 2.
388.1 	(m) "Mental health rehabilitation worker" means a staff person who is qualified under 
388.2 	section 245I.04, subdivision 14.
388.3 	(n) "Mobile crisis services" means screening, assessment, intervention, and 
388.4 	community-based stabilization, excluding residential crisis stabilization, that is provided to 
388.5 	a recipient.
388.6 		Subd. 3.Eligibility. An eligible recipient is an individual who:
388.7 	(1) is age 18 or older;
388.8 	(2) is screened as possibly experiencing a mental health crisis or emergency where a 
388.9 	mental health crisis assessment is needed; and
388.10 	(3) is assessed as experiencing a mental health crisis or emergency, and mental health 
388.11 	crisis intervention or crisis intervention and stabilization services are determined to be 
388.12 	medically necessary.
388.13 	(a) A recipient is eligible for crisis assessment services when the recipient has screened 
388.14 	positive for a potential mental health crisis during a crisis screening.
388.15 	(b) A recipient is eligible for crisis intervention services and crisis stabilization services 
388.16 	when the recipient has been assessed during a crisis assessment to be experiencing a mental 
388.17 	health crisis.
388.18 		Subd. 4.Provider entity standards. (a) A provider entity is an entity that meets the 
388.19 	standards listed in paragraph (c) and mobile crisis provider must be:
388.20 	(1) is a county board operated entity; or
388.21 	(2) an Indian health services facility or facility owned and operated by a tribe or Tribal 
388.22 	organization operating under United States Code, title 325, section 450f; or
388.23 	(2) is (3) a provider entity that is under contract with the county board in the county 
388.24 	where the potential crisis or emergency is occurring. To provide services under this section, 
388.25 	the provider entity must directly provide the services; or if services are subcontracted, the 
388.26 	provider entity must maintain responsibility for services and billing.
388.27 	(b) A mobile crisis provider must meet the following standards:
388.28 	(1) ensure that crisis screenings, crisis assessments, and crisis intervention services are 
388.29 	available to a recipient 24 hours a day, seven days a week;
388.30 	(2) be able to respond to a call for services in a designated service area or according to 
388.31 	a written agreement with the local mental health authority for an adjacent area;
389.1 	(3) have at least one mental health professional on staff at all times and at least one 
389.2 	additional staff member capable of leading a crisis response in the community; and
389.3 	(4) provide the commissioner with information about the number of requests for service, 
389.4 	the number of people that the provider serves face-to-face, outcomes, and the protocols that 
389.5 	the provider uses when deciding when to respond in the community.
389.6 	(b) (c) A provider entity that provides crisis stabilization services in a residential setting 
389.7 	under subdivision 7 is not required to meet the requirements of paragraph paragraphs (a), 
389.8 	clauses (1) and (2) and (b), but must meet all other requirements of this subdivision.
389.9 	(c) The adult mental health (d) A crisis response services provider entity must have the 
389.10 	capacity to meet and carry out the standards in section 245I.011, subdivision 5, and the 
389.11 	following standards:
389.12 	(1) has the capacity to recruit, hire, and manage and train mental health professionals, 
389.13 	practitioners, and rehabilitation workers ensures that staff persons provide support for a 
389.14 	recipient's family and natural supports, by enabling the recipient's family and natural supports 
389.15 	to observe and participate in the recipient's treatment, assessments, and planning services;
389.16 	(2) has adequate administrative ability to ensure availability of services;
389.17 	(3) is able to ensure adequate preservice and in-service training;
389.18 	(4) (3) is able to ensure that staff providing these services are skilled in the delivery of 
389.19 	mental health crisis response services to recipients;
389.20 	(5) (4) is able to ensure that staff are capable of implementing culturally specific treatment 
389.21 	identified in the individual crisis treatment plan that is meaningful and appropriate as 
389.22 	determined by the recipient's culture, beliefs, values, and language;
389.23 	(6) (5) is able to ensure enough flexibility to respond to the changing intervention and 
389.24 	care needs of a recipient as identified by the recipient or family member during the service 
389.25 	partnership between the recipient and providers;
389.26 	(7) (6) is able to ensure that mental health professionals and mental health practitioners
389.27 	staff have the communication tools and procedures to communicate and consult promptly 
389.28 	about crisis assessment and interventions as services occur;
389.29 	(8) (7) is able to coordinate these services with county emergency services, community 
389.30 	hospitals, ambulance, transportation services, social services, law enforcement, engagement 
389.31 	services, and mental health crisis services through regularly scheduled interagency meetings;
390.1 	(9) is able to ensure that mental health crisis assessment and mobile crisis intervention 
390.2 	services are available 24 hours a day, seven days a week;
390.3 	(10) (8) is able to ensure that services are coordinated with other mental behavioral
390.4 	health service providers, county mental health authorities, or federally recognized American 
390.5 	Indian authorities and others as necessary, with the consent of the adult recipient or parent 
390.6 	or guardian. Services must also be coordinated with the recipient's case manager if the adult
390.7 	recipient is receiving case management services;
390.8 	(11) (9) is able to ensure that crisis intervention services are provided in a manner 
390.9 	consistent with sections 245.461 to 245.486 and 245.487 to 245.4879;
390.10 	(12) is able to submit information as required by the state;
390.11 	(13) maintains staff training and personnel files;
390.12 	(10) is able to coordinate detoxification services for the recipient according to Minnesota 
390.13 	Rules, parts 9530.6605 to 9530.6655, or withdrawal management according to chapter 245F;
390.14 	(14) (11) is able to establish and maintain a quality assurance and evaluation plan to 
390.15 	evaluate the outcomes of services and recipient satisfaction; and
390.16 	(15) is able to keep records as required by applicable laws;
390.17 	(16) is able to comply with all applicable laws and statutes;
390.18 	(17) (12) is an enrolled medical assistance provider; and.
390.19 	(18) develops and maintains written policies and procedures regarding service provision 
390.20 	and administration of the provider entity, including safety of staff and recipients in high-risk 
390.21 	situations.
390.22 		Subd. 4a.Alternative provider standards. If a county or tribe demonstrates that, due 
390.23 	to geographic or other barriers, it is not feasible to provide mobile crisis intervention services 
390.24 	according to the standards in subdivision 4, paragraph (c), clause (9) (b), the commissioner 
390.25 	may approve a crisis response provider based on an alternative plan proposed by a county 
390.26 	or group of counties tribe. The alternative plan must:
390.27 	(1) result in increased access and a reduction in disparities in the availability of mobile 
390.28 	crisis services;
390.29 	(2) provide mobile crisis services outside of the usual nine-to-five office hours and on 
390.30 	weekends and holidays; and
390.31 	(3) comply with standards for emergency mental health services in section 245.469.
391.1 		Subd. 5.Mobile Crisis assessment and intervention staff qualifications. For provision 
391.2 	of adult mental health mobile crisis intervention services, a mobile crisis intervention team 
391.3 	is comprised of at least two mental health professionals as defined in section 245.462, 
391.4 	subdivision 18, clauses (1) to (6), or a combination of at least one mental health professional 
391.5 	and one mental health practitioner as defined in section 245.462, subdivision 17, with the 
391.6 	required mental health crisis training and under the clinical supervision of a mental health 
391.7 	professional on the team. The team must have at least two people with at least one member 
391.8 	providing on-site crisis intervention services when needed.(a) Qualified individual staff of 
391.9 	a qualified provider entity must provide crisis assessment and intervention services to a 
391.10 	recipient. A staff member providing crisis assessment and intervention services to a recipient 
391.11 	must be qualified as a:
391.12 	(1) mental health professional;
391.13 	(2) clinical trainee;
391.14 	(3) mental health practitioner;
391.15 	(4) mental health certified family peer specialist; or
391.16 	(5) mental health certified peer specialist.
391.17 	(b) When crisis assessment and intervention services are provided to a recipient in the 
391.18 	community, a mental health professional, clinical trainee, or mental health practitioner must 
391.19 	lead the response.
391.20 	(c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph 
391.21 	(b), must be specific to providing crisis services to children and adults and include training 
391.22 	about evidence-based practices identified by the commissioner of health to reduce the 
391.23 	recipient's risk of suicide and self-injurious behavior.
391.24 	(d) Team members must be experienced in mental health crisis assessment, crisis 
391.25 	intervention techniques, treatment engagement strategies, working with families, and clinical 
391.26 	decision-making under emergency conditions and have knowledge of local services and 
391.27 	resources. The team must recommend and coordinate the team's services with appropriate 
391.28 	local resources such as the county social services agency, mental health services, and local 
391.29 	law enforcement when necessary.
391.30 		Subd. 6.Crisis assessment and mobile intervention treatment planning screening. (a) 
391.31 	Prior to initiating mobile crisis intervention services, a screening of the potential crisis 
391.32 	situation must be conducted. The crisis screening may use the resources of crisis assistance 
391.33 	and emergency services as defined in sections 245.462, subdivision 6, and section245.469, 
392.1 	subdivisions 1 and 2. The crisis screening must gather information, determine whether a 
392.2 	mental health crisis situation exists, identify parties involved, and determine an appropriate 
392.3 	response.
392.4 	(b) When conducting the crisis screening of a recipient, a provider must:
392.5 	(1) employ evidence-based practices to reduce the recipient's risk of suicide and 
392.6 	self-injurious behavior;
392.7 	(2) work with the recipient to establish a plan and time frame for responding to the 
392.8 	recipient's mental health crisis, including responding to the recipient's immediate need for 
392.9 	support by telephone or text message until the provider can respond to the recipient 
392.10 	face-to-face;
392.11 	(3) document significant factors in determining whether the recipient is experiencing a 
392.12 	mental health crisis, including prior requests for crisis services, a recipient's recent 
392.13 	presentation at an emergency department, known calls to 911 or law enforcement, or 
392.14 	information from third parties with knowledge of a recipient's history or current needs;
392.15 	(4) accept calls from interested third parties and consider the additional needs or potential 
392.16 	mental health crises that the third parties may be experiencing;
392.17 	(5) provide psychoeducation, including means reduction, to relevant third parties 
392.18 	including family members or other persons living with the recipient; and
392.19 	(6) consider other available services to determine which service intervention would best 
392.20 	address the recipient's needs and circumstances.
392.21 	(c) For the purposes of this section, the following situations indicate a positive screen 
392.22 	for a potential mental health crisis and the provider must prioritize providing a face-to-face 
392.23 	crisis assessment of the recipient, unless a provider documents specific evidence to show 
392.24 	why this was not possible, including insufficient staffing resources, concerns for staff or 
392.25 	recipient safety, or other clinical factors:
392.26 	(1) the recipient presents at an emergency department or urgent care setting and the 
392.27 	health care team at that location requested crisis services; or
392.28 	(2) a peace officer requested crisis services for a recipient who is potentially subject to 
392.29 	transportation under section 253B.051.
392.30 	(d) A provider is not required to have direct contact with the recipient to determine that 
392.31 	the recipient is experiencing a potential mental health crisis. A mobile crisis provider may 
393.1 	gather relevant information about the recipient from a third party to establish the recipient's 
393.2 	need for services and potential safety factors.
393.3 		Subd. 6a.Crisis assessment. (b) (a) If a crisis exists recipient screens positive for 
393.4 	potential mental health crisis, a crisis assessment must be completed. A crisis assessment 
393.5 	evaluates any immediate needs for which emergency services are needed and, as time 
393.6 	permits, the recipient's current life situation, health information, including current 
393.7 	medications, sources of stress, mental health problems and symptoms, strengths, cultural 
393.8 	considerations, support network, vulnerabilities, current functioning, and the recipient's 
393.9 	preferences as communicated directly by the recipient, or as communicated in a health care 
393.10 	directive as described in chapters 145C and 253B, the crisis treatment plan described under 
393.11 	paragraph (d) subdivision 11, a crisis prevention plan, or a wellness recovery action plan.
393.12 	(b) A provider must conduct a crisis assessment at the recipient's location whenever 
393.13 	possible.
393.14 	(c) Whenever possible, the assessor must attempt to include input from the recipient and 
393.15 	the recipient's family and other natural supports to assess whether a crisis exists.
393.16 	(d) A crisis assessment includes: (1) determining (i) whether the recipient is willing to 
393.17 	voluntarily engage in treatment, or (ii) whether the recipient has an advance directive, and 
393.18 	(2) gathering the recipient's information and history from involved family or other natural 
393.19 	supports.
393.20 	(e) A crisis assessment must include coordinated response with other health care providers 
393.21 	if the assessment indicates that a recipient needs detoxification, withdrawal management, 
393.22 	or medical stabilization in addition to crisis response services. If the recipient does not need 
393.23 	an acute level of care, a team must serve an otherwise eligible recipient who has a 
393.24 	co-occurring substance use disorder.
393.25 	(f) If, after completing a crisis assessment of a recipient, a provider refers a recipient to 
393.26 	an intensive setting, including an emergency department, inpatient hospitalization, or 
393.27 	residential crisis stabilization, one of the crisis team members who completed or conferred 
393.28 	about the recipient's crisis assessment must immediately contact the referral entity and 
393.29 	consult with the triage nurse or other staff responsible for intake at the referral entity. During 
393.30 	the consultation, the crisis team member must convey key findings or concerns that led to 
393.31 	the recipient's referral. Following the immediate consultation, the provider must also send 
393.32 	written documentation upon completion. The provider must document if these releases 
393.33 	occurred with authorization by the recipient, the recipient's legal guardian, or as allowed 
393.34 	by section 144.293, subdivision 5.
394.1 		Subd. 6b.Crisis intervention services. (c) (a) If the crisis assessment determines mobile 
394.2 	crisis intervention services are needed, the crisis intervention services must be provided 
394.3 	promptly. As opportunity presents during the intervention, at least two members of the 
394.4 	mobile crisis intervention team must confer directly or by telephone about the crisis 
394.5 	assessment, crisis treatment plan, and actions taken and needed. At least one of the team 
394.6 	members must be on site providing face-to-face crisis intervention services. If providing 
394.7 	on-site crisis intervention services, a clinical trainee or mental health practitioner must seek 
394.8 	clinical treatment supervision as required in subdivision 9.
394.9 	(b) If a provider delivers crisis intervention services while the recipient is absent, the 
394.10 	provider must document the reason for delivering services while the recipient is absent.
394.11 	(d) (c) The mobile crisis intervention team must develop an initial, brief a crisis treatment 
394.12 	plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention
394.13 	according to subdivision 11. The plan must address the needs and problems noted in the 
394.14 	crisis assessment and include measurable short-term goals, cultural considerations, and 
394.15 	frequency and type of services to be provided to achieve the goals and reduce or eliminate 
394.16 	the crisis. The treatment plan must be updated as needed to reflect current goals and services.
394.17 	(e) (d) The mobile crisis intervention team must document which short-term goals crisis 
394.18 	treatment plan goals and objectives have been met and when no further crisis intervention 
394.19 	services are required.
394.20 	(f) (e) If the recipient's mental health crisis is stabilized, but the recipient needs a referral 
394.21 	to other services, the team must provide referrals to these services. If the recipient has a 
394.22 	case manager, planning for other services must be coordinated with the case manager. If 
394.23 	the recipient is unable to follow up on the referral, the team must link the recipient to the 
394.24 	service and follow up to ensure the recipient is receiving the service.
394.25 	(g) (f) If the recipient's mental health crisis is stabilized and the recipient does not have 
394.26 	an advance directive, the case manager or crisis team shall offer to work with the recipient 
394.27 	to develop one.
394.28 		Subd. 7.Crisis stabilization services. (a) Crisis stabilization services must be provided 
394.29 	by qualified staff of a crisis stabilization services provider entity and must meet the following 
394.30 	standards:
394.31 	(1) a crisis stabilization treatment plan must be developed which that meets the criteria 
394.32 	in subdivision 11;
394.33 	(2) staff must be qualified as defined in subdivision 8; and
395.1 	(3) crisis stabilization services must be delivered according to the crisis treatment plan 
395.2 	and include face-to-face contact with the recipient by qualified staff for further assessment, 
395.3 	help with referrals, updating of the crisis stabilization treatment plan, supportive counseling,
395.4 	skills training, and collaboration with other service providers in the community.; and
395.5 	(4) if a provider delivers crisis stabilization services while the recipient is absent, the 
395.6 	provider must document the reason for delivering services while the recipient is absent.
395.7 	(b) If crisis stabilization services are provided in a supervised, licensed residential setting, 
395.8 	the recipient must be contacted face-to-face daily by a qualified mental health practitioner 
395.9 	or mental health professional. The program must have 24-hour-a-day residential staffing 
395.10 	which may include staff who do not meet the qualifications in subdivision 8. The residential 
395.11 	staff must have 24-hour-a-day immediate direct or telephone access to a qualified mental 
395.12 	health professional or practitioner.
395.13 	(c) (b) If crisis stabilization services are provided in a supervised, licensed residential 
395.14 	setting that serves no more than four adult residents, and one or more individuals are present 
395.15 	at the setting to receive residential crisis stabilization services, the residential staff must 
395.16 	include, for at least eight hours per day, at least one individual who meets the qualifications 
395.17 	in subdivision 8, paragraph (a), clause (1) or (2) mental health professional, clinical trainee, 
395.18 	certified rehabilitation specialist, or mental health practitioner.
395.19 	(d) If crisis stabilization services are provided in a supervised, licensed residential setting 
395.20 	that serves more than four adult residents, and one or more are recipients of crisis stabilization 
395.21 	services, the residential staff must include, for 24 hours a day, at least one individual who 
395.22 	meets the qualifications in subdivision 8. During the first 48 hours that a recipient is in the 
395.23 	residential program, the residential program must have at least two staff working 24 hours 
395.24 	a day. Staffing levels may be adjusted thereafter according to the needs of the recipient as 
395.25 	specified in the crisis stabilization treatment plan.
395.26 		Subd. 8.Adult Crisis stabilization staff qualifications. (a) Adult Mental health crisis 
395.27 	stabilization services must be provided by qualified individual staff of a qualified provider 
395.28 	entity. Individual provider staff must have the following qualifications A staff member 
395.29 	providing crisis stabilization services to a recipient must be qualified as a:
395.30 	(1) be a mental health professional as defined in section 245.462, subdivision 18, clauses 
395.31 	(1) to (6);
395.32 	(2) be a certified rehabilitation specialist;
395.33 	(3) clinical trainee;
396.1 	(4) mental health practitioner as defined in section 245.462, subdivision 17. The mental 
396.2 	health practitioner must work under the clinical supervision of a mental health professional;
396.3 	(5) mental health certified family peer specialist;
396.4 	(3) be a (6) mental health certified peer specialist under section 256B.0615. The certified 
396.5 	peer specialist must work under the clinical supervision of a mental health professional; or
396.6 	(4) be a (7) mental health rehabilitation worker who meets the criteria in section 
396.7 	256B.0623, subdivision 5, paragraph (a), clause (4); works under the direction of a mental 
396.8 	health practitioner as defined in section 245.462, subdivision 17, or under direction of a 
396.9 	mental health professional; and works under the clinical supervision of a mental health 
396.10 	professional.
396.11 	(b) Mental health practitioners and mental health rehabilitation workers must have 
396.12 	completed at least 30 hours of training in crisis intervention and stabilization during the 
396.13 	past two years. The 30 hours of ongoing training required in section 245I.05, subdivision 
396.14 	4, paragraph (b), must be specific to providing crisis services to children and adults and 
396.15 	include training about evidence-based practices identified by the commissioner of health 
396.16 	to reduce a recipient's risk of suicide and self-injurious behavior.
396.17 		Subd. 9.Supervision. Clinical trainees and mental health practitioners may provide 
396.18 	crisis assessment and mobile crisis intervention services if the following clinical treatment
396.19 	supervision requirements are met:
396.20 	(1) the mental health provider entity must accept full responsibility for the services 
396.21 	provided;
396.22 	(2) the mental health professional of the provider entity, who is an employee or under 
396.23 	contract with the provider entity, must be immediately available by phone or in person for 
396.24 	clinical treatment supervision;
396.25 	(3) the mental health professional is consulted, in person or by phone, during the first 
396.26 	three hours when a clinical trainee or mental health practitioner provides on-site service
396.27 	crisis assessment or crisis intervention services; and
396.28 	(4) the mental health professional must:
396.29 	(i) review and approve, as defined in section 245I.02, subdivision 2, of the tentative 
396.30 	crisis assessment and crisis treatment plan within 24 hours of first providing services to the 
396.31 	recipient, notwithstanding section 245I.08, subdivision 3; and
396.32 	(ii) document the consultation; and required in clause (3).
397.1 	(iii) sign the crisis assessment and treatment plan within the next business day;
397.2 	(5) if the mobile crisis intervention services continue into a second calendar day, a mental 
397.3 	health professional must contact the recipient face-to-face on the second day to provide 
397.4 	services and update the crisis treatment plan; and
397.5 	(6) the on-site observation must be documented in the recipient's record and signed by 
397.6 	the mental health professional.
397.7 		Subd. 10.Recipient file. Providers of mobile crisis intervention or crisis stabilization 
397.8 	services must maintain a file for each recipient containing the following information:
397.9 	(1) individual crisis treatment plans signed by the recipient, mental health professional, 
397.10 	and mental health practitioner who developed the crisis treatment plan, or if the recipient 
397.11 	refused to sign the plan, the date and reason stated by the recipient as to why the recipient 
397.12 	would not sign the plan;
397.13 	(2) signed release forms;
397.14 	(3) recipient health information and current medications;
397.15 	(4) emergency contacts for the recipient;
397.16 	(5) case records which document the date of service, place of service delivery, signature 
397.17 	of the person providing the service, and the nature, extent, and units of service. Direct or 
397.18 	telephone contact with the recipient's family or others should be documented;
397.19 	(6) required clinical supervision by mental health professionals;
397.20 	(7) summary of the recipient's case reviews by staff;
397.21 	(8) any written information by the recipient that the recipient wants in the file; and
397.22 	(9) an advance directive, if there is one available.
397.23 	Documentation in the file must comply with all requirements of the commissioner.
397.24 		Subd. 11.Crisis treatment plan. The individual crisis stabilization treatment plan must 
397.25 	include, at a minimum:
397.26 	(1) a list of problems identified in the assessment;
397.27 	(2) a list of the recipient's strengths and resources;
397.28 	(3) concrete, measurable short-term goals and tasks to be achieved, including time frames 
397.29 	for achievement;
397.30 	(4) specific objectives directed toward the achievement of each one of the goals;
398.1 	(5) documentation of the participants involved in the service planning. The recipient, if 
398.2 	possible, must be a participant. The recipient or the recipient's legal guardian must sign the 
398.3 	service plan or documentation must be provided why this was not possible. A copy of the 
398.4 	plan must be given to the recipient and the recipient's legal guardian. The plan should include 
398.5 	services arranged, including specific providers where applicable;
398.6 	(6) planned frequency and type of services initiated;
398.7 	(7) a crisis response action plan if a crisis should occur;
398.8 	(8) clear progress notes on outcome of goals;
398.9 	(9) a written plan must be completed within 24 hours of beginning services with the 
398.10 	recipient; and
398.11 	(10) a treatment plan must be developed by a mental health professional or mental health 
398.12 	practitioner under the clinical supervision of a mental health professional. The mental health 
398.13 	professional must approve and sign all treatment plans.
398.14 	(a) Within 24 hours of the recipient's admission, the provider entity must complete the 
398.15 	recipient's crisis treatment plan. The provider entity must:
398.16 	(1) base the recipient's crisis treatment plan on the recipient's crisis assessment;
398.17 	(2) consider crisis assistance strategies that have been effective for the recipient in the 
398.18 	past;
398.19 	(3) for a child recipient, use a child-centered, family-driven, and culturally appropriate 
398.20 	planning process that allows the recipient's parents and guardians to observe or participate 
398.21 	in the recipient's individual and family treatment services, assessment, and treatment 
398.22 	planning;
398.23 	(4) for an adult recipient, use a person-centered, culturally appropriate planning process 
398.24 	that allows the recipient's family and other natural supports to observe or participate in 
398.25 	treatment services, assessment, and treatment planning;
398.26 	(5) identify the participants involved in the recipient's treatment planning. The recipient, 
398.27 	if possible, must be a participant;
398.28 	(6) identify the recipient's initial treatment goals, measurable treatment objectives, and 
398.29 	specific interventions that the license holder will use to help the recipient engage in treatment;
398.30 	(7) include documentation of referral to and scheduling of services, including specific 
398.31 	providers where applicable;
399.1 	(8) ensure that the recipient or the recipient's legal guardian approves under section 
399.2 	245I.02, subdivision 2, of the recipient's crisis treatment plan unless a court orders the 
399.3 	recipient's treatment plan under chapter 253B. If the recipient or the recipient's legal guardian 
399.4 	disagrees with the crisis treatment plan, the license holder must document in the client file 
399.5 	the reasons why the recipient disagrees with the crisis treatment plan; and
399.6 	(9) ensure that a treatment supervisor approves under section 245I.02, subdivision 2, of 
399.7 	the recipient's treatment plan within 24 hours of the recipient's admission if a mental health 
399.8 	practitioner or clinical trainee completes the crisis treatment plan, notwithstanding section 
399.9 	245I.08, subdivision 3.
399.10 	(b) The provider entity must provide the recipient and the recipient's legal guardian with 
399.11 	a copy of the recipient's crisis treatment plan.
399.12 		Subd. 12.Excluded services. The following services are excluded from reimbursement 
399.13 	under this section:
399.14 	(1) room and board services;
399.15 	(2) services delivered to a recipient while admitted to an inpatient hospital;
399.16 	(3) recipient transportation costs may be covered under other medical assistance 
399.17 	provisions, but transportation services are not an adult mental health crisis response service;
399.18 	(4) services provided and billed by a provider who is not enrolled under medical 
399.19 	assistance to provide adult mental health crisis response services;
399.20 	(5) services performed by volunteers;
399.21 	(6) direct billing of time spent "on call" when not delivering services to a recipient;
399.22 	(7) provider service time included in case management reimbursement. When a provider 
399.23 	is eligible to provide more than one type of medical assistance service, the recipient must 
399.24 	have a choice of provider for each service, unless otherwise provided for by law;
399.25 	(8) outreach services to potential recipients; and
399.26 	(9) a mental health service that is not medically necessary.;
399.27 	(10) services that a residential treatment center licensed under Minnesota Rules, chapter 
399.28 	2960, provides to a client;
399.29 	(11) partial hospitalization or day treatment; and
399.30 	(12) a crisis assessment that a residential provider completes when a daily rate is paid 
399.31 	for the recipient's crisis stabilization.

400.1 	Sec. 5. EFFECTIVE DATE.
 400.2 	This article is effective July 1, 2022, or upon federal approval, whichever is later. The 
400.3 	commissioner of human services shall notify the revisor of statutes when federal approval 
400.4 	is obtained.

400.5 	ARTICLE 17
400.6 	MENTAL HEALTH UNIFORM SERVICE STANDARDS; CONFORMING 
400.7 	CHANGES

400.8 	Section 1. Minnesota Statutes 2020, section 62A.152, subdivision 3, is amended to read:
400.9 		Subd. 3.Provider discrimination prohibited. All group policies and group subscriber 
400.10 	contracts that provide benefits for mental or nervous disorder treatments in a hospital must 
400.11 	provide direct reimbursement for those services if performed by a mental health professional, 
400.12 	as defined in sections 245.462, subdivision 18, clauses (1) to (5); and 245.4871, subdivision 
400.13 	27, clauses (1) to (5) qualified according to section 245I.04, subdivision 2, to the extent that 
400.14 	the services and treatment are within the scope of mental health professional licensure.
400.15 	This subdivision is intended to provide payment of benefits for mental or nervous disorder 
400.16 	treatments performed by a licensed mental health professional in a hospital and is not 
400.17 	intended to change or add benefits for those services provided in policies or contracts to 
400.18 	which this subdivision applies.

400.19 	Sec. 2. Minnesota Statutes 2020, section 62A.3094, subdivision 1, is amended to read:
400.20 		Subdivision 1.Definitions. (a) For purposes of this section, the terms defined in 
400.21 	paragraphs (b) to (d) have the meanings given.
400.22 	(b) "Autism spectrum disorders" means the conditions as determined by criteria set forth 
400.23 	in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of 
400.24 	the American Psychiatric Association.
400.25 	(c) "Medically necessary care" means health care services appropriate, in terms of type, 
400.26 	frequency, level, setting, and duration, to the enrollee's condition, and diagnostic testing 
400.27 	and preventative services. Medically necessary care must be consistent with generally 
400.28 	accepted practice parameters as determined by physicians and licensed psychologists who 
400.29 	typically manage patients who have autism spectrum disorders.
400.30 	(d) "Mental health professional" means a mental health professional as defined in section 
400.31 	245.4871, subdivision 27 who is qualified according to section 245I.04, subdivision 2, 
401.1 	clause (1), (2), (3), (4), or (6), who has training and expertise in autism spectrum disorder 
401.2 	and child development.

401.3 	Sec. 3. Minnesota Statutes 2020, section 62Q.096, is amended to read:
401.4 	62Q.096 CREDENTIALING OF PROVIDERS.
401.5 	If a health plan company has initially credentialed, as providers in its provider network, 
401.6 	individual providers employed by or under contract with an entity that:
401.7 	(1) is authorized to bill under section 256B.0625, subdivision 5;
401.8 	(2) meets the requirements of Minnesota Rules, parts 9520.0750 to 9520.0870 is a mental 
401.9 	health clinic certified under section 245I.20;
401.10 	(3) is designated an essential community provider under section 62Q.19; and
401.11 	(4) is under contract with the health plan company to provide mental health services, 
401.12 	the health plan company must continue to credential at least the same number of providers 
401.13 	from that entity, as long as those providers meet the health plan company's credentialing 
401.14 	standards.
401.15 	A health plan company shall not refuse to credential these providers on the grounds that 
401.16 	their provider network has a sufficient number of providers of that type.

401.17 	Sec. 4. Minnesota Statutes 2020, section 144.651, subdivision 2, is amended to read:
401.18 		Subd. 2.Definitions. For the purposes of this section, "patient" means a person who is 
401.19 	admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for 
401.20 	the purpose of diagnosis or treatment bearing on the physical or mental health of that person. 
401.21 	For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means a 
401.22 	person who receives health care services at an outpatient surgical center or at a birth center 
401.23 	licensed under section 144.615. "Patient" also means a minor who is admitted to a residential 
401.24 	program as defined in section 253C.01. For purposes of subdivisions 1, 3 to 16, 18, 20 and 
401.25 	30, "patient" also means any person who is receiving mental health treatment on an outpatient 
401.26 	basis or in a community support program or other community-based program. "Resident" 
401.27 	means a person who is admitted to a nonacute care facility including extended care facilities, 
401.28 	nursing homes, and boarding care homes for care required because of prolonged mental or 
401.29 	physical illness or disability, recovery from injury or disease, or advancing age. For purposes 
401.30 	of all subdivisions except subdivisions 28 and 29, "resident" also means a person who is 
401.31 	admitted to a facility licensed as a board and lodging facility under Minnesota Rules, parts 
401.32 	4625.0100 to 4625.2355, a boarding care home under sections 144.50 to 144.56, or a 
402.1 	supervised living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which 
402.2 	operates a rehabilitation program licensed under chapter 245Gor 245I, or Minnesota Rules, 
402.3 	parts 9530.6510 to 9530.6590.

402.4 	Sec. 5. Minnesota Statutes 2020, section 144D.01, subdivision 4, is amended to read:
402.5 		Subd. 4.Housing with services establishment or establishment. (a) "Housing with 
402.6 	services establishment" or "establishment" means:
402.7 	(1) an establishment providing sleeping accommodations to one or more adult residents, 
402.8 	at least 80 percent of which are 55 years of age or older, and offering or providing, for a 
402.9 	fee, one or more regularly scheduled health-related services or two or more regularly 
402.10 	scheduled supportive services, whether offered or provided directly by the establishment 
402.11 	or by another entity arranged for by the establishment; or
402.12 	(2) an establishment that registers under section 144D.025.
402.13 	(b) Housing with services establishment does not include:
402.14 	(1) a nursing home licensed under chapter 144A;
402.15 	(2) a hospital, certified boarding care home, or supervised living facility licensed under 
402.16 	sections 144.50 to 144.56;
402.17 	(3) a board and lodging establishment licensed under chapter 157 and Minnesota Rules, 
402.18 	parts 9520.0500 to 9520.0670, or under chapter 245Dor,245G, or 245I;
402.19 	(4) a board and lodging establishment which serves as a shelter for battered women or 
402.20 	other similar purpose;
402.21 	(5) a family adult foster care home licensed by the Department of Human Services;
402.22 	(6) private homes in which the residents are related by kinship, law, or affinity with the 
402.23 	providers of services;
402.24 	(7) residential settings for persons with developmental disabilities in which the services 
402.25 	are licensed under chapter 245D;
402.26 	(8) a home-sharing arrangement such as when an elderly or disabled person or 
402.27 	single-parent family makes lodging in a private residence available to another person in 
402.28 	exchange for services or rent, or both;
402.29 	(9) a duly organized condominium, cooperative, common interest community, or owners' 
402.30 	association of the foregoing where at least 80 percent of the units that comprise the 
403.1 	condominium, cooperative, or common interest community are occupied by individuals 
403.2 	who are the owners, members, or shareholders of the units;
403.3 	(10) services for persons with developmental disabilities that are provided under a license 
403.4 	under chapter 245D; or
403.5 	(11) a temporary family health care dwelling as defined in sections 394.307 and 462.3593.

403.6 	Sec. 6. Minnesota Statutes 2020, section 144G.08, subdivision 7, as amended by Laws 
403.7 	2020, Seventh Special Session chapter 1, article 6, section 5, is amended to read:
403.8 		Subd. 7.Assisted living facility. "Assisted living facility" means a facility that provides 
403.9 	sleeping accommodations and assisted living services to one or more adults. Assisted living 
403.10 	facility includes assisted living facility with dementia care, and does not include:
403.11 	(1) emergency shelter, transitional housing, or any other residential units serving 
403.12 	exclusively or primarily homeless individuals, as defined under section 116L.361;
403.13 	(2) a nursing home licensed under chapter 144A;
403.14 	(3) a hospital, certified boarding care, or supervised living facility licensed under sections 
403.15 	144.50 to 144.56;
403.16 	(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 
403.17 	9520.0500 to 9520.0670, or under chapter 245Dor,245G, or 245I;
403.18 	(5) services and residential settings licensed under chapter 245A, including adult foster 
403.19 	care and services and settings governed under the standards in chapter 245D;
403.20 	(6) a private home in which the residents are related by kinship, law, or affinity with the 
403.21 	provider of services;
403.22 	(7) a duly organized condominium, cooperative, and common interest community, or 
403.23 	owners' association of the condominium, cooperative, and common interest community 
403.24 	where at least 80 percent of the units that comprise the condominium, cooperative, or 
403.25 	common interest community are occupied by individuals who are the owners, members, or 
403.26 	shareholders of the units;
403.27 	(8) a temporary family health care dwelling as defined in sections 394.307 and 462.3593;
403.28 	(9) a setting offering services conducted by and for the adherents of any recognized 
403.29 	church or religious denomination for its members exclusively through spiritual means or 
403.30 	by prayer for healing;
404.1 	(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with 
404.2 	low-income housing tax credits pursuant to United States Code, title 26, section 42, and 
404.3 	units financed by the Minnesota Housing Finance Agency that are intended to serve 
404.4 	individuals with disabilities or individuals who are homeless, except for those developments 
404.5 	that market or hold themselves out as assisted living facilities and provide assisted living 
404.6 	services;
404.7 	(11) rental housing developed under United States Code, title 42, section 1437, or United 
404.8 	States Code, title 12, section 1701q;
404.9 	(12) rental housing designated for occupancy by only elderly or elderly and disabled 
404.10 	residents under United States Code, title 42, section 1437e, or rental housing for qualifying 
404.11 	families under Code of Federal Regulations, title 24, section 983.56;
404.12 	(13) rental housing funded under United States Code, title 42, chapter 89, or United 
404.13 	States Code, title 42, section 8011;
404.14 	(14) a covered setting as defined in section 325F.721, subdivision 1, paragraph (b); or
404.15 	(15) any establishment that exclusively or primarily serves as a shelter or temporary 
404.16 	shelter for victims of domestic or any other form of violence.

404.17 	Sec. 7. Minnesota Statutes 2020, section 148B.5301, subdivision 2, is amended to read:
404.18 		Subd. 2.Supervision. (a) To qualify as a LPCC, an applicant must have completed 
404.19 	4,000 hours of post-master's degree supervised professional practice in the delivery of 
404.20 	clinical services in the diagnosis and treatment of mental illnesses and disorders in both 
404.21 	children and adults. The supervised practice shall be conducted according to the requirements 
404.22 	in paragraphs (b) to (e).
404.23 	(b) The supervision must have been received under a contract that defines clinical practice 
404.24 	and supervision from a mental health professional as defined in section 245.462, subdivision 
404.25 	18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6) who is qualified 
404.26 	according to section 245I.04, subdivision 2, or by a board-approved supervisor, who has at 
404.27 	least two years of postlicensure experience in the delivery of clinical services in the diagnosis 
404.28 	and treatment of mental illnesses and disorders. All supervisors must meet the supervisor 
404.29 	requirements in Minnesota Rules, part 2150.5010.
404.30 	(c) The supervision must be obtained at the rate of two hours of supervision per 40 hours 
404.31 	of professional practice. The supervision must be evenly distributed over the course of the 
404.32 	supervised professional practice. At least 75 percent of the required supervision hours must 
404.33 	be received in person. The remaining 25 percent of the required hours may be received by 
405.1 	telephone or by audio or audiovisual electronic device. At least 50 percent of the required 
405.2 	hours of supervision must be received on an individual basis. The remaining 50 percent 
405.3 	may be received in a group setting.
405.4 	(d) The supervised practice must include at least 1,800 hours of clinical client contact.
405.5 	(e) The supervised practice must be clinical practice. Supervision includes the observation 
405.6 	by the supervisor of the successful application of professional counseling knowledge, skills, 
405.7 	and values in the differential diagnosis and treatment of psychosocial function, disability, 
405.8 	or impairment, including addictions and emotional, mental, and behavioral disorders.

405.9 	Sec. 8. Minnesota Statutes 2020, section 148E.120, subdivision 2, is amended to read:
405.10 		Subd. 2.Alternate supervisors. (a) The board may approve an alternate supervisor as 
405.11 	determined in this subdivision. The board shall approve up to 25 percent of the required 
405.12 	supervision hours by a licensed mental health professional who is competent and qualified 
405.13 	to provide supervision according to the mental health professional's respective licensing 
405.14 	board, as established by section 245.462, subdivision 18, clauses (1) to (6), or 245.4871, 
405.15 	subdivision 27, clauses (1) to (6) 245I.04, subdivision 2.
405.16 	(b) The board shall approve up to 100 percent of the required supervision hours by an 
405.17 	alternate supervisor if the board determines that:
405.18 	(1) there are five or fewer supervisors in the county where the licensee practices social 
405.19 	work who meet the applicable licensure requirements in subdivision 1;
405.20 	(2) the supervisor is an unlicensed social worker who is employed in, and provides the 
405.21 	supervision in, a setting exempt from licensure by section 148E.065, and who has 
405.22 	qualifications equivalent to the applicable requirements specified in sections 148E.100 to 
405.23 	148E.115;
405.24 	(3) the supervisor is a social worker engaged in authorized social work practice in Iowa, 
405.25 	Manitoba, North Dakota, Ontario, South Dakota, or Wisconsin, and has the qualifications 
405.26 	equivalent to the applicable requirements in sections 148E.100 to 148E.115; or
405.27 	(4) the applicant or licensee is engaged in nonclinical authorized social work practice 
405.28 	outside of Minnesota and the supervisor meets the qualifications equivalent to the applicable 
405.29 	requirements in sections 148E.100 to 148E.115, or the supervisor is an equivalent mental 
405.30 	health professional, as determined by the board, who is credentialed by a state, territorial, 
405.31 	provincial, or foreign licensing agency; or
406.1 	(5) the applicant or licensee is engaged in clinical authorized social work practice outside 
406.2 	of Minnesota and the supervisor meets qualifications equivalent to the applicable 
406.3 	requirements in section 148E.115, or the supervisor is an equivalent mental health 
406.4 	professional as determined by the board, who is credentialed by a state, territorial, provincial, 
406.5 	or foreign licensing agency.
406.6 	(c) In order for the board to consider an alternate supervisor under this section, the 
406.7 	licensee must:
406.8 	(1) request in the supervision plan and verification submitted according to section 
406.9 	148E.125 that an alternate supervisor conduct the supervision; and
406.10 	(2) describe the proposed supervision and the name and qualifications of the proposed 
406.11 	alternate supervisor. The board may audit the information provided to determine compliance 
406.12 	with the requirements of this section.

406.13 	Sec. 9. Minnesota Statutes 2020, section 148F.11, subdivision 1, is amended to read:
406.14 		Subdivision 1.Other professionals. (a) Nothing in this chapter prevents members of 
406.15 	other professions or occupations from performing functions for which they are qualified or 
406.16 	licensed. This exception includes, but is not limited to: licensed physicians; registered nurses; 
406.17 	licensed practical nurses; licensed psychologists and licensed psychological practitioners; 
406.18 	members of the clergy provided such services are provided within the scope of regular 
406.19 	ministries; American Indian medicine men and women; licensed attorneys; probation officers; 
406.20 	licensed marriage and family therapists; licensed social workers; social workers employed 
406.21 	by city, county, or state agencies; licensed professional counselors; licensed professional 
406.22 	clinical counselors; licensed school counselors; registered occupational therapists or 
406.23 	occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders 
406.24 	(UMICAD) certified counselors when providing services to Native American people; city, 
406.25 	county, or state employees when providing assessments or case management under Minnesota 
406.26 	Rules, chapter 9530; and individuals defined in section 256B.0623, subdivision 5, paragraph 
406.27 	(a), clauses (1) and (2) to (6), providing integrated dual diagnosis co-occurring substance 
406.28 	use disorder treatment in adult mental health rehabilitative programs certified or licensed 
406.29 	by the Department of Human Services under section 245I.23, 256B.0622, or 256B.0623.
406.30 	(b) Nothing in this chapter prohibits technicians and resident managers in programs 
406.31 	licensed by the Department of Human Services from discharging their duties as provided 
406.32 	in Minnesota Rules, chapter 9530.
407.1 	(c) Any person who is exempt from licensure under this section must not use a title 
407.2 	incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug 
407.3 	counselor" or otherwise hold himself or herself out to the public by any title or description 
407.4 	stating or implying that he or she is engaged in the practice of alcohol and drug counseling, 
407.5 	or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless 
407.6 	that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice 
407.7 	of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the 
407.8 	use of one of the titles in paragraph (a).

407.9 	Sec. 10. Minnesota Statutes 2020, section 245.462, subdivision 1, is amended to read:
407.10 		Subdivision 1.Definitions. The definitions in this section apply to sections 245.461 to 
407.11 	245.486 245.4863.

407.12 	Sec. 11. Minnesota Statutes 2020, section 245.462, subdivision 6, is amended to read:
407.13 		Subd. 6.Community support services program. "Community support services program" 
407.14 	means services, other than inpatient or residential treatment services, provided or coordinated 
407.15 	by an identified program and staff under the clinical treatment supervision of a mental health 
407.16 	professional designed to help adults with serious and persistent mental illness to function 
407.17 	and remain in the community. A community support services program includes:
407.18 	(1) client outreach,
407.19 	(2) medication monitoring,
407.20 	(3) assistance in independent living skills,
407.21 	(4) development of employability and work-related opportunities,
407.22 	(5) crisis assistance,
407.23 	(6) psychosocial rehabilitation,
407.24 	(7) help in applying for government benefits, and
407.25 	(8) housing support services.
407.26 	The community support services program must be coordinated with the case management 
407.27 	services specified in section 245.4711.

407.28 	Sec. 12. Minnesota Statutes 2020, section 245.462, subdivision 8, is amended to read:
407.29 		Subd. 8.Day treatment services. "Day treatment," "day treatment services," or "day 
407.30 	treatment program" means a structured program of treatment and care provided to an adult 
408.1 	in or by: (1) a hospital accredited by the joint commission on accreditation of health 
408.2 	organizations and licensed under sections 144.50 to 144.55; (2) a community mental health 
408.3 	center under section 245.62; or (3) an entity that is under contract with the county board to 
408.4 	operate a program that meets the requirements of section 245.4712, subdivision 2, and 
408.5 	Minnesota Rules, parts 9505.0170 to 9505.0475. Day treatment consists of group 
408.6 	psychotherapy and other intensive therapeutic services that are provided at least two days 
408.7 	a week by a multidisciplinary staff under the clinical supervision of a mental health 
408.8 	professional. Day treatment may include education and consultation provided to families 
408.9 	and other individuals as part of the treatment process. The services are aimed at stabilizing 
408.10 	the adult's mental health status, providing mental health services, and developing and 
408.11 	improving the adult's independent living and socialization skills. The goal of day treatment 
408.12 	is to reduce or relieve mental illness and to enable the adult to live in the community. Day 
408.13 	treatment services are not a part of inpatient or residential treatment services. Day treatment 
408.14 	services are distinguished from day care by their structured therapeutic program of 
408.15 	psychotherapy services. The commissioner may limit medical assistance reimbursement 
408.16 	for day treatment to 15 hours per week per person the treatment services described by section 
408.17 	256B.0671, subdivision 3.

408.18 	Sec. 13. Minnesota Statutes 2020, section 245.462, subdivision 9, is amended to read:
408.19 		Subd. 9.Diagnostic assessment. (a) "Diagnostic assessment" has the meaning given in 
408.20 	Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota 
408.21 	Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a 
408.22 	standard, extended, or brief diagnostic assessment, or an adult update section 245I.10, 
408.23 	subdivisions 4 to 6.
408.24 	(b) A brief diagnostic assessment must include a face-to-face interview with the client 
408.25 	and a written evaluation of the client by a mental health professional or a clinical trainee, 
408.26 	as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or 
408.27 	clinical trainee must gather initial components of a standard diagnostic assessment, including 
408.28 	the client's:
408.29 	(1) age;
408.30 	(2) description of symptoms, including reason for referral;
408.31 	(3) history of mental health treatment;
408.32 	(4) cultural influences and their impact on the client; and
408.33 	(5) mental status examination.
409.1 	(c) On the basis of the initial components, the professional or clinical trainee must draw 
409.2 	a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's 
409.3 	immediate needs or presenting problem.
409.4 	(d) Treatment sessions conducted under authorization of a brief assessment may be used 
409.5 	to gather additional information necessary to complete a standard diagnostic assessment or 
409.6 	an extended diagnostic assessment.
409.7 	(e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
409.8 	unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible 
409.9 	for psychological testing as part of the diagnostic process.
409.10 	(f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
409.11 	unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction 
409.12 	with the diagnostic assessment process, a client is eligible for up to three individual or family 
409.13 	psychotherapy sessions or family psychoeducation sessions or a combination of the above 
409.14 	sessions not to exceed three sessions.
409.15 	(g) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item B, subitem (3), 
409.16 	unit (a), a brief diagnostic assessment may be used for a client's family who requires a 
409.17 	language interpreter to participate in the assessment.

409.18 	Sec. 14. Minnesota Statutes 2020, section 245.462, subdivision 14, is amended to read:
409.19 		Subd. 14.Individual treatment plan. "Individual treatment plan" means a written plan 
409.20 	of intervention, treatment, and services for an adult with mental illness that is developed 
409.21 	by a service provider under the clinical supervision of a mental health professional on the 
409.22 	basis of a diagnostic assessment. The plan identifies goals and objectives of treatment, 
409.23 	treatment strategy, a schedule for accomplishing treatment goals and objectives, and the 
409.24 	individual responsible for providing treatment to the adult with mental illness the formulation 
409.25 	of planned services that are responsive to the needs and goals of a client. An individual 
409.26 	treatment plan must be completed according to section 245I.10, subdivisions 7 and 8.

409.27 	Sec. 15. Minnesota Statutes 2020, section 245.462, subdivision 16, is amended to read:
409.28 		Subd. 16.Mental health funds. "Mental health funds" are funds expended under sections 
409.29 	245.73 and 256E.12, federal mental health block grant funds, and funds expended under 
409.30 	section 256D.06 to facilities licensed under section 245I.23 or Minnesota Rules, parts 
409.31 	9520.0500 to 9520.0670.

410.1 	Sec. 16. Minnesota Statutes 2020, section 245.462, subdivision 17, is amended to read:
410.2 		Subd. 17.Mental health practitioner. (a) "Mental health practitioner" means a staff 
410.3 	person providing services to adults with mental illness or children with emotional disturbance 
410.4 	who is qualified in at least one of the ways described in paragraphs (b) to (g). A mental 
410.5 	health practitioner for a child client must have training working with children. A mental 
410.6 	health practitioner for an adult client must have training working with adults qualified 
410.7 	according to section 245I.04, subdivision 4.
410.8 	(b) For purposes of this subdivision, a practitioner is qualified through relevant 
410.9 	coursework if the practitioner completes at least 30 semester hours or 45 quarter hours in 
410.10 	behavioral sciences or related fields and:
410.11 	(1) has at least 2,000 hours of supervised experience in the delivery of services to adults 
410.12 	or children with:
410.13 	(i) mental illness, substance use disorder, or emotional disturbance; or
410.14 	(ii) traumatic brain injury or developmental disabilities and completes training on mental 
410.15 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
410.16 	mental illness and substance abuse, and psychotropic medications and side effects;
410.17 	(2) is fluent in the non-English language of the ethnic group to which at least 50 percent 
410.18 	of the practitioner's clients belong, completes 40 hours of training in the delivery of services 
410.19 	to adults with mental illness or children with emotional disturbance, and receives clinical 
410.20 	supervision from a mental health professional at least once a week until the requirement of 
410.21 	2,000 hours of supervised experience is met;
410.22 	(3) is working in a day treatment program under section 245.4712, subdivision 2; or
410.23 	(4) has completed a practicum or internship that (i) requires direct interaction with adults 
410.24 	or children served, and (ii) is focused on behavioral sciences or related fields.
410.25 	(c) For purposes of this subdivision, a practitioner is qualified through work experience 
410.26 	if the person:
410.27 	(1) has at least 4,000 hours of supervised experience in the delivery of services to adults 
410.28 	or children with:
410.29 	(i) mental illness, substance use disorder, or emotional disturbance; or
410.30 	(ii) traumatic brain injury or developmental disabilities and completes training on mental 
410.31 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
410.32 	mental illness and substance abuse, and psychotropic medications and side effects; or
411.1 	(2) has at least 2,000 hours of supervised experience in the delivery of services to adults 
411.2 	or children with:
411.3 	(i) mental illness, emotional disturbance, or substance use disorder, and receives clinical 
411.4 	supervision as required by applicable statutes and rules from a mental health professional 
411.5 	at least once a week until the requirement of 4,000 hours of supervised experience is met; 
411.6 	or
411.7 	(ii) traumatic brain injury or developmental disabilities; completes training on mental 
411.8 	illness, recovery from mental illness, mental health de-escalation techniques, co-occurring 
411.9 	mental illness and substance abuse, and psychotropic medications and side effects; and 
411.10 	receives clinical supervision as required by applicable statutes and rules at least once a week 
411.11 	from a mental health professional until the requirement of 4,000 hours of supervised 
411.12 	experience is met.
411.13 	(d) For purposes of this subdivision, a practitioner is qualified through a graduate student 
411.14 	internship if the practitioner is a graduate student in behavioral sciences or related fields 
411.15 	and is formally assigned by an accredited college or university to an agency or facility for 
411.16 	clinical training.
411.17 	(e) For purposes of this subdivision, a practitioner is qualified by a bachelor's or master's 
411.18 	degree if the practitioner:
411.19 	(1) holds a master's or other graduate degree in behavioral sciences or related fields; or
411.20 	(2) holds a bachelor's degree in behavioral sciences or related fields and completes a 
411.21 	practicum or internship that (i) requires direct interaction with adults or children served, 
411.22 	and (ii) is focused on behavioral sciences or related fields.
411.23 	(f) For purposes of this subdivision, a practitioner is qualified as a vendor of medical 
411.24 	care if the practitioner meets the definition of vendor of medical care in section 256B.02, 
411.25 	subdivision 7, paragraphs (b) and (c), and is serving a federally recognized tribe.
411.26 	(g) For purposes of medical assistance coverage of diagnostic assessments, explanations 
411.27 	of findings, and psychotherapy under section 256B.0625, subdivision 65, a mental health 
411.28 	practitioner working as a clinical trainee means that the practitioner's clinical supervision 
411.29 	experience is helping the practitioner gain knowledge and skills necessary to practice 
411.30 	effectively and independently. This may include supervision of direct practice, treatment 
411.31 	team collaboration, continued professional learning, and job management. The practitioner 
411.32 	must also:
412.1 	(1) comply with requirements for licensure or board certification as a mental health 
412.2 	professional, according to the qualifications under Minnesota Rules, part 9505.0371, subpart 
412.3 	5, item A, including supervised practice in the delivery of mental health services for the 
412.4 	treatment of mental illness; or
412.5 	(2) be a student in a bona fide field placement or internship under a program leading to 
412.6 	completion of the requirements for licensure as a mental health professional according to 
412.7 	the qualifications under Minnesota Rules, part 9505.0371, subpart 5, item A.
412.8 	(h) For purposes of this subdivision, "behavioral sciences or related fields" has the 
412.9 	meaning given in section 256B.0623, subdivision 5, paragraph (d).
412.10 	(i) Notwithstanding the licensing requirements established by a health-related licensing 
412.11 	board, as defined in section 214.01, subdivision 2, this subdivision supersedes any other 
412.12 	statute or rule.

412.13 	Sec. 17. Minnesota Statutes 2020, section 245.462, subdivision 18, is amended to read:
412.14 		Subd. 18.Mental health professional. "Mental health professional" means a staff person 
412.15 	providing clinical services in the treatment of mental illness who is qualified in at least one 
412.16 	of the following ways: who is qualified according to section 245I.04, subdivision 2.
412.17 	(1) in psychiatric nursing: a registered nurse who is licensed under sections 148.171 to 
412.18 	148.285; and:
412.19 	(i) who is certified as a clinical specialist or as a nurse practitioner in adult or family 
412.20 	psychiatric and mental health nursing by a national nurse certification organization; or
412.21 	(ii) who has a master's degree in nursing or one of the behavioral sciences or related 
412.22 	fields from an accredited college or university or its equivalent, with at least 4,000 hours 
412.23 	of post-master's supervised experience in the delivery of clinical services in the treatment 
412.24 	of mental illness;
412.25 	(2) in clinical social work: a person licensed as an independent clinical social worker 
412.26 	under chapter 148D, or a person with a master's degree in social work from an accredited 
412.27 	college or university, with at least 4,000 hours of post-master's supervised experience in 
412.28 	the delivery of clinical services in the treatment of mental illness;
412.29 	(3) in psychology: an individual licensed by the Board of Psychology under sections 
412.30 	148.88 to 148.98 who has stated to the Board of Psychology competencies in the diagnosis 
412.31 	and treatment of mental illness;
413.1 	(4) in psychiatry: a physician licensed under chapter 147 and certified by the American 
413.2 	Board of Psychiatry and Neurology or eligible for board certification in psychiatry, or an 
413.3 	osteopathic physician licensed under chapter 147 and certified by the American Osteopathic 
413.4 	Board of Neurology and Psychiatry or eligible for board certification in psychiatry;
413.5 	(5) in marriage and family therapy: the mental health professional must be a marriage 
413.6 	and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of 
413.7 	post-master's supervised experience in the delivery of clinical services in the treatment of 
413.8 	mental illness;
413.9 	(6) in licensed professional clinical counseling, the mental health professional shall be 
413.10 	a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours 
413.11 	of post-master's supervised experience in the delivery of clinical services in the treatment 
413.12 	of mental illness; or
413.13 	(7) in allied fields: a person with a master's degree from an accredited college or university 
413.14 	in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's 
413.15 	supervised experience in the delivery of clinical services in the treatment of mental illness.

413.16 	Sec. 18. Minnesota Statutes 2020, section 245.462, subdivision 21, is amended to read:
413.17 		Subd. 21.Outpatient services. "Outpatient services" means mental health services, 
413.18 	excluding day treatment and community support services programs, provided by or under 
413.19 	the clinical treatment supervision of a mental health professional to adults with mental 
413.20 	illness who live outside a hospital. Outpatient services include clinical activities such as 
413.21 	individual, group, and family therapy; individual treatment planning; diagnostic assessments; 
413.22 	medication management; and psychological testing.

413.23 	Sec. 19. Minnesota Statutes 2020, section 245.462, subdivision 23, is amended to read:
413.24 		Subd. 23.Residential treatment. "Residential treatment" means a 24-hour-a-day program 
413.25 	under the clinical treatment supervision of a mental health professional, in a community 
413.26 	residential setting other than an acute care hospital or regional treatment center inpatient 
413.27 	unit, that must be licensed as a residential treatment program for adults with mental illness 
413.28 	under chapter 245I, Minnesota Rules, parts 9520.0500 to 9520.0670, or other rules adopted 
413.29 	by the commissioner.

414.1 	Sec. 20. Minnesota Statutes 2020, section 245.462, is amended by adding a subdivision 
414.2 	to read:
414.3 		Subd. 27.Treatment supervision. "Treatment supervision" means the treatment 
414.4 	supervision described by section 245I.06.

414.5 	Sec. 21. Minnesota Statutes 2020, section 245.4661, subdivision 5, is amended to read:
414.6 		Subd. 5.Planning for pilot projects. (a) Each local plan for a pilot project, with the 
414.7 	exception of the placement of a Minnesota specialty treatment facility as defined in paragraph 
414.8 	(c), must be developed under the direction of the county board, or multiple county boards 
414.9 	acting jointly, as the local mental health authority. The planning process for each pilot shall 
414.10 	include, but not be limited to, mental health consumers, families, advocates, local mental 
414.11 	health advisory councils, local and state providers, representatives of state and local public 
414.12 	employee bargaining units, and the department of human services. As part of the planning 
414.13 	process, the county board or boards shall designate a managing entity responsible for receipt 
414.14 	of funds and management of the pilot project.
414.15 	(b) For Minnesota specialty treatment facilities, the commissioner shall issue a request 
414.16 	for proposal for regions in which a need has been identified for services.
414.17 	(c) For purposes of this section, "Minnesota specialty treatment facility" is defined as 
414.18 	an intensive residential treatment service licensed under section 256B.0622, subdivision 2, 
414.19 	paragraph (b) chapter 245I.

414.20 	Sec. 22. Minnesota Statutes 2020, section 245.4662, subdivision 1, is amended to read:
414.21 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
414.22 	the meanings given them.
414.23 	(b) "Community partnership" means a project involving the collaboration of two or more 
414.24 	eligible applicants.
414.25 	(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service 
414.26 	provider, hospital, or community partnership. Eligible applicant does not include a 
414.27 	state-operated direct care and treatment facility or program under chapter 246.
414.28 	(d) "Intensive residential treatment services" has the meaning given in section 256B.0622, 
414.29 	subdivision 2.
414.30 	(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section 
414.31 	473.121, subdivision 2.

415.1 	Sec. 23. Minnesota Statutes 2020, section 245.467, subdivision 2, is amended to read:
415.2 		Subd. 2.Diagnostic assessment. All providers of residential, acute care hospital inpatient, 
415.3 	and regional treatment centers must complete a diagnostic assessment for each of their 
415.4 	clients within five days of admission. Providers of day treatment services must complete a 
415.5 	diagnostic assessment within five days after the adult's second visit or within 30 days after 
415.6 	intake, whichever occurs first. In cases where a diagnostic assessment is available and has 
415.7 	been completed within three years preceding admission, only an adult diagnostic assessment 
415.8 	update is necessary. An "adult diagnostic assessment update" means a written summary by 
415.9 	a mental health professional of the adult's current mental health status and service needs 
415.10 	and includes a face-to-face interview with the adult. If the adult's mental health status has 
415.11 	changed markedly since the adult's most recent diagnostic assessment, a new diagnostic 
415.12 	assessment is required. Compliance with the provisions of this subdivision does not ensure 
415.13 	eligibility for medical assistance reimbursement under chapter 256B. Providers of services 
415.14 	governed by this section must complete a diagnostic assessment according to the standards 
415.15 	of section 245I.10, subdivisions 4 to 6.

415.16 	Sec. 24. Minnesota Statutes 2020, section 245.467, subdivision 3, is amended to read:
415.17 		Subd. 3.Individual treatment plans. All providers of outpatient services, day treatment 
415.18 	services, residential treatment, acute care hospital inpatient treatment, and all regional 
415.19 	treatment centers must develop an individual treatment plan for each of their adult clients. 
415.20 	The individual treatment plan must be based on a diagnostic assessment. To the extent 
415.21 	possible, the adult client shall be involved in all phases of developing and implementing 
415.22 	the individual treatment plan. Providers of residential treatment and acute care hospital 
415.23 	inpatient treatment, and all regional treatment centers must develop the individual treatment 
415.24 	plan within ten days of client intake and must review the individual treatment plan every 
415.25 	90 days after intake. Providers of day treatment services must develop the individual 
415.26 	treatment plan before the completion of five working days in which service is provided or 
415.27 	within 30 days after the diagnostic assessment is completed or obtained, whichever occurs 
415.28 	first. Providers of outpatient services must develop the individual treatment plan within 30 
415.29 	days after the diagnostic assessment is completed or obtained or by the end of the second 
415.30 	session of an outpatient service, not including the session in which the diagnostic assessment 
415.31 	was provided, whichever occurs first. Outpatient and day treatment services providers must 
415.32 	review the individual treatment plan every 90 days after intake. Providers of services 
415.33 	governed by this section must complete an individual treatment plan according to the 
415.34 	standards of section 245I.10, subdivisions 7 and 8.

416.1 	Sec. 25. Minnesota Statutes 2020, section 245.470, subdivision 1, is amended to read:
416.2 		Subdivision 1.Availability of outpatient services. (a) County boards must provide or 
416.3 	contract for enough outpatient services within the county to meet the needs of adults with 
416.4 	mental illness residing in the county. Services may be provided directly by the county 
416.5 	through county-operated mental health centers or mental health clinics approved by the 
416.6 	commissioner under section 245.69, subdivision 2 meeting the standards of chapter 245I; 
416.7 	by contract with privately operated mental health centers or mental health clinics approved 
416.8 	by the commissioner under section 245.69, subdivision 2 meeting the standards of chapter 
416.9 	245I; by contract with hospital mental health outpatient programs certified by the Joint 
416.10 	Commission on Accreditation of Hospital Organizations; or by contract with a licensed
416.11 	mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (6). 
416.12 	Clients may be required to pay a fee according to section 245.481. Outpatient services 
416.13 	include:
416.14 	(1) conducting diagnostic assessments;
416.15 	(2) conducting psychological testing;
416.16 	(3) developing or modifying individual treatment plans;
416.17 	(4) making referrals and recommending placements as appropriate;
416.18 	(5) treating an adult's mental health needs through therapy;
416.19 	(6) prescribing and managing medication and evaluating the effectiveness of prescribed 
416.20 	medication; and
416.21 	(7) preventing placement in settings that are more intensive, costly, or restrictive than 
416.22 	necessary and appropriate to meet client needs.
416.23 	(b) County boards may request a waiver allowing outpatient services to be provided in 
416.24 	a nearby trade area if it is determined that the client can best be served outside the county.

416.25 	Sec. 26. Minnesota Statutes 2020, section 245.4712, subdivision 2, is amended to read:
416.26 		Subd. 2.Day treatment services provided. (a) Day treatment services must be developed 
416.27 	as a part of the community support services available to adults with serious and persistent 
416.28 	mental illness residing in the county. Adults may be required to pay a fee according to 
416.29 	section 245.481. Day treatment services must be designed to:
416.30 	(1) provide a structured environment for treatment;
416.31 	(2) provide support for residing in the community;
417.1 	(3) prevent placement in settings that are more intensive, costly, or restrictive than 
417.2 	necessary and appropriate to meet client need;
417.3 	(4) coordinate with or be offered in conjunction with a local education agency's special 
417.4 	education program; and
417.5 	(5) operate on a continuous basis throughout the year.
417.6 	(b) For purposes of complying with medical assistance requirements, an adult day 
417.7 	treatment program must comply with the method of clinical supervision specified in 
417.8 	Minnesota Rules, part 9505.0371, subpart 4. The clinical supervision must be performed 
417.9 	by a qualified supervisor who satisfies the requirements of Minnesota Rules, part 9505.0371, 
417.10 	subpart 5. An adult day treatment program must comply with medical assistance requirements 
417.11 	in section 256B.0671, subdivision 3.
417.12 	A day treatment program must demonstrate compliance with this clinical supervision 
417.13 	requirement by the commissioner's review and approval of the program according to 
417.14 	Minnesota Rules, part 9505.0372, subpart 8.
417.15 	(c) County boards may request a waiver from including day treatment services if they 
417.16 	can document that:
417.17 	(1) an alternative plan of care exists through the county's community support services 
417.18 	for clients who would otherwise need day treatment services;
417.19 	(2) day treatment, if included, would be duplicative of other components of the 
417.20 	community support services; and
417.21 	(3) county demographics and geography make the provision of day treatment services 
417.22 	cost ineffective and infeasible.

417.23 	Sec. 27. Minnesota Statutes 2020, section 245.472, subdivision 2, is amended to read:
417.24 		Subd. 2.Specific requirements. Providers of residential services must be licensed under 
417.25 	chapter 245I or applicable rules adopted by the commissioner and must be clinically 
417.26 	supervised by a mental health professional. Persons employed in facilities licensed under 
417.27 	Minnesota Rules, parts 9520.0500 to 9520.0670, in the capacity of program director as of 
417.28 	July 1, 1987, in accordance with Minnesota Rules, parts 9520.0500 to 9520.0670, may be 
417.29 	allowed to continue providing clinical supervision within a facility, provided they continue 
417.30 	to be employed as a program director in a facility licensed under Minnesota Rules, parts 
417.31 	9520.0500 to 9520.0670. Residential services must be provided under treatment supervision.

418.1 	Sec. 28. Minnesota Statutes 2020, section 245.4863, is amended to read:
418.2 	245.4863 INTEGRATED CO-OCCURRING DISORDER TREATMENT.
418.3 	(a) The commissioner shall require individuals who perform chemical dependency 
418.4 	assessments to screen clients for co-occurring mental health disorders, and staff who perform 
418.5 	mental health diagnostic assessments to screen for co-occurring substance use disorders. 
418.6 	Screening tools must be approved by the commissioner. If a client screens positive for a 
418.7 	co-occurring mental health or substance use disorder, the individual performing the screening 
418.8 	must document what actions will be taken in response to the results and whether further 
418.9 	assessments must be performed.
418.10 	(b) Notwithstanding paragraph (a), screening is not required when:
418.11 	(1) the presence of co-occurring disorders was documented for the client in the past 12 
418.12 	months;
418.13 	(2) the client is currently receiving co-occurring disorders treatment;
418.14 	(3) the client is being referred for co-occurring disorders treatment; or
418.15 	(4) a mental health professional, as defined in Minnesota Rules, part 9505.0370, subpart 
418.16 	18, who is competent to perform diagnostic assessments of co-occurring disorders is 
418.17 	performing a diagnostic assessment that meets the requirements in Minnesota Rules, part 
418.18 	9533.0090, subpart 5, to identify whether the client may have co-occurring mental health 
418.19 	and chemical dependency disorders. If an individual is identified to have co-occurring 
418.20 	mental health and substance use disorders, the assessing mental health professional must 
418.21 	document what actions will be taken to address the client's co-occurring disorders.
418.22 	(c) The commissioner shall adopt rules as necessary to implement this section. The 
418.23 	commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing 
418.24 	a certification process for integrated dual disorder treatment providers and a system through 
418.25 	which individuals receive integrated dual diagnosis treatment if assessed as having both a 
418.26 	substance use disorder and either a serious mental illness or emotional disturbance.
418.27 	(d) The commissioner shall apply for any federal waivers necessary to secure, to the 
418.28 	extent allowed by law, federal financial participation for the provision of integrated dual 
418.29 	diagnosis treatment to persons with co-occurring disorders.

418.30 	Sec. 29. Minnesota Statutes 2020, section 245.4871, subdivision 9a, is amended to read:
418.31 		Subd. 9a.Crisis assistance planning. "Crisis assistance planning" means assistance to 
418.32 	the child, the child's family, and all providers of services to the child to: recognize factors 
419.1 	precipitating a mental health crisis, identify behaviors related to the crisis, and be informed 
419.2 	of available resources to resolve the crisis. Crisis assistance requires the development of a 
419.3 	plan which addresses prevention and intervention strategies to be used in a potential crisis. 
419.4 	Other interventions include: (1) arranging for admission to acute care hospital inpatient 
419.5 	treatment the development of a written plan to assist a child and the child's family in 
419.6 	preventing and addressing a potential crisis and is distinct from mobile crisis services defined 
419.7 	in section 256B.0624. The plan must address prevention, deescalation, and intervention 
419.8 	strategies to be used in a crisis. The plan identifies factors that might precipitate a crisis, 
419.9 	behaviors or symptoms related to the emergence of a crisis, and the resources available to 
419.10 	resolve a crisis. The plan must address the following potential needs: (1) acute care; (2) 
419.11 	crisis placement; (3) community resources for follow-up; and (4) emotional support to the 
419.12 	family during crisis. When appropriate for the child's needs, the plan must include strategies 
419.13 	to reduce the child's risk of suicide and self-injurious behavior. Crisis assistance planning
419.14 	does not include services designed to secure the safety of a child who is at risk of abuse or 
419.15 	neglect or necessary emergency services.

419.16 	Sec. 30. Minnesota Statutes 2020, section 245.4871, subdivision 10, is amended to read:
419.17 		Subd. 10.Day treatment services. "Day treatment," "day treatment services," or "day 
419.18 	treatment program" means a structured program of treatment and care provided to a child 
419.19 	in:
419.20 	(1) an outpatient hospital accredited by the Joint Commission on Accreditation of Health 
419.21 	Organizations and licensed under sections 144.50 to 144.55;
419.22 	(2) a community mental health center under section 245.62;
419.23 	(3) an entity that is under contract with the county board to operate a program that meets 
419.24 	the requirements of section 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170
419.25 	to 9505.0475; or
419.26 	(4) an entity that operates a program that meets the requirements of section 245.4884, 
419.27 	subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475, that is under contract 
419.28 	with an entity that is under contract with a county board.; or
419.29 	(5) a program certified under section 256B.0943.
419.30 	Day treatment consists of group psychotherapy and other intensive therapeutic services 
419.31 	that are provided for a minimum two-hour time block by a multidisciplinary staff under the 
419.32 	clinical treatment supervision of a mental health professional. Day treatment may include 
419.33 	education and consultation provided to families and other individuals as an extension of the 
420.1 	treatment process. The services are aimed at stabilizing the child's mental health status, and 
420.2 	developing and improving the child's daily independent living and socialization skills. Day 
420.3 	treatment services are distinguished from day care by their structured therapeutic program 
420.4 	of psychotherapy services. Day treatment services are not a part of inpatient hospital or 
420.5 	residential treatment services.
420.6 	A day treatment service must be available to a child up to 15 hours a week throughout 
420.7 	the year and must be coordinated with, integrated with, or part of an education program 
420.8 	offered by the child's school.

420.9 	Sec. 31. Minnesota Statutes 2020, section 245.4871, subdivision 11a, is amended to read:
420.10 		Subd. 11a.Diagnostic assessment. (a) "Diagnostic assessment" has the meaning given 
420.11 	in Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota 
420.12 	Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a 
420.13 	standard, extended, or brief diagnostic assessment, or an adult update section 245I.10, 
420.14 	subdivisions 4 to 6.
420.15 	(b) A brief diagnostic assessment must include a face-to-face interview with the client 
420.16 	and a written evaluation of the client by a mental health professional or a clinical trainee, 
420.17 	as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or 
420.18 	clinical trainee must gather initial components of a standard diagnostic assessment, including 
420.19 	the client's:
420.20 	(1) age;
420.21 	(2) description of symptoms, including reason for referral;
420.22 	(3) history of mental health treatment;
420.23 	(4) cultural influences and their impact on the client; and
420.24 	(5) mental status examination.
420.25 	(c) On the basis of the brief components, the professional or clinical trainee must draw 
420.26 	a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's 
420.27 	immediate needs or presenting problem.
420.28 	(d) Treatment sessions conducted under authorization of a brief assessment may be used 
420.29 	to gather additional information necessary to complete a standard diagnostic assessment or 
420.30 	an extended diagnostic assessment.
421.1 	(e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
421.2 	unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible 
421.3 	for psychological testing as part of the diagnostic process.
421.4 	(f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
421.5 	unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction 
421.6 	with the diagnostic assessment process, a client is eligible for up to three individual or family 
421.7 	psychotherapy sessions or family psychoeducation sessions or a combination of the above 
421.8 	sessions not to exceed three sessions.

421.9 	Sec. 32. Minnesota Statutes 2020, section 245.4871, subdivision 17, is amended to read:
421.10 		Subd. 17.Family community support services. "Family community support services" 
421.11 	means services provided under the clinical treatment supervision of a mental health 
421.12 	professional and designed to help each child with severe emotional disturbance to function 
421.13 	and remain with the child's family in the community. Family community support services 
421.14 	do not include acute care hospital inpatient treatment, residential treatment services, or 
421.15 	regional treatment center services. Family community support services include:
421.16 	(1) client outreach to each child with severe emotional disturbance and the child's family;
421.17 	(2) medication monitoring where necessary;
421.18 	(3) assistance in developing independent living skills;
421.19 	(4) assistance in developing parenting skills necessary to address the needs of the child 
421.20 	with severe emotional disturbance;
421.21 	(5) assistance with leisure and recreational activities;
421.22 	(6) crisis assistance planning, including crisis placement and respite care;
421.23 	(7) professional home-based family treatment;
421.24 	(8) foster care with therapeutic supports;
421.25 	(9) day treatment;
421.26 	(10) assistance in locating respite care and special needs day care; and
421.27 	(11) assistance in obtaining potential financial resources, including those benefits listed 
421.28 	in section 245.4884, subdivision 5.

422.1 	Sec. 33. Minnesota Statutes 2020, section 245.4871, subdivision 21, is amended to read:
422.2 		Subd. 21.Individual treatment plan. "Individual treatment plan" means a written plan 
422.3 	of intervention, treatment, and services for a child with an emotional disturbance that is 
422.4 	developed by a service provider under the clinical supervision of a mental health professional 
422.5 	on the basis of a diagnostic assessment. An individual treatment plan for a child must be 
422.6 	developed in conjunction with the family unless clinically inappropriate. The plan identifies 
422.7 	goals and objectives of treatment, treatment strategy, a schedule for accomplishing treatment 
422.8 	goals and objectives, and the individuals responsible for providing treatment to the child 
422.9 	with an emotional disturbance the formulation of planned services that are responsive to 
422.10 	the needs and goals of a client. An individual treatment plan must be completed according 
422.11 	to section 245I.10, subdivisions 7 and 8.

422.12 	Sec. 34. Minnesota Statutes 2020, section 245.4871, subdivision 26, is amended to read:
422.13 		Subd. 26.Mental health practitioner. "Mental health practitioner" has the meaning 
422.14 	given in section 245.462, subdivision 17 means a staff person who is qualified according 
422.15 	to section 245I.04, subdivision 4.

422.16 	Sec. 35. Minnesota Statutes 2020, section 245.4871, subdivision 27, is amended to read:
422.17 		Subd. 27.Mental health professional. "Mental health professional" means a staff person 
422.18 	providing clinical services in the diagnosis and treatment of children's emotional disorders. 
422.19 	A mental health professional must have training and experience in working with children 
422.20 	consistent with the age group to which the mental health professional is assigned. A mental 
422.21 	health professional must be qualified in at least one of the following ways: who is qualified 
422.22 	according to section 245I.04, subdivision 2.
422.23 	(1) in psychiatric nursing, the mental health professional must be a registered nurse who 
422.24 	is licensed under sections 148.171 to 148.285 and who is certified as a clinical specialist in 
422.25 	child and adolescent psychiatric or mental health nursing by a national nurse certification 
422.26 	organization or who has a master's degree in nursing or one of the behavioral sciences or 
422.27 	related fields from an accredited college or university or its equivalent, with at least 4,000 
422.28 	hours of post-master's supervised experience in the delivery of clinical services in the 
422.29 	treatment of mental illness;
422.30 	(2) in clinical social work, the mental health professional must be a person licensed as 
422.31 	an independent clinical social worker under chapter 148D, or a person with a master's degree 
422.32 	in social work from an accredited college or university, with at least 4,000 hours of 
423.1 	post-master's supervised experience in the delivery of clinical services in the treatment of 
423.2 	mental disorders;
423.3 	(3) in psychology, the mental health professional must be an individual licensed by the 
423.4 	board of psychology under sections 148.88 to 148.98 who has stated to the board of 
423.5 	psychology competencies in the diagnosis and treatment of mental disorders;
423.6 	(4) in psychiatry, the mental health professional must be a physician licensed under 
423.7 	chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible 
423.8 	for board certification in psychiatry or an osteopathic physician licensed under chapter 147 
423.9 	and certified by the American Osteopathic Board of Neurology and Psychiatry or eligible 
423.10 	for board certification in psychiatry;
423.11 	(5) in marriage and family therapy, the mental health professional must be a marriage 
423.12 	and family therapist licensed under sections 148B.29 to 148B.39 with at least two years of 
423.13 	post-master's supervised experience in the delivery of clinical services in the treatment of 
423.14 	mental disorders or emotional disturbances;
423.15 	(6) in licensed professional clinical counseling, the mental health professional shall be 
423.16 	a licensed professional clinical counselor under section 148B.5301 with at least 4,000 hours 
423.17 	of post-master's supervised experience in the delivery of clinical services in the treatment 
423.18 	of mental disorders or emotional disturbances; or
423.19 	(7) in allied fields, the mental health professional must be a person with a master's degree 
423.20 	from an accredited college or university in one of the behavioral sciences or related fields, 
423.21 	with at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
423.22 	services in the treatment of emotional disturbances.

423.23 	Sec. 36. Minnesota Statutes 2020, section 245.4871, subdivision 29, is amended to read:
423.24 		Subd. 29.Outpatient services. "Outpatient services" means mental health services, 
423.25 	excluding day treatment and community support services programs, provided by or under 
423.26 	the clinical treatment supervision of a mental health professional to children with emotional 
423.27 	disturbances who live outside a hospital. Outpatient services include clinical activities such 
423.28 	as individual, group, and family therapy; individual treatment planning; diagnostic 
423.29 	assessments; medication management; and psychological testing.

423.30 	Sec. 37. Minnesota Statutes 2020, section 245.4871, subdivision 31, is amended to read:
423.31 		Subd. 31.Professional home-based family treatment. "Professional home-based family 
423.32 	treatment" means intensive mental health services provided to children because of an 
424.1 	emotional disturbance (1) who are at risk of out-of-home placement; (2) who are in 
424.2 	out-of-home placement; or (3) who are returning from out-of-home placement. Services 
424.3 	are provided to the child and the child's family primarily in the child's home environment. 
424.4 	Services may also be provided in the child's school, child care setting, or other community 
424.5 	setting appropriate to the child. Services must be provided on an individual family basis, 
424.6 	must be child-oriented and family-oriented, and must be designed using information from 
424.7 	diagnostic and functional assessments to meet the specific mental health needs of the child 
424.8 	and the child's family. Examples of services are: (1) individual therapy; (2) family therapy; 
424.9 	(3) client outreach; (4) assistance in developing individual living skills; (5) assistance in 
424.10 	developing parenting skills necessary to address the needs of the child; (6) assistance with 
424.11 	leisure and recreational services; (7) crisis assistance planning, including crisis respite care 
424.12 	and arranging for crisis placement; and (8) assistance in locating respite and child care. 
424.13 	Services must be coordinated with other services provided to the child and family.

424.14 	Sec. 38. Minnesota Statutes 2020, section 245.4871, subdivision 32, is amended to read:
424.15 		Subd. 32.Residential treatment. "Residential treatment" means a 24-hour-a-day program 
424.16 	under the clinical treatment supervision of a mental health professional, in a community 
424.17 	residential setting other than an acute care hospital or regional treatment center inpatient 
424.18 	unit, that must be licensed as a residential treatment program for children with emotional 
424.19 	disturbances under Minnesota Rules, parts 2960.0580 to 2960.0700, or other rules adopted 
424.20 	by the commissioner.

424.21 	Sec. 39. Minnesota Statutes 2020, section 245.4871, subdivision 34, is amended to read:
424.22 		Subd. 34.Therapeutic support of foster care. "Therapeutic support of foster care" 
424.23 	means the mental health training and mental health support services and clinical treatment
424.24 	supervision provided by a mental health professional to foster families caring for children 
424.25 	with severe emotional disturbance to provide a therapeutic family environment and support 
424.26 	for the child's improved functioning. Therapeutic support of foster care includes services 
424.27 	provided under section 256B.0946.

424.28 	Sec. 40. Minnesota Statutes 2020, section 245.4871, is amended by adding a subdivision 
424.29 	to read:
424.30 		Subd. 36.Treatment supervision. "Treatment supervision" means the treatment 
424.31 	supervision described by section 245I.06.

425.1 	Sec. 41. Minnesota Statutes 2020, section 245.4876, subdivision 2, is amended to read:
425.2 		Subd. 2.Diagnostic assessment. All residential treatment facilities and acute care 
425.3 	hospital inpatient treatment facilities that provide mental health services for children must 
425.4 	complete a diagnostic assessment for each of their child clients within five working days 
425.5 	of admission. Providers of day treatment services for children must complete a diagnostic 
425.6 	assessment within five days after the child's second visit or 30 days after intake, whichever 
425.7 	occurs first. In cases where a diagnostic assessment is available and has been completed 
425.8 	within 180 days preceding admission, only updating is necessary. "Updating" means a 
425.9 	written summary by a mental health professional of the child's current mental health status 
425.10 	and service needs. If the child's mental health status has changed markedly since the child's 
425.11 	most recent diagnostic assessment, a new diagnostic assessment is required. Compliance 
425.12 	with the provisions of this subdivision does not ensure eligibility for medical assistance 
425.13 	reimbursement under chapter 256B. Providers of services governed by this section shall 
425.14 	complete a diagnostic assessment according to the standards of section 245I.10, subdivisions 
425.15 	4 to 6.

425.16 	Sec. 42. Minnesota Statutes 2020, section 245.4876, subdivision 3, is amended to read:
425.17 		Subd. 3.Individual treatment plans. All providers of outpatient services, day treatment 
425.18 	services, professional home-based family treatment, residential treatment, and acute care 
425.19 	hospital inpatient treatment, and all regional treatment centers that provide mental health 
425.20 	services for children must develop an individual treatment plan for each child client. The 
425.21 	individual treatment plan must be based on a diagnostic assessment. To the extent appropriate, 
425.22 	the child and the child's family shall be involved in all phases of developing and 
425.23 	implementing the individual treatment plan. Providers of residential treatment, professional 
425.24 	home-based family treatment, and acute care hospital inpatient treatment, and regional 
425.25 	treatment centers must develop the individual treatment plan within ten working days of 
425.26 	client intake or admission and must review the individual treatment plan every 90 days after 
425.27 	intake, except that the administrative review of the treatment plan of a child placed in a 
425.28 	residential facility shall be as specified in sections 260C.203 and 260C.212, subdivision 9. 
425.29 	Providers of day treatment services must develop the individual treatment plan before the 
425.30 	completion of five working days in which service is provided or within 30 days after the 
425.31 	diagnostic assessment is completed or obtained, whichever occurs first. Providers of 
425.32 	outpatient services must develop the individual treatment plan within 30 days after the 
425.33 	diagnostic assessment is completed or obtained or by the end of the second session of an 
425.34 	outpatient service, not including the session in which the diagnostic assessment was provided, 
425.35 	whichever occurs first. Providers of outpatient and day treatment services must review the 
426.1 	individual treatment plan every 90 days after intake. Providers of services governed by this 
426.2 	section shall complete an individual treatment plan according to the standards of section 
426.3 	245I.10, subdivisions 7 and 8.

426.4 	Sec. 43. Minnesota Statutes 2020, section 245.488, subdivision 1, is amended to read:
426.5 		Subdivision 1.Availability of outpatient services. (a) County boards must provide or 
426.6 	contract for enough outpatient services within the county to meet the needs of each child 
426.7 	with emotional disturbance residing in the county and the child's family. Services may be 
426.8 	provided directly by the county through county-operated mental health centers or mental 
426.9 	health clinics approved by the commissioner under section 245.69, subdivision 2 meeting 
426.10 	the standards of chapter 245I; by contract with privately operated mental health centers or
426.11 	mental health clinics approved by the commissioner under section 245.69, subdivision 2
426.12 	meeting the standards of chapter 245I; by contract with hospital mental health outpatient 
426.13 	programs certified by the Joint Commission on Accreditation of Hospital Organizations; 
426.14 	or by contract with a licensed mental health professional as defined in section 245.4871, 
426.15 	subdivision 27, clauses (1) to (6). A child or a child's parent may be required to pay a fee 
426.16 	based in accordance with section 245.481. Outpatient services include:
426.17 	(1) conducting diagnostic assessments;
426.18 	(2) conducting psychological testing;
426.19 	(3) developing or modifying individual treatment plans;
426.20 	(4) making referrals and recommending placements as appropriate;
426.21 	(5) treating the child's mental health needs through therapy; and
426.22 	(6) prescribing and managing medication and evaluating the effectiveness of prescribed 
426.23 	medication.
426.24 	(b) County boards may request a waiver allowing outpatient services to be provided in 
426.25 	a nearby trade area if it is determined that the child requires necessary and appropriate 
426.26 	services that are only available outside the county.
426.27 	(c) Outpatient services offered by the county board to prevent placement must be at the 
426.28 	level of treatment appropriate to the child's diagnostic assessment.

426.29 	Sec. 44. Minnesota Statutes 2020, section 245.4901, subdivision 2, is amended to read:
426.30 		Subd. 2.Eligible applicants. An eligible applicant for school-linked mental health grants 
426.31 	is an entity that is:
427.1 	(1) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 9520.0870
427.2 	section 245I.20;
427.3 	(2) a community mental health center under section 256B.0625, subdivision 5;
427.4 	(3) an Indian health service facility or a facility owned and operated by a tribe or tribal 
427.5 	organization operating under United States Code, title 25, section 5321;
427.6 	(4) a provider of children's therapeutic services and supports as defined in section 
427.7 	256B.0943; or
427.8 	(5) enrolled in medical assistance as a mental health or substance use disorder provider 
427.9 	agency and employs at least two full-time equivalent mental health professionals qualified 
427.10 	according to section 245I.16 245I.04, subdivision 2, or two alcohol and drug counselors 
427.11 	licensed or exempt from licensure under chapter 148F who are qualified to provide clinical 
427.12 	services to children and families.

427.13 	Sec. 45. Minnesota Statutes 2020, section 245.62, subdivision 2, is amended to read:
427.14 		Subd. 2.Definition. A community mental health center is a private nonprofit corporation 
427.15 	or public agency approved under the rules promulgated by the commissioner pursuant to 
427.16 	subdivision 4 standards of section 256B.0625, subdivision 5.

427.17 	Sec. 46. Minnesota Statutes 2020, section 245A.04, subdivision 5, is amended to read:
427.18 		Subd. 5.Commissioner's right of access. (a) When the commissioner is exercising the 
427.19 	powers conferred by this chapter, sections 245.69 and section626.557, and chapter 260E, 
427.20 	the commissioner must be given access to:
427.21 	(1) the physical plant and grounds where the program is provided;
427.22 	(2) documents and records, including records maintained in electronic format;
427.23 	(3) persons served by the program; and
427.24 	(4) staff and personnel records of current and former staff whenever the program is in 
427.25 	operation and the information is relevant to inspections or investigations conducted by the 
427.26 	commissioner. Upon request, the license holder must provide the commissioner verification 
427.27 	of documentation of staff work experience, training, or educational requirements.
427.28 	The commissioner must be given access without prior notice and as often as the 
427.29 	commissioner considers necessary if the commissioner is investigating alleged maltreatment, 
427.30 	conducting a licensing inspection, or investigating an alleged violation of applicable laws 
427.31 	or rules. In conducting inspections, the commissioner may request and shall receive assistance 
428.1 	from other state, county, and municipal governmental agencies and departments. The 
428.2 	applicant or license holder shall allow the commissioner to photocopy, photograph, and 
428.3 	make audio and video tape recordings during the inspection of the program at the 
428.4 	commissioner's expense. The commissioner shall obtain a court order or the consent of the 
428.5 	subject of the records or the parents or legal guardian of the subject before photocopying 
428.6 	hospital medical records.
428.7 	(b) Persons served by the program have the right to refuse to consent to be interviewed, 
428.8 	photographed, or audio or videotaped. Failure or refusal of an applicant or license holder 
428.9 	to fully comply with this subdivision is reasonable cause for the commissioner to deny the 
428.10 	application or immediately suspend or revoke the license.

428.11 	Sec. 47. Minnesota Statutes 2020, section 245A.10, subdivision 4, is amended to read:
428.12 		Subd. 4.License or certification fee for certain programs. (a) Child care centers shall 
428.13 	pay an annual nonrefundable license fee based on the following schedule:

428.15428.14
		Licensed Capacity
	Child Care Center
License Fee
	
428.16		1 to 24 persons
	$200
	
428.17		25 to 49 persons
	$300
	
428.18		50 to 74 persons
	$400
	
428.19		75 to 99 persons
	$500
	
428.20		100 to 124 persons
	$600
	
428.21		125 to 149 persons
	$700
	
428.22		150 to 174 persons
	$800
	
428.23		175 to 199 persons
	$900
	
428.24		200 to 224 persons
	$1,000
	
428.25		225 or more persons
	$1,100
	
428.26 	(b)(1) A program licensed to provide one or more of the home and community-based 
428.27 	services and supports identified under chapter 245D to persons with disabilities or age 65 
428.28 	and older, shall pay an annual nonrefundable license fee based on revenues derived from 
428.29 	the provision of services that would require licensure under chapter 245D during the calendar 
428.30 	year immediately preceding the year in which the license fee is paid, according to the 
428.31 	following schedule:

428.32	License Holder Annual Revenue
		License Fee
	
428.33	less than or equal to $10,000
		$200
	
428.34
428.35	greater than $10,000 but less than or 
equal to $25,000
		$300
	
429.1
429.2	greater than $25,000 but less than or 
equal to $50,000
		$400
	
429.3
429.4	greater than $50,000 but less than or 
equal to $100,000
		$500
	
429.5
429.6	greater than $100,000 but less than or 
equal to $150,000
		$600
	
429.7
429.8	greater than $150,000 but less than or 
equal to $200,000
		$800
	
429.9429.10
	greater than $200,000 but less than or 
equal to $250,000
		$1,000
	
429.11
429.12	greater than $250,000 but less than or 
equal to $300,000
		$1,200
	
429.13
429.14	greater than $300,000 but less than or 
equal to $350,000
		$1,400
	
429.15
429.16	greater than $350,000 but less than or 
equal to $400,000
		$1,600
	
429.17
429.18	greater than $400,000 but less than or 
equal to $450,000
		$1,800
	
429.19
429.20	greater than $450,000 but less than or 
equal to $500,000
		$2,000
	
429.21
429.22	greater than $500,000 but less than or 
equal to $600,000
		$2,250
	
429.23
429.24	greater than $600,000 but less than or 
equal to $700,000
		$2,500
	
429.25
429.26	greater than $700,000 but less than or 
equal to $800,000
		$2,750
	
429.27
429.28	greater than $800,000 but less than or 
equal to $900,000
		$3,000
	
429.29
429.30	greater than $900,000 but less than or 
equal to $1,000,000
		$3,250
	
429.31
429.32	greater than $1,000,000 but less than or 
equal to $1,250,000
		$3,500
	
429.33
429.34	greater than $1,250,000 but less than or 
equal to $1,500,000
		$3,750
	
429.35
429.36	greater than $1,500,000 but less than or 
equal to $1,750,000
		$4,000
	
429.37
429.38	greater than $1,750,000 but less than or 
equal to $2,000,000
		$4,250
	
429.39
429.40	greater than $2,000,000 but less than or 
equal to $2,500,000
		$4,500
	
429.41
429.42	greater than $2,500,000 but less than or 
equal to $3,000,000
		$4,750
	
429.43
429.44	greater than $3,000,000 but less than or 
equal to $3,500,000
		$5,000
	
429.45
429.46	greater than $3,500,000 but less than or 
equal to $4,000,000
		$5,500
	
430.1
430.2	greater than $4,000,000 but less than or 
equal to $4,500,000
		$6,000
	
430.3
430.4	greater than $4,500,000 but less than or 
equal to $5,000,000
		$6,500
	
430.5
430.6	greater than $5,000,000 but less than or 
equal to $7,500,000
		$7,000
	
430.7
430.8	greater than $7,500,000 but less than or 
equal to $10,000,000
		$8,500
	
430.9430.10
	greater than $10,000,000 but less than or 
equal to $12,500,000
		$10,000
	
430.11
430.12	greater than $12,500,000 but less than or 
equal to $15,000,000
		$14,000
	
430.13	greater than $15,000,000
		$18,000
	
430.14 	(2) If requested, the license holder shall provide the commissioner information to verify 
430.15 	the license holder's annual revenues or other information as needed, including copies of 
430.16 	documents submitted to the Department of Revenue.
430.17 	(3) At each annual renewal, a license holder may elect to pay the highest renewal fee, 
430.18 	and not provide annual revenue information to the commissioner.
430.19 	(4) A license holder that knowingly provides the commissioner incorrect revenue amounts 
430.20 	for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount 
430.21 	of double the fee the provider should have paid.
430.22 	(5) Notwithstanding clause (1), a license holder providing services under one or more 
430.23 	licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license 
430.24 	fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license 
430.25 	holder for all licenses held under chapter 245B for calendar year 2013. For calendar year 
430.26 	2017 and thereafter, the license holder shall pay an annual license fee according to clause 
430.27 	(1).
430.28 	(c) A chemical dependency treatment program licensed under chapter 245G, to provide 
430.29 	chemical dependency treatment shall pay an annual nonrefundable license fee based on the 
430.30 	following schedule:

430.31		Licensed Capacity
	License Fee
	
430.32		1 to 24 persons
	$600
	
430.33		25 to 49 persons
	$800
	
430.34		50 to 74 persons
	$1,000
	
430.35		75 to 99 persons
	$1,200
	
430.36		100 or more persons
	$1,400
	
431.1 	(d) A chemical dependency program licensed under Minnesota Rules, parts 9530.6510 
431.2 	to 9530.6590, to provide detoxification services shall pay an annual nonrefundable license 
431.3 	fee based on the following schedule:

431.4		Licensed Capacity
	License Fee
	
431.5		1 to 24 persons
	$760
	
431.6		25 to 49 persons
	$960
	
431.7		50 or more persons
	$1,160
	
431.8 	(e) Except for child foster care, a residential facility licensed under Minnesota Rules, 
431.9 	chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the 
431.10 	following schedule:

431.11		Licensed Capacity
	License Fee
	
431.12		1 to 24 persons
	$1,000
	
431.13		25 to 49 persons
	$1,100
	
431.14		50 to 74 persons
	$1,200
	
431.15		75 to 99 persons
	$1,300
	
431.16		100 or more persons
	$1,400
	
431.17 	(f) A residential facility licensed under section 245I.23 or Minnesota Rules, parts 
431.18 	9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual 
431.19 	nonrefundable license fee based on the following schedule:

431.20		Licensed Capacity
	License Fee
	
431.21		1 to 24 persons
	$2,525
	
431.22		25 or more persons
	$2,725
	
431.23 	(g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400, 
431.24 	to serve persons with physical disabilities shall pay an annual nonrefundable license fee 
431.25 	based on the following schedule:

431.26		Licensed Capacity
	License Fee
	
431.27		1 to 24 persons
	$450
	
431.28		25 to 49 persons
	$650
	
431.29		50 to 74 persons
	$850
	
431.30		75 to 99 persons
	$1,050
	
431.31		100 or more persons
	$1,250
	
431.32 	(h) A program licensed to provide independent living assistance for youth under section 
431.33 	245A.22 shall pay an annual nonrefundable license fee of $1,500.
432.1 	(i) A private agency licensed to provide foster care and adoption services under Minnesota 
432.2 	Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.
432.3 	(j) A program licensed as an adult day care center licensed under Minnesota Rules, parts 
432.4 	9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the 
432.5 	following schedule:

432.6		Licensed Capacity
	License Fee
	
432.7		1 to 24 persons
	$500
	
432.8		25 to 49 persons
	$700
	
432.9		50 to 74 persons
	$900
	
432.10		75 to 99 persons
	$1,100
	
432.11		100 or more persons
	$1,300
	
432.12 	(k) A program licensed to provide treatment services to persons with sexual psychopathic 
432.13 	personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to 
432.14 	9515.3110, shall pay an annual nonrefundable license fee of $20,000.
432.15 	(l) A mental health center or mental health clinic requesting certification for purposes 
432.16 	of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750 
432.17 	to 9520.0870 certified under section 245I.20, shall pay aan annual nonrefundable certification 
432.18 	fee of $1,550 per year. If the mentalhealth center or mental health clinic provides services 
432.19 	at a primary location with satellite facilities, the satellite facilities shall be certified with the 
432.20 	primary location without an additional charge.

432.21 	Sec. 48. Minnesota Statutes 2020, section 245A.65, subdivision 2, is amended to read:
432.22 		Subd. 2.Abuse prevention plans. All license holders shall establish and enforce ongoing 
432.23 	written program abuse prevention plans and individual abuse prevention plans as required 
432.24 	under section 626.557, subdivision 14.
432.25 	(a) The scope of the program abuse prevention plan is limited to the population, physical 
432.26 	plant, and environment within the control of the license holder and the location where 
432.27 	licensed services are provided. In addition to the requirements in section 626.557, subdivision 
432.28 	14, the program abuse prevention plan shall meet the requirements in clauses (1) to (5).
432.29 	(1) The assessment of the population shall include an evaluation of the following factors: 
432.30 	age, gender, mental functioning, physical and emotional health or behavior of the client; 
432.31 	the need for specialized programs of care for clients; the need for training of staff to meet 
432.32 	identified individual needs; and the knowledge a license holder may have regarding previous 
432.33 	abuse that is relevant to minimizing risk of abuse for clients.
433.1 	(2) The assessment of the physical plant where the licensed services are provided shall 
433.2 	include an evaluation of the following factors: the condition and design of the building as 
433.3 	it relates to the safety of the clients; and the existence of areas in the building which are 
433.4 	difficult to supervise.
433.5 	(3) The assessment of the environment for each facility and for each site when living 
433.6 	arrangements are provided by the agency shall include an evaluation of the following factors: 
433.7 	the location of the program in a particular neighborhood or community; the type of grounds 
433.8 	and terrain surrounding the building; the type of internal programming; and the program's 
433.9 	staffing patterns.
433.10 	(4) The license holder shall provide an orientation to the program abuse prevention plan 
433.11 	for clients receiving services. If applicable, the client's legal representative must be notified 
433.12 	of the orientation. The license holder shall provide this orientation for each new person 
433.13 	within 24 hours of admission, or for persons who would benefit more from a later orientation, 
433.14 	the orientation may take place within 72 hours.
433.15 	(5) The license holder's governing body or the governing body's delegated representative 
433.16 	shall review the plan at least annually using the assessment factors in the plan and any 
433.17 	substantiated maltreatment findings that occurred since the last review. The governing body 
433.18 	or the governing body's delegated representative shall revise the plan, if necessary, to reflect 
433.19 	the review results.
433.20 	(6) A copy of the program abuse prevention plan shall be posted in a prominent location 
433.21 	in the program and be available upon request to mandated reporters, persons receiving 
433.22 	services, and legal representatives.
433.23 	(b) In addition to the requirements in section 626.557, subdivision 14, the individual 
433.24 	abuse prevention plan shall meet the requirements in clauses (1) and (2).
433.25 	(1) The plan shall include a statement of measures that will be taken to minimize the 
433.26 	risk of abuse to the vulnerable adult when the individual assessment required in section 
433.27 	626.557, subdivision 14, paragraph (b), indicates the need for measures in addition to the 
433.28 	specific measures identified in the program abuse prevention plan. The measures shall 
433.29 	include the specific actions the program will take to minimize the risk of abuse within the 
433.30 	scope of the licensed services, and will identify referrals made when the vulnerable adult 
433.31 	is susceptible to abuse outside the scope or control of the licensed services. When the 
433.32 	assessment indicates that the vulnerable adult does not need specific risk reduction measures 
433.33 	in addition to those identified in the program abuse prevention plan, the individual abuse 
433.34 	prevention plan shall document this determination.
434.1 	(2) An individual abuse prevention plan shall be developed for each new person as part 
434.2 	of the initial individual program plan or service plan required under the applicable licensing 
434.3 	rule or statute. The review and evaluation of the individual abuse prevention plan shall be 
434.4 	done as part of the review of the program plan or, service plan, or treatment plan. The person 
434.5 	receiving services shall participate in the development of the individual abuse prevention 
434.6 	plan to the full extent of the person's abilities. If applicable, the person's legal representative 
434.7 	shall be given the opportunity to participate with or for the person in the development of 
434.8 	the plan. The interdisciplinary team shall document the review of all abuse prevention plans 
434.9 	at least annually, using the individual assessment and any reports of abuse relating to the 
434.10 	person. The plan shall be revised to reflect the results of this review.

434.11 	Sec. 49. Minnesota Statutes 2020, section 245D.02, subdivision 20, is amended to read:
434.12 		Subd. 20.Mental health crisis intervention team. "Mental health crisis intervention 
434.13 	team" means a mental health crisis response provider as identified in section 256B.0624, 
434.14 	subdivision 2, paragraph (d), for adults, and in section 256B.0944, subdivision 1, paragraph 
434.15 	(d), for children.

434.16 	Sec. 50. Minnesota Statutes 2020, section 256B.0615, subdivision 1, is amended to read:
434.17 		Subdivision 1.Scope. Medical assistance covers mental health certified peer specialist 
434.18 	services, as established in subdivision 2, subject to federal approval, if provided to recipients 
434.19 	who are eligible for services under sections 256B.0622, 256B.0623, and 256B.0624 and 
434.20 	are provided by a mental health certified peer specialist who has completed the training 
434.21 	under subdivision 5 and is qualified according to section 245I.04, subdivision 10.

434.22 	Sec. 51. Minnesota Statutes 2020, section 256B.0615, subdivision 5, is amended to read:
434.23 		Subd. 5.Certified peer specialist training and certification. The commissioner of 
434.24 	human services shall develop a training and certification process for certified peer specialists, 
434.25 	who must be at least 21 years of age. The candidates must have had a primary diagnosis of 
434.26 	mental illness, be a current or former consumer of mental health services, and must 
434.27 	demonstrate leadership and advocacy skills and a strong dedication to recovery. The training 
434.28 	curriculum must teach participating consumers specific skills relevant to providing peer 
434.29 	support to other consumers. In addition to initial training and certification, the commissioner 
434.30 	shall develop ongoing continuing educational workshops on pertinent issues related to peer 
434.31 	support counseling.

435.1 	Sec. 52. Minnesota Statutes 2020, section 256B.0616, subdivision 1, is amended to read:
435.2 		Subdivision 1.Scope. Medical assistance covers mental health certified family peer 
435.3 	specialists services, as established in subdivision 2, subject to federal approval, if provided 
435.4 	to recipients who have an emotional disturbance or severe emotional disturbance under 
435.5 	chapter 245, and are provided by a mental health certified family peer specialist who has 
435.6 	completed the training under subdivision 5 and is qualified according to section 245I.04, 
435.7 	subdivision 12. A family peer specialist cannot provide services to the peer specialist's 
435.8 	family.

435.9 	Sec. 53. Minnesota Statutes 2020, section 256B.0616, subdivision 3, is amended to read:
435.10 		Subd. 3.Eligibility. Family peer support services may be located in provided to recipients 
435.11 	of inpatient hospitalization, partial hospitalization, residential treatment, intensive treatment 
435.12 	in foster care, day treatment, children's therapeutic services and supports, or crisis services.

435.13 	Sec. 54. Minnesota Statutes 2020, section 256B.0616, subdivision 5, is amended to read:
435.14 		Subd. 5.Certified family peer specialist training and certification. The commissioner 
435.15 	shall develop a training and certification process for certified family peer specialists who 
435.16 	must be at least 21 years of age. The candidates must have raised or be currently raising a 
435.17 	child with a mental illness, have had experience navigating the children's mental health 
435.18 	system, and must demonstrate leadership and advocacy skills and a strong dedication to 
435.19 	family-driven and family-focused services. The training curriculum must teach participating 
435.20 	family peer specialists specific skills relevant to providing peer support to other parents. In 
435.21 	addition to initial training and certification, the commissioner shall develop ongoing 
435.22 	continuing educational workshops on pertinent issues related to family peer support 
435.23 	counseling.

435.24 	Sec. 55. Minnesota Statutes 2020, section 256B.0622, subdivision 1, is amended to read:
435.25 		Subdivision 1.Scope. (a) Subject to federal approval, medical assistance covers medically 
435.26 	necessary, assertive community treatment for clients as defined in subdivision 2a and 
435.27 	intensive residential treatment services for clients as defined in subdivision 3, when the 
435.28 	services are provided by an entity certified under and meeting the standards in this section.
435.29 	(b) Subject to federal approval, medical assistance covers medically necessary, intensive 
435.30 	residential treatment services when the services are provided by an entity licensed under 
435.31 	and meeting the standards in section 245I.23.
436.1 	(c) The provider entity must make reasonable and good faith efforts to report individual 
436.2 	client outcomes to the commissioner, using instruments and protocols approved by the 
436.3 	commissioner.

436.4 	Sec. 56. Minnesota Statutes 2020, section 256B.0622, subdivision 2, is amended to read:
436.5 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
436.6 	meanings given them.
436.7 	(b) "ACT team" means the group of interdisciplinary mental health staff who work as 
436.8 	a team to provide assertive community treatment.
436.9 	(c) "Assertive community treatment" means intensive nonresidential treatment and 
436.10 	rehabilitative mental health services provided according to the assertive community treatment 
436.11 	model. Assertive community treatment provides a single, fixed point of responsibility for 
436.12 	treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per 
436.13 	day, seven days per week, in a community-based setting.
436.14 	(d) "Individual treatment plan" means the document that results from a person-centered 
436.15 	planning process of determining real-life outcomes with clients and developing strategies 
436.16 	to achieve those outcomes a plan described by section 245I.10, subdivisions 7 and 8.
436.17 	(e) "Assertive engagement" means the use of collaborative strategies to engage clients 
436.18 	to receive services.
436.19 	(f) "Benefits and finance support" means assisting clients in capably managing financial 
436.20 	affairs. Services include, but are not limited to, assisting clients in applying for benefits; 
436.21 	assisting with redetermination of benefits; providing financial crisis management; teaching 
436.22 	and supporting budgeting skills and asset development; and coordinating with a client's 
436.23 	representative payee, if applicable.
436.24 	(g) "Co-occurring disorder treatment" means the treatment of co-occurring mental illness 
436.25 	and substance use disorders and is characterized by assertive outreach, stage-wise 
436.26 	comprehensive treatment, treatment goal setting, and flexibility to work within each stage 
436.27 	of treatment. Services include, but are not limited to, assessing and tracking clients' stages 
436.28 	of change readiness and treatment; applying the appropriate treatment based on stages of 
436.29 	change, such as outreach and motivational interviewing techniques to work with clients in 
436.30 	earlier stages of change readiness and cognitive behavioral approaches and relapse prevention 
436.31 	to work with clients in later stages of change; and facilitating access to community supports.
436.32 	(h) (e) "Crisis assessment and intervention" means mental health crisis response services 
436.33 	as defined in section 256B.0624, subdivision 2, paragraphs (c) to (e).
437.1 	(i) "Employment services" means assisting clients to work at jobs of their choosing. 
437.2 	Services must follow the principles of the individual placement and support (IPS) 
437.3 	employment model, including focusing on competitive employment; emphasizing individual 
437.4 	client preferences and strengths; ensuring employment services are integrated with mental 
437.5 	health services; conducting rapid job searches and systematic job development according 
437.6 	to client preferences and choices; providing benefits counseling; and offering all services 
437.7 	in an individualized and time-unlimited manner. Services shall also include educating clients 
437.8 	about opportunities and benefits of work and school and assisting the client in learning job 
437.9 	skills, navigating the work place, and managing work relationships.
437.10 	(j) "Family psychoeducation and support" means services provided to the client's family 
437.11 	and other natural supports to restore and strengthen the client's unique social and family 
437.12 	relationships. Services include, but are not limited to, individualized psychoeducation about 
437.13 	the client's illness and the role of the family and other significant people in the therapeutic 
437.14 	process; family intervention to restore contact, resolve conflict, and maintain relationships 
437.15 	with family and other significant people in the client's life; ongoing communication and 
437.16 	collaboration between the ACT team and the family; introduction and referral to family 
437.17 	self-help programs and advocacy organizations that promote recovery and family 
437.18 	engagement, individual supportive counseling, parenting training, and service coordination 
437.19 	to help clients fulfill parenting responsibilities; coordinating services for the child and 
437.20 	restoring relationships with children who are not in the client's custody; and coordinating 
437.21 	with child welfare and family agencies, if applicable. These services must be provided with 
437.22 	the client's agreement and consent.
437.23 	(k) "Housing access support" means assisting clients to find, obtain, retain, and move 
437.24 	to safe and adequate housing of their choice. Housing access support includes, but is not 
437.25 	limited to, locating housing options with a focus on integrated independent settings; applying 
437.26 	for housing subsidies, programs, or resources; assisting the client in developing relationships 
437.27 	with local landlords; providing tenancy support and advocacy for the individual's tenancy 
437.28 	rights at the client's home; and assisting with relocation.
437.29 	(l) (f) "Individual treatment team" means a minimum of three members of the ACT team 
437.30 	who are responsible for consistently carrying out most of a client's assertive community 
437.31 	treatment services.
437.32 	(m) "Intensive residential treatment services treatment team" means all staff who provide 
437.33 	intensive residential treatment services under this section to clients. At a minimum, this 
437.34 	includes the clinical supervisor; mental health professionals as defined in section 245.462, 
437.35 	subdivision 18, clauses (1) to (6); mental health practitioners as defined in section 245.462, 
438.1 	subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision 
438.2 	5, paragraph (a), clause (4); and mental health certified peer specialists under section 
438.3 	256B.0615.
438.4 	(n) "Intensive residential treatment services" means short-term, time-limited services 
438.5 	provided in a residential setting to clients who are in need of more restrictive settings and 
438.6 	are at risk of significant functional deterioration if they do not receive these services. Services 
438.7 	are designed to develop and enhance psychiatric stability, personal and emotional adjustment, 
438.8 	self-sufficiency, and skills to live in a more independent setting. Services must be directed 
438.9 	toward a targeted discharge date with specified client outcomes.
438.10 	(o) "Medication assistance and support" means assisting clients in accessing medication, 
438.11 	developing the ability to take medications with greater independence, and providing 
438.12 	medication setup. This includes the prescription, administration, and order of medication 
438.13 	by appropriate medical staff.
438.14 	(p) "Medication education" means educating clients on the role and effects of medications 
438.15 	in treating symptoms of mental illness and the side effects of medications.
438.16 	(q) "Overnight staff" means a member of the intensive residential treatment services 
438.17 	team who is responsible during hours when clients are typically asleep.
438.18 	(r) "Mental health certified peer specialist services" has the meaning given in section 
438.19 	256B.0615.
438.20 	(s) "Physical health services" means any service or treatment to meet the physical health 
438.21 	needs of the client to support the client's mental health recovery. Services include, but are 
438.22 	not limited to, education on primary health issues, including wellness education; medication 
438.23 	administration and monitoring; providing and coordinating medical screening and follow-up; 
438.24 	scheduling routine and acute medical and dental care visits; tobacco cessation strategies; 
438.25 	assisting clients in attending appointments; communicating with other providers; and 
438.26 	integrating all physical and mental health treatment.
438.27 	(t) (g) "Primary team member" means the person who leads and coordinates the activities 
438.28 	of the individual treatment team and is the individual treatment team member who has 
438.29 	primary responsibility for establishing and maintaining a therapeutic relationship with the 
438.30 	client on a continuing basis.
438.31 	(u) "Rehabilitative mental health services" means mental health services that are 
438.32 	rehabilitative and enable the client to develop and enhance psychiatric stability, social 
439.1 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
439.2 	community skills, when these abilities are impaired by the symptoms of mental illness.
439.3 	(v) "Symptom management" means supporting clients in identifying and targeting the 
439.4 	symptoms and occurrence patterns of their mental illness and developing strategies to reduce 
439.5 	the impact of those symptoms.
439.6 	(w) "Therapeutic interventions" means empirically supported techniques to address 
439.7 	specific symptoms and behaviors such as anxiety, psychotic symptoms, emotional 
439.8 	dysregulation, and trauma symptoms. Interventions include empirically supported 
439.9 	psychotherapies including, but not limited to, cognitive behavioral therapy, exposure therapy, 
439.10 	acceptance and commitment therapy, interpersonal therapy, and motivational interviewing.
439.11 	(x) "Wellness self-management and prevention" means a combination of approaches to 
439.12 	working with the client to build and apply skills related to recovery, and to support the client 
439.13 	in participating in leisure and recreational activities, civic participation, and meaningful 
439.14 	structure.
439.15 	(h) "Certified rehabilitation specialist" means a staff person who is qualified according 
439.16 	to section 245I.04, subdivision 8.
439.17 	(i) "Clinical trainee" means a staff person who is qualified according to section 245I.04, 
439.18 	subdivision 6.
439.19 	(j) "Mental health certified peer specialist" means a staff person who is qualified 
439.20 	according to section 245I.04, subdivision 10.
439.21 	(k) "Mental health practitioner" means a staff person who is qualified according to section 
439.22 	245I.04, subdivision 4.
439.23 	(l) "Mental health professional" means a staff person who is qualified according to 
439.24 	section 245I.04, subdivision 2.
439.25 	(m) "Mental health rehabilitation worker" means a staff person who is qualified according 
439.26 	to section 245I.04, subdivision 14.

439.27 	Sec. 57. Minnesota Statutes 2020, section 256B.0622, subdivision 3a, is amended to read:
439.28 		Subd. 3a.Provider certification and contract requirements for assertive community 
439.29 	treatment. (a) The assertive community treatment provider must:
439.30 	(1) have a contract with the host county to provide assertive community treatment 
439.31 	services; and
440.1 	(2) have each ACT team be certified by the state following the certification process and 
440.2 	procedures developed by the commissioner. The certification process determines whether 
440.3 	the ACT team meets the standards for assertive community treatment under this section as 
440.4 	well as, the standards in chapter 245I as required in section 245I.011, subdivision 5, and
440.5 	minimum program fidelity standards as measured by a nationally recognized fidelity tool 
440.6 	approved by the commissioner. Recertification must occur at least every three years.
440.7 	(b) An ACT team certified under this subdivision must meet the following standards:
440.8 	(1) have capacity to recruit, hire, manage, and train required ACT team members;
440.9 	(2) have adequate administrative ability to ensure availability of services;
440.10 	(3) ensure adequate preservice and ongoing training for staff;
440.11 	(4) ensure that staff is capable of implementing culturally specific services that are 
440.12 	culturally responsive and appropriate as determined by the client's culture, beliefs, values, 
440.13 	and language as identified in the individual treatment plan;
440.14 	(5) (3) ensure flexibility in service delivery to respond to the changing and intermittent 
440.15 	care needs of a client as identified by the client and the individual treatment plan;
440.16 	(6) develop and maintain client files, individual treatment plans, and contact charting;
440.17 	(7) develop and maintain staff training and personnel files;
440.18 	(8) submit information as required by the state;
440.19 	(9) (4) keep all necessary records required by law;
440.20 	(10) comply with all applicable laws;
440.21 	(11) (5) be an enrolled Medicaid provider; and
440.22 	(12) (6) establish and maintain a quality assurance plan to determine specific service 
440.23 	outcomes and the client's satisfaction with services; and.
440.24 	(13) develop and maintain written policies and procedures regarding service provision 
440.25 	and administration of the provider entity.
440.26 	(c) The commissioner may intervene at any time and decertify an ACT team with cause. 
440.27 	The commissioner shall establish a process for decertification of an ACT team and shall 
440.28 	require corrective action, medical assistance repayment, or decertification of an ACT team 
440.29 	that no longer meets the requirements in this section or that fails to meet the clinical quality 
440.30 	standards or administrative standards provided by the commissioner in the application and 
440.31 	certification process. The decertification is subject to appeal to the state.

441.1 	Sec. 58. Minnesota Statutes 2020, section 256B.0622, subdivision 4, is amended to read:
441.2 		Subd. 4.Provider entity licensure and contract requirements for intensive residential 
441.3 	treatment services. (a) The intensive residential treatment services provider entity must:
441.4 	(1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;
441.5 	(2) not exceed 16 beds per site; and
441.6 	(3) comply with the additional standards in this section.
441.7 	(b) (a) The commissioner shall develop procedures for counties and providers to submit 
441.8 	other documentation as needed to allow the commissioner to determine whether the standards 
441.9 	in this section are met.
441.10 	(c) (b) A provider entity must specify in the provider entity's application what geographic 
441.11 	area and populations will be served by the proposed program. A provider entity must 
441.12 	document that the capacity or program specialties of existing programs are not sufficient 
441.13 	to meet the service needs of the target population. A provider entity must submit evidence 
441.14 	of ongoing relationships with other providers and levels of care to facilitate referrals to and 
441.15 	from the proposed program.
441.16 	(d) (c) A provider entity must submit documentation that the provider entity requested 
441.17 	a statement of need from each county board and tribal authority that serves as a local mental 
441.18 	health authority in the proposed service area. The statement of need must specify if the local 
441.19 	mental health authority supports or does not support the need for the proposed program and 
441.20 	the basis for this determination. If a local mental health authority does not respond within 
441.21 	60 days of the receipt of the request, the commissioner shall determine the need for the 
441.22 	program based on the documentation submitted by the provider entity.

441.23 	Sec. 59. Minnesota Statutes 2020, section 256B.0622, subdivision 7, is amended to read:
441.24 		Subd. 7.Assertive community treatment service standards. (a) ACT teams must offer 
441.25 	and have the capacity to directly provide the following services:
441.26 	(1) assertive engagement using collaborative strategies to encourage clients to receive 
441.27 	services;
441.28 	(2) benefits and finance support that assists clients to capably manage financial affairs. 
441.29 	Services include but are not limited to assisting clients in applying for benefits, assisting 
441.30 	with redetermination of benefits, providing financial crisis management, teaching and 
441.31 	supporting budgeting skills and asset development, and coordinating with a client's 
441.32 	representative payee, if applicable;
442.1 	(3) co-occurring substance use disorder treatment as defined in section 245I.02, 
442.2 	subdivision 11;
442.3 	(4) crisis assessment and intervention;
442.4 	(5) employment services that assist clients to work at jobs of the clients' choosing. 
442.5 	Services must follow the principles of the individual placement and support employment 
442.6 	model, including focusing on competitive employment, emphasizing individual client 
442.7 	preferences and strengths, ensuring employment services are integrated with mental health 
442.8 	services, conducting rapid job searches and systematic job development according to client 
442.9 	preferences and choices, providing benefits counseling, and offering all services in an 
442.10 	individualized and time-unlimited manner. Services must also include educating clients 
442.11 	about opportunities and benefits of work and school and assisting the client in learning job 
442.12 	skills, navigating the workplace, workplace accommodations, and managing work 
442.13 	relationships;
442.14 	(6) family psychoeducation and support provided to the client's family and other natural 
442.15 	supports to restore and strengthen the client's unique social and family relationships. Services 
442.16 	include but are not limited to individualized psychoeducation about the client's illness and 
442.17 	the role of the family and other significant people in the therapeutic process; family 
442.18 	intervention to restore contact, resolve conflict, and maintain relationships with family and 
442.19 	other significant people in the client's life; ongoing communication and collaboration between 
442.20 	the ACT team and the family; introduction and referral to family self-help programs and 
442.21 	advocacy organizations that promote recovery and family engagement, individual supportive 
442.22 	counseling, parenting training, and service coordination to help clients fulfill parenting 
442.23 	responsibilities; coordinating services for the child and restoring relationships with children 
442.24 	who are not in the client's custody; and coordinating with child welfare and family agencies, 
442.25 	if applicable. These services must be provided with the client's agreement and consent;
442.26 	(7) housing access support that assists clients to find, obtain, retain, and move to safe 
442.27 	and adequate housing of their choice. Housing access support includes but is not limited to 
442.28 	locating housing options with a focus on integrated independent settings; applying for 
442.29 	housing subsidies, programs, or resources; assisting the client in developing relationships 
442.30 	with local landlords; providing tenancy support and advocacy for the individual's tenancy 
442.31 	rights at the client's home; and assisting with relocation;
442.32 	(8) medication assistance and support that assists clients in accessing medication, 
442.33 	developing the ability to take medications with greater independence, and providing 
443.1 	medication setup. Medication assistance and support includes assisting the client with the 
443.2 	prescription, administration, and ordering of medication by appropriate medical staff;
443.3 	(9) medication education that educates clients on the role and effects of medications in 
443.4 	treating symptoms of mental illness and the side effects of medications;
443.5 	(10) mental health certified peer specialists services according to section 256B.0615;
443.6 	(11) physical health services to meet the physical health needs of the client to support 
443.7 	the client's mental health recovery. Services include but are not limited to education on 
443.8 	primary health and wellness issues, medication administration and monitoring, providing 
443.9 	and coordinating medical screening and follow-up, scheduling routine and acute medical 
443.10 	and dental care visits, tobacco cessation strategies, assisting clients in attending appointments, 
443.11 	communicating with other providers, and integrating all physical and mental health treatment;
443.12 	(12) rehabilitative mental health services as defined in section 245I.02, subdivision 33;
443.13 	(13) symptom management that supports clients in identifying and targeting the symptoms 
443.14 	and occurrence patterns of their mental illness and developing strategies to reduce the impact 
443.15 	of those symptoms;
443.16 	(14) therapeutic interventions to address specific symptoms and behaviors such as 
443.17 	anxiety, psychotic symptoms, emotional dysregulation, and trauma symptoms. Interventions 
443.18 	include empirically supported psychotherapies including but not limited to cognitive 
443.19 	behavioral therapy, exposure therapy, acceptance and commitment therapy, interpersonal 
443.20 	therapy, and motivational interviewing;
443.21 	(15) wellness self-management and prevention that includes a combination of approaches 
443.22 	to working with the client to build and apply skills related to recovery, and to support the 
443.23 	client in participating in leisure and recreational activities, civic participation, and meaningful 
443.24 	structure; and
443.25 	(16) other services based on client needs as identified in a client's assertive community 
443.26 	treatment individual treatment plan.
443.27 	(b) ACT teams must ensure the provision of all services necessary to meet a client's 
443.28 	needs as identified in the client's individual treatment plan.

443.29 	Sec. 60. Minnesota Statutes 2020, section 256B.0622, subdivision 7a, is amended to read:
443.30 		Subd. 7a.Assertive community treatment team staff requirements and roles. (a) 
443.31 	The required treatment staff qualifications and roles for an ACT team are:
443.32 	(1) the team leader:
444.1 	(i) shall be a licensed mental health professional who is qualified under Minnesota Rules, 
444.2 	part 9505.0371, subpart 5, item A. Individuals who are not licensed but who are eligible 
444.3 	for licensure and are otherwise qualified may also fulfill this role but must obtain full 
444.4 	licensure within 24 months of assuming the role of team leader;
444.5 	(ii) must be an active member of the ACT team and provide some direct services to 
444.6 	clients;
444.7 	(iii) must be a single full-time staff member, dedicated to the ACT team, who is 
444.8 	responsible for overseeing the administrative operations of the team, providing clinical 
444.9 	oversight treatment supervision of services in conjunction with the psychiatrist or psychiatric 
444.10 	care provider, and supervising team members to ensure delivery of best and ethical practices; 
444.11 	and
444.12 	(iv) must be available to provide overall clinical oversight treatment supervision to the 
444.13 	ACT team after regular business hours and on weekends and holidays. The team leader may 
444.14 	delegate this duty to another qualified member of the ACT team;
444.15 	(2) the psychiatric care provider:
444.16 	(i) must be a licensed psychiatrist certified by the American Board of Psychiatry and 
444.17 	Neurology or eligible for board certification or certified by the American Osteopathic Board 
444.18 	of Neurology and Psychiatry or eligible for board certification, or a psychiatric nurse who 
444.19 	is qualified under Minnesota Rules, part 9505.0371, subpart 5, item A mental health 
444.20 	professional permitted to prescribe psychiatric medications as part of the mental health 
444.21 	professional's scope of practice. The psychiatric care provider must have demonstrated 
444.22 	clinical experience working with individuals with serious and persistent mental illness;
444.23 	(ii) shall collaborate with the team leader in sharing overall clinical responsibility for 
444.24 	screening and admitting clients; monitoring clients' treatment and team member service 
444.25 	delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects, 
444.26 	and health-related conditions; actively collaborating with nurses; and helping provide clinical
444.27 	treatment supervision to the team;
444.28 	(iii) shall fulfill the following functions for assertive community treatment clients: 
444.29 	provide assessment and treatment of clients' symptoms and response to medications, including 
444.30 	side effects; provide brief therapy to clients; provide diagnostic and medication education 
444.31 	to clients, with medication decisions based on shared decision making; monitor clients' 
444.32 	nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and 
444.33 	community visits;
445.1 	(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized 
445.2 	for mental health treatment and shall communicate directly with the client's inpatient 
445.3 	psychiatric care providers to ensure continuity of care;
445.4 	(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per 
445.5 	50 clients. Part-time psychiatric care providers shall have designated hours to work on the 
445.6 	team, with sufficient blocks of time on consistent days to carry out the provider's clinical, 
445.7 	supervisory, and administrative responsibilities. No more than two psychiatric care providers 
445.8 	may share this role;
445.9 	(vi) may not provide specific roles and responsibilities by telemedicine unless approved 
445.10 	by the commissioner; and
445.11 	(vii) shall provide psychiatric backup to the program after regular business hours and 
445.12 	on weekends and holidays. The psychiatric care provider may delegate this duty to another 
445.13 	qualified psychiatric provider;
445.14 	(3) the nursing staff:
445.15 	(i) shall consist of one to three registered nurses or advanced practice registered nurses, 
445.16 	of whom at least one has a minimum of one-year experience working with adults with 
445.17 	serious mental illness and a working knowledge of psychiatric medications. No more than 
445.18 	two individuals can share a full-time equivalent position;
445.19 	(ii) are responsible for managing medication, administering and documenting medication 
445.20 	treatment, and managing a secure medication room; and
445.21 	(iii) shall develop strategies, in collaboration with clients, to maximize taking medications 
445.22 	as prescribed; screen and monitor clients' mental and physical health conditions and 
445.23 	medication side effects; engage in health promotion, prevention, and education activities; 
445.24 	communicate and coordinate services with other medical providers; facilitate the development 
445.25 	of the individual treatment plan for clients assigned; and educate the ACT team in monitoring 
445.26 	psychiatric and physical health symptoms and medication side effects;
445.27 	(4) the co-occurring disorder specialist:
445.28 	(i) shall be a full-time equivalent co-occurring disorder specialist who has received 
445.29 	specific training on co-occurring disorders that is consistent with national evidence-based 
445.30 	practices. The training must include practical knowledge of common substances and how 
445.31 	they affect mental illnesses, the ability to assess substance use disorders and the client's 
445.32 	stage of treatment, motivational interviewing, and skills necessary to provide counseling to 
445.33 	clients at all different stages of change and treatment. The co-occurring disorder specialist 
446.1 	may also be an individual who is a licensed alcohol and drug counselor as described in 
446.2 	section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience, 
446.3 	and other requirements in section 245G.11, subdivision 5. No more than two co-occurring 
446.4 	disorder specialists may occupy this role; and
446.5 	(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients. 
446.6 	The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT 
446.7 	team members on co-occurring disorders;
446.8 	(5) the vocational specialist:
446.9 	(i) shall be a full-time vocational specialist who has at least one-year experience providing 
446.10 	employment services or advanced education that involved field training in vocational services 
446.11 	to individuals with mental illness. An individual who does not meet these qualifications 
446.12 	may also serve as the vocational specialist upon completing a training plan approved by the 
446.13 	commissioner;
446.14 	(ii) shall provide or facilitate the provision of vocational services to clients. The vocational 
446.15 	specialist serves as a consultant and educator to fellow ACT team members on these services; 
446.16 	and
446.17 	(iii) should must not refer individuals to receive any type of vocational services or linkage 
446.18 	by providers outside of the ACT team;
446.19 	(6) the mental health certified peer specialist:
446.20 	(i) shall be a full-time equivalent mental health certified peer specialist as defined in 
446.21 	section 256B.0615. No more than two individuals can share this position. The mental health 
446.22 	certified peer specialist is a fully integrated team member who provides highly individualized 
446.23 	services in the community and promotes the self-determination and shared decision-making 
446.24 	abilities of clients. This requirement may be waived due to workforce shortages upon 
446.25 	approval of the commissioner;
446.26 	(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery, 
446.27 	self-advocacy, and self-direction, promote wellness management strategies, and assist clients 
446.28 	in developing advance directives; and
446.29 	(iii) must model recovery values, attitudes, beliefs, and personal action to encourage 
446.30 	wellness and resilience, provide consultation to team members, promote a culture where 
446.31 	the clients' points of view and preferences are recognized, understood, respected, and 
446.32 	integrated into treatment, and serve in a manner equivalent to other team members;
447.1 	(7) the program administrative assistant shall be a full-time office-based program 
447.2 	administrative assistant position assigned to solely work with the ACT team, providing a 
447.3 	range of supports to the team, clients, and families; and
447.4 	(8) additional staff:
447.5 	(i) shall be based on team size. Additional treatment team staff may include licensed
447.6 	mental health professionals as defined in Minnesota Rules, part 9505.0371, subpart 5, item 
447.7 	A; clinical trainees; certified rehabilitation specialists; mental health practitioners as defined 
447.8 	in section 245.462, subdivision 17; a mental health practitioner working as a clinical trainee 
447.9 	according to Minnesota Rules, part 9505.0371, subpart 5, item C; or mental health 
447.10 	rehabilitation workers as defined in section 256B.0623, subdivision 5, paragraph (a), clause 
447.11 	(4). These individuals shall have the knowledge, skills, and abilities required by the 
447.12 	population served to carry out rehabilitation and support functions; and
447.13 	(ii) shall be selected based on specific program needs or the population served.
447.14 	(b) Each ACT team must clearly document schedules for all ACT team members.
447.15 	(c) Each ACT team member must serve as a primary team member for clients assigned 
447.16 	by the team leader and are responsible for facilitating the individual treatment plan process 
447.17 	for those clients. The primary team member for a client is the responsible team member 
447.18 	knowledgeable about the client's life and circumstances and writes the individual treatment 
447.19 	plan. The primary team member provides individual supportive therapy or counseling, and 
447.20 	provides primary support and education to the client's family and support system.
447.21 	(d) Members of the ACT team must have strong clinical skills, professional qualifications, 
447.22 	experience, and competency to provide a full breadth of rehabilitation services. Each staff 
447.23 	member shall be proficient in their respective discipline and be able to work collaboratively 
447.24 	as a member of a multidisciplinary team to deliver the majority of the treatment, 
447.25 	rehabilitation, and support services clients require to fully benefit from receiving assertive 
447.26 	community treatment.
447.27 	(e) Each ACT team member must fulfill training requirements established by the 
447.28 	commissioner.

447.29 	Sec. 61. Minnesota Statutes 2020, section 256B.0622, subdivision 7b, is amended to read:
447.30 		Subd. 7b.Assertive community treatment program size and opportunities. (a) Each 
447.31 	ACT team shall maintain an annual average caseload that does not exceed 100 clients. 
447.32 	Staff-to-client ratios shall be based on team size as follows:
448.1 	(1) a small ACT team must:
448.2 	(i) employ at least six but no more than seven full-time treatment team staff, excluding 
448.3 	the program assistant and the psychiatric care provider;
448.4 	(ii) serve an annual average maximum of no more than 50 clients;
448.5 	(iii) ensure at least one full-time equivalent position for every eight clients served;
448.6 	(iv) schedule ACT team staff for at least eight-hour shift coverage on weekdays and 
448.7 	on-call duty to provide crisis services and deliver services after hours when staff are not 
448.8 	working;
448.9 	(v) provide crisis services during business hours if the small ACT team does not have 
448.10 	sufficient staff numbers to operate an after-hours on-call system. During all other hours, 
448.11 	the ACT team may arrange for coverage for crisis assessment and intervention services 
448.12 	through a reliable crisis-intervention provider as long as there is a mechanism by which the 
448.13 	ACT team communicates routinely with the crisis-intervention provider and the on-call 
448.14 	ACT team staff are available to see clients face-to-face when necessary or if requested by 
448.15 	the crisis-intervention services provider;
448.16 	(vi) adjust schedules and provide staff to carry out the needed service activities in the 
448.17 	evenings or on weekend days or holidays, when necessary;
448.18 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
448.19 	provider is not regularly scheduled to work. If availability of the ACT team's psychiatric 
448.20 	care provider during all hours is not feasible, alternative psychiatric prescriber backup must 
448.21 	be arranged and a mechanism of timely communication and coordination established in 
448.22 	writing; and
448.23 	(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each 
448.24 	week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time 
448.25 	equivalent nursing, one full-time substance abuse co-occurring disorder specialist, one 
448.26 	full-time equivalent mental health certified peer specialist, one full-time vocational specialist, 
448.27 	one full-time program assistant, and at least one additional full-time ACT team member 
448.28 	who has mental health professional, certified rehabilitation specialist, clinical trainee, or 
448.29 	mental health practitioner status; and
448.30 	(2) a midsize ACT team shall:
448.31 	(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry 
448.32 	time for 51 clients, with an additional two hours for every six clients added to the team, 1.5 
448.33 	to two full-time equivalent nursing staff, one full-time substance abuse co-occurring disorder
449.1 	specialist, one full-time equivalent mental health certified peer specialist, one full-time 
449.2 	vocational specialist, one full-time program assistant, and at least 1.5 to two additional 
449.3 	full-time equivalent ACT members, with at least one dedicated full-time staff member with 
449.4 	mental health professional status. Remaining team members may have mental health 
449.5 	professional, certified rehabilitation specialist, clinical trainee, or mental health practitioner 
449.6 	status;
449.7 	(ii) employ seven or more treatment team full-time equivalents, excluding the program 
449.8 	assistant and the psychiatric care provider;
449.9 	(iii) serve an annual average maximum caseload of 51 to 74 clients;
449.10 	(iv) ensure at least one full-time equivalent position for every nine clients served;
449.11 	(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays 
449.12 	and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum 
449.13 	specifications, staff are regularly scheduled to provide the necessary services on a 
449.14 	client-by-client basis in the evenings and on weekends and holidays;
449.15 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
449.16 	when staff are not working;
449.17 	(vii) have the authority to arrange for coverage for crisis assessment and intervention 
449.18 	services through a reliable crisis-intervention provider as long as there is a mechanism by 
449.19 	which the ACT team communicates routinely with the crisis-intervention provider and the 
449.20 	on-call ACT team staff are available to see clients face-to-face when necessary or if requested 
449.21 	by the crisis-intervention services provider; and
449.22 	(viii) arrange for and provide psychiatric backup during all hours the psychiatric care 
449.23 	provider is not regularly scheduled to work. If availability of the psychiatric care provider 
449.24 	during all hours is not feasible, alternative psychiatric prescriber backup must be arranged 
449.25 	and a mechanism of timely communication and coordination established in writing;
449.26 	(3) a large ACT team must:
449.27 	(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week 
449.28 	per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff, 
449.29 	one full-time substance abuse co-occurring disorder specialist, one full-time equivalent 
449.30 	mental health certified peer specialist, one full-time vocational specialist, one full-time 
449.31 	program assistant, and at least two additional full-time equivalent ACT team members, with 
449.32 	at least one dedicated full-time staff member with mental health professional status. 
450.1 	Remaining team members may have mental health professional or mental health practitioner 
450.2 	status;
450.3 	(ii) employ nine or more treatment team full-time equivalents, excluding the program 
450.4 	assistant and psychiatric care provider;
450.5 	(iii) serve an annual average maximum caseload of 75 to 100 clients;
450.6 	(iv) ensure at least one full-time equivalent position for every nine individuals served;
450.7 	(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the 
450.8 	second shift providing services at least 12 hours per day weekdays. For weekends and 
450.9 	holidays, the team must operate and schedule ACT team staff to work one eight-hour shift, 
450.10 	with a minimum of two staff each weekend day and every holiday;
450.11 	(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services 
450.12 	when staff are not working; and
450.13 	(vii) arrange for and provide psychiatric backup during all hours the psychiatric care 
450.14 	provider is not regularly scheduled to work. If availability of the ACT team psychiatric care 
450.15 	provider during all hours is not feasible, alternative psychiatric backup must be arranged 
450.16 	and a mechanism of timely communication and coordination established in writing.
450.17 	(b) An ACT team of any size may have a staff-to-client ratio that is lower than the 
450.18 	requirements described in paragraph (a) upon approval by the commissioner, but may not 
450.19 	exceed a one-to-ten staff-to-client ratio.

450.20 	Sec. 62. Minnesota Statutes 2020, section 256B.0622, subdivision 7d, is amended to read:
450.21 		Subd. 7d.Assertive community treatment assessment and individual treatment 
450.22 	plan. (a) An initial assessment, including a diagnostic assessment that meets the requirements 
450.23 	of Minnesota Rules, part 9505.0372, subpart 1, and a 30-day treatment plan shall be 
450.24 	completed the day of the client's admission to assertive community treatment by the ACT 
450.25 	team leader or the psychiatric care provider, with participation by designated ACT team 
450.26 	members and the client. The initial assessment must include obtaining or completing a 
450.27 	standard diagnostic assessment according to section 245I.10, subdivision 6, and completing 
450.28 	a 30-day individual treatment plan. The team leader, psychiatric care provider, or other 
450.29 	mental health professional designated by the team leader or psychiatric care provider, must 
450.30 	update the client's diagnostic assessment at least annually.
451.1 	(b) An initial A functional assessment must be completed within ten days of intake and 
451.2 	updated every six months for assertive community treatment, or prior to discharge from the 
451.3 	service, whichever comes first according to section 245I.10, subdivision 9.
451.4 	(c) Within 30 days of the client's assertive community treatment admission, the ACT 
451.5 	team shall complete an in-depth assessment of the domains listed under section 245.462, 
451.6 	subdivision 11a.
451.7 	(d) Each part of the in-depth functional assessment areas shall be completed by each 
451.8 	respective team specialist or an ACT team member with skill and knowledge in the area 
451.9 	being assessed. The assessments are based upon all available information, including that 
451.10 	from client interview family and identified natural supports, and written summaries from 
451.11 	other agencies, including police, courts, county social service agencies, outpatient facilities, 
451.12 	and inpatient facilities, where applicable.
451.13 	(e) (c) Between 30 and 45 days after the client's admission to assertive community 
451.14 	treatment, the entire ACT team must hold a comprehensive case conference, where all team 
451.15 	members, including the psychiatric provider, present information discovered from the 
451.16 	completed in-depth assessments and provide treatment recommendations. The conference 
451.17 	must serve as the basis for the first six-month individual treatment plan, which must be 
451.18 	written by the primary team member.
451.19 	(f) (d) The client's psychiatric care provider, primary team member, and individual 
451.20 	treatment team members shall assume responsibility for preparing the written narrative of 
451.21 	the results from the psychiatric and social functioning history timeline and the comprehensive 
451.22 	assessment.
451.23 	(g) (e) The primary team member and individual treatment team members shall be 
451.24 	assigned by the team leader in collaboration with the psychiatric care provider by the time 
451.25 	of the first treatment planning meeting or 30 days after admission, whichever occurs first.
451.26 	(h) (f) Individual treatment plans must be developed through the following treatment 
451.27 	planning process:
451.28 	(1) The individual treatment plan shall be developed in collaboration with the client and 
451.29 	the client's preferred natural supports, and guardian, if applicable and appropriate. The ACT 
451.30 	team shall evaluate, together with each client, the client's needs, strengths, and preferences 
451.31 	and develop the individual treatment plan collaboratively. The ACT team shall make every 
451.32 	effort to ensure that the client and the client's family and natural supports, with the client's 
451.33 	consent, are in attendance at the treatment planning meeting, are involved in ongoing 
452.1 	meetings related to treatment, and have the necessary supports to fully participate. The 
452.2 	client's participation in the development of the individual treatment plan shall be documented.
452.3 	(2) The client and the ACT team shall work together to formulate and prioritize the 
452.4 	issues, set goals, research approaches and interventions, and establish the plan. The plan is 
452.5 	individually tailored so that the treatment, rehabilitation, and support approaches and 
452.6 	interventions achieve optimum symptom reduction, help fulfill the personal needs and 
452.7 	aspirations of the client, take into account the cultural beliefs and realities of the individual, 
452.8 	and improve all the aspects of psychosocial functioning that are important to the client. The 
452.9 	process supports strengths, rehabilitation, and recovery.
452.10 	(3) Each client's individual treatment plan shall identify service needs, strengths and 
452.11 	capacities, and barriers, and set specific and measurable short- and long-term goals for each 
452.12 	service need. The individual treatment plan must clearly specify the approaches and 
452.13 	interventions necessary for the client to achieve the individual goals, when the interventions 
452.14 	shall happen, and identify which ACT team member shall carry out the approaches and 
452.15 	interventions.
452.16 	(4) The primary team member and the individual treatment team, together with the client 
452.17 	and the client's family and natural supports with the client's consent, are responsible for 
452.18 	reviewing and rewriting the treatment goals and individual treatment plan whenever there 
452.19 	is a major decision point in the client's course of treatment or at least every six months.
452.20 	(5) The primary team member shall prepare a summary that thoroughly describes in 
452.21 	writing the client's and the individual treatment team's evaluation of the client's progress 
452.22 	and goal attainment, the effectiveness of the interventions, and the satisfaction with services 
452.23 	since the last individual treatment plan. The client's most recent diagnostic assessment must 
452.24 	be included with the treatment plan summary.
452.25 	(6) The individual treatment plan and review must be signed approved or acknowledged 
452.26 	by the client, the primary team member, the team leader, the psychiatric care provider, and 
452.27 	all individual treatment team members. A copy of the signed approved individual treatment 
452.28 	plan is must be made available to the client.

452.29 	Sec. 63. Minnesota Statutes 2020, section 256B.0623, subdivision 1, is amended to read:
452.30 		Subdivision 1.Scope. Subject to federal approval, medical assistance covers medically 
452.31 	necessary adult rehabilitative mental health services as defined in subdivision 2, subject to 
452.32 	federal approval, if provided to recipients as defined in subdivision 3 and provided by a 
452.33 	qualified provider entity meeting the standards in this section and by a qualified individual 
453.1 	provider working within the provider's scope of practice and identified in the recipient's 
453.2 	individual treatment plan as defined in section 245.462, subdivision 14, and if determined 
453.3 	to be medically necessary according to section 62Q.53 when the services are provided by 
453.4 	an entity meeting the standards in this section. The provider entity must make reasonable 
453.5 	and good faith efforts to report individual client outcomes to the commissioner, using 
453.6 	instruments and protocols approved by the commissioner.

453.7 	Sec. 64. Minnesota Statutes 2020, section 256B.0623, subdivision 2, is amended to read:
453.8 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
453.9 	given them.
453.10 	(a) "Adult rehabilitative mental health services" means mental health services which are 
453.11 	rehabilitative and enable the recipient to develop and enhance psychiatric stability, social 
453.12 	competencies, personal and emotional adjustment, independent living, parenting skills, and 
453.13 	community skills, when these abilities are impaired by the symptoms of mental illness. 
453.14 	Adult rehabilitative mental health services are also appropriate when provided to enable a 
453.15 	recipient to retain stability and functioning, if the recipient would be at risk of significant 
453.16 	functional decompensation or more restrictive service settings without these services the 
453.17 	services described in section 245I.02, subdivision 33.
453.18 	(1) Adult rehabilitative mental health services instruct, assist, and support the recipient 
453.19 	in areas such as: interpersonal communication skills, community resource utilization and 
453.20 	integration skills, crisis assistance, relapse prevention skills, health care directives, budgeting 
453.21 	and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills, 
453.22 	transportation skills, medication education and monitoring, mental illness symptom 
453.23 	management skills, household management skills, employment-related skills, parenting 
453.24 	skills, and transition to community living services.
453.25 	(2) These services shall be provided to the recipient on a one-to-one basis in the recipient's 
453.26 	home or another community setting or in groups.
453.27 	(b) "Medication education services" means services provided individually or in groups 
453.28 	which focus on educating the recipient about mental illness and symptoms; the role and 
453.29 	effects of medications in treating symptoms of mental illness; and the side effects of 
453.30 	medications. Medication education is coordinated with medication management services 
453.31 	and does not duplicate it. Medication education services are provided by physicians, advanced 
453.32 	practice registered nurses, pharmacists, physician assistants, or registered nurses.
454.1 	(c) "Transition to community living services" means services which maintain continuity 
454.2 	of contact between the rehabilitation services provider and the recipient and which facilitate 
454.3 	discharge from a hospital, residential treatment program under Minnesota Rules, chapter 
454.4 	9505, board and lodging facility, or nursing home. Transition to community living services 
454.5 	are not intended to provide other areas of adult rehabilitative mental health services.

454.6 	Sec. 65. Minnesota Statutes 2020, section 256B.0623, subdivision 3, is amended to read:
454.7 		Subd. 3.Eligibility. An eligible recipient is an individual who:
454.8 	(1) is age 18 or older;
454.9 	(2) is diagnosed with a medical condition, such as mental illness or traumatic brain 
454.10 	injury, for which adult rehabilitative mental health services are needed;
454.11 	(3) has substantial disability and functional impairment in three or more of the areas 
454.12 	listed in section 245.462, subdivision 11a 245I.10, subdivision 9, clause (4), so that 
454.13 	self-sufficiency is markedly reduced; and
454.14 	(4) has had a recent standard diagnostic assessment or an adult diagnostic assessment 
454.15 	update by a qualified professional that documents adult rehabilitative mental health services 
454.16 	are medically necessary to address identified disability and functional impairments and 
454.17 	individual recipient goals.

454.18 	Sec. 66. Minnesota Statutes 2020, section 256B.0623, subdivision 4, is amended to read:
454.19 		Subd. 4.Provider entity standards. (a) The provider entity must be certified by the 
454.20 	state following the certification process and procedures developed by the commissioner.
454.21 	(b) The certification process is a determination as to whether the entity meets the standards 
454.22 	in this subdivision section and chapter 245I, as required in section 245I.011, subdivision 5. 
454.23 	The certification must specify which adult rehabilitative mental health services the entity 
454.24 	is qualified to provide.
454.25 	(c) A noncounty provider entity must obtain additional certification from each county 
454.26 	in which it will provide services. The additional certification must be based on the adequacy 
454.27 	of the entity's knowledge of that county's local health and human service system, and the 
454.28 	ability of the entity to coordinate its services with the other services available in that county. 
454.29 	A county-operated entity must obtain this additional certification from any other county in 
454.30 	which it will provide services.
454.31 	(d) State-level recertification must occur at least every three years.
455.1 	(e) The commissioner may intervene at any time and decertify providers with cause. 
455.2 	The decertification is subject to appeal to the state. A county board may recommend that 
455.3 	the state decertify a provider for cause.
455.4 	(f) The adult rehabilitative mental health services provider entity must meet the following 
455.5 	standards:
455.6 	(1) have capacity to recruit, hire, manage, and train mental health professionals, mental 
455.7 	health practitioners, and mental health rehabilitation workers qualified staff;
455.8 	(2) have adequate administrative ability to ensure availability of services;
455.9 	(3) ensure adequate preservice and inservice and ongoing training for staff;
455.10 	(4) (3) ensure that mental health professionals, mental health practitioners, and mental 
455.11 	health rehabilitation workers staff are skilled in the delivery of the specific adult rehabilitative 
455.12 	mental health services provided to the individual eligible recipient;
455.13 	(5) ensure that staff is capable of implementing culturally specific services that are 
455.14 	culturally competent and appropriate as determined by the recipient's culture, beliefs, values, 
455.15 	and language as identified in the individual treatment plan;
455.16 	(6) (4) ensure enough flexibility in service delivery to respond to the changing and 
455.17 	intermittent care needs of a recipient as identified by the recipient and the individual treatment 
455.18 	plan;
455.19 	(7) ensure that the mental health professional or mental health practitioner, who is under 
455.20 	the clinical supervision of a mental health professional, involved in a recipient's services 
455.21 	participates in the development of the individual treatment plan;
455.22 	(8) (5) assist the recipient in arranging needed crisis assessment, intervention, and 
455.23 	stabilization services;
455.24 	(9) (6) ensure that services are coordinated with other recipient mental health services 
455.25 	providers and the county mental health authority and the federally recognized American 
455.26 	Indian authority and necessary others after obtaining the consent of the recipient. Services 
455.27 	must also be coordinated with the recipient's case manager or care coordinator if the recipient 
455.28 	is receiving case management or care coordination services;
455.29 	(10) develop and maintain recipient files, individual treatment plans, and contact charting;
455.30 	(11) develop and maintain staff training and personnel files;
455.31 	(12) submit information as required by the state;
456.1 	(13) establish and maintain a quality assurance plan to evaluate the outcome of services 
456.2 	provided;
456.3 	(14) (7) keep all necessary records required by law;
456.4 	(15) (8) deliver services as required by section 245.461;
456.5 	(16) comply with all applicable laws;
456.6 	(17) (9) be an enrolled Medicaid provider; and
456.7 	(18) (10) maintain a quality assurance plan to determine specific service outcomes and 
456.8 	the recipient's satisfaction with services; and.
456.9 	(19) develop and maintain written policies and procedures regarding service provision 
456.10 	and administration of the provider entity.

456.11 	Sec. 67. Minnesota Statutes 2020, section 256B.0623, subdivision 5, is amended to read:
456.12 		Subd. 5.Qualifications of provider staff. (a) Adult rehabilitative mental health services 
456.13 	must be provided by qualified individual provider staff of a certified provider entity. 
456.14 	Individual provider staff must be qualified under one of the following criteria as:
456.15 	(1) a mental health professional as defined in section 245.462, subdivision 18, clauses 
456.16 	(1) to (6). If the recipient has a current diagnostic assessment by a licensed mental health 
456.17 	professional as defined in section 245.462, subdivision 18, clauses (1) to (6), recommending 
456.18 	receipt of adult mental health rehabilitative services, the definition of mental health 
456.19 	professional for purposes of this section includes a person who is qualified under section 
456.20 	245.462, subdivision 18, clause (7), and who holds a current and valid national certification 
456.21 	as a certified rehabilitation counselor or certified psychosocial rehabilitation practitioner
456.22 	who is qualified according to section 245I.04, subdivision 2;
456.23 	(2) a certified rehabilitation specialist who is qualified according to section 245I.04, 
456.24 	subdivision 8;
456.25 	(3) a clinical trainee who is qualified according to section 245I.04, subdivision 6;
456.26 	(4) a mental health practitioner as defined in section 245.462, subdivision 17. The mental 
456.27 	health practitioner must work under the clinical supervision of a mental health professional
456.28 	qualified according to section 245I.04, subdivision 4;
456.29 	(3) (5) a mental health certified peer specialist under section 256B.0615. The certified 
456.30 	peer specialist must work under the clinical supervision of a mental health professional who 
456.31 	is qualified according to section 245I.04, subdivision 10; or
457.1 	(4) (6) a mental health rehabilitation worker who is qualified according to section 245I.04, 
457.2 	subdivision 14. A mental health rehabilitation worker means a staff person working under 
457.3 	the direction of a mental health practitioner or mental health professional and under the 
457.4 	clinical supervision of a mental health professional in the implementation of rehabilitative 
457.5 	mental health services as identified in the recipient's individual treatment plan who:
457.6 	(i) is at least 21 years of age;
457.7 	(ii) has a high school diploma or equivalent;
457.8 	(iii) has successfully completed 30 hours of training during the two years immediately 
457.9 	prior to the date of hire, or before provision of direct services, in all of the following areas: 
457.10 	recovery from mental illness, mental health de-escalation techniques, recipient rights, 
457.11 	recipient-centered individual treatment planning, behavioral terminology, mental illness, 
457.12 	co-occurring mental illness and substance abuse, psychotropic medications and side effects, 
457.13 	functional assessment, local community resources, adult vulnerability, recipient 
457.14 	confidentiality; and
457.15 	(iv) meets the qualifications in paragraph (b).
457.16 	(b) In addition to the requirements in paragraph (a), a mental health rehabilitation worker 
457.17 	must also meet the qualifications in clause (1), (2), or (3):
457.18 	(1) has an associates of arts degree, two years of full-time postsecondary education, or 
457.19 	a total of 15 semester hours or 23 quarter hours in behavioral sciences or related fields; is 
457.20 	a registered nurse; or within the previous ten years has:
457.21 	(i) three years of personal life experience with serious mental illness;
457.22 	(ii) three years of life experience as a primary caregiver to an adult with a serious mental 
457.23 	illness, traumatic brain injury, substance use disorder, or developmental disability; or
457.24 	(iii) 2,000 hours of supervised work experience in the delivery of mental health services 
457.25 	to adults with a serious mental illness, traumatic brain injury, substance use disorder, or 
457.26 	developmental disability;
457.27 	(2)(i) is fluent in the non-English language or competent in the culture of the ethnic 
457.28 	group to which at least 20 percent of the mental health rehabilitation worker's clients belong;
457.29 	(ii) receives during the first 2,000 hours of work, monthly documented individual clinical 
457.30 	supervision by a mental health professional;
458.1 	(iii) has 18 hours of documented field supervision by a mental health professional or 
458.2 	mental health practitioner during the first 160 hours of contact work with recipients, and at 
458.3 	least six hours of field supervision quarterly during the following year;
458.4 	(iv) has review and cosignature of charting of recipient contacts during field supervision 
458.5 	by a mental health professional or mental health practitioner; and
458.6 	(v) has 15 hours of additional continuing education on mental health topics during the 
458.7 	first year of employment and 15 hours during every additional year of employment; or
458.8 	(3) for providers of crisis residential services, intensive residential treatment services, 
458.9 	partial hospitalization, and day treatment services:
458.10 	(i) satisfies clause (2), items (ii) to (iv); and
458.11 	(ii) has 40 hours of additional continuing education on mental health topics during the 
458.12 	first year of employment.
458.13 	(c) A mental health rehabilitation worker who solely acts and is scheduled as overnight 
458.14 	staff is not required to comply with paragraph (a), clause (4), item (iv).
458.15 	(d) For purposes of this subdivision, "behavioral sciences or related fields" means an 
458.16 	education from an accredited college or university and includes but is not limited to social 
458.17 	work, psychology, sociology, community counseling, family social science, child 
458.18 	development, child psychology, community mental health, addiction counseling, counseling 
458.19 	and guidance, special education, and other fields as approved by the commissioner.

458.20 	Sec. 68. Minnesota Statutes 2020, section 256B.0623, subdivision 6, is amended to read:
458.21 		Subd. 6.Required training and supervision. (a) Mental health rehabilitation workers 
458.22 	must receive ongoing continuing education training of at least 30 hours every two years in 
458.23 	areas of mental illness and mental health services and other areas specific to the population 
458.24 	being served. Mental health rehabilitation workers must also be subject to the ongoing 
458.25 	direction and clinical supervision standards in paragraphs (c) and (d).
458.26 	(b) Mental health practitioners must receive ongoing continuing education training as 
458.27 	required by their professional license; or if the practitioner is not licensed, the practitioner 
458.28 	must receive ongoing continuing education training of at least 30 hours every two years in 
458.29 	areas of mental illness and mental health services. Mental health practitioners must meet 
458.30 	the ongoing clinical supervision standards in paragraph (c).
458.31 	(c) Clinical supervision may be provided by a full- or part-time qualified professional 
458.32 	employed by or under contract with the provider entity. Clinical supervision may be provided 
459.1 	by interactive videoconferencing according to procedures developed by the commissioner. 
459.2 	A mental health professional providing clinical supervision of staff delivering adult 
459.3 	rehabilitative mental health services must provide the following guidance:
459.4 	(1) review the information in the recipient's file;
459.5 	(2) review and approve initial and updates of individual treatment plans;
459.6 	(a) A treatment supervisor providing treatment supervision required by section 245I.06 
459.7 	must:
459.8 	(3) (1) meet with mental health rehabilitation workers and practitioners, individually or 
459.9 	in small groups, staff receiving treatment supervision at least monthly to discuss treatment 
459.10 	topics of interest to the workers and practitioners;
459.11 	(4) meet with mental health rehabilitation workers and practitioners, individually or in 
459.12 	small groups, at least monthly to discuss and treatment plans of recipients, and approve by 
459.13 	signature and document in the recipient's file any resulting plan updates; and
459.14 	(5) (2) meet at least monthly with the directing clinical trainee or mental health 
459.15 	practitioner, if there is one, to review needs of the adult rehabilitative mental health services 
459.16 	program, review staff on-site observations and evaluate mental health rehabilitation workers, 
459.17 	plan staff training, review program evaluation and development, and consult with the 
459.18 	directing clinical trainee or mental health practitioner; and.
459.19 	(6) be available for urgent consultation as the individual recipient needs or the situation 
459.20 	necessitates.
459.21 	(d) (b) An adult rehabilitative mental health services provider entity must have a treatment 
459.22 	director who is a mental health practitioner or mental health professional clinical trainee, 
459.23 	certified rehabilitation specialist, or mental health practitioner. The treatment director must 
459.24 	ensure the following:
459.25 	(1) while delivering direct services to recipients, a newly hired mental health rehabilitation 
459.26 	worker must be directly observed delivering services to recipients by a mental health 
459.27 	practitioner or mental health professional for at least six hours per 40 hours worked during 
459.28 	the first 160 hours that the mental health rehabilitation worker works ensure the direct 
459.29 	observation of mental health rehabilitation workers required by section 245I.06, subdivision 
459.30 	3, is provided;
459.31 	(2) the mental health rehabilitation worker must receive ongoing on-site direct service 
459.32 	observation by a mental health professional or mental health practitioner for at least six 
459.33 	hours for every six months of employment;
460.1 	(3) progress notes are reviewed from on-site service observation prepared by the mental 
460.2 	health rehabilitation worker and mental health practitioner for accuracy and consistency 
460.3 	with actual recipient contact and the individual treatment plan and goals;
460.4 	(4) (2) ensure immediate availability by phone or in person for consultation by a mental 
460.5 	health professional, certified rehabilitation specialist, clinical trainee, or a mental health 
460.6 	practitioner to the mental health rehabilitation services worker during service provision;
460.7 	(5) oversee the identification of changes in individual recipient treatment strategies, 
460.8 	revise the plan, and communicate treatment instructions and methodologies as appropriate 
460.9 	to ensure that treatment is implemented correctly;
460.10 	(6) (3) model service practices which: respect the recipient, include the recipient in 
460.11 	planning and implementation of the individual treatment plan, recognize the recipient's 
460.12 	strengths, collaborate and coordinate with other involved parties and providers;
460.13 	(7) (4) ensure that clinical trainees, mental health practitioners, and mental health 
460.14 	rehabilitation workers are able to effectively communicate with the recipients, significant 
460.15 	others, and providers; and
460.16 	(8) (5) oversee the record of the results of on-site direct observation and charting, progress 
460.17 	note evaluation, and corrective actions taken to modify the work of the clinical trainees, 
460.18 	mental health practitioners, and mental health rehabilitation workers.
460.19 	(e) (c) A clinical trainee or mental health practitioner who is providing treatment direction 
460.20 	for a provider entity must receive treatment supervision at least monthly from a mental 
460.21 	health professional to:
460.22 	(1) identify and plan for general needs of the recipient population served;
460.23 	(2) identify and plan to address provider entity program needs and effectiveness;
460.24 	(3) identify and plan provider entity staff training and personnel needs and issues; and
460.25 	(4) plan, implement, and evaluate provider entity quality improvement programs.

460.26 	Sec. 69. Minnesota Statutes 2020, section 256B.0623, subdivision 9, is amended to read:
460.27 		Subd. 9.Functional assessment. (a) Providers of adult rehabilitative mental health 
460.28 	services must complete a written functional assessment as defined in section 245.462, 
460.29 	subdivision 11a according to section 245I.10, subdivision 9, for each recipient. The functional 
460.30 	assessment must be completed within 30 days of intake, and reviewed and updated at least 
460.31 	every six months after it is developed, unless there is a significant change in the functioning 
460.32 	of the recipient. If there is a significant change in functioning, the assessment must be 
461.1 	updated. A single functional assessment can meet case management and adult rehabilitative 
461.2 	mental health services requirements if agreed to by the recipient. Unless the recipient refuses, 
461.3 	the recipient must have significant participation in the development of the functional 
461.4 	assessment.
461.5 	(b) When a provider of adult rehabilitative mental health services completes a written 
461.6 	functional assessment, the provider must also complete a level of care assessment as defined 
461.7 	in section 245I.02, subdivision 19, for the recipient.

461.8 	Sec. 70. Minnesota Statutes 2020, section 256B.0623, subdivision 12, is amended to read:
461.9 		Subd. 12.Additional requirements. (a) Providers of adult rehabilitative mental health 
461.10 	services must comply with the requirements relating to referrals for case management in 
461.11 	section 245.467, subdivision 4.
461.12 	(b) Adult rehabilitative mental health services are provided for most recipients in the 
461.13 	recipient's home and community. Services may also be provided at the home of a relative 
461.14 	or significant other, job site, psychosocial clubhouse, drop-in center, social setting, classroom, 
461.15 	or other places in the community. Except for "transition to community services," the place 
461.16 	of service does not include a regional treatment center, nursing home, residential treatment 
461.17 	facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), or section 
461.18 	245I.23, or an acute care hospital.
461.19 	(c) Adult rehabilitative mental health services may be provided in group settings if 
461.20 	appropriate to each participating recipient's needs and individual treatment plan. A group 
461.21 	is defined as two to ten clients, at least one of whom is a recipient, who is concurrently 
461.22 	receiving a service which is identified in this section. The service and group must be specified 
461.23 	in the recipient's individual treatment plan. No more than two qualified staff may bill 
461.24 	Medicaid for services provided to the same group of recipients. If two adult rehabilitative 
461.25 	mental health workers bill for recipients in the same group session, they must each bill for 
461.26 	different recipients.
461.27 	(d) Adult rehabilitative mental health services are appropriate if provided to enable a 
461.28 	recipient to retain stability and functioning, when the recipient is at risk of significant 
461.29 	functional decompensation or requiring more restrictive service settings without these 
461.30 	services.
461.31 	(e) Adult rehabilitative mental health services instruct, assist, and support the recipient 
461.32 	in areas including: interpersonal communication skills, community resource utilization and 
461.33 	integration skills, crisis planning, relapse prevention skills, health care directives, budgeting 
462.1 	and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills, 
462.2 	transportation skills, medication education and monitoring, mental illness symptom 
462.3 	management skills, household management skills, employment-related skills, parenting 
462.4 	skills, and transition to community living services.
462.5 	(f) Community intervention, including consultation with relatives, guardians, friends, 
462.6 	employers, treatment providers, and other significant individuals, is appropriate when 
462.7 	directed exclusively to the treatment of the client.

462.8 	Sec. 71. Minnesota Statutes 2020, section 256B.0625, subdivision 3b, is amended to read:
462.9 		Subd. 3b.Telemedicine services. (a) Medical assistance covers medically necessary 
462.10 	services and consultations delivered by a licensed health care provider via telemedicine in 
462.11 	the same manner as if the service or consultation was delivered in person. Coverage is 
462.12 	limited to three telemedicine services per enrollee per calendar week, except as provided 
462.13 	in paragraph (f). Telemedicine services shall be paid at the full allowable rate.
462.14 	(b) The commissioner shall establish criteria that a health care provider must attest to 
462.15 	in order to demonstrate the safety or efficacy of delivering a particular service via 
462.16 	telemedicine. The attestation may include that the health care provider:
462.17 	(1) has identified the categories or types of services the health care provider will provide 
462.18 	via telemedicine;
462.19 	(2) has written policies and procedures specific to telemedicine services that are regularly 
462.20 	reviewed and updated;
462.21 	(3) has policies and procedures that adequately address patient safety before, during, 
462.22 	and after the telemedicine service is rendered;
462.23 	(4) has established protocols addressing how and when to discontinue telemedicine 
462.24 	services; and
462.25 	(5) has an established quality assurance process related to telemedicine services.
462.26 	(c) As a condition of payment, a licensed health care provider must document each 
462.27 	occurrence of a health service provided by telemedicine to a medical assistance enrollee. 
462.28 	Health care service records for services provided by telemedicine must meet the requirements 
462.29 	set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:
462.30 	(1) the type of service provided by telemedicine;
462.31 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
462.32 	designation;
463.1 	(3) the licensed health care provider's basis for determining that telemedicine is an 
463.2 	appropriate and effective means for delivering the service to the enrollee;
463.3 	(4) the mode of transmission of the telemedicine service and records evidencing that a 
463.4 	particular mode of transmission was utilized;
463.5 	(5) the location of the originating site and the distant site;
463.6 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
463.7 	another physician, the written opinion from the consulting physician providing the 
463.8 	telemedicine consultation; and
463.9 	(7) compliance with the criteria attested to by the health care provider in accordance 
463.10 	with paragraph (b).
463.11 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
463.12 	"telemedicine" is defined as the delivery of health care services or consultations while the 
463.13 	patient is at an originating site and the licensed health care provider is at a distant site. A 
463.14 	communication between licensed health care providers, or a licensed health care provider 
463.15 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
463.16 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
463.17 	by means of real-time two-way, interactive audio and visual communications, including the 
463.18 	application of secure video conferencing or store-and-forward technology to provide or 
463.19 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
463.20 	treatment, education, and care management of a patient's health care.
463.21 	(e) For purposes of this section, "licensed health care provider" means a licensed health 
463.22 	care provider under section 62A.671, subdivision 6, a community paramedic as defined 
463.23 	under section 144E.001, subdivision 5f, or a clinical trainee who is qualified according to 
463.24 	section 245I.04, subdivision 6, a mental health practitioner defined under section 245.462, 
463.25 	subdivision 17, or 245.4871, subdivision 26, working under the general supervision of a 
463.26 	mental health professional qualified according to section 245I.04, subdivision 4, and a 
463.27 	community health worker who meets the criteria under subdivision 49, paragraph (a); "health 
463.28 	care provider" is defined under section 62A.671, subdivision 3; and "originating site" is 
463.29 	defined under section 62A.671, subdivision 7.
463.30 	(f) The limit on coverage of three telemedicine services per enrollee per calendar week 
463.31 	does not apply if:
463.32 	(1) the telemedicine services provided by the licensed health care provider are for the 
463.33 	treatment and control of tuberculosis; and
464.1 	(2) the services are provided in a manner consistent with the recommendations and best 
464.2 	practices specified by the Centers for Disease Control and Prevention and the commissioner 
464.3 	of health.

464.4 	Sec. 72. Minnesota Statutes 2020, section 256B.0625, subdivision 5, is amended to read:
464.5 		Subd. 5.Community mental health center services. Medical assistance covers 
464.6 	community mental health center services provided by a community mental health center 
464.7 	that meets the requirements in paragraphs (a) to (j).
464.8 	(a) The provider is licensed under Minnesota Rules, parts 9520.0750 to 9520.0870 must 
464.9 	be certified as a mental health clinic under section 245I.20.
464.10 	(b) The provider provides mental health services under the clinical supervision of a 
464.11 	mental health professional who is licensed for independent practice at the doctoral level or 
464.12 	by a board-certified psychiatrist In addition to the policies and procedures required by 
464.13 	section 245I.03, the provider must establish, enforce, and maintain the policies and procedures 
464.14 	for oversight of clinical services by a doctoral level psychologist or a board certified or 
464.15 	board eligible psychiatrist who is eligible for board certification. Clinical supervision has 
464.16 	the meaning given in Minnesota Rules, part 9505.0370, subpart 6. These policies and 
464.17 	procedures must be developed with the involvement of a doctoral level psychologist and a 
464.18 	board certified or board eligible psychiatrist, and must include:
464.19 	(1) requirements for when to seek clinical consultation with a doctoral level psychologist 
464.20 	or a board certified or board eligible psychiatrist;
464.21 	(2) requirements for the involvement of a doctoral level psychologist or a board certified 
464.22 	or board eligible psychiatrist in the direction of clinical services; and
464.23 	(3) involvement of a doctoral level psychologist or a board certified or board eligible 
464.24 	psychiatrist in quality improvement initiatives and review as part of a multidisciplinary care 
464.25 	team.
464.26 	(c) The provider must be a private nonprofit corporation or a governmental agency and 
464.27 	have a community board of directors as specified by section 245.66.
464.28 	(d) The provider must have a sliding fee scale that meets the requirements in section 
464.29 	245.481, and agree to serve within the limits of its capacity all individuals residing in its 
464.30 	service delivery area.
464.31 	(e) At a minimum, the provider must provide the following outpatient mental health 
464.32 	services: diagnostic assessment; explanation of findings; family, group, and individual 
465.1 	psychotherapy, including crisis intervention psychotherapy services, multiple family group 
465.2 	psychotherapy, psychological testing, and medication management. In addition, the provider 
465.3 	must provide or be capable of providing upon request of the local mental health authority 
465.4 	day treatment services, multiple family group psychotherapy, and professional home-based 
465.5 	mental health services. The provider must have the capacity to provide such services to 
465.6 	specialized populations such as the elderly, families with children, persons who are seriously 
465.7 	and persistently mentally ill, and children who are seriously emotionally disturbed.
465.8 	(f) The provider must be capable of providing the services specified in paragraph (e) to 
465.9 	individuals who are diagnosed with both dually diagnosed with mental illness or emotional 
465.10 	disturbance, and chemical dependency substance use disorder, and to individuals who are
465.11 	dually diagnosed with a mental illness or emotional disturbance and developmental disability.
465.12 	(g) The provider must provide 24-hour emergency care services or demonstrate the 
465.13 	capacity to assist recipients in need of such services to access such services on a 24-hour 
465.14 	basis.
465.15 	(h) The provider must have a contract with the local mental health authority to provide 
465.16 	one or more of the services specified in paragraph (e).
465.17 	(i) The provider must agree, upon request of the local mental health authority, to enter 
465.18 	into a contract with the county to provide mental health services not reimbursable under 
465.19 	the medical assistance program.
465.20 	(j) The provider may not be enrolled with the medical assistance program as both a 
465.21 	hospital and a community mental health center. The community mental health center's 
465.22 	administrative, organizational, and financial structure must be separate and distinct from 
465.23 	that of the hospital.
465.24 	(k) The commissioner may require the provider to annually attest that the provider meets 
465.25 	the requirements in this subdivision using a form that the commissioner provides.

465.26 	EFFECTIVE DATE. Paragraphs (b), (e), (f), and (k) are effective the day following 
465.27 	final enactment.

465.28 	Sec. 73. Minnesota Statutes 2020, section 256B.0625, subdivision 19c, is amended to 
465.29 	read:
465.30 		Subd. 19c.Personal care. Medical assistance covers personal care assistance services 
465.31 	provided by an individual who is qualified to provide the services according to subdivision 
465.32 	19a and sections 256B.0651 to 256B.0654, provided in accordance with a plan, and 
465.33 	supervised by a qualified professional.
466.1 	"Qualified professional" means a mental health professional as defined in section 245.462, 
466.2 	subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6); a registered 
466.3 	nurse as defined in sections 148.171 to 148.285, a licensed social worker as defined in 
466.4 	sections 148E.010 and 148E.055, or a qualified designated coordinator under section 
466.5 	245D.081, subdivision 2. The qualified professional shall perform the duties required in 
466.6 	section 256B.0659.

466.7 	Sec. 74. Minnesota Statutes 2020, section 256B.0625, subdivision 28a, is amended to 
466.8 	read:
466.9 		Subd. 28a.Licensed physician assistant services. (a) Medical assistance covers services 
466.10 	performed by a licensed physician assistant if the service is otherwise covered under this 
466.11 	chapter as a physician service and if the service is within the scope of practice of a licensed 
466.12 	physician assistant as defined in section 147A.09.
466.13 	(b) Licensed physician assistants, who are supervised by a physician certified by the 
466.14 	American Board of Psychiatry and Neurology or eligible for board certification in psychiatry, 
466.15 	may bill for medication management and evaluation and management services provided to 
466.16 	medical assistance enrollees in inpatient hospital settings, and in outpatient settings after 
466.17 	the licensed physician assistant completes 2,000 hours of clinical experience in the evaluation 
466.18 	and treatment of mental health, consistent with their authorized scope of practice, as defined 
466.19 	in section 147A.09, with the exception of performing psychotherapy or diagnostic 
466.20 	assessments or providing clinical treatment supervision.

466.21 	Sec. 75. Minnesota Statutes 2020, section 256B.0625, subdivision 42, is amended to read:
466.22 		Subd. 42.Mental health professional. Notwithstanding Minnesota Rules, part 
466.23 	9505.0175, subpart 28, the definition of a mental health professional shall include a person 
466.24 	who is qualified as specified in according to section 245.462, subdivision 18, clauses (1) to 
466.25 	(6); or 245.4871, subdivision 27, clauses (1) to (6) 245I.04, subdivision 2, for the purpose 
466.26 	of this section and Minnesota Rules, parts 9505.0170 to 9505.0475.

466.27 	Sec. 76. Minnesota Statutes 2020, section 256B.0625, subdivision 48, is amended to read:
466.28 		Subd. 48.Psychiatric consultation to primary care practitioners.  Medical assistance 
466.29 	covers consultation provided by a psychiatrist, a psychologist, an advanced practice registered 
466.30 	nurse certified in psychiatric mental health, a licensed independent clinical social worker, 
466.31 	as defined in section 245.462, subdivision 18, clause (2), or a licensed marriage and family 
466.32 	therapist, as defined in section 245.462, subdivision 18, clause (5) mental health professional 
467.1 	qualified according to section 245I.04, subdivision 2, except a licensed professional clinical 
467.2 	counselor licensed under section 148B.5301, via telephone, e-mail, facsimile, or other means 
467.3 	of communication to primary care practitioners, including pediatricians. The need for 
467.4 	consultation and the receipt of the consultation must be documented in the patient record 
467.5 	maintained by the primary care practitioner. If the patient consents, and subject to federal 
467.6 	limitations and data privacy provisions, the consultation may be provided without the patient 
467.7 	present.

467.8 	Sec. 77. Minnesota Statutes 2020, section 256B.0625, subdivision 49, is amended to read:
467.9 		Subd. 49.Community health worker. (a) Medical assistance covers the care 
467.10 	coordination and patient education services provided by a community health worker if the 
467.11 	community health worker has:
467.12 	(1) received a certificate from the Minnesota State Colleges and Universities System 
467.13 	approved community health worker curriculum; or.
467.14 	(2) at least five years of supervised experience with an enrolled physician, registered 
467.15 	nurse, advanced practice registered nurse, mental health professional as defined in section 
467.16 	245.462, subdivision 18, clauses (1) to (6), and section 245.4871, subdivision 27, clauses 
467.17 	(1) to (5), or dentist, or at least five years of supervised experience by a certified public 
467.18 	health nurse operating under the direct authority of an enrolled unit of government.
467.19 	Community health workers eligible for payment under clause (2) must complete the 
467.20 	certification program by January 1, 2010, to continue to be eligible for payment.
467.21 	(b) Community health workers must work under the supervision of a medical assistance 
467.22 	enrolled physician, registered nurse, advanced practice registered nurse, mental health 
467.23 	professional as defined in section 245.462, subdivision 18, clauses (1) to (6), and section 
467.24 	245.4871, subdivision 27, clauses (1) to (5), or dentist, or work under the supervision of a 
467.25 	certified public health nurse operating under the direct authority of an enrolled unit of 
467.26 	government.
467.27 	(c) Care coordination and patient education services covered under this subdivision 
467.28 	include, but are not limited to, services relating to oral health and dental care.

468.1 	Sec. 78. Minnesota Statutes 2020, section 256B.0625, subdivision 56a, is amended to 
468.2 	read:
468.3 		Subd. 56a.Officer-involved community-based care coordination. (a) Medical 
468.4 	assistance covers officer-involved community-based care coordination for an individual 
468.5 	who:
468.6 	(1) has screened positive for benefiting from treatment for a mental illness or substance 
468.7 	use disorder using a tool approved by the commissioner;
468.8 	(2) does not require the security of a public detention facility and is not considered an 
468.9 	inmate of a public institution as defined in Code of Federal Regulations, title 42, section 
468.10 	435.1010;
468.11 	(3) meets the eligibility requirements in section 256B.056; and
468.12 	(4) has agreed to participate in officer-involved community-based care coordination.
468.13 	(b) Officer-involved community-based care coordination means navigating services to 
468.14 	address a client's mental health, chemical health, social, economic, and housing needs, or 
468.15 	any other activity targeted at reducing the incidence of jail utilization and connecting 
468.16 	individuals with existing covered services available to them, including, but not limited to, 
468.17 	targeted case management, waiver case management, or care coordination.
468.18 	(c) Officer-involved community-based care coordination must be provided by an 
468.19 	individual who is an employee of or is under contract with a county, or is an employee of 
468.20 	or under contract with an Indian health service facility or facility owned and operated by a 
468.21 	tribe or a tribal organization operating under Public Law 93-638 as a 638 facility to provide 
468.22 	officer-involved community-based care coordination and is qualified under one of the 
468.23 	following criteria:
468.24 	(1) a licensed mental health professional as defined in section 245.462, subdivision 18, 
468.25 	clauses (1) to (6);
468.26 	(2) a clinical trainee qualified according to section 245I.04, subdivision 6, working under 
468.27 	the treatment supervision of a mental health professional according to section 245I.06;
468.28 	(3) a mental health practitioner as defined in section 245.462, subdivision 17 qualified 
468.29 	according to section 245I.04, subdivision 4, working under the clinical treatment supervision 
468.30 	of a mental health professional according to section 245I.06;
469.1 	(3) (4) a mental health certified peer specialist under section 256B.0615 qualified 
469.2 	according to section 245I.04, subdivision 10, working under the clinical treatment supervision 
469.3 	of a mental health professional according to section 245I.06;
469.4 	(4) an individual qualified as an alcohol and drug counselor under section 245G.11, 
469.5 	subdivision 5; or
469.6 	(5) a recovery peer qualified under section 245G.11, subdivision 8, working under the 
469.7 	supervision of an individual qualified as an alcohol and drug counselor under section 
469.8 	245G.11, subdivision 5.
469.9 	(d) Reimbursement is allowed for up to 60 days following the initial determination of 
469.10 	eligibility.
469.11 	(e) Providers of officer-involved community-based care coordination shall annually 
469.12 	report to the commissioner on the number of individuals served, and number of the 
469.13 	community-based services that were accessed by recipients. The commissioner shall ensure 
469.14 	that services and payments provided under officer-involved community-based care 
469.15 	coordination do not duplicate services or payments provided under section 256B.0625, 
469.16 	subdivision 20, 256B.0753, 256B.0755, or 256B.0757.
469.17 	(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for 
469.18 	officer-involved community-based care coordination services shall be provided by the 
469.19 	county providing the services, from sources other than federal funds or funds used to match 
469.20 	other federal funds.

469.21 	Sec. 79. Minnesota Statutes 2020, section 256B.0757, subdivision 4c, is amended to read:
469.22 		Subd. 4c.Behavioral health home services staff qualifications. (a) A behavioral health 
469.23 	home services provider must maintain staff with required professional qualifications 
469.24 	appropriate to the setting.
469.25 	(b) If behavioral health home services are offered in a mental health setting, the 
469.26 	integration specialist must be a registered nurse licensed under the Minnesota Nurse Practice 
469.27 	Act, sections 148.171 to 148.285.
469.28 	(c) If behavioral health home services are offered in a primary care setting, the integration 
469.29 	specialist must be a mental health professional as defined in who is qualified according to
469.30 	section 245.462, subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) 
469.31 	to (6) 245I.04, subdivision 2.
470.1 	(d) If behavioral health home services are offered in either a primary care setting or 
470.2 	mental health setting, the systems navigator must be a mental health practitioner as defined 
470.3 	in who is qualified according to section 245.462, subdivision 17 245I.04, subdivision 4, or 
470.4 	a community health worker as defined in section 256B.0625, subdivision 49.
470.5 	(e) If behavioral health home services are offered in either a primary care setting or 
470.6 	mental health setting, the qualified health home specialist must be one of the following:
470.7 	(1) a mental health certified peer support specialist as defined in who is qualified 
470.8 	according to section 256B.0615 245I.04, subdivision 10;
470.9 	(2) a mental health certified family peer support specialist as defined in who is qualified 
470.10 	according to section 256B.0616 245I.04, subdivision 12;
470.11 	(3) a case management associate as defined in section 245.462, subdivision 4, paragraph 
470.12 	(g), or 245.4871, subdivision 4, paragraph (j);
470.13 	(4) a mental health rehabilitation worker as defined in who is qualified according to
470.14 	section 256B.0623, subdivision 5, clause (4) 245I.04, subdivision 14;
470.15 	(5) a community paramedic as defined in section 144E.28, subdivision 9;
470.16 	(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5); 
470.17 	or
470.18 	(7) a community health worker as defined in section 256B.0625, subdivision 49.

470.19 	Sec. 80. Minnesota Statutes 2020, section 256B.0941, subdivision 1, is amended to read:
470.20 		Subdivision 1.Eligibility. (a) An individual who is eligible for mental health treatment 
470.21 	services in a psychiatric residential treatment facility must meet all of the following criteria:
470.22 	(1) before admission, services are determined to be medically necessary according to 
470.23 	Code of Federal Regulations, title 42, section 441.152;
470.24 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
470.25 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
470.26 	first;
470.27 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
470.28 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
470.29 	or a finding that the individual is a risk to self or others;
470.30 	(4) has functional impairment and a history of difficulty in functioning safely and 
470.31 	successfully in the community, school, home, or job; an inability to adequately care for 
471.1 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
471.2 	the individual's needs;
471.3 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
471.4 	the individual's condition or prevent further regression so that services will no longer be 
471.5 	needed;
471.6 	(6) utilized and exhausted other community-based mental health services, or clinical 
471.7 	evidence indicates that such services cannot provide the level of care needed; and
471.8 	(7) was referred for treatment in a psychiatric residential treatment facility by a qualified
471.9 	mental health professional licensed as defined in qualified according to section 245.4871, 
471.10 	subdivision 27, clauses (1) to (6) 245I.04, subdivision 2.
471.11 	(b) The commissioner shall provide oversight and review the use of referrals for clients 
471.12 	admitted to psychiatric residential treatment facilities to ensure that eligibility criteria, 
471.13 	clinical services, and treatment planning reflect clinical, state, and federal standards for 
471.14 	psychiatric residential treatment facility level of care. The commissioner shall coordinate 
471.15 	the production of a statewide list of children and youth who meet the medical necessity 
471.16 	criteria for psychiatric residential treatment facility level of care and who are awaiting 
471.17 	admission. The commissioner and any recipient of the list shall not use the statewide list to 
471.18 	direct admission of children and youth to specific facilities.

471.19 	Sec. 81. Minnesota Statutes 2020, section 256B.0943, subdivision 1, is amended to read:
471.20 		Subdivision 1.Definitions. For purposes of this section, the following terms have the 
471.21 	meanings given them.
471.22 	(a) "Children's therapeutic services and supports" means the flexible package of mental 
471.23 	health services for children who require varying therapeutic and rehabilitative levels of 
471.24 	intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871, 
471.25 	subdivision 15, or a diagnosed mental illness, as defined in section 245.462, subdivision 
471.26 	20. The services are time-limited interventions that are delivered using various treatment 
471.27 	modalities and combinations of services designed to reach treatment outcomes identified 
471.28 	in the individual treatment plan.
471.29 	(b) "Clinical supervision" means the overall responsibility of the mental health 
471.30 	professional for the control and direction of individualized treatment planning, service 
471.31 	delivery, and treatment review for each client. A mental health professional who is an 
471.32 	enrolled Minnesota health care program provider accepts full professional responsibility 
472.1 	for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, 
472.2 	and oversees or directs the supervisee's work.
472.3 	(c) (b) "Clinical trainee" means a mental health practitioner who meets the qualifications 
472.4 	specified in Minnesota Rules, part 9505.0371, subpart 5, item C staff person who is qualified 
472.5 	according to section 245I.04, subdivision 6.
472.6 	(d) (c) "Crisis assistance planning" has the meaning given in section 245.4871, subdivision 
472.7 	9a. Crisis assistance entails the development of a written plan to assist a child's family to 
472.8 	contend with a potential crisis and is distinct from the immediate provision of crisis 
472.9 	intervention services.
472.10 	(e) (d) "Culturally competent provider" means a provider who understands and can 
472.11 	utilize to a client's benefit the client's culture when providing services to the client. A provider 
472.12 	may be culturally competent because the provider is of the same cultural or ethnic group 
472.13 	as the client or the provider has developed the knowledge and skills through training and 
472.14 	experience to provide services to culturally diverse clients.
472.15 	(f) (e) "Day treatment program" for children means a site-based structured mental health 
472.16 	program consisting of psychotherapy for three or more individuals and individual or group 
472.17 	skills training provided by a multidisciplinary team, under the clinicaltreatment supervision 
472.18 	of a mental health professional.
472.19 	(g) (f) "Standard diagnostic assessment" has the meaning given in Minnesota Rules, part 
472.20 	9505.0372, subpart 1 means the assessment described in 245I.10, subdivision 6.
472.21 	(h) (g) "Direct service time" means the time that a mental health professional, clinical 
472.22 	trainee, mental health practitioner, or mental health behavioral aide spends face-to-face with 
472.23 	a client and the client's family or providing covered telemedicine services. Direct service 
472.24 	time includes time in which the provider obtains a client's history, develops a client's 
472.25 	treatment plan, records individual treatment outcomes, or provides service components of 
472.26 	children's therapeutic services and supports. Direct service time does not include time doing 
472.27 	work before and after providing direct services, including scheduling or maintaining clinical 
472.28 	records.
472.29 	(i) (h) "Direction of mental health behavioral aide" means the activities of a mental 
472.30 	health professional, clinical trainee, or mental health practitioner in guiding the mental 
472.31 	health behavioral aide in providing services to a client. The direction of a mental health 
472.32 	behavioral aide must be based on the client's individualized individual treatment plan and 
472.33 	meet the requirements in subdivision 6, paragraph (b), clause (5).
473.1 	(j) (i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 
473.2 	15.
473.3 	(k) (j) "Individual behavioral plan" means a plan of intervention, treatment, and services 
473.4 	for a child written by a mental health professional or a clinical trainee or mental health 
473.5 	practitioner, under the clinical treatment supervision of a mental health professional, to 
473.6 	guide the work of the mental health behavioral aide. The individual behavioral plan may 
473.7 	be incorporated into the child's individual treatment plan so long as the behavioral plan is 
473.8 	separately communicable to the mental health behavioral aide.
473.9 	(l) (k) "Individual treatment plan" has the meaning given in Minnesota Rules, part 
473.10 	9505.0371, subpart 7 means the plan described in section 245I.10, subdivisions 7 and 8.
473.11 	(m) (l) "Mental health behavioral aide services" means medically necessary one-on-one 
473.12 	activities performed by a trained paraprofessional qualified as provided in subdivision 7, 
473.13 	paragraph (b), clause (3) mental health behavioral aide qualified according to section 245I.04, 
473.14 	subdivision 16, to assist a child retain or generalize psychosocial skills as previously trained 
473.15 	by a mental health professional, clinical trainee, or mental health practitioner and as described 
473.16 	in the child's individual treatment plan and individual behavior plan. Activities involve 
473.17 	working directly with the child or child's family as provided in subdivision 9, paragraph 
473.18 	(b), clause (4).
473.19 	(m) "Mental health certified family peer specialist" means a staff person who is qualified 
473.20 	according to section 245I.04, subdivision 12.
473.21 	(n) "Mental health practitioner" has the meaning given in section 245.462, subdivision 
473.22 	17, except that a practitioner working in a day treatment setting may qualify as a mental 
473.23 	health practitioner if the practitioner holds a bachelor's degree in one of the behavioral 
473.24 	sciences or related fields from an accredited college or university, and: (1) has at least 2,000 
473.25 	hours of clinically supervised experience in the delivery of mental health services to clients 
473.26 	with mental illness; (2) is fluent in the language, other than English, of the cultural group 
473.27 	that makes up at least 50 percent of the practitioner's clients, completes 40 hours of training 
473.28 	on the delivery of services to clients with mental illness, and receives clinical supervision 
473.29 	from a mental health professional at least once per week until meeting the required 2,000 
473.30 	hours of supervised experience; or (3) receives 40 hours of training on the delivery of 
473.31 	services to clients with mental illness within six months of employment, and clinical 
473.32 	supervision from a mental health professional at least once per week until meeting the 
473.33 	required 2,000 hours of supervised experience means a staff person who is qualified according 
473.34 	to section 245I.04, subdivision 4.
474.1 	(o) "Mental health professional" means an individual as defined in Minnesota Rules, 
474.2 	part 9505.0370, subpart 18 a staff person who is qualified according to section 245I.04, 
474.3 	subdivision 2.
474.4 	(p) "Mental health service plan development" includes:
474.5 	(1) the development, review, and revision of a child's individual treatment plan, as 
474.6 	provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of the client 
474.7 	or client's parents, primary caregiver, or other person authorized to consent to mental health 
474.8 	services for the client, and including arrangement of treatment and support activities specified 
474.9 	in the individual treatment plan; and
474.10 	(2) administering and reporting the standardized outcome measurement instruments, 
474.11 	determined and updated by the commissioner measurements in section 245I.10, subdivision 
474.12 	6, paragraph (d), clauses (3) and (4), and other standardized outcome measurements approved 
474.13 	by the commissioner, as periodically needed to evaluate the effectiveness of treatment for 
474.14 	children receiving clinical services and reporting outcome measures, as required by the 
474.15 	commissioner.
474.16 	(q) "Mental illness," for persons at least age 18 but under age 21, has the meaning given 
474.17 	in section 245.462, subdivision 20, paragraph (a).
474.18 	(r) "Psychotherapy" means the treatment of mental or emotional disorders or 
474.19 	maladjustment by psychological means. Psychotherapy may be provided in many modalities 
474.20 	in accordance with Minnesota Rules, part 9505.0372, subpart 6, including patient and/or 
474.21 	family psychotherapy; family psychotherapy; psychotherapy for crisis; group psychotherapy; 
474.22 	or multiple-family psychotherapy. Beginning with the American Medical Association's 
474.23 	Current Procedural Terminology, standard edition, 2014, the procedure "individual 
474.24 	psychotherapy" is replaced with "patient and/or family psychotherapy," a substantive change 
474.25 	that permits the therapist to work with the client's family without the client present to obtain 
474.26 	information about the client or to explain the client's treatment plan to the family. 
474.27 	Psychotherapy is appropriate for crisis response when a child has become dysregulated or 
474.28 	experienced new trauma since the diagnostic assessment was completed and needs 
474.29 	psychotherapy to address issues not currently included in the child's individual treatment 
474.30 	plan described in section 256B.0671, subdivision 11.
474.31 	(s) "Rehabilitative services" or "psychiatric rehabilitation services" means a series or 
474.32 	multidisciplinary combination of psychiatric and psychosocial interventions to: (1) restore 
474.33 	a child or adolescent to an age-appropriate developmental trajectory that had been disrupted 
474.34 	by a psychiatric illness; or (2) enable the child to self-monitor, compensate for, cope with, 
475.1 	counteract, or replace psychosocial skills deficits or maladaptive skills acquired over the 
475.2 	course of a psychiatric illness. Psychiatric rehabilitation services for children combine 
475.3 	coordinated psychotherapy to address internal psychological, emotional, and intellectual 
475.4 	processing deficits, and skills training to restore personal and social functioning. Psychiatric 
475.5 	rehabilitation services establish a progressive series of goals with each achievement building 
475.6 	upon a prior achievement. Continuing progress toward goals is expected, and rehabilitative 
475.7 	potential ceases when successive improvement is not observable over a period of time.
475.8 	(t) "Skills training" means individual, family, or group training, delivered by or under 
475.9 	the supervision of a mental health professional, designed to facilitate the acquisition of 
475.10 	psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate 
475.11 	developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child 
475.12 	to self-monitor, compensate for, cope with, counteract, or replace skills deficits or 
475.13 	maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject 
475.14 	to the service delivery requirements under subdivision 9, paragraph (b), clause (2).
475.15 	(u) "Treatment supervision" means the supervision described in section 245I.06.

475.16 	Sec. 82. Minnesota Statutes 2020, section 256B.0943, subdivision 2, is amended to read:
475.17 		Subd. 2.Covered service components of children's therapeutic services and 
475.18 	supports. (a) Subject to federal approval, medical assistance covers medically necessary 
475.19 	children's therapeutic services and supports as defined in this section that when the services 
475.20 	are provided by an eligible provider entity certified under subdivision 4 provides to a client 
475.21 	eligible under subdivision 3 and meeting the standards in this section. The provider entity 
475.22 	must make reasonable and good faith efforts to report individual client outcomes to the 
475.23 	commissioner, using instruments and protocols approved by the commissioner.
475.24 	(b) The service components of children's therapeutic services and supports are:
475.25 	(1) patient and/or family psychotherapy, family psychotherapy, psychotherapy for crisis, 
475.26 	and group psychotherapy;
475.27 	(2) individual, family, or group skills training provided by a mental health professional, 
475.28 	clinical trainee, or mental health practitioner;
475.29 	(3) crisis assistance planning;
475.30 	(4) mental health behavioral aide services;
475.31 	(5) direction of a mental health behavioral aide;
475.32 	(6) mental health service plan development; and
476.1 	(7) children's day treatment.

476.2 	Sec. 83. Minnesota Statutes 2020, section 256B.0943, subdivision 3, is amended to read:
476.3 		Subd. 3.Determination of client eligibility. (a) A client's eligibility to receive children's 
476.4 	therapeutic services and supports under this section shall be determined based on a standard 
476.5 	diagnostic assessment by a mental health professional or a mental health practitioner who 
476.6 	meets the requirements of a clinical trainee as defined in Minnesota Rules, part 9505.0371, 
476.7 	subpart 5, item C, clinical trainee that is performed within one year before the initial start 
476.8 	of service. The standard diagnostic assessment must meet the requirements for a standard 
476.9 	or extended diagnostic assessment as defined in Minnesota Rules, part 9505.0372, subpart 
476.10 	1, items B and C, and:
476.11 	(1) include current diagnoses, including any differential diagnosis, in accordance with 
476.12 	all criteria for a complete diagnosis and diagnostic profile as specified in the current edition 
476.13 	of the Diagnostic and Statistical Manual of the American Psychiatric Association, or, for 
476.14 	children under age five, as specified in the current edition of the Diagnostic Classification 
476.15 	of Mental Health Disorders of Infancy and Early Childhood;
476.16 	(2) (1) determine whether a child under age 18 has a diagnosis of emotional disturbance 
476.17 	or, if the person is between the ages of 18 and 21, whether the person has a mental illness;
476.18 	(3) (2) document children's therapeutic services and supports as medically necessary to 
476.19 	address an identified disability, functional impairment, and the individual client's needs and 
476.20 	goals; and
476.21 	(4) (3) be used in the development of the individualized individual treatment plan; and.
476.22 	(5) be completed annually until age 18. For individuals between age 18 and 21, unless 
476.23 	a client's mental health condition has changed markedly since the client's most recent 
476.24 	diagnostic assessment, annual updating is necessary. For the purpose of this section, 
476.25 	"updating" means an adult diagnostic update as defined in Minnesota Rules, part 9505.0371, 
476.26 	subpart 2, item E.
476.27 	(b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to 
476.28 	five days of day treatment under this section based on a hospital's medical history and 
476.29 	presentation examination of the client.

476.30 	Sec. 84. Minnesota Statutes 2020, section 256B.0943, subdivision 4, is amended to read:
476.31 		Subd. 4.Provider entity certification. (a) The commissioner shall establish an initial 
476.32 	provider entity application and certification process and recertification process to determine 
477.1 	whether a provider entity has an administrative and clinical infrastructure that meets the 
477.2 	requirements in subdivisions 5 and 6. A provider entity must be certified for the three core 
477.3 	rehabilitation services of psychotherapy, skills training, and crisis assistance planning. The 
477.4 	commissioner shall recertify a provider entity at least every three years. The commissioner 
477.5 	shall establish a process for decertification of a provider entity and shall require corrective 
477.6 	action, medical assistance repayment, or decertification of a provider entity that no longer 
477.7 	meets the requirements in this section or that fails to meet the clinical quality standards or 
477.8 	administrative standards provided by the commissioner in the application and certification 
477.9 	process.
477.10 	(b) For purposes of this section, a provider entity must meet the standards in this section 
477.11 	and chapter 245I, as required under section 245I.011, subdivision 5, and be:
477.12 	(1) an Indian health services facility or a facility owned and operated by a tribe or tribal 
477.13 	organization operating as a 638 facility under Public Law 93-638 certified by the state;
477.14 	(2) a county-operated entity certified by the state; or
477.15 	(3) a noncounty entity certified by the state.

477.16 	Sec. 85. Minnesota Statutes 2020, section 256B.0943, subdivision 5, is amended to read:
477.17 		Subd. 5.Provider entity administrative infrastructure requirements. (a) To be an 
477.18 	eligible provider entity under this section, a provider entity must have an administrative 
477.19 	infrastructure that establishes authority and accountability for decision making and oversight 
477.20 	of functions, including finance, personnel, system management, clinical practice, and 
477.21 	individual treatment outcomes measurement. An eligible provider entity shall demonstrate 
477.22 	the availability, by means of employment or contract, of at least one backup mental health 
477.23 	professional in the event of the primary mental health professional's absence. The provider 
477.24 	must have written policies and procedures that it reviews and updates every three years and 
477.25 	distributes to staff initially and upon each subsequent update.
477.26 	(b) The administrative infrastructure written In addition to the policies and procedures 
477.27 	required under section 245I.03, the policies and procedures must include:
477.28 	(1) personnel procedures, including a process for: (i) recruiting, hiring, training, and 
477.29 	retention of culturally and linguistically competent providers; (ii) conducting a criminal 
477.30 	background check on all direct service providers and volunteers; (iii) investigating, reporting, 
477.31 	and acting on violations of ethical conduct standards; (iv) investigating, reporting, and acting 
477.32 	on violations of data privacy policies that are compliant with federal and state laws; (v) 
477.33 	utilizing volunteers, including screening applicants, training and supervising volunteers, 
478.1 	and providing liability coverage for volunteers; and (vi) documenting that each mental 
478.2 	health professional, mental health practitioner, or mental health behavioral aide meets the 
478.3 	applicable provider qualification criteria, training criteria under subdivision 8, and clinical 
478.4 	supervision or direction of a mental health behavioral aide requirements under subdivision 
478.5 	6;
478.6 	(2) (1) fiscal procedures, including internal fiscal control practices and a process for 
478.7 	collecting revenue that is compliant with federal and state laws; and
478.8 	(3) (2) a client-specific treatment outcomes measurement system, including baseline 
478.9 	measures, to measure a client's progress toward achieving mental health rehabilitation goals. 
478.10 	Effective July 1, 2017, to be eligible for medical assistance payment, a provider entity must 
478.11 	report individual client outcomes to the commissioner, using instruments and protocols 
478.12 	approved by the commissioner; and
478.13 	(4) a process to establish and maintain individual client records. The client's records 
478.14 	must include:
478.15 	(i) the client's personal information;
478.16 	(ii) forms applicable to data privacy;
478.17 	(iii) the client's diagnostic assessment, updates, results of tests, individual treatment 
478.18 	plan, and individual behavior plan, if necessary;
478.19 	(iv) documentation of service delivery as specified under subdivision 6;
478.20 	(v) telephone contacts;
478.21 	(vi) discharge plan; and
478.22 	(vii) if applicable, insurance information.
478.23 	(c) A provider entity that uses a restrictive procedure with a client must meet the 
478.24 	requirements of section 245.8261.

478.25 	Sec. 86. Minnesota Statutes 2020, section 256B.0943, subdivision 5a, is amended to read:
478.26 		Subd. 5a.Background studies. The requirements for background studies under this
478.27 	section 245I.011, subdivision 4, paragraph (d), may be met by a children's therapeutic 
478.28 	services and supports services agency through the commissioner's NETStudy system as 
478.29 	provided under sections 245C.03, subdivision 7, and 245C.10, subdivision 8.

479.1 	Sec. 87. Minnesota Statutes 2020, section 256B.0943, subdivision 6, is amended to read:
479.2 		Subd. 6.Provider entity clinical infrastructure requirements. (a) To be an eligible 
479.3 	provider entity under this section, a provider entity must have a clinical infrastructure that 
479.4 	utilizes diagnostic assessment, individualized individual treatment plans, service delivery, 
479.5 	and individual treatment plan review that are culturally competent, child-centered, and 
479.6 	family-driven to achieve maximum benefit for the client. The provider entity must review, 
479.7 	and update as necessary, the clinical policies and procedures every three years, must distribute 
479.8 	the policies and procedures to staff initially and upon each subsequent update, and must 
479.9 	train staff accordingly.
479.10 	(b) The clinical infrastructure written policies and procedures must include policies and 
479.11 	procedures for meeting the requirements in this subdivision:
479.12 	(1) providing or obtaining a client's standard diagnostic assessment, including a standard 
479.13 	diagnostic assessment performed by an outside or independent clinician, that identifies acute 
479.14 	and chronic clinical disorders, co-occurring medical conditions, and sources of psychological 
479.15 	and environmental problems, including baselines, and a functional assessment. The functional 
479.16 	assessment component must clearly summarize the client's individual strengths and needs.
479.17 	When required components of the standard diagnostic assessment, such as baseline measures,
479.18 	are not provided in an outside or independent assessment or when baseline measures cannot 
479.19 	be attained in a one-session standard diagnostic assessment immediately, the provider entity 
479.20 	must determine the missing information within 30 days and amend the child's standard 
479.21 	diagnostic assessment or incorporate the baselines information into the child's individual 
479.22 	treatment plan;
479.23 	(2) developing an individual treatment plan that:;
479.24 	(i) is based on the information in the client's diagnostic assessment and baselines;
479.25 	(ii) identified goals and objectives of treatment, treatment strategy, schedule for 
479.26 	accomplishing treatment goals and objectives, and the individuals responsible for providing 
479.27 	treatment services and supports;
479.28 	(iii) is developed after completion of the client's diagnostic assessment by a mental health 
479.29 	professional or clinical trainee and before the provision of children's therapeutic services 
479.30 	and supports;
479.31 	(iv) is developed through a child-centered, family-driven, culturally appropriate planning 
479.32 	process, including allowing parents and guardians to observe or participate in individual 
479.33 	and family treatment services, assessment, and treatment planning;
480.1 	(v) is reviewed at least once every 90 days and revised to document treatment progress 
480.2 	on each treatment objective and next goals or, if progress is not documented, to document 
480.3 	changes in treatment; and
480.4 	(vi) is signed by the clinical supervisor and by the client or by the client's parent or other 
480.5 	person authorized by statute to consent to mental health services for the client. A client's 
480.6 	parent may approve the client's individual treatment plan by secure electronic signature or 
480.7 	by documented oral approval that is later verified by written signature;
480.8 	(3) developing an individual behavior plan that documents treatment strategies and 
480.9 	describes interventions to be provided by the mental health behavioral aide. The individual 
480.10 	behavior plan must include:
480.11 	(i) detailed instructions on the treatment strategies to be provided psychosocial skills to 
480.12 	be practiced;
480.13 	(ii) time allocated to each treatment strategy intervention;
480.14 	(iii) methods of documenting the child's behavior;
480.15 	(iv) methods of monitoring the child's progress in reaching objectives; and
480.16 	(v) goals to increase or decrease targeted behavior as identified in the individual treatment 
480.17 	plan;
480.18 	(4) providing clinical treatment supervision plans for mental health practitioners and 
480.19 	mental health behavioral aides. A mental health professional must document the clinical 
480.20 	supervision the professional provides by cosigning individual treatment plans and making 
480.21 	entries in the client's record on supervisory activities. The clinical supervisor also shall 
480.22 	document supervisee-specific supervision in the supervisee's personnel file. Clinical staff 
480.23 	according to section 245I.06. Treatment supervision does not include the authority to make 
480.24 	or terminate court-ordered placements of the child. A clinical treatment supervisor must be 
480.25 	available for urgent consultation as required by the individual client's needs or the situation. 
480.26 	Clinical supervision may occur individually or in a small group to discuss treatment and 
480.27 	review progress toward goals. The focus of clinical supervision must be the client's treatment 
480.28 	needs and progress and the mental health practitioner's or behavioral aide's ability to provide 
480.29 	services;
480.30 	(4a) meeting day treatment program conditions in items (i) to (iii) and (ii):
480.31 	(i) the clinical treatment supervisor must be present and available on the premises more 
480.32 	than 50 percent of the time in a provider's standard working week during which the supervisee 
480.33 	is providing a mental health service; and
481.1 	(ii) the diagnosis and the client's individual treatment plan or a change in the diagnosis 
481.2 	or individual treatment plan must be made by or reviewed, approved, and signed by the 
481.3 	clinical supervisor; and
481.4 	(iii) (ii) every 30 days, the clinical treatment supervisor must review and sign the record 
481.5 	indicating the supervisor has reviewed the client's care for all activities in the preceding 
481.6 	30-day period;
481.7 	(4b) meeting the clinical treatment supervision standards in items (i) to (iv) and (ii) for 
481.8 	all other services provided under CTSS:
481.9 	(i) medical assistance shall reimburse for services provided by a mental health practitioner 
481.10 	who is delivering services that fall within the scope of the practitioner's practice and who 
481.11 	is supervised by a mental health professional who accepts full professional responsibility;
481.12 	(ii) medical assistance shall reimburse for services provided by a mental health behavioral 
481.13 	aide who is delivering services that fall within the scope of the aide's practice and who is 
481.14 	supervised by a mental health professional who accepts full professional responsibility and 
481.15 	has an approved plan for clinical supervision of the behavioral aide. Plans must be developed 
481.16 	in accordance with supervision standards defined in Minnesota Rules, part 9505.0371, 
481.17 	subpart 4, items A to D;
481.18 	(iii) (i) the mental health professional is required to be present at the site of service 
481.19 	delivery for observation as clinically appropriate when the clinical trainee, mental health 
481.20 	practitioner, or mental health behavioral aide is providing CTSS services; and
481.21 	(iv) (ii) when conducted, the on-site presence of the mental health professional must be 
481.22 	documented in the child's record and signed by the mental health professional who accepts 
481.23 	full professional responsibility;
481.24 	(5) providing direction to a mental health behavioral aide. For entities that employ mental 
481.25 	health behavioral aides, the clinical treatment supervisor must be employed by the provider 
481.26 	entity or other provider certified to provide mental health behavioral aide services to ensure 
481.27 	necessary and appropriate oversight for the client's treatment and continuity of care. The 
481.28 	mental health professional or mental health practitioner staff giving direction must begin 
481.29 	with the goals on the individualized individual treatment plan, and instruct the mental health 
481.30 	behavioral aide on how to implement therapeutic activities and interventions that will lead 
481.31 	to goal attainment. The professional or practitioner staff giving direction must also instruct 
481.32 	the mental health behavioral aide about the client's diagnosis, functional status, and other 
481.33 	characteristics that are likely to affect service delivery. Direction must also include 
481.34 	determining that the mental health behavioral aide has the skills to interact with the client 
482.1 	and the client's family in ways that convey personal and cultural respect and that the aide 
482.2 	actively solicits information relevant to treatment from the family. The aide must be able 
482.3 	to clearly explain or demonstrate the activities the aide is doing with the client and the 
482.4 	activities' relationship to treatment goals. Direction is more didactic than is supervision and 
482.5 	requires the professional or practitioner staff providing it to continuously evaluate the mental 
482.6 	health behavioral aide's ability to carry out the activities of the individualized individual
482.7 	treatment plan and the individualized individual behavior plan. When providing direction, 
482.8 	the professional or practitioner staff must:
482.9 	(i) review progress notes prepared by the mental health behavioral aide for accuracy and 
482.10 	consistency with diagnostic assessment, treatment plan, and behavior goals and the 
482.11 	professional or practitioner staff must approve and sign the progress notes;
482.12 	(ii) identify changes in treatment strategies, revise the individual behavior plan, and 
482.13 	communicate treatment instructions and methodologies as appropriate to ensure that treatment 
482.14 	is implemented correctly;
482.15 	(iii) demonstrate family-friendly behaviors that support healthy collaboration among 
482.16 	the child, the child's family, and providers as treatment is planned and implemented;
482.17 	(iv) ensure that the mental health behavioral aide is able to effectively communicate 
482.18 	with the child, the child's family, and the provider; and
482.19 	(v) record the results of any evaluation and corrective actions taken to modify the work 
482.20 	of the mental health behavioral aide; and
482.21 	(vi) ensure the immediate accessibility of a mental health professional, clinical trainee, 
482.22 	or mental health practitioner to the behavioral aide during service delivery;
482.23 	(6) providing service delivery that implements the individual treatment plan and meets 
482.24 	the requirements under subdivision 9; and
482.25 	(7) individual treatment plan review. The review must determine the extent to which 
482.26 	the services have met each of the goals and objectives in the treatment plan. The review 
482.27 	must assess the client's progress and ensure that services and treatment goals continue to 
482.28 	be necessary and appropriate to the client and the client's family or foster family. Revision 
482.29 	of the individual treatment plan does not require a new diagnostic assessment unless the 
482.30 	client's mental health status has changed markedly. The updated treatment plan must be 
482.31 	signed by the clinical supervisor and by the client, if appropriate, and by the client's parent 
482.32 	or other person authorized by statute to give consent to the mental health services for the 
482.33 	child.

483.1 	Sec. 88. Minnesota Statutes 2020, section 256B.0943, subdivision 7, is amended to read:
483.2 		Subd. 7.Qualifications of individual and team providers. (a) An individual or team 
483.3 	provider working within the scope of the provider's practice or qualifications may provide 
483.4 	service components of children's therapeutic services and supports that are identified as 
483.5 	medically necessary in a client's individual treatment plan.
483.6 	(b) An individual provider must be qualified as a:
483.7 	(1) a mental health professional as defined in subdivision 1, paragraph (o); or
483.8 	(2) a clinical trainee;
483.9 	(3) mental health practitioner or clinical trainee. The mental health practitioner or clinical 
483.10 	trainee must work under the clinical supervision of a mental health professional; or
483.11 	(4) mental health certified family peer specialist; or
483.12 	(3) a (5) mental health behavioral aide working under the clinical supervision of a mental 
483.13 	health professional to implement the rehabilitative mental health services previously 
483.14 	introduced by a mental health professional or practitioner and identified in the client's 
483.15 	individual treatment plan and individual behavior plan.
483.16 	(A) A level I mental health behavioral aide must:
483.17 	(i) be at least 18 years old;
483.18 	(ii) have a high school diploma or commissioner of education-selected high school 
483.19 	equivalency certification or two years of experience as a primary caregiver to a child with 
483.20 	severe emotional disturbance within the previous ten years; and
483.21 	(iii) meet preservice and continuing education requirements under subdivision 8.
483.22 	(B) A level II mental health behavioral aide must:
483.23 	(i) be at least 18 years old;
483.24 	(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering 
483.25 	clinical services in the treatment of mental illness concerning children or adolescents or 
483.26 	complete a certificate program established under subdivision 8a; and
483.27 	(iii) meet preservice and continuing education requirements in subdivision 8.
483.28 	(c) A day treatment multidisciplinary team must include at least one mental health 
483.29 	professional or clinical trainee and one mental health practitioner.

484.1 	Sec. 89. Minnesota Statutes 2020, section 256B.0943, subdivision 9, is amended to read:
484.2 		Subd. 9.Service delivery criteria. (a) In delivering services under this section, a certified 
484.3 	provider entity must ensure that:
484.4 	(1) each individual provider's caseload size permits the provider to deliver services to 
484.5 	both clients with severe, complex needs and clients with less intensive needs. the provider's 
484.6 	caseload size should reasonably enable the provider to play an active role in service planning, 
484.7 	monitoring, and delivering services to meet the client's and client's family's needs, as specified 
484.8 	in each client's individual treatment plan;
484.9 	(2) site-based programs, including day treatment programs, provide staffing and facilities 
484.10 	to ensure the client's health, safety, and protection of rights, and that the programs are able 
484.11 	to implement each client's individual treatment plan; and
484.12 	(3) a day treatment program is provided to a group of clients by a multidisciplinary team 
484.13 	under the clinical treatment supervision of a mental health professional. The day treatment 
484.14 	program must be provided in and by: (i) an outpatient hospital accredited by the Joint 
484.15 	Commission on Accreditation of Health Organizations and licensed under sections 144.50 
484.16 	to 144.55; (ii) a community mental health center under section 245.62; or (iii) an entity that 
484.17 	is certified under subdivision 4 to operate a program that meets the requirements of section 
484.18 	245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day 
484.19 	treatment program must stabilize the client's mental health status while developing and 
484.20 	improving the client's independent living and socialization skills. The goal of the day 
484.21 	treatment program must be to reduce or relieve the effects of mental illness and provide 
484.22 	training to enable the client to live in the community. The program must be available 
484.23 	year-round at least three to five days per week, two or three hours per day, unless the normal 
484.24 	five-day school week is shortened by a holiday, weather-related cancellation, or other 
484.25 	districtwide reduction in a school week. A child transitioning into or out of day treatment 
484.26 	must receive a minimum treatment of one day a week for a two-hour time block. The 
484.27 	two-hour time block must include at least one hour of patient and/or family or group 
484.28 	psychotherapy. The remainder of the structured treatment program may include patient 
484.29 	and/or family or group psychotherapy, and individual or group skills training, if included 
484.30 	in the client's individual treatment plan. Day treatment programs are not part of inpatient 
484.31 	or residential treatment services. When a day treatment group that meets the minimum group 
484.32 	size requirement temporarily falls below the minimum group size because of a member's 
484.33 	temporary absence, medical assistance covers a group session conducted for the group 
484.34 	members in attendance. A day treatment program may provide fewer than the minimally 
485.1 	required hours for a particular child during a billing period in which the child is transitioning 
485.2 	into, or out of, the program.
485.3 	(b) To be eligible for medical assistance payment, a provider entity must deliver the 
485.4 	service components of children's therapeutic services and supports in compliance with the 
485.5 	following requirements:
485.6 	(1) patient and/or family, family, and group psychotherapy must be delivered as specified 
485.7 	in Minnesota Rules, part 9505.0372, subpart 6. psychotherapy to address the child's 
485.8 	underlying mental health disorder must be documented as part of the child's ongoing 
485.9 	treatment. A provider must deliver, or arrange for, medically necessary psychotherapy, 
485.10 	unless the child's parent or caregiver chooses not to receive it. When a provider delivering 
485.11 	other services to a child under this section deems it not medically necessary to provide 
485.12 	psychotherapy to the child for a period of 90 days or longer, the provider entity must 
485.13 	document the medical reasons why psychotherapy is not necessary. When a provider 
485.14 	determines that a child needs psychotherapy but psychotherapy cannot be delivered due to 
485.15 	a shortage of licensed mental health professionals in the child's community, the provider 
485.16 	must document the lack of access in the child's medical record;
485.17 	(2) individual, family, or group skills training must be provided by a mental health 
485.18 	professional or a mental health practitioner who is delivering services that fall within the 
485.19 	scope of the provider's practice and is supervised by a mental health professional who 
485.20 	accepts full professional responsibility for the training. Skills training is subject to the 
485.21 	following requirements:
485.22 	(i) a mental health professional, clinical trainee, or mental health practitioner shall provide 
485.23 	skills training;
485.24 	(ii) skills training delivered to a child or the child's family must be targeted to the specific 
485.25 	deficits or maladaptations of the child's mental health disorder and must be prescribed in 
485.26 	the child's individual treatment plan;
485.27 	(iii) the mental health professional delivering or supervising the delivery of skills training 
485.28 	must document any underlying psychiatric condition and must document how skills training 
485.29 	is being used in conjunction with psychotherapy to address the underlying condition;
485.30 	(iv) skills training delivered to the child's family must teach skills needed by parents to 
485.31 	enhance the child's skill development, to help the child utilize daily life skills taught by a 
485.32 	mental health professional, clinical trainee, or mental health practitioner, and to develop or 
485.33 	maintain a home environment that supports the child's progressive use of skills;
486.1 	(v) group skills training may be provided to multiple recipients who, because of the 
486.2 	nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from 
486.3 	interaction in a group setting, which must be staffed as follows:
486.4 	(A) one mental health professional or one, clinical trainee, or mental health practitioner 
486.5 	under supervision of a licensed mental health professional must work with a group of three 
486.6 	to eight clients; or
486.7 	(B) any combination of two mental health professionals, two clinical trainees, or mental 
486.8 	health practitioners under supervision of a licensed mental health professional, or one mental 
486.9 	health professional or clinical trainee and one mental health practitioner must work with a 
486.10 	group of nine to 12 clients;
486.11 	(vi) a mental health professional, clinical trainee, or mental health practitioner must have 
486.12 	taught the psychosocial skill before a mental health behavioral aide may practice that skill 
486.13 	with the client; and
486.14 	(vii) for group skills training, when a skills group that meets the minimum group size 
486.15 	requirement temporarily falls below the minimum group size because of a group member's 
486.16 	temporary absence, the provider may conduct the session for the group members in 
486.17 	attendance;
486.18 	(3) crisis assistance planning to a child and family must include development of a written 
486.19 	plan that anticipates the particular factors specific to the child that may precipitate a 
486.20 	psychiatric crisis for the child in the near future. The written plan must document actions 
486.21 	that the family should be prepared to take to resolve or stabilize a crisis, such as advance 
486.22 	arrangements for direct intervention and support services to the child and the child's family. 
486.23 	Crisis assistance planning must include preparing resources designed to address abrupt or 
486.24 	substantial changes in the functioning of the child or the child's family when sudden change 
486.25 	in behavior or a loss of usual coping mechanisms is observed, or the child begins to present 
486.26 	a danger to self or others;
486.27 	(4) mental health behavioral aide services must be medically necessary treatment services, 
486.28 	identified in the child's individual treatment plan and individual behavior plan, which are 
486.29 	performed minimally by a paraprofessional qualified according to subdivision 7, paragraph 
486.30 	(b), clause (3), and which are designed to improve the functioning of the child in the 
486.31 	progressive use of developmentally appropriate psychosocial skills. Activities involve 
486.32 	working directly with the child, child-peer groupings, or child-family groupings to practice, 
486.33 	repeat, reintroduce, and master the skills defined in subdivision 1, paragraph (t), as previously 
486.34 	taught by a mental health professional, clinical trainee, or mental health practitioner including:
487.1 	(i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions 
487.2 	so that the child progressively recognizes and responds to the cues independently;
487.3 	(ii) performing as a practice partner or role-play partner;
487.4 	(iii) reinforcing the child's accomplishments;
487.5 	(iv) generalizing skill-building activities in the child's multiple natural settings;
487.6 	(v) assigning further practice activities; and
487.7 	(vi) intervening as necessary to redirect the child's target behavior and to de-escalate 
487.8 	behavior that puts the child or other person at risk of injury.
487.9 	To be eligible for medical assistance payment, mental health behavioral aide services must 
487.10 	be delivered to a child who has been diagnosed with an emotional disturbance or a mental 
487.11 	illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must 
487.12 	implement treatment strategies in the individual treatment plan and the individual behavior 
487.13 	plan as developed by the mental health professional, clinical trainee, or mental health 
487.14 	practitioner providing direction for the mental health behavioral aide. The mental health 
487.15 	behavioral aide must document the delivery of services in written progress notes. Progress 
487.16 	notes must reflect implementation of the treatment strategies, as performed by the mental 
487.17 	health behavioral aide and the child's responses to the treatment strategies; and
487.18 	(5) direction of a mental health behavioral aide must include the following:
487.19 	(i) ongoing face-to-face observation of the mental health behavioral aide delivering 
487.20 	services to a child by a mental health professional or mental health practitioner for at least 
487.21 	a total of one hour during every 40 hours of service provided to a child; and
487.22 	(ii) immediate accessibility of the mental health professional, clinical trainee, or mental 
487.23 	health practitioner to the mental health behavioral aide during service provision;
487.24 	(6) (5) mental health service plan development must be performed in consultation with 
487.25 	the child's family and, when appropriate, with other key participants in the child's life by 
487.26 	the child's treating mental health professional or clinical trainee or by a mental health 
487.27 	practitioner and approved by the treating mental health professional. Treatment plan drafting 
487.28 	consists of development, review, and revision by face-to-face or electronic communication. 
487.29 	The provider must document events, including the time spent with the family and other key 
487.30 	participants in the child's life to review, revise, and sign approve the individual treatment 
487.31 	plan. Notwithstanding Minnesota Rules, part 9505.0371, subpart 7, Medical assistance 
487.32 	covers service plan development before completion of the child's individual treatment plan. 
487.33 	Service plan development is covered only if a treatment plan is completed for the child. If 
488.1 	upon review it is determined that a treatment plan was not completed for the child, the 
488.2 	commissioner shall recover the payment for the service plan development; and.
488.3 	(7) to be eligible for payment, a diagnostic assessment must be complete with regard to 
488.4 	all required components, including multiple assessment appointments required for an 
488.5 	extended diagnostic assessment and the written report. Dates of the multiple assessment 
488.6 	appointments must be noted in the client's clinical record.

488.7 	Sec. 90. Minnesota Statutes 2020, section 256B.0943, subdivision 11, is amended to read:
488.8 		Subd. 11.Documentation and billing. (a) A provider entity must document the services 
488.9 	it provides under this section. The provider entity must ensure that documentation complies 
488.10 	with Minnesota Rules, parts 9505.2175 and 9505.2197. Services billed under this section 
488.11 	that are not documented according to this subdivision shall be subject to monetary recovery 
488.12 	by the commissioner. Billing for covered service components under subdivision 2, paragraph 
488.13 	(b), must not include anything other than direct service time.
488.14 	(b) An individual mental health provider must promptly document the following in a 
488.15 	client's record after providing services to the client:
488.16 	(1) each occurrence of the client's mental health service, including the date, type, start 
488.17 	and stop times, scope of the service as described in the child's individual treatment plan, 
488.18 	and outcome of the service compared to baselines and objectives;
488.19 	(2) the name, dated signature, and credentials of the person who delivered the service;
488.20 	(3) contact made with other persons interested in the client, including representatives 
488.21 	of the courts, corrections systems, or schools. The provider must document the name and 
488.22 	date of each contact;
488.23 	(4) any contact made with the client's other mental health providers, case manager, 
488.24 	family members, primary caregiver, legal representative, or the reason the provider did not 
488.25 	contact the client's family members, primary caregiver, or legal representative, if applicable;
488.26 	(5) required clinical supervision directly related to the identified client's services and 
488.27 	needs, as appropriate, with co-signatures of the supervisor and supervisee; and
488.28 	(6) the date when services are discontinued and reasons for discontinuation of services.

488.29 	Sec. 91. Minnesota Statutes 2020, section 256B.0946, subdivision 1, is amended to read:
488.30 		Subdivision 1.Required covered service components. (a) Effective May 23, 2013, 
488.31 	and Subject to federal approval, medical assistance covers medically necessary intensive 
489.1 	treatment services described under paragraph (b) that when the services are provided by a 
489.2 	provider entity eligible under subdivision 3 to a client eligible under subdivision 2 who is 
489.3 	placed in a foster home licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or 
489.4 	placed in a foster home licensed under the regulations established by a federally recognized 
489.5 	Minnesota tribe certified under and meeting the standards in this section. The provider entity 
489.6 	must make reasonable and good faith efforts to report individual client outcomes to the 
489.7 	commissioner, using instruments and protocols approved by the commissioner.
489.8 	(b) Intensive treatment services to children with mental illness residing in foster family 
489.9 	settings that comprise specific required service components provided in clauses (1) to (5) 
489.10 	are reimbursed by medical assistance when they meet the following standards:
489.11 	(1) psychotherapy provided by a mental health professional as defined in Minnesota 
489.12 	Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota 
489.13 	Rules, part 9505.0371, subpart 5, item C;
489.14 	(2) crisis assistance provided according to standards for children's therapeutic services 
489.15 	and supports in section 256B.0943 planning;
489.16 	(3) individual, family, and group psychoeducation services, defined in subdivision 1a, 
489.17 	paragraph (q), provided by a mental health professional or a clinical trainee;
489.18 	(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental 
489.19 	health professional or a clinical trainee; and
489.20 	(5) service delivery payment requirements as provided under subdivision 4.

489.21 	Sec. 92. Minnesota Statutes 2020, section 256B.0946, subdivision 1a, is amended to read:
489.22 		Subd. 1a.Definitions. For the purposes of this section, the following terms have the 
489.23 	meanings given them.
489.24 	(a) "Clinical care consultation" means communication from a treating clinician to other 
489.25 	providers working with the same client to inform, inquire, and instruct regarding the client's 
489.26 	symptoms, strategies for effective engagement, care and intervention needs, and treatment 
489.27 	expectations across service settings, including but not limited to the client's school, social 
489.28 	services, day care, probation, home, primary care, medication prescribers, disabilities 
489.29 	services, and other mental health providers and to direct and coordinate clinical service 
489.30 	components provided to the client and family.
489.31 	(b) "Clinical supervision" means the documented time a clinical supervisor and supervisee 
489.32 	spend together to discuss the supervisee's work, to review individual client cases, and for 
490.1 	the supervisee's professional development. It includes the documented oversight and 
490.2 	supervision responsibility for planning, implementation, and evaluation of services for a 
490.3 	client's mental health treatment.
490.4 	(c) "Clinical supervisor" means the mental health professional who is responsible for 
490.5 	clinical supervision.
490.6 	(d) (b) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371, 
490.7 	subpart 5, item C; means a staff person who is qualified according to section 245I.04, 
490.8 	subdivision 6.
490.9 	(e) (c) "Crisis assistance planning" has the meaning given in section 245.4871, subdivision 
490.10 	9a, including the development of a plan that addresses prevention and intervention strategies 
490.11 	to be used in a potential crisis, but does not include actual crisis intervention.
490.12 	(f) (d) "Culturally appropriate" means providing mental health services in a manner that 
490.13 	incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370, 
490.14 	subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural 
490.15 	strengths and resources to promote overall wellness.
490.16 	(g) (e) "Culture" means the distinct ways of living and understanding the world that are 
490.17 	used by a group of people and are transmitted from one generation to another or adopted 
490.18 	by an individual.
490.19 	(h) (f) "Standard diagnostic assessment" has the meaning given in Minnesota Rules, part 
490.20 	9505.0370, subpart 11 means the assessment described in section 245I.10, subdivision 6.
490.21 	(i) (g) "Family" means a person who is identified by the client or the client's parent or 
490.22 	guardian as being important to the client's mental health treatment. Family may include, 
490.23 	but is not limited to, parents, foster parents, children, spouse, committed partners, former 
490.24 	spouses, persons related by blood or adoption, persons who are a part of the client's 
490.25 	permanency plan, or persons who are presently residing together as a family unit.
490.26 	(j) (h) "Foster care" has the meaning given in section 260C.007, subdivision 18.
490.27 	(k) (i) "Foster family setting" means the foster home in which the license holder resides.
490.28 	(l) (j) "Individual treatment plan" has the meaning given in Minnesota Rules, part 
490.29 	9505.0370, subpart 15 means the plan described in section 245I.10, subdivisions 7 and 8.
490.30 	(m) "Mental health practitioner" has the meaning given in section 245.462, subdivision 
490.31 	17, and a mental health practitioner working as a clinical trainee according to Minnesota 
490.32 	Rules, part 9505.0371, subpart 5, item C.
491.1 	(k) "Mental health certified family peer specialist" means a staff person who is qualified 
491.2 	according to section 245I.04, subdivision 12.
491.3 	(n) (l) "Mental health professional" has the meaning given in Minnesota Rules, part 
491.4 	9505.0370, subpart 18 means a staff person who is qualified according to section 245I.04, 
491.5 	subdivision 2.
491.6 	(o) (m) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370, 
491.7 	subpart 20 section 245I.02, subdivision 29.
491.8 	(p) (n) "Parent" has the meaning given in section 260C.007, subdivision 25.
491.9 	(q) (o) "Psychoeducation services" means information or demonstration provided to an 
491.10 	individual, family, or group to explain, educate, and support the individual, family, or group 
491.11 	in understanding a child's symptoms of mental illness, the impact on the child's development, 
491.12 	and needed components of treatment and skill development so that the individual, family, 
491.13 	or group can help the child to prevent relapse, prevent the acquisition of comorbid disorders, 
491.14 	and achieve optimal mental health and long-term resilience.
491.15 	(r) (p) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370, 
491.16 	subpart 27 means the treatment described in section 256B.0671, subdivision 11.
491.17 	(s) (q) "Team consultation and treatment planning" means the coordination of treatment 
491.18 	plans and consultation among providers in a group concerning the treatment needs of the 
491.19 	child, including disseminating the child's treatment service schedule to all members of the 
491.20 	service team. Team members must include all mental health professionals working with the 
491.21 	child, a parent, the child unless the team lead or parent deem it clinically inappropriate, and 
491.22 	at least two of the following: an individualized education program case manager; probation 
491.23 	agent; children's mental health case manager; child welfare worker, including adoption or 
491.24 	guardianship worker; primary care provider; foster parent; and any other member of the 
491.25 	child's service team.
491.26 	(r) "Trauma" has the meaning given in section 245I.02, subdivision 38.
491.27 	(s) "Treatment supervision" means the supervision described under section 245I.06.

491.28 	Sec. 93. Minnesota Statutes 2020, section 256B.0946, subdivision 2, is amended to read:
491.29 		Subd. 2.Determination of client eligibility. An eligible recipient is an individual, from 
491.30 	birth through age 20, who is currently placed in a foster home licensed under Minnesota 
491.31 	Rules, parts 2960.3000 to 2960.3340, or placed in a foster home licensed under the 
491.32 	regulations established by a federally recognized Minnesota tribe, and has received: (1) a 
492.1 	standard diagnostic assessment and an evaluation of level of care needed, as defined in 
492.2 	paragraphs (a) and (b). within 180 days before the start of service that documents that 
492.3 	intensive treatment services are medically necessary within a foster family setting to 
492.4 	ameliorate identified symptoms and functional impairments; and (2) a level of care 
492.5 	assessment as defined in section 245I.02, subdivision 19, that demonstrates that the individual 
492.6 	requires intensive intervention without 24-hour medical monitoring, and a functional 
492.7 	assessment as defined in section 245I.02, subdivision 17. The level of care assessment and 
492.8 	the functional assessment must include information gathered from the placing county, tribe, 
492.9 	or case manager.
492.10 	(a) The diagnostic assessment must:
492.11 	(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be 
492.12 	conducted by a mental health professional or a clinical trainee;
492.13 	(2) determine whether or not a child meets the criteria for mental illness, as defined in 
492.14 	Minnesota Rules, part 9505.0370, subpart 20;
492.15 	(3) document that intensive treatment services are medically necessary within a foster 
492.16 	family setting to ameliorate identified symptoms and functional impairments;
492.17 	(4) be performed within 180 days before the start of service; and
492.18 	(5) be completed as either a standard or extended diagnostic assessment annually to 
492.19 	determine continued eligibility for the service.
492.20 	(b) The evaluation of level of care must be conducted by the placing county, tribe, or 
492.21 	case manager in conjunction with the diagnostic assessment as described by Minnesota 
492.22 	Rules, part 9505.0372, subpart 1, item B, using a validated tool approved by the 
492.23 	commissioner of human services and not subject to the rulemaking process, consistent with 
492.24 	section 245.4885, subdivision 1, paragraph (d), the result of which evaluation demonstrates 
492.25 	that the child requires intensive intervention without 24-hour medical monitoring. The 
492.26 	commissioner shall update the list of approved level of care tools annually and publish on 
492.27 	the department's website.

492.28 	Sec. 94. Minnesota Statutes 2020, section 256B.0946, subdivision 3, is amended to read:
492.29 		Subd. 3.Eligible mental health services providers. (a) Eligible providers for intensive 
492.30 	children's mental health services in a foster family setting must be certified by the state and 
492.31 	have a service provision contract with a county board or a reservation tribal council and 
492.32 	must be able to demonstrate the ability to provide all of the services required in this section
492.33 	and meet the standards in chapter 245I, as required in section 245I.011, subdivision 5.
493.1 	(b) For purposes of this section, a provider agency must be:
493.2 	(1) a county-operated entity certified by the state;
493.3 	(2) an Indian Health Services facility operated by a tribe or tribal organization under 
493.4 	funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the 
493.5 	Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
493.6 	(3) a noncounty entity.
493.7 	(c) Certified providers that do not meet the service delivery standards required in this 
493.8 	section shall be subject to a decertification process.
493.9 	(d) For the purposes of this section, all services delivered to a client must be provided 
493.10 	by a mental health professional or a clinical trainee.

493.11 	Sec. 95. Minnesota Statutes 2020, section 256B.0946, subdivision 4, is amended to read:
493.12 		Subd. 4.Service delivery payment requirements. (a) To be eligible for payment under 
493.13 	this section, a provider must develop and practice written policies and procedures for 
493.14 	intensive treatment in foster care, consistent with subdivision 1, paragraph (b), and comply 
493.15 	with the following requirements in paragraphs (b) to (n) (l).
493.16 	(b) A qualified clinical supervisor, as defined in and performing in compliance with 
493.17 	Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and 
493.18 	provision of services described in this section.
493.19 	(c) Each client receiving treatment services must receive an extended diagnostic 
493.20 	assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within 30 
493.21 	days of enrollment in this service unless the client has a previous extended diagnostic 
493.22 	assessment that the client, parent, and mental health professional agree still accurately 
493.23 	describes the client's current mental health functioning.
493.24 	(d) (b) Each previous and current mental health, school, and physical health treatment 
493.25 	provider must be contacted to request documentation of treatment and assessments that the 
493.26 	eligible client has received. This information must be reviewed and incorporated into the 
493.27 	standard diagnostic assessment and team consultation and treatment planning review process.
493.28 	(e) (c) Each client receiving treatment must be assessed for a trauma history, and the 
493.29 	client's treatment plan must document how the results of the assessment will be incorporated 
493.30 	into treatment.
494.1 	(d) The level of care assessment as defined in section 245I.02, subdivision 19, and 
494.2 	functional assessment as defined in section 245I.02, subdivision 17, must be updated at 
494.3 	least every 90 days or prior to discharge from the service, whichever comes first.
494.4 	(f) (e) Each client receiving treatment services must have an individual treatment plan 
494.5 	that is reviewed, evaluated, and signed approved every 90 days using the team consultation 
494.6 	and treatment planning process, as defined in subdivision 1a, paragraph (s).
494.7 	(g) (f) Clinical care consultation, as defined in subdivision 1a, paragraph (a), must be 
494.8 	provided in accordance with the client's individual treatment plan.
494.9 	(h) (g) Each client must have a crisis assistance plan within ten days of initiating services 
494.10 	and must have access to clinical phone support 24 hours per day, seven days per week, 
494.11 	during the course of treatment. The crisis plan must demonstrate coordination with the local 
494.12 	or regional mobile crisis intervention team.
494.13 	(i) (h) Services must be delivered and documented at least three days per week, equaling 
494.14 	at least six hours of treatment per week, unless reduced units of service are specified on the 
494.15 	treatment plan as part of transition or on a discharge plan to another service or level of care. 
494.16 	Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
494.17 	(j) (i) Location of service delivery must be in the client's home, day care setting, school, 
494.18 	or other community-based setting that is specified on the client's individualized treatment 
494.19 	plan.
494.20 	(k) (j) Treatment must be developmentally and culturally appropriate for the client.
494.21 	(l) (k) Services must be delivered in continual collaboration and consultation with the 
494.22 	client's medical providers and, in particular, with prescribers of psychotropic medications, 
494.23 	including those prescribed on an off-label basis. Members of the service team must be aware 
494.24 	of the medication regimen and potential side effects.
494.25 	(m) (l) Parents, siblings, foster parents, and members of the child's permanency plan 
494.26 	must be involved in treatment and service delivery unless otherwise noted in the treatment 
494.27 	plan.
494.28 	(n) (m) Transition planning for the child must be conducted starting with the first 
494.29 	treatment plan and must be addressed throughout treatment to support the child's permanency 
494.30 	plan and postdischarge mental health service needs.

495.1 	Sec. 96. Minnesota Statutes 2020, section 256B.0946, subdivision 6, is amended to read:
495.2 		Subd. 6.Excluded services. (a) Services in clauses (1) to (7) are not covered under this 
495.3 	section and are not eligible for medical assistance payment as components of intensive 
495.4 	treatment in foster care services, but may be billed separately:
495.5 	(1) inpatient psychiatric hospital treatment;
495.6 	(2) mental health targeted case management;
495.7 	(3) partial hospitalization;
495.8 	(4) medication management;
495.9 	(5) children's mental health day treatment services;
495.10 	(6) crisis response services under section 256B.0944 256B.0624; and
495.11 	(7) transportation.; and
495.12 	(8) mental health certified family peer specialist services under section 256B.0616.
495.13 	(b) Children receiving intensive treatment in foster care services are not eligible for 
495.14 	medical assistance reimbursement for the following services while receiving intensive 
495.15 	treatment in foster care:
495.16 	(1) psychotherapy and skills training components of children's therapeutic services and 
495.17 	supports under section 256B.0625, subdivision 35b 256B.0943;
495.18 	(2) mental health behavioral aide services as defined in section 256B.0943, subdivision 
495.19 	1, paragraph (m) (l);
495.20 	(3) home and community-based waiver services;
495.21 	(4) mental health residential treatment; and
495.22 	(5) room and board costs as defined in section 256I.03, subdivision 6.

495.23 	Sec. 97. Minnesota Statutes 2020, section 256B.0947, subdivision 1, is amended to read:
495.24 		Subdivision 1.Scope. Effective November 1, 2011, and Subject to federal approval, 
495.25 	medical assistance covers medically necessary, intensive nonresidential rehabilitative mental 
495.26 	health services as defined in subdivision 2, for recipients as defined in subdivision 3, when 
495.27 	the services are provided by an entity meeting the standards in this section. The provider 
495.28 	entity must make reasonable and good faith efforts to report individual client outcomes to 
495.29 	the commissioner, using instruments and protocols approved by the commissioner.

496.1 	Sec. 98. Minnesota Statutes 2020, section 256B.0947, subdivision 2, is amended to read:
496.2 		Subd. 2.Definitions. For purposes of this section, the following terms have the meanings 
496.3 	given them.
496.4 	(a) "Intensive nonresidential rehabilitative mental health services" means child 
496.5 	rehabilitative mental health services as defined in section 256B.0943, except that these 
496.6 	services are provided by a multidisciplinary staff using a total team approach consistent 
496.7 	with assertive community treatment, as adapted for youth, and are directed to recipients 
496.8 	ages 16, 17, 18, 19, or 20 with a serious mental illness or co-occurring mental illness and 
496.9 	substance abuse addiction who require intensive services to prevent admission to an inpatient 
496.10 	psychiatric hospital or placement in a residential treatment facility or who require intensive 
496.11 	services to step down from inpatient or residential care to community-based care.
496.12 	(b) "Co-occurring mental illness and substance abuse addiction use disorder" means a 
496.13 	dual diagnosis of at least one form of mental illness and at least one substance use disorder. 
496.14 	Substance use disorders include alcohol or drug abuse or dependence, excluding nicotine 
496.15 	use.
496.16 	(c) "Standard diagnostic assessment" has the meaning given to it in Minnesota Rules, 
496.17 	part 9505.0370, subpart 11. A diagnostic assessment must be provided according to 
496.18 	Minnesota Rules, part 9505.0372, subpart 1, and for this section must incorporate a 
496.19 	determination of the youth's necessary level of care using a standardized functional 
496.20 	assessment instrument approved and periodically updated by the commissioner means the 
496.21 	assessment described in section 245I.10, subdivision 6.
496.22 	(d) "Education specialist" means an individual with knowledge and experience working 
496.23 	with youth regarding special education requirements and goals, special education plans, 
496.24 	and coordination of educational activities with health care activities.
496.25 	(e) "Housing access support" means an ancillary activity to help an individual find, 
496.26 	obtain, retain, and move to safe and adequate housing. Housing access support does not 
496.27 	provide monetary assistance for rent, damage deposits, or application fees.
496.28 	(f) "Integrated dual disorders treatment" means the integrated treatment of co-occurring 
496.29 	mental illness and substance use disorders by a team of cross-trained clinicians within the 
496.30 	same program, and is characterized by assertive outreach, stage-wise comprehensive 
496.31 	treatment, treatment goal setting, and flexibility to work within each stage of treatment.
496.32 	(g) (d) "Medication education services" means services provided individually or in 
496.33 	groups, which focus on:
497.1 	(1) educating the client and client's family or significant nonfamilial supporters about 
497.2 	mental illness and symptoms;
497.3 	(2) the role and effects of medications in treating symptoms of mental illness; and
497.4 	(3) the side effects of medications.
497.5 	Medication education is coordinated with medication management services and does not 
497.6 	duplicate it. Medication education services are provided by physicians, pharmacists, or 
497.7 	registered nurses with certification in psychiatric and mental health care.
497.8 	(h) "Peer specialist" means an employed team member who is a mental health certified 
497.9 	peer specialist according to section 256B.0615 and also a former children's mental health 
497.10 	consumer who:
497.11 	(1) provides direct services to clients including social, emotional, and instrumental 
497.12 	support and outreach;
497.13 	(2) assists younger peers to identify and achieve specific life goals;
497.14 	(3) works directly with clients to promote the client's self-determination, personal 
497.15 	responsibility, and empowerment;
497.16 	(4) assists youth with mental illness to regain control over their lives and their 
497.17 	developmental process in order to move effectively into adulthood;
497.18 	(5) provides training and education to other team members, consumer advocacy 
497.19 	organizations, and clients on resiliency and peer support; and
497.20 	(6) meets the following criteria:
497.21 	(i) is at least 22 years of age;
497.22 	(ii) has had a diagnosis of mental illness, as defined in Minnesota Rules, part 9505.0370, 
497.23 	subpart 20, or co-occurring mental illness and substance abuse addiction;
497.24 	(iii) is a former consumer of child and adolescent mental health services, or a former or 
497.25 	current consumer of adult mental health services for a period of at least two years;
497.26 	(iv) has at least a high school diploma or equivalent;
497.27 	(v) has successfully completed training requirements determined and periodically updated 
497.28 	by the commissioner;
497.29 	(vi) is willing to disclose the individual's own mental health history to team members 
497.30 	and clients; and
498.1 	(vii) must be free of substance use problems for at least one year.
498.2 	(e) "Mental health professional" means a staff person who is qualified according to 
498.3 	section 245I.04, subdivision 2.
498.4 	(i) (f) "Provider agency" means a for-profit or nonprofit organization established to 
498.5 	administer an assertive community treatment for youth team.
498.6 	(j) (g) "Substance use disorders" means one or more of the disorders defined in the 
498.7 	diagnostic and statistical manual of mental disorders, current edition.
498.8 	(k) (h) "Transition services" means:
498.9 	(1) activities, materials, consultation, and coordination that ensures continuity of the 
498.10 	client's care in advance of and in preparation for the client's move from one stage of care 
498.11 	or life to another by maintaining contact with the client and assisting the client to establish 
498.12 	provider relationships;
498.13 	(2) providing the client with knowledge and skills needed posttransition;
498.14 	(3) establishing communication between sending and receiving entities;
498.15 	(4) supporting a client's request for service authorization and enrollment; and
498.16 	(5) establishing and enforcing procedures and schedules.
498.17 	A youth's transition from the children's mental health system and services to the adult 
498.18 	mental health system and services and return to the client's home and entry or re-entry into 
498.19 	community-based mental health services following discharge from an out-of-home placement 
498.20 	or inpatient hospital stay.
498.21 	(l) (i) "Treatment team" means all staff who provide services to recipients under this 
498.22 	section.
498.23 	(m) (j) "Family peer specialist" means a staff person who is qualified under section 
498.24 	256B.0616.

498.25 	Sec. 99. Minnesota Statutes 2020, section 256B.0947, subdivision 3, is amended to read:
498.26 		Subd. 3.Client eligibility. An eligible recipient is an individual who:
498.27 	(1) is age 16, 17, 18, 19, or 20; and
498.28 	(2) is diagnosed with a serious mental illness or co-occurring mental illness and substance 
498.29 	abuse addiction use disorder, for which intensive nonresidential rehabilitative mental health 
498.30 	services are needed;
499.1 	(3) has received a level-of-care determination, using an instrument approved by the 
499.2 	commissioner level of care assessment as defined in section 245I.02, subdivision 19, that 
499.3 	indicates a need for intensive integrated intervention without 24-hour medical monitoring 
499.4 	and a need for extensive collaboration among multiple providers;
499.5 	(4) has received a functional assessment as defined in section 245I.02, subdivision 17, 
499.6 	that indicates functional impairment and a history of difficulty in functioning safely and 
499.7 	successfully in the community, school, home, or job; or who is likely to need services from 
499.8 	the adult mental health system within the next two years; and
499.9 	(5) has had a recent standard diagnostic assessment, as provided in Minnesota Rules, 
499.10 	part 9505.0372, subpart 1, by a mental health professional who is qualified under Minnesota 
499.11 	Rules, part 9505.0371, subpart 5, item A, that documents that intensive nonresidential 
499.12 	rehabilitative mental health services are medically necessary to ameliorate identified 
499.13 	symptoms and functional impairments and to achieve individual transition goals.

499.14 	Sec. 100. Minnesota Statutes 2020, section 256B.0947, subdivision 3a, is amended to 
499.15 	read:
499.16 		Subd. 3a.Required service components. (a) Subject to federal approval, medical 
499.17 	assistance covers all medically necessary intensive nonresidential rehabilitative mental 
499.18 	health services and supports, as defined in this section, under a single daily rate per client. 
499.19 	Services and supports must be delivered by an eligible provider under subdivision 5 to an 
499.20 	eligible client under subdivision 3.
499.21 	(b) (a) Intensive nonresidential rehabilitative mental health services, supports, and 
499.22 	ancillary activities are covered by the a single daily rate per client must include the following, 
499.23 	as needed by the individual client:
499.24 	(1) individual, family, and group psychotherapy;
499.25 	(2) individual, family, and group skills training, as defined in section 256B.0943, 
499.26 	subdivision 1, paragraph (t);
499.27 	(3) crisis assistance planning as defined in section 245.4871, subdivision 9a, which 
499.28 	includes recognition of factors precipitating a mental health crisis, identification of behaviors 
499.29 	related to the crisis, and the development of a plan to address prevention, intervention, and 
499.30 	follow-up strategies to be used in the lead-up to or onset of, and conclusion of, a mental 
499.31 	health crisis; crisis assistance does not mean crisis response services or crisis intervention 
499.32 	services provided in section 256B.0944;
500.1 	(4) medication management provided by a physician or an advanced practice registered 
500.2 	nurse with certification in psychiatric and mental health care;
500.3 	(5) mental health case management as provided in section 256B.0625, subdivision 20;
500.4 	(6) medication education services as defined in this section;
500.5 	(7) care coordination by a client-specific lead worker assigned by and responsible to the 
500.6 	treatment team;
500.7 	(8) psychoeducation of and consultation and coordination with the client's biological, 
500.8 	adoptive, or foster family and, in the case of a youth living independently, the client's 
500.9 	immediate nonfamilial support network;
500.10 	(9) clinical consultation to a client's employer or school or to other service agencies or 
500.11 	to the courts to assist in managing the mental illness or co-occurring disorder and to develop 
500.12 	client support systems;
500.13 	(10) coordination with, or performance of, crisis intervention and stabilization services 
500.14 	as defined in section 256B.0944 256B.0624;
500.15 	(11) assessment of a client's treatment progress and effectiveness of services using 
500.16 	standardized outcome measures published by the commissioner;
500.17 	(12) (11) transition services as defined in this section;
500.18 	(13) integrated dual disorders treatment as defined in this section (12) co-occurring 
500.19 	substance use disorder treatment as defined in section 245I.02, subdivision 11; and
500.20 	(14) (13) housing access support that assists clients to find, obtain, retain, and move to 
500.21 	safe and adequate housing. Housing access support does not provide monetary assistance 
500.22 	for rent, damage deposits, or application fees.
500.23 	(c) (b) The provider shall ensure and document the following by means of performing 
500.24 	the required function or by contracting with a qualified person or entity:
500.25 	(1) client access to crisis intervention services, as defined in section 256B.0944
500.26 	256B.0624, and available 24 hours per day and seven days per week;.
500.27 	(2) completion of an extended diagnostic assessment, as defined in Minnesota Rules, 
500.28 	part 9505.0372, subpart 1, item C; and
500.29 	(3) determination of the client's needed level of care using an instrument approved and 
500.30 	periodically updated by the commissioner.

501.1 	Sec. 101. Minnesota Statutes 2020, section 256B.0947, subdivision 5, is amended to read:
501.2 		Subd. 5.Standards for intensive nonresidential rehabilitative providers. (a) Services 
501.3 	must be provided by a provider entity as provided in subdivision 4 meet the standards in 
501.4 	this section and chapter 245I as required in section 245I.011, subdivision 5.
501.5 	(b) The treatment team for intensive nonresidential rehabilitative mental health services 
501.6 	comprises both permanently employed core team members and client-specific team members 
501.7 	as follows:
501.8 	(1) The core treatment team is an entity that operates under the direction of an 
501.9 	independently licensed mental health professional, who is qualified under Minnesota Rules, 
501.10 	part 9505.0371, subpart 5, item A, and that assumes comprehensive clinical responsibility 
501.11 	for clients. Based on professional qualifications and client needs, clinically qualified core 
501.12 	team members are assigned on a rotating basis as the client's lead worker to coordinate a 
501.13 	client's care. The core team must comprise at least four full-time equivalent direct care staff 
501.14 	and must minimally include, but is not limited to:
501.15 	(i) an independently licensed a mental health professional, qualified under Minnesota 
501.16 	Rules, part 9505.0371, subpart 5, item A, who serves as team leader to provide administrative 
501.17 	direction and clinical treatment supervision to the team;
501.18 	(ii) an advanced-practice registered nurse with certification in psychiatric or mental 
501.19 	health care or a board-certified child and adolescent psychiatrist, either of which must be 
501.20 	credentialed to prescribe medications;
501.21 	(iii) a licensed alcohol and drug counselor who is also trained in mental health 
501.22 	interventions; and
501.23 	(iv) a mental health certified peer specialist as defined in subdivision 2, paragraph (h)
501.24 	who is qualified according to section 245I.04, subdivision 10, and is also a former children's 
501.25 	mental health consumer.
501.26 	(2) The core team may also include any of the following:
501.27 	(i) additional mental health professionals;
501.28 	(ii) a vocational specialist;
501.29 	(iii) an educational specialist with knowledge and experience working with youth 
501.30 	regarding special education requirements and goals, special education plans, and coordination 
501.31 	of educational activities with health care activities;
501.32 	(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;
502.1 	(v) a clinical trainee qualified according to section 245I.04, subdivision 6;
502.2 	(vi) a mental health practitioner, as defined in section 245.4871, subdivision 26 qualified 
502.3 	according to section 245I.04, subdivision 4;
502.4 	(vi) (vii) a case management service provider, as defined in section 245.4871, subdivision 
502.5 	4;
502.6 	(vii) (viii) a housing access specialist; and
502.7 	(viii) (ix) a family peer specialist as defined in subdivision 2, paragraph (m).
502.8 	(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc 
502.9 	members not employed by the team who consult on a specific client and who must accept 
502.10 	overall clinical direction from the treatment team for the duration of the client's placement 
502.11 	with the treatment team and must be paid by the provider agency at the rate for a typical 
502.12 	session by that provider with that client or at a rate negotiated with the client-specific 
502.13 	member. Client-specific treatment team members may include:
502.14 	(i) the mental health professional treating the client prior to placement with the treatment 
502.15 	team;
502.16 	(ii) the client's current substance abuse use counselor, if applicable;
502.17 	(iii) a lead member of the client's individualized education program team or school-based 
502.18 	mental health provider, if applicable;
502.19 	(iv) a representative from the client's health care home or primary care clinic, as needed 
502.20 	to ensure integration of medical and behavioral health care;
502.21 	(v) the client's probation officer or other juvenile justice representative, if applicable; 
502.22 	and
502.23 	(vi) the client's current vocational or employment counselor, if applicable.
502.24 	(c) The clinical treatment supervisor shall be an active member of the treatment team 
502.25 	and shall function as a practicing clinician at least on a part-time basis. The treatment team 
502.26 	shall meet with the clinical treatment supervisor at least weekly to discuss recipients' progress 
502.27 	and make rapid adjustments to meet recipients' needs. The team meeting must include 
502.28 	client-specific case reviews and general treatment discussions among team members. 
502.29 	Client-specific case reviews and planning must be documented in the individual client's 
502.30 	treatment record.
502.31 	(d) The staffing ratio must not exceed ten clients to one full-time equivalent treatment 
502.32 	team position.
503.1 	(e) The treatment team shall serve no more than 80 clients at any one time. Should local 
503.2 	demand exceed the team's capacity, an additional team must be established rather than 
503.3 	exceed this limit.
503.4 	(f) Nonclinical staff shall have prompt access in person or by telephone to a mental 
503.5 	health practitioner, clinical trainee, or mental health professional. The provider shall have 
503.6 	the capacity to promptly and appropriately respond to emergent needs and make any 
503.7 	necessary staffing adjustments to ensure the health and safety of clients.
503.8 	(g) The intensive nonresidential rehabilitative mental health services provider shall 
503.9 	participate in evaluation of the assertive community treatment for youth (Youth ACT) model 
503.10 	as conducted by the commissioner, including the collection and reporting of data and the 
503.11 	reporting of performance measures as specified by contract with the commissioner.
503.12 	(h) A regional treatment team may serve multiple counties.

503.13 	Sec. 102. Minnesota Statutes 2020, section 256B.0947, subdivision 6, is amended to read:
503.14 		Subd. 6.Service standards. The standards in this subdivision apply to intensive 
503.15 	nonresidential rehabilitative mental health services.
503.16 	(a) The treatment team must use team treatment, not an individual treatment model.
503.17 	(b) Services must be available at times that meet client needs.
503.18 	(c) Services must be age-appropriate and meet the specific needs of the client.
503.19 	(d) The initial functional assessment must be completed within ten days of intake and
503.20 	level of care assessment as defined in section 245I.02, subdivision 19, and functional 
503.21 	assessment as defined in section 245I.02, subdivision 17, must be updated at least every six 
503.22 	months90 days or prior to discharge from the service, whichever comes first.
503.23 	(e) The treatment team must complete an individual treatment plan must for each client, 
503.24 	according to section 245I.10, subdivisions 7 and 8, and the individual treatment plan must:
503.25 	(1) be based on the information in the client's diagnostic assessment and baselines;
503.26 	(2) identify goals and objectives of treatment, a treatment strategy, a schedule for 
503.27 	accomplishing treatment goals and objectives, and the individuals responsible for providing 
503.28 	treatment services and supports;
503.29 	(3) be developed after completion of the client's diagnostic assessment by a mental health 
503.30 	professional or clinical trainee and before the provision of children's therapeutic services 
503.31 	and supports;
504.1 	(4) be developed through a child-centered, family-driven, culturally appropriate planning 
504.2 	process, including allowing parents and guardians to observe or participate in individual 
504.3 	and family treatment services, assessments, and treatment planning;
504.4 	(5) be reviewed at least once every six months and revised to document treatment progress 
504.5 	on each treatment objective and next goals or, if progress is not documented, to document 
504.6 	changes in treatment;
504.7 	(6) be signed by the clinical supervisor and by the client or by the client's parent or other 
504.8 	person authorized by statute to consent to mental health services for the client. A client's 
504.9 	parent may approve the client's individual treatment plan by secure electronic signature or 
504.10 	by documented oral approval that is later verified by written signature;
504.11 	(7) (1) be completed in consultation with the client's current therapist and key providers 
504.12 	and provide for ongoing consultation with the client's current therapist to ensure therapeutic 
504.13 	continuity and to facilitate the client's return to the community. For clients under the age of 
504.14 	18, the treatment team must consult with parents and guardians in developing the treatment 
504.15 	plan;
504.16 	(8) (2) if a need for substance use disorder treatment is indicated by validated assessment:
504.17 	(i) identify goals, objectives, and strategies of substance use disorder treatment;
504.18 	(ii) develop a schedule for accomplishing substance use disorder treatment goals and 
504.19 	objectives; and
504.20 	(iii) identify the individuals responsible for providing substance use disorder treatment 
504.21 	services and supports;
504.22 	(ii) be reviewed at least once every 90 days and revised, if necessary;
504.23 	(9) be signed by the clinical supervisor and by the client and, if the client is a minor, by 
504.24 	the client's parent or other person authorized by statute to consent to mental health treatment 
504.25 	and substance use disorder treatment for the client; and
504.26 	(10) (3) provide for the client's transition out of intensive nonresidential rehabilitative 
504.27 	mental health services by defining the team's actions to assist the client and subsequent 
504.28 	providers in the transition to less intensive or "stepped down" services.; and
504.29 	(4) notwithstanding section 245I.10, subdivision 8, be reviewed at least every 90 days 
504.30 	and revised to document treatment progress or, if progress is not documented, to document 
504.31 	changes in treatment.
505.1 	(f) The treatment team shall actively and assertively engage the client's family members 
505.2 	and significant others by establishing communication and collaboration with the family and 
505.3 	significant others and educating the family and significant others about the client's mental 
505.4 	illness, symptom management, and the family's role in treatment, unless the team knows or 
505.5 	has reason to suspect that the client has suffered or faces a threat of suffering any physical 
505.6 	or mental injury, abuse, or neglect from a family member or significant other.
505.7 	(g) For a client age 18 or older, the treatment team may disclose to a family member, 
505.8 	other relative, or a close personal friend of the client, or other person identified by the client, 
505.9 	the protected health information directly relevant to such person's involvement with the 
505.10 	client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the 
505.11 	client is present, the treatment team shall obtain the client's agreement, provide the client 
505.12 	with an opportunity to object, or reasonably infer from the circumstances, based on the 
505.13 	exercise of professional judgment, that the client does not object. If the client is not present 
505.14 	or is unable, by incapacity or emergency circumstances, to agree or object, the treatment 
505.15 	team may, in the exercise of professional judgment, determine whether the disclosure is in 
505.16 	the best interests of the client and, if so, disclose only the protected health information that 
505.17 	is directly relevant to the family member's, relative's, friend's, or client-identified person's 
505.18 	involvement with the client's health care. The client may orally agree or object to the 
505.19 	disclosure and may prohibit or restrict disclosure to specific individuals.
505.20 	(h) The treatment team shall provide interventions to promote positive interpersonal 
505.21 	relationships.

505.22 	Sec. 103. Minnesota Statutes 2020, section 256B.0947, subdivision 7, is amended to read:
505.23 		Subd. 7.Medical assistance payment and rate setting. (a) Payment for services in this 
505.24 	section must be based on one daily encounter rate per provider inclusive of the following 
505.25 	services received by an eligible client in a given calendar day: all rehabilitative services, 
505.26 	supports, and ancillary activities under this section, staff travel time to provide rehabilitative 
505.27 	services under this section, and crisis response services under section 256B.0944 256B.0624.
505.28 	(b) Payment must not be made to more than one entity for each client for services 
505.29 	provided under this section on a given day. If services under this section are provided by a 
505.30 	team that includes staff from more than one entity, the team shall determine how to distribute 
505.31 	the payment among the members.
505.32 	(c) The commissioner shall establish regional cost-based rates for entities that will bill 
505.33 	medical assistance for nonresidential intensive rehabilitative mental health services. In 
505.34 	developing these rates, the commissioner shall consider:
506.1 	(1) the cost for similar services in the health care trade area;
506.2 	(2) actual costs incurred by entities providing the services;
506.3 	(3) the intensity and frequency of services to be provided to each client;
506.4 	(4) the degree to which clients will receive services other than services under this section; 
506.5 	and
506.6 	(5) the costs of other services that will be separately reimbursed.
506.7 	(d) The rate for a provider must not exceed the rate charged by that provider for the 
506.8 	same service to other payers.

506.9 	Sec. 104. Minnesota Statutes 2020, section 256B.0949, subdivision 2, is amended to read:
506.10 		Subd. 2.Definitions. (a) The terms used in this section have the meanings given in this 
506.11 	subdivision.
506.12 	(b) "Agency" means the legal entity that is enrolled with Minnesota health care programs 
506.13 	as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide 
506.14 	EIDBI services and that has the legal responsibility to ensure that its employees or contractors 
506.15 	carry out the responsibilities defined in this section. Agency includes a licensed individual 
506.16 	professional who practices independently and acts as an agency.
506.17 	(c) "Autism spectrum disorder or a related condition" or "ASD or a related condition" 
506.18 	means either autism spectrum disorder (ASD) as defined in the current version of the 
506.19 	Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found 
506.20 	to be closely related to ASD, as identified under the current version of the DSM, and meets 
506.21 	all of the following criteria:
506.22 	(1) is severe and chronic;
506.23 	(2) results in impairment of adaptive behavior and function similar to that of a person 
506.24 	with ASD;
506.25 	(3) requires treatment or services similar to those required for a person with ASD; and
506.26 	(4) results in substantial functional limitations in three core developmental deficits of 
506.27 	ASD: social or interpersonal interaction; functional communication, including nonverbal 
506.28 	or social communication; and restrictive or repetitive behaviors or hyperreactivity or 
506.29 	hyporeactivity to sensory input; and may include deficits or a high level of support in one 
506.30 	or more of the following domains:
506.31 	(i) behavioral challenges and self-regulation;
507.1 	(ii) cognition;
507.2 	(iii) learning and play;
507.3 	(iv) self-care; or
507.4 	(v) safety.
507.5 	(d) "Person" means a person under 21 years of age.
507.6 	(e) "Clinical supervision" means the overall responsibility for the control and direction 
507.7 	of EIDBI service delivery, including individual treatment planning, staff supervision, 
507.8 	individual treatment plan progress monitoring, and treatment review for each person. Clinical 
507.9 	supervision is provided by a qualified supervising professional (QSP) who takes full 
507.10 	professional responsibility for the service provided by each supervisee.
507.11 	(f) "Commissioner" means the commissioner of human services, unless otherwise 
507.12 	specified.
507.13 	(g) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive 
507.14 	evaluation of a person to determine medical necessity for EIDBI services based on the 
507.15 	requirements in subdivision 5.
507.16 	(h) "Department" means the Department of Human Services, unless otherwise specified.
507.17 	(i) "Early intensive developmental and behavioral intervention benefit" or "EIDBI 
507.18 	benefit" means a variety of individualized, intensive treatment modalities approved and 
507.19 	published by the commissioner that are based in behavioral and developmental science 
507.20 	consistent with best practices on effectiveness.
507.21 	(j) "Generalizable goals" means results or gains that are observed during a variety of 
507.22 	activities over time with different people, such as providers, family members, other adults, 
507.23 	and people, and in different environments including, but not limited to, clinics, homes, 
507.24 	schools, and the community.
507.25 	(k) "Incident" means when any of the following occur:
507.26 	(1) an illness, accident, or injury that requires first aid treatment;
507.27 	(2) a bump or blow to the head; or
507.28 	(3) an unusual or unexpected event that jeopardizes the safety of a person or staff, 
507.29 	including a person leaving the agency unattended.
507.30 	(l) "Individual treatment plan" or "ITP" means the person-centered, individualized written 
507.31 	plan of care that integrates and coordinates person and family information from the CMDE 
508.1 	for a person who meets medical necessity for the EIDBI benefit. An individual treatment 
508.2 	plan must meet the standards in subdivision 6.
508.3 	(m) "Legal representative" means the parent of a child who is under 18 years of age, a 
508.4 	court-appointed guardian, or other representative with legal authority to make decisions 
508.5 	about service for a person. For the purpose of this subdivision, "other representative with 
508.6 	legal authority to make decisions" includes a health care agent or an attorney-in-fact 
508.7 	authorized through a health care directive or power of attorney.
508.8 	(n) "Mental health professional" has the meaning given in means a staff person who is 
508.9 	qualified according to section 245.4871, subdivision 27, clauses (1) to (6) 245I.04, 
508.10 	subdivision 2.
508.11 	(o) "Person-centered" means a service that both responds to the identified needs, interests, 
508.12 	values, preferences, and desired outcomes of the person or the person's legal representative 
508.13 	and respects the person's history, dignity, and cultural background and allows inclusion and 
508.14 	participation in the person's community.
508.15 	(p) "Qualified EIDBI provider" means a person who is a QSP or a level I, level II, or 
508.16 	level III treatment provider.

508.17 	Sec. 105. Minnesota Statutes 2020, section 256B.0949, subdivision 4, is amended to read:
508.18 		Subd. 4.Diagnosis. (a) A diagnosis of ASD or a related condition must:
508.19 	(1) be based upon current DSM criteria including direct observations of the person and 
508.20 	information from the person's legal representative or primary caregivers;
508.21 	(2) be completed by either (i) a licensed physician or advanced practice registered nurse 
508.22 	or (ii) a mental health professional; and
508.23 	(3) meet the requirements of Minnesota Rules, part 9505.0372, subpart 1, items B and 
508.24 	C a standard diagnostic assessment according to section 245I.10, subdivision 6.
508.25 	(b) Additional assessment information may be considered to complete a diagnostic 
508.26 	assessment including specialized tests administered through special education evaluations 
508.27 	and licensed school personnel, and from professionals licensed in the fields of medicine, 
508.28 	speech and language, psychology, occupational therapy, and physical therapy. A diagnostic 
508.29 	assessment may include treatment recommendations.

509.1 	Sec. 106. Minnesota Statutes 2020, section 256B.0949, subdivision 5a, is amended to 
509.2 	read:
509.3 		Subd. 5a.Comprehensive multidisciplinary evaluation provider qualification. A 
509.4 	CMDE provider must:
509.5 	(1) be a licensed physician, advanced practice registered nurse, a mental health 
509.6 	professional, or a mental health practitioner who meets the requirements of a clinical trainee 
509.7 	as defined in Minnesota Rules, part 9505.0371, subpart 5, item C who is qualified according 
509.8 	to section 245I.04, subdivision 6;
509.9 	(2) have at least 2,000 hours of clinical experience in the evaluation and treatment of 
509.10 	people with ASD or a related condition or equivalent documented coursework at the graduate 
509.11 	level by an accredited university in the following content areas: ASD or a related condition 
509.12 	diagnosis, ASD or a related condition treatment strategies, and child development; and
509.13 	(3) be able to diagnose, evaluate, or provide treatment within the provider's scope of 
509.14 	practice and professional license.

509.15 	Sec. 107. Minnesota Statutes 2020, section 256B.25, subdivision 3, is amended to read:
509.16 		Subd. 3.Payment exceptions. The limitation in subdivision 2 shall not apply to:
509.17 	(1) payment of Minnesota supplemental assistance funds to recipients who reside in 
509.18 	facilities which are involved in litigation contesting their designation as an institution for 
509.19 	treatment of mental disease;
509.20 	(2) payment or grants to a boarding care home or supervised living facility licensed by 
509.21 	the Department of Human Services under Minnesota Rules, parts 2960.0130 to 2960.0220 
509.22 	or,2960.0580 to 2960.0700, or9520.0500 to 9520.0670, or under chapter 245G or 245I, 
509.23 	or payment to recipients who reside in these facilities;
509.24 	(3) payments or grants to a boarding care home or supervised living facility which are 
509.25 	ineligible for certification under United States Code, title 42, sections 1396-1396p;
509.26 	(4) payments or grants otherwise specifically authorized by statute or rule.

509.27 	Sec. 108. Minnesota Statutes 2020, section 256B.761, is amended to read:
509.28 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
509.29 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
509.30 	management provided to psychiatric patients, outpatient mental health services, day treatment 
509.31 	services, home-based mental health services, and family community support services shall 
510.1 	be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 
510.2 	1999 charges.
510.3 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
510.4 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
510.5 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, 
510.6 	with at least 33 percent of the clients receiving rehabilitation services in the most recent 
510.7 	calendar year who are medical assistance recipients, will be increased by 38 percent, when 
510.8 	those services are provided within the comprehensive outpatient rehabilitation facility and 
510.9 	provided to residents of nursing facilities owned by the entity.
510.10 	(c) The commissioner shall establish three levels of payment for mental health diagnostic 
510.11 	assessment, based on three levels of complexity. The aggregate payment under the tiered 
510.12 	rates must not exceed the projected aggregate payments for mental health diagnostic 
510.13 	assessment under the previous single rate. The new rate structure is effective January 1, 
510.14 	2011, or upon federal approval, whichever is later.
510.15 	(d) (c) In addition to rate increases otherwise provided, the commissioner may restructure 
510.16 	coverage policy and rates to improve access to adult rehabilitative mental health services 
510.17 	under section 256B.0623 and related mental health support services under section 256B.021, 
510.18 	subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected 
510.19 	state share of increased costs due to this paragraph is transferred from adult mental health 
510.20 	grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent 
510.21 	base adjustment for subsequent fiscal years. Payments made to managed care plans and 
510.22 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
510.23 	the rate changes described in this paragraph.
510.24 	(e) (d) Any ratables effective before July 1, 2015, do not apply to early intensive 
510.25 	developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

510.26 	Sec. 109. Minnesota Statutes 2020, section 256B.763, is amended to read:
510.27 	256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
510.28 	(a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment 
510.29 	rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:
510.30 	(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
510.31 	(2) community mental health centers under section 256B.0625, subdivision 5; and
511.1 	(3) mental health clinics and centers certified under Minnesota Rules, parts 9520.0750 
511.2 	to 9520.0870 section 245I.20, or hospital outpatient psychiatric departments that are 
511.3 	designated as essential community providers under section 62Q.19.
511.4 	(b) This increase applies to group skills training when provided as a component of 
511.5 	children's therapeutic services and support, psychotherapy, medication management, 
511.6 	evaluation and management, diagnostic assessment, explanation of findings, psychological 
511.7 	testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.
511.8 	(c) This increase does not apply to rates that are governed by section 256B.0625, 
511.9 	subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated 
511.10 	with the county, rates that are established by the federal government, or rates that increased 
511.11 	between January 1, 2004, and January 1, 2005.
511.12 	(d) The commissioner shall adjust rates paid to prepaid health plans under contract with 
511.13 	the commissioner to reflect the rate increases provided in paragraphs (a), (e), and (f). The 
511.14 	prepaid health plan must pass this rate increase to the providers identified in paragraphs (a), 
511.15 	(e), (f), and (g).
511.16 	(e) Payment rates shall be increased by 23.7 percent over the rates in effect on December 
511.17 	31, 2007, for:
511.18 	(1) medication education services provided on or after January 1, 2008, by adult 
511.19 	rehabilitative mental health services providers certified under section 256B.0623; and
511.20 	(2) mental health behavioral aide services provided on or after January 1, 2008, by 
511.21 	children's therapeutic services and support providers certified under section 256B.0943.
511.22 	(f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by 
511.23 	children's therapeutic services and support providers certified under section 256B.0943 and 
511.24 	not already included in paragraph (a), payment rates shall be increased by 23.7 percent over 
511.25 	the rates in effect on December 31, 2007.
511.26 	(g) Payment rates shall be increased by 2.3 percent over the rates in effect on December 
511.27 	31, 2007, for individual and family skills training provided on or after January 1, 2008, by 
511.28 	children's therapeutic services and support providers certified under section 256B.0943.
511.29 	(h) For services described in paragraphs (b), (e), and (g) and rendered on or after July 
511.30 	1, 2017, payment rates for mental health clinics and centers certified under Minnesota Rules, 
511.31 	parts 9520.0750 to 9520.0870 section 245I.20, that are not designated as essential community 
511.32 	providers under section 62Q.19 shall be equal to payment rates for mental health clinics 
511.33 	and centers certified under Minnesota Rules, parts 9520.0750 to 9520.0870 section 245I.20, 
512.1 	that are designated as essential community providers under section 62Q.19. In order to 
512.2 	receive increased payment rates under this paragraph, a provider must demonstrate a 
512.3 	commitment to serve low-income and underserved populations by:
512.4 	(1) charging for services on a sliding-fee schedule based on current poverty income 
512.5 	guidelines; and
512.6 	(2) not restricting access or services because of a client's financial limitation.

512.7 	Sec. 110. Minnesota Statutes 2020, section 256P.01, subdivision 6a, is amended to read:
512.8 		Subd. 6a.Qualified professional. (a) For illness, injury, or incapacity, a "qualified 
512.9 	professional" means a licensed physician, physician assistant, advanced practice registered 
512.10 	nurse, physical therapist, occupational therapist, or licensed chiropractor, according to their 
512.11 	scope of practice.
512.12 	(b) For developmental disability, learning disability, and intelligence testing, a "qualified 
512.13 	professional" means a licensed physician, physician assistant, advanced practice registered 
512.14 	nurse, licensed independent clinical social worker, licensed psychologist, certified school 
512.15 	psychologist, or certified psychometrist working under the supervision of a licensed 
512.16 	psychologist.
512.17 	(c) For mental health, a "qualified professional" means a licensed physician, advanced 
512.18 	practice registered nurse, or qualified mental health professional under section 245.462, 
512.19 	subdivision 18, clauses (1) to (6) 245I.04, subdivision 2.
512.20 	(d) For substance use disorder, a "qualified professional" means a licensed physician, a 
512.21 	qualified mental health professional under section 245.462, subdivision 18, clauses (1) to 
512.22 	(6), or an individual as defined in section 245G.11, subdivision 3, 4, or 5.

512.23 	Sec. 111. Minnesota Statutes 2020, section 295.50, subdivision 9b, is amended to read:
512.24 		Subd. 9b.Patient services. (a) "Patient services" means inpatient and outpatient services 
512.25 	and other goods and services provided by hospitals, surgical centers, or health care providers. 
512.26 	They include the following health care goods and services provided to a patient or consumer:
512.27 	(1) bed and board;
512.28 	(2) nursing services and other related services;
512.29 	(3) use of hospitals, surgical centers, or health care provider facilities;
512.30 	(4) medical social services;
513.1 	(5) drugs, biologicals, supplies, appliances, and equipment;
513.2 	(6) other diagnostic or therapeutic items or services;
513.3 	(7) medical or surgical services;
513.4 	(8) items and services furnished to ambulatory patients not requiring emergency care; 
513.5 	and
513.6 	(9) emergency services.
513.7 	(b) "Patient services" does not include:
513.8 	(1) services provided to nursing homes licensed under chapter 144A;
513.9 	(2) examinations for purposes of utilization reviews, insurance claims or eligibility, 
513.10 	litigation, and employment, including reviews of medical records for those purposes;
513.11 	(3) services provided to and by community residential mental health facilities licensed 
513.12 	under section 245I.23 or Minnesota Rules, parts 9520.0500 to 9520.0670, and to and by 
513.13 	residential treatment programs for children with severe emotional disturbance licensed or 
513.14 	certified under chapter 245A;
513.15 	(4) services provided under the following programs: day treatment services as defined 
513.16 	in section 245.462, subdivision 8; assertive community treatment as described in section 
513.17 	256B.0622; adult rehabilitative mental health services as described in section 256B.0623; 
513.18 	adult crisis response services as described in section 256B.0624; and children's therapeutic 
513.19 	services and supports as described in section 256B.0943; and children's mental health crisis 
513.20 	response services as described in section 256B.0944;
513.21 	(5) services provided to and by community mental health centers as defined in section 
513.22 	245.62, subdivision 2;
513.23 	(6) services provided to and by assisted living programs and congregate housing 
513.24 	programs;
513.25 	(7) hospice care services;
513.26 	(8) home and community-based waivered services under chapter 256S and sections 
513.27 	256B.49 and 256B.501;
513.28 	(9) targeted case management services under sections 256B.0621; 256B.0625, 
513.29 	subdivisions 20, 20a, 33, and 44; and 256B.094; and
513.30 	(10) services provided to the following: supervised living facilities for persons with 
513.31 	developmental disabilities licensed under Minnesota Rules, parts 4665.0100 to 4665.9900; 
514.1 	housing with services establishments required to be registered under chapter 144D; board 
514.2 	and lodging establishments providing only custodial services that are licensed under chapter 
514.3 	157 and registered under section 157.17 to provide supportive services or health supervision 
514.4 	services; adult foster homes as defined in Minnesota Rules, part 9555.5105; day training 
514.5 	and habilitation services for adults with developmental disabilities as defined in section 
514.6 	252.41, subdivision 3; boarding care homes as defined in Minnesota Rules, part 4655.0100; 
514.7 	adult day care services as defined in section 245A.02, subdivision 2a; and home health 
514.8 	agencies as defined in Minnesota Rules, part 9505.0175, subpart 15, or licensed under 
514.9 	chapter 144A.

514.10 	Sec. 112. Minnesota Statutes 2020, section 325F.721, subdivision 1, is amended to read:
514.11 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
514.12 	the meanings given them.
514.13 	(b) "Covered setting" means an unlicensed setting providing sleeping accommodations 
514.14 	to one or more adult residents, at least 80 percent of which are 55 years of age or older, and 
514.15 	offering or providing, for a fee, supportive services. For the purposes of this section, covered 
514.16 	setting does not mean:
514.17 	(1) emergency shelter, transitional housing, or any other residential units serving 
514.18 	exclusively or primarily homeless individuals, as defined under section 116L.361;
514.19 	(2) a nursing home licensed under chapter 144A;
514.20 	(3) a hospital, certified boarding care, or supervised living facility licensed under sections 
514.21 	144.50 to 144.56;
514.22 	(4) a lodging establishment licensed under chapter 157 and Minnesota Rules, parts 
514.23 	9520.0500 to 9520.0670, or under chapter 245Dor,245G, or 245I;
514.24 	(5) services and residential settings licensed under chapter 245A, including adult foster 
514.25 	care and services and settings governed under the standards in chapter 245D;
514.26 	(6) private homes in which the residents are related by kinship, law, or affinity with the 
514.27 	providers of services;
514.28 	(7) a duly organized condominium, cooperative, and common interest community, or 
514.29 	owners' association of the condominium, cooperative, and common interest community 
514.30 	where at least 80 percent of the units that comprise the condominium, cooperative, or 
514.31 	common interest community are occupied by individuals who are the owners, members, or 
514.32 	shareholders of the units;
515.1 	(8) temporary family health care dwellings as defined in sections 394.307 and 462.3593;
515.2 	(9) settings offering services conducted by and for the adherents of any recognized 
515.3 	church or religious denomination for its members exclusively through spiritual means or 
515.4 	by prayer for healing;
515.5 	(10) housing financed pursuant to sections 462A.37 and 462A.375, units financed with 
515.6 	low-income housing tax credits pursuant to United States Code, title 26, section 42, and 
515.7 	units financed by the Minnesota Housing Finance Agency that are intended to serve 
515.8 	individuals with disabilities or individuals who are homeless, except for those developments 
515.9 	that market or hold themselves out as assisted living facilities and provide assisted living 
515.10 	services;
515.11 	(11) rental housing developed under United States Code, title 42, section 1437, or United 
515.12 	States Code, title 12, section 1701q;
515.13 	(12) rental housing designated for occupancy by only elderly or elderly and disabled 
515.14 	residents under United States Code, title 42, section 1437e, or rental housing for qualifying 
515.15 	families under Code of Federal Regulations, title 24, section 983.56;
515.16 	(13) rental housing funded under United States Code, title 42, chapter 89, or United 
515.17 	States Code, title 42, section 8011; or
515.18 	(14) an assisted living facility licensed under chapter 144G.
515.19 	(c) "'I'm okay' check services" means providing a service to, by any means, check on 
515.20 	the safety of a resident.
515.21 	(d) "Resident" means a person entering into written contract for housing and services 
515.22 	with a covered setting.
515.23 	(e) "Supportive services" means:
515.24 	(1) assistance with laundry, shopping, and household chores;
515.25 	(2) housekeeping services;
515.26 	(3) provision of meals or assistance with meals or food preparation;
515.27 	(4) help with arranging, or arranging transportation to, medical, social, recreational, 
515.28 	personal, or social services appointments; or
515.29 	(5) provision of social or recreational services.
515.30 	Arranging for services does not include making referrals or contacting a service provider 
515.31 	in an emergency.

516.1 	Sec. 113. REPEALER.
 516.2 	(a) Minnesota Statutes 2020, sections 245.462, subdivision 4a; 245.4879, subdivision 
516.3 	2; 245.62, subdivisions 3 and 4; 245.69, subdivision 2; 256B.0615, subdivision 2; 256B.0616, 
516.4 	subdivision 2; 256B.0622, subdivisions 3 and 5a; 256B.0623, subdivisions 7, 8, 10, and 11; 
516.5 	256B.0625, subdivisions 5l, 35a, 35b, 61, 62, and 65; 256B.0943, subdivisions 8 and 10; 
516.6 	256B.0944; and 256B.0946, subdivision 5, are repealed.
516.7 	(b) Minnesota Rules, parts 9505.0370; 9505.0371; 9505.0372; 9520.0010; 9520.0020; 
516.8 	9520.0030; 9520.0040; 9520.0050; 9520.0060; 9520.0070; 9520.0080; 9520.0090; 
516.9 	9520.0100; 9520.0110; 9520.0120; 9520.0130; 9520.0140; 9520.0150; 9520.0160; 
516.10 	9520.0170; 9520.0180; 9520.0190; 9520.0200; 9520.0210; 9520.0230; 9520.0750; 
516.11 	9520.0760; 9520.0770; 9520.0780; 9520.0790; 9520.0800; 9520.0810; 9520.0820; 
516.12 	9520.0830; 9520.0840; 9520.0850; 9520.0860; and 9520.0870, are repealed.

516.13 	Sec. 114. EFFECTIVE DATE.
 516.14 	Unless otherwise stated, this article is effective July 1, 2022, or upon federal approval, 
516.15 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
516.16 	when federal approval is obtained.

516.17 	ARTICLE 18
516.18 	FORECAST ADJUSTMENTS

516.19	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
 	
516.20 	The dollar amounts shown in the columns marked "Appropriations" are added to or, if 
516.21 	shown in parentheses, are subtracted from the appropriations in Laws 2019, First Special 
516.22 	Session chapter 9, article 14, from the general fund, or any other fund named, to the 
516.23 	commissioner of human services for the purposes specified in this article, to be available 
516.24 	for the fiscal year indicated for each purpose. The figure "2021" used in this article means 
516.25 	that the appropriations listed are available for the fiscal year ending June 30, 2021.

516.26				APPROPRIATIONS
	
516.27				Available for the Year
	
516.28				Ending June 30
	
516.29					2021

516.30
516.31	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

516.32	Subdivision 1.Total Appropriation
 	$
	(816,996,000)

517.1	Appropriations by Fund
	
517.2		2021
		
517.3	General
	(745,266,000)
		
517.4	Health Care Access
	(36,893,000)
		
517.5	Federal TANF
	(34,837,000)

517.6	Subd. 2.Forecasted Programs
 					
517.7
517.8
517.9517.10
	(a) Minnesota Family 
Investment Program 
(MFIP)/Diversionary Work 
Program (DWP)

517.11	Appropriations by Fund
	
517.12		2021
		
517.13	General
	59,004,000
		
517.14	Federal TANF
	(34,843,000)

517.15	(b) MFIP Child Care Assistance
		(54,158,000)

517.16	(c) General Assistance
		3,925,000

517.17	(d) Minnesota Supplemental Aid
		3,849,000

517.18	(e) Housing Support
		3,022,000

517.19	(f) Northstar Care for Children
		(8,639,000)

517.20	(g) MinnesotaCare
		(36,893,000)
			
517.21 	This appropriation is from the health care 
517.22 	access fund.

517.23	(h) Medical Assistance

517.24	Appropriations by Fund
	
517.25		2021
		
517.26	General
	(694,938,000)
		
517.27	Health Care Access
	-0-

517.28	(i) Alternative Care
		247,000

517.29
517.30	(j) Consolidated Chemical Dependency 
Treatment Fund (CCDTF) Entitlement
		(57,578,000)

517.31	Subd. 3.Technical Activities
 		6,000
			
517.32 	This appropriation is from the federal TANF 
517.33 	fund.

518.1 	Sec. 3. EFFECTIVE DATE.
 518.2 	Sections 1 and 2 are effective the day following final enactment.

518.3 	ARTICLE 19
518.4 	EFFECTIVE DATES

518.5 	Section 1. EFFECTIVE DATES.
 518.6 	All sections in this act are effective July 1, 2021, unless another effective date is 
518.7 	specified.
518.8 	Delete the title and insert:
518.9 	A bill for an act
518.10 	relating to state government; modifying policy provisions governing health, health 
518.11 	care, human services, human services licensing and background studies, 
518.12 	health-related licensing boards, prescription drugs, health insurance, telehealth, 
518.13 	children and family services, behavioral health, disability services and continuing 
518.14 	care for older adults, community supports, and chemical and mental health services; 
518.15 	implementing mental health uniform service standards; making forecast 
518.16 	adjustments; making technical and conforming changes; requiring reports; 
518.17 	modifying appropriations;amending Minnesota Statutes 2020, sections 62A.152, 
518.18 	subdivision 3; 62A.3094, subdivision 1; 62J.495, subdivision 3; 62J.498; 62J.4981; 
518.19 	62J.4982; 62J.84, subdivisions 3, 4, 5, 6, 9; 62Q.096; 62W.11; 144.05, by adding 
518.20 	a subdivision; 144.1205, subdivisions 2, 4, 8, 9, by adding a subdivision; 144.1481, 
518.21 	subdivision 1; 144.1911, subdivision 6; 144.223; 144.225, subdivision 7; 144.651, 
518.22 	subdivision 2; 144D.01, subdivision 4; 144G.08, subdivision 7, as amended; 
518.23 	144G.84; 145.893, subdivision 1; 145.894; 145.897; 145.899; 148B.5301, 
518.24 	subdivision 2; 148E.120, subdivision 2; 148F.11, subdivision 1; 151.01, subdivision 
518.25 	29, by adding subdivisions; 151.555, subdivisions 1, 7, 11, by adding a subdivision; 
518.26 	151.72, subdivision 5; 152.22, subdivisions 6, 11, by adding a subdivision; 152.23; 
518.27 	152.26; 152.27, subdivisions 2, 3, 4; 152.28, subdivision 1; 152.29, subdivisions 
518.28 	1, 3, by adding subdivisions; 152.31; 157.22; 245.462, subdivisions 1, 6, 8, 9, 14, 
518.29 	16, 17, 18, 21, 23, by adding a subdivision; 245.4661, subdivision 5; 245.4662, 
518.30 	subdivision 1; 245.467, subdivisions 2, 3; 245.469, subdivisions 1, 2; 245.470, 
518.31 	subdivision 1; 245.4712, subdivision 2; 245.472, subdivision 2; 245.4863; 
518.32 	245.4871, subdivisions 9a, 10, 11a, 17, 21, 26, 27, 29, 31, 32, 34, by adding a 
518.33 	subdivision; 245.4874, subdivision 1; 245.4876, subdivisions 2, 3; 245.4879, 
518.34 	subdivision 1; 245.488, subdivision 1; 245.4885, subdivision 1; 245.4901, 
518.35 	subdivision 2; 245.62, subdivision 2; 245.697, subdivision 1; 245.735, subdivisions 
518.36 	3, 5, by adding a subdivision; 245A.02, by adding subdivisions; 245A.04, 
518.37 	subdivision 5; 245A.041, by adding a subdivision; 245A.043, subdivision 3; 
518.38 	245A.10, subdivision 4; 245A.65, subdivision 2; 245D.02, subdivision 20; 245F.04, 
518.39 	subdivision 2; 245G.03, subdivision 2; 252.43; 252A.01, subdivision 1; 252A.02, 
518.40 	subdivisions 2, 9, 11, 12, by adding subdivisions; 252A.03, subdivisions 3, 4; 
518.41 	252A.04, subdivisions 1, 2, 4; 252A.05; 252A.06, subdivisions 1, 2; 252A.07, 
518.42 	subdivisions 1, 2, 3; 252A.081, subdivisions 2, 3, 5; 252A.09, subdivisions 1, 2; 
518.43 	252A.101, subdivisions 2, 3, 5, 6, 7, 8; 252A.111, subdivisions 2, 4, 6; 252A.12; 
518.44 	252A.16; 252A.17; 252A.19, subdivisions 2, 4, 5, 7, 8; 252A.20; 252A.21, 
518.45 	subdivisions 2, 4; 254B.03, subdivision 2; 256.01, subdivision 14b, by adding a 
518.46 	subdivision; 256.0112, subdivision 6; 256.741, by adding subdivisions; 256.969, 
518.47 	subdivisions 2b, 9, by adding a subdivision; 256.9695, subdivision 1; 256.9741, 
518.48 	subdivision 1; 256.98, subdivision 1; 256.983; 256B.051, subdivisions 1, 3, 5, 6, 
518.49 	7, by adding a subdivision; 256B.057, subdivision 3; 256B.0615, subdivisions 1, 
519.1 	5; 256B.0616, subdivisions 1, 3, 5; 256B.0622, subdivisions 1, 2, 3a, 4, 7, 7a, 7b, 
519.2 	7d; 256B.0623, subdivisions 1, 2, 3, 4, 5, 6, 9, 12; 256B.0624; 256B.0625, 
519.3 	subdivisions 3b, 3c, 3d, 3e, 5, 5m, 19c, 28a, 30, 42, 48, 49, 56a; 256B.0638, 
519.4 	subdivisions 3, 5, 6; 256B.0659, subdivision 13; 256B.0757, subdivision 4c; 
519.5 	256B.0911, subdivision 3a; 256B.0941, subdivision 1; 256B.0943, subdivisions 
519.6 	1, 2, 3, 4, 5, 5a, 6, 7, 9, 11; 256B.0946, subdivisions 1, 1a, 2, 3, 4, 6; 256B.0947, 
519.7 	subdivisions 1, 2, 3, 3a, 5, 6, 7; 256B.0949, subdivisions 2, 4, 5a; 256B.196, 
519.8 	subdivision 2; 256B.25, subdivision 3; 256B.4912, subdivision 13; 256B.69, 
519.9 	subdivision 5a; 256B.6928, subdivision 5; 256B.761; 256B.763; 256B.85, 
519.10 	subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11b, 12, 12b, 13, 13a, 15, 17a, 18a, 
519.11 	20b, 23, 23a, by adding subdivisions; 256E.34, subdivision 1; 256I.05, subdivisions 
519.12 	1a, 11; 256J.08, subdivision 21; 256J.09, subdivision 3; 256J.30, subdivision 8; 
519.13 	256J.45, subdivision 1; 256J.626, subdivision 1; 256J.95, subdivision 5; 256L.01, 
519.14 	subdivision 5; 256L.03, subdivision 1; 256L.04, subdivision 7b; 256L.05, 
519.15 	subdivision 3a; 256N.02, subdivisions 16, 17; 256N.22, subdivision 1; 256N.23, 
519.16 	subdivisions 2, 6; 256N.24, subdivisions 1, 8, 11, 12, 14; 256N.25, subdivision 1, 
519.17 	by adding a subdivision; 256P.01, subdivision 6a; 259.22, subdivision 4; 259.241; 
519.18 	259.35, subdivision 1; 259.53, subdivision 4; 259.73; 259.75, subdivisions 5, 6, 
519.19 	9; 259.83, subdivision 1a; 259A.75, subdivisions 1, 2, 3, 4; 260C.007, subdivisions 
519.20 	22a, 26c, 31; 260C.157, subdivision 3; 260C.212, subdivisions 1, 1a, 2, 13, by 
519.21 	adding a subdivision; 260C.219, subdivision 5; 260C.4412; 260C.452; 260C.503, 
519.22 	subdivision 2; 260C.515, subdivision 3; 260C.605, subdivision 1; 260C.607, 
519.23 	subdivision 6; 260C.609; 260C.615; 260C.704; 260C.706; 260C.708; 260C.71; 
519.24 	260C.712; 260C.714; 260D.01; 260D.05; 260D.06, subdivision 2; 260D.07; 
519.25 	260D.08; 260D.14; 260E.20, subdivision 2; 260E.31, subdivision 1; 260E.33, by 
519.26 	adding a subdivision; 260E.36, by adding a subdivision; 295.50, subdivision 9b; 
519.27 	295.53, subdivision 1; 297E.02, subdivision 3; 325F.721, subdivision 1; 326.71, 
519.28 	subdivision 4; 326.75, subdivisions 1, 2, 3; 518.157, subdivisions 1, 3; 518.68, 
519.29 	subdivision 2; 518A.29; 518A.33; 518A.35, subdivisions 1, 2; 518A.39, subdivision 
519.30 	7; 518A.40, subdivision 4, by adding a subdivision; 518A.42; 518A.43, by adding 
519.31 	a subdivision; 518A.685; 548.091, subdivisions 1a, 2a, 3b, 9, 10; 549.09, 
519.32 	subdivision 1; Laws 2008, chapter 364, section 17; Laws 2019, First Special Session 
519.33 	chapter 9, article 14, section 3, as amended; Laws 2020, Seventh Special Session 
519.34 	chapter 1, article 6, section 12, subdivision 4; proposing coding for new law in 
519.35 	Minnesota Statutes, chapters 62A; 62Q; 145; 145A; 151; 245A; 256B; 363A; 
519.36 	518A; proposing coding for new law as Minnesota Statutes, chapter 245I; repealing 
519.37 	Minnesota Statutes 2020, sections 151.19, subdivision 3; 245.462, subdivision 4a; 
519.38 	245.4879, subdivision 2; 245.62, subdivisions 3, 4; 245.69, subdivision 2; 245.735, 
519.39 	subdivisions 1, 2, 4; 252.28, subdivisions 1, 5; 252A.02, subdivisions 8, 10; 
519.40 	252A.21, subdivision 3; 256B.0615, subdivision 2; 256B.0616, subdivision 2; 
519.41 	256B.0622, subdivisions 3, 5a; 256B.0623, subdivisions 7, 8, 10, 11; 256B.0625, 
519.42 	subdivisions 5l, 35a, 35b, 61, 62, 65; 256B.0943, subdivisions 8, 10; 256B.0944; 
519.43 	256B.0946, subdivision 5; Minnesota Rules, parts 9505.0370; 9505.0371; 
519.44 	9505.0372; 9520.0010; 9520.0020; 9520.0030; 9520.0040; 9520.0050; 9520.0060; 
519.45 	9520.0070; 9520.0080; 9520.0090; 9520.0100; 9520.0110; 9520.0120; 9520.0130; 
519.46 	9520.0140; 9520.0150; 9520.0160; 9520.0170; 9520.0180; 9520.0190; 9520.0200; 
519.47 	9520.0210; 9520.0230; 9520.0750; 9520.0760; 9520.0770; 9520.0780; 9520.0790; 
519.48 	9520.0800; 9520.0810; 9520.0820; 9520.0830; 9520.0840; 9520.0850; 9520.0860; 
519.49 	9520.0870; 9530.6800; 9530.6810.

520.1	We request the adoption of this report and repassage of the bill.
	
520.2	House Conferees:
........			
520.3	........
		........
	
520.4	Tina Liebling
		Jennifer Schultz
	
520.5	........
		........
	
520.6	Aisha Gomez
		Dave Pinto
	
520.7	........
			
520.8	Joe Schomacker
			
520.9	Senate Conferees:
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520.10	........
		........
	
520.11	Michelle Benson
		Jim Abeler
	
520.12	........
		........
	
520.13	Paul Utke
		Mark Koran
	
520.14	........
			
520.15	John Hoffman