Minnesota Legislature
HF 2434
1st Unofficial Engrossment - 94th Legislature (2025 - 2026) Posted on 05/08/2025 08:20am
2.29 2.30
2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24
3.25 3.26
3.27 3.28 3.29 3.30 3.31 3.32 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 6.34 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 8.34 8.35 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 9.35 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 11.34
12.1
12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15
14.16
14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25
14.26
14.27 14.28 14.29 14.30 14.31 14.32 15.1 15.2 15.3
15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25
15.26
15.27 15.28 15.29 15.30 15.31 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16
18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 19.1 19.2 19.3 19.4 19.5
19.6 19.7 19.8 19.9 19.10
19.11
19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30
20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 20.34 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 22.1 22.2 22.3 22.4
22.5
22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16
22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27
22.28
22.29 22.30 22.31 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9
23.10
23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18
23.19
23.20 23.21 23.22 23.23
23.24
23.25 23.26 23.27 23.28
23.29
24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28
24.29
24.30 24.31 24.32 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16
25.17
25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26
25.27
25.28 25.29 25.30 26.1 26.2 26.3 26.4 26.5 26.6 26.7
26.8
26.9 26.10 26.11 26.12 26.13 26.14 26.15
26.16
26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 28.1 28.2 28.3 28.4 28.5 28.6 28.7
28.8
28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 29.1 29.2
29.3
29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32
30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30
31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24
31.25 31.26 31.27 31.28 31.29 31.30 31.31 32.1 32.2
32.3
32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27
33.28
34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12
34.13
34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29
35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12
35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21
35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31
36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17
36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11
37.12 37.13 37.14 37.15 37.16 37.17
37.18 37.19 37.20
37.21 37.22
37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20
38.21 38.22 38.23
38.24 38.25 38.26 38.27 38.28 38.29 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33
40.1 40.2 40.3
40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22
40.23
40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24
41.25 41.26 41.27 41.28 41.29 41.30 41.31 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23
42.24
42.25 42.26 42.27 42.28 42.29 42.30 42.31
43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34
44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31
45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21
46.22
46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 48.1 48.2 48.3 48.4 48.5
48.6
48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23
49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29
51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16
52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30
54.1 54.2 54.3
54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 55.1 55.2
55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30
56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 57.33
58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 59.33 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28
61.29
61.30 61.31 61.32 61.33 61.34 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20
62.21
62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 63.1 63.2 63.3 63.4 63.5 63.6
63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11
64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28
65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26
65.27 65.28 65.29 65.30 65.31 65.32 65.33 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20
66.21 66.22 66.23
66.24 66.25 66.26 66.27 66.28
66.29
67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29
67.30 67.31 67.32
68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27
68.28
68.29 68.30 68.31 68.32 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16
69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31
70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30
71.31
72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13
74.14
74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26
76.27
76.28 76.29 76.30 76.31 76.32 76.33 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 77.33 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12
79.13
79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21
81.22
81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 82.1 82.2 82.3
82.4
82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17
82.18
82.19 82.20 82.21 82.22 82.23 82.24 82.25
82.26 82.27 82.28 82.29 82.30 82.31 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32
85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 86.1 86.2 86.3 86.4 86.5 86.6
86.7
86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25
86.26 86.27 86.28
86.29 86.30 86.31 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 88.33 89.1 89.2
89.3
89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22
89.23 89.24 89.25
89.26 89.27 89.28 89.29 89.30 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 90.30 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20
91.21
91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15
93.16
93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 95.1 95.2 95.3 95.4
95.5
95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31
97.1 97.2
97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26
98.27 98.28
98.29 98.30 98.31 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21
100.22 100.23
100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 103.1 103.2
103.3
103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 105.1 105.2 105.3 105.4 105.5
105.6
105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10
106.11 106.12 106.13
106.14 106.15 106.16 106.17
106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 109.33 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25
111.26 111.27 111.28 111.29 111.30 111.31 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18
112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31
113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32
114.1 114.2 114.3
114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28
114.29
114.30 114.31 114.32 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31
117.1
117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 118.1 118.2
118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 119.1 119.2 119.3 119.4 119.5 119.6 119.7
119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 120.1 120.2 120.3 120.4 120.5 120.6
120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28
121.29
122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 123.1 123.2 123.3 123.4
123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17
124.18
124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28
125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16
125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 126.1 126.2
126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 127.1
127.2 127.3 127.4
127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12
127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20
127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17
128.18
128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 129.1 129.2 129.3 129.4 129.5 129.6 129.7
129.8
129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17
130.18
130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30
130.31
131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27
132.28 132.29 132.30 132.31 132.32 133.1 133.2
133.3
133.4 133.5 133.6 133.7 133.8 133.9 133.10
133.11
133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10
134.11
134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28
134.29 134.30 134.31 134.32 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16
135.17 135.18 135.19 135.20
135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11
136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29
137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11
137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21
137.22 137.23 137.24 137.25 137.26 137.27
137.28 137.29 137.30
138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32
139.1 139.2 139.3 139.4 139.5 139.6 139.7
139.8
139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16
139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25
140.26
140.27 140.28 140.29 140.30 140.31 140.32 140.33 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25
141.26 141.27 141.28 141.29 141.30 141.31 142.1 142.2 142.3 142.4
142.5
142.6 142.7
142.8 142.9 142.10 142.11 142.12
142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16
143.17 143.18 143.19 143.20 143.21 143.22
143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 144.34 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16
145.17
145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 146.34 147.1 147.2
147.3
147.4 147.5 147.6 147.7 147.8 147.9 147.10
147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25
148.26
148.27 148.28 148.29 148.30 148.31 148.32 148.33 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12
149.13 149.14
149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24
149.25 149.26 149.27
149.28 149.29 149.30 149.31 149.32
150.1 150.2 150.3
150.4 150.5 150.6 150.7
150.8 150.9 150.10
150.11 150.12 150.13 150.14
150.15 150.16 150.17
150.18 150.19 150.20 150.21
150.22 150.23 150.24
150.25 150.26 150.27 150.28
151.1 151.2 151.3
151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16
151.17
151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17
152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 152.34 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 154.1 154.2 154.3 154.4 154.5 154.6
154.7 154.8 154.9
154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10
155.11 155.12 155.13
155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 156.1 156.2 156.3 156.4
156.5 156.6 156.7
156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26
156.27 156.28 156.29
157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18
157.19 157.20 157.21
157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 158.33 158.34 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18
159.19 159.20 159.21
159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29
160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15
160.16 160.17 160.18
160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28
160.29 160.30 160.31
161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12
161.13 161.14 161.15
161.16 161.17 161.18 161.19 161.20 161.21
161.22 161.23 161.24
161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15
163.16 163.17
163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 163.33 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 165.33 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27
166.28 166.29 166.30
167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 171.1 171.2 171.3 171.4 171.5 171.6
171.7
171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22 171.23
171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 172.1 172.2 172.3 172.4 172.5
172.6
172.7 172.8 172.9 172.10 172.11 172.12
172.13
172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 173.33 174.1 174.2 174.3 174.4 174.5 174.6
174.7 174.8 174.9
174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23
174.24 174.25
174.26 174.27 174.28 174.29 174.30 174.31 174.32 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 175.32 175.33 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22
176.23 176.24
176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25
177.26 177.27
177.28 177.29 177.30 177.31 177.32 177.33 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 178.34 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 179.33 179.34 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31
181.1 181.2 181.3
181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31
182.1 182.2 182.3
182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 183.1 183.2 183.3
183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 183.33 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31
184.32 184.33 184.34 184.35 185.1 185.2 185.3 185.4 185.5 185.6
185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15
185.16 185.17 185.18
185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29
186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33 186.34 186.35 186.36 186.37 186.38 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14
187.15 187.16 187.17 187.18
187.19 187.20 187.21
187.22
187.23 187.24
187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 187.33
188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9
188.10 188.11
188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 189.1 189.2
189.3
189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23
189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32 191.33 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16
194.17
194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32 194.33 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15
198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 199.1 199.2 199.3 199.4 199.5 199.6 199.7
199.8 199.9
199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21
199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30
200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 200.34 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8
202.9 202.10 202.11 202.12 202.13 202.14 202.15
202.16 202.17
202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23
203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 203.33 203.34 204.1 204.2
204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12
204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 205.1 205.2 205.3 205.4 205.5 205.6 205.7
205.8 205.9 205.10
205.11 205.12 205.13
205.14 205.15 205.16 205.17
205.18 205.19 205.20
205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29
206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18
206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 207.1 207.2
207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16
207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26
207.27 207.28 207.29 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16
209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11
210.12 210.13
210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27
210.28 210.29 210.30 210.31 211.1 211.2 211.3 211.4
211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13
211.14 211.15 211.16 211.17 211.18 211.19
211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 212.1 212.2 212.3 212.4 212.5 212.6 212.7
212.8 212.9
212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17
212.18 212.19 212.20 212.21 212.22 212.23 212.24
212.25 212.26 212.27
212.28 212.29 212.30 212.31 212.32 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8
213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21
213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29
213.30 213.31 213.32
214.1 214.2 214.3 214.4 214.5 214.6 214.7
214.8 214.9
214.10 214.11
214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24
215.25 215.26 215.27
216.1 216.2 216.3 216.4 216.5 216.6 216.7
216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30
216.31 216.32 216.33 217.1 217.2 217.3
217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21
218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20
219.21 219.22 219.23 219.24 219.25 219.26
219.27 219.28 219.29 219.30 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8
220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 220.32
221.1 221.2 221.3 221.4
221.5 221.6 221.7
221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29
222.1 222.2 222.3 222.4
222.5 222.6 222.7 222.8
222.9 222.10 222.11
222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24
222.25 222.26 222.27 222.28 222.29 222.30 222.31 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10
223.11 223.12 223.13 223.14 223.15
223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23
223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16
225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 225.34 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19
226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33
227.1 227.2 227.3 227.4
227.5 227.6 227.7
227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17
227.18 227.19 227.20 227.21
227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21
228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13
229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 229.34 229.35 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18
230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26
230.27 230.28 230.29 230.30 230.31 230.32 230.33 231.1 231.2 231.3 231.4 231.5 231.6 231.7
231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25
233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33
234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 235.33 235.34 235.35 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 236.34 236.35 236.36 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 237.33 237.34 237.35 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20
238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10
239.11 239.12 239.13 239.14 239.15 239.16 239.17
239.18 239.19 239.20 239.21
239.22 239.23
239.24 239.25
239.26 239.27 239.28 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 241.1 241.2 241.3 241.4 241.5 241.6 241.7
241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25
243.26 243.27 243.28 243.29 243.30 243.31 243.32 243.33 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 244.33 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11
246.12 246.13 246.14
246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26
247.27 247.28 247.29 247.30 247.31 247.32 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12
248.13 248.14 248.15 248.16 248.17 248.18 248.19
248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19
249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28
249.29 249.30 249.31 249.32 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21
250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14
251.15 251.16 251.17 251.18 251.19 251.20
251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16
253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 254.1 254.2
254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 255.32 255.33 256.1 256.2 256.3 256.4 256.5 256.6 256.7
256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29
257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 257.31 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 258.32 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14
259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29 260.30 260.31 260.32 260.33 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20
261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 261.31 261.32 261.33 262.1 262.2 262.3 262.4 262.5
262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27
263.28
264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15
264.16 264.17
264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28
264.29 264.30 264.31 264.32 264.33 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9
265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18
265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 266.1 266.2 266.3 266.4 266.5 266.6 266.7
266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16
266.17 266.18
266.19 266.20
266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 266.32
266.33 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33 267.34 267.35 268.1 268.2 268.3
268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20
268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31
268.32 268.33 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 269.34 269.35 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8
270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29
270.30 270.31 270.32 270.33 270.34 271.1 271.2 271.3 271.4 271.5 271.6 271.7
271.8 271.9
271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21
271.22 271.23 271.24 271.25 271.26 271.27
271.28 271.29
271.30 271.31 271.32 271.33 271.34 271.35 272.1 272.2 272.3 272.4
272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12
272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 273.33 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 275.33 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33
277.1 277.2
277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 277.34 277.35 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 281.33 282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 282.31 282.32 282.33 282.34 282.35 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 283.31 283.32 283.33 283.34 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 284.33 284.34 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26
285.27 285.28 285.29 285.30 285.31 285.32 285.33
286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17
286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 286.32 286.33 286.34 286.35 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 287.33 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16
288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 289.31 289.32 289.33 289.34 289.35 290.1 290.2 290.3
290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 290.32 290.33 290.34 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 291.33 291.34 291.35 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 292.32 292.33 292.34 292.35 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 293.32 293.33 293.34 294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 294.32 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32
296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22
296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 296.34 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 297.33 297.34 297.35 298.1 298.2
298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16
300.17
300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 300.32 300.33 300.34 301.1 301.2 301.3 301.4 301.5 301.6 301.7
301.8 301.9 301.10 301.11
301.12 301.13 301.14
301.15 301.16 301.17
301.18 301.19
301.20 301.21
301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 302.1 302.2
302.3 302.4 302.5 302.6 302.7
302.8 302.9
302.10
302.11
302.12
302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32 302.33 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25
303.26 303.27 303.28 303.29 303.30 303.31 303.32 303.33 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25
304.26 304.27 304.28
304.29 304.30 304.31
305.1 305.2
305.3 305.4
305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16
305.17 305.18 305.19 305.20
305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 305.32 305.33 305.34 306.1 306.2 306.3 306.4
306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19
306.20 306.21 306.22 306.23
306.24 306.25 306.26
306.27 306.28 306.29
307.1 307.2
307.3 307.4
307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16
307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25
307.26 307.27 307.28
307.29 307.30
307.31 307.32 307.33 307.34 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9
308.10 308.11 308.12 308.13
308.14 308.15 308.16
308.17 308.18 308.19
308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33
309.1 309.2 309.3
309.4 309.5 309.6
309.7 309.8
A bill for an act
relating to human services; modifying provisions relating to aging and older adult
services, disability services, long-term services and supports reform, substance
use disorder treatment, housing supports, health care, direct care and treatment
services, and the Department of Health; establishing the Department of Direct
Care and Treatment; making conforming changes; establishing grants; requiring
reports; appropriating money; amending Minnesota Statutes 2024, sections 10.65,
subdivision 2; 15.01; 15.06, subdivision 1; 15A.0815, subdivision 2; 15A.082,
subdivisions 1, 3, 7; 43A.08, subdivisions 1, 1a; 43A.241; 144.0724, subdivisions
2, 11, by adding a subdivision; 144A.01, subdivision 4; 144A.071, subdivisions
4a, 4d; 144A.161, subdivision 10; 144A.1888; 144A.351, subdivision 1; 144A.474,
subdivision 11; 144A.4799; 144G.08, subdivision 15; 144G.31, subdivision 8;
144G.52, subdivisions 1, 2, 3, 8; 144G.54, subdivisions 3, 7; 144G.55, subdivision
1; 179A.54, by adding a subdivision; 245.021; 245.073; 245A.042, by adding a
subdivision; 245A.06, subdivisions 1a, 2; 245C.16, subdivision 1; 245D.091,
subdivisions 2, 3; 245D.12; 245G.01, subdivision 13b, by adding subdivisions;
245G.02, subdivision 2; 245G.05, subdivision 1; 245G.07, subdivisions 1, 3, 4,
by adding subdivisions; 245G.11, subdivision 6, by adding a subdivision; 245G.22,
subdivisions 11, 15; 246.13, subdivision 1; 246B.01, by adding a subdivision;
246C.01; 246C.015, subdivision 3, by adding a subdivision; 246C.02, subdivision
1; 246C.04, subdivisions 2, 3; 246C.07, subdivisions 1, 2, 8; 246C.08; 246C.09,
subdivision 3; 246C.091, subdivisions 2, 3, 4; 252.021, by adding a subdivision;
252.32, subdivision 3; 252.50, subdivision 5; 253.195, by adding a subdivision;
253B.02, subdivisions 3, 4c, by adding a subdivision; 253B.03, subdivision 7;
253B.041, subdivision 4; 253B.09, subdivision 3a; 253B.18, subdivision 6;
253B.19, subdivision 2; 253B.20, subdivision 2; 253D.02, subdivision 3, by adding
a subdivision; 254B.01, subdivision 10; 254B.04, subdivision 1a; 254B.05,
subdivisions 1, 4, 5, by adding a subdivision; 254B.06, by adding a subdivision;
254B.09, subdivision 2; 254B.19, subdivision 1; 256.01, subdivision 29, by adding
subdivisions; 256.042, subdivision 4; 256.043, subdivisions 3, 3a; 256.045,
subdivisions 6, 7, by adding a subdivision; 256.476, subdivision 4; 256.9657,
subdivision 1; 256.9752, subdivisions 2, 3; 256B.04, subdivision 21; 256B.0625,
subdivisions 5m, 17; 256B.0659, subdivision 17a; 256B.0757, subdivision 4c;
256B.0761, subdivision 4; 256B.0911, subdivisions 1, 10, 13, 14, 24, 26, by adding
subdivisions; 256B.092, subdivision 1a; 256B.0924, subdivision 6; 256B.0949,
subdivisions 2, 13, 15, 16, 16a, by adding a subdivision; 256B.431, subdivision
30; 256B.434, subdivision 4; 256B.49, subdivisions 12, 13, 18, by adding
subdivisions; 256B.4914, subdivisions 3, 5, 5a, 5b, 6a, 6b, 6c, 7a, 7b, 7c, 8, 9, by
adding subdivisions; 256B.761; 256B.766; 256B.85, subdivisions 2, 5, 7, 7a, 8,
8a, 11, 13, 16, 17a, by adding a subdivision; 256B.851, subdivisions 5, 6, 7, by
adding subdivisions; 256G.09, subdivision 3; 256I.05, by adding subdivisions;
256R.02, subdivisions 18, 19, 22, by adding subdivisions; 256R.10, subdivision
8; 256R.23, subdivisions 5, 7, 8; 256R.24, subdivision 3; 256R.25; 256R.26,
subdivision 9; 256R.27, subdivisions 2, 3; 256R.43; 256S.205, subdivisions 2, 3,
5; 260E.14, subdivision 1; 352.91, subdivisions 2a, 3c, 3d, 4a; 524.3-801; 611.43,
by adding a subdivision; 611.46, subdivision 1; 611.55, by adding a subdivision;
611.57, subdivision 2; 626.5572, subdivision 13; Laws 2021, chapter 30, article
12, section 5, as amended; Laws 2021, First Special Session chapter 7, article 13,
sections 73; 75, subdivision 6, as amended; Laws 2023, chapter 61, article 1,
section 61, subdivision 4; article 9, section 2, subdivisions 13, 16, as amended;
Laws 2024, chapter 127, article 49, section 9, subdivisions 1, 8, 9, by adding a
subdivision; article 50, section 41, subdivision 2; article 53, section 2, subdivisions
13, 15; proposing coding for new law in Minnesota Statutes, chapters 145D; 245A;
245D; 246; 246C; 256; 256R; repealing Minnesota Statutes 2024, sections
144A.071, subdivision 4c; 245A.042, subdivisions 2, 3, 4; 245G.01, subdivision
20d; 245G.07, subdivision 2; 246B.01, subdivision 2; 246C.015, subdivisions 5a,
6; 246C.06, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10; 246C.07, subdivisions 4, 5;
252.021, subdivision 2; 253.195, subdivision 2; 253B.02, subdivision 7b; 253D.02,
subdivision 7a; 254B.01, subdivisions 5, 15; 254B.18; 256.045, subdivision 1a;
256B.0949, subdivision 9; 256G.02, subdivision 5a; 256R.02, subdivision 38;
256R.12, subdivision 10; 256R.23, subdivision 6; 256R.36; 256R.40; 256R.41;
256R.481; 256S.205, subdivision 7; Laws 2023, chapter 59, article 3, section 11;
Laws 2024, chapter 79, article 1, section 20; Laws 2024, chapter 125, article 5,
sections 40; 41; Laws 2024, chapter 127, article 46, section 39; article 50, sections
40; 41, subdivisions 1, 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
AGING AND OLDER ADULT SERVICES
Section 1.
Minnesota Statutes 2024, section 144.0724, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the meanings
given.
(a) "Assessment reference date" or "ARD" means the specific end point for look-back
periods in the MDS assessment process. This look-back period is also called the observation
or assessment period.
(b) "Case mix index" means the weighting factors assigned to the case mix reimbursement
classifications determined by an assessment.
(c) "Index maximization" means classifying a resident who could be assigned to more
than one category, to the category with the highest case mix index.
(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment,
and functional status elements, that include common definitions and coding categories
specified by the Centers for Medicare and Medicaid Services and designated by the
Department of Health.
(e) "Representative" means a person who is the resident's guardian or conservator, the
person authorized to pay the nursing home expenses of the resident, a representative of the
Office of Ombudsman for Long-Term Care whose assistance has been requested, or any
other individual designated by the resident.
(f) "Activities of daily living" new text begin or "ADL" new text end includes personal hygiene, dressing, bathing,
transferring, bed mobility, locomotion, eating, and toileting.
(g) "Nursing facility level of care determination" means the assessment process that
results in a determination of a resident's or prospective resident's need for nursing facility
level of care as established in subdivision 11 for purposes of medical assistance payment
of long-term care services for:
(1) nursing facility services under chapter 256R;
(2) elderly waiver services under chapter 256S;
(3) CADI and BI waiver services under section 256B.49; and
(4) state payment of alternative care services under section 256B.0913.
new text begin
(h) "Patient Driven Payment Model" or "PDPM" means the case mix reimbursement
classification system for residents in nursing facilities according to the resident's condition,
the resident's diagnosis, and the care the resident is receiving as reflected in data supplied
in the facility's MDS with an ARD on or after October 1, 2025.
new text end
new text begin
(i) "Resource utilization group" or "RUG" means the case mix reimbursement
classification system for residents in nursing facilities according to the resident's clinical
and functional status as reflected in data supplied by the facility's MDS with an ARD on or
before September 30, 2025.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2025, and applies to
assessments conducted on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2024, section 144A.071, subdivision 4a, is amended to read:
Subd. 4a.
Exceptions for replacement beds.
It is in the best interest of the state to
ensure that nursing homes and boarding care homes continue to meet the physical plant
licensing and certification requirements by permitting certain construction projects. Facilities
should be maintained in condition to satisfy the physical and emotional needs of residents
while allowing the state to maintain control over nursing home expenditure growth.
The commissioner of health in coordination with the commissioner of human services,
may approve the renovation, replacement, upgrading, or relocation of a nursing home or
boarding care home, under the following conditions:
(a) to license or certify beds in a new facility constructed to replace a facility or to make
repairs in an existing facility that was destroyed or damaged after June 30, 1987, by fire,
lightning, or other hazard provided:
(i) destruction was not caused by the intentional act of or at the direction of a controlling
person of the facility;
(ii) at the time the facility was destroyed or damaged the controlling persons of the
facility maintained insurance coverage for the type of hazard that occurred in an amount
that a reasonable person would conclude was adequate;
(iii) the net proceeds from an insurance settlement for the damages caused by the hazard
are applied to the cost of the new facility or repairs;
(iv) the number of licensed and certified beds in the new facility does not exceed the
number of licensed and certified beds in the destroyed facility; and
(v) the commissioner determines that the replacement beds are needed to prevent an
inadequate supply of beds.
Project construction costs incurred for repairs authorized under this clause shall not be
considered in the dollar threshold amount defined in subdivision 2;
(b) to license or certify beds that are moved from one location to another within a nursing
home facility, provided the total costs of remodeling performed in conjunction with the
relocation of beds does not exceed $1,000,000;
(c) to license or certify beds in a project recommended for approval under section
144A.073;
(d) to license or certify beds that are moved from an existing state nursing home to a
different state facility, provided there is no net increase in the number of state nursing home
beds;
(e) to certify and license as nursing home beds boarding care beds in a certified boarding
care facility if the beds meet the standards for nursing home licensure, or in a facility that
was granted an exception to the moratorium under section 144A.073, and if the cost of any
remodeling of the facility does not exceed $1,000,000. If boarding care beds are licensed
as nursing home beds, the number of boarding care beds in the facility must not increase
beyond the number remaining at the time of the upgrade in licensure. The provisions
contained in section 144A.073 regarding the upgrading of the facilities do not apply to
facilities that satisfy these requirements;
deleted text begin
(f) to license and certify up to 40 beds transferred from an existing facility owned and
operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the
same location as the existing facility that will serve persons with Alzheimer's disease and
other related disorders. The transfer of beds may occur gradually or in stages, provided the
total number of beds transferred does not exceed 40. At the time of licensure and certification
of a bed or beds in the new unit, the commissioner of health shall delicense and decertify
the same number of beds in the existing facility. As a condition of receiving a license or
certification under this clause, the facility must make a written commitment to the
commissioner of human services that it will not seek to receive an increase in its
property-related payment rate as a result of the transfers allowed under this paragraph;
deleted text end
deleted text begin (g)deleted text end new text begin (f)new text end to license and certify nursing home beds to replace currently licensed and certified
boarding care beds which may be located either in a remodeled or renovated boarding care
or nursing home facility or in a remodeled, renovated, newly constructed, or replacement
nursing home facility within the identifiable complex of health care facilities in which the
currently licensed boarding care beds are presently located, provided that the number of
boarding care beds in the facility or complex are decreased by the number to be licensed as
nursing home beds and further provided that, if the total costs of new construction,
replacement, remodeling, or renovation exceed ten percent of the appraised value of the
facility or $200,000, whichever is less, the facility makes a written commitment to the
commissioner of human services that it will not seek to receive an increase in its
property-related payment rate by reason of the new construction, replacement, remodeling,
or renovation. The provisions contained in section 144A.073 regarding the upgrading of
facilities do not apply to facilities that satisfy these requirements;
deleted text begin (h)deleted text end new text begin (g)new text end to license as a nursing home and certify as a nursing facility a facility that is
licensed as a boarding care facility but not certified under the medical assistance program,
but only if the commissioner of human services certifies to the commissioner of health that
licensing the facility as a nursing home and certifying the facility as a nursing facility will
result in a net annual savings to the state general fund of $200,000 or more;
deleted text begin
(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing home
beds in a facility that was licensed and in operation prior to January 1, 1992;
deleted text end
deleted text begin
(j) to license and certify new nursing home beds to replace beds in a facility acquired
by the Minneapolis Community Development Agency as part of redevelopment activities
in a city of the first class, provided the new facility is located within three miles of the site
of the old facility. Operating and property costs for the new facility must be determined and
allowed under section 256B.431 or 256B.434 or chapter 256R;
deleted text end
deleted text begin
(k) to license and certify up to 20 new nursing home beds in a community-operated
hospital and attached convalescent and nursing care facility with 40 beds on April 21, 1991,
that suspended operation of the hospital in April 1986. The commissioner of human services
shall provide the facility with the same per diem property-related payment rate for each
additional licensed and certified bed as it will receive for its existing 40 beds;
deleted text end
deleted text begin (l)deleted text end new text begin (h)new text end to license or certify beds in renovation, replacement, or upgrading projects as
defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the
facility's remodeling projects do not exceed $1,000,000;
deleted text begin
(m) to license and certify beds that are moved from one location to another for the
purposes of converting up to five four-bed wards to single or double occupancy rooms in
a nursing home that, as of January 1, 1993, was county-owned and had a licensed capacity
of 115 beds;
deleted text end
deleted text begin
(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified nursing
facility located in Minneapolis to layaway all of its licensed and certified nursing home
beds. These beds may be relicensed and recertified in a newly constructed teaching nursing
home facility affiliated with a teaching hospital upon approval by the legislature. The
proposal must be developed in consultation with the interagency committee on long-term
care planning. The beds on layaway status shall have the same status as voluntarily delicensed
and decertified beds, except that beds on layaway status remain subject to the surcharge in
section 256.9657. This layaway provision expires July 1, 1998;
deleted text end
deleted text begin
(o) to allow a project which will be completed in conjunction with an approved
moratorium exception project for a nursing home in southern Cass County and which is
directly related to that portion of the facility that must be repaired, renovated, or replaced,
to correct an emergency plumbing problem for which a state correction order has been
issued and which must be corrected by August 31, 1993;
deleted text end
deleted text begin (p)deleted text end new text begin (i)new text end to allow a facility that on April 16, 1993, was a 368-bed licensed and certified
nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to the
commissioner, up to 30 of the facility's licensed and certified beds by converting three-bed
wards to single or double occupancy. Beds on layaway status shall have the same status as
voluntarily delicensed and decertified beds except that beds on layaway status remain subject
to the surcharge in section 256.9657, remain subject to the license application and renewal
fees under section 144A.07 and shall be subject to a $100 per bed reactivation feedeleted text begin . In
addition, at any time within three years of the effective date of the layaway, the beds on
layaway status may be:deleted text end new text begin ;
new text end
deleted text begin
(1) relicensed and recertified upon relocation and reactivation of some or all of the beds
to an existing licensed and certified facility or facilities located in Pine River, Brainerd, or
International Falls; provided that the total project construction costs related to the relocation
of beds from layaway status for any facility receiving relocated beds may not exceed the
dollar threshold provided in subdivision 2 unless the construction project has been approved
through the moratorium exception process under section 144A.073;
deleted text end
deleted text begin
(2) relicensed and recertified, upon reactivation of some or all of the beds within the
facility which placed the beds in layaway status, if the commissioner has determined a need
for the reactivation of the beds on layaway status.
deleted text end
deleted text begin
The property-related payment rate of a facility placing beds on layaway status must be
adjusted by the incremental change in its rental per diem after recalculating the rental per
diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
payment rate for a facility relicensing and recertifying beds from layaway status must be
adjusted by the incremental change in its rental per diem after recalculating its rental per
diem using the number of beds after the relicensing to establish the facility's capacity day
divisor, which shall be effective the first day of the month following the month in which
the relicensing and recertification became effective. Any beds remaining on layaway status
more than three years after the date the layaway status became effective must be removed
from layaway status and immediately delicensed and decertified;
deleted text end
deleted text begin
(q) to license and certify beds in a renovation and remodeling project to convert 12
four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing
home that, as of January 1, 1994, met the following conditions: the nursing home was located
in Ramsey County; had a licensed capacity of 154 beds; and had been ranked among the
top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total
project construction cost estimate for this project must not exceed the cost estimate submitted
in connection with the 1993 moratorium exception process;
deleted text end
deleted text begin
(r) to license and certify up to 117 beds that are relocated from a licensed and certified
138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds
located in South St. Paul, provided that the nursing facility and hospital are owned by the
same or a related organization and that prior to the date the relocation is completed the
hospital ceases operation of its inpatient hospital services at that hospital. After relocation,
the nursing facility's status shall be the same as it was prior to relocation. The nursing
facility's property-related payment rate resulting from the project authorized in this paragraph
shall become effective no earlier than April 1, 1996. For purposes of calculating the
incremental change in the facility's rental per diem resulting from this project, the allowable
appraised value of the nursing facility portion of the existing health care facility physical
plant prior to the renovation and relocation may not exceed $2,490,000;
deleted text end
deleted text begin
(s) to license and certify two beds in a facility to replace beds that were voluntarily
delicensed and decertified on June 28, 1991;
deleted text end
deleted text begin (t)deleted text end new text begin (j)new text end to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed nursing
home and 21-bed boarding care home facility in Minneapolis, notwithstanding the licensure
and certification after July 1, 1995, of the Minneapolis facility as a 147-bed nursing home
facility after completion of a construction project approved in 1993 under section 144A.073,
to be laid away upon 30 days' prior written notice to the commissioner. Beds on layaway
status shall have the same status as voluntarily delicensed or decertified beds except that
they shall remain subject to the surcharge in section 256.9657deleted text begin . The 16 beds on layaway
status may be relicensed as nursing home beds and recertified at any time within five years
of the effective date of the layaway upon relocation of some or all of the beds to a licensed
and certified facility located in Watertown, provided that the total project construction costs
related to the relocation of beds from layaway status for the Watertown facility may not
exceed the dollar threshold provided in subdivision 2 unless the construction project has
been approved through the moratorium exception process under section 144A.073.deleted text end new text begin ;
new text end
deleted text begin
The property-related payment rate of the facility placing beds on layaway status must
be adjusted by the incremental change in its rental per diem after recalculating the rental
deleted text end
deleted text begin
per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
payment rate for the facility relicensing and recertifying beds from layaway status must be
adjusted by the incremental change in its rental per diem after recalculating its rental per
diem using the number of beds after the relicensing to establish the facility's capacity day
divisor, which shall be effective the first day of the month following the month in which
the relicensing and recertification became effective. Any beds remaining on layaway status
more than five years after the date the layaway status became effective must be removed
from layaway status and immediately delicensed and decertified;
deleted text end
deleted text begin
(u) to license and certify beds that are moved within an existing area of a facility or to
a newly constructed addition which is built for the purpose of eliminating three- and four-bed
rooms and adding space for dining, lounge areas, bathing rooms, and ancillary service areas
in a nursing home that, as of January 1, 1995, was located in Fridley and had a licensed
capacity of 129 beds;
deleted text end
deleted text begin
(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County to
a 160-bed facility in Crow Wing County, provided all the affected beds are under common
ownership;
deleted text end
deleted text begin
(w) to license and certify a total replacement project of up to 49 beds located in Norman
County that are relocated from a nursing home destroyed by flood and whose residents were
relocated to other nursing homes. The operating cost payment rates for the new nursing
facility shall be determined based on the interim and settle-up payment provisions of section
256R.27 and the reimbursement provisions of chapter 256R. Property-related reimbursement
rates shall be determined under section 256R.26, taking into account any federal or state
flood-related loans or grants provided to the facility;
deleted text end
deleted text begin
(x) to license and certify to the licensee of a nursing home in Polk County that was
destroyed by flood in 1997 replacement projects with a total of up to 129 beds, with at least
25 beds to be located in Polk County and up to 104 beds distributed among up to three other
counties. These beds may only be distributed to counties with fewer than the median number
of age intensity adjusted beds per thousand, as most recently published by the commissioner
of human services. If the licensee chooses to distribute beds outside of Polk County under
this paragraph, prior to distributing the beds, the commissioner of health must approve the
location in which the licensee plans to distribute the beds. The commissioner of health shall
consult with the commissioner of human services prior to approving the location of the
proposed beds. The licensee may combine these beds with beds relocated from other nursing
facilities as provided in section 144A.073, subdivision 3c. The operating payment rates for
the new nursing facilities shall be determined based on the interim and settle-up payment
deleted text end
deleted text begin
provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. Property-related
reimbursement rates shall be determined under section 256R.26. If the replacement beds
permitted under this paragraph are combined with beds from other nursing facilities, the
rates shall be calculated as the weighted average of rates determined as provided in this
paragraph and section 256R.50;
deleted text end
deleted text begin
(y) to license and certify beds in a renovation and remodeling project to convert 13
three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and add
improvements in a nursing home that, as of January 1, 1994, met the following conditions:
the nursing home was located in Ramsey County, was not owned by a hospital corporation,
had a licensed capacity of 64 beds, and had been ranked among the top 15 applicants by
the 1993 moratorium exceptions advisory review panel. The total project construction cost
estimate for this project must not exceed the cost estimate submitted in connection with the
1993 moratorium exception process;
deleted text end
deleted text begin
(z) to license and certify up to 150 nursing home beds to replace an existing 285 bed
nursing facility located in St. Paul. The replacement project shall include both the renovation
of existing buildings and the construction of new facilities at the existing site. The reduction
in the licensed capacity of the existing facility shall occur during the construction project
as beds are taken out of service due to the construction process. Prior to the start of the
construction process, the facility shall provide written information to the commissioner of
health describing the process for bed reduction, plans for the relocation of residents, and
the estimated construction schedule. The relocation of residents shall be in accordance with
the provisions of law and rule;
deleted text end
deleted text begin
(aa) to allow the commissioner of human services to license an additional 36 beds to
provide residential services for the physically disabled under Minnesota Rules, parts
9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that
the total number of licensed and certified beds at the facility does not increase;
deleted text end
deleted text begin
(bb) to license and certify a new facility in St. Louis County with 44 beds constructed
to replace an existing facility in St. Louis County with 31 beds, which has resident rooms
on two separate floors and an antiquated elevator that creates safety concerns for residents
and prevents nonambulatory residents from residing on the second floor. The project shall
include the elimination of three- and four-bed rooms;
deleted text end
deleted text begin (cc)deleted text end new text begin (k)new text end to license and certify four beds in a 16-bed certified boarding care home in
Minneapolis to replace beds that were voluntarily delicensed and decertified on or before
March 31, 1992. The licensure and certification is conditional upon the facility periodically
assessing and adjusting its resident mix and other factors which may contribute to a potential
institution for mental disease declaration. The commissioner of human services shall retain
the authority to audit the facility at any time and shall require the facility to comply with
any requirements necessary to prevent an institution for mental disease declaration, including
delicensure and decertification of beds, if necessary;new text begin or
new text end
deleted text begin
(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 80
beds as part of a renovation project. The renovation must include construction of an addition
to accommodate ten residents with beginning and midstage dementia in a self-contained
living unit; creation of three resident households where dining, activities, and support spaces
are located near resident living quarters; designation of four beds for rehabilitation in a
self-contained area; designation of 30 private rooms; and other improvements;
deleted text end
deleted text begin
(ee) to license and certify beds in a facility that has undergone replacement or remodeling
as part of a planned closure under section 256R.40;
deleted text end
deleted text begin
(ff) to license and certify a total replacement project of up to 124 beds located in Wilkin
County that are in need of relocation from a nursing home significantly damaged by flood.
The operating cost payment rates for the new nursing facility shall be determined based on
the interim and settle-up payment provisions of section 256R.27 and the reimbursement
provisions of chapter 256R. Property-related reimbursement rates shall be determined under
section 256R.26, taking into account any federal or state flood-related loans or grants
provided to the facility;
deleted text end
deleted text begin
(gg) to allow the commissioner of human services to license an additional nine beds to
provide residential services for the physically disabled under Minnesota Rules, parts
9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the
total number of licensed and certified beds at the facility does not increase;
deleted text end
deleted text begin
(hh) to license and certify up to 120 new nursing facility beds to replace beds in a facility
in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the new
facility is located within four miles of the existing facility and is in Anoka County. Operating
and property rates shall be determined and allowed under chapter 256R and Minnesota
Rules, parts 9549.0010 to 9549.0080; or
deleted text end
deleted text begin
(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County that,
as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit
nursing facility located in the city of Columbia Heights or its affiliate. The transfer is effective
when the receiving facility notifies the commissioner in writing of the number of beds
accepted. The commissioner shall place all transferred beds on layaway status held in the
deleted text end
deleted text begin
name of the receiving facility. The layaway adjustment provisions of section 256B.431,
subdivision 30, do not apply to this layaway. The receiving facility may only remove the
beds from layaway for recertification and relicensure at the receiving facility's current site,
or at a newly constructed facility located in Anoka County. The receiving facility must
receive statutory authorization before removing these beds from layaway status, or may
remove these beds from layaway status if removal from layaway status is part of a
moratorium exception project approved by the commissioner under section 144A.073.
deleted text end
new text begin
(l) to license or certify beds under provisions coded in this subdivision before the
enactment of this law as paragraphs (f), (i) to (k), (m) to (bb), and (dd) to (ii).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 3.
Minnesota Statutes 2024, section 144A.071, subdivision 4d, is amended to read:
Subd. 4d.
Consolidation of nursing facilities.
(a) The commissioner of health, in
consultation with the commissioner of human services, may approve a request for new text begin net savings
from a new text end consolidation of nursing facilities deleted text begin which includesdeleted text end new text begin to be applied to reduce the costs
of a moratorium exception project application under section 144A.073, subdivision 2. For
purposes of this subdivision, "consolidation" meansnew text end the closure of one or more facilities
and the upgrading of the physical plant of the remaining nursing facility or facilitiesdeleted text begin , the
costs of which exceed the threshold project limit under subdivision 2, clause (a). The
commissioners shall consider the criteria in this section, section 144A.073, and section
256R.40, in approving or rejecting a consolidation proposal. In the event the commissioners
approve the request, the commissioner of human services shall calculate an external fixed
costs rate adjustment according to clauses (1) to (3):deleted text end new text begin .
new text end
deleted text begin
(1) the closure of beds shall not be eligible for a planned closure rate adjustment under
section 256R.40, subdivision 5;
deleted text end
deleted text begin
(2) the construction project permitted in this clause shall not be eligible for a threshold
project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception
adjustment under section 144A.073; and
deleted text end
deleted text begin
(3) the payment rate for external fixed costs for a remaining facility or facilities shall
be increased by an amount equal to 65 percent of the projected net cost savings to the state
calculated in paragraph (b), divided by the state's medical assistance percentage of medical
assistance dollars, and then divided by estimated medical assistance resident days, as
determined in paragraph (c), of the remaining nursing facility or facilities in the request in
this paragraph. The rate adjustment is effective on the first day of the month of January or
July, whichever date occurs first following both the completion of the construction upgrades
in the consolidation plan and the complete closure of the facility or facilities designated for
closure in the consolidation plan. If more than one facility is receiving upgrades in the
consolidation plan, each facility's date of construction completion must be evaluated
separately.
deleted text end
(b) For purposes of calculating the net deleted text begin costdeleted text end savings deleted text begin to the statedeleted text end , the commissioner shall
consider clauses (1) to deleted text begin (7)deleted text end new text begin (6)new text end :
(1) the annual savings from estimated medical assistance payments from the net number
of beds closed taking into consideration only beds that are in active service on the date of
the request and that have been in active service for at least three years;
(2) the estimated annual cost of increased case load of individuals receiving services
under the elderly waiver;
(3) the estimated annual cost of elderly waiver recipients receiving support under housing
support under chapter 256I;
(4) the estimated annual cost of increased case load of individuals receiving services
under the alternative care program;
(5) the annual loss of license surcharge payments on closed beds;new text begin and
new text end
deleted text begin
(6) the savings from not paying planned closure rate adjustments that the facilities would
otherwise be eligible for under section 256R.40; and
deleted text end
deleted text begin (7)deleted text end new text begin (6)new text end the savings from not deleted text begin paying external fixed costs payment rate adjustmentsdeleted text end new text begin
providing a rate adjustmentnew text end from submission of renovation costs that would otherwise be
eligible as threshold projects under section 256B.434, subdivision 4f.
deleted text begin
(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical
assistance resident days of the remaining facility or facilities shall be computed assuming
95 percent occupancy multiplied by the historical percentage of medical assistance resident
days of the remaining facility or facilities, as reported on the facility's or facilities' most
deleted text end
deleted text begin
recent nursing facility statistical and cost report filed before the plan of closure is submitted,
multiplied by 365.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end For purposes of new text begin calculating new text end net deleted text begin cost ofdeleted text end savings deleted text begin to the statedeleted text end in paragraph (b), the
average occupancy percentages will be those deleted text begin reporteddeleted text end on the facility's or facilities' most
recent nursing facility statistical and cost report filed before the plan of closure is submitted,
and the average payment rates shall be calculated based on the approved payment rates in
effect at the time the consolidation request is submitted.
deleted text begin
(e) To qualify for the external fixed costs payment rate adjustment under this subdivision,
the closing facilities shall:
deleted text end
deleted text begin
(1) submit an application for closure according to section 256R.40, subdivision 2; and
deleted text end
deleted text begin
(2) follow the resident relocation provisions of section 144A.161.
deleted text end
deleted text begin (f)deleted text end new text begin (d)new text end The county or counties in which a facility or facilities are closed under this
subdivision shall not be eligible for designation as a hardship area under subdivision 3 for
five years from the date of the approval of the proposed consolidation. The applicant shall
notify the county of this limitation and the county shall acknowledge this in a letter of
support.
deleted text begin (g) Projects approved on or after March 1, 2020, are not subject to paragraph (a), clauses
(2) and (3), and paragraph (c). The 65deleted text end new text begin (e) Sixty-fivenew text end percent new text begin of the new text end projected net deleted text begin costdeleted text end savings
deleted text begin to the statedeleted text end calculated in paragraph (b) must be applied to the moratorium cost of the project
and the remainder must be added to the moratorium funding under section 144A.073,
subdivision 11.
deleted text begin (h)deleted text end new text begin (f)new text end Consolidation project applications not approved by the commissioner prior to
March 1, 2020, are subject to the moratorium process under section 144A.073, subdivision
2. deleted text begin Upon request by the applicant, the commissioner may extend this deadline to August 1,
2020, so long as the facilities, bed numbers, and counties specified in the original application
are not altered. Proposals from facilities seeking approval for a consolidation project prior
to March 1, 2020, must be received by the commissioner no later than January 1, 2020. This
paragraph expires August 1, 2020.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 4.
Minnesota Statutes 2024, section 144A.161, subdivision 10, is amended to read:
Subd. 10.
Facility closure rate adjustment.
Upon the request of a closing facility, the
commissioner of human services must allow the facility a closure rate adjustment equal to
a 50 percent payment rate increase to reimburse relocation costs or other costs related to
facility closure. This rate increase is effective on the date the facility's occupancy decreases
to 90 percent of capacity days after the written notice of closure is distributed under
subdivision 5 and shall remain in effect for a period of up to 60 days. deleted text begin The commissioner
shall delay the implementation of rate adjustments under section 256R.40, subdivisions 5
and 6, to offset the cost of this rate adjustment.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 5.
Minnesota Statutes 2024, section 144A.1888, is amended to read:
144A.1888 REUSE OF FACILITIES.
Notwithstanding any local ordinance related to development, planning, or zoning to the
contrary, the conversion or reuse of a nursing home that closes or that curtails, reduces, or
changes operations shall be considered a conforming use permitted under local law, provided
that the facility is converted to another long-term care service deleted text begin approved by a regional
planning group under section 256R.40deleted text end that serves a smaller number of persons than the
number of persons served before the closure or curtailment, reduction, or change in
operations.
Sec. 6.
Minnesota Statutes 2024, section 256.9657, subdivision 1, is amended to read:
Subdivision 1.
Nursing home license surcharge.
(a) Effective July 1, 1993, each
non-state-operated nursing home licensed under chapter 144A shall pay to the commissioner
an annual surcharge according to the schedule in subdivision 4. The surcharge shall be
calculated as deleted text begin $620deleted text end new text begin $2,815new text end per licensed bed. If the number of licensed beds is reduced, the
surcharge shall be based on the number of remaining licensed beds the second month
following the receipt of timely notice by the commissioner of human services that beds
have been delicensed. The nursing home must notify the commissioner of health in writing
when beds are delicensed. The commissioner of health must notify the commissioner of
human services within ten working days after receiving written notification. If the notification
is received by the commissioner of human services by the 15th of the month, the invoice
for the second following month must be reduced to recognize the delicensing of beds. deleted text begin Beds
on layaway status continue to be subject to the surcharge.deleted text end The commissioner of human
services must acknowledge a medical care surcharge appeal within 30 days of receipt of
the written appeal from the provider.
deleted text begin
(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.
deleted text end
deleted text begin
(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased to
$990.
deleted text end
deleted text begin
(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased to
$2,815.
deleted text end
deleted text begin (e)deleted text end new text begin (b)new text end The commissioner may reduce, and may subsequently restore, the surcharge
under paragraph deleted text begin (d)deleted text end new text begin (a)new text end based on the commissioner's determination of a permissible surcharge.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 7.
new text begin
[256.9746] AGE-FRIENDLY MINNESOTA COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The Age-Friendly Minnesota Council is established to
coordinate work across sectors, including state government, nonprofits, communities,
businesses, and others, to ensure the state is an age-friendly state.
new text end
new text begin Subd. 2. new text end
new text begin Membership. new text end
new text begin
(a) The council consists of 15 voting members.
new text end
new text begin
(b) Each of the following commissioners and multimember state agencies must designate
an Age-Friendly Minnesota lead and appoint that designee to serve as a council member:
new text end
new text begin
(1) the Minnesota Board on Aging;
new text end
new text begin
(2) the commissioner of commerce;
new text end
new text begin
(3) the commissioner of employment and economic development;
new text end
new text begin
(4) the commissioner of health;
new text end
new text begin
(5) the commissioner of housing;
new text end
new text begin
(6) the commissioner of human services;
new text end
new text begin
(7) the commissioner of transportation;
new text end
new text begin
(8) the commissioner of veterans affairs; and
new text end
new text begin
(9) the Metropolitan Council.
new text end
new text begin
(c) The governor shall appoint six additional public members to represent older adults
in communities experiencing disparities, direct service caregivers, businesses, experts on
aging, local governments, and Tribal communities. The appointment, terms, compensation,
and removal of public members shall be as provided in section 15.059.
new text end
new text begin
(d) Other state agencies and boards may participate on the council in a nonvoting capacity.
new text end
new text begin Subd. 3. new text end
new text begin Chairperson; executive committee. new text end
new text begin
(a) The council shall elect a chairperson
and other officers as it deems necessary and in accordance with the council's operating
procedures.
new text end
new text begin
(b) The council shall be governed by an executive committee elected by the members
of the council. One member of the executive committee must be the council chairperson.
new text end
new text begin
(c) The executive committee may appoint additional subcommittees and work groups
as necessary to fulfill the duties of the council.
new text end
new text begin Subd. 4. new text end
new text begin Meetings. new text end
new text begin
(a) The council shall meet at the call of the chairperson or at the
request of a majority of council members. The council must meet at least quarterly. Meetings
of the council are subject to section 13D.01, and notice of its meetings is governed by section
13D.04.
new text end
new text begin
(b) Notwithstanding section 13D.01, the council may conduct a meeting of its members
by telephone or other electronic means so long as:
new text end
new text begin
(1) all members of the council participating in the meeting, wherever their physical
location, can hear one another and can hear all discussion and testimony;
new text end
new text begin
(2) members of the public present at the regular meeting location of the council can hear
all discussion and all votes of members of the council and participate in testimony;
new text end
new text begin
(3) at least one member of the council is physically present at the regular meeting location;
and
new text end
new text begin
(4) each member's vote on each issue is identified and recorded by a roll call.
new text end
new text begin
(c) Each member of the council participating in a meeting by telephone or other electronic
means is considered present at the meeting for the purposes of determining a quorum and
participating in all proceedings. If telephone or another electronic means is used to conduct
a meeting, the council, to the extent practicable, shall allow a person to monitor the meeting
from a remote location. If telephone or another electronic means is used to conduct a regular,
special, or emergency meeting, the council shall provide notice of the regular meeting
location, that some members may participate by electronic means, and of the option to
monitor the meeting electronically from a remote location.
new text end
new text begin Subd. 5. new text end
new text begin Duties. new text end
new text begin
(a) The council's duties may include but are not limited to:
new text end
new text begin
(1) elevating the voice of older adults in developing the vision and action plan for an
age-friendly state;
new text end
new text begin
(2) engaging with the community, including older adults, caregivers, businesses, experts,
advocacy organizations, and other interested parties, to provide recommendations and update
interested parties on the council's recommendations;
new text end
new text begin
(3) identifying opportunities for and barriers to collaboration and coordination among
services and state agencies responsible for funding and administering programs and
public-private partnerships;
new text end
new text begin
(4) promoting equity and making progress toward equitable outcomes by examining
programs, policies, and practices to ensure they address disparities experienced by older
adults in greater Minnesota, older adults of color, and indigenous older adults;
new text end
new text begin
(5) catalyzing age-friendly work at the local level, engaging with and empowering older
adults, local constituents, elected officials, and other interested parties to create change in
every community;
new text end
new text begin
(6) establishing a statewide framework that allows for local flexibility to tap into the
potential presented by our aging communities and elevates aging across all of Minnesota;
new text end
new text begin
(7) reviewing, awarding, and monitoring grants under section 256.9747;
new text end
new text begin
(8) assessing and examining relevant programs, policies, practices, and services to make
budget and policy recommendations to establish age-friendly policies in law with appropriate
financial support to ensure Minnesota continues to lead on age-friendly initiatives; and
new text end
new text begin
(9) making budget and policy recommendations to the governor, commissioners, boards,
other state agencies, and the legislature to further the council's mission to ensure the state
is an age-friendly state.
new text end
new text begin
(b) The council may accept technical assistance and in-kind services from outside
organizations for purposes consistent with the council's role and authority.
new text end
new text begin Subd. 6. new text end
new text begin Administration. new text end
new text begin
The Minnesota Board on Aging and Department of Human
Services shall provide staffing and administrative support to the council.
new text end
new text begin Subd. 7. new text end
new text begin Annual report. new text end
new text begin
Beginning January 1, 2026, and every two years thereafter,
the council shall publish a public report on the council's activities, the uses and measurable
outcomes of the grant activities funded under section 256.9747, the council's
recommendations, proposed changes to statutes or rules, and other issues the council may
choose to report.
new text end
Sec. 8.
new text begin
[256.9747] AGE-FRIENDLY MINNESOTA GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Age-friendly community grants. new text end
new text begin
The commissioner of human services,
in collaboration with the Minnesota Board on Aging and the Age-Friendly Minnesota
Council, shall develop the age-friendly community grant program to help communities,
including cities, counties, other municipalities, Tribes, and collaborative efforts become
age-friendly communities, with an emphasis on structures, services, and community features
necessary to support older adult residents, including but not limited to:
new text end
new text begin
(1) coordination of health and social services;
new text end
new text begin
(2) transportation access;
new text end
new text begin
(3) safe, affordable places to live;
new text end
new text begin
(4) reducing social isolation and improving wellness;
new text end
new text begin
(5) combating ageism and racism against older adults;
new text end
new text begin
(6) accessible outdoor space and buildings;
new text end
new text begin
(7) communication and information technology access; and
new text end
new text begin
(8) opportunities to stay engaged and economically productive.
new text end
new text begin Subd. 2. new text end
new text begin Age-friendly technical assistance grants. new text end
new text begin
The commissioner of human services,
in collaboration with the Minnesota Board on Aging and the Age-Friendly Minnesota
Council, shall develop the age-friendly technical assistance grant program to support
communities and organizations who need assistance in applying for age-friendly community
grants and implementing various aspects of their grant-funded projects.
new text end
Sec. 9.
Minnesota Statutes 2024, section 256.9752, subdivision 2, is amended to read:
Subd. 2.
Authority.
The Minnesota Board on Aging shall allocate to area agencies on
aging the deleted text begin state anddeleted text end federal funds which are received for the senior nutrition programs of
congregate dining and home-delivered meals in a manner consistent with federal
requirements.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 10.
Minnesota Statutes 2024, section 256.9752, subdivision 3, is amended to read:
Subd. 3.
Nutrition support services.
(a) Funds allocated to an area agency on aging
for nutrition support services may be used for the following:
(1) transportation of home-delivered meals and purchased food and medications to the
residence of a senior citizen;
(2) expansion of home-delivered meals into unserved and underserved areas;
(3) transportation to supermarkets or delivery of groceries from supermarkets to homes;
(4) vouchers for food purchases at selected restaurants in isolated rural areas;
(5) the Supplemental Nutrition Assistance Program (SNAP) outreach;
(6) transportation of seniors to congregate dining sites;
(7) nutrition screening assessments and counseling as needed by individuals with special
dietary needs, performed by a licensed dietitian or nutritionist; deleted text begin and
deleted text end
(8) other appropriate services which support senior nutrition programs, including new
service delivery modelsnew text begin ; and
new text end
new text begin (9) innovative models of providing healthy and nutritious meals to seniors, including
through partnerships with schools, restaurants, and other community partnersnew text end .
(b) An area agency on aging may transfer unused funding for nutrition support services
to fund congregate dining services and home-delivered mealsnew text begin , but state funds transferred
under this paragraph are not subject to federal requirementsnew text end .
Sec. 11.
Minnesota Statutes 2024, section 256B.431, subdivision 30, is amended to read:
Subd. 30.
Bed layaway and delicensure.
(a) For rate years beginning on or after July
1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway
shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph
(c), and calculation of the rental per diem, have those beds given the same effect as if the
beds had been delicensed so long as the beds remain on layaway. deleted text begin At the time of a layaway,
a facility may change its single bed election for use in calculating capacity days under
Minnesota Rules, part 9549.0060, subpart 11.deleted text end The property payment rate increase shall be
effective the first day of the month of January or July, whichever occurs first following the
date on which the layaway of the beds becomes effective under section 144A.071, subdivision
4b.
(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to
the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under
that section or chapter that has placed beds on layaway shall, for so long as the beds remain
on layaway, be allowed to:
(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;
(2) retain deleted text begin or changedeleted text end the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and
(3) establish capacity days based on the number of beds immediately prior to the layaway
and the number of beds after the layaway.
The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and
(3). If a facility reimbursed under section 256B.434 or chapter 256R completes a moratorium
exception project after its base year, the base year property rate shall be the moratorium
project property rate. The base year rate shall be inflated by the factors in new text begin Minnesota Statutes
2024, new text end section 256B.434, subdivision 4deleted text begin , paragraph (c)deleted text end . The property payment rate increase
shall be effective the first day of the month of January or July, whichever occurs first
following the date on which the layaway of the beds becomes effective.
(c) If a nursing facility removes a bed from layaway status in accordance with section
144A.071, subdivision 4b, the commissioner shall establish capacity days based on the
number of licensed and certified beds in the facility not on layaway and shall reduce the
nursing facility's property payment rate in accordance with paragraph (b).
(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision
to the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under
that section or chapter that has delicensed beds after July 1, 2000, by giving notice of the
delicensure to the commissioner of health according to the notice requirements in section
144A.071, subdivision 4b, shall be allowed to:
(1) aggregate the applicable investment per bed limits based on the number of beds
licensed immediately prior to entering the alternative payment system;
(2) retain deleted text begin or changedeleted text end the facility's single bed election for use in calculating capacity days
under Minnesota Rules, part 9549.0060, subpart 11; and
(3) establish capacity days based on the number of beds immediately prior to the
delicensure and the number of beds after the delicensure.
The commissioner shall increase the facility's property payment rate by the incremental
increase in the rental per diem resulting from the recalculation of the facility's rental per
diem applying only the changes resulting from the delicensure of beds and clauses (1), (2),
and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception
project after its base year, the base year property rate shall be the moratorium project property
rate. The base year rate shall be inflated by the factors in new text begin Minnesota Statutes 2024, new text end section
256B.434, subdivision 4deleted text begin , paragraph (c)deleted text end . The property payment rate increase shall be effective
the first day of the month of January or July, whichever occurs first following the date on
which the delicensure of the beds becomes effective.
(e) For nursing facilities reimbursed under this section, section 256B.434, or chapter
256R, any beds placed on layaway shall not be included in calculating facility occupancy
as it pertains to leave days defined in Minnesota Rules, part 9505.0415.
(f) For nursing facilities reimbursed under this section, section 256B.434, or chapter
256R, the rental rate calculated after placing beds on layaway may not be less than the rental
rate prior to placing beds on layaway.
(g) A nursing facility receiving a rate adjustment as a result of this section shall comply
with section 256R.06, subdivision 5.
(h) A facility that does not utilize the space made available as a result of bed layaway
or delicensure under this subdivision to reduce the number of beds per room or provide
more common space for nursing facility uses or perform other activities related to the
operation of the nursing facility shall have its property rate increase calculated under this
subdivision reduced by the ratio of the square footage made available that is not used for
these purposes to the total square footage made available as a result of bed layaway or
delicensure.
new text begin
(i) The commissioner must not adjust the property payment rates under this subdivision
for beds placed in or removed from layaway on or after July 1, 2025.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 12.
Minnesota Statutes 2024, section 256B.434, subdivision 4, is amended to read:
Subd. 4.
Alternate rates for nursing facilities.
Effective for the rate years beginning
on and after January 1, deleted text begin 2019deleted text end new text begin 2026new text end , a nursing facility's property payment rate deleted text begin for the second
and subsequent years of a facility's contractdeleted text end under this section deleted text begin aredeleted text end new text begin isnew text end the new text begin facility's new text end previous
rate year's property payment rate deleted text begin plus an inflation adjustment. The index for the inflation
adjustment must be based on the change in the Consumer Price Index-All Items (United
States City average) (CPI-U) forecasted by the Reports and Forecasts Division of the
Department of Human Services, as forecasted in the fourth quarter of the calendar year
preceding the rate year. The inflation adjustment must be based on the 12-month period
from the midpoint of the previous rate year to the midpoint of the rate year for which the
rate is being determineddeleted text end .
Sec. 13.
Minnesota Statutes 2024, section 256R.02, subdivision 18, is amended to read:
Subd. 18.
Employer health insurance costs.
"Employer health insurance costs" means:
(1) premium expenses for group coverage;
(2) actual expenses incurred for self-insured plans, including actual claims paid, stop-loss
premiums, and plan fees. Actual expenses incurred for self-insured plans does not include
allowances for future funding unless the plan meets the deleted text begin Medicaredeleted text end new text begin provider reimbursement
manualnew text end requirements for reporting on a premium basis when the deleted text begin Medicaredeleted text end new text begin provider
reimbursement manualnew text end regulations define the actual costs; and
(3) employer contributions to employer-sponsored individual coverage health
reimbursement arrangements as provided by Code of Federal Regulations, title 45, section
146.123, employee health reimbursement accounts, and health savings accounts.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 14.
Minnesota Statutes 2024, section 256R.02, subdivision 19, is amended to read:
Subd. 19.
External fixed costs.
"External fixed costs" means deleted text begin costs related to the nursing
home surcharge under section deleted text end deleted text begin 256.9657, subdivision 1deleted text end deleted text begin ; licensure fees under section deleted text end deleted text begin ;
family advisory council fee under section deleted text end deleted text begin ; scholarships under section deleted text end deleted text begin ;
planned closure rate adjustments under section 256R.40; consolidation rate adjustments
under section deleted text end deleted text begin 144A.071, subdivisions 4cdeleted text end deleted text begin , paragraph (a), clauses (5) and (6), and 4d;
single-bed room incentives under section 256R.41; property taxes, special assessments, and
payments in lieu of taxes; employer health insurance costs; quality improvement incentive
payment rate adjustments under section deleted text end deleted text begin ; performance-based incentive payments
under section deleted text end deleted text begin ; special dietary needs under section deleted text end deleted text begin ; Public Employees
Retirement Association employer costs; and border city rate adjustments under section
256R.481deleted text end new text begin the items described in section 256R.25new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 15.
Minnesota Statutes 2024, section 256R.02, subdivision 22, is amended to read:
Subd. 22.
Fringe benefit costs.
"Fringe benefit costs" means the costs for group lifedeleted text begin ,deleted text end new text begin ;new text end
dentaldeleted text begin ,deleted text end new text begin ;new text end workers' compensationdeleted text begin ,deleted text end new text begin ;new text end short- and long-term disabilitydeleted text begin ,deleted text end new text begin ;new text end long-term care insurancedeleted text begin ,deleted text end new text begin ;new text end
accident insurancedeleted text begin ,deleted text end new text begin ;new text end supplemental insurancedeleted text begin ,deleted text end new text begin ;new text end legal assistance insurancedeleted text begin ,deleted text end new text begin ;new text end profit sharingdeleted text begin ,deleted text end new text begin ;new text end
child care costsdeleted text begin ,deleted text end new text begin ;new text end health insurance costs not covered under subdivision 18, including costs
associated with new text begin eligible new text end part-time employee family members or retireesdeleted text begin ,deleted text end new text begin ;new text end and pension and
retirement plan contributions, except for the Public Employees Retirement Association
costs.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 16.
Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision
to read:
new text begin Subd. 36a. new text end
new text begin Patient driven payment model or PDPM. new text end
new text begin
"Patient driven payment model"
or "PDPM" has the meaning given in section 144.0724, subdivision 2.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 17.
Minnesota Statutes 2024, section 256R.02, is amended by adding a subdivision
to read:
new text begin Subd. 45a. new text end
new text begin Resource utilization group or RUG. new text end
new text begin
"Resource utilization group" or "RUG"
has the meaning given in section 144.0724, subdivision 2.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 18.
Minnesota Statutes 2024, section 256R.10, subdivision 8, is amended to read:
Subd. 8.
Employer health insurance costs.
(a) Employer health insurance costs are
allowable for (1) all new text begin nursing facility new text end employees and (2) the spouse and dependents of those
new text begin nursing facility new text end employees who are employed on average at least 30 hours per week.
new text begin
(b) Effective for the rate year beginning on January 1, 2026, the annual reimbursement
cap for health insurance costs is $14,703, as adjusted according to paragraph (c). The
allowable costs for health insurance must not exceed the reimbursement cap multiplied by
the annual average month end number of allowed enrolled nursing facility employees from
the applicable cost report period. For shared employees, the allowable number of enrolled
employees includes only the nursing facility percentage of any shared allowed enrolled
employees. The allowable number of enrolled employees must not include non-nursing
facility employees or individuals who elect COBRA continuation coverage.
new text end
new text begin
(c) Effective for rate years beginning on or after January 1, 2026, the commissioner shall
adjust the annual reimbursement cap for employer health insurance costs by the previous
year's cap plus an inflation adjustment. The commissioner must index for the inflation based
on the change in the Consumer Price Index (all items-urban) (CPI-U) forecasted by the
Reports and Forecast Division of the Department of Human Services in the fourth quarter
of the calendar year preceding the rate year. The commissioner must base the inflation
adjustment on the 12-month period from the second quarter of the previous cost report year
to the second quarter of the cost report year for which the cap is being applied.
new text end
deleted text begin (b)deleted text end new text begin (d) new text end The commissioner must not treat employer contributions to employer-sponsored
individual coverage health reimbursement arrangements as allowable costs if the facility
does not provide the commissioner copies of the employer-sponsored individual coverage
health reimbursement arrangement plan documents and documentation of any health
insurance premiums and associated co-payments reimbursed under the arrangement.
Documentation of reimbursements must denote any reimbursements for health insurance
premiums or associated co-payments incurred by the spouses or dependents of new text begin nursing
facility new text end employees who work on average less than 30 hours per week.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 19.
Minnesota Statutes 2024, section 256R.23, subdivision 5, is amended to read:
Subd. 5.
Determination of total care-related payment rate limits.
new text begin (a)new text end The commissioner
must determine each facility's total care-related payment rate limit by:
(1) multiplying the facility's quality score, as determined under section 256R.16,
subdivision 1, by 0.5625;
(2) adding 89.375 to the amount determined in clause (1), and dividing the total by 100;
and
(3) multiplying the amount determined in clause (2) by the median total care-related
cost per day.
new text begin
(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31,
2029, the commissioner must determine each facility's total care-related payment rate limit
by:
new text end
new text begin
(1) multiplying the facility's quality score, as determined under section 256R.16,
subdivision 1, by 2.0;
new text end
new text begin
(2) subtracting 40 from the amount determined in clause (1), and dividing the total by
100; and
new text end
new text begin
(3) multiplying the amount determined in clause (2) by the median total care-related
cost per day.
new text end
new text begin
This paragraph expires January 1, 2030.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 20.
Minnesota Statutes 2024, section 256R.23, subdivision 7, is amended to read:
Subd. 7.
Determination of direct care payment rates.
new text begin (a)new text end A facility's direct care
payment rate equals the lesser of (1) the facility's direct care costs per standardized day, or
(2) the facility's direct care costs per standardized day divided by its cost to limit ratio.
new text begin
(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31,
2029, a facility's direct care payment rate equals the lesser of (1) the facility's direct care
costs per standardized day, (2) the facility's direct care costs per standardized day divided
by its cost to limit ratio, or (3) 104 percent of the previous year's direct care payment rate.
This paragraph expires January 1, 2030.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 21.
Minnesota Statutes 2024, section 256R.23, subdivision 8, is amended to read:
Subd. 8.
Determination of other care-related payment rates.
new text begin (a)new text end A facility's other
care-related payment rate equals the lesser of (1) the facility's other care-related cost per
resident day, or (2) the facility's other care-related cost per resident day divided by its cost
to limit ratio.
new text begin
(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31,
2029, a facility's other care-related payment rate equals the lesser of (1) the facility's other
care-related cost per resident day, (2) the facility's other care-related cost per resident day
divided by its cost to limit ratio, or (3) 104 percent of the previous year's other care-related
payment rate. This paragraph expires January 1, 2030.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 22.
Minnesota Statutes 2024, section 256R.24, subdivision 3, is amended to read:
Subd. 3.
Determination of the other operating payment rate.
new text begin (a)new text end A facility's other
operating payment rate equals 105 percent of the median other operating cost per day.
new text begin
(b) Notwithstanding paragraph (a), effective January 1, 2026, through December 31,
2029, a facility's other operating payment rate equals the lesser of 105 percent of the median
other operating cost per day or 104 percent of the previous year's other operating payment
rate. This paragraph expires January 1, 2030.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 23.
Minnesota Statutes 2024, section 256R.25, is amended to read:
256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.
new text begin Subdivision 1. new text end
new text begin Determination of external fixed cost payment rate. new text end
deleted text begin (a)deleted text end The payment
rate for external fixed costs is the sum of the amounts in deleted text begin paragraphs (b) to (p)deleted text end new text begin subdivisions
2 to 14new text end .
new text begin Subd. 2. new text end
new text begin Provider surcharges. new text end
deleted text begin (b)deleted text end For a facility licensed as a nursing home, the portion
related to the provider surcharge under section 256.9657 is equal to $8.86 per resident day.
For a facility licensed as both a nursing home and a boarding care home, the portion related
to the provider surcharge under section 256.9657 is equal to $8.86 per resident day multiplied
by the result of its number of nursing home beds divided by its total number of licensed
beds.
new text begin Subd. 3. new text end
new text begin Licensure fees. new text end
deleted text begin (c)deleted text end The portion related to the licensure fee under section 144.122,
paragraph (d), is the amount of the fee divided by the sum of the facility's resident days.
new text begin Subd. 4. new text end
new text begin Advisory councils. new text end
deleted text begin (d)deleted text end The portion related to development and education of
resident and family advisory councils under section 144A.33 is $5 per resident day divided
by 365.
new text begin Subd. 5. new text end
new text begin Scholarships. new text end
deleted text begin (e)deleted text end The portion related to scholarships is determined under section
256R.37.
deleted text begin
(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.
deleted text end
new text begin Subd. 6. new text end
new text begin Consolidation. new text end
deleted text begin (g)deleted text end The portion related to consolidation rate adjustments deleted text begin shalldeleted text end
deleted text begin be as determined under section deleted text end deleted text begin 144A.071, subdivisions 4cdeleted text end deleted text begin , paragraph (a), clauses deleted text end deleted text begin (5)deleted text end deleted text begin and
deleted text end deleted text begin (6)deleted text end deleted text begin , and 4ddeleted text end new text begin is the amount specified in section 256R.405new text end .
deleted text begin
(h) The portion related to single-bed room incentives is as determined under section
256R.41.
deleted text end
new text begin Subd. 7. new text end
new text begin Taxes. new text end
deleted text begin (i)deleted text end The portions related to real estate taxes, special assessments, and
payments made in lieu of real estate taxes directly identified or allocated to the nursing
facility are the allowable amounts divided by the sum of the facility's resident days. Allowable
costs under this paragraph for payments made by a nonprofit nursing facility that are in lieu
of real estate taxes shall not exceed the amount which the nursing facility would have paid
to a city or township and county for fire, police, sanitation services, and road maintenance
costs had real estate taxes been levied on that property for those purposes.
new text begin Subd. 8. new text end
new text begin Health insurance. new text end
deleted text begin (j)deleted text end The portion related to employer health insurance costs
is the allowable costs divided by the sum of the facility's resident days.
new text begin Subd. 9. new text end
new text begin Public employees retirement. new text end
deleted text begin (k)deleted text end The portion related to the Public Employees
Retirement Association is the allowable costs divided by the sum of the facility's resident
days.
new text begin Subd. 10. new text end
new text begin Quality improvement incentives. new text end
deleted text begin (l)deleted text end The portion related to quality
improvement incentive payment rate adjustments is the amount determined under section
256R.39.
new text begin Subd. 11. new text end
new text begin Performance-based incentives. new text end
deleted text begin (m)deleted text end The portion related to performance-based
incentive payments is the amount determined under section 256R.38.
new text begin Subd. 12. new text end
new text begin Special diets. new text end
deleted text begin (n)deleted text end The portion related to special dietary needs is the amount
determined under section 256R.51.
deleted text begin
(o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.
deleted text end
new text begin Subd. 13. new text end
new text begin Critical access facilities. new text end
deleted text begin (p)deleted text end The portion related to the rate adjustment for
critical access nursing facilities is the amount determined under section 256R.47.
new text begin Subd. 14. new text end
new text begin Workforce standards. new text end
new text begin
The portion related to implementation of the rules
implemented by the Nursing Home Workforce Standards Board is the amount determined
under section 256R.532.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 24.
Minnesota Statutes 2024, section 256R.26, subdivision 9, is amended to read:
Subd. 9.
Transition period.
(a) A facility's property payment rate is the property rate
established for the facility under sections 256B.431 and 256B.434 until the facility's property
rate is transitioned upon completion of any project authorized under section 144A.071,
subdivision 3 or 4d; or 144A.073, subdivision 3, to the fair rental value property rate
calculated under this chapter.
(b) Effective the first day of the first month of the calendar quarter after the completion
of the project described in paragraph (a), the commissioner shall transition a facility to the
property payment rate calculated under this chapter. The initial rate year ends on December
31 and may be less than a full 12-month period. The commissioner shall schedule an appraisal
within 90 days of the commissioner receiving notification from the facility that the project
is completed. The commissioner shall apply the property payment rate determined after the
appraisal retroactively to the first day of the first month of the calendar quarter after the
completion of the project.
(c) Upon a facility's transition to the fair rental value property rates calculated under this
chapter, the facility's total property payment rate under subdivision 8 shall be the only
payment for costs related to capital assets, including depreciation, interest and lease expenses
for all depreciable assets, including movable equipment, land improvements, and land.
Facilities with property payment rates established under subdivisions 1 to 8 are not eligible
for planned closure rate adjustments under new text begin Minnesota Statutes 2024, new text end section 256R.40;
consolidation rate adjustments under section 144A.071, subdivisions 4c, paragraph (a),
clauses deleted text begin (5)deleted text end new text begin (1)new text end and deleted text begin (6)deleted text end new text begin (2)new text end , and 4d; single-bed room incentives under new text begin Minnesota Statutes
2024, new text end section 256R.41; and the property rate inflation adjustment undernew text begin Minnesota Statutes
2024,new text end section 256B.434, subdivision 4. The commissioner shall remove any of these
incentives from the facility's existing rate upon the facility transitioning to the fair rental
value property rates calculated under this chapter.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 25.
Minnesota Statutes 2024, section 256R.27, subdivision 2, is amended to read:
Subd. 2.
Determination of interim payment rates.
(a) The nursing facility shall submit
an interim cost report in a format similar to the Minnesota Statistical and Cost Report and
other supporting information as required by this chapter for the reporting year in which the
nursing facility plans to begin operation at least 60 days before the first day a resident is
admitted to the newly constructed nursing facility bed. The interim cost report must include
the nursing facility's anticipated interim costs and anticipated interim resident days for each
resident class in the interim cost report. The anticipated interim resident days for each
resident class is multiplied by the weight for that resident class to determine the anticipated
interim standardized days as defined in section 256R.02, subdivision 50, and resident days
as defined in section 256R.02, subdivision 45, for the reporting period.
(b) The interim payment rates are determined according to sections 256R.21 to 256R.25,
except that:
(1) the anticipated interim costs and anticipated interim resident days reported on the
interim cost report and the anticipated interim standardized days as defined by section
256R.02, subdivision 50, must be used for the interim;
(2) the commissioner shall use anticipated interim costs and anticipated interim
standardized days in determining the allowable historical direct care cost per standardized
day as determined under section 256R.23, subdivision 2;
(3) the commissioner shall use anticipated interim costs and anticipated interim resident
days in determining the allowable historical other care-related cost per resident day as
determined under section 256R.23, subdivision 3;
(4) the commissioner shall use anticipated interim costs and anticipated interim resident
days to determine the allowable historical external fixed costs per day under section 256R.25,
deleted text begin paragraphs (b) to (k)deleted text end new text begin subdivisions 2 to 9new text end ;
(5) the total care-related payment rate limits established in section 256R.23, subdivision
5, and in effect at the beginning of the interim period must be increased by ten percent; and
(6) the other operating payment rate as determined under section 256R.24 in effect for
the rate year must be used for the other operating cost per day.
Sec. 26.
Minnesota Statutes 2024, section 256R.27, subdivision 3, is amended to read:
Subd. 3.
Determination of settle-up payment rates.
(a) When the interim payment
rates begin between May 1 and September 30, the nursing facility shall file settle-up cost
reports for the period from the beginning of the interim payment rates through September
30 of the following year.
(b) When the interim payment rates begin between October 1 and April 30, the nursing
facility shall file settle-up cost reports for the period from the beginning of the interim
payment rates to the first September 30 following the beginning of the interim payment
rates.
(c) The settle-up payment rates are determined according to sections 256R.21 to 256R.25,
except that:
(1) the allowable costs and resident days reported on the settle-up cost report and the
standardized days as defined by section 256R.02, subdivision 50, must be used for the
interim and settle-up period;
(2) the commissioner shall use the allowable costs and standardized days in clause (1)
to determine the allowable historical direct care cost per standardized day as determined
under section 256R.23, subdivision 2;
(3) the commissioner shall use the allowable costs and the allowable resident days to
determine both the allowable historical other care-related cost per resident day as determined
under section 256R.23, subdivision 3;
(4) the commissioner shall use the allowable costs and the allowable resident days to
determine the allowable historical external fixed costs per day under section 256R.25,
deleted text begin paragraphs (b) to (k)deleted text end new text begin subdivisions 2 to 9new text end ;
(5) the total care-related payment limits established in section 256R.23, subdivision 5,
are the limits for the settle-up reporting periods. If the interim period includes more than
one July 1 date, the commissioner shall use the total care-related payment rate limit
established in section 256R.23, subdivision 5, increased by ten percent for the second July
1 date; and
(6) the other operating payment rate as determined under section 256R.24 in effect for
the rate year must be used for the other operating cost per day.
Sec. 27.
new text begin
[256R.405] CONSOLIDATION RATES.
new text end
new text begin Subdivision 1. new text end
new text begin Consolidation rates; generally. new text end
new text begin
The external fixed costs payment rate
for nursing facilities that have completed a state-approved consolidation project must include
a consolidation rate adjustment. A facility's consolidation rate adjustment expires upon
transition to a fair rental value property payment rate under section 256R.26, subdivision
9. The commissioner must inform the revisor of statutes when a facility's consolidation rate
adjustment specified under this section expires. This subdivision expires upon the expiration
of all other subdivisions of this section.
new text end
new text begin Subd. 2. new text end
new text begin Owatonna. new text end
new text begin
The consolidation rate for the nursing facility located at 2255 30th
Street Northwest in Owatonna is $33.88.
new text end
new text begin Subd. 3. new text end
new text begin Red Wing. new text end
new text begin
The consolidation rate for the nursing facility located at 213 Pioneer
Road in Red Wing is $73.69.
new text end
new text begin Subd. 4. new text end
new text begin White Bear Lake. new text end
new text begin
The consolidation rate for the nursing facility located at
1891 Florence Street in White Bear Lake is $25.56.
new text end
new text begin Subd. 5. new text end
new text begin St. Paul. new text end
new text begin
The consolidation rate for the nursing facility located at 200 Earl
Street in St. Paul is $68.01.
new text end
new text begin Subd. 6. new text end
new text begin Cambridge. new text end
new text begin
The consolidation rate for the nursing facility located at 135 Fern
Street North in Cambridge is $24.30.
new text end
new text begin Subd. 7. new text end
new text begin Maple Plain. new text end
new text begin
The consolidation rate for the nursing facility located at 4848
Gateway Boulevard in Maple Plain is $38.76.
new text end
new text begin Subd. 8. new text end
new text begin Maplewood. new text end
new text begin
The consolidation rate for the nursing facility located at 1438
County Road C East in Maplewood is $55.63.
new text end
new text begin Subd. 9. new text end
new text begin Apple Valley. new text end
new text begin
The consolidation rate for the nursing facility located at 14650
Garrett Avenue in Apple Valley is $26.99.
new text end
Sec. 28.
Minnesota Statutes 2024, section 256R.43, is amended to read:
256R.43 BED HOLDS.
The commissioner shall limit payment for leave days in a nursing facility to 30 percent
of that nursing facility's total payment rate for the involved resident, and shall allow this
payment only when the occupancy of the nursing facility, inclusive of bed hold days, is
equal to or greater than 96 percent, notwithstanding Minnesota Rules, part 9505.0415.new text begin For
the purpose of establishing leave day payments, the commissioner shall determine occupancy
based on the number of licensed and certified beds in the facility that are not in layaway
status.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 29.
new text begin
[256R.531] PATIENT DRIVEN PAYMENT MODEL PHASE-IN.
new text end
new text begin Subdivision 1. new text end
new text begin PDPM phase-in. new text end
new text begin
Effective October 1, 2025, through December 31, 2028,
for each facility, the commissioner must determine an adjustment to its total payment rate
as determined under sections 256R.21 and 256R.27 to phase in the transition from the
RUG-IV case mix classification system to the patient driven payment model (PDPM) case
mix classification system.
new text end
new text begin Subd. 1a. new text end
new text begin Definition. new text end
new text begin
"Medical assistance facility average case mix index" means the
facility average case mix index for the subset of a facility's residents that includes only
medical assistance recipients.
new text end
new text begin Subd. 2. new text end
new text begin PDPM phase-in rate adjustment. new text end
new text begin
A facility's PDPM phase-in rate adjustment
to its total payment rate is equal to:
new text end
new text begin
(1) the blended medical assistance case mix adjusted direct care payment rate determined
in subdivision 6; minus
new text end
new text begin
(2) the PDPM medical assistance case mix adjusted direct care payment rate determined
in section 256R.23, subdivision 7.
new text end
new text begin Subd. 3. new text end
new text begin RUG-IV standardized days and RUG-IV facility case mix index. new text end
new text begin
(a) Effective
October 1, 2025, through December 31, 2027, for each facility, the commissioner must
determine the RUG-IV standardized days and RUG-IV medical assistance facility average
case mix index.
new text end
new text begin
(b) For the rate year beginning January 1, 2028, only:
new text end
new text begin
(1) for each facility, the commissioner must determine both the RUG-IV facility average
case mix index and the RUG-IV medical assistance facility average case mix index using
resident days by the case mix classification on the facility's September 30, 2025, Minnesota
Statistical and Cost Report; and
new text end
new text begin
(2) for each facility, the commissioner must determine the RUG-IV standardized days
by multiplying the facility's resident days on the facility's September 30, 2026, Minnesota
Statistical and Cost Report by the facility's RUG-IV facility average case mix index
determined under clause (1).
new text end
new text begin Subd. 4. new text end
new text begin RUG-IV medical assistance case mix adjusted direct care payment rate. new text end
new text begin
The
commissioner must determine a facility's RUG-IV medical assistance case mix adjusted
direct care payment rate as the product of:
new text end
new text begin
(1) the facility's RUG-IV direct care payment rate determined in section 256R.23,
subdivision 7, using the RUG-IV standardized days determined in subdivision 3; and
new text end
new text begin
(2) the corresponding RUG-IV medical assistance facility average case mix index
determined in subdivision 3.
new text end
new text begin Subd. 5. new text end
new text begin PDPM medical assistance case mix adjusted direct care payment rate. new text end
new text begin
The
commissioner must determine a facility's PDPM case mix adjusted direct care payment rate
as the product of:
new text end
new text begin
(1) the facility's direct care payment rate determined in section 256R.23, subdivision 7;
and
new text end
new text begin
(2) the corresponding medical assistance facility average case mix index.
new text end
new text begin Subd. 6. new text end
new text begin Blended medical assistance case mix adjusted direct care payment rate. new text end
new text begin
The
commissioner must determine a facility's blended medical assistance case mix adjusted
direct care payment rate as the sum of:
new text end
new text begin
(1) the RUG-IV medical assistance case mix adjusted direct care payment rate determined
in subdivision 4 multiplied by the following percentages:
new text end
new text begin
(i) after September 30, 2025, through December 31, 2026, 75 percent;
new text end
new text begin
(ii) after December 31, 2026, through December 31, 2027, 50 percent; and
new text end
new text begin
(iii) after December 31, 2027, through December 31, 2028, 25 percent; and
new text end
new text begin
(2) the PDPM medical assistance case mix adjusted direct care payment rate determined
in subdivision 5 multiplied by the following percentages:
new text end
new text begin
(i) after September 30, 2025, through December 31, 2026, 25 percent;
new text end
new text begin
(ii) after December 31, 2026, through December 31, 2027, 50 percent; and
new text end
new text begin
(iii) after December 31, 2027, through December 31, 2028, 75 percent.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
This section expires January 1, 2029.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2025.
new text end
Sec. 30.
new text begin
[256R.532] NURSING FACILITY RATE ADD-ON FOR WORKFORCE
STANDARDS.
new text end
new text begin
(a) Effective for rate years beginning on and after January 1, 2028, or upon federal
approval, whichever is later, the commissioner shall annually provide a rate add-on amount
for nursing facilities reimbursed under this chapter for the initial standards for wages for
nursing home workers adopted by the Nursing Home Workforce Standards Board in
Minnesota Rules, parts 5200.2060 to 5200.2090, pursuant to section 181.213, subdivision
2, paragraph (c). The add-on amount is equal to:
new text end
new text begin
(1) $3.93 per resident day, effective January 1, 2028, through December 31, 2028; and
new text end
new text begin
(2) $8.55 per resident day, effective January 1, 2029.
new text end
new text begin
(b) Effective upon federal approval, the commissioner must determine the add-on amount
for subsequent rate years in consultation with the commissioner of labor and industry.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 31.
Minnesota Statutes 2024, section 256S.205, subdivision 2, is amended to read:
Subd. 2.
Rate adjustment application.
(a) Effective through September 30, 2023, a
facility may apply to the commissioner for new text begin an initial new text end designation as a disproportionate share
facility. Applications must be submitted annually between September 1 and September 30.
The applying facility must apply in a manner determined by the commissioner. The applying
facility must document each of the following on the application:
(1) the number of customized living residents in the facility on September 1 of the
application year, broken out by specific waiver program; and
(2) the total number of people residing in the facility on September 1 of the application
year.
(b) Effective October 1, 2023, the commissioner must not process any new new text begin initial
new text end applications for disproportionate share facilities deleted text begin after the September 1 through September
30, 2023, application perioddeleted text end .
(c) A facility that deleted text begin receivesdeleted text end new text begin receivednew text end rate floor payments in rate year 2024 may submit
an new text begin annual new text end application under this subdivision to maintain its designation as a disproportionate
share facility deleted text begin for rate year 2025deleted text end .
Sec. 32.
Minnesota Statutes 2024, section 256S.205, subdivision 3, is amended to read:
Subd. 3.
Rate adjustment eligibility criteria.
(a) deleted text begin Effective through September 30, 2023,deleted text end
Only facilities satisfying all of the following conditions on September 1 of the application
year are eligible for designation as a disproportionate share facility:
(1) at least 83.5 percent of the residents of the facility are customized living residents;
and
(2) at least 70 percent of the customized living residents are elderly waiver participants.
(b) A facility determined eligible for the disproportionate share rate adjustment in
application year 2023 and receiving payments in rate year 2024 is eligible to receive payments
in rate deleted text begin year 2025deleted text end new text begin years beginning on or after January 1, 2025,new text end only if the commissioner
determines that the facility continues to meet the eligibility requirements under this
subdivision as determined by the application process under subdivision 2, paragraph (c).
Sec. 33.
Minnesota Statutes 2024, section 256S.205, subdivision 5, is amended to read:
Subd. 5.
Rate adjustment; rate floor.
(a) deleted text begin Effective through December 31, 2025,deleted text end
Notwithstanding the 24-hour customized living monthly service rate limits under section
256S.202, subdivision 2, and the component service rates established under section 256S.201,
subdivision 4, the commissioner must establish a rate floor equal to $141 per resident per
day for 24-hour customized living services provided to an elderly waiver participant in a
designated disproportionate share facility.
(b) The commissioner must apply the rate floor to the services described in paragraph
(a) provided during the rate year.
Sec. 34.
Laws 2021, chapter 30, article 12, section 5, as amended by Laws 2021, First
Special Session chapter 7, article 17, section 2, and Laws 2023, chapter 61, article 2, section
35, is amended to read:
Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.
The Governor's Council on an Age-Friendly Minnesota, established in Executive Order
19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and
private partners' collaborative work on emergency preparedness, with a focus on older
adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic.
The Governor's Council on an Age-Friendly Minnesota is extended and expires June 30,
deleted text begin 2027deleted text end new text begin 2025new text end .
Sec. 35. new text begin AGE-FRIENDLY MINNESOTA COUNCIL; CONTINUATION OF
APPOINTMENTS AND DESIGNATION OF INITIAL TERMS.
new text end
new text begin Subdivision 1. new text end
new text begin Continuation of appointments. new text end
new text begin
Each member of the Governor's Council
on an Age-Friendly Minnesota, established in Executive Order 19-38, serving on June 30,
2025, shall be deemed appointed to the Age-Friendly Minnesota Council by the applicable
appointing authority under Minnesota Statutes, section 256.9746, effective July 1, 2025.
new text end
new text begin Subd. 2. new text end
new text begin First meeting. new text end
new text begin
The individual who was serving as chairperson of the Governor's
Council on an Age-Friendly Minnesota, established in Executive Order 19-38, as of June
30, 2025, must convene the first meeting of the Age-Friendly Minnesota Council no later
than July 9, 2025. The former chairperson of the Governor's Council on an Age-Friendly
Minnesota shall preside over the first meeting until the Age-Friendly Minnesota Council
elects a chairperson.
new text end
new text begin Subd. 3. new text end
new text begin Designation of initial terms. new text end
new text begin
The governor must notify the secretary of state
which initial public members of the Age-Friendly Minnesota Council will have terms
coterminous with that of the governor or request that the secretary of state randomly
determine which initial public members will have terms coterminous with the governor's
term.
new text end
Sec. 36. new text begin DIRECTION TO THE COMMISSIONER; IMPACT STUDY OF REPEAL
OF DISPROPORTIONATE SHARE PAYMENTS.
new text end
new text begin
(a) The commissioner of human services must conduct a study of the impact of the repeal
of Minnesota Statutes, section 256S.205, on those facilities that received a rate floor payment
in rate year 2025. For each facility that received a rate floor payment in rate year 2025, the
commissioner must determine:
new text end
new text begin
(1) how many facilities remain operational on September 1, 2026;
new text end
new text begin
(2) the total number of residents of the facility on September 1, 2026;
new text end
new text begin
(3) the proportion of residents of the facility who are customized living residents on
September 1, 2026;
new text end
new text begin
(4) the proportion of residents who are elderly waiver participants on September 1, 2026;
and
new text end
new text begin
(5) the difference by facility between the results under clauses (1) to (4) and the same
or similar information submitted by the facility on its rate year 2025 application.
new text end
new text begin
(b) The commissioner must solicit from each provider a summary of its financial position
as of September 1, 2026, as compared to its financial position on September 1, 2025, and
a statement of the facility's change in operational margin between September 1, 2025, and
September 1, 2026. The controlling individual of a facility that submits a financial summary
and statement of the facility's change in operational margin must attest to the accuracy of
the financial summary and statement.
new text end
new text begin
(c) By January 1, 2027, the commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services a report
summarizing the data on the impact of the repeal of Minnesota Statutes, section 256S.205,
on those facilities that received a rate floor payment in rate year 2025.
new text end
new text begin
(d) The definitions in Minnesota Statutes 2024, section 256S.205, apply to this section.
new text end
Sec. 37. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2024, sections 144A.071, subdivision 4c; 256R.02, subdivision
38; 256R.40; 256R.41; and 256R.481,
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are repealed.
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(b)
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Minnesota Statutes 2024, sections 256R.12, subdivision 10; and 256R.36,
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are repealed.
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(c)
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Minnesota Statutes 2024, section 256R.23, subdivision 6,
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is repealed.
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(d)
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Minnesota Statutes 2024, section 256S.205, subdivision 7,
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is repealed.
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new text begin EFFECTIVE DATE. new text end
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Paragraph (a) is effective January 1, 2026. Paragraphs (b) and
(d) are effective the day following final enactment. Paragraph (c) is effective October 1,
2025.
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ARTICLE 2
DISABILITY SERVICES
Section 1.
Minnesota Statutes 2024, section 144.0724, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For purposes of this section, the following terms have the meanings
given.
(a) "Assessment reference date" or "ARD" means the specific end point for look-back
periods in the MDS assessment process. This look-back period is also called the observation
or assessment period.
(b) "Case mix index" means the weighting factors assigned to the case mix reimbursement
classifications determined by an assessment.
(c) "Index maximization" means classifying a resident who could be assigned to more
than one category, to the category with the highest case mix index.
(d) "Minimum Data Set" or "MDS" means a core set of screening, clinical assessment,
and functional status elements, that include common definitions and coding categories
specified by the Centers for Medicare and Medicaid Services and designated by the
Department of Health.
(e) "Representative" means a person who is the resident's guardian or conservator, the
person authorized to pay the nursing home expenses of the resident, a representative of the
Office of Ombudsman for Long-Term Care whose assistance has been requested, or any
other individual designated by the resident.
(f) "Activities of daily living" includes personal hygiene, dressing, bathing, transferring,
bed mobility, locomotion, eating, and toileting.
(g) "Nursing facility level of care determination" means the assessment process that
results in a determination of a resident's or prospective resident's need for nursing facility
level of care as established in subdivision 11 for purposes of medical assistance payment
of long-term care services for:
(1) nursing facility services under chapter 256R;
(2) elderly waiver services under chapter 256S;new text begin and
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(3) CADI and BI waiver services under section 256B.49; and
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deleted text begin (4)deleted text end new text begin (3)new text end state payment of alternative care services under section 256B.0913.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
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Sec. 2.
Minnesota Statutes 2024, section 144.0724, subdivision 11, is amended to read:
Subd. 11.
Nursing facility level of care.
(a) For purposes of medical assistance payment
of long-term care servicesnew text begin specified in subdivision 2, paragraph (g)new text end , a recipient must be
determined, using assessments defined in subdivision 4, to meet one of the following nursing
facility level of care criteria:
(1) the person requires formal clinical monitoring at least once per day;
(2) the person needs the assistance of another person or constant supervision to begin
and complete at least four of the following activities of living: bathing, bed mobility, dressing,
eating, grooming, toileting, transferring, and walking;
(3) the person needs the assistance of another person or constant supervision to begin
and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
(4) the person has significant difficulty with memory, using information, daily decision
making, or behavioral needs that require intervention;
(5) the person has had a qualifying nursing facility stay of at least 90 days;
(6) the person meets the nursing facility level of care criteria determined 90 days after
admission or on the first quarterly assessment after admission, whichever is later; or
(7) the person is determined to be at risk for nursing facility admission or readmission
through a face-to-face long-term care consultation assessment as specified in section
256B.0911, subdivision 17 to 21, 23, 24, 27, or 28, by a county, tribe, or managed care
organization under contract with the Department of Human Services. The person is
considered at risk under this clause if the person currently lives alone or will live alone or
be homeless without the person's current housing and also meets one of the following criteria:
(i) the person has experienced a fall resulting in a fracture;
(ii) the person has been determined to be at risk of maltreatment or neglect, including
self-neglect; or
(iii) the person has a sensory impairment that substantially impacts functional ability
and maintenance of a community residence.
(b) The assessment used to establish medical assistance payment for nursing facility
services must be the most recent assessment performed under subdivision 4, paragraphs (b)
and (c), that occurred no more than 90 calendar days before the effective date of medical
assistance eligibility for payment of long-term care services. In no case shall medical
assistance payment for long-term care services occur prior to the date of the determination
of nursing facility level of care.
(c) The assessment used to establish medical assistance payment for long-term care
services provided under chapter 256S and section 256B.49 and alternative care payment
for services provided under section 256B.0913 must be the most recent face-to-face
assessment performed under section 256B.0911, subdivisions 17 to 21, 23, 24, 27, or 28,
that occurred no more than 60 calendar days before the effective date of medical assistance
eligibility for payment of long-term care services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
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Sec. 3.
Minnesota Statutes 2024, section 144.0724, is amended by adding a subdivision
to read:
new text begin Subd. 11a. new text end
new text begin
Determination of nursing facility level of care for the brain injury and
community access for disability inclusion waivers.
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new text begin
(a) Effective January 1, 2026, or upon
federal approval, whichever is later, a person must be determined to meet one of the following
nursing facility level of care criteria to be eligible for the brain injury and community access
for disability inclusion waivers under section 256B.49:
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new text begin
(1) the person requires the assistance of another person or constant supervision to begin
and complete at least four of the following activities of daily living: bathing, bed mobility,
dressing, eating, grooming, toileting, transferring, or walking;
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new text begin
(2) the person needs the assistance of another person or constant supervision to begin
and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
or
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(3) the person has significant difficulty with memory, using information, daily decision
making, or behavioral needs that require the person to be constantly supervised or require
interventions that cannot be scheduled.
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(b) Nursing facility level of care determinations for purposes of initial and ongoing
access to the brain injury and community access for disability inclusion waiver programs
must be conducted by a certified assessor under section 256B.0911.
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new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
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Sec. 4.
Minnesota Statutes 2024, section 144A.351, subdivision 1, is amended to read:
Subdivision 1.
Report requirements.
(a) The commissioners of health and human
services, with the cooperation of counties and in consultation with stakeholders, including
persons who need or are using long-term care services and supports, lead agencies, regional
entities, senior, disability, and mental health organization representatives, service providers,
and community members shall compile data regarding the status of the full range of long-term
care services and supports for the elderly and children and adults with disabilities and mental
illnesses in Minnesota. The compiled data shall include:
(1) demographics and need for long-term care services and supports in Minnesota;
(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances,
and corrective action plans;
(3) status of long-term care services and related mental health services, housing options,
and supports by county and region including:
(i) changes in availability of the range of long-term care services and housing options;
(ii) access problems, including access to the least restrictive and most integrated services
and settings, regarding long-term care services; and
(iii) comparative measures of long-term care services availability, including serving
people in their home areas near family, and changes over time; deleted text begin and
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(4) recommendations regarding goals for the future of long-term care services and
supports, policy and fiscal changes, and resource development and transition needsdeleted text begin .deleted text end new text begin ; and
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(5) the following information on the availability of integrated community supports,
updated within 30 days of the end of each of four three-month reporting periods, which
begin on January 1 of each year:
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(i) the average number of integrated community supports beds occupied, per month, for
the preceding reporting period;
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(ii) the average number of integrated community supports beds available, per month,
for the preceding reporting period;
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(iii) the number of integrated community supports setting applications being reviewed
by the commissioner of human services as of the final day of the reporting period; and
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(vi) the average time of review for integrated community supports setting applications
submitted during the preceding quarter.
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(b) The commissioners of health and human services shall make the compiled data
available on at least one of the department's websites.
Sec. 5.
Minnesota Statutes 2024, section 179A.54, is amended by adding a subdivision to
read:
new text begin Subd. 12. new text end
new text begin Minnesota Caregiver Retirement Fund Trust. new text end
new text begin
(a) The state and an exclusive
representative certified pursuant to this section may establish a joint labor and management
trust, referred to as the Minnesota Caregiver Retirement Fund Trust, for the exclusive
purpose of creating, implementing, and administering a retirement program for individual
providers of direct support services who are represented by the exclusive representative.
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(b) The state must make financial contributions to the Minnesota Caregiver Retirement
Fund Trust pursuant to a collective bargaining agreement negotiated under this section. The
financial contributions by the state must be held in trust for the purpose of paying, from
principal, income, or both, the costs associated with creating, implementing, and
administering a defined contribution or other individual account retirement program for
individual providers of direct support services working under a collective bargaining
agreement and providing services through a covered program under section 256B.0711. A
board of trustees composed of an equal number of trustees appointed by the governor and
trustees appointed by the exclusive representative under this section must administer, manage,
and otherwise jointly control the Minnesota Caregiver Retirement Fund Trust. The trust
must not be an agent of either the state or the exclusive representative.
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(c) A third-party administrator, financial management institution, other appropriate
entity, or any combination thereof may provide trust administrative, management, legal,
and financial services to the board of trustees as designated by the board of trustees from
time to time. The services must be paid from the money held in trust and created by the
state's financial contributions to the Minnesota Caregiver Retirement Fund Trust.
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(d) The state is authorized to purchase liability insurance for members of the board of
trustees appointed by the governor.
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(e) Financial contributions to or participation in the management or administration of
the Minnesota Caregiver Retirement Fund Trust must not be considered an unfair labor
practice under section 179A.13, or a violation of Minnesota law.
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new text begin
(f) Nothing in this section shall be construed to authorize the creation of a defined benefit
retirement plan or program.
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new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
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Sec. 6.
Minnesota Statutes 2024, section 245A.042, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Compliance education required. new text end
new text begin
The commissioner must make licensing
compliance education available to all license holders operating programs licensed under
both this chapter and chapter 245D. The licensing compliance education must include clear
and accessible explanations of achieving and maintaining compliance with the relevant
licensing requirements under this chapter and chapter 245D.
new text end
Sec. 7.
Minnesota Statutes 2024, section 245A.06, subdivision 1a, is amended to read:
Subd. 1a.
Correction orders and conditional licenses for programs licensed as home
and community-based services.
(a) For programs licensed under both this chapter and
chapter 245D, if the license holder operates more than one service site under a single license
governed by chapter 245D, the new text begin correction new text end order new text begin or order of conditional license new text end issued under
this section shall be specific to the service site or sites at which the violations of applicable
law or rules occurred. The order shall not apply to other service sites governed by chapter
245D and operated by the same license holder unless the commissioner has included in the
order the articulable basis for applying the order to another service site.
(b) If the commissioner has issued more than one license to the license holder under this
chapter, the deleted text begin conditions imposeddeleted text end new text begin order issuednew text end under this section shall be specific to the license
for the program at which the violations of applicable law or rules occurred and shall not
apply to other licenses held by the same license holder if those programs are being operated
in substantial compliance with applicable law and rules.
new text begin
(c) Prior to issuing an order of conditional license under this section to a license holder
operating a program licensed under both this chapter and chapter 245D, the commissioner
must inform the license holder that the next audit or investigation may lead to an order of
conditional license if the provider fails to correct the violations specified in a prior correction
order or has any new violations. Nothing in this paragraph limits the commissioner's authority
to take immediate action under section 245A.07 to prevent or correct actions by the license
holder that imminently endanger the health, safety, or rights of the persons served by the
program.
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(d) The commissioner may reduce the length of time of a conditional license for a license
holder operating a program licensed under both this chapter and chapter 245D if the license
holder demonstrates compliance or progress toward compliance before the conditional
license period expires.
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new text begin
(e) By January 1, 2026, and annually thereafter, the commissioner must provide a report
to the chairs and ranking minority members of the legislative committees with jurisdiction
over chapter 245D licensing on the number of correction orders and orders of conditional
license issued to license holders who operate programs licensed under both this chapter and
chapter 245D. The report must include aggregated data on the zip codes of locations, number
of employees, license effective dates for any license holders subject to correction orders
and orders of conditional license, and the commissioner's efforts to offer collaborative safety
process improvements to license holders under section 245A.042 and this subdivision.
new text end
Sec. 8.
Minnesota Statutes 2024, section 245A.06, subdivision 2, is amended to read:
Subd. 2.
Reconsideration of correction orders.
(a) If the applicant or license holder
believes that the contents of the commissioner's correction order are in error, the applicant
or license holder may ask the Department of Human Services to reconsider the parts of the
correction order that are alleged to be in error. The request for reconsideration must be made
in writing and must be postmarked and sent to the commissioner within 20 calendar days
after receipt of the correction order by the applicant or license holder or submitted in the
provider licensing and reporting hub within 20 calendar days from the date the commissioner
issued the order through the hub, and:
(1) specify the parts of the correction order that are alleged to be in error;
(2) explain why they are in error; and
(3) include documentation to support the allegation of error.
Upon implementation of the provider licensing and reporting hub, the provider must use
the hub to request reconsideration. A request for reconsideration does not stay any provisions
or requirements of the correction order. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14.
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(b) This paragraph applies only to licensed family child care providers. A licensed family
child care provider who requests reconsideration of a correction order under paragraph (a)
may also request, on a form and in the manner prescribed by the commissioner, that the
commissioner expedite the review if:
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(1) the provider is challenging a violation and provides a description of how complying
with the corrective action for that violation would require the substantial expenditure of
funds or a significant change to their program; and
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(2) describes what actions the provider will take in lieu of the corrective action ordered
to ensure the health and safety of children in care pending the commissioner's review of the
correction order.
deleted text end
new text begin
(b) Notwithstanding paragraph (a), when a request for reconsideration is denied, the
commissioner must offer the option of mediation for a license holder operating a program
licensed under both this chapter and chapter 245D, if a license holder further disputes the
commissioner's correction order. The costs of the mediation option under this paragraph
must be paid by the license holder.
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Sec. 9.
new text begin
[245A.142] EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL
INTERVENTION PROVISIONAL LICENSURE.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
The definitions in section 256B.0949, subdivision 2, apply
to this section.
new text end
new text begin Subd. 2. new text end
new text begin Regulatory powers. new text end
new text begin
The commissioner shall regulate early intensive
developmental and behavioral intervention (EIDBI) agencies pursuant to this section.
new text end
new text begin Subd. 3. new text end
new text begin Provisional license. new text end
new text begin
(a) Beginning on January 1, 2026, the commissioner shall
begin issuing provisional licenses to agencies enrolled under chapter 256B to provide EIDBI
services.
new text end
new text begin
(b) Agencies enrolled prior to July 1, 2025, have until March 31, 2026, to submit an
application for provisional licensure on the forms and in the manner prescribed by the
commissioner.
new text end
new text begin
(c) Beginning April 1, 2026, an agency must not operate if it has not submitted an
application for provisional licensure under this section. The commissioner shall disenroll
an agency from providing EIDBI services under chapter 256B if the agency fails to submit
an application for provisional licensure by March 31, 2026, or a complete application by
July 1, 2026.
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new text begin
(d) The commissioner must determine whether a provisional license applicant complies
with all applicable rules and laws and either issue a provisional license to the applicant or
deny the application by December 31, 2026.
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new text begin
(e) A provisional license is effective until comprehensive EIDBI agency licensure
standards are in effect unless the provisional license is revoked.
new text end
new text begin
(f) Beginning January 1, 2027, an agency providing EIDBI services must not operate in
Minnesota unless provisionally licensed under this section.
new text end
new text begin Subd. 4. new text end
new text begin Provisional license regulatory functions. new text end
new text begin
The commissioner may:
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new text begin
(1) enter the physical premises of an agency without advance notice in accordance with
section 245A.04, subdivision 5;
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new text begin
(2) investigate reports of maltreatment;
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new text begin
(3) investigate complaints against agencies;
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new text begin
(4) take action on a license pursuant to sections 245A.06 and 245A.07;
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new text begin
(5) deny an application for provisional licensure pursuant to section 245A.05; and
new text end
new text begin
(6) take other action reasonably required to accomplish the purposes of this section.
new text end
new text begin Subd. 5. new text end
new text begin Provisional license requirements. new text end
new text begin
A provisional license holder must:
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new text begin
(1) identify all controlling individuals, as defined in section 245A.02, subdivision 5a,
of the agency;
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new text begin
(2) provide documented disclosures surrounding the use of billing agencies or other
consultants, available to the department upon request;
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new text begin
(3) establish provider policies and procedures related to staff training, staff qualifications,
quality assurance, and service activities;
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new text begin
(4) document contracts with independent contractors for qualified supervising
professionals, including the number of hours contracted and responsibilities, available to
the department upon request; and
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new text begin
(5) comply with section 256B.0949, including exceptions to qualifications, standards,
and requirements granted by the commissioner under section 256B.0949, subdivision 17.
new text end
new text begin Subd. 6. new text end
new text begin Reconsideration requests and appeals. new text end
new text begin
An applicant or provisional license
holder has reconsideration and appeal rights under sections 245A.05, 245A.06, and 245A.07.
new text end
new text begin Subd. 7. new text end
new text begin Disenrollment. new text end
new text begin
The commissioner shall disenroll an agency from providing
EIDBI services under chapter 256B if:
new text end
new text begin
(1) the agency's application has been suspended or denied under subdivision 2 or the
agency's provisional license has been revoked; and
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new text begin
(2) if the agency appealed the application suspension or denial or the provisional license
revocation, the commissioner has issued a final order on the appeal.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 10.
Minnesota Statutes 2024, section 245C.16, subdivision 1, is amended to read:
Subdivision 1.
Determining immediate risk of harm.
(a) If the commissioner determines
that the individual studied has a disqualifying characteristic, the commissioner shall review
the information immediately available and make a determination as to the subject's immediate
risk of harm to persons served by the program where the individual studied will have direct
contact with, or access to, people receiving services.
(b) The commissioner shall consider all relevant information available, including the
following factors in determining the immediate risk of harm:
(1) the recency of the disqualifying characteristic;
(2) the recency of discharge from probation for the crimes;
(3) the number of disqualifying characteristics;
(4) the intrusiveness or violence of the disqualifying characteristic;
(5) the vulnerability of the victim involved in the disqualifying characteristic;
(6) the similarity of the victim to the persons served by the program where the individual
studied will have direct contact;
(7) whether the individual has a disqualification from a previous background study that
has not been set aside;
(8) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 1, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense in
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with, or access to, persons receiving services from
the program and from working in a children's residential facility or foster residence setting;
and
(9) if the individual has a disqualification which may not be set aside because it is a
permanent bar under section 245C.24, subdivision 2, or the individual is a child care
background study subject who has a felony-level conviction for a drug-related offense during
the last five years, the commissioner may order the immediate removal of the individual
from any position allowing direct contact with or access to persons receiving services from
the center and from working in a licensed child care center or certified license-exempt child
care center.
(c) This section does not apply when the subject of a background study is regulated by
a health-related licensing board as defined in chapter 214, and the subject is determined to
be responsible for substantiated maltreatment under section 626.557 or chapter 260E.
(d) This section does not apply to a background study related to an initial application
for a child foster family setting license.
(e) Except for paragraph (f), this section does not apply to a background study that is
also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a
personal care assistant or a qualified professional as defined in section 256B.0659,
subdivision 1new text begin , or to a background study for an individual providing early intensive
developmental and behavioral intervention services under section 256B.0949new text end .
(f) If the commissioner has reason to believe, based on arrest information or an active
maltreatment investigation, that an individual poses an imminent risk of harm to persons
receiving services, the commissioner may order that the person be continuously supervised
or immediately removed pending the conclusion of the maltreatment investigation or criminal
proceedings.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 11.
Minnesota Statutes 2024, section 245D.091, subdivision 2, is amended to read:
Subd. 2.
Positive support professional qualifications.
A positive support professional
providing positive support services as identified in section 245D.03, subdivision 1, paragraph
(c), clause (1), item (i), must have competencies in the following areas as required under
the brain injury, community access for disability inclusion, community alternative care, and
developmental disabilities waiver plans or successor plans:
(1) ethical considerations;
(2) functional assessment;
(3) functional analysis;
(4) measurement of behavior and interpretation of data;
(5) selecting intervention outcomes and strategies;
(6) behavior reduction and elimination strategies that promote least restrictive approved
alternatives;
(7) data collection;
(8) staff and caregiver training;
(9) support plan monitoring;
(10) co-occurring mental disorders or neurocognitive disorder;
(11) demonstrated expertise with populations being served; and
(12) must be a:
(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board
of Psychology competencies in the above identified areas;
(ii) clinical social worker licensed as an independent clinical social worker under chapter
148D, or a person with a master's degree in social work from an accredited college or
university, with at least 4,000 hours of post-master's supervised experience in the delivery
of clinical services in the areas identified in clauses (1) to (11);
(iii) physician licensed under chapter 147 and certified by the American Board of
Psychiatry and Neurology or eligible for board certification in psychiatry with competencies
in the areas identified in clauses (1) to (11);
(iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39
with at least 4,000 hours of post-master's supervised experience in the delivery of clinical
services who has demonstrated competencies in the areas identified in clauses (1) to (11);
(v) person with a master's degree from an accredited college or university in one of the
behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical services with demonstrated competencies in the areas
identified in clauses (1) to (11);
(vi) person with a master's degree or PhD in one of the behavioral sciences or related
fields with demonstrated expertise in positive support services, as determined by the person's
needs as outlined in the person's assessment summary; deleted text begin or
deleted text end
(vii) registered nurse who is licensed under sections 148.171 to 148.285, and who is
certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
mental health nursing by a national nurse certification organization, or who has a master's
degree in nursing or one of the behavioral sciences or related fields from an accredited
college or university or its equivalent, with at least 4,000 hours of post-master's supervised
experience in the delivery of clinical servicesnew text begin ; or
new text end
new text begin (viii) person who has completed a competency-based training program as determined
by the commissionernew text end .
Sec. 12.
Minnesota Statutes 2024, section 245D.091, subdivision 3, is amended to read:
Subd. 3.
Positive support analyst qualifications.
(a) A positive support analyst providing
positive support services as identified in section 245D.03, subdivision 1, paragraph (c),
clause (1), item (i), must deleted text begin have competencies in one of the following areasdeleted text end new text begin satisfy one of the
following requirementsnew text end as required under the brain injury, community access for disability
inclusion, community alternative care, and developmental disabilities waiver plans or
successor plans:
(1) have obtained a baccalaureate degree, master's degree, or PhD in either a social
services discipline or nursing;
(2) meet the qualifications of a mental health practitioner as defined in section 245.462,
subdivision 17; deleted text begin or
deleted text end
(3) be a board-certified behavior analyst or board-certified assistant behavior analyst by
the Behavior Analyst Certification Board, Incorporatednew text begin ; or
new text end
new text begin (4) have completed a competency-based training program as determined by the
commissionernew text end .
(b) In addition, a positive support analyst must:
(1) new text begin either new text end have two years of supervised experience conducting functional behavior
assessments and designing, implementing, and evaluating effectiveness of positive practices
behavior support strategies for people who exhibit challenging behaviors as well as
co-occurring mental disorders and neurocognitive disordernew text begin , or for those who have obtained
a baccalaureate degree in one of the behavioral sciences or related fields, demonstrated
expertise in positive support servicesnew text end ;
(2) have received training prior to hire or within 90 calendar days of hire that includes:
(i) ten hours of instruction in functional assessment and functional analysis;
(ii) 20 hours of instruction in the understanding of the function of behavior;
(iii) ten hours of instruction on design of positive practices behavior support strategies;
(iv) 20 hours of instruction preparing written intervention strategies, designing data
collection protocols, training other staff to implement positive practice strategies,
summarizing and reporting program evaluation data, analyzing program evaluation data to
identify design flaws in behavioral interventions or failures in implementation fidelity, and
recommending enhancements based on evaluation data; and
(v) eight hours of instruction on principles of person-centered thinking;
(3) be determined by a positive support professional to have the training and prerequisite
skills required to provide positive practice strategies as well as behavior reduction approved
and permitted intervention to the person who receives positive support; and
(4) be under the direct supervision of a positive support professional.
(c) Meeting the qualifications for a positive support professional under subdivision 2
shall substitute for meeting the qualifications listed in paragraph (b).
Sec. 13.
Minnesota Statutes 2024, section 245D.12, is amended to read:
245D.12 INTEGRATED COMMUNITY SUPPORTSdeleted text begin ; SETTING CAPACITY
REPORTdeleted text end .
new text begin Subdivision 1. new text end
new text begin Setting capacity report. new text end
(a) The license holder providing integrated
community support, as defined in section 245D.03, subdivision 1, paragraph (c), clause (8),
must submit a setting capacity report to the commissioner to ensure the identified location
of service delivery meets the criteria of the home and community-based service requirements
as specified in section 256B.492.
(b) The license holder shall provide the setting capacity report on the forms and in the
manner prescribed by the commissioner. The report must include:
(1) the address of the multifamily housing building where the license holder delivers
integrated community supports and owns, leases, or has a direct or indirect financial
relationship with the property owner;
(2) the total number of living units in the multifamily housing building described in
clause (1) where integrated community supports are delivered;
(3) the total number of living units in the multifamily housing building described in
clause (1), including the living units identified in clause (2);
(4) the total number of people who could reside in the living units in the multifamily
housing building described in clause (2) and receive integrated community supports; and
(5) the percentage of living units that are controlled by the license holder in the
multifamily housing building by dividing clause (2) by clause (3).
(c) Only one license holder may deliver integrated community supports at the address
of the multifamily housing building.
new text begin Subd. 2. new text end
new text begin Setting approval moratorium. new text end
new text begin
(a) The commissioner must not approve an
integrated community supports setting for which a setting capacity report was submitted
between July 1, 2025, and June 30, 2027.
new text end
new text begin
(b) The commissioner may approve exceptions to the approval moratorium under this
subdivision if the commissioner determines:
new text end
new text begin
(1) a new integrated community supports setting is needed to provide integrated
community supports for a person requiring hospital-level care;
new text end
new text begin
(2) a new integrated community supports setting is needed for a licensed assisted living
facility that is closing or converting from an assisted living facility license to a licensed
integrated community supports provider;
new text end
new text begin
(3) a new integrated community supports setting with specialized qualities, including
wheelchair accessible units, specialized equipment, or other unique qualities is needed to
meet the needs of a client identified by the local county board; or
new text end
new text begin
(4) a new integrated community supports setting has funding from the Minnesota Housing
Finance Agency or the United States Department of Housing and Urban Development.
new text end
new text begin
(c) When approving an exception under this subdivision, the commissioner shall consider:
the availability of approved integrated community supports settings in the geographic area
where the licensee seeks to operate, including the number of living units approved and the
total number of people who could reside in the approved living units while receiving
integrated community services; the results of a person's choices during the person's annual
assessment and service plan review; and the recommendation of the local county board.
The approval or denial of an exception by the commissioner is final and is not subject to
appeal.
new text end
Sec. 14.
new text begin
[245D.13] OUT-OF-HOME RESPITE CARE SERVICES FOR CHILDREN.
new text end
new text begin Subdivision 1. new text end
new text begin Licensed setting required. new text end
new text begin
A license holder with a home and
community-based services license providing out-of-home respite care services for children
may do so only in a licensed setting, unless exempt under subdivision 2. For the purposes
of this section, "respite care services" has the meaning given in section 245A.02, subdivision
15.
new text end
new text begin Subd. 2. new text end
new text begin Exemption from licensed setting requirement. new text end
new text begin
(a) The exemption under this
subdivision does not apply to the provision of respite care services to a child in foster care
under chapter 260C or 260D.
new text end
new text begin
(b) A license holder with a home and community-based services license may provide
out-of-home respite care services for children in an unlicensed residential setting if:
new text end
new text begin
(1) all background studies are completed according to the requirements in chapter 245C;
new text end
new text begin
(2) a child's case manager conducts and documents an assessment of the residential
setting and its environment before services are provided and at least once each calendar
year thereafter if services continue to be provided at that residence. The assessment must
ensure that the setting is suitable for the child receiving respite care services. The assessment
must be conducted and documented in the manner prescribed by the commissioner;
new text end
new text begin
(3) the child's legal representative visits the residence and signs and dates a statement
authorizing services in the residence before services are provided and at least once each
calendar year thereafter if services continue to be provided at that residence;
new text end
new text begin
(4) the services are provided in a residential setting that is not licensed to provide any
other licensed services;
new text end
new text begin
(5) the services are provided to no more than four children at any one time. Each child
must have an individual bedroom, except two siblings may share a bedroom;
new text end
new text begin
(6) the services are not provided to children and adults over the age of 21 in the same
residence at the same time;
new text end
new text begin
(7) the services are not provided to a single family for more than 46 calendar days in a
calendar year and no more than ten consecutive days;
new text end
new text begin
(8) the license holder's license was not made conditional, suspended, or revoked during
the previous 24 months; and
new text end
new text begin
(9) each individual in the residence at the time services are provided, other than
individuals receiving services, is an employee, as defined under section 245C.02, of the
license holder and has had a background study completed under chapter 245C. No other
household members or other individuals may be present in the residence while services are
provided.
new text end
new text begin
(c) A child may not receive out-of-home respite care services in more than two unlicensed
residential settings in a calendar year.
new text end
new text begin
(d) The license holder must ensure the requirements in this section are met.
new text end
new text begin Subd. 3. new text end
new text begin Documentation requirements. new text end
new text begin
The license holder must maintain documentation
of the following:
new text end
new text begin
(1) background studies completed under chapter 245C;
new text end
new text begin
(2) service recipient records indicating the calendar dates and times when services were
provided;
new text end
new text begin
(3) the case manager's initial residential setting assessment and each residential assessment
completed thereafter; and
new text end
new text begin
(4) the legal representative's approval of the residential setting before services are
provided and each year thereafter.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall inform the revisor of statutes
when federal approval is obtained.
new text end
Sec. 15.
Minnesota Statutes 2024, section 252.32, subdivision 3, is amended to read:
Subd. 3.
Amount of support grant; use.
(a) Support grant amounts shall be determined
by the county social service agency. Services and items purchased with a support grant
must:
(1) be over and above the normal costs of caring for the dependent if the dependent did
not have a disabilitynew text begin , including adaptive or one-on-one swimming lessons for drowning
prevention for a dependent younger than 12 years of age whose disability puts the dependent
at a higher risk of drowning according to the Centers for Disease Control Vital Statistics
Systemnew text end ;
(2) be directly attributable to the dependent's disabling condition; and
(3) enable the family to delay or prevent the out-of-home placement of the dependent.
(b) The design and delivery of services and items purchased under this section must be
provided in the least restrictive environment possible, consistent with the needs identified
in the individual service plan.
(c) Items and services purchased with support grants must be those for which there are
no other public or private funds available to the family. Fees assessed to parents for health
or human services that are funded by federal, state, or county dollars are not reimbursable
through this program.
(d) In approving or denying applications, the county shall consider the following factors:
(1) the extent and areas of the functional limitations of a child with a disability;
(2) the degree of need in the home environment for additional support; and
(3) the potential effectiveness of the grant to maintain and support the person in the
family environment.
(e) The maximum monthly grant amount shall be $250 per eligible dependent, or $3,000
per eligible dependent per state fiscal year, within the limits of available funds and as
adjusted by any legislatively authorized cost of living adjustment. The county social service
agency may consider the dependent's Supplemental Security Income in determining the
amount of the support grant.
(f) Any adjustments to their monthly grant amount must be based on the needs of the
family and funding availability.
Sec. 16.
Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to
read:
new text begin Subd. 30a. new text end
new text begin State certified MnCHOICES assessor team. new text end
new text begin
(a) To facilitate the timely
processing of long-term care consultation assessments under section 256B.0911, the
commissioner must establish and maintain a team of assessors certified according to section
256B.0911, subdivision 13. Members of the state assessment team are authorized to conduct
assessments under section 256B.0911 throughout the state. The commissioner may deploy
members of the state assessment team to lead agencies with significant backlogs of pending
or incomplete long-term care consultation assessments to temporarily supplement the
capacity of the lead agency.
new text end
new text begin
(b) The commissioner may deploy a state assessment team member to a hospital, nursing
facility, intermediate care facility, or state-operated facility to expedite an assessment of a
person who:
new text end
new text begin
(1) is awaiting release or discharge because the person does not meet the applicable
admission criteria or level of care criteria for the setting, but the setting cannot identify a
setting to which the patient could be safely released or discharged without an assessment;
or
new text end
new text begin
(2) requests transition assistance under section 256B.0911, subdivision 27 or 28.
new text end
new text begin
If the commissioner deploys a state assessment team member under this paragraph, the
commissioner may require any organization receiving grant funds from the MNsure board
of directors that support the organization's medical assistance and MinnesotaCare enrollment
work to deploy an in-person assistor or navigator to assist the person being assessed in
expediting the person's application for medical assistance or MinnesotaCare.
new text end
new text begin
(c) Nothing in the subdivision shall be construed to relieve a lead agency of its obligations
under section 256B.0911, subdivision 14, paragraph (b), to have sufficient numbers of
certified assessors employed by the lead agency or under contract with the lead agency to
provide long-term consultation assessment and support planning within the timelines and
parameters required under section 256B.0911.
new text end
Sec. 17.
Minnesota Statutes 2024, section 256.476, subdivision 4, is amended to read:
Subd. 4.
Support grants; criteria and limitations.
(a) A county board may choose to
participate in the consumer support grant program. If a county has not chosen to participate
by July 1, 2002, the commissioner shall contract with another county or other entity to
provide access to residents of the nonparticipating county who choose the consumer support
grant option. The commissioner shall notify the county board in a county that has declined
to participate of the commissioner's intent to enter into a contract with another county or
other entity at least 30 days in advance of entering into the contract. The local agency shall
establish written procedures and criteria to determine the amount and use of support grants.
These procedures must include, at least, the availability of respite care, assistance with daily
living, and adaptive aids. The local agency may establish monthly or annual maximum
amounts for grants and procedures where exceptional resources may be required to meet
the health and safety needs of the person on a time-limited basis, however, the total amount
awarded to each individual may not exceed the limits established in subdivision 11.
(b) Support grants to a person, a person's legal representative, or other authorized
representative will be provided through a monthly subsidy payment and be in the form of
cash, voucher, or direct county payment to vendor. Support grant amounts must be determined
by the local agency. Each service and item purchased with a support grant must meet all of
the following criteria:
(1) it must be over and above the normal cost of caring for the person if the person did
not have functional limitationsnew text begin , including adaptive or one-on-one swimming lessons for
drowning prevention for a person younger than 12 years of age whose disability puts the
person at a higher risk of drowning according to the Centers for Disease Control Vital
Statistics Systemnew text end ;
(2) it must be directly attributable to the person's functional limitations;
(3) it must enable the person, a person's legal representative, or other authorized
representative to delay or prevent out-of-home placement of the person; and
(4) it must be consistent with the needs identified in the service agreement, when
applicable.
(c) Items and services purchased with support grants must be those for which there are
no other public or private funds available to the person, a person's legal representative, or
other authorized representative. Fees assessed to the person or the person's family for health
and human services are not reimbursable through the grant.
(d) In approving or denying applications, the local agency shall consider the following
factors:
(1) the extent and areas of the person's functional limitations;
(2) the degree of need in the home environment for additional support; and
(3) the potential effectiveness of the grant to maintain and support the person in the
family environment or the person's own home.
(e) At the time of application to the program or screening for other services, the person,
a person's legal representative, or other authorized representative shall be provided sufficient
information to ensure an informed choice of alternatives by the person, the person's legal
representative, or other authorized representative, if any. The application shall be made to
the local agency and shall specify the needs of the person or the person's legal representative
or other authorized representative, the form and amount of grant requested, the items and
services to be reimbursed, and evidence of eligibility for medical assistance.
(f) Upon approval of an application by the local agency and agreement on a support plan
for the person or the person's legal representative or other authorized representative, the
local agency shall make grants to the person or the person's legal representative or other
authorized representative. The grant shall be in an amount for the direct costs of the services
or supports outlined in the service agreement.
(g) Reimbursable costs shall not include costs for resources already available, such as
special education classes, day training and habilitation, case management, other services to
which the person is entitled, medical costs covered by insurance or other health programs,
or other resources usually available at no cost to the person or the person's legal representative
or other authorized representative.
(h) The state of Minnesota, the county boards participating in the consumer support
grant program, or the agencies acting on behalf of the county boards in the implementation
and administration of the consumer support grant program shall not be liable for damages,
injuries, or liabilities sustained through the purchase of support by the individual, the
individual's family, or the authorized representative under this section with funds received
through the consumer support grant program. Liabilities include but are not limited to:
workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the
Federal Unemployment Tax Act (FUTA). For purposes of this section, participating county
boards and agencies acting on behalf of county boards are exempt from the provisions of
section 268.035.
Sec. 18.
Minnesota Statutes 2024, section 256B.04, subdivision 21, is amended to read:
Subd. 21.
Provider enrollment.
(a) The commissioner shall enroll providers and conduct
screening activities as required by Code of Federal Regulations, title 42, section 455, subpart
E. A provider must enroll each provider-controlled location where direct services are
provided. The commissioner may deny a provider's incomplete application if a provider
fails to respond to the commissioner's request for additional information within 60 days of
the request. The commissioner must conduct a background study under chapter 245C,
including a review of databases in section 245C.08, subdivision 1, paragraph (a), clauses
(1) to (5), for a provider described in this paragraph. The background study requirement
may be satisfied if the commissioner conducted a fingerprint-based background study on
the provider that includes a review of databases in section 245C.08, subdivision 1, paragraph
(a), clauses (1) to (5).
(b) The commissioner shall revalidate deleted text begin eachdeleted text end :
(1)new text begin eachnew text end provider under this subdivision at least once every five years; deleted text begin and
deleted text end
(2) new text begin each new text end personal care assistance agencynew text begin , CFSS provider-agency, and CFSS financial
management services providernew text end under this subdivision new text begin at least new text end once every three yearsdeleted text begin .deleted text end new text begin ;
new text end
new text begin
(3) each EIDBI agency under this subdivision at least once every three years; and
new text end
new text begin
(4) at the commissioner's discretion, any medical-assistance-only provider type the
commissioner deems "high risk" under this subdivision.
new text end
(c) The commissioner shall conduct revalidation as follows:
(1) provide 30-day notice of the revalidation due date including instructions for
revalidation and a list of materials the provider must submit;
(2) if a provider fails to submit all required materials by the due date, notify the provider
of the deficiency within 30 days after the due date and allow the provider an additional 30
days from the notification date to comply; and
(3) if a provider fails to remedy a deficiency within the 30-day time period, give 60-day
notice of termination and immediately suspend the provider's ability to bill. The provider
does not have the right to appeal suspension of ability to bill.
(d) If a provider fails to comply with any individual provider requirement or condition
of participation, the commissioner may suspend the provider's ability to bill until the provider
comes into compliance. The commissioner's decision to suspend the provider is not subject
to an administrative appeal.
(e) Correspondence and notifications, including notifications of termination and other
actions, may be delivered electronically to a provider's MN-ITS mailbox. This paragraph
does not apply to correspondences and notifications related to background studies.
(f) If the commissioner or the Centers for Medicare and Medicaid Services determines
that a provider is designated "high-risk," the commissioner may withhold payment from
providers within that category upon initial enrollment for a 90-day period. The withholding
for each provider must begin on the date of the first submission of a claim.
(g) An enrolled provider that is also licensed by the commissioner under chapter 245A,
is licensed as a home care provider by the Department of Health under chapter 144A, or is
licensed as an assisted living facility under chapter 144G and has a home and
community-based services designation on the home care license under section 144A.484,
must designate an individual as the entity's compliance officer. The compliance officer
must:
(1) develop policies and procedures to assure adherence to medical assistance laws and
regulations and to prevent inappropriate claims submissions;
(2) train the employees of the provider entity, and any agents or subcontractors of the
provider entity including billers, on the policies and procedures under clause (1);
(3) respond to allegations of improper conduct related to the provision or billing of
medical assistance services, and implement action to remediate any resulting problems;
(4) use evaluation techniques to monitor compliance with medical assistance laws and
regulations;
(5) promptly report to the commissioner any identified violations of medical assistance
laws or regulations; and
(6) within 60 days of discovery by the provider of a medical assistance reimbursement
overpayment, report the overpayment to the commissioner and make arrangements with
the commissioner for the commissioner's recovery of the overpayment.
The commissioner may require, as a condition of enrollment in medical assistance, that a
provider within a particular industry sector or category establish a compliance program that
contains the core elements established by the Centers for Medicare and Medicaid Services.
(h) The commissioner may revoke the enrollment of an ordering or rendering provider
for a period of not more than one year, if the provider fails to maintain and, upon request
from the commissioner, provide access to documentation relating to written orders or requests
for payment for durable medical equipment, certifications for home health services, or
referrals for other items or services written or ordered by such provider, when the
commissioner has identified a pattern of a lack of documentation. A pattern means a failure
to maintain documentation or provide access to documentation on more than one occasion.
Nothing in this paragraph limits the authority of the commissioner to sanction a provider
under the provisions of section 256B.064.
(i) The commissioner shall terminate or deny the enrollment of any individual or entity
if the individual or entity has been terminated from participation in Medicare or under the
Medicaid program or Children's Health Insurance Program of any other state. The
commissioner may exempt a rehabilitation agency from termination or denial that would
otherwise be required under this paragraph, if the agency:
(1) is unable to retain Medicare certification and enrollment solely due to a lack of billing
to the Medicare program;
(2) meets all other applicable Medicare certification requirements based on an on-site
review completed by the commissioner of health; and
(3) serves primarily a pediatric population.
(j) As a condition of enrollment in medical assistance, the commissioner shall require
that a provider designated "moderate" or "high-risk" by the Centers for Medicare and
Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid
Services, its agents, or its designated contractors and the state agency, its agents, or its
designated contractors to conduct unannounced on-site inspections of any provider location.
The commissioner shall publish in the Minnesota Health Care Program Provider Manual a
list of provider types designated "limited," "moderate," or "high-risk," based on the criteria
and standards used to designate Medicare providers in Code of Federal Regulations, title
42, section 424.518. The list and criteria are not subject to the requirements of chapter 14.
The commissioner's designations are not subject to administrative appeal.
(k) As a condition of enrollment in medical assistance, the commissioner shall require
that a high-risk provider, or a person with a direct or indirect ownership interest in the
provider of five percent or higher, consent to criminal background checks, including
fingerprinting, when required to do so under state law or by a determination by the
commissioner or the Centers for Medicare and Medicaid Services that a provider is designated
high-risk for fraud, waste, or abuse.
(l)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all durable
medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers
meeting the durable medical equipment provider and supplier definition in clause (3),
operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is
annually renewed and designates the Minnesota Department of Human Services as the
obligee, and must be submitted in a form approved by the commissioner. For purposes of
this clause, the following medical suppliers are not required to obtain a surety bond: a
federally qualified health center, a home health agency, the Indian Health Service, a
pharmacy, and a rural health clinic.
(2) At the time of initial enrollment or reenrollment, durable medical equipment providers
and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating
provider's Medicaid revenue in the previous calendar year is up to and including $300,000,
the provider agency must purchase a surety bond of $50,000. If a revalidating provider's
Medicaid revenue in the previous calendar year is over $300,000, the provider agency must
purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and
fees in pursuing a claim on the bond.
(3) "Durable medical equipment provider or supplier" means a medical supplier that can
purchase medical equipment or supplies for sale or rental to the general public and is able
to perform or arrange for necessary repairs to and maintenance of equipment offered for
sale or rental.
(m) The Department of Human Services may require a provider to purchase a surety
bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment
if: (1) the provider fails to demonstrate financial viability, (2) the department determines
there is significant evidence of or potential for fraud and abuse by the provider, or (3) the
provider or category of providers is designated high-risk pursuant to paragraph (f) and as
per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in an
amount of $100,000 or ten percent of the provider's payments from Medicaid during the
immediately preceding 12 months, whichever is greater. The surety bond must name the
Department of Human Services as an obligee and must allow for recovery of costs and fees
in pursuing a claim on the bond. This paragraph does not apply if the provider currently
maintains a surety bond under the requirements in section 256B.0659 or 256B.85.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 19.
Minnesota Statutes 2024, section 256B.0659, subdivision 17a, is amended to
read:
Subd. 17a.
Enhanced rate.
(a) An enhanced rate of 107.5 percent of the rate paid for
personal care assistance services shall be paid for services provided to persons who qualify
for ten or more hours of personal care assistance services per day when provided by a
personal care assistant who meets the requirements of subdivision 11, paragraph (d).new text begin This
paragraph expires upon the effective date of paragraph (b).
new text end
new text begin
(b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced
rate of 112.5 percent of the rate paid for personal care assistance services shall be paid for
services provided to persons who qualify for ten or more hours of personal care assistance
services per day when provided by a personal care assistant who meets the requirements of
subdivision 11, paragraph (d).
new text end
deleted text begin (b)deleted text end new text begin (c)new text end A personal care assistance provider must use all additional revenue attributable
to the rate enhancements under this subdivision for the wages and wage-related costs of the
personal care assistants, including any corresponding increase in the employer's share of
FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
compensation premiums. The agency must not use the additional revenue attributable to
any enhanced rate under this subdivision to pay for mileage reimbursement, health and
dental insurance, life insurance, disability insurance, long-term care insurance, uniform
allowance, contributions to employee retirement accounts, or any other employee benefits.
deleted text begin (c)deleted text end new text begin (d)new text end Any change in the eligibility criteria for the enhanced rate for personal care
assistance services as described in this subdivision and referenced in subdivision 11,
paragraph (d), does not constitute a change in a term or condition for individual providers
as defined in section 256B.0711, and is not subject to the state's obligation to meet and
negotiate under chapter 179A.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 20.
Minnesota Statutes 2024, section 256B.0911, subdivision 1, is amended to read:
Subdivision 1.
Purpose and goal.
(a) The purpose of long-term care consultation services
is to assist persons with long-term or chronic care needs in making care decisions and
selecting support and service options that meet their needs and reflect their preferences.
The availability of, and access to, information and other types of assistance, including
long-term care consultation assessment and support planning, is also intended to prevent
or delay institutional placements and to provide access to transition assistance after
placement. Further, the goal of long-term care consultation services is to contain costs
associated with unnecessary institutional admissions. Long-term care consultation services
must be available to any person regardless of public program eligibility.
(b) The commissioner of human services shall seek to maximize use of available federal
and state funds and establish the broadest program possible within the funding available.
(c) Long-term care consultation services must be coordinated with long-term care options
counseling, long-term care options counseling deleted text begin for assisted livingdeleted text end new text begin at critical care transitionsnew text end ,
the Disability Hub, and preadmission screening.
(d) A lead agency providing long-term care consultation services shall encourage the
use of volunteers from families, religious organizations, social clubs, and similar civic and
service organizations to provide community-based services.
Sec. 21.
Minnesota Statutes 2024, section 256B.0911, subdivision 10, is amended to read:
Subd. 10.
Definitions.
(a) For purposes of this section, the following definitions apply.
(b) "Available service and setting options" or "available options," with respect to the
home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49,
means all services and settings defined under the waiver plan for which a waiver applicant
or waiver participant is eligible.
(c) "Competitive employment" means work in the competitive labor market that is
performed on a full-time or part-time basis in an integrated setting, and for which an
individual is compensated at or above the minimum wage, but not less than the customary
wage and level of benefits paid by the employer for the same or similar work performed by
individuals without disabilities.
(d) "Cost-effective" means community services and living arrangements that cost the
same as or less than institutional care. For an individual found to meet eligibility criteria
for home and community-based service programs under chapter 256S or section 256B.49,
"cost-effectiveness" has the meaning found in the federally approved waiver plan for each
program.
(e) "Independent living" means living in a setting that is not controlled by a provider.
(f) "Informed choice" has the meaning given in section 256B.4905, subdivision 1a.
(g) "Lead agency" means a county administering or a Tribe or health plan under contract
with the commissioner to administer long-term care consultation services.
(h) "Long-term care consultation services" means the activities described in subdivision
11.
(i) "Long-term care options counseling" means the services provided by sections 256.01,
subdivision 24, and 256.975, subdivision 7, and also includes telephone assistance and
follow-up after a long-term care consultation assessment has been completed.
(j) "Long-term care options counseling deleted text begin for assisted livingdeleted text end new text begin at critical care transitionsnew text end "
means the services provided under section 256.975, deleted text begin subdivisionsdeleted text end new text begin subdivisionnew text end 7e deleted text begin to 7gdeleted text end .
(k) "Minnesota health care programs" means the medical assistance program under this
chapter and the alternative care program under section 256B.0913.
(l) "Person-centered planning" is a process that includes the active participation of a
person in the planning of the person's services, including in making meaningful and informed
choices about the person's own goals, talents, and objectives, as well as making meaningful
and informed choices about the services the person receives, the settings in which the person
receives the services, and the setting in which the person lives.
(m) "Preadmission screening" means the services provided under section 256.975,
subdivisions 7a to 7c.
Sec. 22.
Minnesota Statutes 2024, section 256B.0911, subdivision 13, is amended to read:
Subd. 13.
MnCHOICES assessor qualifications, training, and certification.
(a) The
commissioner shall develop and implement a curriculum and an assessor certification
process.
(b) MnCHOICES certified assessors mustnew text begin have received training and certification specific
to assessment and consultation for long-term care services in the state and eithernew text end :
(1) deleted text begin eitherdeleted text end have deleted text begin a bachelor'sdeleted text end new text begin at least an associate'snew text end degree in deleted text begin social work,deleted text end new text begin human services,
or other closely related field;
new text end
new text begin (2) have at least an associate's degree innew text end nursing with a public health nursing certificate,
or other closely related fieldnew text begin ;new text end or
new text begin (3)new text end be a registered nursedeleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(2) have received training and certification specific to assessment and consultation for
long-term care services in the state.
deleted text end
(c) Certified assessors shall demonstrate best practices in assessment and support
planning, including person-centered planning principles, and have a common set of skills
that ensures consistency and equitable access to services statewide.
(d) Certified assessors must be recertified every three years.
Sec. 23.
Minnesota Statutes 2024, section 256B.0911, subdivision 14, is amended to read:
Subd. 14.
Use of MnCHOICES certified assessors required.
(a) Each lead agency
shall use MnCHOICES certified assessors who have completed MnCHOICES training and
the certification process determined by the commissioner in subdivision 13.
(b) Each lead agency must ensure that the lead agency has sufficient numbers of certified
assessors to provide long-term consultation assessment and support planning within the
timelines and parameters of the service.
(c) A lead agency may choose, according to departmental policies, to contract with a
qualified, certified assessor to conduct assessments and reassessments on behalf of the lead
agency.
(d) Tribes and health plans under contract with the commissioner must provide long-term
care consultation services as specified in the contract.
(e) A lead agency must provide the commissioner with an administrative contact for
communication purposes.
new text begin
(f) A lead agency may contract under this subdivision with any hospital licensed under
sections 144.50 to 144.56 to conduct assessments of patients in the hospital on behalf of
the lead agency when the lead agency has failed to meet its obligations under subdivision
17. The contracted assessment must be conducted by a hospital employee who is a qualified,
certified assessor. The hospital employees who perform assessments under the contract
between the hospital and the lead agency may perform assessments in addition to other
duties assigned to the employee by the hospital, except the hospital employees who perform
the assessments under contract with the lead agency must not perform any waiver-related
tasks other than assessments. Hospitals are not eligible for reimbursement under subdivision
33. The lead agency that enters into a contract with a hospital under this paragraph is
responsible for oversight, compliance, and quality assurance for all assessments performed
under the contract.
new text end
Sec. 24.
Minnesota Statutes 2024, section 256B.0911, subdivision 24, is amended to read:
Subd. 24.
Remote reassessments.
(a) Assessments performed according to subdivisions
17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the
requirements of this subdivision. Remote reassessments conducted by interactive video or
telephone may substitute for in-person reassessments.
(b) For services provided by the developmental disabilities waiver under section
256B.092, and the community access for disability inclusion, community alternative care,
and brain injury waiver programs under section 256B.49, remote reassessments may be
substituted for deleted text begin twodeleted text end new text begin fournew text end consecutive reassessments if followed by an in-person reassessment.
(c) For services provided by alternative care under section 256B.0913, essential
community supports under section 256B.0922, and the elderly waiver under chapter 256S,
remote reassessments may be substituted for one reassessment if followed by an in-person
reassessment.
(d) For personal care assistance provided under section 256B.0659 and community first
services and supports provided under section 256B.85, remote reassessments may be
substituted for two consecutive reassessments if followed by an in-person reassessment.
(e) A remote reassessment is permitted only if the lead agency provides informed choice
and the person being reassessed or the person's legal representative provides informed
consent for a remote assessment. Lead agencies must document that informed choice was
offered.
(f) The person being reassessed, or the person's legal representative, may refuse a remote
reassessment at any time.
(g) During a remote reassessment, if the certified assessor determines an in-person
reassessment is necessary in order to complete the assessment, the lead agency shall schedule
an in-person reassessment.
(h) All other requirements of an in-person reassessment apply to a remote reassessment,
including updates to a person's support plan.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 25.
Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision
to read:
new text begin Subd. 24a. new text end
new text begin Verbal attestation to replace required reassessment signatures. new text end
new text begin
Effective
January 1, 2026, or upon federal approval, whichever is later, the commissioner shall allow
for verbal attestation to replace required reassessment signatures.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 26.
Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision
to read:
new text begin Subd. 25a. new text end
new text begin Attesting to no changes in needs or services. new text end
new text begin
(a) A person who is older
than 21 years of age, under 65 years of age, and receiving home and community-based
waiver services under the developmental disabilities waiver program under section 256B.092;
community access for disability inclusion, community alternative care, and brain injury
waiver programs under section 256B.49; or community first services and supports under
section 256B.85 may attest that the person has unchanged needs from the most recent prior
assessment or reassessment for up to two consecutive reassessments if the lead agency
provides informed choice and the person being reassessed or the person's legal representative
provides informed consent. Lead agencies must document that informed choice was offered.
new text end
new text begin
(b) The person or person's legal representative must attest, verbally or through alternative
communications, that the information provided in the previous assessment or reassessment
is still accurate and applicable and that no changes in the person's circumstances have
occurred that would require changes from the most recent prior assessment or reassessment.
The person or the person's legal representative may request a full reassessment at any time.
new text end
new text begin
(c) The assessor must review the most recent prior assessment or reassessment as required
in subdivision 22, paragraphs (a) and (b), clause (1), before conducting the interview. The
certified assessor must confirm that the information from the previous assessment or
reassessment is current.
new text end
new text begin
(d) The assessment conducted under this section must:
new text end
new text begin
(1) verify current assessed support needs;
new text end
new text begin
(2) confirm continued need for the currently assessed level of care;
new text end
new text begin
(3) inform the person of alternative long-term services and supports available;
new text end
new text begin
(4) provide informed choice of institutional or home and community-based services;
and
new text end
new text begin
(5) identify changes in need that may require a full reassessment.
new text end
new text begin
(e) The assessor must ensure that any new assessment items or requirements mandated
by federal or state authority are addressed and the person must provide required information.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 27.
Minnesota Statutes 2024, section 256B.0911, subdivision 26, is amended to read:
Subd. 26.
Determination of institutional level of care.
(a) The determination of need
for hospital and intermediate care facility levels of care must be made according to criteria
developed by the commissioner, and in section 256B.092, using forms developed by the
commissioner.
(b) The determination of need for nursing facility level of care must be made based on
criteria in section 144.0724, subdivision 11.new text begin This paragraph expires upon the effective date
of paragraph (c).
new text end
new text begin
(c) Effective January 1, 2026, or upon federal approval, whichever is later, the
determination of need for nursing facility level of care must be made based on criteria in
section 144.0724, subdivision 11, except for determinations of need for purposes of the
brain injury and community access for disability inclusion waivers under section 256B.49.
new text end
new text begin
(d) Determinations of need for the purposes of the brain injury and community access
for disability inclusion waivers must be made based on criteria in section 144.0724,
subdivision 11a. If a person is found ineligible for waiver services under this paragraph
because of a determination that the person does not meet the criteria in section 144.0724,
subdivision 11a, the lead agency must review the person's latest assessment under section
256B.0911 to determine if the person meets any of the nursing facility level of care criteria
under section 144.0724, subdivision 11. If the lead agency determines after the review that
the person does meet a nursing facility level of care criteria under section 144.0724,
subdivision 11, the lead agency must provide a notice of action to the person informing the
person specifically that the person's waiver services are being terminated because the person
meets only a nursing facility level of care of under section 144.0724, subdivision 11, that
is no longer a basis for waiver eligibility. The lead agency must also inform the person of
other benefits options for which the person may be eligible. For existing waiver participants,
the effective date of the termination of waiver services based on this paragraph must be no
sooner than 90 days after the date of the assessment under section 256B.0911.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 28.
Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision
to read:
new text begin Subd. 35. new text end
new text begin Dashboard on assessment completions. new text end
new text begin
(a) The commissioner shall maintain
a dashboard on the department's public website containing summary data on the completion
of assessments under this section. The commissioner must update the dashboard at least
twice per year.
new text end
new text begin
(b) The dashboard must include:
new text end
new text begin
(1) the total number of assessments performed since the previous reporting period, by
lead agency;
new text end
new text begin
(2) the total number of initial assessments performed since the previous reporting period,
by lead agency;
new text end
new text begin
(3) the total number of reassessments performed since the previous reporting period, by
lead agency;
new text end
new text begin
(4) the number and percentage of assessments completed within the required timeline,
by a lead agency;
new text end
new text begin
(5) the average length of time to complete an assessment, by a lead agency;
new text end
new text begin
(6) summary data of the location in which the assessments were performed, by lead
agency; and
new text end
new text begin
(7) other information the commissioner determines is valuable to assess the capacity of
lead agencies to complete assessments within the timelines prescribed by law.
new text end
Sec. 29.
Minnesota Statutes 2024, section 256B.0911, is amended by adding a subdivision
to read:
new text begin Subd. 36. new text end
new text begin Cooperation with state certified MnCHOICES assessor teams. new text end
new text begin
(a) In the
event that the commissioner deploys state certified assessors under section 256.01,
subdivision 30a, to temporarily supplement the capacity of the lead agency to perform
long-term care consultation assessments and to meet its obligations under this section, the
lead agency must cooperate with the commissioner and the state assessor team to implement
a work plan to reduce the backlog and improve both training of lead agency staff and
processes to minimize future backlogs.
new text end
new text begin
(b) In the event that the commissioner deploys state certified assessors under section
256.01, subdivision 30a, to perform an expedited long-term care consultation assessment
under section 256.01, subdivision 30a, at the request of the state assessor, the lead agency
must ensure that the person is visited by lead agency staff within five days of the visit by
the state assessor to begin the process of determining financial eligibility for medical
assistance.
new text end
Sec. 30.
Minnesota Statutes 2024, section 256B.0924, subdivision 6, is amended to read:
Subd. 6.
Payment for targeted case management.
(a) Medical assistance and
MinnesotaCare payment for targeted case management shall be made on a monthly basis.
In order to receive payment for an eligible adult, the provider must document at least one
contact per month and not more than two consecutive months without a face-to-face contact
either in person or by interactive video that meets the requirements in section 256B.0625,
subdivision 20b, with the adult or the adult's legal representative, family, primary caregiver,
or other relevant persons identified as necessary to the development or implementation of
the goals of the personal service plan.
(b) new text begin Except as provided under paragraph (m), new text end payment for targeted case management
provided by county staff under this subdivision shall be based on the monthly rate
methodology under section 256B.094, subdivision 6, paragraph (b), calculated as one
combined average rate together with adult mental health case management under section
256B.0625, subdivision 20, except for calendar year 2002. In calendar year 2002, the rate
for case management under this section shall be the same as the rate for adult mental health
case management in effect as of December 31, 2001. Billing and payment must identify the
recipient's primary population group to allow tracking of revenues.
(c) Payment for targeted case management provided by county-contracted vendors shall
be based on a monthly rate calculated in accordance with section 256B.076, subdivision 2.
The rate must not exceed the rate charged by the vendor for the same service to other payers.
If the service is provided by a team of contracted vendors, the team shall determine how to
distribute the rate among its members. No reimbursement received by contracted vendors
shall be returned to the county, except to reimburse the county for advance funding provided
by the county to the vendor.
(d) If the service is provided by a team that includes contracted vendors and county staff,
the costs for county staff participation on the team shall be included in the rate for
county-provided services. In this case, the contracted vendor and the county may each
receive separate payment for services provided by each entity in the same month. In order
to prevent duplication of services, the county must document, in the recipient's file, the need
for team targeted case management and a description of the different roles of the team
members.
(e) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
targeted case management shall be provided by the recipient's county of responsibility, as
defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds.
(f) The commissioner may suspend, reduce, or terminate reimbursement to a provider
that does not meet the reporting or other requirements of this section. The county of
responsibility, as defined in sections 256G.01 to 256G.12, is responsible for any federal
disallowances. The county may share this responsibility with its contracted vendors.
(g) The commissioner shall set aside five percent of the federal funds received under
this section for use in reimbursing the state for costs of developing and implementing this
section.
(h) Payments to counties for targeted case management expenditures under this section
shall only be made from federal earnings from services provided under this section. Payments
to contracted vendors shall include both the federal earnings and the county share.
(i) Notwithstanding section 256B.041, county payments for the cost of case management
services provided by county staff shall not be made to the commissioner of management
and budget. For the purposes of targeted case management services provided by county
staff under this section, the centralized disbursement of payments to counties under section
256B.041 consists only of federal earnings from services provided under this section.
(j) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for targeted case
management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
(k) Payment for targeted case management services under this subdivision shall not
duplicate payments made under other program authorities for the same purpose.
(l) Any growth in targeted case management services and cost increases under this
section shall be the responsibility of the counties.
new text begin
(m) The commissioner may make payments for Tribes according to section 256B.0625,
subdivision 34, or other relevant federally approved rate setting methodologies for vulnerable
adult and developmental disability targeted case management provided by Indian health
services and facilities operated by a Tribe or Tribal organization.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 31.
Minnesota Statutes 2024, section 256B.0949, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) The terms used in this section have the meanings given in this
subdivision.
(b) "Advanced certification" means a person who has completed advanced certification
in an approved modality under subdivision 13, paragraph (b).
(c) "Agency" means the legal entity that is enrolled with Minnesota health care programs
as a medical assistance provider according to Minnesota Rules, part 9505.0195, to provide
EIDBI services and that has the legal responsibility to ensure that its employees deleted text begin or contractorsdeleted text end
carry out the responsibilities defined in this section. Agency includes a licensed individual
professional who practices independently and acts as an agency.
(d) "Autism spectrum disorder or a related condition" or "ASD or a related condition"
means either autism spectrum disorder (ASD) as defined in the current version of the
Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found
to be closely related to ASD, as identified under the current version of the DSM, and meets
all of the following criteria:
(1) is severe and chronic;
(2) results in impairment of adaptive behavior and function similar to that of a person
with ASD;
(3) requires treatment or services similar to those required for a person with ASD; and
(4) results in substantial functional limitations in three core developmental deficits of
ASD: social or interpersonal interaction; functional communication, including nonverbal
or social communication; and restrictive or repetitive behaviors or hyperreactivity or
hyporeactivity to sensory input; and may include deficits or a high level of support in one
or more of the following domains:
(i) behavioral challenges and self-regulation;
(ii) cognition;
(iii) learning and play;
(iv) self-care; or
(v) safety.
(e) "Person" means a person under 21 years of age.
(f) "Clinical supervision" means the overall responsibility for the control and direction
of EIDBI service delivery, including individual treatment planning, staff supervision,
individual treatment plan progress monitoring, and treatment review for each person. Clinical
supervision is provided by a qualified supervising professional (QSP) who takes full
professional responsibility for the service provided by each superviseenew text begin and the clinical
effectiveness of all interventionsnew text end .
(g) "Commissioner" means the commissioner of human services, unless otherwise
specified.
(h) "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive
evaluation of a person to determine medical necessity for EIDBI services based on the
requirements in subdivision 5.
(i) "Department" means the Department of Human Services, unless otherwise specified.
(j) "Early intensive developmental and behavioral intervention benefit" or "EIDBI
benefit" means a variety of individualized, intensive treatment modalities approved and
published by the commissioner that are based in behavioral and developmental science
consistent with best practices on effectiveness.
new text begin
(k) "Employee" means any person who is employed by an agency, including temporary
and part-time employees, and who performs work for at least 80 hours in a year for that
agency in Minnesota. Employee does not include an independent contractor.
new text end
deleted text begin (k)deleted text end new text begin (l)new text end "Generalizable goals" means results or gains that are observed during a variety
of activities over time with different people, such as providers, family members, other adults,
and people, and in different environments including, but not limited to, clinics, homes,
schools, and the community.
deleted text begin (l)deleted text end new text begin (m)new text end "Incident" means when any of the following occur:
(1) an illness, accident, or injury that requires first aid treatment;
(2) a bump or blow to the head; or
(3) an unusual or unexpected event that jeopardizes the safety of a person or staff,
including a person leaving the agency unattended.
deleted text begin (m)deleted text end new text begin (n)new text end "Individual treatment plan" or "ITP" means the person-centered, individualized
written plan of care that integrates and coordinates person and family information from the
CMDE for a person who meets medical necessity for the EIDBI benefit. An individual
treatment plan must meet the standards in subdivision 6.
deleted text begin (n)deleted text end new text begin (o)new text end "Legal representative" means the parent of a child who is under 18 years of age,
a court-appointed guardian, or other representative with legal authority to make decisions
about service for a person. For the purpose of this subdivision, "other representative with
legal authority to make decisions" includes a health care agent or an attorney-in-fact
authorized through a health care directive or power of attorney.
deleted text begin (o)deleted text end new text begin (p)new text end "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.
deleted text begin (p)deleted text end new text begin (q)new text end "Person-centered" means a service that both responds to the identified needs,
interests, values, preferences, and desired outcomes of the person or the person's legal
representative and respects the person's history, dignity, and cultural background and allows
inclusion and participation in the person's community.
deleted text begin (q)deleted text end new text begin (r)new text end "Qualified EIDBI provider" means a person who is a QSP or a level I, level II,
or level III treatment provider.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 32.
Minnesota Statutes 2024, section 256B.0949, subdivision 13, is amended to read:
Subd. 13.
Covered services.
(a) The services described in paragraphs (b) to (l) are
eligible for reimbursement by medical assistance under this section. Services must be
provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must
address the person's medically necessary treatment goals and must be targeted to develop,
enhance, or maintain the individual developmental skills of a person with ASD or a related
condition to improve functional communication, including nonverbal or social
communication, social or interpersonal interaction, restrictive or repetitive behaviors,
hyperreactivity or hyporeactivity to sensory input, behavioral challenges and self-regulation,
cognition, learning and play, self-care, and safety.
(b) EIDBI treatment must be delivered consistent with the standards of an approved
modality, as published by the commissioner. EIDBI modalities include:
(1) applied behavior analysis (ABA);
(2) developmental individual-difference relationship-based model (DIR/Floortime);
(3) early start Denver model (ESDM);new text begin or
new text end
deleted text begin
(4) PLAY project;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end relationship development intervention (RDI)deleted text begin ; ordeleted text end new text begin .
new text end
deleted text begin
(6) additional modalities not listed in clauses (1) to (5) upon approval by the
commissioner.
deleted text end
(c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b),
clauses (1) to deleted text begin (5)deleted text end new text begin (4)new text end , as the primary modality for treatment as a covered service, or several
EIDBI modalities in combination as the primary modality of treatment, as approved by the
commissioner. An EIDBI provider that identifies and provides assurance of qualifications
for a single specific treatment modality, including an EIDBI provider with advanced
certification overseeing implementation, must document the required qualifications to meet
fidelity to the specific model in a manner determined by the commissioner.
(d) Each qualified EIDBI provider must identify and provide assurance of qualifications
for professional licensure certification, or training in evidence-based treatment methods,
and must document the required qualifications outlined in subdivision 15 in a manner
determined by the commissioner.
(e) CMDE is a comprehensive evaluation of the person's developmental status to
determine medical necessity for EIDBI services and meets the requirements of subdivision
5. The services must be provided by a qualified CMDE provider.
(f) EIDBI intervention observation and direction is the clinical direction and oversight
of EIDBI services by the QSP, level I treatment provider, or level II treatment provider,
including developmental and behavioral techniques, progress measurement, data collection,
function of behaviors, and generalization of acquired skills for the direct benefit of a person.
EIDBI intervention observation and direction informs any modification of the current
treatment protocol to support the outcomes outlined in the ITP.
(g) Intervention is medically necessary direct treatment provided to a person with ASD
or a related condition as outlined in their ITP. All intervention services must be provided
under the direction of a QSP. Intervention may take place across multiple settings. The
frequency and intensity of intervention services are provided based on the number of
treatment goals, person and family or caregiver preferences, and other factors. Intervention
services may be provided individually or in a group. Intervention with a higher provider
ratio may occur when deemed medically necessary through the person's ITP.
(1) Individual intervention is treatment by protocol administered by a single qualified
EIDBI provider delivered to one person.
(2) Group intervention is treatment by protocol provided by one or more qualified EIDBI
providers, delivered to at least two people who receive EIDBI services.
(3) Higher provider ratio intervention is treatment with protocol modification provided
by two or more qualified EIDBI providers delivered to one person in an environment that
meets the person's needs and under the direction of the QSP or level I provider.
(h) ITP development and ITP progress monitoring is development of the initial, annual,
and progress monitoring of an ITP. ITP development and ITP progress monitoring documents
provide oversight and ongoing evaluation of a person's treatment and progress on targeted
goals and objectives and integrate and coordinate the person's and the person's legal
representative's information from the CMDE and ITP progress monitoring. This service
must be reviewed and completed by the QSP, and may include input from a level I provider
or a level II provider.
(i) Family caregiver training and counseling is specialized training and education for a
family or primary caregiver to understand the person's developmental status and help with
the person's needs and development. This service must be provided by the QSP, level I
provider, or level II provider.
(j) A coordinated care conference is a voluntary meeting with the person and the person's
family to review the CMDE or ITP progress monitoring and to integrate and coordinate
services across providers and service-delivery systems to develop the ITP. This service may
include the CMDE provider, QSP, a level I provider, or a level II provider.
(k) Travel time is allowable billing for traveling to and from the person's home, school,
a community setting, or place of service outside of an EIDBI center, clinic, or office from
a specified location to provide in-person EIDBI intervention, observation and direction, or
family caregiver training and counseling. The person's ITP must specify the reasons the
provider must travel to the person.
(l) Medical assistance covers medically necessary EIDBI services and consultations
delivered via telehealth, as defined under section 256B.0625, subdivision 3b, in the same
manner as if the service or consultation was delivered in person.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 33.
Minnesota Statutes 2024, section 256B.0949, subdivision 15, is amended to read:
Subd. 15.
EIDBI provider qualifications.
(a) A QSP must be deleted text begin employed bydeleted text end new text begin an employee
ofnew text end an agency and be:
(1) a licensed mental health professional who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child
development; or
(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and
typical child development.
(b) A level I treatment provider must be deleted text begin employed bydeleted text end new text begin an employee ofnew text end an agency and:
(1) have at least 2,000 hours of supervised clinical experience or training in examining
or treating people with ASD or a related condition or equivalent documented coursework
at the graduate level by an accredited university in ASD diagnostics, ASD developmental
and behavioral treatment strategies, and typical child development or an equivalent
combination of documented coursework or hours of experience; and
(2) have or be at least one of the following:
(i) a master's degree in behavioral health or child development or related fields including,
but not limited to, mental health, special education, social work, psychology, speech
pathology, or occupational therapy from an accredited college or university;
(ii) a bachelor's degree in a behavioral health, child development, or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy, from an accredited college or university, and
advanced certification in a treatment modality recognized by the department;
(iii) a board-certified behavior analyst as defined by the Behavior Analyst Certification
Board or a qualified behavior analyst as defined by the Qualified Applied Behavior Analysis
Credentialing Board; or
(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical
experience that meets all registration, supervision, and continuing education requirements
of the certification.
(c) A level II treatment provider must be deleted text begin employed bydeleted text end new text begin an employee ofnew text end an agency and
must be:
(1) a person who has a bachelor's degree from an accredited college or university in a
behavioral or child development science or related field including, but not limited to, mental
health, special education, social work, psychology, speech pathology, or occupational
therapy; and meets at least one of the following:
(i) has at least 1,000 hours of supervised clinical experience or training in examining or
treating people with ASD or a related condition or equivalent documented coursework at
the graduate level by an accredited university in ASD diagnostics, ASD developmental and
behavioral treatment strategies, and typical child development or a combination of
coursework or hours of experience;
(ii) has certification as a board-certified assistant behavior analyst from the Behavior
Analyst Certification Board or a qualified autism service practitioner from the Qualified
Applied Behavior Analysis Credentialing Board;
(iii) is a registered behavior technician as defined by the Behavior Analyst Certification
Board or an applied behavior analysis technician as defined by the Qualified Applied
Behavior Analysis Credentialing Board; or
(iv) is certified in one of the other treatment modalities recognized by the department;
or
(2) a person who has:
(i) an associate's degree in a behavioral or child development science or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy from an accredited college or university; and
(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people
with ASD or a related condition. Hours worked as a mental health behavioral aide or level
III treatment provider may be included in the required hours of experience; or
(3) a person who has at least 4,000 hours of supervised clinical experience in delivering
treatment to people with ASD or a related condition. Hours worked as a mental health
behavioral aide or level III treatment provider may be included in the required hours of
experience; or
(4) a person who is a graduate student in a behavioral science, child development science,
or related field and is receiving clinical supervision by a QSP affiliated with an agency to
meet the clinical training requirements for experience and training with people with ASD
or a related condition; or
(5) a person who is at least 18 years of age and who:
(i) is fluent in a non-English language or is an individual certified by a Tribal Nation;
(ii) completed the level III EIDBI training requirements; and
(iii) receives observation and direction from a QSP or level I treatment provider at least
once a week until the person meets 1,000 hours of supervised clinical experience.
(d) A level III treatment provider must be deleted text begin employed bydeleted text end new text begin an employee ofnew text end an agency, have
completed the level III training requirement, be at least 18 years of age, and have at least
one of the following:
(1) a high school diploma or commissioner of education-selected high school equivalency
certification;
(2) fluency in a non-English language or Tribal Nation certification;
(3) one year of experience as a primary personal care assistant, community health worker,
waiver service provider, or special education assistant to a person with ASD or a related
condition within the previous five years; or
(4) completion of all required EIDBI training within six months of employment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 34.
Minnesota Statutes 2024, section 256B.0949, subdivision 16, is amended to read:
Subd. 16.
Agency duties.
(a) An agency delivering an EIDBI service under this section
must:
(1) enroll as a medical assistance Minnesota health care program provider according to
Minnesota Rules, part 9505.0195, and section 256B.04, subdivision 21, and meet all
applicable provider standards and requirements;
(2) new text begin designate an individual as the agency's compliance officer who must perform the
duties described in section 256B.04, subdivision 21, paragraph (g);
new text end
new text begin (3) new text end demonstrate compliance with federal and state laws for new text begin the delivery of and billing
for new text end EIDBI service;
deleted text begin (3)deleted text end new text begin (4)new text end verify and maintain records of a service provided to the person or the person's
legal representative as required under Minnesota Rules, parts 9505.2175 and 9505.2197;
deleted text begin (4)deleted text end new text begin (5)new text end demonstrate that while enrolled or seeking enrollment as a Minnesota health care
program provider the agency did not have a lead agency contract or provider agreement
discontinued because of a conviction of fraud; or did not have an owner, board member, or
manager fail a state or federal criminal background check or appear on the list of excluded
individuals or entities maintained by the federal Department of Human Services Office of
Inspector General;
deleted text begin (5)deleted text end new text begin (6)new text end have established business practices including written policies and procedures,
internal controls, and a system that demonstrates the organization's ability to deliver quality
EIDBI servicesnew text begin , appropriately submit claims, conduct required staff training, document staff
qualifications, document service activities, and document service qualitynew text end ;
deleted text begin (6)deleted text end new text begin (7)new text end have an office located in Minnesota or a border state;
deleted text begin (7) conduct a criminal background check on an individual who has direct contact with
the person or the person's legal representativedeleted text end new text begin (8) initiate a background study as required
under subdivision 16anew text end ;
deleted text begin (8)deleted text end new text begin (9)new text end report maltreatment according to section 626.557 and chapter 260E;
deleted text begin (9)deleted text end new text begin (10)new text end comply with any data requests consistent with the Minnesota Government Data
Practices Act, sections 256B.064 and 256B.27;
deleted text begin (10)deleted text end new text begin (11)new text end provide training for all agency staff on the requirements and responsibilities
listed in the Maltreatment of Minors Act, chapter 260E, and the Vulnerable Adult Protection
Act, section 626.557, including mandated and voluntary reporting, nonretaliation, and the
agency's policy for all staff on how to report suspected abuse and neglect;
deleted text begin (11)deleted text end new text begin (12)new text end have a written policy to resolve issues collaboratively with the person and the
person's legal representative when possible. The policy must include a timeline for when
the person and the person's legal representative will be notified about issues that arise in
the provision of services;
deleted text begin (12)deleted text end new text begin (13)new text end provide the person's legal representative with prompt notification if the person
is injured while being served by the agency. An incident report must be completed by the
agency staff member in charge of the person. A copy of all incident and injury reports must
remain on file at the agency for at least five years from the report of the incident; deleted text begin and
deleted text end
deleted text begin (13)deleted text end new text begin (14)new text end before starting a service, provide the person or the person's legal representative
a description of the treatment modality that the person shall receive, including the staffing
certification levels and training of the staff who shall provide a treatmentdeleted text begin .deleted text end new text begin ;
new text end
new text begin
(15) provide clinical supervision for a minimum of one hour for every 20 hours of direct
treatment per person; and
new text end
new text begin
(16) provide clinical supervision sessions at least once per month for EIDBI intervention
observation and direction. Notwithstanding subdivision 13, paragraph (l), clinical supervision
sessions under this clause may be conducted via telehealth provided:
new text end
new text begin
(i) the telehealth clinical supervision session is conducted in tandem with a level I or
level II provider who is in person and not billing for any EIDBI services; and
new text end
new text begin
(ii) no more than two consecutive monthly clinical supervision sessions under this clause
are conducted via telehealth.
new text end
new text begin
(b) Upon request of the commissioner, an agency delivering services under this section
must:
new text end
new text begin
(1) identify the agency's controlling individuals, as defined under section 245A.02,
subdivision 5a;
new text end
new text begin
(2) provide disclosures of the use of billing agencies and other consultants; and
new text end
new text begin
(3) provide copies of any contracts with independent contractors for qualified supervising
professionals, including hours contracted and responsibilities.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end When delivering the ITP, and annually thereafter, an agency must provide the
person or the person's legal representative with:
(1) a written copy and a verbal explanation of the person's or person's legal
representative's rights and the agency's responsibilities;
(2) documentation in the person's file the date that the person or the person's legal
representative received a copy and explanation of the person's or person's legal
representative's rights and the agency's responsibilities; and
(3) reasonable accommodations to provide the information in another format or language
as needed to facilitate understanding of the person's or person's legal representative's rights
and the agency's responsibilities.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 35.
Minnesota Statutes 2024, section 256B.0949, subdivision 16a, is amended to
read:
Subd. 16a.
Background studies.
An early intensive developmental and behavioral
intervention services agency must fulfill any background studies requirements under this
section by initiating a background study through the commissioner's NETStudy new text begin 2.0 new text end system
as provided under sections 245C.03, subdivision 15deleted text begin , and 245C.10, subdivision 17deleted text end .new text begin Before
an individual subject to the background study requirements under this subdivision has direct
contact with the person, the agency must have received a notice from the commissioner that
the subject of the background study is:
new text end
new text begin
(1) not disqualified under section 245C.14; or
new text end
new text begin
(2) disqualified but the subject of the study has received a set-aside of the disqualification
under section 245C.22.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 36.
Minnesota Statutes 2024, section 256B.0949, is amended by adding a subdivision
to read:
new text begin Subd. 18. new text end
new text begin Site visits and sanctions. new text end
new text begin
(a) The commissioner may conduct unannounced
on-site inspections of any and all EIDBI agencies and service locations to verify that
information submitted to the commissioner is accurate, determine compliance with all
enrollment requirements, investigate reports of maltreatment, determine compliance with
service delivery and billing requirements, and determine compliance with any other applicable
laws or rules.
new text end
new text begin
(b) The commissioner may withhold payment from an agency or suspend or terminate
the agency's enrollment number if the agency fails to provide access to the agency's service
locations or records or the commissioner determines the agency has failed to comply fully
with applicable laws or rules. The provider has the right to appeal the decision of the
commissioner under section 256B.064.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 37.
Minnesota Statutes 2024, section 256B.49, subdivision 12, is amended to read:
Subd. 12.
Informed choice.
Persons who are determined deleted text begin likelydeleted text end to require the level of
care provided in a nursing facility as determined under section 256B.0911, subdivision 26,
or a hospital shall be informed of the home and community-based support alternatives to
the provision of inpatient hospital services or nursing facility services. Each person must
be given the choice of either institutional or home and community-based services using the
provisions described in section 256B.77, subdivision 2, paragraph (p).
Sec. 38.
Minnesota Statutes 2024, section 256B.49, subdivision 13, is amended to read:
Subd. 13.
Case management.
(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:
(1) finalizing the person-centered written support plan within the timelines established
by the commissioner and section 256B.0911, subdivision 29;
(2) informing the recipient or the recipient's legal guardian or conservator of service
options, including all service options available under the waiver plans;
(3) assisting the recipient in the identification of potential service providers of chosen
services, including:
(i) available options for case management service and providers;
(ii) providers of services provided in a non-disability-specific setting;
(iii) employment service providers;
(iv) providers of services provided in settings that are not community residential settings;
and
(v) providers of financial management services;
(4) assisting the recipient to access services and assisting with appeals under section
256.045; and
(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.
(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:
(1) finalizing the person-centered support plan;
(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved person-centered support plan; and
(3) adjustments to the person-centered support plan.
(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. If a county agency provides case
management under contracts with other individuals or agencies and the county agency
utilizes a competitive proposal process for the procurement of contracted case management
services, the competitive proposal process must include evaluation criteria to ensure that
the county maintains a culturally responsive program for case management services adequate
to meet the needs of the population of the county. For the purposes of this section, "culturally
responsive program" means a case management services program that: (1) ensures effective,
equitable, comprehensive, and respectful quality care services that are responsive to
individuals within a specific population's values, beliefs, practices, health literacy, preferred
language, and other communication needs; and (2) is designed to address the unique needs
of individuals who share a common language or racial, ethnic, or social background.
(d) Case management services must not be provided to a recipient by a private agency
that has any financial interest in the provision of any other services included in the recipient's
support plan. For purposes of this section, "private agency" means any agency that is not
identified as a lead agency under section 256B.0911, subdivision 10.
(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:
(1) phasing out the use of prohibited procedures;
(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and
(3) accomplishment of identified outcomes.
If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.
(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than 20 hours of case management
education and disability-related training each year. The education and training must include
new text begin appropriate service authorization under the community access for disability inclusion waiver,
new text end person-centered planning, informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supports. By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case
managers shall document completion of training in a system identified by the commissioner.
Sec. 39.
Minnesota Statutes 2024, section 256B.4914, subdivision 3, is amended to read:
Subd. 3.
Applicable services.
deleted text begin (a)deleted text end Applicable services are those authorized under the
state's home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:
(1) 24-hour customized living;
(2) adult day services;
(3) adult day services bath;
(4) community residential services;
(5) customized living;
(6) day support services;
(7) employment development services;
(8) employment exploration services;
(9) employment support services;
(10) family residential services;
(11) individualized home supports;
(12) individualized home supports with family training;
(13) individualized home supports with training;
(14) integrated community supports;
(15) life sharing;
(16) new text begin effective until the effective date of clauses (17) and (18), new text end night supervision;
new text begin
(17) effective January 1, 2026, or upon federal approval, whichever is later, awake night
supervision;
new text end
new text begin
(18) effective January 1, 2026, or upon federal approval, whichever is later, asleep night
supervision;
new text end
deleted text begin (17)deleted text end new text begin (19)new text end positive support services;
deleted text begin (18)deleted text end new text begin (20)new text end prevocational services;
deleted text begin (19)deleted text end new text begin (21)new text end residential support services;
deleted text begin
(20) respite services;
deleted text end
deleted text begin (21)deleted text end new text begin (22)new text end transportation services; and
deleted text begin (22)deleted text end new text begin (23)new text end other services as approved by the federal government in the state home and
community-based services waiver plan.
deleted text begin
(b) Effective January 1, 2024, or upon federal approval, whichever is later, respite
services under paragraph (a), clause (20), are not an applicable service under this section.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 40.
Minnesota Statutes 2024, section 256B.4914, subdivision 5, is amended to read:
Subd. 5.
Base wage index; establishment and updates.
(a) The base wage index is
established to determine staffing costs associated with providing services to individuals
receiving home and community-based services. For purposes of calculating the base wage,
Minnesota-specific wages taken from job descriptions and standard occupational
classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational
Handbook must be used.
(b) The commissioner shall update the base wage index in subdivision 5a, publish these
updated values, and load them into the rate management system deleted text begin as follows:deleted text end new text begin on January 1,
2030, and every two years thereafter, based on wage data by SOC from the Bureau of Labor
Statistics published in the spring approximately 21 months prior to the scheduled update.
new text end
deleted text begin
(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2019;
deleted text end
deleted text begin
(2) on January 1, 2024, based on wage data by SOC from the Bureau of Labor Statistics
published in March 2022; and
deleted text end
deleted text begin
(3) on January 1, 2026, and every two years thereafter, based on wage data by SOC from
the Bureau of Labor Statistics published in the spring approximately 21 months prior to the
scheduled update.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 41.
Minnesota Statutes 2024, section 256B.4914, subdivision 5a, is amended to read:
Subd. 5a.
Base wage index; calculations.
The base wage index must be calculated as
follows:
(1) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of positive
supports professional, positive supports analyst, and positive supports specialist, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);
(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
code 29-1141);
(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
nurses (SOC code 29-2061);
(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employers;
(5) for residential direct care staff, the sum of:
(i) 15 percent of the subtotal of 50 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
(SOC code 31-1131); and 20 percent of the median wage for social and human services
aide (SOC code 21-1093); and
(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093);
(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
code 31-1131); and 30 percent of the median wage for home health and personal care aide
(SOC code 31-1120);
(7) for day support services staff and prevocational services staff, 20 percent of the
median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
and human services aide (SOC code 21-1093);
(8) for positive supports analyst staff, 100 percent of the median wage for substance
abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);
(9) for positive supports professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);
(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);
(11) for individualized home supports with family training staff, 20 percent of the median
wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);
(12) for individualized home supports with training services staff, 40 percent of the
median wage for community social service specialist (SOC code 21-1099); 50 percent of
the median wage for social and human services aide (SOC code 21-1093); and ten percent
of the median wage for psychiatric technician (SOC code 29-2053);
(13) for employment support services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);
(14) for employment exploration services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselor (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);
(15) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);
(16) for individualized home support without training staff, 50 percent of the median
wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
median wage for nursing assistant (SOC code 31-1131); deleted text begin and
deleted text end
(17) new text begin effective until the effective date of clauses (18) and (19), new text end for night supervision staff,
40 percent of the median wage for home health and personal care aide (SOC code 31-1120);
20 percent of the median wage for nursing assistant (SOC code 31-1131); 20 percent of the
median wage for psychiatric technician (SOC code 29-2053); and 20 percent of the median
wage for social and human services aide (SOC code 21-1093)deleted text begin .deleted text end new text begin ;
new text end
new text begin
(18) effective January 1, 2026, or upon federal approval, whichever is later, for awake
night supervision staff, 40 percent of the median wage for home health and personal care
aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant (SOC code
31-1131); 20 percent the median wage for psychiatric technician (SOC code 29-2053); and
20 percent of the median wage for social and human services aid (SOC code 21-1093); and
new text end
new text begin
(19) effective January 1, 2026, or upon federal approval, whichever is later, for asleep
night supervision staff, the minimum wage in Minnesota for large employers.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 42.
Minnesota Statutes 2024, section 256B.4914, subdivision 5b, is amended to read:
Subd. 5b.
Standard component value adjustments.
new text begin (a)new text end The commissioner shall update
the client and programming support, transportation, and program facility cost component
values as required in subdivisions 6 to 9 and the rates identified in subdivision 19 for changes
in the Consumer Price Index. The commissioner shall adjust these values higher or lower,
publish these updated values, and load them into the rate management system deleted text begin as follows:
deleted text end
deleted text begin
(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the
previous update to the data available on December 31, 2019;
deleted text end
deleted text begin
(2) on January 1, 2024, by the percentage change in the CPI-U from the date of the
previous update to the data available as of December 31, 2022; and
deleted text end
deleted text begin (3)deleted text end on January 1, 2026, and every two years thereafter, by the percentage change in the
CPI-U from the date of the previous update to the data available 24 months and one day
prior to the scheduled update.
new text begin
(b) The commissioner shall update the base wage index under subdivision 5a for changes
in the Consumer Price Index. The commissioner shall adjust these values higher or lower,
publish these updated values, and load them into the rate management system on January
1, 2026, and January 1, 2028, by the percentage change in the CPI-U from the date of the
previous update to the data available 24 months and one day prior to the scheduled update.
This paragraph expires December 31, 2029.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
new text end
Sec. 43.
Minnesota Statutes 2024, section 256B.4914, subdivision 6a, is amended to read:
Subd. 6a.
Community residential services; component values and calculation of
payment rates.
(a) Component values for community residential services are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) general administrative support ratio: 13.25 percent;
(6) program-related expense ratio: 1.3 percent; and
(7) absence and utilization factor ratio: 3.9 percent.
(b) Payments for community residential services must be calculated as follows:
(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;
(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervision span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);
(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
individual direct staffing hours provided through monitoring technology, and multiply the
result by one plus the employee vacation, sick, and training allowance ratio. This is defined
as the direct staffing cost;
(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
direct staffing and individual hours provided through monitoring technology, by one plus
the employee-related cost ratio;
(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;
(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
by 365 if customized for adapted transport, based on the resident with the highest assessed
need. The commissioner shall update the amounts in this clause as specified in subdivision
5b;
(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
and individual direct staffing hours provided through monitoring technology that was
excluded in clause (8);
(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount; and
(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 44.
Minnesota Statutes 2024, section 256B.4914, subdivision 6b, is amended to read:
Subd. 6b.
Family residential services; component values and calculation of payment
rates.
(a) Component values for family residential services are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) general administrative support ratio: 3.3 percent;
(6) program-related expense ratio: 1.3 percent; and
(7) absence factor: 1.7 percent.
(b) Payments for family residential services must be calculated as follows:
(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;
(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);
(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
individual direct staffing hours provided through monitoring technology, and multiply the
result by one plus the employee vacation, sick, and training allowance ratio. This is defined
as the direct staffing cost;
(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
and individual direct staffing hours provided through monitoring technology, by one plus
the employee-related cost ratio;
(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;
(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
by 365 if customized for adapted transport, based on the resident with the highest assessed
need. The commissioner shall update the amounts in this clause as specified in subdivision
5b;
(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
and individual direct staffing hours provided through monitoring technology that was
excluded in clause (8);
(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment rate; and
(14) adjust the result of clause (13) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 45.
Minnesota Statutes 2024, section 256B.4914, subdivision 6c, is amended to read:
Subd. 6c.
Integrated community supports; component values and calculation of
payment rates.
(a) Component values for integrated community supports are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) general administrative support ratio: 13.25 percent;
(6) program-related expense ratio: 1.3 percent; and
(7) absence and utilization factor ratio: 3.9 percent.
(b) Payments for integrated community supports must be calculated as follows:
(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs. The base shared direct staffing hours must be eight hours divided
by the number of people receiving support in the integrated community support setting, and
the individual direct staffing hours must be the average number of direct support hours
provided directly to the service recipient;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of shared direct staffing and individual direct staffing hours in
clause (1) by the appropriate staff wages;
(6) multiply the number of shared direct staffing and individual direct staffing hours in
clause (1) by the product of the supervisory span of control ratio and the appropriate
supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6) and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
cost;
(8) for employee-related expenses, multiply the direct staffing cost by one plus the
employee-related cost ratio;
(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;
(10) add the results of clauses (8) and (9);
(11) add the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;
(12) divide the result of clause (10) by one minus the result of clause (11). This is the
total payment amount; and
(13) adjust the result of clause (12) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 46.
Minnesota Statutes 2024, section 256B.4914, subdivision 7a, is amended to read:
Subd. 7a.
Adult day services; component values and calculation of payment rates.
(a)
Component values for adult day services are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 5.6 percent;
(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision
5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 1.8 percent; and
(9) absence and utilization factor ratio: 9.4 percent.
(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of
service is six or more hours of time spent providing direct service.
(c) Payments for adult day services must be calculated as follows:
(1) determine the number of units of service and the staffing ratio to meet a recipient's
needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;
(6) multiply the number of day program direct staffing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;
(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;
(12) for adult day bath services, add $7.01 per 15 minute unit;
(13) this is the subtotal rate;
(14) sum the standard general administrative rate support ratio, the program-related
expense ratio, and the absence and utilization factor ratio;
(15) divide the result of clause (13) by one minus the result of clause (14). This is the
total payment amount; and
(16) adjust the result of clause (15) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin EFFECTIVE DATE. new text end
new text begin
The amendments to paragraph (a), clause (1), are effective the
day following final enactment.
new text end
Sec. 47.
Minnesota Statutes 2024, section 256B.4914, subdivision 7b, is amended to read:
Subd. 7b.
Day support services; component values and calculation of payment
rates.
(a) Component values for day support services are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 5.6 percent;
(6) client programming and support ratio: 10.37 percent, updated as specified in
subdivision 5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 1.8 percent; and
(9) absence and utilization factor ratio: 9.4 percent.
(b) A unit of service for day support services is 15 minutes.
(c) Payments for day support services must be calculated as follows:
(1) determine the number of units of service and the staffing ratio to meet a recipient's
needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;
(6) multiply the number of day program direct staffing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;
(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;
(12) this is the subtotal rate;
(13) sum the standard general administrative rate support ratio, the program-related
expense ratio, and the absence and utilization factor ratio;
(14) divide the result of clause (12) by one minus the result of clause (13). This is the
total payment amount; and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin EFFECTIVE DATE. new text end
new text begin
The amendments to paragraph (a), clause (1), are effective the
day following final enactment.
new text end
Sec. 48.
Minnesota Statutes 2024, section 256B.4914, subdivision 7c, is amended to read:
Subd. 7c.
Prevocational services; component values and calculation of payment
rates.
(a) Component values for prevocational services are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 5.6 percent;
(6) client programming and support ratio: 10.37 percent, updated as specified in
subdivision 5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 1.8 percent; and
(9) absence and utilization factor ratio: 9.4 percent.
(b) A unit of service for prevocational services is either a day or 15 minutes. A day unit
of service is six or more hours of time spent providing direct service.
(c) Payments for prevocational services must be calculated as follows:
(1) determine the number of units of service and the staffing ratio to meet a recipient's
needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;
(6) multiply the number of day program direct staffing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;
(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;
(12) this is the subtotal rate;
(13) sum the standard general administrative rate support ratio, the program-related
expense ratio, and the absence and utilization factor ratio;
(14) divide the result of clause (12) by one minus the result of clause (13). This is the
total payment amount; and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin EFFECTIVE DATE. new text end
new text begin
The amendments to paragraph (a), clause (1), are effective the
day following final enactment.
new text end
Sec. 49.
Minnesota Statutes 2024, section 256B.4914, subdivision 8, is amended to read:
Subd. 8.
Unit-based services with programming; component values and calculation
of payment rates.
(a) For the purpose of this section, unit-based services with programming
include employment exploration services, employment development services, employment
support services, individualized home supports with family training, individualized home
supports with training, and positive support services provided to an individual outside of
any service plan for a day program or residential support service.
(b) Component values for unit-based services with programming are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 15.5 percent;
(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision
5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 6.1 percent; and
(9) absence and utilization factor ratio: 3.9 percent.
(c) A unit of service for unit-based services with programming is 15 minutes.
(d) Payments for unit-based services with programming must be calculated as follows,
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:
(1) determine the number of units of service to meet a recipient's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of direct staffing hours by the appropriate staff wage;
(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;
(11) this is the subtotal rate;
(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;
(14) for services provided in a shared manner, divide the total payment in clause (13)
as follows:
(i) for employment exploration services, divide by the number of service recipients, not
to exceed five;
(ii) for employment support services, divide by the number of service recipients, not to
exceed six;
(iii) for individualized home supports with training and individualized home supports
with family training, divide by the number of service recipients, not to exceed three; and
(iv) for night supervision, divide by the number of service recipients, not to exceed two;
and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin
(e) Effective January 1, 2026, or upon federal approval, whichever is later, providers
must not bill more than nine hours per day for individualized home supports with training
and individualized home supports with family training. This maximum does not limit a
person's use of other disability waiver services.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 50.
Minnesota Statutes 2024, section 256B.4914, subdivision 9, is amended to read:
Subd. 9.
Unit-based services without programming; component values and
calculation of payment rates.
(a) For the purposes of this section, unit-based services
without programming include individualized home supports without training and night
supervision provided to an individual outside of any service plan for a day program or
residential support service. Unit-based services without programming do not include respite.new text begin
This paragraph expires upon the effective date of paragraph (b).
new text end
new text begin
(b) Effective January 1, 2026, or upon federal approval, whichever is later, for the
purposes of this section, unit-based services without programming include individualized
home supports without training, awake night supervision, and asleep night supervision
provided to an individual outside of any service plan for a day program or residential support
service.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end Component values for unit-based services without programming are:
(1) competitive workforce factor: deleted text begin 6.7 percent;
deleted text end
new text begin
(i) 6.7 percent. This item expires upon the effective date of item (ii);
new text end
new text begin
(ii) effective January 1, 2026, or upon federal approval, whichever is later, 9.71 percent.
This item expires upon the effective date of item (iii);
new text end
new text begin
(iii) effective January 1, 2028, or upon federal approval, whichever is later, 21.79 percent.
This item expires upon the effective date of item (iv); and
new text end
new text begin
(iv) effective January 1, 2030, or upon federal approval, whichever is later, 6.7 percent;
new text end
(2) supervisory span of control ratio: 11 percent;
(3) employee vacation, sick, and training allowance ratio: 8.71 percent;
(4) employee-related cost ratio: 23.6 percent;
(5) program plan support ratio: 7.0 percent;
(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision
5b;
(7) general administrative support ratio: 13.25 percent;
(8) program-related expense ratio: 2.9 percent; and
(9) absence and utilization factor ratio: 3.9 percent.
deleted text begin (c)deleted text end new text begin (d)new text end A unit of service for unit-based services without programming is 15 minutes.
deleted text begin (d)deleted text end new text begin (e)new text end Payments for unit-based services without programming must be calculated as
follows unless the services are reimbursed separately as part of a residential support services
or day program payment rate:
(1) determine the number of units of service to meet a recipient's needs;
(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 to 5a;
(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;
(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);
(5) multiply the number of direct staffing hours by the appropriate staff wage;
(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);
(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;
(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;
(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;
(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;
(11) this is the subtotal rate;
(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;
(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;
(14) for individualized home supports without training provided in a shared manner,
divide the total payment amount in clause (13) by the number of service recipients, not to
exceed three; and
(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 51.
Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
to read:
new text begin Subd. 14a. new text end
new text begin Limitations on rate exceptions for residential services. new text end
new text begin
(a) Effective July
1, 2026, the commissioner must implement limitations on the size and number of rate
exceptions for community residential services, customized living services, family residential
services, and integrated community supports.
new text end
new text begin
(b) The commissioner must restrict rate exceptions to the absence and utilization factor
ratio to people temporarily receiving hospital or crisis respite services.
new text end
new text begin
(c) For rate exceptions related to behavioral needs, the commissioner must include:
new text end
new text begin
(1) a documented behavioral diagnosis; or
new text end
new text begin
(2) determined assessed needs for behavioral supports as identified in the person's most
recent assessment.
new text end
new text begin
(d) Community residential services rate exceptions must not include positive supports
costs.
new text end
new text begin
(e) The commissioner must not approve rate exception requests related to increased
community time or transportation.
new text end
new text begin
(f) For the commissioner to approve a rate exception annual renewal, the person's most
recent assessment must indicate continued extraordinary needs in the areas cited in the
exception request. If a person's assessment continues to identify these extraordinary needs,
lead agencies requesting an annual renewal of rate exceptions must submit provider-created
documentation supporting the continuation of the exception, including but not limited to:
new text end
new text begin
(1) payroll records for direct care wages cited in the request;
new text end
new text begin
(2) payment records or receipts for other costs cited in the request; and
new text end
new text begin
(3) documentation of expenses paid that were identified as necessary for the initial rate
exception.
new text end
new text begin
(g) The commissioner must not increase rate exception annual renewals that request an
exception to direct care or supervision wages more than the most recently implemented
base wage index determined under subdivision 5.
new text end
new text begin
(h) The commissioner must publish online an annual report detailing the impact of the
limitations under this subdivision on home and community-based services spending, including
but not limited to:
new text end
new text begin
(1) the number and percentage of rate exceptions granted and denied;
new text end
new text begin
(2) total spending on community residential setting services and rate exceptions;
new text end
new text begin
(3) trends in the percentage of spending attributable to rate exceptions; and
new text end
new text begin
(4) an evaluation of the effectiveness of the limitations in controlling spending growth.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 52.
Minnesota Statutes 2024, section 256B.4914, is amended by adding a subdivision
to read:
new text begin Subd. 20. new text end
new text begin Sanctions and monetary recovery. new text end
new text begin
Payments under this section are subject
to the sanctions and monetary recovery requirements under section 256B.064.
new text end
Sec. 53.
Minnesota Statutes 2024, section 256B.85, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For the purposes of this section and section 256B.851, the terms
defined in this subdivision have the meanings given.
(b) "Activities of daily living" or "ADLs" means:
(1) dressing, including assistance with choosing, applying, and changing clothing and
applying special appliances, wraps, or clothing;
(2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
care, except for recipients who are diabetic or have poor circulation;
(3) bathing, including assistance with basic personal hygiene and skin care;
(4) eating, including assistance with hand washing and applying orthotics required for
eating or feeding;
(5) transfers, including assistance with transferring the participant from one seating or
reclining area to another;
(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a participant;
(7) positioning, including assistance with positioning or turning a participant for necessary
care and comfort; and
(8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.
(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.
(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.
(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.
(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, advanced practice registered nurse, or physician's assistant
and is specified in an assessment summary, including:
(1) tube feedings requiring:
(i) a gastrojejunostomy tube; or
(ii) continuous tube feeding lasting longer than 12 hours per day;
(2) wounds described as:
(i) stage III or stage IV;
(ii) multiple wounds;
(iii) requiring sterile or clean dressing changes or a wound vac; or
(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;
(3) parenteral therapy described as:
(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or
(ii) total parenteral nutrition (TPN) daily;
(4) respiratory interventions, including:
(i) oxygen required more than eight hours per day;
(ii) respiratory vest more than one time per day;
(iii) bronchial drainage treatments more than two times per day;
(iv) sterile or clean suctioning more than six times per day;
(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and
(vi) ventilator dependence under section 256B.0651;
(5) insertion and maintenance of catheter, including:
(i) sterile catheter changes more than one time per month;
(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or
(iii) bladder irrigations;
(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;
(7) neurological intervention, including:
(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or
(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse,
or physician's assistant and requiring specialized assistance from another on a daily basis;
and
(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.
(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.
(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the support plan identified
in sections 256B.092, subdivision 1b, and 256S.10.
(i) "Consultation services" means deleted text begin a Minnesota health care program enrolled provider
organization that provides assistance to thedeleted text end new text begin assisting anew text end participant in making informed
choices about CFSS services in general and self-directed tasks in particular, and in developing
a person-centered CFSS service delivery plan to achieve quality service outcomes.
(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.
(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
must not be found to be dependent in an activity of daily living if, because of the child's
age, an adult would either perform the activity for the child or assist the child with the
activity and the assistance needed is the assistance appropriate for a typical child of the
same age.
(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under chapter 256S and sections 256B.092,
subdivision 5, and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants. Extended CFSS excludes the purchase of goods.
(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).
(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.
(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community,
including traveling to medical appointments. For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the individual CFSS service delivery plan.
(p) "Lead agency" has the meaning given in section 256B.0911, subdivision 10.
(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.
(r) "Level I behavior" means physical aggression toward self or others or destruction of
property that requires the immediate response of another person.
(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker must not determine medication
dose or time for medication or inject medications into veins, muscles, or skin:
(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;
(2) organizing medications as directed by the participant or the participant's representative;
and
(3) providing verbal or visual reminders to perform regularly scheduled medications.
(t) "Participant" means a person who is eligible for CFSS.
(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. If the participant is unable to assist
in the selection of a participant's representative, the legal representative shall appoint one.
(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.
(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.
(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into a written agreement to receive
services at the same time, in the same setting, and through the same agency-provider or
FMS provider.
(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.
(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.
(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.
(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
mileage reimbursement, health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.
(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.
Sec. 54.
Minnesota Statutes 2024, section 256B.85, subdivision 5, is amended to read:
Subd. 5.
Assessment requirements.
(a) The assessment of functional need must:
(1) be conducted by a certified assessor according to the criteria established in section
256B.0911, subdivisions 17 to 21, 23, 24, and 29 to 31;
(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
a significant change in the participant's condition or a change in the need for services and
supports, or at the request of the participant when the participant experiences a change in
condition or needs a change in the services or supports; and
(3) be completed using the format established by the commissioner.
(b) The results of the assessment and any recommendations and authorizations for CFSS
must be determined and communicated in writing by the lead agency's assessor as defined
in section 256B.0911 to the participant or the participant's representative and chosen CFSS
providers within ten business days and must include the participant's right to appeal the
assessment under section 256.045, subdivision 3.
deleted text begin
(c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. The lead agency assessor may authorize
a temporary authorization for CFSS services to be provided under the agency-provider
model without using the assessment process described in this subdivision. Authorization
for a temporary level of CFSS services under the agency-provider model is limited to the
time specified by the commissioner, but shall not exceed 45 days. The level of services
authorized under this paragraph shall have no bearing on a future authorization. For CFSS
services needed beyond the 45-day temporary authorization, the lead agency must conduct
an assessment as described in this subdivision and participants must use consultation services
to complete their orientation and selection of a service model.
deleted text end
Sec. 55.
Minnesota Statutes 2024, section 256B.85, is amended by adding a subdivision
to read:
new text begin Subd. 5a. new text end
new text begin Temporary authorization without assessment. new text end
new text begin
The lead agency assessor
may authorize a temporary authorization for CFSS services to be provided under the
agency-provider model. The lead agency assessor may authorize a temporary authorization
for CFSS services to be provided under the agency-provider model without using the
assessment process described in subdivision 5. Authorization for a temporary level of CFSS
services under the agency-provider model is limited to the time specified by the
commissioner, but shall not exceed 45 days. The level of services authorized under this
subdivision shall have no bearing on a future authorization. For CFSS services needed
beyond the 45-day temporary authorization, the lead agency must conduct an assessment
as described in subdivision 5 and participants must use consultation services to complete
their orientation and selection of a service model.
new text end
Sec. 56.
Minnesota Statutes 2024, section 256B.85, subdivision 7, is amended to read:
Subd. 7.
Community first services and supports; covered services.
Services and
supports covered under CFSS include:
(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;
(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;
(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:
(i) relate to a need identified in a participant's CFSS service delivery plan; and
(ii) increase independence or substitute for human assistance, to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;
(4) observation and redirection for behavior or symptoms where there is a need for
assistance;
(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;
new text begin
(6) swimming lessons for a participant younger than 12 years of age whose disability
puts the participant at a higher risk of drowning according to the Centers for Disease Control
Vital Statistics System;
new text end
deleted text begin (6)deleted text end new text begin (7)new text end services new text begin described under subdivision 17 new text end provided by a consultation services
provider deleted text begin as defined under subdivision 17, that is under contract with the department and
enrolled as a Minnesota health care program providerdeleted text end new text begin meeting the requirements of subdivision
17anew text end ;
deleted text begin (7)deleted text end new text begin (8)new text end services provided by an FMS provider as defined under subdivision 13a, that is
an enrolled provider with the department;
deleted text begin (8)deleted text end new text begin (9)new text end CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. Covered services
under this clause are subject to the limitations described in subdivision 7b; and
deleted text begin (9)deleted text end new text begin (10)new text end worker training and development services as described in subdivision 18a.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 57.
Minnesota Statutes 2024, section 256B.85, subdivision 7a, is amended to read:
Subd. 7a.
Enhanced rate.
(a) An enhanced rate of 107.5 percent of the rate paid for
CFSS must be paid for services provided to persons who qualify for ten or more hours of
CFSS per day when provided by a support worker who meets the requirements of subdivision
16, paragraph (e).new text begin This paragraph expires upon the effective date of paragraph (b).
new text end
new text begin
(b) Effective January 1, 2026, or upon federal approval, whichever is later, an enhanced
rate of 112.5 percent of the rate paid for CFSS must be paid for services provided to persons
who qualify for ten or more hours of CFSS per day when provided by a support worker
who meets the requirements of subdivision 16, paragraph (e). This paragraph expires upon
the effective date of paragraph (c).
new text end
new text begin
(c) Effective January 1, 2027, or upon federal approval, whichever is later, an enhanced
rate of 112.5 percent of the rate paid for CFSS must be paid for services provided to persons
who qualify for ten or more hours of CFSS per day.
new text end
deleted text begin (b)deleted text end new text begin (d)new text end An agency provider must use all additional revenue attributable to the rate
enhancements under this subdivision for the wages and wage-related costs of the support
workers, including any corresponding increase in the employer's share of FICA taxes,
Medicare taxes, state and federal unemployment taxes, and workers' compensation premiums.
The agency provider must not use the additional revenue attributable to any enhanced rate
under this subdivision to pay for mileage reimbursement, health and dental insurance, life
insurance, disability insurance, long-term care insurance, uniform allowance, contributions
to employee retirement accounts, or any other employee benefits.
deleted text begin (c)deleted text end new text begin (e)new text end Any change in the eligibility criteria for the enhanced rate for CFSS as described
in this subdivision and referenced in subdivision 16, paragraph (e), does not constitute a
change in a term or condition for individual providers as defined in section 256B.0711, and
is not subject to the state's obligation to meet and negotiate under chapter 179A.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 58.
Minnesota Statutes 2024, section 256B.85, subdivision 8, is amended to read:
Subd. 8.
Determination of CFSS service authorization amount.
(a) All community
first services and supports must be authorized by the commissioner or the commissioner's
designee before services begin. The authorization for CFSS must be completed as soon as
possible following an assessment but no later than 40 calendar days from the date of the
assessment.
(b) The amount of CFSS authorized must be based on the participant's home care rating
described in paragraphs (d) and (e) and any additional service units for which the participant
qualifies as described in paragraph (f).
(c) The home care rating shall be determined by the commissioner or the commissioner's
designee based on information submitted to the commissioner identifying the following for
a participant:
(1) the total number of dependencies of activities of daily living;
(2) the presence of complex health-related needs; and
(3) the presence of Level I behavior.
(d) The methodology to determine the total service units for CFSS for each home care
rating is based on the median paid units per day for each home care rating from fiscal year
2007 data for the PCA program.
(e) Each home care rating is designated by the letters P through Z and EN and has the
following base number of service units assigned:
(1) P home care rating requires Level I behavior or one to three dependencies in ADLs
and qualifies the person for five service units;
(2) Q home care rating requires Level I behavior and one to three dependencies in ADLs
and qualifies the person for six service units;
(3) R home care rating requires a complex health-related need and one to three
dependencies in ADLs and qualifies the person for seven service units;
(4) S home care rating requires four to six dependencies in ADLs and qualifies the person
for ten service units;
(5) T home care rating requires four to six dependencies in ADLs and Level I behavior
and qualifies the person for 11 service units;
(6) U home care rating requires four to six dependencies in ADLs and a complex
health-related need and qualifies the person for 14 service units;
(7) V home care rating requires seven to eight dependencies in ADLs and qualifies the
person for 17 service units;
(8) W home care rating requires seven to eight dependencies in ADLs and Level I
behavior and qualifies the person for 20 service units;
(9) Z home care rating requires seven to eight dependencies in ADLs and a complex
health-related need and qualifies the person for 30 service units; and
(10) EN home care rating includes ventilator dependency as defined in section 256B.0651,
subdivision 1, paragraph (g). A person who meets the definition of ventilator-dependent
and the EN home care rating and utilize a combination of CFSS and home care nursing
services is limited to a total of 96 service units per day for those services in combination.
Additional units may be authorized when a person's assessment indicates a need for two
staff to perform activities. Additional time is limited to 16 service units per day.
(f) Additional service units are provided through the assessment and identification of
the following:
(1) 30 additional minutes per day for a dependency in each critical activity of daily
living;
(2) 30 additional minutes per day for each complex health-related need; and
(3) 30 additional minutes per day for each behavior under this clause that requires
assistance at least four times per week:
(i) level I behavior that requires the immediate response of another person;
(ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior;
or
(iii) increased need for assistance for participants who are verbally aggressive or resistive
to care so that the time needed to perform activities of daily living is increased.
(g) The service budget for budget model participants shall be based on:
(1) assessed units as determined by the home care rating; and
(2) an adjustment needed for administrative expenses.new text begin This paragraph expires upon the
effective date of paragraph (h).
new text end
new text begin
(h) Effective January 1, 2026, or upon federal approval, whichever is later, the service
budget for budget model participants shall be based on:
new text end
new text begin
(1) assessed units as determined by the home care rating and the payment methodologies
under section 256B.851; and
new text end
new text begin
(2) an adjustment needed for administrative expenses.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 59.
Minnesota Statutes 2024, section 256B.85, subdivision 8a, is amended to read:
Subd. 8a.
Authorization; exceptions.
All CFSS services must be authorized by the
commissioner or the commissioner's designee as described in subdivision 8 except when:
(1) the lead agency temporarily authorizes services in the agency-provider model as
described in subdivision deleted text begin 5, paragraph (c)deleted text end new text begin 5anew text end ;
(2) CFSS services in the agency-provider model were required to treat an emergency
medical condition that if not immediately treated could cause a participant serious physical
or mental disability, continuation of severe pain, or death. The CFSS agency provider must
request retroactive authorization from the lead agency no later than five working days after
providing the initial emergency service. The CFSS agency provider must be able to
substantiate the emergency through documentation such as reports, notes, and admission
or discharge histories. A lead agency must follow the authorization process in subdivision
5 after the lead agency receives the request for authorization from the agency provider;
(3) the lead agency authorizes a temporary increase to the amount of services authorized
in the agency or budget model to accommodate the participant's temporary higher need for
services. Authorization for a temporary level of CFSS services is limited to the time specified
by the commissioner, but shall not exceed 45 days. The level of services authorized under
this clause shall have no bearing on a future authorization;
(4) a participant's medical assistance eligibility has lapsed, is then retroactively reinstated,
and an authorization for CFSS services is completed based on the date of a current
assessment, eligibility, and request for authorization;
(5) a third-party payer for CFSS services has denied or adjusted a payment. Authorization
requests must be submitted by the provider within 20 working days of the notice of denial
or adjustment. A copy of the notice must be included with the request;
(6) the commissioner has determined that a lead agency or state human services agency
has made an error; or
(7) a participant enrolled in managed care experiences a temporary disenrollment from
a health plan, in which case the commissioner shall accept the current health plan
authorization for CFSS services for up to 60 days. The request must be received within the
first 30 days of the disenrollment. If the recipient's reenrollment in managed care is after
the 60 days and before 90 days, the provider shall request an additional 30-day extension
of the current health plan authorization, for a total limit of 90 days from the time of
disenrollment.
Sec. 60.
Minnesota Statutes 2024, section 256B.85, subdivision 11, is amended to read:
Subd. 11.
Agency-provider model.
(a) The agency-provider model includes services
provided by support workers and staff providing worker training and development services
who are employed by an agency-provider that meets the criteria established by the
commissioner, including required training.
(b) The agency-provider shall allow the participant to have a significant role in the
selection and dismissal of the support workers for the delivery of the services and supports
specified in the participant's CFSS service delivery plan. The agency must make a reasonable
effort to fulfill the participant's request for the participant's preferred support worker.
(c) A participant may use authorized units of CFSS services as needed within a service
agreement that is not greater than 12 months. Using authorized units in a flexible manner
in either the agency-provider model or the budget model does not increase the total amount
of services and supports authorized for a participant or included in the participant's CFSS
service delivery plan.
(d) A participant may share CFSS services. Two or three CFSS participants may share
services at the same time provided by the same support worker.
(e) The agency-provider must use a minimum of 72.5 percent of the revenue generated
by the medical assistance payment for CFSS for support worker wages and benefits, except
all of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The agency-provider must document how this requirement is being met. The
revenue generated by the worker training and development services and the reasonable costs
associated with the worker training and development services must not be used in making
this calculation.
(f) The agency-provider model must be used by participants who are restricted by the
Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to
9505.2245.
(g) Participants purchasing goods under deleted text begin thisdeleted text end new text begin the agency-providernew text end model, along with
support worker services, must:
(1) specify the goods in the CFSS service delivery plan and detailed budget for
expenditures that must be approved by the lead agency, case manager, or care coordinator;
and
(2) use the FMS provider for the billing and payment of such goods.
(h) The agency provider is responsible for ensuring that any worker driving a participant
under subdivision 2, paragraph (o), has a valid driver's license and the vehicle used is
registered and insured according to Minnesota law.
Sec. 61.
Minnesota Statutes 2024, section 256B.85, subdivision 13, is amended to read:
Subd. 13.
Budget model.
(a) Under the budget model participants exercise responsibility
and control over the services and supports described and budgeted within the CFSS service
delivery plan. Participants must use new text begin consultation services specified in subdivision 17 and
new text end services specified in subdivision 13a provided by an FMS provider. Under this model,
participants may use their approved service budget allocation to:
(1) directly employ support workers, and pay wages, federal and state payroll taxes, and
premiums for workers' compensation, liability, family and medical benefit insurance, and
health insurance coverage; and
(2) obtain supports and goods as defined in subdivision 7.
(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) may
authorize a legal representative or participant's representative to do so on their behalf.
(c) If two or more participants using the budget model live in the same household and
have the same support worker, the participants must use the same FMS provider.
(d) If the FMS provider advises that there is a joint employer in the budget model, all
participants associated with that joint employer must use the same FMS provider.
(e) The commissioner shall disenroll or exclude participants from the budget model and
transfer them to the agency-provider model under, but not limited to, the following
circumstances:
(1) when a participant has been restricted by the Minnesota restricted recipient program,
in which case the participant may be excluded for a specified time period under Minnesota
Rules, parts 9505.2160 to 9505.2245;
(2) when a participant exits the budget model during the participant's service plan year.
Upon transfer, the participant shall not access the budget model for the remainder of that
service plan year; or
(3) when the department determines that the participant or participant's representative
or legal representative is unable to fulfill the responsibilities under the budget model, as
specified in subdivision 14.
(f) A participant may appeal in writing to the department under section 256.045,
subdivision 3, to contest the department's decision under paragraph (e), clause (3), to disenroll
or exclude the participant from the budget model.
Sec. 62.
Minnesota Statutes 2024, section 256B.85, subdivision 16, is amended to read:
Subd. 16.
Support workers requirements.
(a) Support workers shall:
(1) enroll with the department as a support worker after a background study under chapter
245C has been completed and the support worker has received a notice from the
commissioner that the support worker:
(i) is not disqualified under section 245C.14; or
(ii) is disqualified, but has received a set-aside of the disqualification under section
245C.22;
(2) have the ability to effectively communicate with the participant or the participant's
representative;
(3) have the skills and ability to provide the services and supports according to the
participant's CFSS service delivery plan and respond appropriately to the participant's needs;
(4) complete the basic standardized CFSS training as determined by the commissioner
before completing enrollment. The training must be available in languages other than English
and to those who need accommodations due to disabilities. CFSS support worker training
must include successful completion of the following training components: basic first aid,
vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and
responsibilities of support workers including information about basic body mechanics,
emergency preparedness, orientation to positive behavioral practices, orientation to
responding to a mental health crisis, fraud issues, time cards and documentation, and an
overview of person-centered planning and self-direction. Upon completion of the training
components, the support worker must pass the certification test to provide assistance to
participants;
(5) complete employer-directed training and orientation on the participant's individual
needs;
(6) maintain the privacy and confidentiality of the participant; and
(7) not independently determine the medication dose or time for medications for the
participant.
(b) The commissioner may deny or terminate a support worker's provider enrollment
and provider number if the support worker:
(1) does not meet the requirements in paragraph (a);
(2) fails to provide the authorized services required by the employer;
(3) has been intoxicated by alcohol or drugs while providing authorized services to the
participant or while in the participant's home;
(4) has manufactured or distributed drugs while providing authorized services to the
participant or while in the participant's home; or
(5) has been excluded as a provider by the commissioner of human services, or by the
United States Department of Health and Human Services, Office of Inspector General, from
participation in Medicaid, Medicare, or any other federal health care program.
(c) A support worker may appeal in writing to the commissioner to contest the decision
to terminate the support worker's provider enrollment and provider number.
(d) A support worker must not provide or be paid for more than 310 hours of CFSS per
month, regardless of the number of participants the support worker serves or the number
of agency-providers or participant employers by which the support worker is employed.
The department shall not disallow the number of hours per day a support worker works
unless it violates other law.
(e) CFSS qualify for an enhanced ratenew text begin or budgetnew text end if the support worker providing the
services:
(1) provides services, within the scope of CFSS described in subdivision 7, to a participant
who qualifies for ten or more hours per day of CFSS; and
(2) satisfies the current requirements of Medicare for training and competency or
competency evaluation of home health aides or nursing assistants, as provided in the Code
of Federal Regulations, title 42, section 483.151 or 484.36, or alternative state-approved
training or competency requirements.new text begin This paragraph expires December 31, 2026.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 63.
Minnesota Statutes 2024, section 256B.85, subdivision 17a, is amended to read:
Subd. 17a.
Consultation services provider qualifications and
requirements.
Consultation services providers must meet the following qualifications and
requirements:
(1) meet the requirements under subdivision 10, paragraph (a), excluding clauses (4)
and (5);
(2) deleted text begin aredeleted text end new text begin benew text end under contract with the departmentnew text begin and enrolled as a Minnesota health care
program providernew text end ;
(3) deleted text begin are notdeleted text end new text begin not benew text end the FMS provider, the lead agency, or the CFSS or home and
community-based services waiver vendor or agency-provider to the participant;
(4) meet the service standards as established by the commissioner;
(5) have proof of surety bond coverage. Upon new enrollment, or if the consultation
service provider's Medicaid revenue in the previous calendar year is less than or equal to
$300,000, the consultation service provider must purchase a surety bond of $50,000. If the
agency-provider's Medicaid revenue in the previous calendar year is greater than $300,000,
the consultation service provider must purchase a surety bond of $100,000. The surety bond
must be in a form approved by the commissioner, must be renewed annually, and must
allow for recovery of costs and fees in pursuing a claim on the bond;
(6) employ lead professional staff with a minimum of two years of experience in
providing services such as support planning, support broker, case management or care
coordination, or consultation services and consumer education to participants using a
self-directed program using FMS under medical assistance;
(7) report maltreatment as required under chapter 260E and section 626.557;
(8) comply with medical assistance provider requirements;
(9) understand the CFSS program and its policies;
(10) deleted text begin aredeleted text end new text begin benew text end knowledgeable about self-directed principles and the application of the
person-centered planning process;
(11) have general knowledge of the FMS provider duties and the vendor fiscal/employer
agent model, including all applicable federal, state, and local laws and regulations regarding
tax, labor, employment, and liability and workers' compensation coverage for household
workers; and
(12) have all employees, including lead professional staff, staff in management and
supervisory positions, and owners of the agency who are active in the day-to-day management
and operations of the agency, complete training as specified in the contract with the
department.
Sec. 64.
Minnesota Statutes 2024, section 256B.851, subdivision 5, is amended to read:
Subd. 5.
Payment rates; component values.
(a) The commissioner must use the
following component values:
(1) employee vacation, sick, and training factor, 8.71 percent;
(2) employer taxes and workers' compensation factor, 11.56 percent;
(3) employee benefits factor, 12.04 percent;
(4) client programming and supports factor, 2.30 percent;
(5) program plan support factor, 7.00 percent;
(6) general business and administrative expenses factor, 13.25 percent;
(7) program administration expenses factor, 2.90 percent; and
(8) absence and utilization factor, 3.90 percent.
deleted text begin
(b) For purposes of implementation, the commissioner shall use the following
deleted text end
deleted text begin
implementation components:
deleted text end
deleted text begin
(1) personal care assistance services and CFSS: 88.19 percent;
deleted text end
deleted text begin
(2) enhanced rate personal care assistance services and enhanced rate CFSS: 88.19
deleted text end
deleted text begin
percent; and
deleted text end
deleted text begin
(3) qualified professional services and CFSS worker training and development: 88.19
deleted text end
deleted text begin
percent.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end Effective January 1, 2025, for purposes of implementation, the commissioner
shall use the following implementation components:
(1) personal care assistance services and CFSS: 92.08 percent;
(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08
percent; and
(3) qualified professional services and CFSS worker training and development: 92.08
percent.new text begin This paragraph expires upon the effective date of subdivision 5a.
new text end
deleted text begin (d)deleted text end new text begin (c)new text end The commissioner shall use the following worker retention components:
(1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is zero percent;
(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 2.17 percent;
(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 4.36 percent;
(4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 7.35 percent;
and
(5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 10.81 percent.new text begin This paragraph
expires upon the effective date of subdivision 5b.
new text end
deleted text begin (e)deleted text end new text begin (d)new text end The commissioner shall define the appropriate worker retention component new text begin under
subdivision 5b or 5cnew text end based on the total number of units billed for services rendered by the
individual provider since July 1, 2017. The worker retention component must be determined
by the commissioner for each individual provider and is not subject to appeal.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 65.
Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision
to read:
new text begin Subd. 5a. new text end
new text begin Payment rates; implementation factor. new text end
new text begin
Effective January 1, 2026, or upon
federal approval, whichever is later, for purposes of implementation, the commissioner shall
use the following implementation components:
new text end
new text begin
(1) personal care assistance services and CFSS: 92.20 percent;
new text end
new text begin
(2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.20
percent; and
new text end
new text begin
(3) qualified professional services and CFSS worker training and development: 92.20
percent.
new text end
Sec. 66.
Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision
to read:
new text begin Subd. 5b. new text end
new text begin Payment rates; worker retention component. new text end
new text begin
Effective January 1, 2026,
or upon federal approval, whichever is later, the commissioner shall use the following
worker retention components:
new text end
new text begin
(1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is zero percent;
new text end
new text begin
(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 4.05 percent;
new text end
new text begin
(3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 6.24 percent;
new text end
new text begin
(4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 9.23 percent;
and
new text end
new text begin
(5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 12.69 percent.
new text end
Sec. 67.
Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision
to read:
new text begin Subd. 5c. new text end
new text begin Payment rates; enhanced worker retention component. new text end
new text begin
Effective January
1, 2027, or upon federal approval, whichever is later, the commissioner shall use the
following worker retention components if a worker has completed either the orientation for
individual providers offered through the Home Care Orientation Trust or an orientation
defined and offered by the commissioner:
new text end
new text begin
(1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 1.88 percent;
new text end
new text begin
(2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 5.92 percent;
new text end
new text begin
(3) for workers who have provided between 2,001, and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 8.11 percent;
new text end
new text begin
(4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 11.10 percent;
and
new text end
new text begin
(5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 14.56 percent.
new text end
Sec. 68.
Minnesota Statutes 2024, section 256B.851, subdivision 6, is amended to read:
Subd. 6.
Payment rates; rate determination.
(a) The commissioner must determine
the rate for personal care assistance services, CFSS, extended personal care assistance
services, extended CFSS, enhanced rate personal care assistance services, enhanced rate
CFSS, qualified professional services, and CFSS worker training and development as
follows:
(1) multiply the appropriate total wage component value calculated in subdivision 4 by
one plus the employee vacation, sick, and training factor in subdivision 5;
(2) for program plan support, multiply the result of clause (1) by one plus the program
plan support factor in subdivision 5;
(3) for employee-related expenses, add the employer taxes and workers' compensation
factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is
employee-related expenses. Multiply the product of clause (2) by one plus the value for
employee-related expenses;
(4) for client programming and supports, multiply the product of clause (3) by one plus
the client programming and supports factor in subdivision 5;
(5) for administrative expenses, add the general business and administrative expenses
factor in subdivision 5, the program administration expenses factor in subdivision 5, and
the absence and utilization factor in subdivision 5;
(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is
the hourly rate;
(7) multiply the hourly rate by the appropriate implementation component under
subdivision 5new text begin or 5anew text end . This is the adjusted hourly rate; and
(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment
rate.
(b) In processing new text begin personal care assistance provider agency and CFSS provider agency
new text end claims, the commissioner shall incorporate the new text begin applicable new text end worker retention deleted text begin componentdeleted text end new text begin
componentsnew text end specified in subdivision 5new text begin , 5b, or 5cnew text end , by multiplying one plus the total adjusted
payment rate by the appropriate worker retention component under subdivision 5, deleted text begin paragraph
(d)deleted text end new text begin 5b, or 5cnew text end .
(c) The commissioner must publish the total final payment rates.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 69.
Minnesota Statutes 2024, section 256B.851, subdivision 7, is amended to read:
Subd. 7.
Treatment of rate adjustments provided outside of cost components.
Any
rate adjustments applied to the service rates calculated under this section outside of the cost
components and rate methodology specified in this section, including but not limited to
those implemented to enable participant-employers and provider agencies to meet the terms
and conditions of any collective bargaining agreement negotiated under chapter 179A, shall
be applied as changes to the value of component values deleted text begin ordeleted text end new text begin ,new text end implementation componentsnew text begin ,
or worker retention componentsnew text end in deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 5new text begin to 5cnew text end .
Sec. 70.
Minnesota Statutes 2024, section 256B.851, is amended by adding a subdivision
to read:
new text begin Subd. 7a. new text end
new text begin Budget determinations. new text end
new text begin
The commissioner shall increase the authorized
amount for the CFSS budget model of those CFSS participant-employers employing
individual providers who have provided more than 1,000 hours of services and individual
providers who have completed the orientation offered by the Home Care Orientation Trust
or an orientation defined and offered by the commissioner. The commissioner shall determine
the amount and method of the authorized amount increase.
new text end
Sec. 71.
Minnesota Statutes 2024, section 260E.14, subdivision 1, is amended to read:
Subdivision 1.
Facilities and schools.
(a) The local welfare agency is the agency
responsible for investigating allegations of maltreatment in child foster care, family child
care, legally nonlicensed child care, and reports involving children served by an unlicensed
personal care provider organization under section 256B.0659. Copies of findings related to
personal care provider organizations under section 256B.0659 must be forwarded to the
Department of Human Services provider enrollment.
(b) The Department of Children, Youth, and Families is the agency responsible for
screening and investigating allegations of maltreatment in juvenile correctional facilities
listed under section 241.021 located in the local welfare agency's county and in facilities
licensed or certified under chapters 245A and 245D.
(c) The Department of Health is the agency responsible for screening and investigating
allegations of maltreatment in facilities licensed under sections 144.50 to 144.58 and 144A.43
to 144A.482 or chapter 144H.
(d) The Department of Education is the agency responsible for screening and investigating
allegations of maltreatment in a school as defined in section 120A.05, subdivisions 9, 11,
and 13, and chapter 124E. The Department of Education's responsibility to screen and
investigate includes allegations of maltreatment involving students 18 through 21 years of
age, including students receiving special education services, up to and including graduation
and the issuance of a secondary or high school diploma.
new text begin
(e) The Department of Human Services is the agency responsible for screening and
investigating allegations of maltreatment of minors in an EIDBI agency operating under
sections 245A.142 and 256B.0949.
new text end
deleted text begin (e)deleted text end new text begin (f)new text end A health or corrections agency receiving a report may request the local welfare
agency to provide assistance pursuant to this section and sections 260E.20 and 260E.22.
deleted text begin (f)deleted text end new text begin (g)new text end The Department of Children, Youth, and Families is the agency responsible for
screening and investigating allegations of maltreatment in facilities or programs not listed
in paragraph (a) that are licensed or certified under chapters 142B and 142C.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 72.
Minnesota Statutes 2024, section 626.5572, subdivision 13, is amended to read:
Subd. 13.
Lead investigative agency.
"Lead investigative agency" is the primary
administrative agency responsible for investigating reports made under section 626.557.
(a) The Department of Health is the lead investigative agency for facilities or services
licensed or required to be licensed as hospitals, home care providers, nursing homes, boarding
care homes, hospice providers, residential facilities that are also federally certified as
intermediate care facilities that serve people with developmental disabilities, or any other
facility or service not listed in this subdivision that is licensed or required to be licensed by
the Department of Health for the care of vulnerable adults. "Home care provider" has the
meaning provided in section 144A.43, subdivision 4, and applies when care or services are
delivered in the vulnerable adult's home.
(b) The Department of Human Services is the lead investigative agency for facilities or
services licensed or required to be licensed as adult day care, adult foster care, community
residential settings, programs for people with disabilities, new text begin EIDBI agencies, new text end family adult day
services, mental health programs, mental health clinics, substance use disorder programs,
the Minnesota Sex Offender Program, or any other facility or service not listed in this
subdivision that is licensed or required to be licensed by the Department of Human Services.new text begin
The Department of Human Services is also the lead investigative agency for unlicensed
EIDBI agencies under section 256B.0949.
new text end
(c) The county social service agency or its designee is the lead investigative agency for
all other reports, including, but not limited to, reports involving vulnerable adults receiving
services from a personal care provider organization under section 256B.0659.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 73.
Laws 2021, First Special Session chapter 7, article 13, section 73, is amended to
read:
Sec. 73. WAIVER REIMAGINE PHASE II.
(a) new text begin Effective January 1, 2027, or upon federal approval, whichever is later, new text end the
commissioner of human services must implement a two-home and community-based services
waiver program structure, as authorized under section 1915(c) of the federal Social Security
Act, that serves persons who are determined by a certified assessor to require the levels of
care provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate
care facility for persons with developmental disabilities.
(b) The commissioner of human services must implement an individualized budget
methodology, as authorized under section 1915(c) of the federal Social Security Act, that
serves persons who are determined by a certified assessor to require the levels of care
provided in a nursing home, a hospital, a neurobehavioral hospital, or an intermediate care
facility for persons with developmental disabilities.
new text begin
(c) The commissioner must develop an individualized budget methodology exception
to support access to self-directed home care nursing services. Lead agencies must submit
budget exception requests to the commissioner in a manner identified by the commissioner.
Eligibility for the budget exception in this paragraph is limited to persons meeting all of the
following criteria in the person's most recent assessment:
new text end
new text begin
(1) the person is assessed to need the level of care delivered in a hospital setting as
evidenced by the submission of the Department of Human Services form 7096, primary
medical provider's documentation of medical monitoring and treatment needs;
new text end
new text begin
(2) the person is assessed to receive a support range budget of E or H; and
new text end
new text begin
(3) the person does not receive community residential services, family residential services,
integrated community supports services, or customized living services.
new text end
new text begin
(d) Home care nursing services funded through the budget exception developed under
paragraph (c) must be ordered by a physician, physician assistant, or advanced practice
registered nurse. If the participant chooses home care nursing, the home care nursing services
must be performed by a registered nurse or licensed practical nurse practicing within the
registered nurse's or licensed practical nurse's scope of practice as defined under Minnesota
Statutes, sections 148.171 to 148.285. If after a person's annual reassessment under Minnesota
Statutes, section 256B.0911, any requirements of this paragraph or paragraph (c) are no
longer met, the commissioner must terminate the budget exception.
new text end
deleted text begin (c)deleted text end new text begin (e)new text end The commissioner of human services may seek all federal authority necessary to
implement this section.
deleted text begin (d)deleted text end new text begin (f)new text end The commissioner must ensure that the new waiver service menu and individual
budgets allow people to live in their own home, family home, or any home and
community-based setting of their choice. The commissioner must ensure, within available
resources and subject to state and federal regulations and law, that waiver reimagine does
not result in unintended service disruptions.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 74.
Laws 2021, First Special Session chapter 7, article 13, section 75, subdivision 6,
as amended by Laws 2024, chapter 108, article 1, section 28, is amended to read:
Subd. 6.
Online support planning tool.
The commissioner must develop an online
support planning and tracking tool for people using disability waiver services that allows
access to the total budget available to the person, the services for which they are eligible,
and the services they have chosen and used. The commissioner must explore operability
options that would facilitate real-time tracking of a person's remaining available budget
throughout the service year. The online support planning tool must provide information in
an accessible format to support the person's informed choice. The commissioner must seek
input from people with disabilities about the online support planning tool prior to its
implementation.new text begin The commissioner must implement the online support planning and tracking
tool no later than January 1, 2027.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 75.
new text begin
DISABILITY SERVICES TECHNOLOGY AND ADVOCACY EXPANSION
GRANT.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
(a) A disability services technology and advocacy
expansion grant is established to:
new text end
new text begin
(1) support the expansion of assistive technology and remote support services for people
with disabilities; and
new text end
new text begin
(2) strengthen advocacy efforts for individuals with disabilities and the providers who
serve individuals with disabilities.
new text end
new text begin
(b) The commissioner of human services must award the grant to an eligible grantee. In
awarding the grant, the commissioner must consult with the commissioner of administration's
System of Technology to Achieve Results (STAR) Program under Minnesota Statutes,
section 16B.055.
new text end
new text begin Subd. 2. new text end
new text begin Eligible grantee. new text end
new text begin
An eligible grantee must:
new text end
new text begin
(1) be a nonprofit organization with a statewide reach;
new text end
new text begin
(2) have demonstrated knowledge of various forms of assistive technology and remote
support for people with disabilities; and
new text end
new text begin
(3) have proven capacity to provide education and training to multiple constituencies.
new text end
new text begin Subd. 3. new text end
new text begin Allowable uses of grant money. new text end
new text begin
Grant money must be used to:
new text end
new text begin
(1) develop and deliver comprehensive training programs for lead agencies, disability
service providers, schools, employment support agencies, and individuals with disabilities
and their families to ensure effective use of assistive technology and remote support tools.
Training programs must be developed in consultation with the STAR Program to ensure
alignment with national assistive technology standards and best practices. Training must
address specific challenges faced by individuals with disabilities, such as accessibility,
independence, and health monitoring;
new text end
new text begin
(2) provide resources and support to advocacy organizations that work with individuals
with disabilities and service providers. Resources and support must be used to promote the
use of assistive technology to increase self-determination and community participation;
new text end
new text begin
(3) maintain, distribute, and create accessible resources related to assistive technology
and remote support. Resources must be developed in collaboration with the STAR Program
to reflect current assistive technology tools and guidance that are tailored to Minnesota's
disability community. Materials must be tailored to address the unique needs of individuals
with disabilities and the people and organizations who support individuals with disabilities;
new text end
new text begin
(4) conduct research to explore new and emerging assistive technology solutions that
address the evolving needs of individuals with disabilities. The research must emphasize
the role of technology in promoting independence, improving quality of life, and ensuring
safety; and
new text end
new text begin
(5) conduct outreach initiatives to engage disability communities, service providers, and
advocacy groups across Minnesota to promote awareness of assistive technology and remote
support services. Outreach initiatives must focus on reaching underserved and rural
populations.
new text end
new text begin Subd. 4. new text end
new text begin Evaluation and reporting requirements. new text end
new text begin
(a) The grant recipient must submit
an annual report by June 30 each year to the chairs and ranking minority members of the
legislative committees with jurisdiction over disability services. The annual report must
include:
new text end
new text begin
(1) the number of individuals with disabilities and service providers who received training
during the reporting year;
new text end
new text begin
(2) data on the impact of assistive technology and remote support in improving quality
of life, safety, and independence for individuals with disabilities; and
new text end
new text begin
(3) recommendations for further advancing technology-driven disability advocacy efforts
based on feedback and research findings.
new text end
new text begin
(b) No later than three months after the grant period has ended, a final evaluation must
be submitted to the chairs and ranking minority members of the legislative committees with
jurisdiction over disability services to assess the overall impact on expanding access to
assistive technology and remote support, with a focus on lessons learned and future
opportunities for Minnesota's disability communities and service providers.
new text end
new text begin Subd. 5. new text end
new text begin Grant period. new text end
new text begin
The grant period under this section is from July 1, 2025, to June
30, 2030.
new text end
Sec. 76. new text begin BUDGET INCREASE FOR CONSUMER-DIRECTED COMMUNITY
SUPPORTS.
new text end
new text begin
Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner
of human services must increase the consumer-directed community support budgets identified
in the waiver plans under Minnesota Statutes, sections 256B.092 and 256B.49, and chapter
256S; and the alternative care program under Minnesota Statutes, section 256B.0913, by
0.13 percent.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 77. new text begin ENHANCED BUDGET INCREASE FOR CONSUMER-DIRECTED
COMMUNITY SUPPORTS.
new text end
new text begin
Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner
of human services must increase the consumer-directed community supports budget exception
percentage identified in the waiver plans under Minnesota Statutes, sections 256B.092 and
256B.49, and chapter 256S; and the alternative care program under Minnesota Statutes,
section 256B.0913, from 7.5 to 12.5.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 78. new text begin STIPEND PAYMENTS TO SEIU HEALTHCARE MINNESOTA & IOWA
BARGAINING UNIT MEMBERS.
new text end
new text begin
(a) The commissioner of human services shall issue stipend payments to collective
bargaining unit members as required by the labor agreement between the state of Minnesota
and the Service Employees International Union (SEIU) Healthcare Minnesota & Iowa.
new text end
new text begin
(b) The definitions in Minnesota Statutes, section 290.01, apply to this section.
new text end
new text begin
(c) For the purposes of this section, "subtraction" has the meaning given in Minnesota
Statutes, section 290.0132, subdivision 1, and the rules in that subdivision apply to this
section.
new text end
new text begin
(d) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa
collective bargaining unit members under this section is a subtraction.
new text end
new text begin
(e) The amount of stipend payments received by SEIU Healthcare Minnesota & Iowa
collective bargaining unit members under this section is excluded from income as defined
in Minnesota Statutes, sections 290.0693, subdivision 1, paragraph (i), and 290A.03,
subdivision 3.
new text end
new text begin
(f) Notwithstanding any law to the contrary, stipend payments under this section must
not be considered income, assets, or personal property for purposes of determining or
recertifying eligibility for:
new text end
new text begin
(1) child care assistance programs under Minnesota Statutes, chapter 142E;
new text end
new text begin
(2) general assistance, Minnesota supplemental aid, and food support under Minnesota
Statutes, chapter 256D;
new text end
new text begin
(3) housing support under Minnesota Statutes, chapter 256I;
new text end
new text begin
(4) the Minnesota family investment program under Minnesota Statutes, chapter 142G;
and
new text end
new text begin
(5) economic assistance programs under Minnesota Statutes, chapter 256P.
new text end
new text begin
(g) The commissioner of human services must not consider stipend payments under this
section as income or assets under Minnesota Statutes, section 256B.056, subdivision 1a,
paragraph (a); 3; or 3c, or for persons with eligibility determined under Minnesota Statutes,
section 256B.057, subdivision 3, 3a, or 3b.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 79. new text begin DIRECTION TO COMMISSIONER; COST REPORTING IMPROVEMENT
AND DIRECT CARE STAFF REVIEW.
new text end
new text begin
(a) The commissioner of human services must consult with interested parties and make
recommendations to the legislature to clarify provider cost reporting obligations to promote
more uniform and meaningful data collection under Minnesota Statutes, section 256B.4914.
By February 15, 2026, the commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance draft legislation required to implement the commissioner's
recommendations.
new text end
new text begin
(b) The commissioner of human services must consult with interested parties and, based
on the results of the cost reporting completed for calendar year 2026, recommend what, if
any, encumbrance of medical assistance reimbursement is appropriate to support direct care
staff retention and the provision of quality services under Minnesota Statutes, section
256B.4914. By January 15, 2028, the commissioner must submit to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance draft legislation required to implement the commissioner's
recommendations.
new text end
Sec. 80. new text begin COMMUNITY FIRST SERVICES AND SUPPORTS REIMBURSEMENT
DURING ACUTE CARE HOSPITAL STAYS.
new text end
new text begin
(a) The commissioner of human services must seek to amend Minnesota's federally
approved community first services and supports program, authorized under United States
Code, title 42, sections 1915(i) and 1915(k), to reimburse for delivery of community first
services and supports under Minnesota Statutes, sections 256B.85 and 256B.851, during
an acute care stay in an acute care hospital setting that does not have the effect of isolating
individuals receiving community first services and supports from the broader community
of individuals not receiving community first services and supports, as permitted under Code
of Federal Regulations, title 42, section 441.530.
new text end
new text begin
(b) Reimbursed services must:
new text end
new text begin
(1) be identified in an individual's person-centered support plan as required under
Minnesota Statutes, section 256B.0911;
new text end
new text begin
(2) be provided to meet the needs of the person that are not met through the provision
of hospital services;
new text end
new text begin
(3) not substitute services that the hospital is obligated to provide as required under state
and federal law; and
new text end
new text begin
(4) be designed to preserve the person's functional abilities during a hospital stay for
acute care and to ensure smooth transitions between acute care settings and home and
community-based settings.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (a) is effective the day following final enactment.
Paragraph (b) is effective January 1, 2026, or upon federal approval, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end
Sec. 81. new text begin POSITIVE SUPPORTS COMPETENCY PROGRAM.
new text end
new text begin
(a) The commissioner shall establish a positive supports competency program with the
money appropriated for this purpose.
new text end
new text begin
(b) When establishing the positive supports competency program, the commissioner
must use a community-partner-driven process to:
new text end
new text begin
(1) define the core activities associated with effective intervention services at the levels
of positive support specialist, positive support analyst, and positive support professional;
new text end
new text begin
(2) create tools providers may use to track whether their positive supports specialists,
positive support analysts, and positive support professionals are competently performing
the core activities associated with effective intervention services;
new text end
new text begin
(3) align existing training systems funded through the Department of Human Services
and develop free online modules for competency-based training to prepare positive support
specialists, positive support analysts, and positive support professionals to provide effective
intervention services;
new text end
new text begin
(4) assist providers interested in utilizing a competency-based training model to create
a career pathway for the positive support analysts and positive support specialists within
their organizations by using experienced professionals;
new text end
new text begin
(5) create written guidelines, stories, and examples for providers that will be placed on
Department of Human Services websites promoting capacity building; and
new text end
new text begin
(6) disseminate resources and guidance to providers interested in meeting
competency-based qualifications for positive supports through existing regional networks
of experts, including communities of practice, and develop new avenues for disseminating
these resources and guidance, including through implementation of ECHO models.
new text end
Sec. 82. new text begin DIRECTION TO COMMISSIONER; INTEGRATED COMMUNITY
SUPPORTS CODIFICATION.
new text end
new text begin
(a) The commissioner of human services must develop draft language to codify in
Minnesota Statutes the standards and requirements for integrated community supports as
specified in the federally approved brain injury, community access for disability inclusion,
community alternative care, and developmental disabilities waiver plans.
new text end
new text begin
(b) When developing and drafting the proposed legislative language, the commissioner
must consult with interested parties, including the Association of Residential Resources in
Minnesota, the Residential Providers Association of Minnesota, the Minnesota Association
of County Social Service Administrators, and people with disabilities currently or potentially
receiving integrated community supports. The commissioner must ensure that the interested
parties with whom the commissioner consults represent a broad spectrum of active and
potential providers and service recipients. The commissioner's consultation with interested
parties must be transparent and provide the opportunity for meaningful input from active
and potential providers and service recipients.
new text end
new text begin
(c) The commissioner must submit the draft legislation to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by January 1, 2026.
new text end
Sec. 83. new text begin DIRECTION TO COMMISSIONER; PROVISIONAL OR TRANSITIONAL
APPROVAL OF INTEGRATED COMMUNITY SERVICES SETTINGS.
new text end
new text begin
(a) The commissioner of human services must develop draft language to improve the
process for approving integrated community supports settings, including a process for issuing
provisional or transitional licenses to allow applicants to obtain an initial approval to operate
prior to securing control of the approved setting. This process must also allow applicants
to change the approved setting during the application review period when needed to ensure
an available setting.
new text end
new text begin
(b) The commissioner must submit the draft legislation to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by January 1, 2026.
new text end
Sec. 84. new text begin DIRECTION TO COMMISSIONER; GUIDANCE TO COUNTIES.
new text end
new text begin
Upon receipt of approval from the Centers for Medicare and Medicaid Services, the
commissioner of human services shall provide guidance to counties on the administration
of the family support program under Minnesota Statutes, section 252.32; the consumer
support program under Minnesota Statutes, section 256.476; disability waivers under
Minnesota Statutes, sections 256B.092 and 256B.49; and the community first services and
supports program under Minnesota Statutes, section 256B.85, to clarify that the cost of
adaptive or one-on-one swimming lessons provided to a person younger than 12 years of
age whose disability puts the person at a higher risk of drowning according to the Centers
for Disease Control Vital Statistics System is an allowable use of money.
new text end
Sec. 85. new text begin DIRECTION TO COMMISSIONER; SWIMMING LESSONS COVERED
UNDER DISABILITY WAIVERS.
new text end
new text begin
The commissioner of human services shall include swimming lessons for a participant
younger than 12 years of age whose disability puts the participant at a higher risk of drowning
as a covered service under the disability waivers, including the consumer-directed community
supports option, under Minnesota Statutes, sections 256B.092 and 256B.49.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 86. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
DEVELOPMENT OF COMPREHENSIVE EIDBI LICENSE.
new text end
new text begin
(a) By October 1, 2025, the commissioner of human services must convene a working
group consisting of staff from the Department of Human Services with policy and clinical
expertise related to EIDBI services, and with expertise in licensing standards for other
licensed programs and settings, particularly other programs serving children; staff from the
Department of Children, Youth, and Families with expertise in the licensing standards for
home child care and child care centers; the Early Intensive Developmental and Behavioral
Advisory Council; families of individuals receiving EIDBI services; advocates for individuals
receiving EIDBI services; and other community partners and interested parties.
new text end
new text begin
(b) The working group must advise the commissioner as the commissioner develops
comprehensive EIDBI licensing standards and a plan to transition EIDBI agencies from the
provisional license established under Minnesota Statutes, section 245A.142, to a newly
established comprehensive EIDBI license. The working group must provide the commissioner
with advice on at least the following topics:
new text end
new text begin
(1) basic health and safety standards;
new text end
new text begin
(2) basic physical plant standards;
new text end
new text begin
(3) medication management and other ancillary services that might be provided by EIDBI
providers;
new text end
new text begin
(4) privacy and the use of cameras in settings where EIDBI services are being provided;
new text end
new text begin
(5) third-party billing procedures and requirements;
new text end
new text begin
(6) billing standards and policies regarding duplicative, simultaneous, and mid-point
billing practices;
new text end
new text begin
(7) measures of clinical effectiveness; and
new text end
new text begin
(8) appropriate restrictions on the commissioner's authority under Minnesota Statutes,
section 256B.0949, subdivision 17, to issue exceptions to EIDBI provider qualifications,
medical assistance provider enrollment requirements, and EIDBI provider or agency standards
or requirements.
new text end
new text begin
(c) By January 1, 2027, the commissioner must propose standards for a nonprovisional,
comprehensive EIDBI license or licenses, and submit proposed draft legislation to the chairs
and ranking minority members of the legislative committees with jurisdiction over EIDBI
services.
new text end
Sec. 87. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
TEMPORARY MORATORIUM ON ENROLLMENT OF NEW EIDBI PROVIDERS.
new text end
new text begin
Upon federal approval and subject to continued federal approval, beginning July 1, 2025,
the commissioner must not enroll new EIDBI agencies to provide EIDBI services under
Minnesota Statutes, chapter 256B, unless the agency is licensed as an EIDBI agency under
Minnesota Statutes, chapter 245A, but may enroll new locations where EIDBI services are
provided by an agency that was enrolled prior to July 1, 2025.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 88. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
INCREASE TO PAYMENTS FOR FAMILY RESIDENTIAL AND LIFE SHARING
SERVICES.
new text end
new text begin
Effective January 1, 2026, or upon federal approval, whichever is later, the commissioner
of human services must increase by 51.69 percent payment rates previously established
under Minnesota Statutes, section 256B.4914, subdivision 19, for family residential services.
Rates for life sharing services must be ten percent higher than the corresponding family
residential services rate established under this section.
new text end
Sec. 89. new text begin COMMISSIONER OF HUMAN SERVICES; WAIVER CASE
MANAGEMENT EVALUATION AND RATE STUDY.
new text end
new text begin Subdivision 1. new text end
new text begin Reimbursement rate study. new text end
new text begin
The commissioner of human services must
issue a request for proposals to develop and model a proposed reimbursement rate
methodology for waiver case management services under Minnesota Statutes, sections
256B.0913, 256B.092, 256B.0922, and 256B.49, and Minnesota Statutes, chapter 256S.
The proposed methodology for waiver case management reimbursement rates must be
predicated on a methodology that is transparent, culturally responsive, and supportive of
lead agency staffing needed to provide high-quality, person-centered, and culturally
responsive case management services. The development of the rate methodology must
consider costs and workforce pressures that impact the delivery of case management services;
costs to provide culturally responsive case management services as described in Minnesota
Statutes, section 256B.076, subdivision 3; and compensation required to attract and retain
qualified case managers.
new text end
new text begin Subd. 2. new text end
new text begin Evaluation of case management service delivery. new text end
new text begin
The commissioner must
conduct an evaluation of lead agency duties associated with waiver case management;
current caseloads; best practices related to caseloads and case mix; required professional
qualifications, experience, and training of case management professionals; and quality
assurance measures, and make recommendations to improve the quality, consistency, and
timeliness of the provision of waiver case management services.
new text end
new text begin Subd. 3. new text end
new text begin Community engagement. new text end
new text begin
(a) The commissioner must consult with interested
parties from across each region of the state including, but not limited to, lead agencies,
contracted waiver case management service providers, culturally responsive providers,
individuals receiving services and their families, advocacy organizations, and relevant
experts in the development of the request for proposals under subdivision 1.
new text end
new text begin
(b) The commissioner must collaborate with interested parties from across each region
of the state including, but not limited to, lead agencies, contracted waiver case management
service providers, culturally responsive providers, individuals receiving services and their
families, advocacy organizations, and relevant experts in the evaluation of the delivery of
waiver case management services.
new text end
new text begin Subd. 4. new text end
new text begin Recommendations and reports. new text end
new text begin
By December 15, 2025, the commissioner
of human services must submit a preliminary report to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services policy and
finance on the initial results of the rate study and service delivery evaluation. By December
15, 2026, the commissioner of human services must submit to the chairs and ranking minority
members of committees with jurisdiction over health and human services a report detailing
(1) the waiver rate methodology, including all rate components, and modeled rates; and (2)
findings and recommendations of the evaluation of case management service delivery. The
report must include (1) legislative language necessary to modify existing or implement new
rate methodologies and a detailed fiscal analysis of the proposed rate methodology; and (2)
legislative language necessary to implement recommendations to improve wavier case
management service delivery.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 90. new text begin CHAPTER 245D PROVIDER LICENSING TIMELINESS IMPROVEMENT
INITIATIVE.
new text end
new text begin
(a) The commissioner of human services must conduct a comprehensive business process
analysis and redesign of the provider licensing system with a particular focus on Minnesota
Statutes, chapter 245D, licensing activities.
new text end
new text begin
(b) The commissioner's business process analysis must include at least the following
elements:
new text end
new text begin
(1) a full mapping of the current provider licensing process, including provider inquiry,
application intake, documentation requirements, inspections, background checks, approval
or denial, and renewal processes;
new text end
new text begin
(2) identification of all bottlenecks, backlogs, batches, redundancies, and inefficiencies;
new text end
new text begin
(3) engagement with providers, people receiving services, lead agencies, and advocates
and other stakeholders to gather feedback on process challenges and recommendations for
improvement; and
new text end
new text begin
(4) analysis of opportunities to incorporate digital and tech solutions or workflow
automation.
new text end
new text begin
(c) When developing a proposal to redesign Minnesota Statutes, chapter 245D, licensing
processes to better service individuals and providers, the commissioner must work directly
with licensing staff, managers, and leadership and develop revised performance metrics and
timelines, including a target average time frame for initial license decisions and renewals
with the creation of a dashboard assuring transparency and ongoing accountability.
new text end
new text begin
(d) By January 1, 2026, the commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services licensing and
over long-term services and supports a report that includes:
new text end
new text begin
(1) the findings of the analysis of current Minnesota Statutes, chapter 245D, provider
licensing processes;
new text end
new text begin
(2) the proposed redesign of Minnesota Statutes, chapter 245D, provider licensing
processes;
new text end
new text begin
(3) an implementation plan of agreed upon improvements with timelines and required
resources; and
new text end
new text begin
(4) recommended statutory or regulatory changes, if any, necessary to support
implementation.
new text end
Sec. 91. new text begin REPEALER.
new text end
new text begin Subdivision 1. new text end
new text begin
Obsolete home and community-based services licensing
provisions.
new text end
new text begin
Minnesota Statutes 2024, section 245A.042, subdivisions 2, 3, and 4,
new text end
new text begin
are
repealed.
new text end
new text begin Subd. 2. new text end
new text begin Direct care provider premiums. new text end
new text begin
Laws 2023, chapter 59, article 3, section 11,
new text end
new text begin
is repealed.
new text end
new text begin Subd. 3. new text end
new text begin Legislative Task Force on Guardianship. new text end
new text begin
Laws 2024, chapter 127, article
46, section 39,
new text end
new text begin
is repealed.
new text end
new text begin Subd. 4. new text end
new text begin Revision of treatment modalities. new text end
new text begin
Minnesota Statutes 2024, section 256B.0949,
subdivision 9,
new text end
new text begin
is repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
ARTICLE 3
LONG-TERM SERVICES AND SUPPORTS REFORM
Section 1.
Minnesota Statutes 2024, section 256B.49, is amended by adding a subdivision
to read:
new text begin Subd. 17a. new text end
new text begin Service authorizations and service agreements; generally. new text end
new text begin
Recipients
must be screened and authorized for services according to the federally approved waiver
application and its subsequent amendments.
new text end
Sec. 2.
Minnesota Statutes 2024, section 256B.49, is amended by adding a subdivision to
read:
new text begin Subd. 17b. new text end
new text begin
Service authorizations and service agreements; community access for
disability inclusion waiver services.
new text end
new text begin
(a) For service agreements under the community
access for disability inclusion waiver program only, the commissioner must require lead
agency supervisors to review and accept all service agreements entered by lead agency staff
into the Medicaid management information system (MMIS) prior to the commissioner's
approval of the service agreement.
new text end
new text begin
(b) For a service agreement under the community access for disability inclusion waiver
with a proposed total authorized amount that exceeds the total authorized amount in the
recipient's prior service agreement by more than the value of legislatively enacted rate
increases, the commissioner must manually review and manually approve the service
agreement in the MMIS. For purposes of this paragraph, "prior service agreement" means
the service agreement that was in effect 12 months prior to the start date of the new proposed
service agreement.
new text end
new text begin
(c) In a format prescribed by the commissioner, lead agencies must submit the following
information for all service agreements subject to the commissioner's approval in paragraph
(b):
new text end
new text begin
(1) changes in the number of units authorized;
new text end
new text begin
(2) new services authorized;
new text end
new text begin
(3) changes in the values used to calculate service rates under section 256B.4914, except
for automatic adjustments required under section 256B.4914, subdivisions 5 and 5b;
new text end
new text begin
(4) changes in the person's level of need requiring an increase in the amount of services
authorized;
new text end
new text begin
(5) documentation detailing why the previous amount of services is not sufficient to
meet the person's needs; and
new text end
new text begin
(6) anticipated impact if the total service amount is not increased to the proposed amount.
new text end
new text begin
(d) Except for rate increases required under section 256B.4914, subdivisions 5 and 5b,
and rate changes authorized by the 2025 legislature, the commissioner must not approve
service agreements under paragraph (b) that are not the result of either a documented change
in a person's assessed needs or documented evidence that the previous level of service was
insufficient to meet the person's assessed needs.
new text end
new text begin
(e) This subdivision expires upon full implementation of waiver reimagine. The
commissioner must inform the revisor of statutes when waiver reimagine is fully
implemented.
new text end
Sec. 3.
Minnesota Statutes 2024, section 256B.49, subdivision 18, is amended to read:
Subd. 18.
Payments.
The commissioner shall reimburse approved vendors from the
medical assistance account for the costs of providing home and community-based services
to eligible recipients using the invoice processing procedures of the Medicaid management
information system (MMIS). deleted text begin Recipients will be screened and authorized for services
according to the federally approved waiver application and its subsequent amendments.
deleted text end
Sec. 4. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
LONG-TERM SERVICES AND SUPPORTS REFORM WORK GROUP.
new text end
new text begin Subdivision 1. new text end
new text begin
Development of alternative service models for long-term services
and supports.
new text end
new text begin
(a) By October 1, 2025, the commissioner of human services must convene
a group of department staff and community partners to assist the commissioner in developing
alternative service models to provide long-term services and supports to people with limited
dependencies, low-acuity assessed needs, or natural supports. The commissioner is
encouraged to consider increasing available service models; tailoring available services to
meet the needs of the target population; supplementing or subsidizing family caregivers,
religious organizations, social clubs, and similar civic and service organizations; exercising
the commissioner's authority under Minnesota Statutes, section 256B.092, subdivision 4a;
reexamining the provision of services under Minnesota Statutes, section 245A.03, subdivision
9; reexamining the viability of a demonstration project similar for the target population to
the projects authorized under Minnesota Statutes, sections 256B.69, subdivision 23, and
256B.77; modifying licensing and regulator requirements to permit family or other natural
supports to live with a person with a disability, behavioral health needs, or an older adult
in licensed settings, such as an assisted living facility or senior living setting; and tax credits
or other tax incentives to encourage intergenerational living arrangements, accessory dwelling
units, or other residential arrangements that permit easier access to natural supports.
new text end
new text begin
(b) By October 1, 2026, the commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over medical assistance long-term
services and supports a set of proposals that if enacted is estimated to reduce expected
general fund expenditures relative to the February 2025 forecast during the biennium
beginning July 1, 2027, by at least the amount assumed in subdivision 3, paragraph (a). An
estimate of the estimated savings as well as a summary of the expected impact on people
served must accompany each proposal.
new text end
new text begin Subd. 2. new text end
new text begin Administration. new text end
new text begin
(a) The commissioner of human services must provide meeting
space and general administrative support to the workgroup.
new text end
new text begin
(b) The commissioner of human services must contract with a third party to provide
facilitation services for the workgroup. Use of a third party for this purpose is exempt from
state procurement process requirements under Minnesota Statutes, chapter 16C.
new text end
new text begin
(c) The commissioner of human services may contract with a third party or parties to
provide policy research and analysis, data analysis, and administrative support related to
drafting the action plan and supporting materials. Use of a third party for these purposes is
exempt from state procurement process requirements under Minnesota Statutes, chapter
16C.
new text end
new text begin Subd. 3. new text end
new text begin Savings determination. new text end
new text begin
(a) When preparing the forecast for state revenues and
expenditures under Minnesota Statutes, section 16A.103, the commissioner of management
and budget must assume a reduction of human services spending of $135,000,000 relative
to the February 2025 forecast for the biennium beginning July 1, 2027, until the end of the
legislative session that enacts a budget for the Department of Human Services for the
biennium beginning July 1, 2027.
new text end
new text begin
(b) Upon enactment of a budget for the Department of Human Services for the biennium
beginning July 1, 2027, the legislature must identify enacted provisions that were
recommended by or based on the action plan submitted by the commissioner of human
services under subdivision 1.
new text end
new text begin
(c) To the extent the net savings attributable to the provisions identified by the legislature
under paragraph (b) for the biennium beginning July 1, 2027, are less than the assumed
savings in paragraph (a), the commissioner of human services must implement the contingent
rate reductions described in subdivision 4.
new text end
new text begin Subd. 4. new text end
new text begin Contingent rate reductions. new text end
new text begin
If upon enactment of a budget for the Department
of Human Services for the biennium beginning July 1, 2027, the net savings for the biennium
beginning July 1, 2027, attributable to the provisions identified by the legislature under
subdivision 3, paragraph (b), are less than the assumed savings in subdivision 3, paragraph
(a), notwithstanding Minnesota Statutes, section 256B.4914, the commissioner of human
services must adjust the competitive workforce factors under Minnesota Statutes, section
256B.4914, subdivisions 6 to 9, to a value that will produce by June 30, 2029, a net reduction
in expected general fund expenditures relative to the February 2025 forecast equal to the
difference between the savings attributable to the provisions identified in subdivision 3,
paragraph (b), and the assumed savings in subdivision 3, paragraph (a).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 5. new text begin DIRECTION TO THE COMMISSIONERS OF HUMAN SERVICES AND
MANAGEMENT AND BUDGET; COST SAVING REFORMS WORKING GROUP.
new text end
new text begin Subdivision 1. new text end
new text begin Identifying cost saving reforms. new text end
new text begin
(a) By October 1, 2025, the
commissioner of human services must convene a group of department staff and community
partners to assist the commissioner in identifying cost saving reforms to licensing
requirements, service standards, provider qualifications, provider duties and responsibilities,
lead agency duties and responsibilities, eligibility, covered services, service authorizations,
service limits, service rate calculations, rate enhancements and add-ons, rate exceptions,
rate limits, budget limits, or any other cost saving reforms to medical assistance long-term
services and supports and other programs serving people with disabilities, people with
behavioral health needs, or older adults.
new text end
new text begin
(b) By October 1, 2026, the commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over medical assistance long-term
services and supports an action plan that if enacted is estimated to reduce expected general
fund expenditures relative to the February 2025 forecast during the biennium beginning
July 1, 2027, by at least the amount assumed in subdivision 3, paragraph (a). Each strategy
included in the action plan must include an estimate of the estimated savings as well as a
summary of the expected impact on people served.
new text end
new text begin Subd. 2. new text end
new text begin Administration. new text end
new text begin
(a) The commissioner of human services must provide meeting
space and general administrative support to the workgroup.
new text end
new text begin
(b) The commissioner of human services must contract with a third party to provide
facilitation services for the workgroup. Use of a third party for this purpose is exempt from
state procurement process requirements under Minnesota Statutes, chapter 16C.
new text end
new text begin
(c) The commissioner of human services may contract with a third party or parties to
provide policy research and analysis, data analysis, and administrative support related to
drafting the action plan and supporting materials. Use of a third party for these purposes is
exempt from state procurement process requirements under Minnesota Statutes, chapter
16C.
new text end
new text begin Subd. 3. new text end
new text begin Savings determination. new text end
new text begin
(a) When preparing the forecast for state revenues and
expenditures under Minnesota Statutes, section 16A.103, the commissioner of management
and budget must assume a reduction of human services spending of $150,000,000 relative
to the February 2025 forecast for the biennium beginning July 1, 2027, until the end of the
legislative session that enacts a budget for the Department of Human Services for the
biennium beginning July 1, 2027.
new text end
new text begin
(b) Upon enactment of a budget for the Department of Human Services for the biennium
beginning July 1, 2027, the legislature must identify enacted provisions that were
recommended by or based on the action plan submitted by the commissioner of human
services under subdivision 1.
new text end
new text begin
(c) To the extent the net savings attributable to the provisions identified by the legislature
under paragraph (b) for the biennium beginning July 1, 2027, are less than the assumed
savings in paragraph (a), the commissioner of human services must implement the contingent
rate reductions described in subdivision 4.
new text end
new text begin Subd. 4. new text end
new text begin Contingent rate reductions. new text end
new text begin
If upon enactment of a budget for the Department
of Human Services for the biennium beginning July 1, 2027, the net savings for the biennium
beginning July 1, 2027, attributable to the provisions identified by the legislature under
subdivision 3, paragraph (b), are less than the assumed savings in subdivision 3, paragraph
(a), notwithstanding Minnesota Statutes, section 256B.4914, the commissioner of human
services must adjust the competitive workforce factors under Minnesota Statutes, section
256B.4914, subdivisions 6 to 9, to a value that will produce by June 30, 2029, a net reduction
in expected general fund expenditures relative to the February 2025 forecast equal to the
difference between the savings attributable to the provisions identified in subdivision 3,
paragraph (b), and the assumed savings in subdivision 3, paragraph (a).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 6. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; OPTIONAL
CONSULTATION SERVICES.
new text end
new text begin
The commissioner of human services must consider submitting a medical assistance
state plan amendment to permit consultation services that are currently required under the
community first services and supports program to be an optional service for individuals
receiving waiver case management services under Minnesota Statutes, sections 256B.0913,
256B.092, 256B.0922, and 256B.49, or Minnesota Statutes, chapter 256S.
new text end
Sec. 7. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
LONG-TERM CARE CONSULTATION SERVICES PAYMENT REFORM.
new text end
new text begin Subdivision 1. new text end
new text begin
Development of alternative payment methodology for long-term care
consultation services.
new text end
new text begin
(a) The commissioner of human services must develop a proposal
for a long-term care consultation services payment methodology that does not rely on a
time study to determine reimbursement to the counties for providing long-term care
consultation services under Minnesota Statutes, section 256B.0911. The new reimbursement
methodology must be a methodology that:
new text end
new text begin
(1) results in a flat reimbursement amount per long-term care consultation assessment
under Minnesota Statutes, section 256B.0911;
new text end
new text begin
(2) reduces expected general fund expenditures relative to the February 2025 forecast
during the biennium beginning July 1, 2027, by at least the amount assumed in subdivision
2, paragraph (a);
new text end
new text begin
(3) preserves the commissioner's ability to allocate to medical assistance costs incurred
by counties for providing long-term care consultation services; and
new text end
new text begin
(4) does not jeopardize the commissioner's ability to allocate other local administrative
costs to medical assistance or other federal programs.
new text end
new text begin
(b) By October 1, 2026, the commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over medical assistance long-term
services and supports the proposal developed under paragraph (a) and any draft legislation
required to implement the proposal.
new text end
new text begin Subd. 2. new text end
new text begin Savings determination. new text end
new text begin
(a) When preparing the forecast for state revenues and
expenditures under Minnesota Statutes, section 16A.103, the commissioner of management
and budget must assume a reduction of human services spending of $18,000,000 relative
to the February 2025 forecast for the biennium beginning July 1, 2027, until the end of the
legislative session that enacts a budget for the Department of Human Services for the
biennium beginning July 1, 2027.
new text end
new text begin
(b) Upon enactment of a budget for the Department of Human Services for the biennium
beginning July 1, 2027, the legislature must identify enacted provisions that were
recommended by or based on the proposal submitted by the commissioner of human services
under subdivision 1.
new text end
new text begin
(c) To the extent the net savings attributable to the provisions identified by the legislature
under paragraph (b) for the biennium beginning July 1, 2027, are less than the assumed
savings in paragraph (a), the commissioner of human services shall implement the contingent
reductions in reimbursement to counties described in subdivision 4.
new text end
new text begin Subd. 3. new text end
new text begin Contingent reimbursement reductions. new text end
new text begin
If upon enactment of a budget for
the Department of Human Services for the biennium beginning July 1, 2027, the net savings
for the biennium beginning July 1, 2027, attributable to the provisions identified by the
legislature under subdivision 2, paragraph (b), are less than the assumed savings in
subdivision 2, paragraph (a), notwithstanding Minnesota Statutes, section 256B.0911,
subdivision 33, the commissioner of human services must reduce the percentage of the
nonfederal share for the provision of long-term care consultation services the state pays to
the counties as reimbursement to a value that will produce by June 30, 2029, a net reduction
in expected general fund expenditures relative to the February 2025 forecast equal to the
difference between the savings attributable to the provisions identified in subdivision 2,
paragraph (b), and the assumed savings in subdivision 2, paragraph (a).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 8. new text begin DIRECTIONS TO THE COMMISSIONERS OF HUMAN SERVICES AND
MANAGEMENT AND BUDGET; ADDITIONAL OFFSETS TO CONTINGENT
REIMBURSEMENT REDUCTIONS.
new text end
new text begin
(a) When preparing the forecast for state revenues and expenditures under Minnesota
Statutes, section 16A.103, the commissioner of management and budget, in consultation
with the commissioner of human services, must estimate the net reduction in estimated
spending for the biennium beginning July 1, 2027, attributable to the amendments in sections
1 to 3 and 6 of this article that exceed the general fund reductions included in this act for
these sections of this article.
new text end
new text begin
(b) The commissioner of management and budget must reduce the assumed reductions
in human services spending required under section 7, subdivision 2, paragraph (a), of this
article by the amount identified in paragraph (a).
new text end
new text begin
(c) If the amount identified in paragraph (a) exceeds the assumed reductions required
under section 7, subdivision 2, paragraph (a), of this article, notwithstanding Minnesota
Statutes, section 256B.0911, subdivision 33, the commissioner of human services must
increase the percentage of the nonfederal share for the provision of long-term care
consultation services the state pays to the counties as reimbursement to a value that will
produce, by June 30, 2029, a net zero change in expected general fund expenditures relative
to the February 2025 forecast for these services.
new text end
ARTICLE 4
SUBSTANCE USE DISORDER TREATMENT
Section 1.
Minnesota Statutes 2024, section 245G.01, subdivision 13b, is amended to
read:
Subd. 13b.
Guest speaker.
new text begin (a) new text end "Guest speaker" means an individual who is not an alcohol
and drug counselor qualified according to section 245G.11, subdivision 5; is not qualified
according to the commissioner's list of professionals under section 245G.07, subdivision
3; and who works under the direct observation of an alcohol and drug counselor to present
to clients on topics in which the guest speaker has expertise and that the license holder has
determined to be beneficial to a client's recovery.
new text begin (b)new text end Tribally licensed programs have autonomy to identify the qualifications of their guest
speakers.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 2.
Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 13d. new text end
new text begin Individual counseling. new text end
new text begin
"Individual counseling" means professionally led
psychotherapeutic treatment for substance use disorders that is delivered in a one-to-one
setting or in a setting with the client and the client's family and other natural supports.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 3.
Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 20f. new text end
new text begin Psychoeducation. new text end
new text begin
"Psychoeducation" means the services described in section
245G.07, subdivision 1a, clause (2).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 4.
Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 20g. new text end
new text begin Psychosocial treatment services. new text end
new text begin
"Psychosocial treatment services" means
the services described in section 245G.07, subdivision 1a.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 5.
Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 20h. new text end
new text begin Recovery support services. new text end
new text begin
"Recovery support services" means the services
described in section 245G.07, subdivision 2a, paragraph (b), clause (1).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 6.
Minnesota Statutes 2024, section 245G.01, is amended by adding a subdivision to
read:
new text begin Subd. 26a. new text end
new text begin Treatment coordination. new text end
new text begin
"Treatment coordination" means the services
described in section 245G.07, subdivision 1b.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 7.
Minnesota Statutes 2024, section 245G.02, subdivision 2, is amended to read:
Subd. 2.
Exemption from license requirement.
This chapter does not apply to a county
or recovery community organization that is providing a service for which the county or
recovery community organization is an eligible vendor under section 254B.05. This chapter
does not apply to an organization whose primary functions are information, referral,
diagnosis, case management, and assessment for the purposes of client placement, education,
support group services, or self-help programs. This chapter does not apply to the activities
of a licensed professional in private practice. A license holder providing the initial set of
substance use disorder services allowable under section 254A.03, subdivision 3, paragraph
(c), to an individual referred to a licensed nonresidential substance use disorder treatment
program after a positive screen for alcohol or substance misuse is exempt from sections
245G.05; 245G.06, subdivisions 1, 1a, and 4; 245G.07, deleted text begin subdivisions 1deleted text end deleted text begin , paragraph (a), clauses
(2) to (4), and 2, clauses (1) to (7)deleted text end new text begin subdivision 1a, clause (2)new text end ; and 245G.17.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026.
new text end
Sec. 8.
Minnesota Statutes 2024, section 245G.05, subdivision 1, is amended to read:
Subdivision 1.
Comprehensive assessment.
new text begin (a) new text end A comprehensive assessment of the
client's substance use disorder must be administered face-to-face deleted text begin by an alcohol and drug
counselordeleted text end within five calendar days from the day of service initiation for a residential
program or by the end of the fifth day on which a treatment service is provided in a
nonresidential program. The number of days to complete the comprehensive assessment
excludes the day of service initiation.
new text begin
(b) A comprehensive assessment must be administered by:
new text end
new text begin
(1) an alcohol and drug counselor;
new text end
new text begin
(2) a mental health professional who meets the qualifications under section 245I.04,
subdivision 2, practices within the scope of their professional licensure, and has training in
addiction, co-occurring disorders, and substance use disorder diagnosis and treatment
according to the requirements in section 245G.13, subdivision 2, paragraph (f);
new text end
new text begin
(3) a clinical trainee who meets the qualifications under section 245I.04, subdivision 6,
practicing under the supervision of a mental health professional who meets the requirements
of clause (2); or
new text end
new text begin
(4) an advanced practice registered nurse as defined in section 148.171, subdivision 3,
who practices within the scope of their professional licensure and has training in addiction,
co-occurring disorders, and substance use disorder diagnosis and treatment according to
the requirements in section 245G.13, subdivision 2, paragraph (f).
new text end
new text begin (c) new text end If the comprehensive assessment is not completed within the required time frame,
the person-centered reason for the delay and the planned completion date must be documented
in the client's file. The comprehensive assessment is complete upon a qualified staff member's
dated signature. If the client received a comprehensive assessment that authorized the
treatment service, deleted text begin an alcohol and drug counselordeleted text end new text begin a staff member qualified under paragraph
(b)new text end may use the comprehensive assessment for requirements of this subdivision but must
document a review of the comprehensive assessment and update the comprehensive
assessment as clinically necessary to ensure compliance with this subdivision within
applicable timelines. deleted text begin An alcohol and drug counselordeleted text end new text begin A staff member qualified under
paragraph (b)new text end must sign and date the comprehensive assessment review and update.
Sec. 9.
Minnesota Statutes 2024, section 245G.07, subdivision 1, is amended to read:
Subdivision 1.
Treatment service.
(a) A licensed deleted text begin residentialdeleted text end treatment program must
offer the treatment services in deleted text begin clauses (1) to (5)deleted text end new text begin subdivisions 1a and 1b and may offer the
treatment services in subdivision 2new text end to each client, unless clinically inappropriate and the
justifying clinical rationale is documented. deleted text begin A nonresidentialdeleted text end new text begin Thenew text end treatment program must
deleted text begin offer all treatment services in clauses (1) to (5) anddeleted text end document in the individual treatment
plan the specific services for which a client has an assessed need and the plan to provide
the servicesdeleted text begin :deleted text end new text begin .
new text end
deleted text begin
(1) individual and group counseling to help the client identify and address needs related
to substance use and develop strategies to avoid harmful substance use after discharge and
to help the client obtain the services necessary to establish a lifestyle free of the harmful
effects of substance use disorder;
deleted text end
deleted text begin
(2) client education strategies to avoid inappropriate substance use and health problems
related to substance use and the necessary lifestyle changes to regain and maintain health.
Client education must include information on tuberculosis education on a form approved
by the commissioner, the human immunodeficiency virus according to section 245A.19,
other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis;
deleted text end
deleted text begin
(3) a service to help the client integrate gains made during treatment into daily living
and to reduce the client's reliance on a staff member for support;
deleted text end
deleted text begin
(4) a service to address issues related to co-occurring disorders, including client education
on symptoms of mental illness, the possibility of comorbidity, and the need for continued
medication compliance while recovering from substance use disorder. A group must address
co-occurring disorders, as needed. When treatment for mental health problems is indicated,
the treatment must be integrated into the client's individual treatment plan; and
deleted text end
deleted text begin
(5) treatment coordination provided one-to-one by an individual who meets the staff
qualifications in section 245G.11, subdivision 7. Treatment coordination services include:
deleted text end
deleted text begin
(i) assistance in coordination with significant others to help in the treatment planning
process whenever possible;
deleted text end
deleted text begin
(ii) assistance in coordination with and follow up for medical services as identified in
the treatment plan;
deleted text end
deleted text begin
(iii) facilitation of referrals to substance use disorder services as indicated by a client's
medical provider, comprehensive assessment, or treatment plan;
deleted text end
deleted text begin
(iv) facilitation of referrals to mental health services as identified by a client's
comprehensive assessment or treatment plan;
deleted text end
deleted text begin
(v) assistance with referrals to economic assistance, social services, housing resources,
and prenatal care according to the client's needs;
deleted text end
deleted text begin
(vi) life skills advocacy and support accessing treatment follow-up, disease management,
and education services, including referral and linkages to long-term services and supports
as needed; and
deleted text end
deleted text begin
(vii) documentation of the provision of treatment coordination services in the client's
file.
deleted text end
(b) A treatment service provided to a client must be provided according to the individual
treatment plan and must consider cultural differences and special needs of a client.
new text begin
(c) A supportive service alone does not constitute a treatment service. Supportive services
include:
new text end
new text begin
(1) milieu management or supervising or monitoring clients without also providing a
treatment service identified in subdivision 1a, 1b, or 2a;
new text end
new text begin
(2) transporting clients;
new text end
new text begin
(3) waiting with clients for appointments at social service agencies, court hearings, and
similar activities; and
new text end
new text begin
(4) collecting urinalysis samples.
new text end
new text begin
(d) A treatment service provided in a group setting must be provided in a cohesive
manner and setting that allows every client receiving the service to interact and receive the
same service at the same time.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 10.
Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Psychosocial treatment service. new text end
new text begin
Psychosocial treatment services must be
provided according to the hours identified in section 254B.19 for the ASAM level of care
provided to the client. A license holder must provide the following psychosocial treatment
services as a part of the client's individual treatment:
new text end
new text begin
(1) counseling services that provide a client with professional assistance in managing
substance use disorder and co-occurring conditions, either individually or in a group setting.
Counseling must:
new text end
new text begin
(i) use evidence-based techniques to help a client modify behavior, overcome obstacles,
and achieve and sustain recovery through techniques such as active listening, guidance,
discussion, feedback, and clarification;
new text end
new text begin
(ii) help the client to identify and address needs related to substance use, develop
strategies to avoid harmful substance use, and establish a lifestyle free of the harmful effects
of substance use disorder; and
new text end
new text begin
(iii) work to improve well-being and mental health, resolve or mitigate symptomatic
behaviors, beliefs, compulsions, thoughts, and emotions, and enhance relationships and
social skills, while addressing client-centered psychological and emotional needs; and
new text end
new text begin
(2) psychoeducation services to provide a client with information about substance use
and co-occurring conditions, either individually or in a group setting. Psychoeducation
includes structured presentations, interactive discussions, and practical exercises to help
clients understand and manage their conditions effectively. Topics include but are not limited
to:
new text end
new text begin
(i) the causes of substance use disorder and co-occurring disorders;
new text end
new text begin
(ii) behavioral techniques that help a client change behaviors, thoughts, and feelings;
new text end
new text begin
(iii) the importance of maintaining mental health, including understanding symptoms
of mental illness;
new text end
new text begin
(iv) medications for addiction and psychiatric disorders and the importance of medication
adherence;
new text end
new text begin
(v) the importance of maintaining physical health, health-related risk factors associated
with substance use disorder, and specific health education on tuberculosis, HIV, other
sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis; and
new text end
new text begin
(vi) harm-reduction strategies.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 11.
Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin Treatment coordination. new text end
new text begin
(a) Treatment coordination must be provided to a
single client by an individual who meets the staff qualifications in section 245G.11,
subdivision 7. Treatment coordination services include:
new text end
new text begin
(1) coordinating directly with others involved in the client's treatment and recovery,
including the referral source, family or natural supports, social services agencies, and external
care providers;
new text end
new text begin
(2) providing clients with training and facilitating connections to community resources
that support recovery;
new text end
new text begin
(3) assisting clients in obtaining necessary resources and services such as financial
assistance, housing, food, clothing, medical care, education, harm reduction services,
vocational support, and recreational services that promote recovery;
new text end
new text begin
(4) helping clients connect and engage with self-help support groups and expand social
support networks with family, friends, and organizations; and
new text end
new text begin
(5) assisting clients in transitioning between levels of care, including providing direct
connections to ensure continuity of care.
new text end
new text begin
(b) Treatment coordination does not include coordinating services or communicating
with staff members within the licensed program.
new text end
new text begin
(c) Treatment coordination may be provided in a setting with the individual client and
others involved in the client's treatment and recovery.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 12.
Minnesota Statutes 2024, section 245G.07, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Ancillary treatment service. new text end
new text begin
(a) A license holder may provide ancillary
services in addition to the hours of psychosocial treatment services identified in section
254B.19 for the ASAM level of care provided to the client.
new text end
new text begin
(b) A license holder may provide the following ancillary treatment services as a part of
the client's individual treatment:
new text end
new text begin
(1) recovery support services provided individually or in a group setting, that include:
new text end
new text begin
(i) supporting clients in restoring daily living skills, such as health and health care
navigation and self-care to enhance personal well-being;
new text end
new text begin
(ii) providing resources and assistance to help clients restore life skills, including effective
parenting, financial management, pro-social behavior, education, employment, and nutrition;
new text end
new text begin
(iii) assisting clients in restoring daily functioning and routines affected by substance
use and supporting them in developing skills for successful community integration; and
new text end
new text begin
(iv) helping clients respond to or avoid triggers that threaten their community stability,
assisting the client in identifying potential crises and developing a plan to address them,
and providing support to restore the client's stability and functioning; and
new text end
new text begin
(2) peer recovery support services provided according to sections 254B.05, subdivision
5, and 254B.052.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 13.
Minnesota Statutes 2024, section 245G.07, subdivision 3, is amended to read:
Subd. 3.
deleted text begin Counselorsdeleted text end new text begin Treatment service providersnew text end .
new text begin (a) new text end All treatment servicesdeleted text begin , except
peer recovery support services and treatment coordination,deleted text end must be provided by an deleted text begin alcohol
and drug counselor qualified according to section 245G.11, subdivision 5, unless thedeleted text end
individual deleted text begin providing the service isdeleted text end specifically qualified according to the accepted credential
required to provide the service. deleted text begin The commissioner shall maintain a current list of
professionals qualified to provide treatment services.
deleted text end
new text begin
(b) Psychosocial treatment services must be provided by an alcohol and drug counselor
qualified according to section 245G.11, subdivision 5, unless the individual providing the
service is specifically qualified according to the accepted credential required to provide the
service. The commissioner shall maintain a current list of professionals qualified to provide
psychosocial treatment services.
new text end
new text begin
(c) Treatment coordination must be provided by a treatment coordinator qualified
according to section 245G.11, subdivision 7.
new text end
new text begin
(d) Recovery support services must be provided by a behavioral health practitioner
qualified according to section 245G.11, subdivision 12.
new text end
new text begin
(e) Peer recovery support services must be provided by a recovery peer qualified
according to section 245I.04, subdivision 18.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 14.
Minnesota Statutes 2024, section 245G.07, subdivision 4, is amended to read:
Subd. 4.
Location of service provision.
(a) The license holder must provide all treatment
services a client receives at one of the license holder's substance use disorder treatment
licensed locations or at a location allowed under paragraphs (b) to (f). If the services are
provided at the locations in paragraphs (b) to (d), the license holder must document in the
client record the location services were provided.
(b) The license holder may provide nonresidential individual treatment services at a
client's home or place of residence.
(c) If the license holder provides treatment services by telehealth, the services must be
provided according to this paragraph:
(1) the license holder must maintain a licensed physical location in Minnesota where
the license holder must offer all treatment services in subdivision deleted text begin 1, paragraph (a), clauses
(1) to (4),deleted text end new text begin 1anew text end physically in-person to each client;
(2) the license holder must meet all requirements for the provision of telehealth in sections
254B.05, subdivision 5, paragraph (f), and 256B.0625, subdivision 3b. The license holder
must document all items in section 256B.0625, subdivision 3b, paragraph (c), for each client
receiving services by telehealth, regardless of payment type or whether the client is a medical
assistance enrollee;
(3) the license holder may provide treatment services by telehealth to clients individually;
(4) the license holder may provide treatment services by telehealth to a group of clients
that are each in a separate physical location;
(5) the license holder must not provide treatment services remotely by telehealth to a
group of clients meeting together in person, unless permitted under clause (7);
(6) clients and staff may join an in-person group by telehealth if a staff member qualified
to provide the treatment service is physically present with the group of clients meeting
together in person; and
(7) the qualified professional providing a residential group treatment service by telehealth
must be physically present on-site at the licensed residential location while the service is
being provided. If weather conditions or short-term illness prohibit a qualified professional
from traveling to the residential program and another qualified professional is not available
to provide the service, a qualified professional may provide a residential group treatment
service by telehealth from a location away from the licensed residential location. In such
circumstances, the license holder must ensure that a qualified professional does not provide
a residential group treatment service by telehealth from a location away from the licensed
residential location for more than one day at a time, must ensure that a staff person who
qualifies as a paraprofessional is physically present with the group of clients, and must
document the reason for providing the remote telehealth service in the records of clients
receiving the service. The license holder must document the dates that residential group
treatment services were provided by telehealth from a location away from the licensed
residential location in a central log and must provide the log to the commissioner upon
request.
(d) The license holder may provide the deleted text begin additionaldeleted text end new text begin ancillarynew text end treatment services under
subdivision deleted text begin 2, clauses (2) to (6) and (8),deleted text end new text begin 2anew text end away from the licensed location at a suitable
location appropriate to the treatment service.
(e) Upon written approval from the commissioner for each satellite location, the license
holder may provide nonresidential treatment services at satellite locations that are in a
school, jail, or nursing home. A satellite location may only provide services to students of
the school, inmates of the jail, or residents of the nursing home. Schools, jails, and nursing
homes are exempt from the licensing requirements in section 245A.04, subdivision 2a, to
document compliance with building codes, fire and safety codes, health rules, and zoning
ordinances.
(f) The commissioner may approve other suitable locations as satellite locations for
nonresidential treatment services. The commissioner may require satellite locations under
this paragraph to meet all applicable licensing requirements. The license holder may not
have more than two satellite locations per license under this paragraph.
(g) The license holder must provide the commissioner access to all files, documentation,
staff persons, and any other information the commissioner requires at the main licensed
location for all clients served at any location under paragraphs (b) to (f).
(h) Notwithstanding sections 245A.65, subdivision 2, and 626.557, subdivision 14, a
program abuse prevention plan is not required for satellite or other locations under paragraphs
(b) to (e). An individual abuse prevention plan is still required for any client that is a
vulnerable adult as defined in section 626.5572, subdivision 21.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 15.
Minnesota Statutes 2024, section 245G.11, subdivision 6, is amended to read:
Subd. 6.
Paraprofessionals.
A paraprofessional must have knowledge of client rights,
according to section 148F.165, and staff member responsibilities. A paraprofessional may
notnew text begin make decisions tonew text end admit, transfer, or discharge a client but maynew text begin perform tasks related
to intake and orientation. A paraprofessional maynew text end benew text begin thenew text end responsible deleted text begin for the delivery of
treatment servicedeleted text end new text begin staff membernew text end according to section 245G.10, subdivision 3.new text begin A
paraprofessional must not provide a treatment service unless qualified to do so according
to section 245G.07, subdivision 3.
new text end
Sec. 16.
Minnesota Statutes 2024, section 245G.11, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Behavioral health practitioners. new text end
new text begin
(a) A behavioral health practitioner must
meet the mental health practitioner qualifications in section 245I.04, subdivision 4.
new text end
new text begin
(b) A behavioral health practitioner working within a substance use disorder treatment
program licensed under this chapter has the following scope of practice:
new text end
new text begin
(1) a behavioral health practitioner may provide clients with recovery support services,
as defined in section 245G.07, subdivision 2a, paragraph (b), clause (1); and
new text end
new text begin
(2) a behavioral health practitioner must not provide treatment supervision to other staff
persons.
new text end
new text begin
(c) A behavioral health practitioner working within a substance use disorder treatment
program licensed under this chapter must receive at least one hour of supervision per month
on individual service delivery from an alcohol and drug counselor or a mental health
professional who has substance use treatment and assessments within the scope of their
practice.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 17.
Minnesota Statutes 2024, section 245G.22, subdivision 11, is amended to read:
Subd. 11.
Waiting list.
An opioid treatment program must have a waiting list system.
If the person seeking admission cannot be admitted within 14 days of the date of application,
each person seeking admission must be placed on the waiting list, unless the person seeking
admission is assessed by the program and found ineligible for admission according to this
chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12 (e),
and title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each
person seeking treatment while awaiting admission. A person seeking admission on a waiting
list who receives no services under section 245G.07, subdivision deleted text begin 1deleted text end new text begin 1a or 1bnew text end , must not be
considered a client as defined in section 245G.01, subdivision 9.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 18.
Minnesota Statutes 2024, section 245G.22, subdivision 15, is amended to read:
Subd. 15.
Nonmedication treatment services; documentation.
(a) The program must
offer at least deleted text begin 50 consecutive minutesdeleted text end new text begin four unitsnew text end of individual or group therapy treatment
services as defined in section 245G.07, subdivision deleted text begin 1deleted text end deleted text begin , paragraph (a)deleted text end new text begin 1anew text end , clause (1), per week,
for the first ten weeks following the day of service initiation, and at least deleted text begin 50 consecutive
minutesdeleted text end new text begin one unitnew text end per month thereafter. deleted text begin As clinically appropriate, the program may offer
these services deleted text end deleted text begin cumulatively and not consecutively in increments of no less than 15 minutes
over the required deleted text end deleted text begin time period, and for a total of 60 minutes of treatment services over the
time period, and deleted text end deleted text begin must document the reason for providing services cumulatively in the client's
record.deleted text end The program may offer additional levels of service when deemed clinically necessary.
(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
the assessment must be completed within 21 days from the day of service initiation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 19.
Minnesota Statutes 2024, section 254B.01, subdivision 10, is amended to read:
Subd. 10.
deleted text begin Skilleddeleted text end new text begin Psychosocialnew text end treatment services.
"deleted text begin Skilleddeleted text end new text begin Psychosocialnew text end treatment
services" includes the treatment services described in section 245G.07, deleted text begin subdivisions 1,
paragraph (a), clauses (1) to (4), and 2, clauses (1) to (6). Skilleddeleted text end new text begin subdivision 1a. Psychosocialnew text end
treatment services must be provided by qualified professionals as identified in section
245G.07, subdivision 3new text begin , paragraph (b)new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 20.
Minnesota Statutes 2024, section 254B.04, subdivision 1a, is amended to read:
Subd. 1a.
Client eligibility.
(a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, who meet the income standards of section 256B.056,
subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.
(b) Persons with dependent children who are determined to be in need of substance use
disorder treatment pursuant to an assessment under section 260E.20, subdivision 1, or in
need of chemical dependency treatment pursuant to a case plan under section 260C.201,
subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment
services. Treatment services must be appropriate for the individual or family, which may
include long-term care treatment or treatment in a facility that allows the dependent children
to stay in the treatment facility. The county shall pay for out-of-home placement costs, if
applicable.
(c) Notwithstanding paragraph (a), any person enrolled in medical assistance or
MinnesotaCare is eligible for room and board services under section 254B.05, subdivision
5, paragraph (b), clause (9).
(d) A client is eligible to have substance use disorder treatment paid for with funds from
the behavioral health fund when the client:
(1) is eligible for MFIP as determined under chapter 142G;
(2) is eligible for medical assistance as determined under Minnesota Rules, parts
9505.0010 to deleted text begin 9505.0150deleted text end new text begin 9505.140new text end ;
(3) is eligible for general assistance, general assistance medical care, or work readiness
as determined under Minnesota Rules, parts 9500.1200 to deleted text begin 9500.1318deleted text end new text begin 9500.1272new text end ; or
(4) has income that is within current household size and income guidelines for entitled
persons, as defined in this subdivision and subdivision 7.
(e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
a third-party payment source are eligible for the behavioral health fund if the third-party
payment source pays less than 100 percent of the cost of treatment services for eligible
clients.
(f) A client is ineligible to have substance use disorder treatment services paid for with
behavioral health fund money if the client:
(1) has an income that exceeds current household size and income guidelines for entitled
persons as defined in this subdivision and subdivision 7; or
(2) has an available third-party payment source that will pay the total cost of the client's
treatment.
(g) A client who is disenrolled from a state prepaid health plan during a treatment episode
is eligible for continued treatment service that is paid for by the behavioral health fund until
the treatment episode is completed or the client is re-enrolled in a state prepaid health plan
if the client:
(1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
medical care; or
(2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
agency under section 254B.04.
(h) When a county commits a client under chapter 253B to a regional treatment center
for substance use disorder services and the client is ineligible for the behavioral health fund,
the county is responsible for the payment to the regional treatment center according to
section 254B.05, subdivision 4.
(i) Persons enrolled in MinnesotaCare are eligible for room and board services when
provided through intensive residential treatment services and residential crisis services under
section 256B.0622.
new text begin
(j) A person is eligible for one 60-consecutive-calendar-day period per year. A person
may submit a request for additional eligibility to the commissioner. A person denied
additional eligibility under this paragraph may request a state agency hearing under section
256.045.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, except the amendments to
paragraph (d) are effective July 1, 2025.
new text end
Sec. 21.
Minnesota Statutes 2024, section 254B.05, subdivision 1, is amended to read:
Subdivision 1.
Licensure or certification required.
(a) Programs licensed by the
commissioner are eligible vendors. Hospitals may apply for and receive licenses to be
eligible vendors, notwithstanding the provisions of section 245A.03. American Indian
programs that provide substance use disorder treatment, extended care, transitional residence,
or outpatient treatment services, and are licensed by tribal government are eligible vendors.
(b) A licensed professional in private practice as defined in section 245G.01, subdivision
17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible
vendor of a comprehensive assessment provided according to section 254A.19, subdivision
3, and treatment services provided according to sections 245G.06 and 245G.07, deleted text begin subdivision
1deleted text end deleted text begin , paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses (1) to (6).deleted text end new text begin subdivisions
1, 1a, and 1b.
new text end
(c) A county is an eligible vendor for a comprehensive assessment when provided by
an individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 5,
and completed according to the requirements of section 254A.19, subdivision 3. A county
is an eligible vendor of deleted text begin caredeleted text end new text begin treatmentnew text end coordination services when provided by an individual
who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and provided
according to the requirements of section 245G.07, subdivision deleted text begin 1deleted text end deleted text begin , paragraph (a), clause (5)deleted text end new text begin
1bnew text end . A county is an eligible vendor of peer recovery services when the services are provided
by an individual who meets the requirements of section 245G.11, subdivision 8new text begin , and
according to section 254B.052new text end .
(d) A recovery community organization that meets the requirements of clauses (1) to
(14) and meets certification or accreditation requirements of the Alliance for Recovery
Centered Organizations, the Council on Accreditation of Peer Recovery Support Services,
or a Minnesota statewide recovery organization identified by the commissioner is an eligible
vendor of peer recovery support services. A Minnesota statewide recovery organization
identified by the commissioner must update recovery community organization applicants
for certification or accreditation on the status of the application within 45 days of receipt.
If the approved statewide recovery organization denies an application, it must provide a
written explanation for the denial to the recovery community organization. Eligible vendors
under this paragraph must:
(1) be nonprofit organizations under section 501(c)(3) of the Internal Revenue Code, be
free from conflicting self-interests, and be autonomous in decision-making, program
development, peer recovery support services provided, and advocacy efforts for the purpose
of supporting the recovery community organization's mission;
(2) be led and governed by individuals in the recovery community, with more than 50
percent of the board of directors or advisory board members self-identifying as people in
personal recovery from substance use disorders;
(3) have a mission statement and conduct corresponding activities indicating that the
organization's primary purpose is to support recovery from substance use disorder;
(4) demonstrate ongoing community engagement with the identified primary region and
population served by the organization, including individuals in recovery and their families,
friends, and recovery allies;
(5) be accountable to the recovery community through documented priority-setting and
participatory decision-making processes that promote the engagement of, and consultation
with, people in recovery and their families, friends, and recovery allies;
(6) provide nonclinical peer recovery support services, including but not limited to
recovery support groups, recovery coaching, telephone recovery support, skill-building,
and harm-reduction activities, and provide recovery public education and advocacy;
(7) have written policies that allow for and support opportunities for all paths toward
recovery and refrain from excluding anyone based on their chosen recovery path, which
may include but is not limited to harm reduction paths, faith-based paths, and nonfaith-based
paths;
(8) maintain organizational practices to meet the needs of Black, Indigenous, and people
of color communities, LGBTQ+ communities, and other underrepresented or marginalized
communities. Organizational practices may include board and staff training, service offerings,
advocacy efforts, and culturally informed outreach and services;
(9) use recovery-friendly language in all media and written materials that is supportive
of and promotes recovery across diverse geographical and cultural contexts and reduces
stigma;
(10) establish and maintain a publicly available recovery community organization code
of ethics and grievance policy and procedures;
(11) not classify or treat any recovery peer hired on or after July 1, 2024, as an
independent contractor;
(12) not classify or treat any recovery peer as an independent contractor on or after
January 1, 2025;
(13) provide an orientation for recovery peers that includes an overview of the consumer
advocacy services provided by the Ombudsman for Mental Health and Developmental
Disabilities and other relevant advocacy services; and
(14) provide notice to peer recovery support services participants that includes the
following statement: "If you have a complaint about the provider or the person providing
your peer recovery support services, you may contact the Minnesota Alliance of Recovery
Community Organizations. You may also contact the Office of Ombudsman for Mental
Health and Developmental Disabilities." The statement must also include:
(i) the telephone number, website address, email address, and mailing address of the
Minnesota Alliance of Recovery Community Organizations and the Office of Ombudsman
for Mental Health and Developmental Disabilities;
(ii) the recovery community organization's name, address, email, telephone number, and
name or title of the person at the recovery community organization to whom problems or
complaints may be directed; and
(iii) a statement that the recovery community organization will not retaliate against a
peer recovery support services participant because of a complaint.
(e) A recovery community organization approved by the commissioner before June 30,
2023, must have begun the application process as required by an approved certifying or
accrediting entity and have begun the process to meet the requirements under paragraph (d)
by September 1, 2024, in order to be considered as an eligible vendor of peer recovery
support services.
(f) A recovery community organization that is aggrieved by an accreditation, certification,
or membership determination and believes it meets the requirements under paragraph (d)
may appeal the determination under section 256.045, subdivision 3, paragraph (a), clause
(14), for reconsideration as an eligible vendor. If the human services judge determines that
the recovery community organization meets the requirements under paragraph (d), the
recovery community organization is an eligible vendor of peer recovery support services.
(g) All recovery community organizations must be certified or accredited by an entity
listed in paragraph (d) by June 30, 2025.
(h) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, are not eligible vendors. Programs that are not licensed as a residential or
nonresidential substance use disorder treatment or withdrawal management program by the
commissioner or by tribal government or do not meet the requirements of subdivisions 1a
and 1b are not eligible vendors.
(i) Hospitals, federally qualified health centers, and rural health clinics are eligible
vendors of a comprehensive assessment when the comprehensive assessment is completed
according to section 254A.19, subdivision 3, and by an individual who meets the criteria
of an alcohol and drug counselor according to section 245G.11, subdivision 5. The alcohol
and drug counselor must be individually enrolled with the commissioner and reported on
the claim as the individual who provided the service.
(j) Any complaints about a recovery community organization or peer recovery support
services may be made to and reviewed or investigated by the ombudsperson for behavioral
health and developmental disabilities under sections 245.91 and 245.94.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 22.
Minnesota Statutes 2024, section 254B.05, subdivision 5, is amended to read:
Subd. 5.
Rate requirements.
(a) new text begin Subject to the requirements of subdivision 6, new text end the
commissioner shall establish rates for new text begin the following new text end substance use disorder new text begin treatment new text end services
deleted text begin and service enhancementsdeleted text end funded under this chapterdeleted text begin .deleted text end new text begin :
new text end
deleted text begin
(b) Eligible substance use disorder treatment services include:
deleted text end
(1) those licensed, as applicable, according to chapter 245G or applicable Tribal license
and provided according to the following ASAM levels of care:
(i) ASAM level 0.5 early intervention services provided according to section 254B.19,
subdivision 1, clause (1);
(ii) ASAM level 1.0 outpatient services provided according to section 254B.19,
subdivision 1, clause (2);
(iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19,
subdivision 1, clause (3);
(iv) ASAM level 2.5 partial hospitalization services provided according to section
254B.19, subdivision 1, clause (4);
(v) ASAM level 3.1 clinically managed low-intensity residential services provided
according to section 254B.19, subdivision 1, clause (5)deleted text begin . The commissioner shall use the
base payment rate of $79.84 per day for services provided under this itemdeleted text end ;
(vi) ASAM level 3.1 clinically managed low-intensity residential services provided
according to section 254B.19, subdivision 1, clause (5), at 15 or more hours of skilled
treatment services each weekdeleted text begin . The commissioner shall use the base payment rate of $166.13
per day for services provided under this itemdeleted text end ;
(vii) ASAM level 3.3 clinically managed population-specific high-intensity residential
services provided according to section 254B.19, subdivision 1, clause (6)deleted text begin . The commissioner
shall use the specified base payment rate of $224.06 per day for services provided under
this itemdeleted text end ; and
(viii) ASAM level 3.5 clinically managed high-intensity residential services provided
according to section 254B.19, subdivision 1, clause (7)deleted text begin . The commissioner shall use the
specified base payment rate of $224.06 per day for services provided under this itemdeleted text end ;
(2) comprehensive assessments provided according to section 254A.19, subdivision 3;
(3) treatment coordination services provided according to section 245G.07, subdivision
1, paragraph (a), clause (5);
(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);
(5) withdrawal management services provided according to chapter 245F;
(6) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable Tribal license and licensed as a hospital under sections 144.50 to
144.56;
(7) substance use disorder treatment services with medications for opioid use disorder
provided in an opioid treatment program licensed according to sections 245G.01 to 245G.17
and 245G.22, or under an applicable Tribal license;
(8) medium-intensity residential treatment services that provide 15 hours of skilled
treatment services each week and are licensed according to sections 245G.01 to 245G.17
and 245G.21 or applicable Tribal license;
(9) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable Tribal license;
(10) ASAM 3.5 clinically managed high-intensity residential services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable Tribal license, which
provide ASAM level of care 3.5 according to section 254B.19, subdivision 1, clause (7),
and are provided by a state-operated vendor or to clients who have been civilly committed
to the commissioner, present the most complex and difficult care needs, and are a potential
threat to the community; and
(11) room and board facilities that meet the requirements of subdivision 1a.
deleted text begin (c)deleted text end new text begin (b)new text end The commissioner shall establish higher rates for programs that meet the
requirements of paragraph deleted text begin (b)deleted text end new text begin (a)new text end and deleted text begin one of the following additional requirements:deleted text end new text begin the
requirements of one clause in this paragraph.
new text end
(1) Programs that serve parents with their children new text begin are eligible for an enhanced payment
rate new text end if the program:
(i) provides on-site child care during the hours of treatment activity that:
(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or
(B) is licensed under chapter 245A and sections 245G.01 to 245G.19; or
(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:
(A) a child care center under Minnesota Rules, chapter 9503; or
(B) a family child care home under Minnesota Rules, chapter 9502deleted text begin ;deleted text end new text begin .
new text end
new text begin
In order to be eligible for a higher rate under this clause, a program that provides
arrangements for off-site child care must maintain current documentation at the substance
use disorder facility of the child care provider's current licensure to provide child care
services.
new text end
(2) Culturally specific or culturally responsive programs as defined in section 254B.01,
subdivision 4adeleted text begin ;deleted text end new text begin are eligible for an enhanced payment rate.
new text end
(3) Disability responsive programs as defined in section 254B.01, subdivision 4bdeleted text begin ;deleted text end new text begin are
eligible for an enhanced payment rate.
new text end
(4) Programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to one hour per client per week new text begin are eligible for an enhanced
payment rate new text end if the medical needs of the client and the nature and provision of any medical
services provided are documented in the client filedeleted text begin ; ordeleted text end new text begin .
new text end
(5) Programs that offer services to individuals with co-occurring mental health and
substance use disorder problems new text begin are eligible for an enhanced payment rate new text end if:
(i) the program meets the co-occurring requirements in section 245G.20;
(ii) the program employs a mental health professional as defined in section 245I.04,
subdivision 2;
(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;
(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;
(v) family education is offered that addresses mental health and substance use disorder
and the interaction between the two; and
(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.
deleted text begin
(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the substance use disorder facility of the child care provider's current licensure to provide
child care services.
deleted text end
deleted text begin (e)deleted text end Adolescent residential programs that meet the requirements of Minnesota Rules, parts
2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in deleted text begin paragraph (c), clause (5),deleted text end items (i) to (iv).
deleted text begin (f)deleted text end new text begin (c)new text end Substance use disorder services that are otherwise covered as direct face-to-face
services may be provided via telehealth as defined in section 256B.0625, subdivision 3b.
The use of telehealth to deliver services must be medically appropriate to the condition and
needs of the person being served. Reimbursement shall be at the same rates and under the
same conditions that would otherwise apply to direct face-to-face services.
deleted text begin (g)deleted text end new text begin (d)new text end For the purpose of reimbursement under this section, substance use disorder
treatment services provided in a group setting without a group participant maximum or
maximum client to staff ratio under chapter 245G shall not exceed a client to staff ratio of
48 to one. At least one of the attending staff must meet the qualifications as established
under this chapter for the type of treatment service provided. A recovery peer may not be
included as part of the staff ratio.
deleted text begin (h)deleted text end new text begin (e)new text end Payment for outpatient substance use disorder services that are licensed according
to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
prior authorization of a greater number of hours is obtained from the commissioner.
deleted text begin (i)deleted text end new text begin (f)new text end Payment for substance use disorder services under this section must start from the
day of service initiation, when the comprehensive assessment is completed within the
required timelines.
deleted text begin (j)deleted text end new text begin (g)new text end A license holder that is unable to provide all residential treatment services because
a client missed services remains eligible to bill for the client's intensity level of services
under this paragraph if the license holder can document the reason the client missed services
and the interventions done to address the client's absence.
deleted text begin (k)deleted text end new text begin (h)new text end Hours in a treatment week may be reduced in observance of federally recognized
holidays.
deleted text begin (l)deleted text end new text begin (i)new text end Eligible vendors of peer recovery support services must:
(1) submit to a review by the commissioner of up to ten percent of all medical assistance
and behavioral health fund claims to determine the medical necessity of peer recovery
support services for entities billing for peer recovery support services individually and not
receiving a daily rate; and
(2) limit an individual client to 14 hours per week for peer recovery support services
from an individual provider of peer recovery support services.
deleted text begin (m)deleted text end new text begin (j)new text end Peer recovery support services not provided in accordance with section 254B.052
are subject to monetary recovery under section 256B.064 as money improperly paid.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 23.
Minnesota Statutes 2024, section 254B.05, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Rate adjustments. new text end
new text begin
(a) Effective for services rendered on or after January 1,
2026, the commissioner must implement the following base payment rates for substance
use disorder treatment services under subdivision 5, paragraph (a):
new text end
new text begin
(1) for low-intensity residential, 100 percent of the modeled rate included in the final
report required by Laws 2021, First Special Session chapter 7, article 17, section 18;
new text end
new text begin
(2) for high-intensity residential services, the rates in effect on December 31, 2025; and
new text end
new text begin
(3) for all other services not included in clause (1) or (2), 55 percent of the modeled rate
included in the final report required by Laws 2021, First Special Session chapter 7, article
17, section 18.
new text end
new text begin
(b) Effective January 1, 2028, and annually thereafter, the commissioner of human
services must adjust the payment rates under paragraph (a) according to the change from
the midpoint of the previous rate year to the midpoint of the rate year for which the rate is
being determined using the Centers for Medicare and Medicaid Services Medicare Economic
Index as forecasted in the fourth quarter of the calendar year before the rate year.
new text end
Sec. 24.
Minnesota Statutes 2024, section 254B.06, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Prohibition of duplicative claim submission. new text end
new text begin
(a) For time-based claims,
submissions must follow the guidelines in the Centers for Medicare and Medicaid Services'
Healthcare Common Procedure Coding System and the American Medical Association's
Current Procedural Terminology to determine the appropriate units of time to report.
new text end
new text begin
(b) More than half the duration of a time-based code must be spent performing the service
to be eligible under this section. Any provision of service during the remaining balance of
the unit of time is not eligible for any other claims submission and would be considered a
duplicative claim submission.
new text end
new text begin
(c) A provider may only round up to the next whole number of service units on a
submitted claim when more than one and one-half times the defined value of the code has
occurred and no additional time increment code exists.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 25.
Minnesota Statutes 2024, section 254B.09, subdivision 2, is amended to read:
Subd. 2.
American Indian agreements.
The commissioner may enter into agreements
with federally recognized Tribal units to pay for substance use disorder treatment services
provided under Laws 1986, chapter 394, sections 8 to 20. The agreements must clarify how
the governing body of the Tribal unit fulfills deleted text begin local agencydeleted text end new text begin the Tribal unit'snew text end responsibilities
regarding the form and manner of invoicing.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026.
new text end
Sec. 26.
Minnesota Statutes 2024, section 254B.19, subdivision 1, is amended to read:
Subdivision 1.
Level of care requirements.
(a) For each client assigned an ASAM level
of care, eligible vendors must implement the standards set by the ASAM for the respective
level of care. Additionally, vendors must meet the following requirements:
(1) For ASAM level 0.5 early intervention targeting individuals who are at risk of
developing a substance-related problem but may not have a diagnosed substance use disorder,
early intervention services may include individual or group counseling, treatment
coordination, peer recovery support, screening brief intervention, and referral to treatment
provided according to section 254A.03, subdivision 3, paragraph (c).
(2) For ASAM level 1.0 outpatient clients, adults must receive up to eight hours per
week of deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment services and adolescents must receive up to five
hours per week. Services must be licensed according to section 245G.20 and meet
requirements under section 256B.0759. deleted text begin Peer recoverydeleted text end new text begin Ancillary servicesnew text end and treatment
coordination may be provided beyond the hourly deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment service
hours allowable per week.
(3) For ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours
per week of deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment services and adolescents must receive six or
more hours per week. Vendors must be licensed according to section 245G.20 and must
meet requirements under section 256B.0759. deleted text begin Peer recoverydeleted text end new text begin Ancillarynew text end services and treatment
coordination may be provided beyond the hourly deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment service
hours allowable per week. If clinically indicated on the client's treatment plan, this service
may be provided in conjunction with room and board according to section 254B.05,
subdivision 1a.
(4) For ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or
more of deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment services. Services must be licensed according to
section 245G.20 deleted text begin and must meet requirements under section 256B.0759deleted text end . Level 2.5 is for
clients who need daily monitoring in a structured setting, as directed by the individual
treatment plan and in accordance with the limitations in section 254B.05, subdivision 5,
paragraph (h). If clinically indicated on the client's treatment plan, this service may be
provided in conjunction with room and board according to section 254B.05, subdivision
1a.
(5) For ASAM level 3.1 clinically managed low-intensity residential clients, programs
must provide at least 5 hours of deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment services per week according
to each client's specific treatment schedule, as directed by the individual treatment plan.
Programs must be licensed according to section 245G.20 and must meet requirements under
section 256B.0759.
(6) For ASAM level 3.3 clinically managed population-specific high-intensity residential
clients, programs must be licensed according to section 245G.20 and must meet requirements
under section 256B.0759. Programs must have 24-hour staffing coverage. Programs must
be enrolled as a disability responsive program as described in section 254B.01, subdivision
4b, and must specialize in serving persons with a traumatic brain injury or a cognitive
impairment so significant, and the resulting level of impairment so great, that outpatient or
other levels of residential care would not be feasible or effective. Programs must provide,
at a minimum, daily deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment services seven days a week according
to each client's specific treatment schedule, as directed by the individual treatment plan.
(7) For ASAM level 3.5 clinically managed high-intensity residential clients, services
must be licensed according to section 245G.20 and must meet requirements under section
256B.0759. Programs must have 24-hour staffing coverage and provide, at a minimum,
daily deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment services seven days a week according to each client's
specific treatment schedule, as directed by the individual treatment plan.
(8) For ASAM level withdrawal management 3.2 clinically managed clients, withdrawal
management must be provided according to chapter 245F.
(9) For ASAM level withdrawal management 3.7 medically monitored clients, withdrawal
management must be provided according to chapter 245F.
(b) Notwithstanding the minimum daily deleted text begin skilleddeleted text end new text begin psychosocialnew text end treatment service
requirements under paragraph (a), clauses (6) and (7), ASAM level 3.3 and 3.5 vendors
must provide each client at least 30 hours of treatment services per week for the period
between January 1, 2024, through June 30, 2024.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 27.
Minnesota Statutes 2024, section 256.042, subdivision 4, is amended to read:
Subd. 4.
Grants.
(a) The commissioner of human services shall submit a report of the
grants proposed by the advisory council to be awarded for the upcoming calendar year to
the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services policy and finance, by December 1 of each year, beginning
December 1, 2022. This paragraph expires upon the expiration of the advisory council.
(b) The grants shall be awarded to proposals selected by the advisory council that address
the priorities in subdivision 1, paragraph (a), clauses (1) to (4), unless otherwise appropriated
by the legislature. The advisory council shall determine grant awards and funding amounts
based on the funds appropriated to the commissioner under section 256.043, subdivision 3,
paragraph deleted text begin (n)deleted text end new text begin (m)new text end , and subdivision 3a, paragraph (d). The commissioner shall award the
grants from the opiate epidemic response fund and administer the grants in compliance with
section 16B.97. No more than ten percent of the grant amount may be used by a grantee for
administration.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment or
retroactively from June 30, 2025, whichever is earlier.
new text end
Sec. 28.
Minnesota Statutes 2024, section 256.043, subdivision 3, is amended to read:
Subd. 3.
Appropriations from registration and license fee account.
(a) The
appropriations in paragraphs (b) to deleted text begin (n)deleted text end new text begin (m)new text end shall be made from the registration and license
fee account on a fiscal year basis in the order specified.
(b) The appropriations specified in Laws 2019, chapter 63, article 3, section 1, paragraphs
(b), (f), (g), and (h), as amended by Laws 2020, chapter 115, article 3, section 35, shall be
made accordingly.
(c) $100,000 is appropriated to the commissioner of human services for grants for opiate
antagonist distribution. Grantees may utilize funds for opioid overdose prevention,
community asset mapping, education, and opiate antagonist distribution.
(d) $2,000,000 is appropriated to the commissioner of human services for grants to Tribal
nations and five urban Indian communities for traditional healing practices for American
Indians and to increase the capacity of culturally specific providers in the behavioral health
workforce.
(e) $400,000 is appropriated to the commissioner of human services for competitive
grants for opioid-focused Project ECHO programs.
(f) $277,000 in fiscal year 2024 and $321,000 each year thereafter is appropriated to the
commissioner of human services to administer the funding distribution and reporting
requirements in paragraph deleted text begin (o)deleted text end new text begin (n)new text end .
deleted text begin
(g) $3,000,000 in fiscal year 2025 and $3,000,000 each year thereafter is appropriated
to the commissioner of human services for safe recovery sites start-up and capacity building
grants under section 254B.18.
deleted text end
deleted text begin (h)deleted text end new text begin (g)new text end $395,000 in fiscal year 2024 and $415,000 each year thereafter is appropriated
to the commissioner of human services for the opioid overdose surge alert system under
section 245.891.
deleted text begin (i)deleted text end new text begin (h)new text end $300,000 is appropriated to the commissioner of management and budget for
evaluation activities under section 256.042, subdivision 1, paragraph (c).
deleted text begin (j)deleted text end new text begin (i)new text end $261,000 is appropriated to the commissioner of human services for the provision
of administrative services to the Opiate Epidemic Response Advisory Council and for the
administration of the grants awarded under paragraph deleted text begin (n)deleted text end new text begin (m)new text end .
deleted text begin (k)deleted text end new text begin (j)new text end $126,000 is appropriated to the Board of Pharmacy for the collection of the
registration fees under section 151.066.
deleted text begin (l)deleted text end new text begin (k)new text end $672,000 is appropriated to the commissioner of public safety for the Bureau of
Criminal Apprehension. Of this amount, $384,000 is for drug scientists and lab supplies
and $288,000 is for special agent positions focused on drug interdiction and drug trafficking.
deleted text begin (m)deleted text end new text begin (l)new text end After the appropriations in paragraphs (b) to deleted text begin (l)deleted text end new text begin (k)new text end are made, 50 percent of the
remaining amount is appropriated to the commissioner of children, youth, and families for
distribution to county social service agencies and Tribal social service agency initiative
projects authorized under section 256.01, subdivision 14b, to provide prevention and child
protection services to children and families who are affected by addiction. The commissioner
shall distribute this money proportionally to county social service agencies and Tribal social
service agency initiative projects through a formula based on intake data from the previous
three calendar years related to substance use and out-of-home placement episodes where
parental drug abuse is a reason for the out-of-home placement. County social service agencies
and Tribal social service agency initiative projects receiving funds from the opiate epidemic
response fund must annually report to the commissioner on how the funds were used to
provide prevention and child protection services, including measurable outcomes, as
determined by the commissioner. County social service agencies and Tribal social service
agency initiative projects must not use funds received under this paragraph to supplant
current state or local funding received for child protection services for children and families
who are affected by addiction.
deleted text begin (n)deleted text end new text begin (m)new text end After the appropriations in paragraphs (b) to deleted text begin (m)deleted text end new text begin (l)new text end are made, the remaining
amount in the account is appropriated to the commissioner of human services to award
grants as specified by the Opiate Epidemic Response Advisory Council in accordance with
section 256.042, unless otherwise appropriated by the legislature.
deleted text begin (o)deleted text end new text begin (n)new text end Beginning in fiscal year 2022 and each year thereafter, funds for county social
service agencies and Tribal social service agency initiative projects under paragraph deleted text begin (m)deleted text end new text begin
(l)new text end and grant funds specified by the Opiate Epidemic Response Advisory Council under
paragraph deleted text begin (n)deleted text end new text begin (m)new text end may be distributed on a calendar year basis.
deleted text begin (p)deleted text end new text begin (o)new text end Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
(c), (d), (e), deleted text begin (g)deleted text end new text begin (h)new text end , deleted text begin (m)deleted text end new text begin (l)new text end , and deleted text begin (n)deleted text end new text begin (m)new text end are available for three years after the funds are
appropriated.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment or
retroactively from June 30, 2025, whichever is earlier.
new text end
Sec. 29.
Minnesota Statutes 2024, section 256.043, subdivision 3a, is amended to read:
Subd. 3a.
Appropriations from settlement account.
(a) The appropriations in paragraphs
(b) to (e) shall be made from the settlement account on a fiscal year basis in the order
specified.
(b) If the balance in the registration and license fee account is not sufficient to fully fund
the appropriations specified in subdivision 3, paragraphs (b) to deleted text begin (l)deleted text end new text begin (k)new text end , an amount necessary
to meet any insufficiency shall be transferred from the settlement account to the registration
and license fee account to fully fund the required appropriations.
(c) $209,000 in fiscal year 2023 and $239,000 in fiscal year 2024 and subsequent fiscal
years are appropriated to the commissioner of human services for the administration of
grants awarded under paragraph (e). $276,000 in fiscal year 2023 and $151,000 in fiscal
year 2024 and subsequent fiscal years are appropriated to the commissioner of human
services to collect, collate, and report data submitted and to monitor compliance with
reporting and settlement expenditure requirements by grantees awarded grants under this
section and municipalities receiving direct payments from a statewide opioid settlement
agreement as defined in section 256.042, subdivision 6.
(d) After any appropriations necessary under paragraphs (b) and (c) are made, an amount
equal to the calendar year allocation to Tribal social service agency initiative projects under
subdivision 3, paragraph deleted text begin (m)deleted text end new text begin (l)new text end , is appropriated from the settlement account to the
commissioner of children, youth, and families for distribution to Tribal social service agency
initiative projects to provide child protection services to children and families who are
affected by addiction. The requirements related to proportional distribution, annual reporting,
and maintenance of effort specified in subdivision 3, paragraph deleted text begin (m)deleted text end new text begin (l)new text end , also apply to the
appropriations made under this paragraph.
(e) After making the appropriations in paragraphs (b), (c), and (d), the remaining amount
in the account is appropriated to the commissioner of human services to award grants as
specified by the Opiate Epidemic Response Advisory Council in accordance with section
256.042.
(f) Funds for Tribal social service agency initiative projects under paragraph (d) and
grant funds specified by the Opiate Epidemic Response Advisory Council under paragraph
(e) may be distributed on a calendar year basis.
(g) Notwithstanding section 16A.28, subdivision 3, funds appropriated in paragraphs
(d) and (e) are available for three years after the funds are appropriated.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment or
retroactively from June 30, 2025, whichever is earlier.
new text end
Sec. 30.
Minnesota Statutes 2024, section 256B.0625, subdivision 5m, is amended to read:
Subd. 5m.
Certified community behavioral health clinic services.
(a) Medical
assistance covers services provided by a not-for-profit certified community behavioral health
clinic (CCBHC) that meets the requirements of section 245.735, subdivision 3.
(b) The commissioner shall reimburse CCBHCs on a per-day basis for each day that an
eligible service is delivered using the CCBHC daily bundled rate system for medical
assistance payments as described in paragraph (c). The commissioner shall include a quality
incentive payment in the CCBHC daily bundled rate system as described in paragraph (e).
There is no county share for medical assistance services when reimbursed through the
CCBHC daily bundled rate system.
(c) The commissioner shall ensure that the CCBHC daily bundled rate system for CCBHC
payments under medical assistance meets the following requirements:
(1) the CCBHC daily bundled rate shall be a provider-specific rate calculated for each
CCBHC, based on the daily cost of providing CCBHC services and the total annual allowable
CCBHC costs divided by the total annual number of CCBHC visits. For calculating the
payment rate, total annual visits include visits covered by medical assistance and visits not
covered by medical assistance. Allowable costs include but are not limited to the salaries
and benefits of medical assistance providers; the cost of CCBHC services provided under
section 245.735, subdivision 3, paragraph (a), clauses (6) and (7); and other costs such as
insurance or supplies needed to provide CCBHC services;
(2) payment shall be limited to one payment per day per medical assistance enrollee
when an eligible CCBHC service is provided. A CCBHC visit is eligible for reimbursement
if at least one of the CCBHC services listed under section 245.735, subdivision 3, paragraph
(a), clause (6), is furnished to a medical assistance enrollee by a health care practitioner or
licensed agency employed by or under contract with a CCBHC;
(3) initial CCBHC daily bundled rates for newly certified CCBHCs under section 245.735,
subdivision 3, shall be established by the commissioner using a provider-specific rate based
on the newly certified CCBHC's audited historical cost report data adjusted for the expected
cost of delivering CCBHC services. Estimates are subject to review by the commissioner
and must include the expected cost of providing the full scope of CCBHC services and the
expected number of visits for the rate period;
(4) the commissioner shall rebase CCBHC rates once every two years following the last
rebasing and no less than 12 months following an initial rate or a rate change due to a change
in the scope of services. For CCBHCs certified after September 31, 2020, and before January
1, 2021, the commissioner shall rebase rates according to this clause for services provided
on or after January 1, 2024;
(5) the commissioner shall provide for a 60-day appeals process after notice of the results
of the rebasing;
(6) an entity that receives a CCBHC daily bundled rate that overlaps with another federal
Medicaid rate is not eligible for the CCBHC rate methodology;
(7) payments for CCBHC services to individuals enrolled in managed care shall be
coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
complete the phase-out of CCBHC wrap payments within 60 days of the implementation
of the CCBHC daily bundled rate system in the Medicaid Management Information System
(MMIS), for CCBHCs reimbursed under this chapter, with a final settlement of payments
due made payable to CCBHCs no later than 18 months thereafter;
(8) the CCBHC daily bundled rate for each CCBHC shall be updated by trending each
provider-specific rate by the Medicare Economic Index for primary care services. This
update shall occur each year in between rebasing periods determined by the commissioner
in accordance with clause (4). CCBHCs must provide data on costs and visits to the state
annually using the CCBHC cost report established by the commissioner; and
(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
services when such changes are expected to result in an adjustment to the CCBHC payment
rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
regarding the changes in the scope of services, including the estimated cost of providing
the new or modified services and any projected increase or decrease in the number of visits
resulting from the change. Estimated costs are subject to review by the commissioner. Rate
adjustments for changes in scope shall occur no more than once per year in between rebasing
periods per CCBHC and are effective on the date of the annual CCBHC rate update.
(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
providers at the CCBHC daily bundled rate. The commissioner shall monitor the effect of
this requirement on the rate of access to the services delivered by CCBHC providers. If, for
any contract year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this provision. This paragraph expires if federal
approval is not received for this paragraph at any time.
(e) The commissioner shall implement a quality incentive payment program for CCBHCs
that meets the following requirements:
(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
thresholds for performance metrics established by the commissioner, in addition to payments
for which the CCBHC is eligible under the CCBHC daily bundled rate system described in
paragraph (c);
(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement
year to be eligible for incentive payments;
(3) each CCBHC shall receive written notice of the criteria that must be met in order to
receive quality incentive payments at least 90 days prior to the measurement year; and
(4) a CCBHC must provide the commissioner with data needed to determine incentive
payment eligibility within six months following the measurement year. The commissioner
shall notify CCBHC providers of their performance on the required measures and the
incentive payment amount within 12 months following the measurement year.
(f) All claims to managed care plans for CCBHC services as provided under this section
shall be submitted directly to, and paid by, the commissioner on the dates specified no later
than January 1 of the following calendar year, if:
(1) one or more managed care plans does not comply with the federal requirement for
payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
section 447.45(b), and the managed care plan does not resolve the payment issue within 30
days of noncompliance; and
(2) the total amount of clean claims not paid in accordance with federal requirements
by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
eligible for payment by managed care plans.
If the conditions in this paragraph are met between January 1 and June 30 of a calendar
year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
the following year. If the conditions in this paragraph are met between July 1 and December
31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
on July 1 of the following year.
(g) Peer services provided by a CCBHC certified under section 245.735 are a covered
service under medical assistance when a licensed mental health professional or alcohol and
drug counselor determines that peer services are medically necessary. Eligibility under this
subdivision for peer services provided by a CCBHC supersede eligibility standards under
sections 256B.0615, 256B.0616, and 245G.07, subdivision deleted text begin 2deleted text end new text begin 2anew text end ,new text begin paragraph (b),new text end clause deleted text begin (8)deleted text end new text begin
(2)new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 31.
Minnesota Statutes 2024, section 256B.0757, subdivision 4c, is amended to read:
Subd. 4c.
Behavioral health home services staff qualifications.
(a) A behavioral health
home services provider must maintain staff with required professional qualifications
appropriate to the setting.
(b) If behavioral health home services are offered in a mental health setting, the
integration specialist must be a licensed nurse, as defined in section 148.171, subdivision
9.
(c) If behavioral health home services are offered in a primary care setting, the integration
specialist must be a mental health professional who is qualified according to section 245I.04,
subdivision 2.
(d) If behavioral health home services are offered in either a primary care setting or
mental health setting, the systems navigator must be a mental health practitioner who is
qualified according to section 245I.04, subdivision 4, or a community health worker as
defined in section 256B.0625, subdivision 49.
(e) If behavioral health home services are offered in either a primary care setting or
mental health setting, the qualified health home specialist must be one of the following:
(1) a mental health certified peer specialist who is qualified according to section 245I.04,
subdivision 10;
(2) a mental health certified family peer specialist who is qualified according to section
245I.04, subdivision 12;
(3) a case management associate as defined in section 245.462, subdivision 4, paragraph
(g), or 245.4871, subdivision 4, paragraph (j);
(4) a mental health rehabilitation worker who is qualified according to section 245I.04,
subdivision 14;
(5) a community paramedic as defined in section 144E.28, subdivision 9;
(6) a peer recovery specialist as defined in section deleted text begin 245G.07, subdivision 1, clause (5)deleted text end new text begin
245G.11, subdivision 8new text end ; or
(7) a community health worker as defined in section 256B.0625, subdivision 49.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 32.
Minnesota Statutes 2024, section 256B.0761, subdivision 4, is amended to read:
Subd. 4.
Services and duration.
(a) Services must be provided 90 days prior to an
individual's release date or, if an individual's confinement is less than 90 days, during the
time period between a medical assistance eligibility determination and the release to the
community.
(b) Facilities must offer the following services using either community-based or
corrections-based providers:
(1) case management activities to address physical and behavioral health needs, including
a comprehensive assessment of individual needs, development of a person-centered care
plan, referrals and other activities to address assessed needs, and monitoring and follow-up
activities;
(2) drug coverage in accordance with section 256B.0625, subdivision 13, including up
to a 30-day supply of drugs upon release;
(3) substance use disorder comprehensive assessments according to section 254B.05,
subdivision 5, paragraph (b), clause (2);
(4) treatment coordination services according to section 254B.05, subdivision 5, paragraph
(b), clause (3);
(5) peer recovery support services according to sections 245I.04, subdivisions 18 and
19, and 254B.05, subdivision 5, paragraph (b), clause (4);
(6) substance use disorder individual and group counseling provided according to sections
245G.07, subdivision 1, paragraph (a), clause (1), and 254B.05;
(7) mental health diagnostic assessments as required under section 245I.10;
(8) group and individual psychotherapy as required under section 256B.0671;
(9) peer specialist services as required under sections 245I.04 and 256B.0615;
(10) family planning and obstetrics and gynecology services; deleted text begin and
deleted text end
(11) physical health well-being and screenings and care for adults and youthnew text begin ; and
new text end
new text begin (12) medications and nonmedication treatment services for opioid use disorder under
section 245G.22new text end .
(c) Services outlined in this subdivision must only be authorized when an individual
demonstrates medical necessity or other eligibility as required under this chapter or applicable
state and federal laws.
Sec. 33.
Minnesota Statutes 2024, section 256B.761, is amended to read:
256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
(a) Effective for services rendered on or after July 1, 2001, payment for medication
management provided to psychiatric patients, outpatient mental health services, day treatment
services, home-based mental health services, and family community support services shall
be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of
1999 charges.
(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation services in the most recent
calendar year who are medical assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient rehabilitation facility and
provided to residents of nursing facilities owned by the entity.
(c) In addition to rate increases otherwise provided, the commissioner may restructure
coverage policy and rates to improve access to adult rehabilitative mental health services
under section 256B.0623 and related mental health support services under section 256B.021,
subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected
state share of increased costs due to this paragraph is transferred from adult mental health
grants under sections 245.4661 and 256K.10. The transfer for fiscal year 2016 is a permanent
base adjustment for subsequent fiscal years. Payments made to managed care plans and
county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect
the rate changes described in this paragraph.
(d) Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.
(e) Effective for services rendered on or after January 1, 2024, payment rates for
behavioral health services included in the rate analysis required by Laws 2021, First Special
Session chapter 7, article 17, section 18, except for adult day treatment services under section
256B.0671, subdivision 3; early intensive developmental and behavioral intervention services
under section 256B.0949; and substance use disorder services under chapter 254B, must be
increased by three percent from the rates in effect on December 31, 2023. Effective for
services rendered on or after January 1, 2025, payment rates for behavioral health services
included in the rate analysis required by Laws 2021, First Special Session chapter 7, article
17, section 18deleted text begin ;deleted text end new text begin , andnew text end early intensive developmental behavioral intervention services under
section 256B.0949deleted text begin ; and substance use disorder services under chapter 254B,deleted text end must be annually
adjusted according to the change from the midpoint of the previous rate year to the midpoint
of the rate year for which the rate is being determined using the Centers for Medicare and
Medicaid Services Medicare Economic Index as forecasted in the fourth quarter of the
calendar year before the rate year. For payments made in accordance with this paragraph,
if and to the extent that the commissioner identifies that the state has received federal
financial participation for behavioral health services in excess of the amount allowed under
United States Code, title 42, section 447.321, the state shall repay the excess amount to the
Centers for Medicare and Medicaid Services with state money and maintain the full payment
rate under this paragraph. This paragraph does not apply to federally qualified health centers,
rural health centers, Indian health services, certified community behavioral health clinics,
cost-based rates, and rates that are negotiated with the county. This paragraph expires upon
legislative implementation of the new rate methodology resulting from the rate analysis
required by Laws 2021, First Special Session chapter 7, article 17, section 18.
(f) Effective January 1, 2024, the commissioner shall increase capitation payments made
to managed care plans and county-based purchasing plans to reflect the behavioral health
service rate increase provided in paragraph (e). Managed care and county-based purchasing
plans must use the capitation rate increase provided under this paragraph to increase payment
rates to behavioral health services providers. The commissioner must monitor the effect of
this rate increase on enrollee access to behavioral health services. If for any contract year
federal approval is not received for this paragraph, the commissioner must adjust the
capitation rates paid to managed care plans and county-based purchasing plans for that
contract year to reflect the removal of this provision. Contracts between managed care plans
and county-based purchasing plans and providers to whom this paragraph applies must
allow recovery of payments from those providers if capitation rates are adjusted in accordance
with this paragraph. Payment recoveries must not exceed the amount equal to any increase
in rates that results from this provision.
Sec. 34. new text begin DIRECTION TO COMMISSIONER; SUBSTANCE USE DISORDER
TREATMENT STAFF REPORT AND RECOMMENDATIONS.
new text end
new text begin
The commissioner of human services must, in consultation with the Board of Nursing,
Board of Behavioral Health and Therapy, and Board of Medical Practice, conduct a study
and develop recommendations to the legislature for amendments to Minnesota Statutes,
chapter 245G, that would eliminate any limitations on licensed health professionals' ability
to provide substance use disorder treatment services while practicing within their licensed
or statutory scopes of practice. The commissioner must submit a report on the study and
recommendations to the chairs and ranking minority members of the legislative committees
with jurisdiction over human services finance and policy by January 15, 2027.
new text end
Sec. 35. new text begin DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER
TREATMENT BILLING UNITS.
new text end
new text begin
The commissioner of human services must establish six new billing codes for
nonresidential substance use disorder individual and group counseling, individual and group
psychoeducation, and individual and group recovery support services. The commissioner
must identify reimbursement rates for the newly defined codes and update the substance
use disorder fee schedule. The new billing codes must correspond to a 15-minute unit and
become effective for services provided on or after July 1, 2026, or upon federal approval,
whichever is later.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services must inform the revisor of statutes
when federal approval is obtained.
new text end
Sec. 36. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes, in consultation with the House Research Department; the Office
of Senate Counsel, Research and Fiscal Analysis; and the Department of Human Services
shall make necessary cross-reference changes and remove statutory cross-references in
Minnesota Statutes to conform with the renumbering in this act. The revisor may make
technical and other necessary changes to sentence structure to preserve the meaning of the
text. The revisor may alter the coding in this act to incorporate statutory changes made by
other law in the 2025 regular legislative session or a special session. If a provision stricken
in this act is also amended in the 2025 regular legislative session or a special session by
other law, the revisor shall merge the amendment into the numbering, notwithstanding
Minnesota Statutes, section 645.30.
new text end
Sec. 37. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber each provision of Minnesota Statutes listed in
column A as amended in this act to the number listed in column B. The revisor shall also
make necessary cross-reference changes consistent with the renumbering.
new text end
|
new text begin
Column A new text end |
new text begin
Column B new text end |
|
new text begin
254B.05, subdivision 1, paragraph (a) new text end |
new text begin
254B.0501, subdivision 1 new text end |
|
new text begin
254B.05, subdivision 1, paragraph (i) new text end |
new text begin
254B.0501, subdivision 2 new text end |
|
new text begin
254B.05, subdivision 4 new text end |
new text begin
254B.0501, subdivision 3 new text end |
|
new text begin
254B.05, subdivision 1, paragraph (b) new text end |
new text begin
254B.0501, subdivision 4 new text end |
|
new text begin
254B.05, subdivision 1, paragraph (c) new text end |
new text begin
254B.0501, subdivision 5 new text end |
|
new text begin
254B.05, subdivision 1, paragraph (d) new text end |
new text begin
254B.0501, subdivision 6, paragraph (a) new text end |
|
new text begin
254B.05, subdivision 1, paragraph (e) new text end |
new text begin
254B.0501, subdivision 6, paragraph (b) new text end |
|
new text begin
254B.05, subdivision 1, paragraph (f) new text end |
new text begin
254B.0501, subdivision 6, paragraph (c) new text end |
|
new text begin
254B.05, subdivision 1, paragraph (g) new text end |
new text begin
254B.0501, subdivision 6, paragraph (d) new text end |
|
new text begin
254B.05, subdivision 1, paragraph (h) new text end |
new text begin
254B.0501, subdivision 7 new text end |
|
new text begin
254B.05, subdivision 1b new text end |
new text begin
254B.0501, subdivision 8 new text end |
|
new text begin
254B.05, subdivision 2 new text end |
new text begin
254B.0501, subdivision 9 new text end |
|
new text begin
254B.05, subdivision 3 new text end |
new text begin
254B.0501, subdivision 10 new text end |
|
new text begin
254B.05, subdivision 1a, paragraph (a) new text end |
new text begin
254B.0503, subdivision 1, paragraph (a) new text end |
|
new text begin
254B.05, subdivision 1a, paragraph (c) new text end |
new text begin
254B.0503, subdivision 1, paragraph (b) new text end |
|
new text begin
254B.05, subdivision 1a, paragraph (d) new text end |
new text begin
254B.0503, subdivision 1, paragraph (c) new text end |
|
new text begin
254B.05, subdivision 1a, paragraph (e) new text end |
new text begin
254B.0503, subdivision 1, paragraph (d) new text end |
|
new text begin
254B.05, subdivision1a, paragraph (b) new text end |
new text begin
254B.0503, subdivision 2, paragraph (a) new text end |
|
new text begin
254B.05, subdivision 1a, paragraph (e) new text end |
new text begin
254B.0503, subdivision 2, paragraph (b) new text end |
|
new text begin
254B.05, subdivision 5, paragraph (a) new text end |
new text begin
254B.0505, subdivision 1 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (c) new text end |
new text begin
254B.0505, subdivision 2 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (d) new text end |
new text begin
254B.0505, subdivision 3 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (e) new text end |
new text begin
254B.0505, subdivision 4 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (f) new text end |
new text begin
254B.0505, subdivision 5 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (g) new text end |
new text begin
254B.0505, subdivision 6 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (h) new text end |
new text begin
254B.0505, subdivision 7 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (i) new text end |
new text begin
254B.0505, subdivision 8 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), first sentence new text end |
new text begin
254B.0507, subdivision 1 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), clause (1), items (i) and (ii) new text end |
new text begin
254B.0507, subdivision 2, paragraph (a) new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), block left paragraph new text end |
new text begin
254B.0507, subdivision 2, paragraph (b) new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), clause (2) new text end |
new text begin
254B.0507, subdivision 3 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), clause (3) new text end |
new text begin
254B.0507, subdivision 4 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), clause (4) new text end |
new text begin
254B.0507, subdivision 5 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), clause (5) new text end |
new text begin
254B.0507, subdivision 6, paragraph (a) new text end |
|
new text begin
254B.05, subdivision 5, paragraph (b), clause (5), block left paragraph new text end |
new text begin
254B.0507, subdivision 6, paragraph (b) new text end |
|
new text begin
254B.05, subdivision 6, paragraph (a) new text end |
new text begin
254B.0509, subdivision 1 new text end |
|
new text begin
254B.05, subdivision 6, paragraph (b) new text end |
new text begin
254B.0509, subdivision 2 new text end |
|
new text begin
254B.05, subdivision 1, paragraph (j) new text end |
new text begin
254B.052, subdivision 4 new text end |
|
new text begin
254B.05, subdivision 5, paragraph (j) new text end |
new text begin
254B.052, subdivision 5 new text end |
Sec. 38. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall change the terms "mental health practitioner" and "mental
health practitioners" to "behavioral health practitioner" or "behavioral health practitioners"
wherever they appear in Minnesota Statutes, chapter 245I.
new text end
Sec. 39. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, sections 245G.01, subdivision 20d; 245G.07, subdivision 2;
254B.01, subdivision 5; and 254B.18,
new text end
new text begin
are repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
ARTICLE 5
HOUSING SUPPORTS
Section 1.
Minnesota Statutes 2024, section 256I.05, is amended by adding a subdivision
to read:
new text begin Subd. 1v. new text end
new text begin Supplemental rate; Blue Earth County. new text end
new text begin
Notwithstanding the provisions of
subdivisions 1a and 1c, beginning July 1, 2025, a county agency shall negotiate a
supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per
month, including any legislatively authorized inflationary adjustments, for a housing support
provider located in Blue Earth County that operates a long-term residential facility that
opened in 2007 in Garden City with a total of 20 beds that serves chemically dependent
women and provides 24-hour-a-day supervision and other support services.
new text end
Sec. 2.
Minnesota Statutes 2024, section 256I.05, is amended by adding a subdivision to
read:
new text begin Subd. 1w. new text end
new text begin Supplemental rate; Otter Tail County. new text end
new text begin
Notwithstanding the provisions in
this section, beginning July 1, 2025, a county agency shall negotiate a supplemental rate
for up to 24 beds in addition to the rate specified in subdivision 1, not to exceed the maximum
rate allowed under subdivision 1a, including any legislatively authorized inflationary
adjustments, for housing support providers located in Otter Tail County that operate facilities
and provide room and board and supplementary services to adults recovering from substance
use disorder, mental illness, or housing instability.
new text end
ARTICLE 6
HEALTH CARE
Section 1.
Minnesota Statutes 2024, section 256.01, subdivision 29, is amended to read:
Subd. 29.
State medical review team.
(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the
commissioner shall review all medical evidence and seek information from providers,
applicants, and enrollees to support the determination of disability where necessary. Disability
shall be determined according to the rules of title XVI and title XIX of the Social Security
Act and pertinent rules and policies of the Social Security Administration.
new text begin
(b) Medical assistance providers must grant the state medical review team access to
electronic health records held by the medical assistance providers, when available, to support
efficient and accurate disability determinations.
new text end
new text begin
(c) Medicaid providers shall accept electronically signed authorizations to release medical
records provided by the state medical review team.
new text end
deleted text begin (b)deleted text end new text begin (d)new text end Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.
deleted text begin (c)deleted text end new text begin (e)new text end Any appeal made under section 256.045, subdivision 3, of a disability
determination made by the state medical review team must be decided according to the
timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is not
issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal
must be immediately reviewed by the chief human services judge.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 2.
Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision to
read:
new text begin Subd. 29a. new text end
new text begin State medical review team; expedited disability determinations. new text end
new text begin
(a) The
commissioner must establish an expedited disability determination process within the state
medical review team for applicants in the following high-risk categories:
new text end
new text begin
(1) individuals in a facility who cannot be discharged without home- and
community-based services or long-term care supports in place;
new text end
new text begin
(2) individuals experiencing life-threatening medical conditions requiring urgent access
to treatment or prescription medication;
new text end
new text begin
(3) individuals diagnosed with a condition listed on the Social Security Administration's
Compassionate Allowance List; and
new text end
new text begin
(4) children under the age of two who have screened positive for a rare disease recognized
by national medical registries or evidence-based standards.
new text end
new text begin
(b) Hospitals submitting requests under paragraph (a) must complete an application for
medical assistance prior to an expedited request and assist patients with returning required
documentation necessary to determine disability.
new text end
new text begin
(c) The commissioner must designate staff within the state medical review team to
coordinate expedited requests, communicate with county and tribal agencies, and ensure
timely electronic transmission of required documentation, including the use of electronic
signature platforms.
new text end
Sec. 3.
Minnesota Statutes 2024, section 256B.0625, subdivision 17, is amended to read:
Subd. 17.
Transportation costs.
(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
(b) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.
(c) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:
(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;
(2) ambulances, as defined in section 144E.001, subdivision 2;
(3) taxicabs that meet the requirements of this subdivision;
(4) public transportation, within the meaning of "public transportation" as defined in
section 174.22, subdivision 7; or
(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (p).
(d) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.
(e) An organization may be terminated, denied, or suspended from enrollment if:
(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and
(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.
(f) The administrative agency of nonemergency medical transportation must:
(1) adhere to the policies defined by the commissioner;
(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;
(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and
(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.
(g) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (l), clauses (4), (5), (6), and (7).
(h) The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.
(i) Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.
(j) Nonemergency medical transportation providers may not bill for separate base rates
for the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.
(k) The administrative agency shall use the level of service process established by the
commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.
(l) The covered modes of transportation are:
(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;
(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;
(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;
(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;
(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;
(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and
(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.
(m) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (l) according to paragraphs (p) and (q) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.
(n) The commissioner shall:
(1) verify that the mode and use of nonemergency medical transportation is appropriate;
(2) verify that the client is going to an approved medical appointment; and
(3) investigate all complaints and appeals.
(o) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
(p) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (k), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:
(1) $0.22 per mile for client reimbursement;
(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;
(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and $12.10 for the base rate and $1.43 per mile when provided by a nonemergency
medical transportation provider;
(4) $14.30 for the base rate and $1.43 per mile for assisted transport;
(5) $19.80 for the base rate and $1.70 per mile for lift-equipped/ramp transport;
(6) $75 for the base rate new text begin for the first 100 miles and an additional $75 for trips over 100
miles new text end and $2.40 per mile for protected transport; and
(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.
(q) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (p), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:
(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (p), clauses (1) to (7); and
(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (p), clauses (1) to (7).
(r) For purposes of reimbursement rates for nonemergency medical transportation services
under paragraphs (p) and (q), the zip code of the recipient's place of residence shall determine
whether the urban, rural, or super rural reimbursement rate applies.
(s) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (p) and (q), shall exempt all modes of transportation listed
under paragraph (l) from Minnesota Rules, part 9505.0445, item R, subitem (2).
(t) Effective for the first day of each calendar quarter in which the price of gasoline as
posted publicly by the United States Energy Information Administration exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraph (p) by one percent
up or down for every increase or decrease of ten cents for the price of gasoline. The increase
or decrease must be calculated using a base gasoline price of $3.00. The percentage increase
or decrease must be calculated using the average of the most recently available price of all
grades of gasoline for Minnesota as posted publicly by the United States Energy Information
Administration.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 4.
Minnesota Statutes 2024, section 256B.766, is amended to read:
256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
new text begin Subdivision 1. new text end
new text begin Payment reductions for base care services effective July 1, 2009. new text end
deleted text begin (a)deleted text end
Effective for services provided on or after July 1, 2009, total payments for basic care services,
shall be reduced by three percent, except that for the period July 1, 2009, through June 30,
2011, total payments shall be reduced by 4.5 percent for the medical assistance and general
assistance medical care programs, prior to third-party liability and spenddown calculation.
new text begin Subd. 2. new text end
new text begin Classification of therapies as basic care services. new text end
deleted text begin Effective July 1, 2010,deleted text end The
commissioner shall classify physical therapy services, occupational therapy services, and
speech-language pathology and related services as basic care services. The reduction in deleted text begin this
paragraphdeleted text end new text begin subdivision 1new text end shall apply to physical therapy services, occupational therapy
services, and speech-language pathology and related services provided on or after July 1,
2010.
new text begin Subd. 3. new text end
new text begin Payment reductions to managed care plans effective October 1, 2009. new text end
deleted text begin (b)deleted text end
Payments made to managed care plans and county-based purchasing plans shall be reduced
for services provided on or after October 1, 2009, to reflect the reduction new text begin in subdivision 1
new text end effective July 1, 2009, and payments made to the plans shall be reduced effective October
1, 2010, to reflect the reduction new text begin in subdivision 1 new text end effective July 1, 2010.
new text begin Subd. 4. new text end
new text begin Temporary payment reductions effective September 1, 2011. new text end
deleted text begin (c)deleted text end new text begin (a)new text end Effective
for services provided on or after September 1, 2011, through June 30, 2013, total payments
for outpatient hospital facility fees shall be reduced by five percent from the rates in effect
on August 31, 2011.
deleted text begin (d)deleted text end new text begin (b)new text end Effective for services provided on or after September 1, 2011, through June 30,
2013, total payments for ambulatory surgery centers facility fees, medical supplies and
durable medical equipment not subject to a volume purchase contract, prosthetics and
orthotics, renal dialysis services, laboratory services, public health nursing services, physical
therapy services, occupational therapy services, speech therapy services, eyeglasses not
subject to a volume purchase contract, hearing aids not subject to a volume purchase contract,
and anesthesia services shall be reduced by three percent from the rates in effect on August
31, 2011.
new text begin Subd. 5. new text end
new text begin Payment increases effective September 1, 2014. new text end
deleted text begin (e)deleted text end new text begin (a)new text end Effective for services
provided on or after September 1, 2014, payments for ambulatory surgery centers facility
fees, hospice services, renal dialysis services, laboratory services, public health nursing
services, eyeglasses not subject to a volume purchase contract, and hearing aids not subject
to a volume purchase contract shall be increased by three percent and payments for outpatient
hospital facility fees shall be increased by three percent.
new text begin (b) new text end Payments made to managed care plans and county-based purchasing plans shall not
be adjusted to reflect payments under this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end .
new text begin Subd. 6. new text end
new text begin Temporary payment reductions effective July 1, 2014. new text end
deleted text begin (f)deleted text end Payments for
medical supplies and durable medical equipment not subject to a volume purchase contract,
and prosthetics and orthotics, provided on or after July 1, 2014, through June 30, 2015, shall
be decreased by .33 percent.
new text begin Subd. 7. new text end
new text begin Payment increases effective July 1, 2015. new text end
new text begin (a) new text end Payments for medical supplies
and durable medical equipment not subject to a volume purchase contract, and prosthetics
and orthotics, provided on or after July 1, 2015, shall be increased by three percent from
the rates as determined under deleted text begin paragraphs (i) and (j)deleted text end new text begin subdivisions 9 and 10new text end .
deleted text begin (g)deleted text end new text begin (b)new text end Effective for services provided on or after July 1, 2015, payments for outpatient
hospital facility fees, medical supplies and durable medical equipment not subject to a
volume purchase contract, prosthetics, and orthotics to a hospital meeting the criteria specified
in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent
from the rates in effect on June 30, 2015.
new text begin (c) new text end Payments made to managed care plans and county-based purchasing plans shall not
be adjusted to reflect payments under deleted text begin thisdeleted text end paragraphnew text begin (b)new text end .
new text begin Subd. 8. new text end
new text begin Exempt services. new text end
deleted text begin (h)deleted text end This section does not apply to physician and professional
services, inpatient hospital services, family planning services, mental health services, dental
services, prescription drugs, medical transportation, federally qualified health centers, rural
health centers, Indian health services, and Medicare cost-sharing.
new text begin Subd. 9. new text end
new text begin Individually priced items. new text end
deleted text begin (i)deleted text end new text begin (a)new text end Effective for services provided on or after
July 1, 2015, the following categories of medical supplies and durable medical equipment
shall be individually priced items: customized and other specialized tracheostomy tubes
and supplies, electric patient lifts, and durable medical equipment repair and service.
new text begin (b) new text end This deleted text begin paragraphdeleted text end new text begin subdivisionnew text end does not apply to medical supplies and durable medical
equipment subject to a volume purchase contract, products subject to the preferred diabetic
testing supply program, and items provided to dually eligible recipients when Medicare is
the primary payer for the item.
new text begin (c) new text end The commissioner shall not apply any medical assistance rate reductions to durable
medical equipment as a result of Medicare competitive bidding.
new text begin Subd. 10. new text end
new text begin Rate increases effective July 1, 2015. new text end
deleted text begin (j)deleted text end new text begin (a)new text end Effective for services provided
on or after July 1, 2015, medical assistance payment rates for durable medical equipment,
prosthetics, orthotics, or supplies shall be increased as follows:
(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that
were subject to the Medicare competitive bid that took effect in January of 2009 shall be
increased by 9.5 percent; and
(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on
the medical assistance fee schedule, whether or not subject to the Medicare competitive bid
that took effect in January of 2009, shall be increased by 2.94 percent, with this increase
being applied after calculation of any increased payment rate under clause (1).
deleted text begin Thisdeleted text end new text begin (b)new text end Paragraph new text begin (a) new text end does not apply to medical supplies and durable medical equipment
subject to a volume purchase contract, products subject to the preferred diabetic testing
supply program, items provided to dually eligible recipients when Medicare is the primary
payer for the item, and individually priced items identified in deleted text begin paragraph (i)deleted text end new text begin subdivision 9new text end .
new text begin (c) new text end Payments made to managed care plans and county-based purchasing plans shall not
be adjusted to reflect the rate increases in this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end .
new text begin Subd. 11. new text end
new text begin Rates for ventilators. new text end
deleted text begin (k)deleted text end new text begin (a)new text end Effective for nonpressure support ventilators
provided on or after January 1, 2016, the rate shall be the lower of the submitted charge or
the Medicare fee schedule rate.
new text begin (b) new text end Effective for pressure support ventilators provided on or after January 1, 2016, the
rate shall be the lower of the submitted charge or 47 percent above the Medicare fee schedule
rate.
new text begin (c) new text end For payments made in accordance with this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end , if, and to the
extent that, the commissioner identifies that the state has received federal financial
participation for ventilators in excess of the amount allowed effective January 1, 2018,
under United States Code, title 42, section 1396b(i)(27), the state shall repay the excess
amount to the Centers for Medicare and Medicaid Services with state funds and maintain
the full payment rate under this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end .
new text begin Subd. 12. new text end
new text begin Rates subject to the upper payment limit. new text end
deleted text begin (l)deleted text end Payment rates for durable
medical equipment, prosthetics, orthotics or supplies, that are subject to the upper payment
limit in accordance with section 1903(i)(27) of the Social Security Act, shall be paid the
Medicare rate. Rate increases provided in this chapter shall not be applied to the items listed
in this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end .
new text begin Subd. 13. new text end
new text begin Temporary rates for enteral nutrition and supplies. new text end
deleted text begin (m)deleted text end new text begin (a)new text end For dates of
service on or after July 1, 2023, through June 30, deleted text begin 2025deleted text end new text begin 2027new text end , enteral nutrition and supplies
must be paid according to this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end . If sufficient data exists for a product
or supply, payment must be based upon the 50th percentile of the usual and customary
charges per product code submitted to the commissioner, using only charges submitted per
unit. Increases in rates resulting from the 50th percentile payment method must not exceed
150 percent of the previous fiscal year's rate per code and product combination. Data are
sufficient if: (1) the commissioner has at least 100 paid claim lines by at least ten different
providers for a given product or supply; or (2) in the absence of the data in clause (1), the
commissioner has at least 20 claim lines by at least five different providers for a product or
supply that does not meet the requirements of clause (1). If sufficient data are not available
to calculate the 50th percentile for enteral products or supplies, the payment rate must be
the payment rate in effect on June 30, 2023.
new text begin
(b) This subdivision expires June 30, 2027.
new text end
new text begin Subd. 14. new text end
new text begin Rates for enteral nutrition and supplies. new text end
deleted text begin (n)deleted text end For dates of service on or after
July 1, deleted text begin 2025deleted text end new text begin 2027new text end , enteral nutrition and supplies must be paid according to this deleted text begin paragraphdeleted text end new text begin
subdivisionnew text end and updated annually each January 1. If sufficient data exists for a product or
supply, payment must be based upon the 50th percentile of the usual and customary charges
per product code submitted to the commissioner for the previous calendar year, using only
charges submitted per unit. Increases in rates resulting from the 50th percentile payment
method must not exceed 150 percent of the previous year's rate per code and product
combination. Data are sufficient if: (1) the commissioner has at least 100 paid claim lines
by at least ten different providers for a given product or supply; or (2) in the absence of the
data in clause (1), the commissioner has at least 20 claim lines by at least five different
providers for a product or supply that does not meet the requirements of clause (1). If
sufficient data are not available to calculate the 50th percentile for enteral products or
supplies, the payment must be the manufacturer's suggested retail price of that product or
supply minus 20 percent. If the manufacturer's suggested retail price is not available, payment
must be the actual acquisition cost of that product or supply plus 20 percent.
Sec. 5. new text begin SINGLE ADMINISTRATIVE STRUCTURE AND DELIVERY SYSTEM
PILOT PROGRAM.
new text end
new text begin
(a) By January 1, 2026, the commissioner of human services, in coordination with the
commissioner of transportation, must implement one or two pilot programs for a web-based
single administrative structure and delivery system for nonemergency medical transportation
under medical assistance and MinnesotaCare. The administrative structure and delivery
system must meet the requirements in paragraph (b). Each pilot program must include at
least two counties. Metropolitan counties, as defined in Minnesota Statutes, section 473.121,
subdivision 4, are not eligible to participate. Each pilot program shall operate for three years
from the date of implementation.
new text end
new text begin
(b) The web-based single administrative structure and delivery system must provide for
the following:
new text end
new text begin
(1) bidirectional communication between payers and transportation providers;
new text end
new text begin
(2) client and client advocate access to ride scheduling and real-time trip monitoring;
new text end
new text begin
(3) real-time eligibility and level of service determination;
new text end
new text begin
(4) on-demand reporting;
new text end
new text begin
(5) expedited payments for transportation providers; and
new text end
new text begin
(6) the ability to collect feedback, including but not limited to complaints regarding
inappropriate level of needs determinations, utilization of inappropriate transportation modes,
and interference with accessing nonemergency medical transportation.
new text end
new text begin
(c) By February 1, 2027, and each year thereafter that a pilot program is in effect, the
commissioner must submit a report on the pilot programs to the chairs and ranking minority
members of the legislative committees with jurisdiction over nonemergency medical
transportation under medical assistance and MinnesotaCare.
new text end
ARTICLE 7
DIRECT CARE AND TREATMENT
Section 1.
new text begin
[246.0142] FREE COMMUNICATION SERVICES FOR PATIENTS AND
CLIENTS.
new text end
new text begin Subdivision 1. new text end
new text begin Free communication services. new text end
new text begin
The commissioner of human services
and the Direct Care and Treatment executive board and all facilities, settings, and programs
owned, operated, or under the programmatic or fiscal control of the commissioner of human
services or the Direct Care and Treatment executive board are subject to section 241.252.
The commissioner and executive board must not include the cost of voice or other
communication services in the cost of care as defined under section 246.50 or 246B.01.
new text end
new text begin Subd. 2. new text end
new text begin Communication service restrictions. new text end
new text begin
Notwithstanding section 241.252,
subdivisions 2 and 4, nothing in this section entitles a civilly committed person to
communication services restricted or limited under section 253B.03, subdivision 3, or
253D.19.
new text end
Sec. 2.
Minnesota Statutes 2024, section 611.43, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Costs related to confined treatment. new text end
new text begin
(a) When a defendant is ordered to
participate in an examination in a treatment facility, a locked treatment facility, or a
state-operated treatment facility under subdivision 1, paragraph (b), the facility shall bill
the responsible health plan.
new text end
new text begin
(b) The Direct Care and Treatment executive board shall determine the cost of
confinement in a state-operated treatment facility based on the executive board's
determination of cost of care pursuant to section 246.50, subdivision 5.
new text end
Sec. 3.
Minnesota Statutes 2024, section 611.46, subdivision 1, is amended to read:
Subdivision 1.
Order to competency attainment program.
(a) If the court finds the
defendant incompetent and the charges have not been dismissed, the court shall order the
defendant to participate in a program to assist the defendant in attaining competency. The
court may order participation in a competency attainment program provided outside of a
jail, a jail-based competency attainment program, or an alternative program. The court must
determine the least-restrictive program appropriate to meet the defendant's needs and public
safety. In making this determination, the court must consult with the forensic navigator and
consider any recommendations of the court examiner. The court shall not order a defendant
to participate in a jail-based program or a state-operated treatment program if the highest
criminal charge is a targeted misdemeanor.
(b) If the court orders the defendant to a locked treatment facility or jail-based program,
the court must calculate the defendant's custody credit and cannot order the defendant to a
locked treatment facility or jail-based program for a period that would cause the defendant's
custody credit to exceed the maximum sentence for the underlying charge.
(c) The court may only order the defendant to participate in competency attainment at
an inpatient or residential treatment program under this section if the head of the treatment
program determines that admission to the program is clinically appropriate and consents to
the defendant's admission. The court may only order the defendant to participate in
competency attainment at a state-operated treatment facility under this section if the Direct
Care and Treatment executive board or a designee determines that admission of the defendant
is clinically appropriate and consents to the defendant's admission. The court may require
a competency program that qualifies as a locked facility or a state-operated treatment program
to notify the court in writing of the basis for refusing consent for admission of the defendant
in order to ensure transparency and maintain an accurate record. The court may not require
personal appearance of any representative of a competency program. The court shall send
a written request for notification to the locked facility or state-operated treatment program
and the locked facility or state-operated treatment program shall provide a written response
to the court within ten days of receipt of the court's request.
(d) If the defendant is confined in jail and has not received competency attainment
services within 30 days of the finding of incompetency, the court shall review the case with
input from the prosecutor and defense counsel and may:
(1) order the defendant to participate in an appropriate competency attainment program
that takes place outside of a jail;
(2) order a conditional release of the defendant with conditions that include but are not
limited to a requirement that the defendant participate in a competency attainment program
when one becomes available and accessible;
(3) make a determination as to whether the defendant is likely to attain competency in
the reasonably foreseeable future and proceed under section 611.49; or
(4) upon a motion, dismiss the charges in the interest of justice.
(e) The court may order any hospital, treatment facility, or correctional facility that has
provided care or supervision to a defendant in the previous two years to provide copies of
the defendant's medical records to the competency attainment program or alternative program
in which the defendant was ordered to participate. This information shall be provided in a
consistent and timely manner and pursuant to all applicable laws.
(f) If at any time the defendant refuses to participate in a competency attainment program
or an alternative program, the head of the program shall notify the court and any entity
responsible for supervision of the defendant.
(g) At any time, the head of the program may discharge the defendant from the program
or facility. The head of the program must notify the court, prosecutor, defense counsel, and
any entity responsible for the supervision of the defendant prior to any planned discharge.
Absent emergency circumstances, this notification shall be made five days prior to the
discharge if the defendant is not being discharged to jail or a correctional facility. Upon the
receipt of notification of discharge or upon the request of either party in response to
notification of discharge, the court may order that a defendant who is subject to bail or
unmet conditions of release be returned to jail upon being discharged from the program or
facility. If the court orders a defendant returned to jail, the court shall notify the parties and
head of the program at least one day before the defendant's planned discharge, except in
the event of an emergency discharge where one day notice is not possible. The court must
hold a review hearing within seven days of the defendant's return to jail. The forensic
navigator must be given notice of the hearing and be allowed to participate.
(h) If the defendant is discharged from the program or facility under emergency
circumstances, notification of emergency discharge shall include a description of the
emergency circumstances and may include a request for emergency transportation. The
court shall make a determination on a request for emergency transportation within 24 hours.
Nothing in this section prohibits a law enforcement agency from transporting a defendant
pursuant to any other authority.
new text begin
(i) If the defendant is ordered to participate in an inpatient or residential competency
attainment or alternative program, the program or facility must notify the court, prosecutor,
defense counsel, forensic navigator, and any entity responsible for the supervision of the
defendant if the defendant is placed on a leave or elopement status from the program and
if the defendant returns to the program from a leave or elopement status.
new text end
new text begin
(j) Defense counsel, prosecutors, and forensic navigators must have access to information
relevant to a defendant's participation and treatment in a competency attainment program
or alternative program, including but not limited to discharge planning.
new text end
Sec. 4.
Minnesota Statutes 2024, section 611.55, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Data access. new text end
new text begin
Forensic navigators must have access to all data collected, created,
or maintained by a competency attainment program or an alternative program regarding a
defendant in order for navigators to carry out their duties under this section. A competency
attainment program or alternative program may request a copy of the court order appointing
the forensic navigator before disclosing any private information about a defendant.
new text end
ARTICLE 8
DEPARTMENT OF DIRECT CARE AND TREATMENT ESTABLISHMENT
Section 1.
Minnesota Statutes 2024, section 10.65, subdivision 2, is amended to read:
Subd. 2.
Definitions.
As used in this section, the following terms have the meanings
given:
(1) "agency" means the Department of Administration; Department of Agriculture;
Department of Children, Youth, and Families; Department of Commerce; Department of
Corrections; new text begin Department of Direct Care and Treatment; new text end Department of Education; Department
of Employment and Economic Development; Department of Health; Office of Higher
Education; Housing Finance Agency; Department of Human Rights; Department of Human
Services; Department of Information Technology Services; Department of Iron Range
Resources and Rehabilitation; Department of Labor and Industry; Minnesota Management
and Budget; Bureau of Mediation Services; Department of Military Affairs; Metropolitan
Council; Department of Natural Resources; Pollution Control Agency; Department of Public
Safety; Department of Revenue; Department of Transportation; Department of Veterans
Affairs; deleted text begin Direct Care and Treatment;deleted text end Gambling Control Board; Racing Commission; the
Minnesota Lottery; the Animal Health Board; the Public Utilities Commission; and the
Board of Water and Soil Resources;
(2) "consultation" means the direct and interactive involvement of the Minnesota Tribal
governments in the development of policy on matters that have Tribal implications.
Consultation is the proactive, affirmative process of identifying and seeking input from
appropriate Tribal governments and considering their interest as a necessary and integral
part of the decision-making process. This definition adds to statutorily mandated notification
procedures. During a consultation, the burden is on the agency to show that it has made a
good faith effort to elicit feedback. Consultation is a formal engagement between agency
officials and the governing body or bodies of an individual Minnesota Tribal government
that the agency or an individual Tribal government may initiate. Formal meetings or
communication between top agency officials and the governing body of a Minnesota Tribal
government is a necessary element of consultation;
(3) "matters that have Tribal implications" means rules, legislative proposals, policy
statements, or other actions that have substantial direct effects on one or more Minnesota
Tribal governments, or on the distribution of power and responsibilities between the state
and Minnesota Tribal governments;
(4) "Minnesota Tribal governments" means the federally recognized Indian Tribes located
in Minnesota including: Bois Forte Band; Fond Du Lac Band; Grand Portage Band; Leech
Lake Band; Mille Lacs Band; White Earth Band; Red Lake Nation; Lower Sioux Indian
Community; Prairie Island Indian Community; Shakopee Mdewakanton Sioux Community;
and Upper Sioux Community; and
(5) "timely and meaningful" means done or occurring at a favorable or useful time that
allows the result of consultation to be included in the agency's decision-making process for
a matter that has Tribal implications.
Sec. 2.
Minnesota Statutes 2024, section 15.01, is amended to read:
15.01 DEPARTMENTS OF THE STATE.
The following agencies are designated as the departments of the state government: the
Department of Administration; the Department of Agriculture; the Department of Children,
Youth, and Families; the Department of Commerce; the Department of Corrections; new text begin the
Department of Direct Care and Treatment; new text end the Department of Education; the Department
of Employment and Economic Development; the Department of Health; the Department of
Human Rights; the Department of Human Services; the Department of Information
Technology Services; the Department of Iron Range Resources and Rehabilitation; the
Department of Labor and Industry; the Department of Management and Budget; the
Department of Military Affairs; the Department of Natural Resources; the Department of
Public Safety; the Department of Revenue; the Department of Transportation; the Department
of Veterans Affairs; and their successor departments.
Sec. 3.
Minnesota Statutes 2024, section 15.06, subdivision 1, is amended to read:
Subdivision 1.
Applicability.
This section applies to the following departments or
agencies: the Departments of Administration; Agriculture; Children, Youth, and Families;
Commerce; Corrections; new text begin Direct Care and Treatment; new text end Education; Employment and Economic
Development; Health; Human Rights; Human Services; Iron Range Resources and
Rehabilitation; Labor and Industry; Management and Budget; Natural Resources; Public
Safety; Revenue; Transportation; and Veterans Affairs; the Housing Finance and Pollution
Control Agencies; the Department of Information Technology Services; the Bureau of
Mediation Services; and their successor departments and agencies. The heads of the foregoing
departments or agencies are "commissioners."
Sec. 4.
Minnesota Statutes 2024, section 43A.241, is amended to read:
43A.241 INSURANCE CONTRIBUTIONS; FORMER EMPLOYEES.
(a) This section applies to a person who:
(1) was employed by the commissioner of corrections, the commissioner of human
services, or the new text begin commissioner of new text end direct care and treatment deleted text begin executive boarddeleted text end ;
(2) was covered by the correctional employee retirement plan under section 352.91 or
the general state employees retirement plan of the Minnesota State Retirement System as
defined in section 352.021;
(3) while employed under clause (1), was assaulted by:
(i) a person under correctional supervision for a criminal offense; or
(ii) a client or patient at the Minnesota Sex Offender Program, or at a state-operated
forensic services program as defined in section 352.91, subdivision 3j; and
(4) as a direct result of the assault under clause (3), was determined to be totally and
permanently physically disabled under laws governing the Minnesota State Retirement
System.
(b) For a person to whom this section applies, the commissioner of corrections, the
commissioner of human services, or the new text begin commissioner of new text end direct care and treatment deleted text begin executive
boarddeleted text end , using existing budget resources, must continue to make the employer contribution
for medical and dental benefits under the State Employee Group Insurance Program after
the person terminates state service. If the person had dependent coverage at the time of
terminating state service, employer contributions for dependent coverage also must continue
under this section. The employer contributions must be in the amount of the employer
contribution for active state employees at the time each payment is made. The employer
contributions must continue until the person reaches age 65, provided the person makes the
required employee contributions, in the amount required of an active state employee, at the
time and in the manner specified by the commissioner deleted text begin or executive boarddeleted text end .
Sec. 5.
Minnesota Statutes 2024, section 246C.01, is amended to read:
246C.01 TITLE.
This chapter may be cited as the "new text begin Department of new text end Direct Care and Treatment Act."
Sec. 6.
Minnesota Statutes 2024, section 246C.015, subdivision 3, is amended to read:
Subd. 3.
Commissioner.
"Commissioner" means the commissioner of deleted text begin human servicesdeleted text end new text begin
direct care and treatmentnew text end .
Sec. 7.
Minnesota Statutes 2024, section 246C.015, is amended by adding a subdivision
to read:
new text begin Subd. 5b. new text end
new text begin Department. new text end
new text begin
"Department" means the Department of Direct Care and
Treatment.
new text end
Sec. 8.
Minnesota Statutes 2024, section 246C.02, subdivision 1, is amended to read:
Subdivision 1.
Establishment.
new text begin The Department ofnew text end Direct Care and Treatment is deleted text begin created
as an agency headed by an executive boarddeleted text end new text begin establishednew text end .
Sec. 9.
Minnesota Statutes 2024, section 246C.04, subdivision 2, is amended to read:
Subd. 2.
Transfer of custody of civilly committed persons.
The commissioner of
human services shall continue to exercise all authority and responsibility for and retain
custody of persons subject to civil commitment under chapter 253B or 253D until July 1,
2025. Effective July 1, 2025, custody of persons subject to civil commitment under chapter
253B or 253D and in the custody of the commissioner of human services as of that date is
hereby transferred to the deleted text begin executive boarddeleted text end new text begin commissionernew text end without any further act or proceeding.
Authority and responsibility for the commitment of such persons is transferred to the
deleted text begin executive boarddeleted text end new text begin commissionernew text end July 1, 2025.
Sec. 10.
Minnesota Statutes 2024, section 246C.04, subdivision 3, is amended to read:
Subd. 3.
Control of direct care and treatment.
The commissioner of human services
shall continue to exercise all authorities and responsibilities under this chapter and chapters
13, 245, 246, 246B, 252, 253, 253B, 253C, 253D, 254A, 254B, and 256, with reference to
any state-operated service, program, or facility subject to transfer under Laws 2024, chapter
79; Laws 2024, chapter 125, article 5; and Laws 2024, chapter 127, article 50, until July 1,
2025. Effective July 1, 2025, the powers and duties vested in or imposed upon the
commissioner of human services with reference to any state-operated service, program, or
facility are hereby transferred to, vested in, and imposed upon the deleted text begin executive boarddeleted text end new text begin
commissionernew text end according to this chapter and applicable state law. Effective July 1, 2025, the
deleted text begin executive boarddeleted text end new text begin commissionernew text end has the exclusive power of administration and management
of all state hospitals for persons with a developmental disability, mental illness, or substance
use disorder. Effective July 1, 2025, the deleted text begin executive boarddeleted text end new text begin commissionernew text end has the power and
authority to determine all matters relating to the development of all of the foregoing
institutions and of such other institutions vested in the deleted text begin executive boarddeleted text end new text begin commissionernew text end .
Effective July 1, 2025, the powers, functions, and authority vested in the commissioner of
human services relative to such state institutions are transferred to the deleted text begin executive boarddeleted text end new text begin
commissionernew text end according to this chapter and applicable state law.
Sec. 11.
Minnesota Statutes 2024, section 246C.07, subdivision 1, is amended to read:
Subdivision 1.
Generally.
(a) The deleted text begin executive boarddeleted text end new text begin commissionernew text end must operate the
deleted text begin agencydeleted text end new text begin departmentnew text end according to this chapter and applicable state and federal law. The overall
management and control of the deleted text begin agencydeleted text end new text begin departmentnew text end is vested in the deleted text begin executive boarddeleted text end new text begin
commissionernew text end in accordance with this chapter.
(b) The deleted text begin executive boarddeleted text end new text begin commissionernew text end must appoint a chief executive officer according
to section 246C.08. The chief executive officer is responsible for the administrative and
operational duties of new text begin the Department of new text end Direct Care and Treatment in accordance with this
chapternew text begin and serves as the deputy commissioner for the purposes of section 15.06 and as
deputy agency head for the purposes of section 43A.08new text end .
(c) The deleted text begin executive boarddeleted text end new text begin commissionernew text end may delegate duties imposed by this chapter and
under applicable state and federal law as deemed appropriate by the deleted text begin boarddeleted text end new text begin commissionernew text end
and in accordance with this chapter. Any delegation of a specified statutory duty or power
to an employee of new text begin the Department of new text end Direct Care and Treatment other than the chief executive
officer must be made by written order and filed with the secretary of state. Only the chief
executive officer shall have the powers and duties of the deleted text begin executive boarddeleted text end new text begin commissionernew text end as
specified in section 246C.08.
Sec. 12.
Minnesota Statutes 2024, section 246C.07, subdivision 2, is amended to read:
Subd. 2.
Principles.
The deleted text begin executive boarddeleted text end new text begin commissionernew text end , in undertaking deleted text begin itsdeleted text end new text begin the
commissioner'snew text end duties and responsibilities and within new text begin the Department of new text end Direct Care and
Treatment resources, shall act according to the following principles:
(1) prevent the waste or unnecessary spending of public money;
(2) use innovative fiscal and human resource practices to manage the state's resources
and operate the deleted text begin agencydeleted text end new text begin departmentnew text end as efficiently as possible;
(3) coordinate new text begin Department of new text end Direct Care and Treatment activities wherever appropriate
with the activities of other governmental agencies;
(4) use technology where appropriate to increase deleted text begin agencydeleted text end new text begin departmentnew text end productivity, improve
customer service, increase public access to information about government, and increase
public participation in the business of government; and
(5) utilize constructive and cooperative labor management practices to the extent
otherwise required by chapter 43A or 179A.
Sec. 13.
Minnesota Statutes 2024, section 246C.07, subdivision 8, is amended to read:
Subd. 8.
Biennial estimates; suggestions for legislation.
The deleted text begin executive boarddeleted text end new text begin
commissionernew text end shall prepare, for the use of the legislature, biennial estimates of appropriations
necessary or expedient to be made for the support of the institutions and for extraordinary
and special expenditures for buildings and other improvements. The deleted text begin executive boarddeleted text end new text begin
commissionernew text end shall make suggestions relative to legislation for the benefit of the institutions.
The deleted text begin executive boarddeleted text end new text begin commissionernew text end shall report the estimates and suggestions to the legislature
on or before November 15 in each even-numbered year. deleted text begin A designee of the executive boarddeleted text end new text begin
The commissionernew text end on request shall appear before any legislative committee and furnish any
required information in regard to the condition of any such institution.
Sec. 14.
new text begin
[246C.075] ADVISORY COUNCIL ON DIRECT CARE AND TREATMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
An Advisory Council on Direct Care and Treatment is
established.
new text end
new text begin Subd. 2. new text end
new text begin Membership. new text end
new text begin
(a) The Advisory Council on Direct Care and Treatment must
consist of no more than 15 members appointed as provided in section 15.0597. The advisory
council must include:
new text end
new text begin
(1) one member who is a licensed physician with experience serving behavioral health
patients or a licensed psychiatrist, appointed by the commissioner;
new text end
new text begin
(2) two members with executive management experience at a hospital or health care
system, or experience serving on the board of a hospital or health care system, appointed
by the commissioner;
new text end
new text begin
(3) three members, each appointed by the commissioner, who have experience working:
new text end
new text begin
(i) in the delivery of behavioral health services;
new text end
new text begin
(ii) in care coordination;
new text end
new text begin
(iii) in traditional healing practices;
new text end
new text begin
(iv) as a licensed health care professional;
new text end
new text begin
(v) within health care administration; or
new text end
new text begin
(vi) with residential services;
new text end
new text begin
(4) one member appointed by the Association of Counties;
new text end
new text begin
(5) one member who has an active role as a union representative representing staff at
the Department of Direct Care and Treatment appointed by joint representatives of the
following unions: American Federation of State, County, and Municipal Employees
(AFSCME); Minnesota Association of Professional Employees (MAPE); Minnesota Nurses
Association (MNA); Middle Management Association (MMA); and State Residential
Schools Education Association (SRSEA);
new text end
new text begin
(6) one member appointed by the National Alliance on Mental Illness Minnesota;
new text end
new text begin
(7) two members representing people with lived experience being served by state-operated
treatment programs or their families, appointed by the commissioner;
new text end
new text begin
(8) one member appointed by the Minnesota Disability Law Center; and
new text end
new text begin
(9) up to three additional members appointed by the commissioner reflecting community
interests or perspectives the commissioner deems valuable.
new text end
new text begin
(b) Membership on the advisory council must include representation from outside the
seven-county metropolitan area, as defined in section 473.121, subdivision 2.
new text end
new text begin
(c) Appointing authorities under paragraph (a) must make initial appointments by
September 1, 2025.
new text end
new text begin Subd. 3. new text end
new text begin Terms; compensation; removal; vacancies; expiration. new text end
new text begin
(a) The membership
terms, compensation, removal of members, and filling of vacancies of members are as
provided in section 15.059, except that council members shall not receive a per diem.
new text end
new text begin
(b) The advisory council does not expire.
new text end
new text begin Subd. 4. new text end
new text begin Meetings. new text end
new text begin
(a) The members of the advisory council shall elect a chair from
among their membership at the first meeting and annually thereafter or upon a vacancy in
the chair. The advisory council shall meet at the call of the commissioner, the call of the
chair, or upon the call of a majority of members.
new text end
new text begin
(b) The first meeting of the advisory council must be held no later than September 15,
2025.
new text end
new text begin Subd. 5. new text end
new text begin Duties. new text end
new text begin
The advisory council shall advise the commissioner regarding the
operations of the Department of Direct Care and Treatment, the clinical standards of care
for patients and clients of state-operated programs, and provide recommendations to the
commissioner for improving the department's role in the state's mental health care system.
new text end
Sec. 15.
Minnesota Statutes 2024, section 246C.08, is amended to read:
246C.08 CHIEF EXECUTIVE OFFICER; SERVICE; DUTIES.
Subdivision 1.
Service.
(a) The direct care and treatment chief executive officer is
appointed by the deleted text begin executive board, in consultation with the governor, and serves at the
pleasure of the executive board, with the advice and consent of the senatedeleted text end new text begin commissioner,
and is the deputy commissioner for the purposes of section 15.06new text end .
(b) The chief executive officer shall serve in the unclassified service in accordance with
section 43A.08. deleted text begin The Compensation Council under section deleted text end deleted text begin shall establish the salary
deleted text end deleted text begin of the chief executive officer.
deleted text end
Subd. 2.
Powers and duties.
(a) The chief executive officer's primary duty is to assist
the deleted text begin executive boarddeleted text end new text begin commissionernew text end . The chief executive officer is responsible for the
administrative and operational management of the agency.
deleted text begin
(b) The chief executive officer shall have all the powers of the executive board unless
the executive board directs otherwise. The chief executive officer shall have the authority
to speak for the executive board and Direct Care and Treatment within and outside the
agency.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end In the event that a vacancy occurs for any reason within the chief executive officer
position, the executive medical director appointed under section 246C.09 shall immediately
become the temporary chief executive officer until the deleted text begin executive boarddeleted text end new text begin commissionernew text end
appoints a new chief executive officer. During this period, the executive medical director
shall have all the powers and authority delegated to the chief executive officer by the deleted text begin boarddeleted text end new text begin
commissionernew text end and specified in this chapter.
new text begin Subd. 3. new text end
new text begin Minimum qualifications. new text end
new text begin
The chief executive officer must be selected by the
commissioner without regard to political affiliation and must have wide and successful
administrative experience in and understanding of health care, preferably behavioral health
care, including clinical and operational needs of a large health care service and delivery
organization.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025, except the amendment to
subdivision 1, paragraph (b), is effective retroactively from July 1, 2024.
new text end
Sec. 16.
Minnesota Statutes 2024, section 246C.09, subdivision 3, is amended to read:
Subd. 3.
Duties.
The executive medical director shall:
(1) oversee the clinical provision of inpatient mental health services provided in the
state's regional treatment centers;
(2) recruit and retain psychiatrists to serve on the deleted text begin Direct Care and Treatmentdeleted text end new text begin departmentnew text end
medical staff established in subdivision 4;
(3) consult with the deleted text begin executive board, the chief executive officer,deleted text end new text begin commissioner, the chief
executive officer,new text end and community mental health center directors to develop standards for
treatment and care of patients in state-operated service programs;
(4) develop and oversee a continuing education program for members of the medical
staff; and
(5) participate and cooperate in the development and maintenance of a quality assurance
program for state-operated services that assures that residents receive continuous quality
inpatient, outpatient, and postdischarge care.
Sec. 17.
Minnesota Statutes 2024, section 246C.091, subdivision 2, is amended to read:
Subd. 2.
Facilities management account.
A facilities management account is created
in the special revenue fund of the state treasury. Beginning July 1, 2025, money in the
account is appropriated to thenew text begin commissioner ofnew text end direct care and treatment deleted text begin executive boarddeleted text end
and may be used to maintain buildings, acquire facilities, renovate existing buildings, or
acquire land for the design and construction of buildings for deleted text begin Direct Care and Treatmentdeleted text end new text begin
departmentnew text end use. Money received for maintaining state property under control of the deleted text begin executive
boarddeleted text end new text begin commissionernew text end may be deposited into this account.
Sec. 18.
Minnesota Statutes 2024, section 246C.091, subdivision 3, is amended to read:
Subd. 3.
Direct care and treatment systems account.
(a) The direct care and treatment
systems account is created in the special revenue fund of the state treasury. Beginning July
1, 2025, money in the account is appropriated to the new text begin commissioner of new text end direct care and
treatment deleted text begin executive boarddeleted text end and may be used for security systems and information technology
projects, services, and support under the control of the deleted text begin executive boarddeleted text end new text begin commissionernew text end .
(b) The commissioner of human services shall transfer all money allocated to the direct
care and treatment systems projects under section 256.014 to the direct care and treatment
systems account new text begin under this section new text end by June 30, 2026.
Sec. 19.
Minnesota Statutes 2024, section 246C.091, subdivision 4, is amended to read:
Subd. 4.
Cemetery maintenance account.
The cemetery maintenance account is created
in the special revenue fund of the state treasury. Money in the account is appropriated to
the deleted text begin executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end for the maintenance of
cemeteries under control of the deleted text begin executive boarddeleted text end new text begin commissionernew text end . Money allocated to deleted text begin Direct
Care and Treatmentdeleted text end new text begin departmentnew text end cemeteries may be transferred to this account.
Sec. 20.
Laws 2024, chapter 127, article 50, section 41, subdivision 2, is amended to read:
Subd. 2.
Chief executive officer.
(a) The new text begin commissioner of new text end direct care and treatment
deleted text begin executive boarddeleted text end must appoint as the initial chief executive officer for direct care and treatment
under Minnesota Statutes, section deleted text begin 246C.07deleted text end new text begin 246C.08new text end , the chief executive officer of the direct
care and treatment division of the Department of Human Services holding that position at
the time the initial appointment is made by the deleted text begin boarddeleted text end new text begin commissionernew text end . The initial appointment
of the chief executive officer must be made by the deleted text begin executive boarddeleted text end new text begin commissionernew text end by July
1, 2025. deleted text begin The initial appointment of the chief executive officer is subject to confirmation by
the senate.
deleted text end
(b) deleted text begin In its report issued April 1, 2025, the Compensation Council under Minnesota Statutes,
deleted text end deleted text begin section deleted text end deleted text begin , must establish the salary of the chief executive officer at an amount equal
deleted text end deleted text begin to or greater than the amount paid to the chief executive officer of the direct care and
deleted text end deleted text begin treatment division of the Department of Human Services as of the date of initial appointment.
deleted text end deleted text begin The salary of the chief executive officer shall become effective July 1, 2025, pursuant to
deleted text end deleted text begin Minnesota Statutes, section deleted text end deleted text begin 15A.082, subdivision 3deleted text end deleted text begin . Notwithstanding Minnesota Statutes,
deleted text end deleted text begin sections deleted text end deleted text begin and deleted text end deleted text begin 246C.08, subdivision 1deleted text end deleted text begin , if the initial appointment of the chief executive
deleted text end deleted text begin officer occurs prior to the effective date of the salary specified by the Compensation Council
deleted text end deleted text begin in its April 1, 2025, report, thedeleted text end new text begin The initialnew text end salary of the chief executive officer must equal
the amount paid to the chief executive officer of the direct care and treatment division of
the Department of Human Services as of the date of initial appointment.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025, except the amendment to
paragraph (b) is effective retroactively from July 1, 2024.
new text end
Sec. 21. new text begin INITIAL APPOINTMENT OF COMMISSIONER OF DIRECT CARE
AND TREATMENT.
new text end
new text begin
The initial appointment of a commissioner of direct care and treatment or initial
designation of a temporary commissioner of direct care and treatment by the governor under
Minnesota Statutes, section 15.06, must be made by July 1, 2025. Notwithstanding Minnesota
Statutes, section 15.066, subdivision 2, clause (4), the initial appointment of a commissioner
of direct care and treatment or initial designation of a temporary commissioner of direct
care and treatment is effective no earlier than July 1, 2025.
new text end
Sec. 22. new text begin SALARY FOR THE COMMISSIONER OF THE DEPARTMENT OF
DIRECT CARE AND TREATMENT.
new text end
new text begin
If the initial appointment of the commissioner of the Department of Direct Care and
Treatment occurs prior to the commissioner's salary being determined by the Compensation
Council under Minnesota Statutes, section 15A.082, the commissioner's salary must equal
the salary of the commissioner of human services, as determined under Minnesota Statutes,
section 15A.0815, subdivision 2.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
expires upon adoption by the Compensation Council of a salary for the position of
commissioner of the Department of Direct Care and Treatment.
new text end
Sec. 23. new text begin DISSOLUTION OF THE DIRECT CARE AND TREATMENT EXECUTIVE
BOARD.
new text end
new text begin Subdivision 1. new text end
new text begin Dissolution of executive board. new text end
new text begin
Upon the effective date of this section,
the direct care and treatment executive board under Minnesota Statutes, section 246C.06,
is dissolved.
new text end
new text begin Subd. 2. new text end
new text begin Transfer of duties. new text end
new text begin
(a) Any authorities and responsibilities that were vested
in the executive board prior to July 1, 2025, are transferred to the commissioner of human
services. Minnesota Statutes, section 15.039, applies to the transfer of responsibilities from
the direct care and treatment executive board to the commissioner of human services between
the effective date of this section and July 1, 2025.
new text end
new text begin
(b) Minnesota Statutes, section 246C.04, governs the transfer of authority and
responsibility on July 1, 2025, from the commissioner of human services to the commissioner
of direct care and treatment.
new text end
Sec. 24. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) The revisor of statutes shall change the term "Direct Care and Treatment" to "the
Department of Direct Care and Treatment" and "agency" to "department" wherever the
terms appear in respect to the governmental entity with programmatic direction and fiscal
control over state-operated services, programs, or facilities under Minnesota Statutes, chapter
246C. The revisor may make technical and other necessary changes to sentence structure
to preserve the meaning of the text.
new text end
new text begin
(b) The revisor of statutes shall change the term "executive board" to "commissioner"
and "Direct Care and Treatment executive board" to "commissioner of direct care and
treatment" wherever the terms appear in respect to the head of the governmental entity with
programmatic direction and fiscal control over state-operated services, programs, or facilities
under Minnesota Statutes, chapter 246C. The revisor may make technical and other necessary
changes to sentence structure to preserve the meaning of the text.
new text end
Sec. 25. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes, in consultation with the House Research Department; the Office
of Senate Counsel, Research and Fiscal Analysis; the Department of Human Services; and
the Department of Direct Care and Treatment, shall make necessary cross-reference changes
to conform with this act. The revisor may make technical and other necessary changes to
sentence structure to preserve the meaning of the text. The revisor may alter the coding in
this act to incorporate statutory changes made by other law in the 2025 regular legislative
session.
new text end
Sec. 26. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber Minnesota Statutes, section 246C.06, subdivision
11, as Minnesota Statutes, section 246C.07, subdivision 4a, and correct all cross-references.
new text end
Sec. 27. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2024, sections 246C.015, subdivisions 5a and 6; 246C.06,
subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10; and 246C.07, subdivisions 4 and 5,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Laws 2024, chapter 79, article 1, section 20,
new text end
new text begin
is repealed.
new text end
new text begin
(c)
new text end
new text begin
Laws 2024, chapter 125, article 5, sections 40; and 41; and Laws 2024, chapter 127,
article 50, sections 40; and 41, subdivisions 1, and 3,
new text end
new text begin
are repealed retroactive to July 1,
2024.
new text end
Sec. 28. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective the day following final enactment.
new text end
ARTICLE 9
DEPARTMENT OF DIRECT CARE AND TREATMENT CONFORMING CHANGES
Section 1.
Minnesota Statutes 2024, section 15A.0815, subdivision 2, is amended to read:
Subd. 2.
Agency head salaries.
The salary for a position listed in this subdivision shall
be determined by the Compensation Council under section 15A.082. The commissioner of
management and budget must publish the salaries on the department's website. This
subdivision applies to the following positions:
Commissioner of administration;
Commissioner of agriculture;
Commissioner of education;
Commissioner of children, youth, and families;
Commissioner of commerce;
Commissioner of corrections;
Commissioner of health;
Commissioner, Minnesota Office of Higher Education;
Commissioner, Minnesota IT Services;
Commissioner, Housing Finance Agency;
Commissioner of human rights;
Commissioner of human services;
Commissioner of labor and industry;
Commissioner of management and budget;
Commissioner of natural resources;
Commissioner, Pollution Control Agency;
Commissioner of public safety;
Commissioner of revenue;
Commissioner of employment and economic development;
Commissioner of transportation;
Commissioner of veterans affairs;
new text begin
Commissioner of direct care and treatment;
new text end
Executive director of the Gambling Control Board;
Executive director of the Minnesota State Lottery;
Executive director of the Office of Cannabis Management;
Commissioner of Iron Range resources and rehabilitation;
Commissioner, Bureau of Mediation Services;
Ombudsman for mental health and developmental disabilities;
Ombudsperson for corrections;
Chair, Metropolitan Council;
Chair, Metropolitan Airports Commission;
School trust lands director;
Executive director of pari-mutuel racing;
Commissioner, Public Utilities Commission;
deleted text begin Chief Executive Officer, Direct Care and Treatment;deleted text end and
Director of the Office of Emergency Medical Services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025, except the amendment
striking "Chief Executive Officer, Direct Care and Treatment;" is effective retroactively
from July 1, 2024.
new text end
Sec. 2.
Minnesota Statutes 2024, section 15A.082, subdivision 1, is amended to read:
Subdivision 1.
Creation.
A Compensation Council is created each odd-numbered year
to establish the compensation of constitutional officers and the heads of state and metropolitan
agencies identified in section 15A.0815deleted text begin ,deleted text end new text begin andnew text end to assist the legislature in establishing the
compensation of justices of the supreme court and judges of the court of appeals and district
courtdeleted text begin , and to determine the daily compensation for voting members of the Direct Care and
Treatment executive boarddeleted text end .
Sec. 3.
Minnesota Statutes 2024, section 15A.082, subdivision 3, is amended to read:
Subd. 3.
Submission of recommendations and determination.
(a) By April 1 in each
odd-numbered year, the Compensation Council shall submit to the speaker of the house and
the president of the senate salary recommendations for justices of the supreme court, and
judges of the court of appeals and district court. The recommended salaries take effect on
July 1 of that year and July 1 of the subsequent even-numbered year and at whatever interval
the council recommends thereafter, unless the legislature by law provides otherwise. The
salary recommendations take effect if an appropriation of money to pay the recommended
salaries is enacted after the recommendations are submitted and before their effective date.
Recommendations may be expressly modified or rejected.
(b) By April 1 in each odd-numbered year, the Compensation Council must prescribe
salaries for constitutional officers, and for the agency and metropolitan agency heads
identified in section 15A.0815. The prescribed salary for each office must take effect July
1 of that year and July 1 of the subsequent even-numbered year and at whatever interval
the council determines thereafter, unless the legislature by law provides otherwise. An
appropriation by the legislature to fund the relevant office, branch, or agency of an amount
sufficient to pay the salaries prescribed by the council constitutes a prescription by law as
provided in the Minnesota Constitution, article V, sections 4 and 5.
deleted text begin
(c) By April 1 in each odd-numbered year, the Compensation Council must prescribe
daily compensation for voting members of the Direct Care and Treatment executive board.
The recommended daily compensation takes effect on July 1 of that year and July 1 of the
subsequent even-numbered year and at whatever interval the council recommends thereafter,
unless the legislature by law provides otherwise.
deleted text end
Sec. 4.
Minnesota Statutes 2024, section 15A.082, subdivision 7, is amended to read:
Subd. 7.
No ex parte communications.
Members may not have any communication
with a constitutional officer, a head of a state agency, new text begin or new text end a member of the judiciarydeleted text begin , or a
member of the Direct Care and Treatment executive boarddeleted text end during the period after the first
meeting is convened under this section and the date the prescribed and recommended salaries
deleted text begin and daily compensationdeleted text end are submitted under subdivision 3.
Sec. 5.
Minnesota Statutes 2024, section 43A.08, subdivision 1, is amended to read:
Subdivision 1.
Unclassified positions.
Unclassified positions are held by employees
who are:
(1) chosen by election or appointed to fill an elective office;
(2) heads of agencies required by law to be appointed by the governor or other elective
officers, and the executive or administrative heads of departments, bureaus, divisions, and
institutions specifically established by law in the unclassified service;
(3) deputy and assistant agency heads and one confidential secretary in the agencies
listed in subdivision 1a;
(4) the confidential secretary to each of the elective officers of this state and, for the
secretary of state and state auditor, an additional deputy, clerk, or employee;
(5) intermittent help employed by the commissioner of public safety to assist in the
issuance of vehicle licenses;
(6) employees in the offices of the governor and of the lieutenant governor and one
confidential employee for the governor in the Office of the Adjutant General;
(7) employees of the Washington, D.C., office of the state of Minnesota;
(8) employees of the legislature and of legislative committees or commissions; provided
that employees of the Legislative Audit Commission, except for the legislative auditor, the
deputy legislative auditors, and their confidential secretaries, shall be employees in the
classified service;
(9) presidents, vice-presidents, deans, other managers and professionals in academic
and academic support programs, administrative or service faculty, teachers, research
assistants, and student employees eligible under terms of the federal Economic Opportunity
Act work study program in the Perpich Center for Arts Education and the Minnesota State
Colleges and Universities, but not the custodial, clerical, or maintenance employees, or any
professional or managerial employee performing duties in connection with the business
administration of these institutions;
(10) officers and enlisted persons in the National Guard;
(11) attorneys, legal assistants, and three confidential employees appointed by the attorney
general or employed with the attorney general's authorization;
(12) judges and all employees of the judicial branch, referees, receivers, jurors, and
notaries public, except referees and adjusters employed by the Department of Labor and
Industry;
(13) members of the State Patrol; provided that selection and appointment of State Patrol
troopers must be made in accordance with applicable laws governing the classified service;
(14) examination monitors and intermittent training instructors employed by the
Departments of Management and Budget and Commerce and by professional examining
boards and intermittent staff employed by the technical colleges for the administration of
practical skills tests and for the staging of instructional demonstrations;
(15) student workers;
(16) executive directors or executive secretaries appointed by and reporting to any
policy-making board or commission established by statute;
(17) employees unclassified pursuant to other statutory authority;
(18) intermittent help employed by the commissioner of agriculture to perform duties
relating to pesticides, fertilizer, and seed regulation;
(19) the administrators and the deputy administrators at the State Academies for the
Deaf and the Blind; and
(20) the chief executive officer of Direct Care and Treatment new text begin who serves as the deputy
agency headnew text end .
Sec. 6.
Minnesota Statutes 2024, section 43A.08, subdivision 1a, is amended to read:
Subd. 1a.
Additional unclassified positions.
Appointing authorities for the following
agencies may designate additional unclassified positions according to this subdivision: the
Departments of Administration; Agriculture; Children, Youth, and Families; Commerce;
Corrections; new text begin Direct Care and Treatment; new text end Education; Employment and Economic
Development; Explore Minnesota Tourism; Management and Budget; Health; Human
Rights; Human Services; Labor and Industry; Natural Resources; Public Safety; Revenue;
Transportation; and Veterans Affairs; the Housing Finance and Pollution Control Agencies;
the State Lottery; the State Board of Investment; the Office of Administrative Hearings; the
Department of Information Technology Services; the Offices of the Attorney General,
Secretary of State, and State Auditor; the Minnesota State Colleges and Universities; the
Minnesota Office of Higher Education; the Perpich Center for Arts Education; deleted text begin Direct Care
and Treatment;deleted text end the Minnesota Zoological Board; and the Office of Emergency Medical
Services.
A position designated by an appointing authority according to this subdivision must
meet the following standards and criteria:
(1) the designation of the position would not be contrary to other law relating specifically
to that agency;
(2) the person occupying the position would report directly to the agency head or deputy
agency head and would be designated as part of the agency head's management team;
(3) the duties of the position would involve significant discretion and substantial
involvement in the development, interpretation, and implementation of agency policy;
(4) the duties of the position would not require primarily personnel, accounting, or other
technical expertise where continuity in the position would be important;
(5) there would be a need for the person occupying the position to be accountable to,
loyal to, and compatible with, the governor and the agency head, the employing statutory
board or commission, or the employing constitutional officer;
(6) the position would be at the level of division or bureau director or assistant to the
agency head; and
(7) the commissioner has approved the designation as being consistent with the standards
and criteria in this subdivision.
Sec. 7.
Minnesota Statutes 2024, section 245.021, is amended to read:
245.021 deleted text begin DEFINITIONSdeleted text end new text begin DEFINITIONnew text end .
(a) For the purposes of this chapter, the deleted text begin definitionsdeleted text end new text begin definitionnew text end in this section deleted text begin havedeleted text end new text begin hasnew text end
the deleted text begin meaningsdeleted text end new text begin meaningnew text end given deleted text begin themdeleted text end .
(b) "Commissioner" means the commissioner of human services.
deleted text begin
(c) "Executive board" has the meaning given in section 246C.015.
deleted text end
Sec. 8.
Minnesota Statutes 2024, section 245.073, is amended to read:
245.073 TECHNICAL TRAINING; COMMUNITY-BASED PROGRAMS.
(a) In conjunction with the discharge of persons from regional treatment centers and
their admission to state-operated and privately operated community-based programs, the
commissioner may provide technical training assistance to the community-based programs.
The commissioner may apply for and accept money from any source including reimbursement
charges from the community-based programs for reasonable costs of training. Money
received must be deposited in the general fund and is appropriated annually to the
commissioner of human services for training under this section.
(b) The commissioner must coordinate with the deleted text begin executive boarddeleted text end new text begin commissioner of direct
care and treatment or the commissioner's designeenew text end to provide technical training assistance
to community-based programs under this section and section 246C.11, subdivision 5.
Sec. 9.
Minnesota Statutes 2024, section 246.13, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Executive boarddeleted text end Record responsibilities.
(a) The chief executive officer
or a designee shall have, accessible only by consent of the deleted text begin executive boarddeleted text end new text begin commissionernew text end
or on the order of a judge or court of record, a record showing:
(1) the residence, sex, age, nativity, occupation, civil condition, and date of entrance or
commitment of every person, in the state-operated services facilities as defined under section
246C.02 under exclusive control of the deleted text begin executive boarddeleted text end new text begin commissionernew text end ;
(2) the date of discharge of any such person and whether such discharge was final;
(3) the condition of the person when the person left the state-operated services facility;
(4) the vulnerable adult abuse prevention associated with the person; and
(5) the date and cause of any death of such person.
(b) The record in paragraph (a) must state every transfer of a person from one
state-operated services facility to another, naming each state-operated services facility. The
head of each facility or a designee must provide this transfer information to the deleted text begin executive
boarddeleted text end new text begin commissionernew text end , along with other obtainable facts as the deleted text begin executive boarddeleted text end new text begin commissionernew text end
requests.
(c) The head of the state-operated services facility or designee shall inform the deleted text begin executive
boarddeleted text end new text begin commissionernew text end of any discharge, transfer, or death of a person in that facility within
ten days of the date of discharge, transfer, or death in a manner determined by the deleted text begin executive
boarddeleted text end new text begin commissionernew text end .
(d) The deleted text begin executive boarddeleted text end new text begin commissionernew text end shall maintain an adequate system of records and
statistics for all basic record forms, including patient personal records and medical record
forms. The use and maintenance of such records must be consistent throughout all
state-operated services facilities.
Sec. 10.
Minnesota Statutes 2024, section 246B.01, is amended by adding a subdivision
to read:
new text begin Subd. 2e. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of direct care and
treatment.
new text end
Sec. 11.
Minnesota Statutes 2024, section 252.021, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of human services.
new text end
Sec. 12.
Minnesota Statutes 2024, section 252.50, subdivision 5, is amended to read:
Subd. 5.
Location of programs.
(a) In determining the location of state-operated,
community-based programs, the needs of the individual client shall be paramount. The
deleted text begin executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end shall also take into account:
(1) prioritization of beds in state-operated, community-based programs for individuals
with complex behavioral needs that cannot be met by private community-based providers;
(2) choices made by individuals who chose to move to a more integrated setting, and
shall coordinate with the lead agency to ensure that appropriate person-centered transition
plans are created;
(3) the personal preferences of the persons being served and their families as determined
by Minnesota Rules, parts 9525.0004 to 9525.0036;
(4) the location of the support services established by the individual service plans of the
persons being served;
(5) the appropriate grouping of the persons served;
(6) the availability of qualified staff;
(7) the need for state-operated, community-based programs in the geographical region
of the state; and
(8) a reasonable commuting distance from a regional treatment center or the residences
of the program staff.
(b) The deleted text begin executive boarddeleted text end new text begin commissioner of direct care and treatment new text end must locate
state-operated, community-based programs in coordination with the commissioner of human
services according to section 252.28.
Sec. 13.
Minnesota Statutes 2024, section 253.195, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of direct care and
treatment.
new text end
Sec. 14.
Minnesota Statutes 2024, section 253B.02, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of direct care and
treatment.
new text end
Sec. 15.
Minnesota Statutes 2024, section 253B.02, subdivision 3, is amended to read:
Subd. 3.
Commissionernew text begin of human servicesnew text end .
"Commissionernew text begin of human servicesnew text end " means
the commissioner of human services or the commissioner's designee.
Sec. 16.
Minnesota Statutes 2024, section 253B.02, subdivision 4c, is amended to read:
Subd. 4c.
County of financial responsibility.
(a) "County of financial responsibility"
has the meaning specified in chapter 256G. This definition does not require that the person
qualifies for or receives any other form of financial, medical, or social service assistance
in addition to the services under this chapter. Disputes about the county of financial
responsibility shall be submitted for determination to the deleted text begin executive boarddeleted text end new text begin commissionernew text end
through the commissioner of human services in the manner prescribed in section 256G.09.
(b) For purposes of proper venue for filing a petition pursuant to section 253B.064,
subdivision 1, paragraph (a); 253B.07, subdivision 1, paragraph (a); or 253D.07, where the
designated agency of a county has determined that it is the county of financial responsibility,
then that county is the county of financial responsibility until a different determination is
made by the appropriate county agencies or the commissionernew text begin of human servicesnew text end pursuant
to chapter 256G.
Sec. 17.
Minnesota Statutes 2024, section 253B.03, subdivision 7, is amended to read:
Subd. 7.
Treatment plan.
A patient receiving services under this chapter has the right
to receive proper care and treatment, best adapted, according to contemporary professional
standards, to rendering further supervision unnecessary. The treatment facility, state-operated
treatment program, or community-based treatment program shall devise a written treatment
plan for each patient which describes in behavioral terms the case problems, the precise
goals, including the expected period of time for treatment, and the specific measures to be
employed. The development and review of treatment plans must be conducted as required
under the license or certification of the treatment facility, state-operated treatment program,
or community-based treatment program. If there are no review requirements under the
license or certification, the treatment plan must be reviewed quarterly. The treatment plan
shall be devised and reviewed with the designated agency and with the patient. The clinical
record shall reflect the treatment plan review. If the designated agency or the patient does
not participate in the planning and review, the clinical record shall include reasons for
nonparticipation and the plans for future involvement. The commissionernew text begin of human servicesnew text end
shall monitor the treatment plan and review process for state-operated treatment programs
to ensure compliance with the provisions of this subdivision.
Sec. 18.
Minnesota Statutes 2024, section 253B.041, subdivision 4, is amended to read:
Subd. 4.
Evaluation.
Counties may, but are not required to, provide engagement services.
The commissioner new text begin of human services new text end may conduct a pilot project evaluating the impact of
engagement services in decreasing commitments, increasing engagement in treatment, and
other measures.
Sec. 19.
Minnesota Statutes 2024, section 253B.09, subdivision 3a, is amended to read:
Subd. 3a.
Reporting judicial commitments; private treatment program or
facility.
Notwithstanding section 253B.23, subdivision 9, when a court commits a patient
to a non-state-operated treatment facility or program, the court shall report the commitment
to the commissioner through the supreme court information system for purposes of providing
commitment information for firearm background checks under section 246C.15. If the
patient is committed to a state-operated treatment program, the court shall send a copy of
the commitment order to the commissioner deleted text begin and the executive boarddeleted text end .
Sec. 20.
Minnesota Statutes 2024, section 253B.18, subdivision 6, is amended to read:
Subd. 6.
Transfer.
(a) A patient who is a person who has a mental illness and is
dangerous to the public shall not be transferred out of a secure treatment facility unless it
appears to the satisfaction of the deleted text begin executive boarddeleted text end new text begin commissionernew text end , after a hearing and favorable
recommendation by a majority of the special review board, that the transfer is appropriate.
Transfer may be to another state-operated treatment program. In those instances where a
commitment also exists to the Department of Corrections, transfer may be to a facility
designated by the commissioner of corrections.
(b) The following factors must be considered in determining whether a transfer is
appropriate:
(1) the person's clinical progress and present treatment needs;
(2) the need for security to accomplish continuing treatment;
(3) the need for continued institutionalization;
(4) which facility can best meet the person's needs; and
(5) whether transfer can be accomplished with a reasonable degree of safety for the
public.
(c) If a committed person has been transferred out of a secure treatment facility pursuant
to this subdivision, that committed person may voluntarily return to a secure treatment
facility for a period of up to 60 days with the consent of the head of the treatment facility.
(d) If the committed person is not returned to the original, nonsecure transfer facility
within 60 days of being readmitted to a secure treatment facility, the transfer is revoked and
the committed person must remain in a secure treatment facility. The committed person
must immediately be notified in writing of the revocation.
(e) Within 15 days of receiving notice of the revocation, the committed person may
petition the special review board for a review of the revocation. The special review board
shall review the circumstances of the revocation and shall recommend to the commissioner
whether or not the revocation should be upheld. The special review board may also
recommend a new transfer at the time of the revocation hearing.
(f) No action by the special review board is required if the transfer has not been revoked
and the committed person is returned to the original, nonsecure transfer facility with no
substantive change to the conditions of the transfer ordered under this subdivision.
(g) The head of the treatment facility may revoke a transfer made under this subdivision
and require a committed person to return to a secure treatment facility if:
(1) remaining in a nonsecure setting does not provide a reasonable degree of safety to
the committed person or others; or
(2) the committed person has regressed clinically and the facility to which the committed
person was transferred does not meet the committed person's needs.
(h) Upon the revocation of the transfer, the committed person must be immediately
returned to a secure treatment facility. A report documenting the reasons for revocation
must be issued by the head of the treatment facility within seven days after the committed
person is returned to the secure treatment facility. Advance notice to the committed person
of the revocation is not required.
(i) The committed person must be provided a copy of the revocation report and informed,
orally and in writing, of the rights of a committed person under this section. The revocation
report must be served upon the committed person, the committed person's counsel, and the
designated agency. The report must outline the specific reasons for the revocation, including
but not limited to the specific facts upon which the revocation is based.
(j) If a committed person's transfer is revoked, the committed person may re-petition for
transfer according to subdivision 5.
(k) A committed person aggrieved by a transfer revocation decision may petition the
special review board within seven business days after receipt of the revocation report for a
review of the revocation. The matter must be scheduled within 30 days. The special review
board shall review the circumstances leading to the revocation and, after considering the
factors in paragraph (b), shall recommend to the commissioner whether or not the revocation
shall be upheld. The special review board may also recommend a new transfer out of a
secure treatment facility at the time of the revocation hearing.
Sec. 21.
Minnesota Statutes 2024, section 253B.19, subdivision 2, is amended to read:
Subd. 2.
Petition; hearing.
(a) A patient committed as a person who has a mental illness
and is dangerous to the public under section 253B.18, or the county attorney of the county
from which the patient was committed or the county of financial responsibility, may petition
the judicial appeal panel for a rehearing and reconsideration of a decision by the
commissioner under section 253B.18, subdivision 5. The judicial appeal panel must not
consider petitions for relief other than those considered by the deleted text begin executive boarddeleted text end new text begin commissionernew text end
from which the appeal is taken. The petition must be filed with the supreme court within
30 days after the decision of the deleted text begin executive boarddeleted text end new text begin commissionernew text end is signed. The hearing must
be held within 45 days of the filing of the petition unless an extension is granted for good
cause.
(b) For an appeal under paragraph (a), the supreme court shall refer the petition to the
chief judge of the judicial appeal panel. The chief judge shall notify the patient, the county
attorney of the county of commitment, the designated agency, the deleted text begin executive boarddeleted text end new text begin
commissionernew text end , the head of the facility or program to which the patient was committed, any
interested person, and other persons the chief judge designates, of the time and place of the
hearing on the petition. The notice shall be given at least 14 days prior to the date of the
hearing.
(c) Any person may oppose the petition. The patient, the patient's counsel, the county
attorney of the committing county or the county of financial responsibility, and the deleted text begin executive
boarddeleted text end new text begin commissionernew text end shall participate as parties to the proceeding pending before the judicial
appeal panel and shall, except when the patient is committed solely as a person who has a
mental illness and is dangerous to the public, no later than 20 days before the hearing on
the petition, inform the judicial appeal panel and the opposing party in writing whether they
support or oppose the petition and provide a summary of facts in support of their position.
The judicial appeal panel may appoint court examiners and may adjourn the hearing from
time to time. It shall hear and receive all relevant testimony and evidence and make a record
of all proceedings. The patient, the patient's counsel, and the county attorney of the
committing county or the county of financial responsibility have the right to be present and
may present and cross-examine all witnesses and offer a factual and legal basis in support
of their positions. The petitioning party seeking discharge or provisional discharge bears
the burden of going forward with the evidence, which means presenting a prima facie case
with competent evidence to show that the person is entitled to the requested relief. If the
petitioning party has met this burden, the party opposing discharge or provisional discharge
bears the burden of proof by clear and convincing evidence that the discharge or provisional
discharge should be denied. A party seeking transfer under section 253B.18, subdivision 6,
must establish by a preponderance of the evidence that the transfer is appropriate.
Sec. 22.
Minnesota Statutes 2024, section 253B.20, subdivision 2, is amended to read:
Subd. 2.
Necessities.
(a) The state-operated treatment program shall make necessary
arrangements at the expense of the state to insure that no patient is discharged or provisionally
discharged without suitable clothing. The head of the state-operated treatment program
shall, if necessary, provide the patient with a sufficient sum of money to secure transportation
home, or to another destination of the patient's choice, if the destination is located within a
reasonable distance of the state-operated treatment program.
(b) The commissioner new text begin of human services new text end shall establish procedures by rule to help the
patient receive all public assistance benefits provided by state or federal law to which the
patient is entitled by residence and circumstances. The rule shall be uniformly applied in
all counties. All counties shall provide temporary relief whenever necessary to meet the
intent of this subdivision.
(c) The commissioner new text begin of human services new text end and the deleted text begin executive boarddeleted text end new text begin commissionernew text end may
adopt joint rules necessary to accomplish the requirements under paragraph (b).
Sec. 23.
Minnesota Statutes 2024, section 253D.02, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of direct care and
treatment.
new text end
Sec. 24.
Minnesota Statutes 2024, section 253D.02, subdivision 3, is amended to read:
Subd. 3.
Commissionernew text begin of correctionsnew text end .
"Commissionernew text begin of correctionsnew text end " means the
commissioner of corrections or the commissioner's designee.
Sec. 25.
Minnesota Statutes 2024, section 254B.05, subdivision 4, is amended to read:
Subd. 4.
Regional treatment centers.
Regional treatment center substance use disorder
treatment units are eligible vendors. The deleted text begin executive boarddeleted text end new text begin commissioner of direct care and
treatmentnew text end may expand the capacity of substance use disorder treatment units beyond the
capacity funded by direct legislative appropriation to serve individuals who are referred for
treatment by counties and whose treatment will be paid for by funding under this chapter
or other funding sources. Notwithstanding the provisions of sections 254B.03 to 254B.04,
payment for any person committed at county request to a regional treatment center under
chapter 253B for chemical dependency treatment and determined to be ineligible under the
behavioral health fund, shall become the responsibility of the county.
Sec. 26.
Minnesota Statutes 2024, section 256.045, is amended by adding a subdivision
to read:
new text begin Subd. 1b. new text end
new text begin Commissioner. new text end
new text begin
For purposes of this section, "commissioner" means the
commissioner of human services.
new text end
Sec. 27.
Minnesota Statutes 2024, section 256.045, subdivision 6, is amended to read:
Subd. 6.
Additional powers of commissioner; subpoenas.
(a) The commissioner of
human services, the commissioner of health for matters within the commissioner's jurisdiction
under subdivision 3b, or the deleted text begin Direct Care and Treatment executive boarddeleted text end new text begin commissioner of
direct care and treatmentnew text end for matters within the new text begin commissioner's new text end jurisdiction deleted text begin of the executive
boarddeleted text end under subdivision 5a, may initiate a review of any action or decision of a county
agency and direct that the matter be presented to a state human services judge for a hearing
held under subdivision 3, 3a, 3b, or 4a. In all matters dealing with human services committed
by law to the discretion of the county agency, the judgment of the applicable commissioner
deleted text begin or executive boarddeleted text end may be substituted for that of the county agency. The applicable
commissioner deleted text begin or executive boarddeleted text end may order an independent examination when appropriate.
(b) Any party to a hearing held pursuant to subdivision 3, 3a, 3b, or 4a may request that
the applicable commissioner deleted text begin or executive boarddeleted text end issue a subpoena to compel the attendance
of witnesses and the production of records at the hearing. A local agency may request that
the applicable commissioner deleted text begin or executive boarddeleted text end issue a subpoena to compel the release of
information from third parties prior to a request for a hearing under section 256.046 upon
a showing of relevance to such a proceeding. The issuance, service, and enforcement of
subpoenas under this subdivision is governed by section 357.22 and the Minnesota Rules
of Civil Procedure.
(c) The commissioner of human services may issue a temporary order staying a proposed
demission by a residential facility licensed under chapter 245A:
(1) while an appeal by a recipient under subdivision 3 is pending;
(2) for the period of time necessary for the case management provider to implement the
commissioner's order; or
(3) for appeals under subdivision 3, paragraph (a), clause (11), when the individual is
seeking a temporary stay of demission on the basis that the county has not yet finalized an
alternative arrangement for a residential facility, a program, or services that will meet the
assessed needs of the individual by the effective date of the service termination, a temporary
stay of demission may be issued for no more than 30 calendar days to allow for such
arrangements to be finalized.
Sec. 28.
Minnesota Statutes 2024, section 256.045, subdivision 7, is amended to read:
Subd. 7.
Judicial review.
Except for a prepaid health plan, any party who is aggrieved
by an order of the commissioner of human services; the commissioner of health; or the
commissioner of children, youth, and families in appeals within the commissioner's
jurisdiction under subdivision 3b; or the deleted text begin Direct Care and Treatment executive boarddeleted text end new text begin
commissioner of direct care and treatmentnew text end in appeals within the new text begin commissioner's new text end jurisdiction
deleted text begin of the executive boarddeleted text end under subdivision 5a may appeal the order to the district court of the
county responsible for furnishing assistance, or, in appeals under subdivision 3b, the county
where the maltreatment occurred, by serving a written copy of a notice of appeal upon the
applicable commissioner deleted text begin or executive boarddeleted text end and any adverse party of record within 30 days
after the date the commissioner deleted text begin or executive boarddeleted text end issued the order, the amended order, or
order affirming the original order, and by filing the original notice and proof of service with
the court administrator of the district court. Service may be made personally or by mail;
service by mail is complete upon mailing; no filing fee shall be required by the court
administrator in appeals taken pursuant to this subdivision, with the exception of appeals
taken under subdivision 3b. The applicable commissioner deleted text begin or executive boarddeleted text end may elect to
become a party to the proceedings in the district court. Except for appeals under subdivision
3b, any party may demand that the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end furnish all
parties to the proceedings with a copy of the decision, and a transcript of any testimony,
evidence, or other supporting papers from the hearing held before the human services judge,
by serving a written demand upon the applicable commissioner deleted text begin or executive boarddeleted text end within
30 days after service of the notice of appeal. Any party aggrieved by the failure of an adverse
party to obey an order issued by the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end under
subdivision 5 or 5a may compel performance according to the order in the manner prescribed
in sections 586.01 to 586.12.
Sec. 29.
Minnesota Statutes 2024, section 256G.09, subdivision 3, is amended to read:
Subd. 3.
Commissioner obligations.
(a) Except as provided in paragraph (b) for matters
under the jurisdiction of the deleted text begin Direct Care and Treatment executive boarddeleted text end new text begin commissioner of
direct care and treatmentnew text end , the commissioner shall then promptly decide any question of
financial responsibility as outlined in this chapter and make an order referring the application
to the local agency of the proper county for further action. Further action may include
reimbursement by that county of assistance that another county has provided to the applicant
under this subdivision. The commissioner shall decide disputes within 60 days of the last
county evidentiary submission and shall issue an immediate opinion.
(b) For disputes regarding financial responsibility relating to matters under the jurisdiction
of the deleted text begin direct care and treatment executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end ,
the commissioner shall promptly issue an advisory opinion on any question of financial
responsibility as outlined in this chapter and recommend to the deleted text begin executive boarddeleted text end new text begin commissioner
of direct care and treatmentnew text end an order referring the application to the local agency of the
proper county for further action. Further action may include reimbursement by that county
of assistance that another county has provided to the applicant under this subdivision. The
commissioner shall provide an advisory opinion and recommended order to the deleted text begin executive
boarddeleted text end new text begin commissioner of direct care and treatmentnew text end within 30 days of the last county evidentiary
submission. The deleted text begin executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end shall decide to
accept or reject the commissioner's advisory opinion and recommended order within 60
days of the last county evidentiary submission and shall issue an immediate opinion stating
the reasons for accepting or rejecting the commissioner's recommendation.
(c) The commissioner may make any investigation deleted text begin itdeleted text end new text begin the commissionernew text end considers proper
before making a decision or a recommendation to the deleted text begin executive boarddeleted text end new text begin commissioner of
direct care and treatmentnew text end . The commissioner may prescribe rules deleted text begin itdeleted text end new text begin the commissionernew text end
considers necessary to carry out this subdivision except that the commissioner must not
create rules purporting to bind the deleted text begin executive board'sdeleted text end decision new text begin of the commissioner of direct
care and treatment new text end on any advisory opinion or recommended order under paragraph (b).
(d) Except as provided in paragraph (e) for matters under the jurisdiction of the deleted text begin executive
boarddeleted text end new text begin commissioner of direct care and treatmentnew text end , the order of the commissioner binds the
local agency involved and the applicant or recipient. That agency shall comply with the
order unless reversed on appeal as provided in section 256.045, subdivision 7. The agency
shall comply with the order pending the appeal.
(e) For disputes regarding financial responsibility relating to matters under the jurisdiction
of the deleted text begin Direct Care and Treatment executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end ,
the order of the deleted text begin executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end binds the local
agency involved and the applicant or recipient. That agency shall comply with the order of
the deleted text begin executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end unless the order is reversed
on appeal as provided in section 256.045, subdivision 7. The agency shall comply with the
order of the deleted text begin executive boarddeleted text end new text begin commissioner of direct care and treatmentnew text end pending the appeal.
Sec. 30.
Minnesota Statutes 2024, section 352.91, subdivision 2a, is amended to read:
Subd. 2a.
Special teachers.
"Covered correctional service" also means service rendered
by a state employee as a special teacher employed by the Department of Corrections or by
new text begin the Department of new text end Direct Care and Treatment at a security unit, provided that at least 75
percent of the employee's working time is spent in direct contact with inmates or patients
and the fact of this direct contact is certified to the executive director by the appropriate
commissioner deleted text begin or executive boarddeleted text end , unless the person elects to retain the current retirement
coverage under Laws 1996, chapter 408, article 8, section 21.
Sec. 31.
Minnesota Statutes 2024, section 352.91, subdivision 3c, is amended to read:
Subd. 3c.
Nursing personnel.
(a) "Covered correctional service" means service by a
state employee in one of the employment positions at a correctional facility, in the
state-operated forensic services program, or in the Minnesota Sex Offender Program that
are specified in paragraph (b) if at least 75 percent of the employee's working time is spent
in direct contact with inmates or patients and the fact of this direct contact is certified to the
executive director by the appropriate commissioner deleted text begin or executive boarddeleted text end .
(b) The employment positions are as follows:
(1) registered nurse - senior;
(2) registered nurse;
(3) registered nurse - principal;
(4) licensed practical nurse;
(5) registered nurse advance practice; and
(6) psychiatric advance practice registered nurse.
Sec. 32.
Minnesota Statutes 2024, section 352.91, subdivision 3d, is amended to read:
Subd. 3d.
Other correctional personnel.
(a) "Covered correctional service" means
service by a state employee in one of the employment positions at a correctional facility or
in the state-operated forensic services program specified in paragraph (b) if at least 75
percent of the employee's working time is spent in direct contact with inmates or patients
and the fact of this direct contact is certified to the executive director by the appropriate
commissioner deleted text begin or executive boarddeleted text end .
(b) The employment positions are:
(1) automotive mechanic;
(2) baker;
(3) central services administrative specialist, intermediate;
(4) central services administrative specialist, principal;
(5) chaplain;
(6) chief cook;
(7) clinical program therapist 1;
(8) clinical program therapist 2;
(9) clinical program therapist 3;
(10) clinical program therapist 4;
(11) cook;
(12) cook coordinator;
(13) corrections inmate program coordinator;
(14) corrections transitions program coordinator;
(15) corrections security caseworker;
(16) corrections security caseworker career;
(17) corrections teaching assistant;
(18) delivery van driver;
(19) dentist;
(20) electrician supervisor;
(21) general maintenance worker lead;
(22) general repair worker;
(23) library/information research services specialist;
(24) library/information research services specialist senior;
(25) library technician;
(26) painter lead;
(27) plant maintenance engineer lead;
(28) plumber supervisor;
(29) psychologist 1;
(30) psychologist 3;
(31) recreation therapist;
(32) recreation therapist coordinator;
(33) recreation program assistant;
(34) recreation therapist senior;
(35) sports medicine specialist;
(36) work therapy assistant;
(37) work therapy program coordinator; and
(38) work therapy technician.
Sec. 33.
Minnesota Statutes 2024, section 352.91, subdivision 4a, is amended to read:
Subd. 4a.
Process for evaluating and recommending potential employment positions
for membership inclusion.
(a) The Department of Corrections and new text begin the Department of
new text end Direct Care and Treatment must establish a procedure for evaluating periodic requests by
department deleted text begin and agencydeleted text end employees for qualification for recommendation by the new text begin applicable
new text end commissioner deleted text begin or executive boarddeleted text end for inclusion of the employment position in the correctional
facility or direct care and treatment facility in the correctional retirement plan and for
periodically determining employment positions that no longer qualify for continued
correctional retirement plan coverage.
(b) The procedure must provide for an evaluation of the extent of the employee's working
time spent in direct contact with patients or inmates, the extent of the physical hazard that
the employee is routinely subjected to in the course of employment, and the extent of
intervention routinely expected of the employee in the event of a facility incident. The
percentage of routine direct contact with inmates or patients may not be less than 75 percent.
(c) The applicable commissioner deleted text begin or executive boarddeleted text end shall notify the employee of the
determination of the appropriateness of recommending the employment position for inclusion
in the correctional retirement plan, if the evaluation procedure results in a finding that the
employee:
(1) routinely spends 75 percent of the employee's time in direct contact with inmates or
patients; and
(2) is regularly engaged in the rehabilitation, treatment, custody, or supervision of inmates
or patients.
(d) After providing the affected employee an opportunity to dispute or clarify any
evaluation determinations, if the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end determines
that the employment position is appropriate for inclusion in the correctional retirement plan,
the commissioner deleted text begin or executive boarddeleted text end shall forward that recommendation and supporting
documentation to the chair of the Legislative Commission on Pensions and Retirement, the
chair of the State and Local Governmental Operations Committee of the senate, the chair
of the Governmental Operations and Veterans Affairs Policy Committee of the house of
representatives, and the executive director of the Legislative Commission on Pensions and
Retirement in the form of the appropriate proposed legislation. The recommendation must
be forwarded to the legislature before January 15 for the recommendation to be considered
in that year's legislative session.
Sec. 34.
Minnesota Statutes 2024, section 524.3-801, is amended to read:
524.3-801 NOTICE TO CREDITORS.
(a) Unless notice has already been given under this section, upon appointment of a
general personal representative in informal proceedings or upon the filing of a petition for
formal appointment of a general personal representative, notice thereof, in the form prescribed
by court rule, shall be given under the direction of the court administrator by publication
once a week for two successive weeks in a legal newspaper in the county wherein the
proceedings are pending giving the name and address of the general personal representative
and notifying creditors of the estate to present their claims within four months after the date
of the court administrator's notice which is subsequently published or be forever barred,
unless they are entitled to further service of notice under paragraph (b) or (c).
(b) The personal representative shall, within three months after the date of the first
publication of the notice, serve a copy of the notice upon each then known and identified
creditor in the manner provided in paragraph (c). If the decedent or a predeceased spouse
of the decedent received assistance for which a claim could be filed under section 246.53,
256B.15, 256D.16, or 261.04, notice to the commissioner of human services or deleted text begin Direct Care
and Treatment executive boarddeleted text end new text begin the commissioner of direct care and treatmentnew text end , as applicable,
must be given under paragraph (d) instead of under this paragraph or paragraph (c). A
creditor is "known" if: (i) the personal representative knows that the creditor has asserted
a claim that arose during the decedent's life against either the decedent or the decedent's
estate; (ii) the creditor has asserted a claim that arose during the decedent's life and the fact
is clearly disclosed in accessible financial records known and available to the personal
representative; or (iii) the claim of the creditor would be revealed by a reasonably diligent
search for creditors of the decedent in accessible financial records known and available to
the personal representative. Under this section, a creditor is "identified" if the personal
representative's knowledge of the name and address of the creditor will permit service of
notice to be made under paragraph (c).
(c) Unless the claim has already been presented to the personal representative or paid,
the personal representative shall serve a copy of the notice required by paragraph (b) upon
each creditor of the decedent who is then known to the personal representative and identified
either by delivery of a copy of the required notice to the creditor, or by mailing a copy of
the notice to the creditor by certified, registered, or ordinary first class mail addressed to
the creditor at the creditor's office or place of residence.
(d)(1) Effective for decedents dying on or after July 1, 1997, if the decedent or a
predeceased spouse of the decedent received assistance for which a claim could be filed
under section 246.53, 256B.15, 256D.16, or 261.04, the personal representative or the
attorney for the personal representative shall serve the commissioner new text begin of human services new text end or
deleted text begin executive boarddeleted text end new text begin the commissioner of direct care and treatmentnew text end , as applicable, with notice
in the manner prescribed in paragraph (c), or electronically in a manner prescribed by the
new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end , as soon as practicable after the appointment
of the personal representative. The notice must state the decedent's full name, date of birth,
and Social Security number and, to the extent then known after making a reasonably diligent
inquiry, the full name, date of birth, and Social Security number for each of the decedent's
predeceased spouses. The notice may also contain a statement that, after making a reasonably
diligent inquiry, the personal representative has determined that the decedent did not have
any predeceased spouses or that the personal representative has been unable to determine
one or more of the previous items of information for a predeceased spouse of the decedent.
A copy of the notice to creditors must be attached to and be a part of the notice to the
new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end .
(2) Notwithstanding a will or other instrument or law to the contrary, except as allowed
in this paragraph, no property subject to administration by the estate may be distributed by
the estate or the personal representative until 70 days after the date the notice is served on
the commissioner new text begin of human services new text end or deleted text begin executive boarddeleted text end new text begin commissioner of direct care and
treatmentnew text end as provided in paragraph (c), unless the local agency consents as provided for in
clause (6). This restriction on distribution does not apply to the personal representative's
sale of real or personal property, but does apply to the net proceeds the estate receives from
these sales. The personal representative, or any person with personal knowledge of the facts,
may provide an affidavit containing the description of any real or personal property affected
by this paragraph and stating facts showing compliance with this paragraph. If the affidavit
describes real property, it may be filed or recorded in the office of the county recorder or
registrar of titles for the county where the real property is located. This paragraph does not
apply to proceedings under sections 524.3-1203 and 525.31, or when a duly authorized
agent of a county is acting as the personal representative of the estate.
(3) At any time before an order or decree is entered under section 524.3-1001 or
524.3-1002, or a closing statement is filed under section 524.3-1003, the personal
representative or the attorney for the personal representative may serve an amended notice
on the commissioner new text begin of human services new text end or deleted text begin executive boarddeleted text end new text begin commissioner of direct care and
treatmentnew text end to add variations or other names of the decedent or a predeceased spouse named
in the notice, the name of a predeceased spouse omitted from the notice, to add or correct
the date of birth or Social Security number of a decedent or predeceased spouse named in
the notice, or to correct any other deficiency in a prior notice. The amended notice must
state the decedent's name, date of birth, and Social Security number, the case name, case
number, and district court in which the estate is pending, and the date the notice being
amended was served on the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end . If the amendment
adds the name of a predeceased spouse omitted from the notice, it must also state that
spouse's full name, date of birth, and Social Security number. The amended notice must be
served on the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end in the same manner as the original
notice. Upon service, the amended notice relates back to and is effective from the date the
notice it amends was served, and the time for filing claims arising under section 246.53,
256B.15, 256D.16 or 261.04 is extended by 60 days from the date of service of the amended
notice. Claims filed during the 60-day period are undischarged and unbarred claims, may
be prosecuted by the entities entitled to file those claims in accordance with section
524.3-1004, and the limitations in section 524.3-1006 do not apply. The personal
representative or any person with personal knowledge of the facts may provide and file or
record an affidavit in the same manner as provided for in clause (1).
(4) Within one year after the date an order or decree is entered under section 524.3-1001
or 524.3-1002 or a closing statement is filed under section 524.3-1003, any person who has
an interest in property that was subject to administration by the estate may serve an amended
notice on the commissioner new text begin of human services new text end or deleted text begin executive boarddeleted text end new text begin commissioner of direct
care and treatmentnew text end to add variations or other names of the decedent or a predeceased spouse
named in the notice, the name of a predeceased spouse omitted from the notice, to add or
correct the date of birth or Social Security number of a decedent or predeceased spouse
named in the notice, or to correct any other deficiency in a prior notice. The amended notice
must be served on the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end in the same manner as
the original notice and must contain the information required for amendments under clause
(3). If the amendment adds the name of a predeceased spouse omitted from the notice, it
must also state that spouse's full name, date of birth, and Social Security number. Upon
service, the amended notice relates back to and is effective from the date the notice it amends
was served. If the amended notice adds the name of an omitted predeceased spouse or adds
or corrects the Social Security number or date of birth of the decedent or a predeceased
spouse already named in the notice, then, notwithstanding any other laws to the contrary,
claims against the decedent's estate on account of those persons resulting from the amendment
and arising under section 246.53, 256B.15, 256D.16, or 261.04 are undischarged and
unbarred claims, may be prosecuted by the entities entitled to file those claims in accordance
with section 524.3-1004, and the limitations in section 524.3-1006 do not apply. The person
filing the amendment or any other person with personal knowledge of the facts may provide
and file or record an affidavit describing affected real or personal property in the same
manner as clause (1).
(5) After one year from the date an order or decree is entered under section 524.3-1001
or 524.3-1002, or a closing statement is filed under section 524.3-1003, no error, omission,
or defect of any kind in the notice to the commissioner new text begin of human services new text end or deleted text begin executive boarddeleted text end new text begin
commissioner of direct care and treatmentnew text end required under this paragraph or in the process
of service of the notice on the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end , or the failure
to serve the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end with notice as required by this
paragraph, makes any distribution of property by a personal representative void or voidable.
The distributee's title to the distributed property shall be free of any claims based upon a
failure to comply with this paragraph.
(6) The local agency may consent to a personal representative's request to distribute
property subject to administration by the estate to distributees during the 70-day period after
service of notice on the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end . The local agency may
grant or deny the request in whole or in part and may attach conditions to its consent as it
deems appropriate. When the local agency consents to a distribution, it shall give the estate
a written certificate evidencing its consent to the early distribution of assets at no cost. The
certificate must include the name, case number, and district court in which the estate is
pending, the name of the local agency, describe the specific real or personal property to
which the consent applies, state that the local agency consents to the distribution of the
specific property described in the consent during the 70-day period following service of the
notice on the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end , state that the consent is
unconditional or list all of the terms and conditions of the consent, be dated, and may include
other contents as may be appropriate. The certificate must be signed by the director of the
local agency or the director's designees and is effective as of the date it is dated unless it
provides otherwise. The signature of the director or the director's designee does not require
any acknowledgment. The certificate shall be prima facie evidence of the facts it states,
may be attached to or combined with a deed or any other instrument of conveyance and,
when so attached or combined, shall constitute a single instrument. If the certificate describes
real property, it shall be accepted for recording or filing by the county recorder or registrar
of titles in the county in which the property is located. If the certificate describes real property
and is not attached to or combined with a deed or other instrument of conveyance, it shall
be accepted for recording or filing by the county recorder or registrar of titles in the county
in which the property is located. The certificate constitutes a waiver of the 70-day period
provided for in clause (2) with respect to the property it describes and is prima facie evidence
of service of notice on the new text begin applicable new text end commissioner deleted text begin or executive boarddeleted text end . The certificate is
not a waiver or relinquishment of any claims arising under section 246.53, 256B.15, 256D.16,
or 261.04, and does not otherwise constitute a waiver of any of the personal representative's
duties under this paragraph. Distributees who receive property pursuant to a consent to an
early distribution shall remain liable to creditors of the estate as provided for by law.
(7) All affidavits provided for under this paragraph:
(i) shall be provided by persons who have personal knowledge of the facts stated in the
affidavit;
(ii) may be filed or recorded in the office of the county recorder or registrar of titles in
the county in which the real property they describe is located for the purpose of establishing
compliance with the requirements of this paragraph; and
(iii) are prima facie evidence of the facts stated in the affidavit.
(8) This paragraph applies to the estates of decedents dying on or after July 1, 1997.
Clause (5) also applies with respect to all notices served on the commissioner of human
services before July 1, 1997, under Laws 1996, chapter 451, article 2, section 55. All notices
served on the commissionernew text begin of human servicesnew text end before July 1, 1997, pursuant to Laws 1996,
chapter 451, article 2, section 55, shall be deemed to be legally sufficient for the purposes
for which they were intended, notwithstanding any errors, omissions or other defects.
Sec. 35.
Minnesota Statutes 2024, section 611.57, subdivision 2, is amended to read:
Subd. 2.
Membership.
(a) The Certification Advisory Committee consists of the
following members:
(1) a mental health professional, as defined in section 245I.02, subdivision 27, with
community behavioral health experience, appointed by the governor;
(2) a board-certified forensic psychiatrist with experience in competency evaluations,
providing competency attainment services, or both, appointed by the governor;
(3) a board-certified forensic psychologist with experience in competency evaluations,
providing competency attainment services, or both, appointed by the governor;
(4) the president of the Minnesota Corrections Association or a designee;
(5) the deleted text begin direct care and treatment deputy commissionerdeleted text end new text begin chief executive officer of direct
care and treatment new text end or a designee;
(6) the president of the Minnesota Association of County Social Service Administrators
or a designee;
(7) the president of the Minnesota Association of Community Mental Health Providers
or a designee;
(8) the president of the Minnesota Sheriffs' Association or a designee; and
(9) the executive director of the National Alliance on Mental Illness Minnesota or a
designee.
(b) Members of the advisory committee serve without compensation and at the pleasure
of the appointing authority. Vacancies shall be filled by the appointing authority consistent
with the qualifications of the vacating member required by this subdivision.
Sec. 36. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber each provision of Minnesota Statutes listed in
column A to the number listed in column B.
new text end
|
new text begin
Column A new text end |
new text begin
Column B new text end |
|
|
new text begin
246B.01, subdivision 2b new text end |
new text begin
246B.01, subdivision 2f new text end |
|
|
new text begin
246B.01, subdivision 2c new text end |
new text begin
246B.01, subdivision 2g new text end |
|
|
new text begin
246B.01, subdivision 2d new text end |
new text begin
246B.01, subdivision 2h new text end |
Sec. 37. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, sections 246B.01, subdivision 2; 252.021, subdivision 2;
253.195, subdivision 2; 253B.02, subdivision 7b; 253D.02, subdivision 7a; 254B.01,
subdivision 15; 256.045, subdivision 1a; and 256G.02, subdivision 5a,
new text end
new text begin
are repealed.
new text end
Sec. 38. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective the day following final enactment.
new text end
ARTICLE 10
DEPARTMENT OF HEALTH
Section 1.
Minnesota Statutes 2024, section 144A.01, subdivision 4, is amended to read:
Subd. 4.
Controlling person.
(a) "Controlling person" means an owner and the following
individuals and entities, if applicable:
(1) each officer of the organization, including the chief executive officer and the chief
financial officer;
(2) the nursing home administrator; deleted text begin and
deleted text end
(3) any managerial officialdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) if no individual has at least a five percent ownership interest, every individual with
an ownership interest in a privately held corporation, limited liability company, or other
business entity, including a business entity that is publicly traded or nonpublicly traded,
that collects capital investments from individuals or entities.
new text end
(b) "Controlling person" also means any entity or natural person who has any direct or
indirect ownership interest in:
(1) any corporation, partnership or other business association which is a controlling
person;
(2) the land on which a nursing home is located;
(3) the structure in which a nursing home is located;
(4) any entity with at least a five percent mortgage, contract for deed, deed of trust, or
other security interest in the land or structure comprising a nursing home; or
(5) any lease or sublease of the land, structure, or facilities comprising a nursing home.
(c) "Controlling person" does not include:
(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
directly or through a subsidiary operates a nursing home;
(2) government and government-sponsored entities such as the United States Department
of Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the
Minnesota Housing Finance Agency which provide loans, financing, and insurance products
for housing sites;
(3) an individual who is a state or federal official, a state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more nursing homes, unless the individual is also an officer,
owner, or managerial official of the nursing home, receives any remuneration from a nursing
home, or who is a controlling person not otherwise excluded in this subdivision;
(4) a natural person who is a member of a tax-exempt organization under section 290.05,
subdivision 2, unless the individual is also a controlling person not otherwise excluded in
this subdivision; and
(5) a natural person who owns less than five percent of the outstanding common shares
of a corporation:
(i) whose securities are exempt by virtue of section 80A.45, clause (6); or
(ii) whose transactions are exempt by virtue of section 80A.46, clause (7).
Sec. 2.
Minnesota Statutes 2024, section 144A.474, subdivision 11, is amended to read:
Subd. 11.
Fines.
(a) Fines and enforcement actions under this subdivision may be assessed
based on the level and scope of the violations described in paragraph (b) and imposed
immediately with no opportunity to correct the violation first as follows:
(1) Level 1, no fines or enforcement;
(2) Level 2, a fine of $500 per violation, in addition to any of the enforcement
mechanisms authorized in section 144A.475 for widespread violations;
(3) Level 3, a fine of $3,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;
(4) Level 4, a fine of $5,000 per incident, in addition to any of the enforcement
mechanisms authorized in section 144A.475;
(5) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000.
A fine of $5,000 may be imposed if the commissioner determines the licensee is responsible
for maltreatment consisting of sexual assault, death, or abuse resulting in serious injury;
and
(6) the fines in clauses (1) to (4) are increased and immediate fine imposition is authorized
for both surveys and investigations conducted.
When a fine is assessed against a facility for substantiated maltreatment, the commissioner
shall not also impose an immediate fine under this chapter for the same circumstance.
(b) Correction orders for violations are categorized by both level and scope and fines
shall be assessed as follows:
(1) level of violation:
(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
the client and does not affect health or safety;
(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
to have harmed a client's health or safety, but was not likely to cause serious injury,
impairment, or death;
(iii) Level 3 is a violation that harmed a client's health or safety, not including serious
injury, impairment, or death, or a violation that has the potential to lead to serious injury,
impairment, or death; and
(iv) Level 4 is a violation that results in serious injury, impairment, or death;
(2) scope of violation:
(i) isolated, when one or a limited number of clients are affected or one or a limited
number of staff are involved or the situation has occurred only occasionally;
(ii) pattern, when more than a limited number of clients are affected, more than a limited
number of staff are involved, or the situation has occurred repeatedly but is not found to be
pervasive; and
(iii) widespread, when problems are pervasive or represent a systemic failure that has
affected or has the potential to affect a large portion or all of the clients.
(c) If the commissioner finds that the applicant or a home care provider has not corrected
violations by the date specified in the correction order or conditional license resulting from
a survey or complaint investigation, the commissioner shall provide a notice of
noncompliance with a correction order by email to the applicant's or provider's last known
email address. The noncompliance notice must list the violations not corrected.
(d) For every violation identified by the commissioner, the commissioner shall issue an
immediate fine pursuant to paragraph (a), clause (6). The license holder must still correct
the violation in the time specified. The issuance of an immediate fine can occur in addition
to any enforcement mechanism authorized under section 144A.475. The immediate fine
may be appealed as allowed under this subdivision.
(e) The license holder must pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies by paying the fine. A
timely appeal shall stay payment of the fine until the commissioner issues a final order.
(f) A license holder shall promptly notify the commissioner in writing when a violation
specified in the order is corrected. If upon reinspection the commissioner determines that
a violation has not been corrected as indicated by the order, the commissioner may issue a
second fine. The commissioner shall notify the license holder by mail to the last known
address in the licensing record that a second fine has been assessed. The license holder may
appeal the second fine as provided under this subdivision.
(g) A home care provider that has been assessed a fine under this subdivision has a right
to a reconsideration or a hearing under this section and chapter 14.
(h) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder shall be liable for payment of the fine.
(i) In addition to any fine imposed under this section, the commissioner may assess a
penalty amount based on costs related to an investigation that results in a final order assessing
a fine or other enforcement action authorized by this chapter.
(j) Fines collected under paragraph (a), clauses (1) to (4), shall be deposited in a dedicated
special revenue account. On an annual basis, the balance in the special revenue account
shall be appropriated to the commissioner to implement the recommendations of the advisory
council established in section 144A.4799.new text begin The commissioner must publish on the department's
website an annual report on the fines assessed and collected, and how the appropriated
money was allocated.
new text end
deleted text begin
(k) Fines collected under paragraph (a), clause (5), shall be deposited in a dedicated
special revenue account and appropriated to the commissioner to provide compensation
according to subdivision 14 to clients subject to maltreatment. A client may choose to receive
compensation from this fund, not to exceed $5,000 for each substantiated finding of
maltreatment, or take civil action. This paragraph expires July 31, 2021.
deleted text end
Sec. 3.
Minnesota Statutes 2024, section 144A.4799, is amended to read:
144A.4799 deleted text begin DEPARTMENT OF HEALTH LICENSEDdeleted text end HOME CARE deleted text begin PROVIDERdeleted text end new text begin
AND ASSISTED LIVINGnew text end ADVISORY COUNCIL.
Subdivision 1.
Membership.
The commissioner of health shall appoint deleted text begin 13deleted text end new text begin 14new text end persons
to a home care and assisted living deleted text begin programdeleted text end advisory council consisting of the following:
(1) deleted text begin twodeleted text end new text begin fournew text end public members as defined in section 214.02 deleted text begin who shall be persons who are
currently receiving home care services, persons who have received home care services
within five years of the application date, persons who have family members receiving home
care services, or persons who have family members who have received home care services
within five years of the application datedeleted text end new text begin , one of whom must be a person who either is
receiving or has received home care services preferably within the five years prior to initial
appointment, one of whom must be a person who has or had a family member receiving
home care services preferably within the five years prior to initial appointment, one of whom
must be a person who either is or has been a resident in an assisted living facility preferably
within the five years prior to initial appointment, and one of whom must be a person who
has or had a family member residing in an assisted living facility preferably within the five
years prior to initial appointmentnew text end ;
(2) two Minnesota home care licensees representing basic and comprehensive levels of
licensure who may be a managerial official, an administrator, a supervising registered nurse,
or an unlicensed personnel performing home care tasks;
(3) one member representing the Minnesota Board of Nursing;
(4) one member representing the Office of Ombudsman for Long-Term Care;
(5) one member representing the Office of Ombudsman for Mental Health and
Developmental Disabilities;
(6) deleted text begin beginning July 1, 2021,deleted text end one member of a county health and human services or county
adult protection office;
(7) two Minnesota assisted living facility licensees representing assisted living facilities
and assisted living facilities with dementia care levels of licensure who may be the facility's
assisted living director, managerial official, or clinical nurse supervisor;
(8) one organization representing long-term care providers, home care providers, and
assisted living providers in Minnesota; and
(9) deleted text begin two public members as defined in section 214.02. One public member shall be a
person who either is or has been a resident in an assisted living facility and one public
member shall be a person who has or had a family member living in an assisted living
facility settingdeleted text end new text begin one representative of a consumer advocacy organization representing
individuals receiving long-term care from licensed home care or assisted living providersnew text end .
Subd. 2.
Organizations and meetings.
The advisory council shall be organized and
administered under section 15.059 with per diems and costs paid within the limits of available
appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees
may be developed as necessary by the commissioner. Advisory council meetings are subject
to the Open Meeting Law under chapter 13D.
Subd. 3.
Duties.
(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of Department of Health licensed assisted living and home
care providers in this chapternew text begin and chapter 144Gnew text end , including advice on the following:
(1) community standards for home care practices;
(2) enforcement of licensing standards and whether certain disciplinary actions are
appropriate;
(3) ways of distributing information to licensees and consumers of new text begin .new text end home care and
assisted living services defined under chapter 144G;
(4) training standards;
(5) identifying emerging issues and opportunities in home care and assisted living services
defined under chapter 144G;
(6) identifying the use of technology in home and telehealth capabilities;
(7) allowable home care licensing modifications and exemptions, including a method
for an integrated license with an existing license for rural licensed nursing homes to provide
limited home care services in an adjacent independent living apartment building owned by
the licensed nursing home; and
(8) recommendations for studies using the data in section 62U.04, subdivision 4, including
but not limited to studies concerning costs related to dementia and chronic disease among
an elderly population over 60 and additional long-term care costsdeleted text begin , as described in section
62U.10, subdivision 6deleted text end .
(b) The advisory council shall perform other duties as directed by the commissioner.
(c) The advisory council shall deleted text begin annuallydeleted text end make recommendations new text begin annually new text end to the
commissioner for the purposes new text begin of allocating the appropriation new text end in deleted text begin sectiondeleted text end new text begin sectionsnew text end 144A.474,
subdivision 11, paragraph deleted text begin (i)deleted text end new text begin (j), and 144G.31, subdivision 8new text end . new text begin The commissioner shall act
upon the recommendations of the advisory council within one year of the advisory council
submitting its recommendations to the commissioner.new text end The recommendations shall address
ways the commissioner may improve protection of the public under existing statutes and
laws and new text begin improve quality of care. The council's recommendations may new text end include but are not
limited to new text begin special new text end projects new text begin or initiatives new text end thatnew text begin :
new text end
new text begin (1)new text end create and administer training of licensees and new text begin ongoing training for new text end their employees
to improvenew text begin clients' andnew text end residents' lives, deleted text begin supporting ways thatdeleted text end new text begin supportnew text end licenseesnew text begin ,new text end deleted text begin candeleted text end improve
and enhance quality carenew text begin ,new text end and deleted text begin ways todeleted text end provide technical assistance to licensees to improve
compliance;
new text begin (2) develop and implementnew text end information technology and data projects that analyze and
communicate information about trends deleted text begin ofdeleted text end new text begin innew text end violations or lead to ways of improving new text begin resident
and new text end client care;
new text begin (3) improvenew text end communications strategies to licensees and the publicnew text begin ;
new text end
new text begin
(4) recruit and retain direct care staff;
new text end
new text begin (5) recommend education related to the care of vulnerable adults in professional nursing
programs, nurse aide programs, and home health aide programsnew text end ; and
new text begin (6)new text end deleted text begin other projects or pilots thatdeleted text end benefit new text begin residents, new text end clients, families, and the publicnew text begin in other
waysnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025, and the amendments to
subdivision 1, clause (1), apply to members whose initial appointment occurs on or after
that date.
new text end
Sec. 4.
Minnesota Statutes 2024, section 144G.08, subdivision 15, is amended to read:
Subd. 15.
Controlling individual.
(a) "Controlling individual" means an owner and the
following individuals and entities, if applicable:
(1) each officer of the organization, including the chief executive officer and chief
financial officer;
(2) each managerial official; deleted text begin and
deleted text end
(3) any entity with at least a five percent mortgage, deed of trust, or other security interest
in the facilitydeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(4) if no individual has at least a five percent ownership interest, every individual with
an ownership interest in a privately held corporation, limited liability company, or other
business entity, including a business entity that is publicly traded or nonpublicly traded,
that collects capital investments from individuals or entities.
new text end
new text begin
(b) Controlling individual also means any entity or natural person who has any direct
or indirect ownership interest in:
new text end
new text begin
(1) any corporation, partnership, or other business association such as a limited liability
company that is a controlling individual;
new text end
new text begin
(2) the land on which an assisted living facility is located; or
new text end
new text begin
(3) the structure in which an assisted living facility is located.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end Controlling individual does not include:
(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;
(2) government and government-sponsored entities such as the U.S. Department of
Housing and Urban Development, Ginnie Mae, Fannie Mae, Freddie Mac, and the Minnesota
Housing Finance Agency which provide loans, financing, and insurance products for housing
sites;
(3) an individual who is a state or federal official, a state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more facilities, unless the individual is also an officer,
owner, or managerial official of the facility, receives remuneration from the facility, or
owns any of the beneficial interests not excluded in this subdivision;
(4) an individual who owns less than five percent of the outstanding common shares of
a corporation:
(i) whose securities are exempt under section 80A.45, clause (6); or
(ii) whose transactions are exempt under section 80A.46, clause (2);
(5) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the license
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or
(6) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual.
Sec. 5.
Minnesota Statutes 2024, section 144G.31, subdivision 8, is amended to read:
Subd. 8.
Deposit of fines.
new text begin (a) new text end Fines collected under this section shall be deposited in a
dedicated special revenue account. On an annual basis, the balance in the special revenue
account shall be appropriated to new text begin a competitive grant program for assisted living providers
licensed under chapter 144G or other organizations with experience in assisted living
operations, compliance, and best practices for the purpose of new text end the commissioner for special
projects to improve resident quality of care and outcomes in assisted living facilities licensed
under this chapter in Minnesotanew text begin . A provider with a provisional license under chapter 144G
is not eligible to apply. The balance in the special revenue account as of January 1, 2026,
must be appropriated for grants within two years, provided there are enough grant requests
totaling the sum in the account. Thereafter, money in the special revenue account must be
appropriated annuallynew text end as recommended by the advisory council established in section
144A.4799new text begin , or as recommended by the commissioner after the advisory council's review
and approval. The minimum amount of a grant award is $10,000. The commissioner may
retain up to ten percent of the amount available to cover costs to administer the grants under
this sectionnew text end .
new text begin
(b) The commissioner must publish on the department's website an annual report on the
fines assessed and collected, and how the appropriated money was allocated.
new text end
Sec. 6.
Minnesota Statutes 2024, section 144G.52, subdivision 1, is amended to read:
Subdivision 1.
Definition.
For purposes of sections 144G.52 to 144G.55, "termination"
means:
(1) a facility-initiated termination of deleted text begin housing provided to the resident under the contractdeleted text end new text begin
an assisted living contractnew text end ; or
(2) a facility-initiated termination deleted text begin or nonrenewaldeleted text end of all assisted living services the resident
receives from the facility under the new text begin assisted living new text end contract.
Sec. 7.
Minnesota Statutes 2024, section 144G.52, subdivision 2, is amended to read:
Subd. 2.
Prerequisite to termination of a contract.
(a) Before issuing a notice of
termination of an assisted living contract, a facility must schedule and participate in a meeting
with the resident and the resident's legal representative and designated representative. The
purposes of the meeting are to:
(1) explain in detail the reasons for the proposed termination; and
(2) identify and offer reasonable accommodations or modifications, interventions, or
alternatives to avoid the termination or enable the resident to remain in the facility, including
but not limited to securing services from another provider of the resident's choosing that
may allow the resident to avoid the termination. A facility is not required to offer
accommodations, modifications, interventions, or alternatives that fundamentally alter the
nature of the operation of the facility.
(b) new text begin For a termination pursuant to subdivision 3 or 4, new text end the meeting must be scheduled to
take place at least seven days before a notice of termination is issued. The facility must
make reasonable efforts to ensure that the resident, legal representative, and designated
representative are able to attend the meeting.
(c) new text begin For a termination pursuant to subdivision 5, the meeting must be scheduled to take
place at least five days before a notice of termination is issued. The facility must make
reasonable efforts to ensure that the resident, legal representative, and designated
representative are able to attend the meeting.
new text end
new text begin (d) new text end The facility must notify the resident that the resident may invite family members,
relevant health professionals, a representative of the Office of Ombudsman for Long-Term
Care, a representative of the Office of Ombudsman for Mental Health and Developmental
Disabilities, or other persons of the resident's choosing to participate in the meeting. For
residents who receive home and community-based waiver services under chapter 256S and
section 256B.49, the facility must notify the resident's case manager of the meeting.
deleted text begin (d)deleted text end new text begin (e)new text end In the event of an emergency relocation under subdivision 9, where the facility
intends to issue a notice of termination and an in-person meeting is impractical or impossible,
the facility must use telephone, video, or other electronic means to conduct and participate
in the meeting required under this subdivision and rules within Minnesota Rules, chapter
4659.
Sec. 8.
Minnesota Statutes 2024, section 144G.52, subdivision 3, is amended to read:
Subd. 3.
Termination for nonpayment.
(a) A facility may initiate a termination of
housing because of nonpayment of rent or a termination of services because of nonpayment
for services. Upon issuance of a notice of termination for nonpayment, the facility must
inform the resident that public benefits may be available and must provide contact
information for the Senior LinkAge Line under section 256.975, subdivision 7new text begin , or the
Disability Hub under section 256.01, subdivision 24new text end .
(b) An interruption to a resident's public benefits that lasts for no more than 60 days
does not constitute nonpayment.
Sec. 9.
Minnesota Statutes 2024, section 144G.52, subdivision 8, is amended to read:
Subd. 8.
Content of notice of termination.
The notice required under subdivision 7
must contain, at a minimum:
(1) the effective date of the termination of the assisted living contract;
(2) a detailed explanation of the basis for the termination, including the clinical or other
supporting rationale;
(3) a detailed explanation of the conditions under which a new or amended contract may
be executed;
(4) a statement that the resident has the right to appeal the termination by requesting a
hearing, and information concerning the time frame within which the request must be
submitted and the contact information for the agency to which the request must be submitted;
(5) a statement that the facility must participate in a coordinated move to another provider
or caregiver, as required under section 144G.55;
(6) the name and contact information of the person employed by the facility with whom
the resident may discuss the notice of termination;
(7) information on how to contact the Office of Ombudsman for Long-Term Care and
the Office of Ombudsman for Mental Health and Developmental Disabilities to request an
advocate to assist regarding the termination;
(8) information on how to contact the Senior LinkAge Line under section 256.975,
subdivision 7, new text begin or the Disability Hub under section 256.01, subdivision 24, new text end and an explanation
that the Senior LinkAge Line new text begin and the Disability Hub new text end may provide information about other
available housing or service options; and
(9) if the termination is only for services, a statement that the resident may remain in
the facility and may secure any necessary services from another provider of the resident's
choosing.
Sec. 10.
Minnesota Statutes 2024, section 144G.54, subdivision 3, is amended to read:
Subd. 3.
Appeals process.
(a) The Office of Administrative Hearings must conduct an
expedited hearing as soon as practicable under this section, but in no event later than 14
calendar days after the office receives the request, unless the parties agree otherwise or the
chief administrative law judge deems the timing to be unreasonable, given the complexity
of the issues presented.new text begin For terminations initiated pursuant to section 144G.52, subdivision
5, the Office of Administrative Hearings must conduct an expedited hearing as soon as
practicable but in no event later than ten calendar days after the office receives the request,
unless the parties agree otherwise. The Office of Administrative Hearings has discretion to
order a continuance.
new text end
(b) The hearing must be held at the facility where the resident lives, unless holding the
hearing at that location is impractical, the parties agree to hold the hearing at a different
location, or the chief administrative law judge grants a party's request to appear at another
location or by telephone or interactive video.
(c) The hearing is not a formal contested case proceeding, except when determined
necessary by the chief administrative law judge.
(d) Parties may but are not required to be represented by counsel. The appearance of a
party without counsel does not constitute the unauthorized practice of law.
(e) The hearing shall be limited to the amount of time necessary for the participants to
expeditiously present the facts about the proposed termination. The administrative law judge
shall issue a recommendation to the commissioner as soon as practicable, but in no event
later than ten business days after the hearingnew text begin related to a termination issued under section
144G.52, subdivision 3 or 4, or five business days for a hearing related to a termination
issued under section 144G.52, subdivision 5new text end .
Sec. 11.
Minnesota Statutes 2024, section 144G.54, subdivision 7, is amended to read:
Subd. 7.
Application of chapter 504B to appeals of terminations.
A resident may not
bring an action under chapter 504B to challenge a termination that has occurred and been
upheld under this section.new text begin A facility is entitled to a writ of recovery of premises and order
to vacate pursuant to section 504B.361 when a termination has been upheld under this
section and the facility has met its obligation under section 144G.55.
new text end
Sec. 12.
Minnesota Statutes 2024, section 144G.55, subdivision 1, is amended to read:
Subdivision 1.
Duties of facility.
(a) If a facility terminates an assisted living contract,
reduces services to the extent that a resident needs to move or obtain a new service provider
or the facility has its license restricted under section 144G.20, or the facility conducts a
planned closure under section 144G.57, the facility:
(1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is
appropriate for the resident and that is identified by the facility prior to any hearing under
section 144G.54new text begin and document the samenew text end ;
(2) must ensure a coordinated move of the resident to an appropriate service provider
identified by the facility prior to any hearing under section 144G.54, provided services are
still needed and desired by the resident; and
(3) must consult and cooperate with the resident, legal representative, designated
representative, case manager for a resident who receives home and community-based waiver
services under chapter 256S and section 256B.49, relevant health professionals, and any
other persons of the resident's choosing to make arrangements to move the resident, including
consideration of the resident's goalsnew text begin and document the samenew text end .
(b) A facility may satisfy the requirements of paragraph (a), clauses (1) and (2), by
moving the resident to a different location within the same facility, if appropriate for the
resident.
(c) A resident may decline to move to the location the facility identifies or to accept
services from a service provider the facility identifies, and may choose instead to move to
a location of the resident's choosing or receive services from a service provider of the
resident's choosing within the timeline prescribed in the termination notice.
(d) new text begin A facility has met its obligations under this section, following a termination completed
in accordance with section 144G.52 if:
new text end
new text begin
(1) for residents of facilities in the seven-county metropolitan area, the facility identifies
at least three other facilities willing and able to meet the individual's service needs, one of
which is within the seven-county metropolitan area;
new text end
new text begin
(2) for residents of facilities outside of the seven-county metropolitan area, the facility
identifies at least two other facilities willing and able to meet the individual's service needs,
and to the extent such facilities exist, one must be within two hours or 120 miles from the
resident's current location; and
new text end
new text begin
(3) the facility documents, in writing, the resident or the resident's designated
representative has:
new text end
new text begin
(i) consented to move; or
new text end
new text begin
(ii) expressly refused to relocate to any of the facilities identified in accordance with
this subdivision.
new text end
new text begin (e) new text end Sixty days before the facility plans to reduce or eliminate one or more services for
a particular resident, the facility must provide written notice of the reduction that includes:
(1) a detailed explanation of the reasons for the reduction and the date of the reduction;
(2) the contact information for the Office of Ombudsman for Long-Term Care, the Office
of Ombudsman for Mental Health and Developmental Disabilities, and the name and contact
information of the person employed by the facility with whom the resident may discuss the
reduction of services;
(3) a statement that if the services being reduced are still needed by the resident, the
resident may remain in the facility and seek services from another provider; and
(4) a statement that if the reduction makes the resident need to move, the facility must
participate in a coordinated move of the resident to another provider or caregiver, as required
under this section.
deleted text begin (e)deleted text end new text begin (f)new text end In the event of an unanticipated reduction in services caused by extraordinary
circumstances, the facility must provide the notice required under paragraph deleted text begin (d)deleted text end new text begin (e)new text end as soon
as possible.
deleted text begin (f)deleted text end new text begin (g)new text end If the facility, a resident, a legal representative, or a designated representative
determines that a reduction in services will make a resident need to move to a new location,
the facility must ensure a coordinated move in accordance with this section, and must provide
notice to the Office of Ombudsman for Long-Term Care.
deleted text begin (g)deleted text end new text begin (h)new text end Nothing in this section affects a resident's right to remain in the facility and seek
services from another provider.
Sec. 13.
new text begin
[145D.40] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Application. new text end
new text begin
For purposes of sections 145D.40 to 145D.41, the following
terms have the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Assisted living facility. new text end
new text begin
"Assisted living facility" has the meaning given in
section 144G.08, subdivision 7. Assisted living facility includes an assisted living facility
with dementia care as defined in section 144G.08, subdivision 8.
new text end
new text begin Subd. 3. new text end
new text begin Health care professional. new text end
new text begin
"Health care professional" means an individual who
is licensed or registered by the state to provide health care services within the professional's
scope of practice and in accordance with state law.
new text end
new text begin Subd. 4. new text end
new text begin Nursing home. new text end
new text begin
"Nursing home" means a facility licensed as a nursing home
under chapter 144A.
new text end
new text begin Subd. 5. new text end
new text begin Ownership or control. new text end
new text begin
"Ownership or control" means the assumption of
governance or the acquisition of an ownership interest or direct or indirect control by a
for-profit entity over the operations of a nonprofit nursing home or a nonprofit assisted
living facility through any means, including but not limited to a purchase, lease, transfer,
exchange, option, conveyance, creation of a joint venture, or other manner of acquisition
of assets, governance, an ownership interest, or direct or indirect control of a nonprofit
nursing home or a nonprofit assisted living facility.
new text end
Sec. 14.
new text begin
[145D.41] NOTICE, INFORMATION, AND AFFIDAVIT REQUIRED.
new text end
new text begin Subdivision 1. new text end
new text begin Notice and information. new text end
new text begin
(a) At least 120 days prior to the transfer of
ownership or control of a nonprofit nursing home or nonprofit assisted living facility to a
for-profit entity, the nursing home or assisted living facility must provide written notice to
the attorney general, the commissioner of health, and the commissioner of human services
of its intent to transfer ownership or control to a for-profit entity.
new text end
new text begin
(b) Together with the notice, the for-profit entity seeking to acquire ownership or control
of the nonprofit nursing home or nonprofit assisted living facility must provide the following
information to the attorney general, commissioner of health, and commissioner of human
services:
new text end
new text begin
(1) the names of each individual with an interest in the for-profit entity and the percentage
of interest each individual holds in the for-profit entity;
new text end
new text begin
(2) a complete and detailed description of the for-profit entity's corporate structure;
new text end
new text begin
(3) the names of each individual holding an interest in, and the percentage of interest
held in, any affiliate, subsidiary, or otherwise related entity that the for-profit entity has a
contract to provide goods or services for the operation or maintenance of the nursing home
or assisted living facility or has a contract for goods and services to be provided to residents,
including any real estate investment trusts;
new text end
new text begin
(4) for the previous five years, any filings required to be made to any federal or state
agency;
new text end
new text begin
(5) the for-profit entity's current balance sheet;
new text end
new text begin
(6) all application materials required under section 144A.03 or 144G.12, as applicable;
new text end
new text begin
(7) a description of the condition of the buildings the for-profit entity seeks to acquire
or manage, identifying any cooling problems, electric medical devices present, recent exterior
additions and replacements, external building conditions, recent flush toilet breakdowns,
foreclosure status in the last 12 months, heat risk, heating problems, indoor air quality,
recent interior additions and replacements, and mold, as those terms are defined and described
in Appendix A of the American Housing Survey for the United States: 2023;
new text end
new text begin
(8) an affidavit and evidence as required under subdivision 2; and
new text end
new text begin
(9) other information required by the attorney general, commissioner of health, and
commissioner of human services.
new text end
new text begin Subd. 2. new text end
new text begin Affidavit and evidence. new text end
new text begin
In addition to the notice required under subdivision
1, a for-profit entity seeking to acquire ownership or control of a nonprofit nursing home
or nonprofit assisted living facility must submit to the attorney general an affidavit and
evidence sufficient to demonstrate that:
new text end
new text begin
(1) the for-profit entity has the financial, managerial, and operational ability to operate
or manage the nursing home or assisted living facility consistent with the requirements of
(i) for a nursing home, sections 144A.01 to 144A.1888, chapter 256R, and Minnesota Rules,
chapter 4658; or (ii) for an assisted living facility, chapter 144G and Minnesota Rules,
chapter 4659;
new text end
new text begin
(2) neither the for-profit entity nor any of its owners, managerial officials, or managers
have committed a crime listed in, or been found civilly liable for an offense listed in section
144A.03, subdivision 1, clause (13), or 144G.12, subdivision 1, clause (13), as applicable;
new text end
new text begin
(3) in the preceding ten years, there have been no judgments and no filed, pending, or
completed public or private litigations, tax liens, written complaints, administrative actions,
or investigations by a government agency against the for-profit entity or any of its owners,
managerial officials, or managers;
new text end
new text begin
(4) in the preceding ten years, the for-profit entity has not defaulted in the payment of
money collected for others and has not discharged debts through bankruptcy proceedings;
new text end
new text begin
(5) the for-profit entity will invest sufficient capital in the nursing home or assisted living
facility to maintain or improve the facility's infrastructure and staffing;
new text end
new text begin
(6)(i) housing costs or costs for services in a nursing home or assisted living facility in
the United States over which the for-profit entity acquired ownership or control have not
increased by more than the increase in the Consumer Price Index for all urban consumers
published by the federal Bureau of Labor Statistics for the 12 months preceding the month
in which the increase became effective; or (ii) if housing costs or costs for services in the
nursing home or assisted living facility increased by more than the increase in the Consumer
Price Index as described in item (i), the increase was justified;
new text end
new text begin
(7) within five years after acquiring ownership or control of any other nursing home or
assisted living facility in the United States, the for-profit entity did not sell or otherwise
transfer ownership or control of the nursing home or assisted living facility to another person;
and
new text end
new text begin
(8) after acquiring ownership or control of another nursing home in the United States,
that nursing home, with respect to the Centers for Medicare and Medicaid Services rating
system:
new text end
new text begin
(i) maintained or improved the nursing home's rating if upon acquisition of ownership
or control the rating was three or more stars; or
new text end
new text begin
(ii) improved the nursing home's rating to at least three stars if upon acquisition of
ownership or control the rating was one or two stars.
new text end
Sec. 15.
new text begin
[256.4751] MINNESOTA HOMELESS STUDY GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Minnesota homeless study grant program established. new text end
new text begin
The
commissioner shall establish a grant program for activities directly related to a triennial
Minnesota homeless study.
new text end
new text begin Subd. 2. new text end
new text begin Eligibility. new text end
new text begin
Minnesota-based nonprofits with experience conducting point-in-time
studies of prevalence of homelessness in Minnesota are eligible for grants under this section.
new text end
new text begin Subd. 3. new text end
new text begin Study administration and reporting. new text end
new text begin
Beginning in fiscal year 2027, the grantee
must conduct a triennial point-in-time study that includes face-to-face interviews with people
experiencing homelessness. The grantee must submit a copy of the Minnesota homeless
study and a report that summarizes the findings of the study to the chairs and ranking
minority members of the legislative committees with jurisdiction over human services and
housing and homelessness by March 1 of the year that is approximately 18 months after the
date of the point-in-time study.
new text end
new text begin Subd. 4. new text end
new text begin Minnesota homeless study account created. new text end
new text begin
A Minnesota homeless study
account is created in the special revenue fund in the state treasury. Appropriations made
for the Minnesota homeless study administered under this section must be transferred to
this account. Money in the Minnesota homeless study account is appropriated to the
commissioner of human services for purposes of this section. Notwithstanding section
16B.98, subdivision 14, for each fiscal year in which a grant is awarded under this section,
the commissioner may use an amount not to exceed one percent of the money awarded.
new text end
new text begin Subd. 5. new text end
new text begin Carryforward. new text end
new text begin
Notwithstanding section 16A.28, subdivision 3, money in the
Minnesota homeless study account does not cancel.
new text end
Sec. 16.
Minnesota Statutes 2024, section 256B.092, subdivision 1a, is amended to read:
Subd. 1a.
Case management services.
(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described in
the federally approved waiver application.
(b) Case management service activities provided to or arranged for a person include:
(1) development of the person-centered support plan under subdivision 1b;
(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options, including all service options available under the
waiver plan;
(3) consulting with relevant medical experts or service providers;
(4) assisting the person in the identification of potential providers of chosen services,
including:
(i) providers of services provided in a non-disability-specific setting;
(ii) employment service providers;
(iii) providers of services provided in settings that are not controlled by a provider; and
(iv) providers of financial management services;
(5) assisting the person to access services and assisting in appeals under section 256.045;
(6) coordination of services, if coordination is not provided by another service provider;
(7) evaluation and monitoring of the services identified in the support plan, which must
incorporate at least one annual face-to-face visit by the case manager with each person; deleted text begin and
deleted text end
(8) reviewing support plans and providing the lead agency with recommendations for
service authorization based upon the individual's needs identified in the support plannew text begin ; and
new text end
new text begin (9) assisting and cooperating with providers licensed under chapter 144G with the
licensee's obligations under section 144G.55new text end .
(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.
If a county agency contracts for case management services, the county agency must provide
each recipient of home and community-based services who is receiving contracted case
management services with the contact information the recipient may use to file a grievance
with the county agency about the quality of the contracted services the recipient is receiving
from a county-contracted case manager. If a county agency provides case management
under contracts with other individuals or agencies and the county agency utilizes a
competitive proposal process for the procurement of contracted case management services,
the competitive proposal process must include evaluation criteria to ensure that the county
maintains a culturally responsive program for case management services adequate to meet
the needs of the population of the county. For the purposes of this section, "culturally
responsive program" means a case management services program that: (1) ensures effective,
equitable, comprehensive, and respectful quality care services that are responsive to
individuals within a specific population's values, beliefs, practices, health literacy, preferred
language, and other communication needs; and (2) is designed to address the unique needs
of individuals who share a common language or racial, ethnic, or social background.
(d) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has a financial interest in the provision
of any other services included in the recipient's support plan. For purposes of this section,
"private agency" means any agency that is not identified as a lead agency under section
256B.0911, subdivision 10.
(e) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
person-centered support plan and habilitation plan.
(f) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:
(1) phasing out the use of prohibited procedures;
(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and
(3) accomplishment of identified outcomes.
If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.
(g) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than 20 hours of case management
education and disability-related training each year. The education and training must include
person-centered planning, informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supports. By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case
managers must document completion of training in a system identified by the commissioner.
Sec. 17.
Minnesota Statutes 2024, section 256B.49, subdivision 13, is amended to read:
Subd. 13.
Case management.
(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:
(1) finalizing the person-centered written support plan within the timelines established
by the commissioner and section 256B.0911, subdivision 29;
(2) informing the recipient or the recipient's legal guardian or conservator of service
options, including all service options available under the waiver plans;
(3) assisting the recipient in the identification of potential service providers of chosen
services, including:
(i) available options for case management service and providers;
(ii) providers of services provided in a non-disability-specific setting;
(iii) employment service providers;
(iv) providers of services provided in settings that are not community residential settings;
and
(v) providers of financial management services;
(4) assisting the recipient to access services and assisting with appeals under section
256.045; deleted text begin and
deleted text end
(5) coordinating, evaluating, and monitoring of the services identified in the service
plannew text begin ; and
new text end
new text begin (6) assisting and cooperating with providers licensed under chapter 144G with the
licensee's obligations under section 144G.55new text end .
(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:
(1) finalizing the person-centered support plan;
(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved person-centered support plan; and
(3) adjustments to the person-centered support plan.
(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. If a county agency provides case
management under contracts with other individuals or agencies and the county agency
utilizes a competitive proposal process for the procurement of contracted case management
services, the competitive proposal process must include evaluation criteria to ensure that
the county maintains a culturally responsive program for case management services adequate
to meet the needs of the population of the county. For the purposes of this section, "culturally
responsive program" means a case management services program that: (1) ensures effective,
equitable, comprehensive, and respectful quality care services that are responsive to
individuals within a specific population's values, beliefs, practices, health literacy, preferred
language, and other communication needs; and (2) is designed to address the unique needs
of individuals who share a common language or racial, ethnic, or social background.
(d) Case management services must not be provided to a recipient by a private agency
that has any financial interest in the provision of any other services included in the recipient's
support plan. For purposes of this section, "private agency" means any agency that is not
identified as a lead agency under section 256B.0911, subdivision 10.
(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:
(1) phasing out the use of prohibited procedures;
(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and
(3) accomplishment of identified outcomes.
If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.
(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than 20 hours of case management
education and disability-related training each year. The education and training must include
person-centered planning, informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supports. By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 10. Case
managers shall document completion of training in a system identified by the commissioner.
Sec. 18. new text begin DIRECTION TO COMMISSIONER; COMPLIANCE COSTS AND
REIMBURSEMENT RATES.
new text end
new text begin
(a) The commissioner of human services and the commissioner of health must convene
a group of interested parties to examine the relationship between the costs incurred to comply
with the licensing requirements under Minnesota Statutes, chapter 144G, and reimbursement
rates for providing customized living services under Minnesota Statutes, chapter 256S, and
section 256B.4914, subdivision 6d. The commissioners must include among the interested
parties the Long-Term Care Imperative, the Residential Providers Association of Minnesota,
the Minnesota Association of County Social Service Administrators, and people with
disabilities currently receiving customized living services under the federally approved
brain injury, community access for disability inclusion, and elderly waiver plans.
new text end
new text begin
(b) The commissioners of human services and health must develop draft legislative
language to better align the licensing requirements and reimbursement framework so that
the costs incurred to comply with licensing requirements and fees are adequately reimbursed
through the rates paid for providing customized living services.
new text end
new text begin
(c) The commissioners must submit the draft legislation to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance by January 1, 2027.
new text end
Sec. 19. new text begin DIRECTION TO THE COMMISSIONER OF HEALTH; COMMUNITY
CARE HUB GRANT.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of health shall establish a single grant
to expand and strengthen the community care hub model in Minnesota by organizing and
supporting a network of health and social care service providers to address health-related
social needs.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms have the
meanings given.
new text end
new text begin
(b) "Community-based organization" means a public or private nonprofit organization
of demonstrated effectiveness that is representative of a community or significant segments
of a community and provides services that address the social drivers of health, education,
or related services to individuals in the community.
new text end
new text begin
(c) "Community care hub" means a nonprofit organization that provides a centralized
administrative and operational interface between health care institutions and a network of
community-based organizations that provide health promotion and social care services.
new text end
new text begin
(d) "Health-related social needs" means the individual-level, adverse social conditions
that can negatively impact a person's health or health care, such as poor health literacy, food
insecurity, housing instability, and lack of access to transportation.
new text end
new text begin
(e) "Social care services" means culturally informed services to address health-related
social needs and community-informed health promotion programs.
new text end
new text begin Subd. 3. new text end
new text begin Eligible applicants. new text end
new text begin
To be eligible for the single grant available under this
section, a grant applicant must:
new text end
new text begin
(1) be recognized as a selected community care hub by the federal Administration for
Community Living and the Centers for Disease Control and Prevention;
new text end
new text begin
(2) be the recipient of the community care hub planning grant under Laws 2024, chapter
127, article 53, section 3, subdivision 2, paragraph (a);
new text end
new text begin
(3) hold contracts with health plans within Minnesota that allow the applicant to provide
social care services to a plan's covered member population; and
new text end
new text begin
(4) demonstrate active engagement in providing, coordinating, and aiding health care
and social care services at the community level.
new text end
new text begin Subd. 4. new text end
new text begin Eligible uses. new text end
new text begin
The grantee must use awarded money to:
new text end
new text begin
(1) engage and organize community-based organizations to deliver social care services;
new text end
new text begin
(2) expand the reach and scope of social care services;
new text end
new text begin
(3) centralize administrative functions and operational infrastructure of community care
hubs related to:
new text end
new text begin
(i) contracting with health care organizations;
new text end
new text begin
(ii) payment operations;
new text end
new text begin
(iii) management of referrals, including reporting on the outcome of the services and
the specific help provided;
new text end
new text begin
(iv) service delivery fidelity and compliance;
new text end
new text begin
(v) quality improvement;
new text end
new text begin
(vi) technology;
new text end
new text begin
(vii) information security; and
new text end
new text begin
(viii) data collection, data analysis, and reporting;
new text end
new text begin
(4) create sustainable financial pathways for services that address health-related social
needs throughout the state of Minnesota; and
new text end
new text begin
(5) support tracking of the financial pathways and the services provided.
new text end
new text begin Subd. 5. new text end
new text begin Grantee report. new text end
new text begin
The grantee must report community care hub initiative
outcomes as determined by the commissioner of health to the commissioner on the forms
and according to the timelines established by the commissioner.
new text end
new text begin Subd. 6. new text end
new text begin Evaluation. new text end
new text begin
The commissioner of health shall design, conduct, and evaluate
the community care hub initiative implemented by the grantee using measures to assess
cost savings, impact, and health impact outcomes.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 20. new text begin RESIDENTIAL HOSPICE; IVY HOUSE.
new text end
new text begin
(a) Southern Minnesota Crisis Nursery, DBA Ivy House, may apply under Minnesota
Statutes, sections 144A.75 to 144A.756, to be a licensed residential hospice facility as
defined in Minnesota Statutes, section 144A.75, subdivision 13, paragraph (a). Nothing in
this section shall be construed to require the commissioner of health to issue a license to an
applicant that does not meet the licensing requirements under Minnesota Statutes, sections
144A.75 to 144A.756.
new text end
new text begin
(b) If Southern Minnesota Crisis Nursery, DBA Ivy House, is issued a residential hospice
facility license under Minnesota Statutes, sections 144A.75 to 144A.756, and meets all
applicable enrollment criteria under Minnesota Statutes, chapter 256B, it may seek
reimbursement for the provision of hospice respite and end-of-life care for children under
Minnesota Statutes, section 256B.0625, subdivision 22a. Nothing in this section shall be
construed to require the commissioner of human services to make payments to any provider
of hospice respite or end-of-life care for children that the provider is not otherwise lawfully
eligible to receive under Minnesota Statutes, chapter 256B.
new text end
ARTICLE 11
MISCELLANEOUS
Section 1.
Minnesota Statutes 2024, section 256.01, is amended by adding a subdivision
to read:
new text begin Subd. 44. new text end
new text begin Implementation of audit recommendations. new text end
new text begin
No later than February 1 each
year following a year in which the Department of Human Services was subject to an audit
under section 3.971, the commissioner must submit to the chairs and ranking minority
members of the legislative committees with fiscal jurisdiction over the Department of Human
Services a report detailing whether the department has implemented any recommendations
identified during the prior five years by the legislative auditor in a financial audit, program
evaluation, or special review. The report must include a specific itemization of
recommendations that have not been implemented during that period, along with the basis
for that decision.
new text end
Sec. 2.
Laws 2023, chapter 61, article 1, section 61, subdivision 4, is amended to read:
Subd. 4.
Evaluation and report.
By December 1, 2024, the commissioner must submit
to the chairs and ranking minority members of the legislative committees with jurisdiction
over human services finance and policy an interim report on the impact and outcomes of
the grants, including the number of grants awarded and the organizations receiving the
grants. The interim report must include any available evidence of how grantees were able
to increase utilization of supported decision making and reduce or avoid more restrictive
forms of decision making such as guardianship and conservatorship. By December 1, deleted text begin 2025deleted text end new text begin
2026new text end , the commissioner must submit to the chairs and ranking minority members of the
legislative committees with jurisdiction over human services finance and policy a final
report on the impact and outcomes of the grants, including any updated information from
the interim report and the total number of people served by the grants. The final report must
also detail how the money was used to achieve the requirements in subdivision 3, paragraph
(b).
Sec. 3.
Laws 2024, chapter 127, article 49, section 9, subdivision 1, is amended to read:
Subdivision 1.
Establishment; purpose.
The Mentally Ill and Dangerous Civil
Commitment Reform Task Force is established tonew text begin :
new text end
new text begin (1)new text end evaluate current statutes related to mentally ill and dangerous civil commitments
deleted text begin anddeleted text end new text begin ;
new text end
new text begin
(2) evaluate current statutes related to the process by which a former patient may seek
an order to expunge or vacate a prior commitment as mentally ill and dangerous; and
new text end
new text begin (3)new text end develop recommendations to optimize the use of state-operated mental health
resources and increase equitable access and outcomes for patients.
Sec. 4.
Laws 2024, chapter 127, article 49, section 9, is amended by adding a subdivision
to read:
new text begin Subd. 7a. new text end
new text begin Duties; expungements and vacaturs. new text end
new text begin
The task force must:
new text end
new text begin
(1) analyze current trends in civil commitments as mentally ill and dangerous,
expungements, and vacaturs, including but not limited to the frequency of expungements
and vacaturs in Minnesota as compared to other jurisdictions;
new text end
new text begin
(2) review national practices and criteria for expunging and vacating civil commitments
as mentally ill and dangerous;
new text end
new text begin
(3) develop recommended statutory changes necessary to provide clear direction to
former patients who are seeking to file a motion to expunge or vacate a civil commitment
as mentally ill and dangerous;
new text end
new text begin
(4) develop recommended statutory changes necessary to provide clear direction, criteria
to apply, and evidentiary standards to the courts when considering a motion from a former
patient to expunge or vacate a civil commitment as mentally ill and dangerous; and
new text end
new text begin
(5) develop recommended statutory changes to provide clear direction to former patients
and the courts to address situations in which an individual is civilly committed as mentally
ill and dangerous and is later determined to not have an organic disorder of the brain or a
substantial psychiatric disorder of thought, mood, perception, orientation, or memory.
new text end
Sec. 5.
Laws 2024, chapter 127, article 49, section 9, subdivision 8, is amended to read:
Subd. 8.
Report required.
new text begin (a) new text end By August 1, 2025, the task force shall submit to the
chairs and ranking minority members of the legislative committees with jurisdiction over
mentally ill and dangerous civil commitments a written report that includes the outcome of
the duties in subdivision 7, including but not limited to recommended statutory changes.
new text begin
(b) By August 1, 2026, the task force shall submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over civil commitments a written
report that includes the outcome of the duties in subdivision 7a, including but not limited
to recommended statutory changes.
new text end
Sec. 6.
Laws 2024, chapter 127, article 49, section 9, subdivision 9, is amended to read:
Subd. 9.
Expiration.
The task force expires January 1, deleted text begin 2026deleted text end new text begin 2027new text end .
ARTICLE 12
DEPARTMENT OF HUMAN SERVICES APPROPRIATIONS
Section 1. new text begin HUMAN SERVICES APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the
commissioner of human services and for the purposes specified in this article. The
appropriations are from the general fund, or another named fund, and are available for the
fiscal years indicated for each purpose. The figures "2026" and "2027" used in this article
mean that the appropriations listed under them are available for the fiscal year ending June
30, 2026, or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The second
year" is fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2.new text begin TOTAL APPROPRIATIONnew text end |
new text begin
$ new text end |
new text begin
7,779,124,000 new text end |
new text begin
$ new text end |
new text begin
7,976,910,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Appropriations by Fund
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
7,777,163,000 new text end |
new text begin
7,974,721,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
1,733,000 new text end |
new text begin
1,733,000 new text end |
|
new text begin
State Government Special Revenue Fund new text end |
new text begin
228,000 new text end |
new text begin
456,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following sections
and subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Information Technology Appropriations
|
||||||
new text begin
(a) IT Appropriations Generally
new text end
new text begin
This appropriation includes money for
information technology projects, services, and
support. Funding for information technology
project costs must be incorporated into the
service-level agreement and paid to Minnesota
IT Services by the Department of Human
Services under the rates and mechanism
specified in that agreement.
new text end
new text begin
(b) Receipts for Systems Project
new text end
new text begin
Appropriations and federal receipts for
information technology systems projects for
MMIS and METS must be deposited in the
state systems account authorized in Minnesota
Statutes, section 256.014. Money appropriated
for information technology projects approved
by the commissioner of Minnesota IT
Services, funded by the legislature, and
approved by the commissioner of management
and budget may be transferred from one
project to another and from development to
operations as the commissioner of human
services deems necessary. Any unexpended
balance in the appropriation for these projects
does not cancel and is available for ongoing
development and operations.
new text end
Sec. 3. new text begin CENTRAL OFFICE; OPERATIONS
|
new text begin
$ new text end |
new text begin
4,309,000 new text end |
new text begin
$ new text end |
new text begin
5,032,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Budget and Legislative Staff
|
||||||
new text begin
$805,000 in fiscal year 2026 and $955,000 in
fiscal year 2027 are for five additional
full-time budget and legislative staff. The
commissioner must not supplant existing
spending on staff performing budget and
legislative functions and must not supplement
compensation of existing staff performing
budget and legislative functions, but must use
the money appropriated under this subdivision
only to hire additional staff. This subdivision
does not expire.
new text end
new text begin Subd. 2. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$3,385,000 in fiscal year 2028 and $3,201,000
in fiscal year 2029.
new text end
Sec. 4. new text begin CENTRAL OFFICE; HEALTH CARE
|
new text begin
$ new text end |
new text begin
1,066,000 new text end |
new text begin
$ new text end |
new text begin
1,349,000 new text end |
||
new text begin
Single Administrative Structure and
Delivery System Pilot Program
new text end
new text begin
$150,000 in fiscal year 2026 and $300,000 in
fiscal year 2027 are for a contract to
implement a web-based single administrative
structure and delivery system for the delivery
of nonemergency medical transportation. The
base for this appropriation is $300,000 in fiscal
year 2028, $300,000 in fiscal year 2029, and
$0 in fiscal year 2030.
new text end
Sec. 5. new text begin CENTRAL OFFICE; AGING AND
|
new text begin
$ new text end |
new text begin
13,707,000 new text end |
new text begin
$ new text end |
new text begin
9,216,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Provisional or Transitional
|
||||||
new text begin
$150,000 in fiscal year 2026 is to develop
draft legislative language to improve the
process for approving integrated community
support settings. This is a onetime
appropriation.
new text end
new text begin Subd. 2. new text end
new text begin
Positive Supports Competency Program
|
||||||
new text begin
$1,000,000 in fiscal year 2026 is for the
positive supports competency program. This
is a onetime appropriation and is available
until June 30, 2029.
new text end
new text begin Subd. 3. new text end
new text begin
Cost Reporting Improvement and Direct
|
||||||
new text begin
$150,000 in fiscal year 2026 is to complete a
cost reporting improvement study and direct
care staffing review. This is a onetime
appropriation.
new text end
new text begin Subd. 4. new text end
new text begin
Assisted Living Licensure and Disability
|
||||||
new text begin
$100,000 in fiscal year 2026 is to complete a
study on assisted living licensure and disability
waiver reimbursement rates and to draft
proposed legislation. This is a onetime
appropriation.
new text end
new text begin Subd. 5. new text end
new text begin
Budget and Legislative Analysis
|
||||||
new text begin
$458,000 in fiscal year 2026 and $540,000 in
fiscal year 2027 are for three additional
full-time budget and legislative analysis staff.
The commissioner must not supplant existing
spending on staff performing budget and
legislative analysis functions and must not
supplement compensation of existing staff
performing budget and legislative analysis
functions, but must use the money
appropriated under this subdivision only to
hire additional staff. This subdivision does not
expire.
new text end
new text begin Subd. 6. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$7,201,000 in fiscal year 2028 and $5,755,000
in fiscal year 2029.
new text end
Sec. 6. new text begin CENTRAL OFFICE; BEHAVIORAL
|
new text begin
$ new text end |
new text begin
(39,000) new text end |
new text begin
$ new text end |
new text begin
12,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Fiscal Year 2026 Reduction
|
||||||
new text begin
The reduction in the fiscal year 2026
appropriation in this section is subtracted from
appropriations to the Department of Human
Services for behavioral health administration
made in any other law enacted by the
ninety-fourth legislature during the 2025
legislative session.
new text end
new text begin Subd. 2. new text end
new text begin
Substance Use Disorder Treatment Staff
|
||||||
new text begin
$100,000 in fiscal year 2026 and $50,000 in
fiscal year 2027 are for a substance use
disorder treatment staff report and
recommendations. This is a onetime
appropriation.
new text end
new text begin Subd. 3. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
reduced by $38,000 in fiscal year 2028 and
$38,000 in fiscal year 2029.
new text end
Sec. 7. new text begin CENTRAL OFFICE; OFFICE OF
|
new text begin
$ new text end |
new text begin
4,257,000 new text end |
new text begin
$ new text end |
new text begin
5,105,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Appropriations by Fund
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
4,029,000 new text end |
new text begin
4,649,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
228,000 new text end |
new text begin
456,000 new text end |
new text begin Subd. 2. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$4,648,000 in fiscal year 2028 and $4,648,000
in fiscal year 2029.
new text end
Sec. 8. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
323,000 new text end |
new text begin
$ new text end |
new text begin
323,000 new text end |
||
Sec. 9. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
7,445,352,000 new text end |
new text begin
$ new text end |
new text begin
7,703,200,000 new text end |
||
new text begin
Additional Critical Access Nursing Facility
Funding
new text end
new text begin
Up to $5,000,000 in fiscal year 2026 and up
to $10,000,000 in fiscal year 2027 are for
supplemental payments under Minnesota
Statutes, section 256R.47, to designated
critical access nursing facilities. The base for
this appropriation is $17,500,000 in fiscal year
2028, $17,500,000 in fiscal year 2029, and $0
each year thereafter.
new text end
Sec. 10. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
55,694,000 new text end |
new text begin
$ new text end |
new text begin
56,382,000 new text end |
||
new text begin
Any money allocated to the alternative care
program that is not spent for the purposes
indicated does not cancel but must be
transferred to the medical assistance account.
new text end
Sec. 11. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
138,575,000 new text end |
new text begin
$ new text end |
new text begin
122,512,000 new text end |
||
Sec. 12. new text begin GRANT PROGRAMS; CHILD AND
|
new text begin
$ new text end |
new text begin
(5,655,000) new text end |
new text begin
$ new text end |
new text begin
(5,655,000) new text end |
||
new text begin
Fiscal Year 2026 and 2027 Reductions
new text end
new text begin
The reductions in the fiscal year 2026 and
fiscal year 2027 appropriations in this section
are subtracted from appropriations to the
Department of Human Services for child and
community service grants made in any other
law enacted by the ninety-fourth legislature
during the 2025 legislative session.
new text end
Sec. 13. new text begin GRANT PROGRAMS; OTHER
|
new text begin
$ new text end |
new text begin
2,747,000 new text end |
new text begin
$ new text end |
new text begin
1,925,000 new text end |
||
new text begin
Home and Community-Based Services
Incentive Pool
new text end
new text begin
$2,747,000 in fiscal year 2026 and $1,925,000
in fiscal year 2027 are for the home and
community-based services incentive pool
under Minnesota Statutes, section 256B.0921.
new text end
Sec. 14. new text begin GRANT PROGRAMS; AGING AND
|
new text begin
$ new text end |
new text begin
40,804,000 new text end |
new text begin
$ new text end |
new text begin
40,805,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Age-Friendly Community Grants
|
||||||
new text begin
The base for this appropriation for age-friendly
community grants under Minnesota Statutes,
section 256.9747, subdivision 1, is $882,000
in fiscal year 2028 and $882,000 in fiscal year
2029.
new text end
new text begin Subd. 2. new text end
new text begin
Age-Friendly Technical Assistance
|
||||||
new text begin
The base for this appropriation for age-friendly
technical assistance grants under Minnesota
Statutes, section 256.9747, subdivision 2, is
$507,000 in fiscal year 2028 and $507,000 in
fiscal year 2029.
new text end
new text begin Subd. 3. new text end
new text begin
Minnesota Board on Aging
|
||||||
new text begin
$788,000 in fiscal year 2026 and $788,000 in
fiscal year 2027 are for the Minnesota Board
on Aging under Minnesota Statutes, section
256.975, to add additional staff positions for
the area agencies on aging contact centers to
support senior LinkAge Line operations.
new text end
new text begin Subd. 4. new text end
new text begin
Senior Dining Programs
|
||||||
new text begin
$250,000 in fiscal year 2026 and $250,000 in
fiscal year 2027 are for a competitive grant or
grants to address the unique nutritional needs
of older adults or to operate senior dining
programs. The base for this appropriation is
$400,000 in fiscal year 2028 and $400,000 in
fiscal year 2029.
new text end
new text begin Subd. 5. new text end
new text begin
Long-Term Care Consultation Services
|
||||||
new text begin
$1,739,000 in fiscal year 2026 and $1,739,000
in fiscal year 2027 are for grants for long-term
care consultation services under Minnesota
Statutes, section 256B.0911, and long-term
care options counseling under Minnesota
Statutes, section 256.975, subdivision 7.
new text end
new text begin Subd. 6. new text end
new text begin
Prescription Drug Assistance Program
|
||||||
new text begin
$1,191,000 in fiscal year 2026 and $1,191,000
in fiscal year 2027 are for a grant to the Board
on Aging for the prescription drug assistance
program under Minnesota Statutes, section
256.975, subdivision 9.
new text end
new text begin Subd. 7. new text end
new text begin
Core Home and Community-Based
|
||||||
new text begin
$1,585,000 in fiscal year 2026 and $1,585,000
in fiscal year 2027 are for core home and
community-based service projects under
Minnesota Statutes, section 256.9754,
subdivision 3d.
new text end
new text begin Subd. 8. new text end
new text begin
Caregiver Support and Respite Care
|
||||||
new text begin
$479,000 in fiscal year 2026 and $479,000 in
fiscal year 2027 are for caregiver support and
respite care projects under Minnesota Statutes,
section 256.9754, subdivision 3c.
new text end
new text begin Subd. 9. new text end
new text begin
Community Services Development
|
||||||
new text begin
$2,980,000 in fiscal year 2026 and $2,980,000
in fiscal year 2027 are for community services
development grants under Minnesota Statutes,
section 256.9754, subdivision 3.
new text end
new text begin Subd. 10. new text end
new text begin
Community Service Grants
|
||||||
new text begin
$3,128,000 in fiscal year 2026 and $3,128,000
in fiscal year 2027 are for community service
grants under Minnesota Statutes, section
256.9754, subdivision 3e.
new text end
new text begin Subd. 11. new text end
new text begin
Customized Living Quality
|
||||||
new text begin
$1,000,000 in fiscal year 2026 and $1,000,000
in fiscal year 2027 are for customized living
quality improvement grants under Minnesota
Statutes, section 256.479.
new text end
new text begin Subd. 12. new text end
new text begin
Regional and Local Dementia Grants
|
||||||
new text begin
$1,000,000 in fiscal year 2026 and $1,000,000
in fiscal year 2027 are for regional and local
dementia grants under Minnesota Statutes,
section 256.975, subdivision 11. The base for
this appropriation is $1,500,000 in fiscal year
2028 and $1,500,000 in fiscal year 2029.
new text end
new text begin Subd. 13. new text end
new text begin
Eldercare Development Partnerships
|
||||||
new text begin
$1,758,000 in fiscal year 2026 and $1,758,000
in fiscal year 2027 are for eldercare
development partnerships under Minnesota
Statutes, section 256B.0917, subdivision 1c.
new text end
new text begin Subd. 14. new text end
new text begin
Gaps Analysis
|
||||||
new text begin
$218,000 in fiscal year 2026 and $218,000 in
fiscal year 2027 are for analysis of gaps in
long-term care services under Minnesota
Statutes, section 144A.351.
new text end
new text begin Subd. 15. new text end
new text begin
Consumer Information and Assistance
|
||||||
new text begin
$3,449,000 in fiscal year 2026 and $3,449,000
in fiscal year 2027 are for a grant to the Board
on Aging to provide information and
assistance services under Minnesota Statutes,
section 256.975, subdivision 7.
new text end
new text begin Subd. 16. new text end
new text begin
Minnesota Adult Abuse Reporting
|
||||||
new text begin
$1,819,000 in fiscal year 2026 and $1,819,000
in fiscal year 2027 are for a grant to the
Minnesota Board on Aging to handle all
reports of adult abuse for older adults and
people with disabilities in various care
settings.
new text end
new text begin Subd. 17. new text end
new text begin
Return to Community Services
|
||||||
new text begin
$9,341,000 in fiscal year 2026 and $9,341,000
in fiscal year 2027 are for a grant to the Board
on Aging for return to community services
under Minnesota Statutes, section 256.975,
subdivision 7.
new text end
new text begin Subd. 18. new text end
new text begin
Preadmission Screening
|
||||||
new text begin
$817,000 in fiscal year 2026 and $817,000 in
fiscal year 2027 are for a grant to the Board
on Aging for preadmission screening under
Minnesota Statutes, section 256.975,
subdivisions 7a to 7d.
new text end
new text begin Subd. 19. new text end
new text begin
Direct Support Connect
|
||||||
new text begin
$236,000 in fiscal year 2026 and $236,000 in
fiscal year 2027 are for a grant to the Board
on Aging for activities supporting Direct
Support Connect.
new text end
new text begin Subd. 20. new text end
new text begin
Self-Directed Caregiver Grants
|
||||||
new text begin
$477,000 in fiscal year 2026 and $477,000 in
fiscal year 2027 are for self-directed caregiver
grants under Minnesota Statutes, section
256.975, subdivision 12.
new text end
new text begin Subd. 21. new text end
new text begin
Senior Nutrition Program
|
||||||
new text begin
$2,695,000 in fiscal year 2026 and $2,695,000
in fiscal year 2027 are for the senior nutrition
program under Minnesota Statutes, section
256.9752. The base for senior nutrition
programs under Minnesota Statutes, section
256.9752, is $2,820,000 in fiscal year 2028
and $2,820,000 in fiscal year 2029.
new text end
new text begin Subd. 22. new text end
new text begin
Senior Volunteer Programs
|
||||||
new text begin
$1,988,000 in fiscal year 2026 and $1,988,000
in fiscal year 2027 are for volunteer programs
for retired senior citizens under Minnesota
Statutes, section 256.9753; the foster
grandparents program under Minnesota
Statutes, section 256.976; and the senior
companion program under Minnesota Statutes,
section 256.977.
new text end
new text begin Subd. 23. new text end
new text begin
Adult Protection Grants
|
||||||
new text begin
$866,000 in fiscal year 2026 and $867,000 in
fiscal year 2027 are for adult protection grants
to counties and Tribes under Minnesota
Statutes, section 256M.42.
new text end
new text begin Subd. 24. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$42,969,000 in fiscal year 2028 and
$42,969,000 in fiscal year 2029.
new text end
Sec. 15. new text begin DEAF, DEAFBLIND, AND HARD OF
|
new text begin
$ new text end |
new text begin
2,886,000 new text end |
new text begin
$ new text end |
new text begin
2,886,000 new text end |
||
Sec. 16. new text begin GRANT PROGRAMS; DISABILITY
|
new text begin
$ new text end |
new text begin
67,522,000 new text end |
new text begin
$ new text end |
new text begin
28,293,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Self-Directed Bargaining
|
||||||
new text begin
$3,000,000 in fiscal year 2026 is for
orientation program start-up costs as defined
by the SEIU collective bargaining agreement.
This is a onetime appropriation.
new text end
new text begin Subd. 2. new text end
new text begin
Self-Directed Bargaining Agreement;
|
||||||
new text begin
$2,000,000 in fiscal year 2026 and $500,000
in fiscal year 2027 are for ongoing costs
related to the orientation program as defined
by the SEIU collective bargaining agreement.
new text end
new text begin Subd. 3. new text end
new text begin
Self-Directed Bargaining Agreement;
|
||||||
new text begin
$2,250,000 in fiscal year 2026 is for onetime
stipends of $750 for collective bargaining unit
members for training. This is a onetime
appropriation.
new text end
new text begin Subd. 4. new text end
new text begin
Self-Directed Bargaining Agreement;
|
||||||
new text begin
$350,000 in fiscal year 2026 is for a vendor
to create a retirement trust, as defined by the
SEIU collective bargaining agreement. This
is a onetime appropriation.
new text end
new text begin Subd. 5. new text end
new text begin
Self-Directed Bargaining Agreement;
|
||||||
new text begin
$30,750,000 in fiscal year 2026 is for stipends
of $1,200 for each collective bargaining unit
member for retention and defraying any health
insurance costs the member may incur.
Stipends are available once per fiscal year per
member for fiscal year 2026 and fiscal year
2027. Of this amount, $30,000,000 in fiscal
year 2026 is for stipends and $750,000 in
fiscal year 2026 is for administration. This is
a onetime appropriation and is available until
June 30, 2027.
new text end
new text begin Subd. 6. new text end
new text begin
Disability Services Technology And
|
||||||
new text begin
(a) $226,000 in fiscal year 2026 and $220,000
in fiscal year 2027 are for the disability
services technology and advocacy expansion
grant under Minnesota Statutes, section
256.4768. The general fund base for this
purpose is $220,000 in fiscal year 2028,
$220,000 in fiscal year 2029, $220,000 in
fiscal year 2030, and $0 in fiscal year 2031.
new text end
new text begin
(b) This subdivision expires June 30, 2030.
new text end
new text begin Subd. 7. new text end
new text begin
Disability Inclusion Pilot Project
|
||||||
new text begin
(a) $816,000 in fiscal year 2026 is for a
competitive grant for a statewide disability
inclusion pilot project. This is a onetime
appropriation.
new text end
new text begin
(b) The pilot project must:
new text end
new text begin
(1) persuade employers to diversify their
workforces by hiring people with disabilities;
new text end
new text begin
(2) educate businesses on the economic
benefits of inclusive employment and provide
coaching on affordable accommodations;
new text end
new text begin
(3) educate Minnesotans with disabilities and
their families on navigating services and
achieving inclusion in both work and
community settings;
new text end
new text begin
(4) build capacity and support for culturally
specific services by rural, Black, Indigenous,
or People of Color entrepreneurs;
new text end
new text begin
(5) pilot community-requested support
services;
new text end
new text begin
(6) invest in safe community-focused spaces
to host trainings and requested support
services; and
new text end
new text begin
(7) launch a statewide disability inclusion
assessment for businesses and community
spaces to improve accessibility and inclusion.
new text end
new text begin
(c) The pilot project must reach all six
Minnesota planning areas to ensure equal
access to the pilot project activities in rural
and Tribal regions.
new text end
new text begin Subd. 8. new text end
new text begin
Direct Support Professional
|
||||||
new text begin
(a) $230,000 in fiscal year 2026 is for a
competitive grant to:
new text end
new text begin
(1) develop curriculum for a pretraining
program tailored to the educational needs of
potential direct support professionals;
new text end
new text begin
(2) provide workforce readiness training for
individuals entering the field of direct care
and support services;
new text end
new text begin
(3) expand recruitment efforts to increase
direct support professional workforce capacity,
particularly among diverse and
underrepresented communities; and
new text end
new text begin
(4) collaborate with community-based
organizations, educational institutions, and
providers to support the long-term
development of the direct support
professionals workforce.
new text end
new text begin
(b) This is a onetime appropriation.
new text end
new text begin Subd. 9. new text end
new text begin
Technology for Home Grants
|
||||||
new text begin
$922,000 in fiscal year 2026 and $922,000 in
fiscal year 2027 are for technology for home
grants under Minnesota Statutes, section
256.4773.
new text end
new text begin Subd. 10. new text end
new text begin
Self-Advocacy Grants for Persons with
|
||||||
new text begin
$248,000 in fiscal year 2026 and $248,000 in
fiscal year 2027 are for self-advocacy grants
under Minnesota Statutes, section 256.477.
Of these amounts:
new text end
new text begin
(1) $143,000 in fiscal year 2026 and $143,000
in fiscal year 2027 are for the activities under
Minnesota Statutes, section 256.477,
subdivision 1, paragraph (a), and for
administrative costs associated with those
activities incurred by the grantee; and
new text end
new text begin
(2) $105,000 in fiscal year 2026 and $105,000
in fiscal year 2027 are for the activities under
Minnesota Statutes, section 256.477,
subdivision 2.
new text end
new text begin Subd. 11. new text end
new text begin
Case Management Training Grants
|
||||||
new text begin
$45,000 in fiscal year 2026 and $45,000 in
fiscal year 2027 are for grants to provide case
management training to organizations and
employers to support the state's disability
employment supports system.
new text end
new text begin Subd. 12. new text end
new text begin
Family Support Program
|
||||||
new text begin
$9,423,000 in fiscal year 2026 and $9,096,000
in fiscal year 2027 are for support grants under
Minnesota Statutes, section 252.32.
new text end
new text begin Subd. 13. new text end
new text begin
Disability Hub for Families Grants
|
||||||
new text begin
$200,000 in fiscal year 2026 and $200,000 in
fiscal year 2027 are for grants under Laws
2019, First Special Session chapter 9, article
14, section 2, subdivision 29, paragraph (e),
to connect families through innovation grants,
life planning tools, and website information
as they support a child or family member with
disabilities.
new text end
new text begin Subd. 14. new text end
new text begin
Disability Hub
|
||||||
new text begin
$1,716,000 in fiscal year 2026 and $2,041,000
in fiscal year 2027 are for the Disability Hub
under Minnesota Statutes, section 256.01,
subdivision 24.
new text end
new text begin Subd. 15. new text end
new text begin
Minnesota Aging and Disability
|
||||||
new text begin
$900,000 in fiscal year 2026 and $900,000 in
fiscal year 2027 are for grants under
Minnesota Statutes, section 256.01,
subdivision 2, paragraph (z), to support the
Minnesota Aging and Disability Resource
Center.
new text end
new text begin Subd. 16. new text end
new text begin
Day Training and Habilitation Facility
|
||||||
new text begin
$811,000 in fiscal year 2026 and $811,000 in
fiscal year 2027 are for grant allocations to
counties for day training and habilitation
services for adults with developmental
disabilities when provided as a social service
under Minnesota Statutes, sections 252.41 to
252.46.
new text end
new text begin Subd. 17. new text end
new text begin
Employment and Technical Assistance
|
||||||
new text begin
$450,000 in fiscal year 2026 and $1,800,000
in fiscal year 2027 are for employment and
technical assistance grants to assist
organizations and employers in promoting a
more inclusive workplace for people with
disabilities.
new text end
new text begin Subd. 18. new text end
new text begin
Grant to Family Voices in Minnesota
|
||||||
new text begin
$75,000 in fiscal year 2026 and $75,000 in
fiscal year 2027 are for a grant to Family
Voices in Minnesota under Minnesota
Statutes, section 256.4776.
new text end
new text begin Subd. 19. new text end
new text begin
Intractable Epilepsy Demonstration
|
||||||
new text begin
$344,000 in fiscal year 2026 and $344,000 in
fiscal year 2027 are for the demonstration
project established under Laws 1988, chapter
689, article 2, section 251, and a grant to a
nonresidential program that provides medical
monitoring and living skills training programs
for persons with intractable epilepsy who need
assistance in the transition to independent
living. The grant awarded under this section
must be used for salaries, administration,
transportation, and other program costs.
new text end
new text begin Subd. 20. new text end
new text begin
Lead Agency Capacity-Building
|
||||||
new text begin
$2,413,000 in fiscal year 2026 and $2,411,000
in fiscal year 2027 are for grants to assist
organizations, counties, and Tribes to build
capacity for employment opportunities for
people with disabilities.
new text end
new text begin Subd. 21. new text end
new text begin
Minnesota Inclusion Initiative Grants
|
||||||
new text begin
$150,000 in fiscal year 2026 and $150,000 in
fiscal year 2027 are from the general fund for
grants under Minnesota Statutes, section
256.4772.
new text end
new text begin Subd. 22. new text end
new text begin
MnCHOICES Modifications
|
||||||
new text begin
$450,000 in fiscal year 2026 and $125,000 in
fiscal year 2027 are for enhancements to the
MnCHOICES assessment tool to provide
real-time employment information,
communication, and resources, supporting
individuals and professionals in improving
education, engagement, and access to
employment opportunities.
new text end
new text begin Subd. 23. new text end
new text begin
Parent-to-Parent USA Peer Support
|
||||||
new text begin
$125,000 in fiscal year 2026 and $125,000 in
fiscal year 2027 are for a grant to an alliance
member of Parent-to-Parent USA under
Minnesota Statutes, section 256.4776.
new text end
new text begin Subd. 24. new text end
new text begin
Preadmission Screening and Resident
|
||||||
new text begin
$20,000 in fiscal year 2026 and $20,000 in
fiscal year 2027 are for reimbursement to
counties for costs associated with completing
federally required preadmission screening and
resident reviews of nursing home applicants
or residents with a probable mental illness or
a developmental disability.
new text end
new text begin Subd. 25. new text end
new text begin
Regional Support for Person-Centered
|
||||||
new text begin
$710,000 in fiscal year 2026 and $710,000 in
fiscal year 2027 are for grants to regional
cohorts to extend and expand regional capacity
for person-centered planning through training,
coaching, and mentoring for person-centered
and collaborative safety practices benefiting
people with disabilities and employees,
organizations, and communities serving people
with disabilities.
new text end
new text begin Subd. 26. new text end
new text begin
Region 10 Grants
|
||||||
new text begin
$100,000 in fiscal year 2026 and $100,000 in
fiscal year 2027 are for a grant provided under
Minnesota Statutes, section 256B.097.
new text end
new text begin Subd. 27. new text end
new text begin
Semi-Independent Living Services
|
||||||
new text begin
$7,229,000 in fiscal year 2026 and $7,229,000
in fiscal year 2027 are for semi-independent
living services grants under Minnesota
Statutes, section 252.275.
new text end
new text begin Subd. 28. new text end
new text begin
Case Management Supportive Services
|
||||||
new text begin
$1,156,000 in fiscal year 2026 and $1,156,000
in fiscal year 2027 are for grants to
community-based HIV/AIDS supportive
services providers as defined in Minnesota
Statutes, section 256.01, subdivision 19.
new text end
new text begin Subd. 29. new text end
new text begin
Health Care Coverage for People
|
||||||
new text begin
$1,064,000 in fiscal year 2026 and $1,064,000
in fiscal year 2027 are for payment of allowed
health care costs under Minnesota Statutes,
section 256.9365.
new text end
new text begin Subd. 30. new text end
new text begin
State Quality Council
|
||||||
new text begin
$600,000 in fiscal year 2026 and $600,000 in
fiscal year 2027 are for the State Quality
Council under Minnesota Statutes, section
256B.097, to provide technical assistance and
monitoring of person-centered outcomes
related to inclusive community living and
employment. The funding must be used by the
State Quality Council to execute a statewide
plan for a systems change in person-centered
planning that will achieve desired outcomes,
including increased integrated employment
and community living.
new text end
new text begin Subd. 31. new text end
new text begin
Transition to Community Initiative
|
||||||
new text begin
$1,811,000 in fiscal year 2026 and $1,811,000
in fiscal year 2027 are for the transition to
community initiative under Minnesota
Statutes, section 256.478.
new text end
new text begin Subd. 32. new text end
new text begin
Self-Directed Bargaining Agreement;
|
||||||
new text begin
$87,000 in fiscal year 2026 and $87,000 in
fiscal year 2027 are to correct a funding
allocation mistake for stipends for collective
bargaining unit members initially appropriated
under Laws 2017, First Special Session
chapter 6, article 18, section 2, subdivision 15,
paragraph (b), clause (2).
new text end
new text begin Subd. 33. new text end
new text begin
Base Level Adjustments
|
||||||
new text begin
The general fund base for this section is
$28,293,000 in fiscal year 2028 and
$28,293,000 in fiscal year 2029.
new text end
Sec. 17. new text begin GRANT PROGRAMS; HOUSING
|
new text begin
$ new text end |
new text begin
450,000 new text end |
new text begin
$ new text end |
new text begin
450,000 new text end |
||
new text begin
Minnesota Homeless Study
new text end
new text begin
$450,000 in fiscal year 2026 and $450,000 in
fiscal year 2027 are for the Minnesota
homeless study under Minnesota Statutes,
section 256.4751.
new text end
Sec. 18. new text begin GRANT PROGRAMS; ADULT
|
new text begin
$ new text end |
new text begin
1,300,000 new text end |
new text begin
$ new text end |
new text begin
250,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Health Services and Support
|
||||||
new text begin
$1,300,000 in fiscal year 2026 and $250,000
in fiscal year 2027 are for competitive grants
to provide health services and supports to
communities that are underserved due to
language or demographic barriers. The
amounts appropriated in fiscal years 2026 and
2027 are available until June 30, 2029. The
base for this appropriation is $500,000 in fiscal
year 2028 and $500,000 in fiscal year 2029.
new text end
new text begin Subd. 2. new text end
new text begin
Base Level Adjustments
|
||||||
new text begin
The general fund base for this section is
$500,000 in fiscal year 2028 and $500,000 in
fiscal year 2029.
new text end
Sec. 19. new text begin GRANT PROGRAMS; CHEMICAL
|
new text begin
$ new text end |
new text begin
5,826,000 new text end |
new text begin
$ new text end |
new text begin
4,825,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Appropriations by Fund
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
4,093,000 new text end |
new text begin
3,092,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
1,733,000 new text end |
new text begin
1,733,000 new text end |
new text begin Subd. 2. new text end
new text begin
Problem Gambling
|
||||||
new text begin
$225,000 in fiscal year 2026 and $225,000 in
fiscal year 2027 are from the lottery prize fund
for a grant to a state affiliate recognized by
the National Council on Problem Gambling.
The affiliate must provide services to increase
public awareness of problem gambling,
education, training for individuals and
organizations that provide effective treatment
services to problem gamblers and their
families, and research related to problem
gambling.
new text end
new text begin Subd. 3. new text end
new text begin
Recovery Community Grants
|
||||||
new text begin
$1,475,000 in fiscal year 2026 and $775,000
in fiscal year 2027 are from the general fund
for competitive grants to recovery community
organizations serving underserved
communities or geographic locations.
new text end
new text begin Subd. 4. new text end
new text begin
Suicide Prevention Grants
|
||||||
new text begin
$435,000 in fiscal year 2026 and $434,000 in
fiscal year 2027 are from the general fund for
a competitive grant for activities designed to
enhance culturally relevant services and
resources for Minnesota's African immigrant
refugee community related to mental health,
substance use disorder, and suicide prevention.
Grant money may also be used to address the
physical and mental wellness needs of the
elderly and mental health support and suicide
prevention for underrepresented students in
higher education. This is a onetime
appropriation and is available until June 30,
2027.
new text end
new text begin Subd. 5. new text end
new text begin
Peer Specialists
|
||||||
new text begin
$300,000 in fiscal year 2026 is for peer
specialists grants first established under Laws
2016, chapter 189, article 23, section 2,
subdivision 4, paragraph (f). This is a onetime
appropriation.
new text end
new text begin Subd. 6. new text end
new text begin
American Indian Programs
|
||||||
new text begin
$1,397,000 in fiscal year 2026 and $1,397,000
in fiscal year 2027 are from the general fund
for the American Indian programs under
Minnesota Statutes, section 254A.03,
subdivision 2.
new text end
new text begin Subd. 7. new text end
new text begin
Methamphetamine Treatment Grant
|
||||||
new text begin
$125,000 in fiscal year 2026 and $125,000 in
fiscal year 2027 are from the general fund for
a grant to a nonprofit organization to treat
methamphetamine abuse and the abuse of
other substances. The focus audience is
women with dependent children identified as
substance abusers, especially those whose
most-used controlled substance is
methamphetamine.
new text end
new text begin Subd. 8. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$2,658,000 in fiscal year 2028 and $2,658,000
in fiscal year 2029.
new text end
Sec. 20.
Laws 2023, chapter 61, article 9, section 2, subdivision 13, is amended to read:
Subd. 13.Grant Programs; Other Long-Term
|
152,387,000 |
1,925,000 |
||||
(a) Provider Capacity Grant for Rural and
Underserved Communities. $17,148,000 in
fiscal year 2024 is for provider capacity grants
for rural and underserved communities.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.
(b) New American Legal, Social Services,
and Long-Term Care Grant Program.
$28,316,000 in fiscal year 2024 is for
long-term care workforce grants for new
Americans. Notwithstanding Minnesota
Statutes, section 16A.28, this appropriation is
available until June 30, 2027. This is a onetime
appropriation.
(c) Supported Decision Making Programs.
$4,000,000 in fiscal year 2024 is for supported
decision making grants. This is a onetime
appropriation and is available until June 30,
deleted text begin 2025deleted text end new text begin 2026new text end .
(d) Direct Support Professionals
Employee-Owned Cooperative Program.
$350,000 in fiscal year 2024 is for a grant to
the Metropolitan Consortium of Community
Developers for the Direct Support
Professionals Employee-Owned Cooperative
program. The grantee must use the grant
amount for outreach and engagement,
managing a screening and selection process,
providing one-on-one technical assistance,
developing and providing training curricula
related to cooperative development and home
and community-based waiver services,
administration, reporting, and program
evaluation. This is a onetime appropriation
and is available until June 30, 2025.
(e) Long-Term Services and Supports
Workforce Incentive Grants. $83,560,000
in fiscal year 2024 is for long-term services
and supports workforce incentive grants
administered according to Minnesota Statutes,
section 256.4764. Notwithstanding Minnesota
Statutes, section 16A.28, this appropriation is
available until June 30, 2029. This is a onetime
appropriation.
(f) Base Level Adjustment. The general fund
base is $3,949,000 in fiscal year 2026 and
$3,949,000 in fiscal year 2027. Of these
amounts, $2,024,000 in fiscal year 2026 and
$2,024,000 in fiscal year 2027 are for PCA
background study grants.
Sec. 21.
Laws 2023, chapter 61, article 9, section 2, subdivision 16, as amended by Laws
2023, chapter 70, article 15, section 8, and Laws 2024, chapter 125, article 8, section 14, is
amended to read:
Subd. 16.Grant Programs; Disabilities Grants
|
113,684,000 |
30,377,000 |
||||
(a) Temporary Grants for Small
Customized Living Providers. $5,450,000
in fiscal year 2024 is for grants to assist small
customized living providers to transition to
community residential services licensure or
integrated community supports licensure.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.
(b) Lead Agency Capacity Building Grants.
$444,000 in fiscal year 2024 and $2,396,000
in fiscal year 2025 are for grants to assist
organizations, counties, and Tribes to build
capacity for employment opportunities for
people with disabilities. The base for this
appropriation is $2,413,000 in fiscal year 2026
and $2,411,000 in fiscal year 2027.
(c) Employment and Technical Assistance
Center Grants. $450,000 in fiscal year 2024
and $1,800,000 in fiscal year 2025 are for
employment and technical assistance grants
to assist organizations and employers in
promoting a more inclusive workplace for
people with disabilities.
(d) Case Management Training Grants.
$37,000 in fiscal year 2024 and $123,000 in
fiscal year 2025 are for grants to provide case
management training to organizations and
employers to support the state's disability
employment supports system. The base for
this appropriation is $45,000 in fiscal year
2026 and $45,000 in fiscal year 2027.
(e) Self-Directed Bargaining Agreement;
Electronic Visit Verification Stipends.
$6,095,000 in fiscal year 2024 is for onetime
stipends of $200 to bargaining members to
offset the potential costs related to people
using individual devices to access the
electronic visit verification system. Of this
amount, $5,600,000 is for stipends and
$495,000 is for administration. This is a
onetime appropriation and is available until
June 30, 2025.
(f) Self-Directed Collective Bargaining
Agreement; Temporary Rate Increase
Memorandum of Understanding. $1,600,000
in fiscal year 2024 is for onetime stipends for
individual providers covered by the SEIU
collective bargaining agreement based on the
memorandum of understanding related to the
temporary rate increase in effect between
December 1, 2020, and February 7, 2021. Of
this amount, $1,400,000 of the appropriation
is for stipends and $200,000 is for
administration. This is a onetime
appropriation.
(g) Self-Directed Collective Bargaining
Agreement; Retention Bonuses. $50,750,000
in fiscal year 2024 is for onetime retention
bonuses covered by the SEIU collective
bargaining agreement. Of this amount,
$50,000,000 is for retention bonuses and
$750,000 is for administration of the bonuses.
This is a onetime appropriation and is
available until June 30, 2025.
(h) Self-Directed Bargaining Agreement;
Training Stipends. $2,100,000 in fiscal year
2024 and $100,000 in fiscal year 2025 are for
onetime stipends of $500 for collective
bargaining unit members who complete
designated, voluntary trainings made available
through or recommended by the State Provider
Cooperation Committee. Of this amount,
$2,000,000 in fiscal year 2024 is for stipends,
and $100,000 in fiscal year 2024 and $100,000
in fiscal year 2025 are for administration. This
is a onetime appropriation.
(i) Self-Directed Bargaining Agreement;
Orientation Program. $2,000,000 in fiscal
year 2024 and $2,000,000 in fiscal year 2025
are for onetime $100 payments to collective
bargaining unit members who complete
voluntary orientation requirements. Of this
amount, $1,500,000 in fiscal year 2024 and
$1,500,000 in fiscal year 2025 are for the
onetime $100 payments, and $500,000 in
fiscal year 2024 and $500,000 in fiscal year
2025 are for orientation-related costs. This is
a onetime appropriation.
(j) Self-Directed Bargaining Agreement;
Home Care Orientation Trust. $1,000,000
in fiscal year 2024 is for the Home Care
Orientation Trust under Minnesota Statutes,
section 179A.54, subdivision 11. The
commissioner shall disburse the appropriation
to the board of trustees of the Home Care
Orientation Trust for deposit into an account
designated by the board of trustees outside the
state treasury and state's accounting system.
This is a onetime appropriation and is
available until June 30, 2025.
(k) HIV/AIDS Supportive Services.
$12,100,000 in fiscal year 2024 is for grants
to community-based HIV/AIDS supportive
services providers as defined in Minnesota
Statutes, section 256.01, subdivision 19, and
for payment of allowed health care costs as
defined in Minnesota Statutes, section
256.9365. This is a onetime appropriation and
is available until June 30, 2025.
(l) Motion Analysis Advancements Clinical
Study and Patient Care. $400,000 deleted text begin isdeleted text end new text begin innew text end fiscal
year 2024 is for a grant to the Mayo Clinic
Motion Analysis Laboratory and Limb Lab
for continued research in motion analysis
advancements and patient care. This is a
onetime appropriation and is available through
June 30, deleted text begin 2025deleted text end new text begin 2027new text end .
(m) Grant to Family Voices in Minnesota.
$75,000 in fiscal year 2024 and $75,000 in
fiscal year 2025 are for a grant to Family
Voices in Minnesota under Minnesota
Statutes, section 256.4776.
(n) Parent-to-Parent Programs.
(1) $550,000 in fiscal year 2024 and $550,000
in fiscal year 2025 are for grants to
organizations that provide services to
underserved communities with a high
prevalence of autism spectrum disorder. This
is a onetime appropriation and is available
until June 30, 2025.
(2) The commissioner shall give priority to
organizations that provide culturally specific
and culturally responsive services.
(3) Eligible organizations must:
(i) conduct outreach and provide support to
newly identified parents or guardians of a child
with special health care needs;
(ii) provide training to educate parents and
guardians in ways to support their child and
navigate the health, education, and human
services systems;
(iii) facilitate ongoing peer support for parents
and guardians from trained volunteer support
parents; and
(iv) communicate regularly with other
parent-to-parent programs and national
organizations to ensure that best practices are
implemented.
(4) Grant recipients must use grant money for
the activities identified in clause (3).
(5) For purposes of this paragraph, "special
health care needs" means disabilities, chronic
illnesses or conditions, health-related
educational or behavioral problems, or the risk
of developing disabilities, illnesses, conditions,
or problems.
(6) Each grant recipient must report to the
commissioner of human services annually by
January 15 with measurable outcomes from
programs and services funded by this
appropriation the previous year including the
number of families served and the number of
volunteer support parents trained by the
organization's parent-to-parent program.
(o) Self-Advocacy Grants for Persons with
Intellectual and Developmental Disabilities.
$323,000 in fiscal year 2024 and $323,000 in
fiscal year 2025 are for self-advocacy grants
under Minnesota Statutes, section 256.477.
This is a onetime appropriation. Of these
amounts, $218,000 in fiscal year 2024 and
$218,000 in fiscal year 2025 are for the
activities under Minnesota Statutes, section
256.477, subdivision 1, paragraph (a), clauses
(5) to (7), and for administrative costs, and
$105,000 in fiscal year 2024 and $105,000 in
fiscal year 2025 are for the activities under
Minnesota Statutes, section 256.477,
subdivision 2.
(p) Technology for Home Grants. $300,000
in fiscal year 2024 and $300,000 in fiscal year
2025 are for technology for home grants under
Minnesota Statutes, section 256.4773.
(q) Community Residential Setting
Transition. $500,000 in fiscal year 2024 is
for a grant to Hennepin County to expedite
approval of community residential setting
licenses subject to the corporate foster care
moratorium exception under Minnesota
Statutes, section 245A.03, subdivision 7,
paragraph (a), clause (5).
(r) Base Level Adjustment. The general fund
base is $27,343,000 in fiscal year 2026 and
$27,016,000 in fiscal year 2027.
Sec. 22.
Laws 2024, chapter 127, article 53, section 2, subdivision 13, is amended to read:
Subd. 13.Grant Programs; Aging and Adult
|
-0- |
4,500,000 |
||||
(a) Caregiver Respite Services Grants.
$2,000,000 in fiscal year 2025 is for caregiver
respite services grants under Minnesota
Statutes, section 256.9756. This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16A.28, subdivision 3, this
appropriation is available until June 30, 2027.
(b) Caregiver Support Programs.
$2,500,000 in fiscal year 2025 is for the
Minnesota Board on Aging for the purposes
of the caregiver support programs under
Minnesota Statutes, section 256.9755.
Programs receiving funding under this
paragraph must include an ALS-specific
respite service in their caregiver support
program. This is a onetime appropriation.
Notwithstanding Minnesota Statutes, section
16A.28, subdivision 3, this appropriation is
available until June 30, deleted text begin 2027deleted text end new text begin 2028new text end .
Sec. 23.
Laws 2024, chapter 127, article 53, section 2, subdivision 15, is amended to read:
Subd. 15.Grant Programs; Adult Mental Health
|
(8,900,000) |
2,364,000 |
||||
(a) Locked Intensive Residential Treatment
Services. $1,000,000 in fiscal year 2025 is for
start-up funds to intensive residential treatment
services providers to provide treatment in
locked facilities for patients meeting medical
necessity criteria and who may also be referred
for competency attainment or a competency
examination under Minnesota Statutes,
sections 611.40 to 611.59. This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16A.28, subdivision 3, this
appropriation is available until June 30, 2027.
(b) Engagement Services Pilot Grants.
$1,500,000 in fiscal year 2025 is for
engagement services pilot grants. Of this
amount, $250,000 in fiscal year 2025 is for an
engagement services pilot grant to Otter Tail
County. This is a onetime appropriation.
Notwithstanding Minnesota Statutes, section
16A.28, subdivision 3, this appropriation is
available until June 30, deleted text begin 2026deleted text end new text begin 2028new text end .
(c) Mental Health Innovation Grant
Program. $1,321,000 in fiscal year 2025 is
for the mental health innovation grant program
under Minnesota Statutes, section 245.4662.
This is a onetime appropriation.
Notwithstanding Minnesota Statutes, section
16A.28, subdivision 3, this appropriation is
available until June 30, 2026.
(d) Behavioral Health Services For
Immigrant And Refugee Communities.
$354,000 in fiscal year 2025 is for a payment
to African Immigrant Community Services to
provide culturally and linguistically
appropriate services to new Americans with
disabilities, mental health needs, and substance
use disorders and to connect such individuals
with appropriate alternative service providers
to ensure continuity of care. This is a onetime
appropriation. Notwithstanding Minnesota
Statutes, section 16A.28, subdivision 3, this
appropriation is available until June 30, 2027.
(e) Base Level Adjustment. The general fund
base is decreased by $1,811,000 in fiscal year
2026 and decreased by $1,811,000 in fiscal
year 2027.
Sec. 24. new text begin TRANSFERS AND GRANT CANCELLATIONS AND ELIMINATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Local planning grant elimination. new text end
new text begin
The fiscal year 2026 and fiscal year
2027 general fund base appropriations for local planning grants for creating alternatives to
congregate living for individuals with lower needs first established under Laws 2011, First
Special Session chapter 9, article 10, section 3, subdivision 4, paragraph (k), are reduced
from $254,000 to $0.
new text end
new text begin Subd. 2. new text end
new text begin Chemical dependency peer specialists grant elimination. new text end
new text begin
The fiscal year
2027 general fund base appropriation for grants for peer specialists first established under
Laws 2016, chapter 189, article 23, section 2, subdivision 4, paragraph (f), is reduced from
$725,000 to $0.
new text end
new text begin Subd. 3. new text end
new text begin Community residential setting transitional grant cancellation. new text end
new text begin
Any
unencumbered and unexpended amount of the fiscal year 2024 appropriation in Laws 2023,
chapter 61, article 9, section 2, subdivision 16, paragraph (a), for grants to assist small
customized living providers to transition to community residential services licensure or
integrated community supports licensure, estimated to be $5,450,000, is canceled.
new text end
new text begin Subd. 4. new text end
new text begin Retention bonus cancellation. new text end
new text begin
Any unencumbered and unexpended amount
of the fiscal year 2024 appropriation in Laws 2023, chapter 61, article 9, section 2,
subdivision 16, paragraph (g), for retention bonuses, estimated to be $27,000,000, is canceled.
new text end
new text begin Subd. 5. new text end
new text begin Orientation payments cancellation. new text end
new text begin
Any unencumbered and unexpended
amount of the fiscal year 2024 appropriation referenced in Laws 2023, chapter 61, article
9, section 2, subdivision 16, paragraph (i), for orientation payments, estimated to be
$1,830,000, is canceled.
new text end
new text begin Subd. 6. new text end
new text begin Safe recovery site grant cancellation. new text end
new text begin
Any unencumbered and unexpended
amount of the fiscal year 2024 appropriation in Laws 2023, chapter 61, article 9, section 2,
subdivision 18, paragraph (b), for grants to establish safe recovery sites, estimated to be
$13,528,000, is canceled.
new text end
new text begin Subd. 7. new text end
new text begin Harm reduction grant cancellation. new text end
new text begin
Any unencumbered and unexpended
amount of the fiscal year 2024 appropriation in Laws 2023, chapter 61, article 9, section 2,
subdivision 18, paragraph (e), for grants to purchase syringes, testing supplies, and opiate
antagonists, estimated to be $7,597,000, is canceled.
new text end
new text begin Subd. 8. new text end
new text begin Nursing facility payment program cancellation. new text end
new text begin
Any unencumbered and
unexpended amount of the fiscal year 2024 appropriation in Laws 2023, chapter 74, article
1, section 6, subdivision 2, for payments to nursing facilities, estimated to be $1,416,000,
is canceled.
new text end
new text begin Subd. 9. new text end
new text begin
Advisory committee for Direct Care and Treatment funding
cancellation.
new text end
new text begin
Any unencumbered and unexpended amount of the fiscal year 2025
appropriation in Laws 2024, chapter 127, article 53, section 2, subdivision 20, paragraph
(d), for the Direct Care and Treatment advisory committee, estimated to be $482,000, is
canceled.
new text end
new text begin Subd. 10. new text end
new text begin
Cancellation and transfer of the human services response contingency
account balance.
new text end
new text begin
(a) $813,000 of the remaining unencumbered balance in the human
services response contingency account established under Minnesota Statutes, section 256.044,
is canceled to the special revenue fund.
new text end
new text begin
(b) An amount equal to the amount canceled under paragraph (a) is transferred from the
special revenue fund to the general fund.
new text end
new text begin Subd. 11. new text end
new text begin Cancellation and transfer of family and medical benefit funding. new text end
new text begin
(a)
$20,000,000 in fiscal year 2026 is canceled from the family and medical benefit account to
the family and medical benefit insurance fund.
new text end
new text begin
(b) An amount equal to the amount canceled under paragraph (a) is transferred from the
family and medical benefit insurance fund to the general fund.
new text end
new text begin Subd. 12. new text end
new text begin Transfer from the opiate epidemic response fund to the general fund. new text end
new text begin
The
commissioner of management and budget must transfer $1,000,000 in fiscal year 2026 and
$1,000,000 in fiscal year 2027 from the registration and license fee account in the opiate
epidemic response fund under Minnesota Statutes, section 256.043, subdivision 3, to the
general fund. For fiscal years 2028 to 2031, the commissioner of management and budget
must include a transfer of $1,000,000 each year from the registration and license fee account
in the opiate epidemic response fund to the general fund when preparing each forecast under
Minnesota Statutes, section 16A.103, from the effective date of this subdivision through
the February 2027 forecast.
new text end
new text begin Subd. 13. new text end
new text begin Transfers to and from the workforce incentive grant account. new text end
new text begin
(a) By July
30, 2025, the commissioner must transfer $70,805,000 from the workforce incentive grant
account in the special revenue fund, under Minnesota Statutes, section 256.4764, subdivision
9, to the general fund. This is a onetime transfer.
new text end
new text begin
(b) In fiscal year 2028, the commissioner must transfer $70,805,000 from the general
fund to the workforce incentive grant account in the special revenue fund under Minnesota
Statutes, section 256.4764, subdivision 9. This is a onetime transfer and is available for the
purposes of the account until June 30, 2029. Any remaining balance cancels to the general
fund.
new text end
new text begin Subd. 14. new text end
new text begin
Transfer from the long-term services and supports loan account to the
general fund.
new text end
new text begin
The commissioner of management and budget must transfer unencumbered
money from the long-term services and supports loan account under Minnesota Statutes,
section 256.4792, subdivision 8a, in the special revenue fund, to the general fund. The
amounts transferred must not exceed $5,000,000 in fiscal year 2026 and $10,000,000 in
fiscal year 2027. For fiscal years 2028 through 2031, the commissioner of management and
budget must include an assumption that a transfer of $17,500,000 in fiscal year 2028,
$17,500,000 in fiscal year 2029, and $0 each year thereafter of unencumbered money in
the long-term services and supports loan account from the special revenue fund to the general
fund, when preparing each forecast from the effective date of this section through the
February 2027 forecast, under Minnesota Statutes, section 16A.103.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 25. new text begin TRANSFERS.
new text end
new text begin Subdivision 1. new text end
new text begin Grants. new text end
new text begin
The commissioner of human services, with the advance approval
of the commissioner of management and budget, may transfer unencumbered appropriation
balances for the biennium ending June 30, 2027, within fiscal years among general assistance,
medical assistance, MinnesotaCare, the Minnesota supplemental aid program, the housing
support program, and the entitlement portion of the behavioral health fund between fiscal
years of the biennium. The commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services a
quarterly grants transfer report. The report must include the amounts transferred and the
purpose of each transfer.
new text end
new text begin Subd. 2. new text end
new text begin Administration; intra-agency transfers. new text end
new text begin
Positions, salary money, and nonsalary
administrative money may be transferred within the Department of Human Services as the
commissioner deems necessary, with the advance approval of the commissioner of
management and budget. The commissioner must submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
finance a quarterly intra-agency transfer report. The report must include the amounts
transferred and the purpose of each transfer.
new text end
new text begin Subd. 3. new text end
new text begin Administration; interagency transfers. new text end
new text begin
During fiscal year 2026, with advance
approval of the commissioner of management and budget, administrative money may be
transferred between the Department of Human Services and Direct Care and Treatment as
the commissioner and executive board deem necessary. The commissioner and executive
board must submit to the chairs and ranking minority members of the legislative committees
with jurisdiction over human services and direct care and treatment an interagency transfers
report. The report must include the amounts transferred and the purpose of each transfer.
new text end
Sec. 26. new text begin GRANT ADMINISTRATION.
new text end
new text begin
Notwithstanding Minnesota Statutes, section 16B.98, subdivision 14, the commissioner
of human services must not use any of the grant amounts appropriated under this article for
administrative costs.
new text end
Sec. 27. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation or transfer in this article is enacted more than once during the 2025
regular session, the appropriation or transfer must be given effect once.
new text end
Sec. 28. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit.
new text end
Sec. 29. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2025, unless a different effective date is specified.
new text end
ARTICLE 13
DIRECT CARE AND TREATMENT APPROPRIATIONS
Section 1. new text begin DIRECT CARE AND TREATMENT APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the
executive board of direct care and treatment and for the purposes specified in this article.
The appropriations are from the general fund, or another named fund, and are available for
the fiscal years indicated for each purpose. The figures "2026" and "2027" used in this
article mean that the appropriations listed under them are available for the fiscal year ending
June 30, 2026, or June 30, 2027, respectively. "The first year" is fiscal year 2026. "The
second year" is fiscal year 2027. "The biennium" is fiscal years 2026 and 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2. new text begin EXECUTIVE BOARD OF DIRECT
|
new text begin
$ new text end |
new text begin
577,915,000 new text end |
new text begin
$ new text end |
new text begin
603,261,000 new text end |
||
new text begin
The amounts that may be spent for each
purpose are specified in the following sections.
new text end
Sec. 3. new text begin MENTAL HEALTH AND SUBSTANCE
|
new text begin
$ new text end |
new text begin
189,761,000 new text end |
new text begin
$ new text end |
new text begin
194,840,000 new text end |
||
Sec. 4. new text begin COMMUNITY-BASED SERVICES
|
new text begin
$ new text end |
new text begin
13,927,000 new text end |
new text begin
$ new text end |
new text begin
14,170,000 new text end |
||
Sec. 5. new text begin FORENSIC SERVICES
|
new text begin
$ new text end |
new text begin
160,239,000 new text end |
new text begin
$ new text end |
new text begin
164,094,000 new text end |
||
Sec. 6. new text begin SEX OFFENDER PROGRAM
|
new text begin
$ new text end |
new text begin
128,050,000 new text end |
new text begin
$ new text end |
new text begin
131,351,000 new text end |
||
Sec. 7. new text begin ADMINISTRATION
|
new text begin
$ new text end |
new text begin
85,938,000 new text end |
new text begin
$ new text end |
new text begin
98,806,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Locked Psychiatric Residential
|
||||||
new text begin
(a) $100,000 in fiscal year 2026 is for planning
a build out of a locked psychiatric residential
treatment facility operated by Direct Care and
Treatment. This is a onetime appropriation
and is available until June 30, 2027.
new text end
new text begin
(b) By March 1, 2026, the executive board
must report to the chairs and ranking minority
members of the legislative committees with
jurisdiction over human services finance and
policy on the plan developed using the
appropriation in this section to build out a
locked psychiatric residential treatment facility
(PRTF) operated by Direct Care and
Treatment.
new text end
new text begin
(c) The report must include but is not limited
to the following information:
new text end
new text begin
(1) the risks and benefits of locating the locked
PRTF in a metropolitan or rural location;
new text end
new text begin
(2) the estimated cost for the build out of the
locked PRTF;
new text end
new text begin
(3) the estimated ongoing cost of maintaining
the locked PRTF; and
new text end
new text begin
(4) the estimated amount of costs that can be
recouped from medical assistance,
MinnesotaCare, and private insurance
payments.
new text end
new text begin Subd. 2. new text end
new text begin
Mentally Ill and Dangerous
|
||||||
new text begin
$31,000 in fiscal year 2026 and $31,000 in
fiscal year 2027 are for the administrative
costs associated with the extension of the
Mentally Ill and Dangerous Commitment
Reform Task Force and preparing the
recommendations and report of the task force.
This is a onetime appropriation.
new text end
new text begin Subd. 3. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$173,775,000 in fiscal year 2028 and
$98,775,000 in fiscal year 2029. The base for
fiscal year 2028 includes $75,000,000 for the
renovation of the Anoka Regional Treatment
Center Miller Building.
new text end
Sec. 8. new text begin TRANSFER AUTHORITY.
new text end
new text begin Subdivision 1. new text end
new text begin Interprogrammatic transfers. new text end
new text begin
Money appropriated for budget programs
in this article may be transferred between budget programs and between years of the biennium
with the approval of the commissioner of management and budget.
new text end
new text begin Subd. 2. new text end
new text begin Security systems and information technology transfer. new text end
new text begin
The Direct Care and
Treatment executive board, with the advance approval of the commissioner of management
and budget, may transfer money appropriated for Direct Care and Treatment into the special
revenue account for security systems and information technology projects, services, and
support. The executive board must submit to the chairs and ranking minority members of
the legislative committees with jurisdiction over Direct Care and Treatment a quarterly
security systems and information technology transfer report. The report must include the
amounts transferred in that period and the purpose of each transfer.
new text end
new text begin Subd. 3. new text end
new text begin Facilities management transfer. new text end
new text begin
The Direct Care and Treatment executive
board, with the advance approval of the commissioner of management and budget, may
transfer money appropriated for Direct Care and Treatment into the special revenue account
for facilities management. The executive board must submit to the chairs and ranking
minority members of the legislative committees with jurisdiction over Direct Care and
Treatment a quarterly facilities management transfer report. The report must include the
amounts transferred in that period and the purpose of each transfer.
new text end
new text begin Subd. 4. new text end
new text begin Administration. new text end
new text begin
Positions, salary money, and nonsalary administrative money
may be transferred within Direct Care and Treatment as the executive board considers
necessary, with the advance approval of the commissioner of management and budget. The
executive board must submit to the chairs and ranking minority members of the legislative
committees with jurisdiction over Direct Care and Treatment a quarterly intra-agency transfer
report. The report must include the amounts transferred in that period and the purpose of
each transfer.
new text end
new text begin Subd. 5. new text end
new text begin Administration; interagency transfers. new text end
new text begin
During fiscal year 2026, administrative
money may be transferred between the Department of Human Services and Direct Care and
Treatment as the commissioner and executive board deem necessary, with advance approval
of the commissioner of management and budget. The commissioner and executive board
shall submit to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services and direct care and treatment an interagency transfers
report. The report must include the amounts transferred and the purpose of each transfer.
new text end
Sec. 9. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation or transfer in this article is enacted more than once during the 2025
regular session, the appropriation or transfer must be given effect once.
new text end
Sec. 10. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit.
new text end
Sec. 11. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2025, unless a different effective date is specified.
new text end
ARTICLE 14
HEALTH APPROPRIATIONS
Section 1. new text begin HEALTH APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2026" and "2027" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2026, or June 30, 2027, respectively.
"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium"
is fiscal years 2026 and 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF HEALTH;
|
new text begin
$ new text end |
new text begin
3,092,000 new text end |
new text begin
$ new text end |
new text begin
2,996,000 new text end |
||
new text begin
The amounts that may be spent for each
purpose are specified in the following sections.
new text end
Sec. 3. new text begin HEALTH IMPROVEMENT
|
new text begin
$ new text end |
new text begin
2,836,000 new text end |
new text begin
$ new text end |
new text begin
2,836,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Community Care Hub Grant
|
||||||
new text begin
$2,240,000 in fiscal year 2026 and $2,240,000
in fiscal year 2027 are for the community care
hub grant.
new text end
new text begin Subd. 2. new text end
new text begin
Spinal Cord and Traumatic Brain
|
||||||
new text begin
$500,000 in fiscal year 2026 and $500,000 in
fiscal year 2027 are for a transfer to the spinal
cord and traumatic brain injury grant account
in the special revenue fund under Minnesota
Statutes, section 136A.901, subdivision 1. The
commissioner of management and budget must
include a transfer of $500,000 each year from
the general fund to the spinal cord and
traumatic brain injury grant account in each
forecast prepared under Minnesota Statutes,
section 16A.103.
new text end
Sec. 4. new text begin HEALTH PROTECTION
|
new text begin
$ new text end |
new text begin
256,000 new text end |
new text begin
$ new text end |
new text begin
160,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Skin-Lightening Product
|
||||||
new text begin
$100,000 in fiscal year 2026 and $100,000 in
fiscal year 2027 are for a competitive grant
for public awareness and education activities
to address issues of colorism, skin-lightening
products, and chemical exposures from
skin-lightening products. This is a onetime
appropriation and is available until June 30,
2027.
new text end
new text begin Subd. 2. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$60,000 in fiscal year 2028 and $60,000 in
fiscal year 2029.
new text end
Sec. 5. new text begin GRANT ADMINISTRATION.
new text end
new text begin
Notwithstanding Minnesota Statutes, section 16B.98, subdivision 14, the commissioner
of health must not use any of the grant amounts appropriated under this article for
administrative costs.
new text end
Sec. 6. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation or transfer in this article is enacted more than once during the 2025
regular session, the appropriation or transfer must be given effect once.
new text end
Sec. 7. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit.
new text end
Sec. 8. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2025, unless a different effective date is specified.
new text end
ARTICLE 15
OTHER AGENCY APPROPRIATIONS
Section 1. new text begin OTHER AGENCY APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2026" and "2027" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2026, or June 30, 2027, respectively.
"The first year" is fiscal year 2026. "The second year" is fiscal year 2027. "The biennium"
is fiscal years 2026 and 2027.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|||||
Sec. 2. new text begin COUNCIL ON DISABILITY
|
new text begin
$ new text end |
new text begin
2,432,000 new text end |
new text begin
$ new text end |
new text begin
2,457,000 new text end |
||
new text begin
Legislative Task Force On Guardianship
Funding Cancellation
new text end
new text begin
Any unencumbered and unexpended amount
of the fiscal year 2025 appropriation
referenced in Laws 2024, chapter 127, article
53, section 4, for the Legislative Task Force
on Guardianship, estimated to be $400,000,
is canceled.
new text end
Sec. 3. new text begin OFFICE OF THE OMBUDSMAN FOR
|
new text begin
$ new text end |
new text begin
3,706,000 new text end |
new text begin
$ new text end |
new text begin
3,765,000 new text end |
||
Sec. 4. new text begin OFFICE OF ADMINISTRATIVE
|
new text begin
$ new text end |
new text begin
272,000 new text end |
new text begin
$ new text end |
new text begin
262,000 new text end |
||
Sec. 5. new text begin MINNESOTA HUMANITIES CENTER
|
new text begin
$ new text end |
new text begin
68,000 new text end |
new text begin
$ new text end |
new text begin
-0- new text end |
||
new text begin
YouLead2025
new text end
new text begin
$68,000 in fiscal year 2026 is for a competitive
grant for a youth development and youth
leadership program focused on inspiring youth
to be intercultural ambassadors for positive
change in their respective countries. This is a
onetime appropriation. Notwithstanding
Minnesota Statutes, section 16B.98,
subdivision 14, the Board of Directors of the
Minnesota Humanities Center must not use
any of the grant amounts for administrative
costs.
new text end
Sec. 6. new text begin BOARD OF BEHAVIORAL HEALTH
|
new text begin
$ new text end |
new text begin
2,000 new text end |
new text begin
$ new text end |
new text begin
1,000 new text end |
||
new text begin
The general fund base for this section is $0 in
fiscal year 2028 and $0 in fiscal year 2029.
new text end
Sec. 7. new text begin BOARD OF MEDICAL PRACTICE
|
new text begin
$ new text end |
new text begin
3,000 new text end |
new text begin
$ new text end |
new text begin
1,000 new text end |
||
new text begin
The general fund base for this section is $0 in
fiscal year 2028 and $0 in fiscal year 2029.
new text end
Sec. 8. new text begin BOARD OF NURSING
|
new text begin
$ new text end |
new text begin
4,000 new text end |
new text begin
$ new text end |
new text begin
2,000 new text end |
||
new text begin
The general fund base for this section is $0 in
fiscal year 2028 and $0 in fiscal year 2029.
new text end
Sec. 9. new text begin COMMISSIONER OF CHILDREN,
|
new text begin
$ new text end |
new text begin
100,000 new text end |
new text begin
$ new text end |
new text begin
100,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Families and Children Opiate
|
||||||
new text begin
$100,000 in fiscal year 2026 and $100,000 in
fiscal year 2027 are for a grant to Beltrami
County to support families and children
affected by the opiate epidemic who are in the
child welfare system or at risk of entering the
child welfare system. This is a onetime
appropriation.
new text end
new text begin Subd. 2. new text end
new text begin
General Fund Base
|
||||||
new text begin
The general fund base for this section is $0 in
fiscal year 2028 and $0 in fiscal year 2029.
new text end
Sec. 10. new text begin APPROPRIATIONS GIVEN EFFECT ONCE.
new text end
new text begin
If an appropriation or transfer in this article is enacted more than once during the 2025
regular session, the appropriation or transfer must be given effect once.
new text end
Sec. 11. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit.
new text end
Sec. 12. new text begin EFFECTIVE DATE.
new text end
new text begin
This article is effective July 1, 2025, unless a different effective date is specified.
new text end
APPENDIX
Repealed Minnesota Statutes: ueh2434-1
144A.071 MORATORIUM ON CERTIFICATION OF NURSING HOME BEDS.
Subd. 4c.
Exceptions for replacement beds after June 30, 2003.
(a) The commissioner of health, in coordination with the commissioner of human services, may approve the renovation, replacement, upgrading, or relocation of a nursing home or boarding care home, under the following conditions:
(1) to license and certify an 80-bed city-owned facility in Nicollet County to be constructed on the site of a new city-owned hospital to replace an existing 85-bed facility attached to a hospital that is also being replaced. The threshold allowed for this project under section 144A.073 shall be the maximum amount available to pay the additional medical assistance costs of the new facility;
(2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis County, provided that the 29 beds must be transferred from active or layaway status at an existing facility in St. Louis County that had 235 beds on April 1, 2003.
The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment rate at that facility shall not be adjusted as a result of this transfer. The operating payment rate of the facility adding beds after completion of this project shall be the same as it was on the day prior to the day the beds are licensed and certified. This project shall not proceed unless it is approved and financed under the provisions of section 144A.073;
(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new beds are transferred from a 45-bed facility in Austin under common ownership that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common ownership; (ii) the commissioner of human services is authorized by the 2004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii) money is available from planned closures of facilities under common ownership to make implementation of this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's disease or related dementias;
(4) to license and certify up to 80 beds transferred from an existing state-owned nursing facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be determined based on the interim and settle-up payment provisions of section 256R.27 and the reimbursement provisions of chapter 256R. The property payment rate for the first three years of operation shall be $35 per day. For subsequent years, the property payment rate of $35 per day shall be adjusted for inflation as provided in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract under section 256B.434;
(5) to initiate a pilot program to license and certify up to 80 beds transferred from an existing county-owned nursing facility in Steele County relocated to the site of a new acute care facility as part of the county's Communities for a Lifetime comprehensive plan to create innovative responses to the aging of its population. Upon relocation to the new site, the nursing facility shall delicense 28 beds. The payment rate for external fixed costs for the new facility shall be increased by an amount as calculated according to items (i) to (v):
(i) compute the estimated decrease in medical assistance residents served by the nursing facility by multiplying the decrease in licensed beds by the historical percentage of medical assistance resident days;
(ii) compute the annual savings to the medical assistance program from the delicensure of 28 beds by multiplying the anticipated decrease in medical assistance residents, determined in item (i), by the existing facility's weighted average payment rate multiplied by 365;
(iii) compute the anticipated annual costs for community-based services by multiplying the anticipated decrease in medical assistance residents served by the nursing facility, determined in item (i), by the average monthly elderly waiver service costs for individuals in Steele County multiplied by 12;
(iv) subtract the amount in item (iii) from the amount in item (ii);
(v) divide the amount in item (iv) by an amount equal to the relocated nursing facility's occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance resident days; and
(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County and to integrate these services with other community-based programs and services under a communities for a lifetime pilot program and comprehensive plan to create innovative responses to the aging of its population. Two nursing facilities, one for 84 beds and one for 65 beds, in the city of Red Wing licensed on July 1, 2015, shall be consolidated into a newly renovated 64-bed nursing facility resulting in the delicensure of 85 beds. Notwithstanding the carryforward of the approval authority in section 144A.073, subdivision 11, the funding approved in April 2009 by the commissioner of health for a project in Goodhue County shall not carry forward. The closure of the 85 beds shall not be eligible for a planned closure rate adjustment under section 256R.40. The construction project permitted in this clause shall not be eligible for a threshold project rate adjustment under section 256B.434, subdivision 4f. The payment rate for external fixed costs for the new facility shall be increased by an amount as calculated according to items (i) to (vi):
(i) compute the estimated decrease in medical assistance residents served by both nursing facilities by multiplying the difference between the occupied beds of the two nursing facilities for the reporting year ending September 30, 2009, and the projected occupancy of the facility at 95 percent occupancy by the historical percentage of medical assistance resident days;
(ii) compute the annual savings to the medical assistance program from the delicensure by multiplying the anticipated decrease in the medical assistance residents, determined in item (i), by the hospital-owned nursing facility weighted average payment rate multiplied by 365;
(iii) compute the anticipated annual costs for community-based services by multiplying the anticipated decrease in medical assistance residents served by the facilities, determined in item (i), by the average monthly elderly waiver service costs for individuals in Goodhue County multiplied by 12;
(iv) subtract the amount in item (iii) from the amount in item (ii);
(v) multiply the amount in item (iv) by 57.2 percent; and
(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an amount equal to the relocated nursing facility's occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance resident days.
(b) Projects approved under this subdivision shall be treated in a manner equivalent to projects approved under subdivision 4a.
245A.042 HOME AND COMMUNITY-BASED SERVICES; ADDITIONAL STANDARDS AND PROCEDURES.
Subd. 2.
Modified application procedures.
(a) Applicants seeking chapter 245D licensure who meet the following criteria are subject to modified application procedures:
(1) the applicant holds a chapter 245B license issued on or before December 31, 2012, at the time of application;
(2) the applicant's chapter 245B license or licenses are in substantial compliance according to the licensing standards in this chapter and chapter 245B; and
(3) the commissioner has conducted at least one on-site inspection of the chapter 245B license or licenses within the two-year period before submitting the chapter 245D license application.
For purposes of this subdivision, "substantial compliance" means the commissioner has not issued a sanction according to section 245A.07 against any chapter 245B license held by the applicant or made the chapter 245B license or licenses conditional according to section 245A.06 within the 12-month period before submitting the application for chapter 245D licensure.
(b) The modified application procedures mean the commissioner must accept the applicant's attestation of compliance with certain requirements in lieu of providing information to the commissioner for evaluation that is otherwise required when seeking chapter 245D licensure.
Subd. 3.
Implementation.
(a) The commissioner shall implement the responsibilities of this chapter according to the timelines in paragraphs (b) and (c) only within the limits of available appropriations or other administrative cost recovery methodology.
(b) The licensure of home and community-based services according to this section shall be implemented January 1, 2014. License applications shall be received and processed on a phased-in schedule as determined by the commissioner beginning July 1, 2013. Licenses will be issued thereafter upon the commissioner's determination that the application is complete according to section 245A.04.
(c) Within the limits of available appropriations or other administrative cost recovery methodology, implementation of compliance monitoring must be phased in after January 1, 2014.
(1) Applicants who do not currently hold a license issued under chapter 245B must receive an initial compliance monitoring visit after 12 months of the effective date of the initial license for the purpose of providing technical assistance on how to achieve and maintain compliance with the applicable law or rules governing the provision of home and community-based services under chapter 245D. If during the review the commissioner finds that the license holder has failed to achieve compliance with an applicable law or rule and this failure does not imminently endanger the health, safety, or rights of the persons served by the program, the commissioner may issue a licensing review report with recommendations for achieving and maintaining compliance.
(2) Applicants who do currently hold a license issued under this chapter must receive a compliance monitoring visit after 24 months of the effective date of the initial license.
(d) Nothing in this subdivision shall be construed to limit the commissioner's authority to suspend or revoke a license or issue a fine at any time under section 245A.07, or issue correction orders and make a license conditional for failure to comply with applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity of the violation of law or rule and the effect of the violation on the health, safety, or rights of persons served by the program.
(e) License holders governed under chapter 245D must ensure compliance with the following requirements within the stated timelines:
(1) service initiation and service planning requirements must be met at the next annual meeting of the person's support team or by January 1, 2015, whichever is later, for the following:
(i) provision of a written notice that identifies the service recipient rights and an explanation of those rights as required under section 245D.04, subdivision 1;
(ii) service planning for basic support services as required under section 245D.07, subdivision 2; and
(iii) service planning for intensive support services under section 245D.071, subdivisions 3 and 4;
(2) staff orientation to program requirements as required under section 245D.09, subdivision 4, for staff hired before January 1, 2014, must be met by January 1, 2015. The license holder may otherwise provide documentation verifying these requirements were met before January 1, 2014;
(3) development of policy and procedures as required under section 245D.11, must be completed no later than August 31, 2014;
(4) written or electronic notice and copies of policies and procedures must be provided to all persons or their legal representatives and case managers as required under section 245D.10, subdivision 4, paragraphs (b) and (c), by September 15, 2014, or within 30 days of development of the required policies and procedures, whichever is earlier; and
(5) all employees must be informed of the revisions and training must be provided on implementation of the revised policies and procedures as required under section 245D.10, subdivision 4, paragraph (d), by September 15, 2014, or within 30 days of development of the required policies and procedures, whichever is earlier.
Subd. 4.
Stakeholder consultation.
The commissioner shall consult with the existing stakeholder group established as part of the provider standards process to gather input related to the development of an administrative cost recovery methodology to implement the provisions in chapter 245D.
245G.01 DEFINITIONS.
Subd. 20d.
Skilled treatment services.
"Skilled treatment services" has the meaning provided in section 254B.01, subdivision 10.
245G.07 TREATMENT SERVICE.
Subd. 2.
Additional treatment service.
A license holder may provide or arrange the following additional treatment service as a part of the client's individual treatment plan:
(1) relationship counseling provided by a qualified professional to help the client identify the impact of the client's substance use disorder on others and to help the client and persons in the client's support structure identify and change behaviors that contribute to the client's substance use disorder;
(2) therapeutic recreation to allow the client to participate in recreational activities without the use of mood-altering chemicals and to plan and select leisure activities that do not involve the inappropriate use of chemicals;
(3) stress management and physical well-being to help the client reach and maintain an appropriate level of health, physical fitness, and well-being;
(4) living skills development to help the client learn basic skills necessary for independent living;
(5) employment or educational services to help the client become financially independent;
(6) socialization skills development to help the client live and interact with others in a positive and productive manner;
(7) room, board, and supervision at the treatment site to provide the client with a safe and appropriate environment to gain and practice new skills; and
(8) peer recovery support services must be provided by a recovery peer qualified according to section 245I.04, subdivision 18. Peer recovery support services must be provided according to sections 254B.05, subdivision 5, and 254B.052.
246B.01 MINNESOTA SEX OFFENDER PROGRAM; DEFINITIONS.
246C.015 DEFINITIONS.
Subd. 5a.
Direct Care and Treatment.
"Direct Care and Treatment" means the agency of Direct Care and Treatment established under this chapter.
Subd. 6.
Executive board.
"Executive board" means the Direct Care and Treatment executive board established under section 246C.06.
246C.06 EXECUTIVE BOARD; MEMBERSHIP; GOVERNANCE.
Subdivision 1.
Establishment.
The Direct Care and Treatment executive board is established.
Subd. 2.
Membership.
(a) The Direct Care and Treatment executive board consists of nine members with seven voting members and two nonvoting members. The seven voting members must include six members appointed by the governor with the advice and consent of the senate in accordance with paragraph (b) and the commissioner of human services or a designee. The two nonvoting members must be appointed in accordance with paragraph (c). Section 15.0597 applies to all executive board appointments except for the commissioner of human services.
(b) The executive board voting members appointed by the governor must meet the following qualifications:
(1) one member must be a licensed physician who is a psychiatrist or has experience in serving behavioral health patients;
(2) two members must have experience serving on a hospital or nonprofit board; and
(3) three members must have experience working: (i) in the delivery of behavioral health services or care coordination or in traditional healing practices; (ii) as a licensed health care professional; (iii) within health care administration; or (iv) with residential services.
(c) The executive board nonvoting members must be appointed as follows:
(1) one member appointed by the Association of Counties; and
(2) one member who has an active role as a union representative representing staff at Direct Care and Treatment appointed by joint representatives of the following unions: American Federation of State, County and Municipal Employees (AFSCME); Minnesota Association of Professional Employees (MAPE); Minnesota Nurses Association (MNA); Middle Management Association (MMA); and State Residential Schools Education Association (SRSEA).
(d) Membership on the board must include representation from outside the seven-county metropolitan area, as defined in section 473.121, subdivision 2.
(e) A voting member of the executive board must not be or must not have been within one year prior to appointment: (1) an employee of Direct Care and Treatment; (2) an employee of a county, including a county commissioner; (3) an active employee or representative of a labor union that represents employees of Direct Care and Treatment; or (4) a member of the state legislature. This paragraph does not apply to the nonvoting members or the commissioner of human services or designee.
Subd. 3.
Procedures.
Except as otherwise provided in this section, the membership terms and removal and filling of vacancies for the executive board are governed by section 15.0575.
Subd. 4.
Compensation.
(a) Notwithstanding section 15.0575, subdivision 3, paragraph (a), the nonvoting members of the executive board must not receive daily compensation for executive board activities. Nonvoting members of the executive board may receive expenses in the same manner and amount as authorized by the commissioner's plan adopted under section 43A.18, subdivision 2. Nonvoting members who, as a result of time spent attending board meetings, incur child care expenses that would not otherwise have been incurred may be reimbursed for those expenses upon board authorization.
(b) Notwithstanding section 15.0575, subdivision 3, paragraph (a), the Compensation Council under section 15A.082 must determine the compensation for voting members of the executive board per day spent on executive board activities authorized by the executive board. Voting members of the executive board may also receive the expenses in the same manner and amount as authorized by the commissioner's plan adopted under section 43A.18, subdivision 2. Voting members who, as a result of time spent attending board meetings, incur child care expenses that would not otherwise have been incurred may be reimbursed for those expenses upon board authorization.
(c) The commissioner of management and budget must publish the daily compensation rate for voting members of the executive board determined under paragraph (b) on the Department of Management and Budget's website.
(d) Voting members of the executive board must adopt internal standards prescribing what constitutes a day spent on board activities for the purposes of making payments authorized under paragraph (b).
(e) All other requirements under section 15.0575, subdivision 3, apply to the compensation of executive board members.
Subd. 5.
Acting chair; officers.
(a) The governor shall designate one member from the voting membership appointed by the governor as acting chair of the executive board.
(b) At the first meeting of the executive board, the executive board must elect a chair from among the voting membership appointed by the governor.
(c) The executive board must annually elect a chair from among the voting membership appointed by the governor.
(d) The executive board must elect officers from among the voting membership appointed by the governor. The elected officers shall serve for one year.
Subd. 6.
Terms.
(a) Except for the commissioner of human services, executive board members must not serve more than two consecutive terms unless service beyond two consecutive terms is approved by the majority of voting members. The commissioner of human services or a designee shall serve until replaced by the governor.
(b) An executive board member may resign at any time by giving written notice to the executive board.
(c) The initial term of the member appointed under subdivision 2, paragraph (b), clause (1), is two years. The initial term of the members appointed under subdivision 2, paragraph (b), clause (2), is three years. The initial term of the members appointed under subdivision 2, paragraph (b), clause (3), and the members appointed under subdivision 2, paragraph (c), is four years.
(d) After the initial term, the term length of all appointed executive board members is four years.
Subd. 7.
Conflicts of interest.
Executive board members must recuse themselves from discussion of and voting on an official matter if the executive board member has a conflict of interest. A conflict of interest means an association, including a financial or personal association, that has the potential to bias or have the appearance of biasing an executive board member's decision in matters related to Direct Care and Treatment or the conduct of activities under this chapter.
Subd. 8.
Meetings.
The executive board must meet at least four times per fiscal year at a place and time determined by the executive board.
Subd. 9.
Quorum.
A majority of the voting members of the executive board constitutes a quorum. The affirmative vote of a majority of the voting members of the executive board is necessary and sufficient for action taken by the executive board.
Subd. 10.
Immunity; indemnification.
(a) Members of the executive board are immune from civil liability for any act or omission occurring within the scope of the performance of their duties under this chapter.
(b) When performing executive board duties or actions, members of the executive board are employees of the state for purposes of indemnification under section 3.736, subdivision 9.
246C.07 POWERS AND DUTIES OF EXECUTIVE BOARD.
Subd. 4.
Creation of bylaws.
The board may establish bylaws governing its operations and the operations of Direct Care and Treatment in accordance with this chapter.
Subd. 5.
Performance of chief executive officer.
The governor may request that the executive board review the performance of the chief executive officer at any time. Within 14 days of receipt of the request, the board must meet and conduct a performance review as specifically requested by the governor. During the performance review, a representative of the governor must be included as a voting member of the board for the purpose of the board's discussions and decisions regarding the governor's request. The board must establish a performance improvement plan as necessary or take disciplinary or other corrective action, including dismissal. The executive board must report to the governor on action taken by the board, including an explanation if no action is deemed necessary.
252.021 DEFINITION.
253.195 DEFINITIONS.
253B.02 DEFINITIONS.
253D.02 DEFINITIONS.
254B.01 DEFINITIONS.
Subd. 5.
Local agency.
"Local agency" means the agency designated by a board of county commissioners, a local social services agency, or a human services board authorized under section 254B.03, subdivision 1, to determine financial eligibility for the behavioral health fund.
254B.18 SAFE RECOVERY SITES START-UP AND CAPACITY-BUILDING GRANTS.
(a) The commissioner of human services must establish start-up and capacity-building grants for current or prospective harm reduction organizations to promote health, wellness, safety, and recovery to people who are in active stages of substance use disorder. Grants must be used to establish safe recovery sites that offer harm reduction services and supplies, including but not limited to:
(1) safe injection spaces;
(2) sterile needle exchange;
(3) opiate antagonist rescue kits;
(4) fentanyl and other drug testing;
(5) street outreach;
(6) educational and referral services;
(7) health, safety, and wellness services; and
(8) access to hygiene and sanitation.
(b) The commissioner must conduct local community outreach and engagement in collaboration with newly established safe recovery sites. The commissioner must evaluate the efficacy of safe recovery sites and collect data to measure health-related and public safety outcomes.
(c) The commissioner must prioritize grant applications for organizations that are culturally specific or culturally responsive and that commit to serving individuals from communities that are disproportionately impacted by the opioid epidemic, including:
(1) Native American, American Indian, and Indigenous communities; and
(2) Black, African American, and African-born communities.
(d) For purposes of this section, a "culturally specific" or "culturally responsive" organization is an organization that is designed to address the unique needs of individuals who share a common language, racial, ethnic, or social background, and is governed with significant input from individuals of that specific background.
256.045 ADMINISTRATIVE AND JUDICIAL REVIEW OF HUMAN SERVICES MATTERS.
Subd. 1a.
Direct Care and Treatment executive board or executive board.
For purposes of this section, "Direct Care and Treatment executive board" or "executive board" means the Direct Care and Treatment executive board established under section 246C.06.
256B.0949 EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL INTERVENTION BENEFIT.
Subd. 9.
Revision of treatment modalities.
(a) The commissioner may revise covered treatment modalities as needed based on outcome data and other evidence. EIDBI treatment modalities approved by the department must:
(1) cause no harm to the person or the person's family;
(2) be individualized and person-centered;
(3) be developmentally appropriate and highly structured, with well-defined goals and objectives that provide a strategic direction for treatment;
(4) be based in recognized principles of developmental and behavioral science;
(5) utilize sound practices that are replicable across providers and maintain the fidelity of the specific modality;
(6) demonstrate an evidentiary basis;
(7) have goals and objectives that are measurable, achievable, and regularly evaluated and adjusted to ensure that adequate progress is being made;
(8) be provided intensively with a high staff-to-person ratio; and
(9) include participation by the person and the person's legal representative in decision making, knowledge building and capacity building, and developing and implementing the person's ITP.
(b) Before revisions in department recognized treatment modalities become effective, the commissioner must provide public notice of the changes, the reasons for the change, and a 30-day public comment period to those who request notice through an electronic list accessible to the public on the department's website.
256G.02 DEFINITIONS.
Subd. 5a.
Direct Care and Treatment executive board or executive board.
"Direct Care and Treatment executive board" or "executive board" means the Direct Care and Treatment executive board established under section 246C.06.
256R.02 DEFINITIONS.
Subd. 38.
Prior system operating cost payment rate.
"Prior system operating cost payment rate" means the operating cost payment rate in effect on December 31, 2015, under Minnesota Rules and Minnesota Statutes, inclusive of health insurance, plus property insurance costs from external fixed costs, minus any rate increases allowed under Minnesota Statutes 2015 Supplement, section 256B.441, subdivision 55a.
256R.12 COST ALLOCATION.
Subd. 10.
Allocation of self-insurance costs.
For the rate year beginning on July 1, 1998, a group of nursing facilities related by common ownership that self-insures group health, dental, or life insurance may allocate its directly identified costs of self-insuring its Minnesota nursing facility workers among those nursing facilities in the group that are reimbursed under this chapter. The method of cost allocation shall be based on the ratio of each nursing facility's total allowable salaries and wages to that of the nursing facility group's total allowable salaries and wages, then similarly allocated within each nursing facility's operating cost categories. The costs associated with the administration of the group's self-insurance plan must remain classified in the nursing facility's administrative cost category. A written request of the nursing facility group's election to use this alternate method of allocation of self-insurance costs must be received by the commissioner no later than May 1, 1998, to take effect July 1, 1998, or those self-insurance costs shall continue to be allocated under the existing cost allocation methods. Once a nursing facility group elects this method of cost allocation for its group health, dental, or life insurance self-insurance costs, it shall remain in effect until such time as the group no longer self-insures these costs.
256R.23 TOTAL CARE-RELATED PAYMENT RATES.
Subd. 6.
Payment rate limit reduction.
No facility shall be subject in any rate year to a care-related payment rate limit reduction greater than five percent of the median determined in subdivision 4.
256R.36 HOLD HARMLESS.
No nursing facility's operating payment rate, plus its employer health insurance costs portion of the external fixed costs payment rate, will be less than its prior system operating cost payment rate.
256R.40 NURSING FACILITY VOLUNTARY CLOSURE; ALTERNATIVES.
Subdivision 1.
Definitions.
(a) The definitions in this subdivision apply to this section.
(b) "Closure" means the cessation of operations of a nursing facility and delicensure and decertification of all beds within the facility.
(c) "Closure plan" means a plan to close a nursing facility and reallocate a portion of the resulting savings to provide planned closure rate adjustments at other facilities.
(d) "Commencement of closure" means the date on which residents and designated representatives are notified of a planned closure as provided in section 144A.161, subdivision 5a, as part of an approved closure plan.
(e) "Completion of closure" means the date on which the final resident of the nursing facility designated for closure in an approved closure plan is discharged from the facility or the date that beds from a partial closure are delicensed and decertified.
(f) "Partial closure" means the delicensure and decertification of a portion of the beds within the facility.
(g) "Planned closure rate adjustment" means an increase in a nursing facility's operating rates resulting from a planned closure or a planned partial closure of another facility.
Subd. 2.
Applications for planned closure rate.
(a) To be considered for approval of a planned closure, an application must include:
(1) a description of the proposed closure plan, which must include identification of the facility or facilities to receive a planned closure rate adjustment;
(2) the proposed timetable for any proposed closure, including the proposed dates for announcement to residents, commencement of closure, and completion of closure;
(3) if available, the proposed relocation plan for current residents of any facility designated for closure. If a relocation plan is not available, the application must include a statement agreeing to develop a relocation plan designed to comply with section 144A.161;
(4) a description of the relationship between the nursing facility that is proposed for closure and the nursing facility or facilities proposed to receive the planned closure rate adjustment. If these facilities are not under common ownership, copies of any contracts, purchase agreements, or other documents establishing a relationship or proposed relationship must be provided; and
(5) documentation, in a format approved by the commissioner, that all the nursing facilities receiving a planned closure rate adjustment under the plan have accepted joint and several liability for recovery of overpayments under section 256B.0641, subdivision 2, for the facilities designated for closure under the plan.
(b) The application must also address the criteria listed in subdivision 3.
Subd. 3.
Criteria for review of application.
In reviewing and approving closure proposals, the commissioner shall consider, but not be limited to, the following criteria:
(1) improved quality of care and quality of life for consumers;
(2) closure of a nursing facility that has a poor physical plant;
(3) the existence of excess nursing facility beds, measured in terms of beds per thousand persons aged 85 or older. The excess must be measured in reference to:
(i) the county in which the facility is located. A facility in a county that is in the lowest quartile of counties with reference to beds per thousand persons aged 85 or older is not in an area of excess capacity;
(ii) the county and all contiguous counties;
(iii) the region in which the facility is located; or
(iv) the facility's service area. The facility shall indicate in its application the service area it believes is appropriate for this measurement;
(4) low-occupancy rates, provided that the unoccupied beds are not the result of a personnel shortage. In analyzing occupancy rates, the commissioner shall examine waiting lists in the applicant facility and at facilities in the surrounding area, as determined under clause (3);
(5) evidence of coordination between the community planning process and the facility application. If the planning group does not support a level of nursing facility closures that the commissioner considers to be reasonable, the commissioner may approve a planned closure proposal without its support;
(6) proposed usage of funds available from a planned closure rate adjustment for care-related purposes;
(7) innovative use planned for the closed facility's physical plant;
(8) evidence that the proposal serves the interests of the state; and
(9) evidence of other factors that affect the viability of the facility, including excessive nursing pool costs.
Subd. 4.
Review and approval of applications.
(a) The commissioner, in consultation with the commissioner of health, shall approve or deny an application within 30 days after receiving it. The commissioner may appoint an advisory review panel composed of representatives of counties, consumers, and providers to review proposals and provide comments and recommendations to the committee. The commissioners of human services and health shall provide staff and technical assistance to the committee for the review and analysis of proposals.
(b) Approval of a planned closure expires 18 months after approval by the commissioner unless commencement of closure has begun.
(c) The commissioner may change any provision of the application to which the applicant, the regional planning group, and the commissioner agree.
Subd. 5.
Planned closure rate adjustment.
(a) The commissioner shall calculate the amount of the planned closure rate adjustment available under subdivision 6 according to clauses (1) to (4):
(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;
(2) the total number of beds in the nursing facility or facilities receiving the planned closure rate adjustment must be identified;
(3) capacity days are determined by multiplying the number determined under clause (2) by 365; and
(4) the planned closure rate adjustment is the amount available in clause (1), divided by capacity days determined under clause (3).
(b) A planned closure rate adjustment under this section is effective on the first day of the month of January or July, whichever occurs immediately following completion of closure of the facility designated for closure in the application and becomes part of the nursing facility's external fixed payment rate.
(c) Upon the request of a closing facility, the commissioner must allow the facility a closure rate adjustment as provided under section 144A.161, subdivision 10.
(d) A facility that has received a planned closure rate adjustment may reassign it to another facility that is under the same ownership at any time within three years of its effective date. The amount of the adjustment is computed according to paragraph (a).
(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the commissioner shall recalculate planned closure rate adjustments for facilities that delicense beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar amount. The recalculated planned closure rate adjustment is effective from the date the per bed dollar amount is increased.
Subd. 6.
Assignment of closure rate to another facility.
A facility or facilities reimbursed under this chapter with a closure plan approved by the commissioner under subdivision 4 may assign a planned closure rate adjustment to another facility or facilities that are not closing or in the case of a partial closure, to the facility undertaking the partial closure. A facility may also elect to have a planned closure rate adjustment shared equally by the five nursing facilities with the lowest total operating payment rates in the state development region designated under section 462.385, in which the facility that is closing is located. The planned closure rate adjustment must be calculated under subdivision 5. Facilities that delicense beds without a closure plan, or whose closure plan is not approved by the commissioner, are not eligible to assign a planned closure rate adjustment under subdivision 5, unless they: (1) are delicensing five or fewer beds, or less than six percent of their total licensed bed capacity, whichever is greater; (2) are located in a county in the top three quartiles of beds per 1,000 persons aged 65 or older; and (3) have not delicensed beds in the prior three months. Facilities meeting these criteria are eligible to assign the amount calculated under subdivision 5 to themselves. If a facility is delicensing the greater of six or more beds, or six percent or more of its total licensed bed capacity, and does not have an approved closure plan or is not eligible for the adjustment under subdivision 5, the commissioner shall calculate the amount the facility would have been eligible to assign under subdivision 5, and shall use this amount to provide equal rate adjustments to the five nursing facilities with the lowest total operating payment rates in the state development region designated under section 462.385, in which the facility that delicensed beds is located.
Subd. 7.
Other rate adjustments.
Facilities receiving planned closure rate adjustments remain eligible for any applicable rate adjustments provided under this chapter.
256R.41 SINGLE-BED ROOM INCENTIVE.
(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed under this chapter shall be increased by 20 percent multiplied by the ratio of the number of new single-bed rooms created divided by the number of active beds on July 1, 2005, for each bed closure that results in the creation of a single-bed room after July 1, 2005. The commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each year. For eligible bed closures for which the commissioner receives a notice from a facility that a bed has been delicensed and a new single-bed room has been established, the rate adjustment in this paragraph shall be effective on either the first day of the month of January or July, whichever occurs first following the date of the bed delicensure.
(b) A nursing facility is prohibited from discharging residents for purposes of establishing single-bed rooms. A nursing facility must submit documentation to the commissioner in a form prescribed by the commissioner, certifying the occupancy status of beds closed to create single-bed rooms. In the event that the commissioner determines that a facility has discharged a resident for purposes of establishing a single-bed room, the commissioner shall not provide a rate adjustment under paragraph (a).
256R.481 RATE ADJUSTMENTS FOR BORDER CITY FACILITIES.
(a) The commissioner shall allow each nonprofit nursing facility located within the boundaries of the city of Breckenridge or Moorhead prior to January 1, 2015, to apply once annually for a rate add-on to the facility's external fixed costs payment rate.
(b) A facility seeking an add-on to its external fixed costs payment rate under this section must apply annually to the commissioner to receive the add-on. A facility must submit the application within 60 calendar days of the effective date of any add-on under this section. The commissioner may waive the deadlines required by this paragraph under extraordinary circumstances.
(c) The commissioner shall provide the add-on to each eligible facility that applies by the application deadline.
(d) The add-on to the external fixed costs payment rate is the difference on January 1 of the median total payment rate for case mix classification PA1 of the nonprofit facilities located in an adjacent city in another state and in cities contiguous to the adjacent city minus the eligible nursing facility's total payment rate for case mix classification PA1 as determined under section 256R.22, subdivision 4.
256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE RATE ADJUSTMENTS.
Subd. 7.
Expiration.
This section expires January 1, 2026.
Repealed Minnesota Session Laws: ueh2434-1
Laws 2023, chapter 59, article 3, section 11
Sec. 11. new text begin DIRECT CARE PROVIDER PREMIUMS THROUGH HCBS WORKFORCE INCENTIVE FUND.new text end
new text begin (a) $20,000,000 in fiscal year 2026 is added to the base appropriation from the family and medical benefit account to the commissioner of human services to provide reimbursement for premiums incurred for the paid family and medical leave program under this chapter. Funds shall be administered through the home and community-based workforce incentive fund under Minnesota Statutes, section 256.4764. new text end
new text begin (b) The commissioner of employment and economic development shall share premium payment data collected under this chapter to assist the commissioner of human services in the verification process of premiums paid under this section. new text end
new text begin (c) This amount is for the purposes of Minnesota Statutes, section 256.4764. This is a one-time appropriation and is available until June 30, 2027. new text end
Laws 2024, chapter 125, article 5, section 40
Sec. 40. new text begin DIRECT CARE AND TREATMENT ADVISORY COMMITTEE.new text end
new text begin (a) The Direct Care and Treatment executive board under Minnesota Statutes, section 246C.07, shall establish an advisory committee to provide state legislators, counties, union representatives, the National Alliance on Mental Illness Minnesota, people being served by direct care and treatment programs, and other stakeholders the opportunity to advise the executive board regarding the operation of Direct Care and Treatment. new text end
new text begin (b) The members of the advisory committee must be appointed as follows: new text end
new text begin (1) one member appointed by the speaker of the house; new text end
new text begin (2) one member appointed by the minority leader of the house of representatives; new text end
new text begin (3) two members appointed by the senate Committee on Committees, one member representing the majority caucus and one member representing the minority caucus; new text end
new text begin (4) one member appointed by the Association of Minnesota Counties; new text end
new text begin (5) one member appointed by joint representatives of the American Federation of State and Municipal Employees, the Minnesota Association of Professional Employees, the Minnesota Nurses Association, the Middle Management Association, and the State Residential Schools Education Association; new text end
new text begin (6) one member appointed by the National Alliance on Mental Illness Minnesota; and new text end
new text begin (7) two members representing people with lived experience being served by state-operated treatment programs or their families, appointed by the governor. new text end
new text begin (c) Appointing authorities under paragraph (b) shall make appointments by January 1, 2026. new text end
new text begin (d) The first meeting of the advisory committee must be held no later than January 15, 2026. The members of the advisory committee shall elect a chair from among their membership at the first meeting. The advisory committee shall meet as frequently as it determines necessary. new text end
new text begin (e) The executive board shall regularly consult with the advisory committee. new text end
new text begin (f) The advisory committee under this section expires December 31, 2027. new text end
Laws 2024, chapter 125, article 5, section 41
Sec. 41. new text begin INITIAL APPOINTMENTS AND COMPENSATION OF THE DIRECT CARE AND TREATMENT EXECUTIVE BOARD AND CHIEF EXECUTIVE OFFICER.new text end
new text begin Subdivision 1. new text end
new text begin Executive board. new text end
new text begin (a) The initial appointments of the members of the Direct Care and Treatment executive board under Minnesota Statutes, section 246C.06, must be made by January 1, 2025. new text end
new text begin (b) Prior to the first Compensation Council determination of the daily compensation rate for voting members of the executive board under Minnesota Statutes, section 246C.06, subdivision 4, paragraph (b), voting members of the executive board must be paid the per diem rate provided for in Minnesota Statutes, section 15.0575, subdivision 3, paragraph (a). new text end
new text begin (c) The executive board is exempt from Minnesota Statutes, section 13D.01, until the authority and responsibilities for Direct Care and Treatment are transferred to the executive board in accordance with Minnesota Statutes, section 246C.04. new text end
new text begin Subd. 2. new text end
new text begin Chief executive officer. new text end
new text begin (a) The Direct Care and Treatment executive board must appoint as the initial chief executive officer for Direct Care and Treatment under Minnesota Statutes, section 246C.07, the chief executive officer of the direct care and treatment division of the Department of Human Services holding that position at the time the initial appointment is made by the board. The initial appointment of the chief executive officer must be made by the executive board by July 1, 2025. The initial appointment of the chief executive officer is subject to confirmation by the senate. new text end
new text begin (b) In its report issued April 1, 2025, the Compensation Council under Minnesota Statutes, section 15A.082, must establish the salary of the chief executive officer at an amount equal to or greater than the amount paid to the chief executive officer of the direct care and treatment division of the Department of Human Services as of the date of initial appointment. The salary of the chief executive officer shall become effective July 1, 2025, pursuant to Minnesota Statutes, section 15A.082, subdivision 3. Notwithstanding Minnesota Statutes, sections 15A.082 and 246C.08, subdivision 1, if the initial appointment of the chief executive officer occurs prior to the effective date of the salary specified by the Compensation Council in its April 1, 2025, report, the salary of the chief executive officer must equal the amount paid to the chief executive officer of the direct care and treatment division of the Department of Human Services as of the date of initial appointment. new text end
new text begin Subd. 3. new text end
new text begin Commissioner of human services to consult. new text end
new text begin In preparing the budget estimates required under Minnesota Statutes, section 16A.10, for the direct care and treatment division for the 2026-2027 biennial budget and any legislative proposals for the 2025 legislative session that involve direct care and treatment operations, the commissioner of human services must consult with the Direct Care and Treatment executive board before submitting the budget estimates or legislative proposals. If the executive board is not appointed by the date the budget estimates must be submitted to the commissioner of management and budget, the commissioner of human services must provide the executive board with a summary of the budget estimates that were submitted. new text end
new text begin EFFECTIVE DATE. new text end
new text begin This section is effective July 1, 2024. new text end
Laws 2024, chapter 127, article 46, section 39
Sec. 39. new text begin LEGISLATIVE TASK FORCE ON GUARDIANSHIP.new text end
new text begin Subdivision 1. new text end
new text begin Membership. new text end
new text begin (a) The Legislative Task Force on Guardianship consists of the following members: new text end
new text begin (1) one member of the house of representatives, appointed by the speaker of the house of representatives; new text end
new text begin (2) one member of the house of representatives, appointed by the minority leader of the house of representatives; new text end
new text begin (3) one member of the senate, appointed by the senate majority leader; new text end
new text begin (4) one member of the senate, appointed by the senate minority leader; new text end
new text begin (5) one judge who has experience working on guardianship cases, appointed by the chief justice of the supreme court; new text end
new text begin (6) two individuals presently or formerly under guardianship or emergency guardianship, appointed by the Minnesota Council on Disability; new text end
new text begin (7) one private, professional guardian, appointed by the Minnesota Council on Disability; new text end
new text begin (8) one private, nonprofessional guardian, appointed by the Minnesota Council on Disability; new text end
new text begin (9) one representative of the Department of Human Services with knowledge of public guardianship issues, appointed by the commissioner of human services; new text end
new text begin (10) one member appointed by the Minnesota Council on Disability; new text end
new text begin (11) two members of two different disability advocacy organizations, appointed by the Minnesota Council on Disability; new text end
new text begin (12) one member of a professional or advocacy group representing the interests of the guardian who has experience working in the judicial system on guardianship cases, appointed by the Minnesota Council on Disability; new text end
new text begin (13) one member of a professional or advocacy group representing the interests of persons subject to guardianship who has experience working in the judicial system on guardianship cases, appointed by the Minnesota Council on Disability; new text end
new text begin (14) two members of two different advocacy groups representing the interests of older Minnesotans who are or may find themselves subject to guardianship, appointed by the Minnesota Council on Disability; new text end
new text begin (15) one employee acting as the Disability Systems Planner in the Center for Health Equity at the Minnesota Department of Health, appointed by the commissioner of health; new text end
new text begin (16) one member appointed by the Minnesota Indian Affairs Council; new text end
new text begin (17) one member from the Commission of the Deaf, Deafblind, and Hard-of-Hearing, appointed by the executive director of the commission; new text end
new text begin (18) one member of the Council on Developmental Disabilities, appointed by the executive director of the council; new text end
new text begin (19) one employee from the Office of Ombudsman for Mental Health and Developmental Disabilities, appointed by the ombudsman; new text end
new text begin (20) one employee from the Office of Ombudsman for Long Term Care, appointed by the ombudsman; new text end
new text begin (21) one member appointed by the Minnesota Association of County Social Services Administrators (MACSSA); new text end
new text begin (22) one employee from the Olmstead Implementation Office, appointed by the director of the office; and new text end
new text begin (23) one member representing an organization dedicated to supported decision-making alternatives to guardianship, appointed by the Minnesota Council on Disability. new text end
new text begin (b) Appointees to the task force must be named by each appointing authority by June 30, 2025. Appointments made by an agency or commissioner may also be made by a designee. new text end
new text begin (c) The member from the Minnesota Council on Disability serves as chair of the task force. The chair must designate a member to serve as secretary. new text end
new text begin Subd. 2. new text end
new text begin Meetings; administrative support. new text end
new text begin The first meeting of the task force must be convened by the chair no later than September 1, 2025, if an appropriation is made by that date for the task force. The task force must meet at least quarterly. Meetings are subject to Minnesota Statutes, chapter 13D. The task force may meet by telephone or interactive technology consistent with Minnesota Statutes, section 13D.015. The Minnesota Council on Disability shall provide meeting space and administrative and research support to the task force. new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin (a) The task force must make recommendations to address concerns and gaps related to guardianships and less restrictive alternatives to guardianships in Minnesota, including but not limited to: new text end
new text begin (1) developing efforts to sustain and increase the number of qualified guardians; new text end
new text begin (2) increasing compensation for in forma pauperis (IFP) guardians by studying current funding streams to develop approaches to ensure that the funding streams are consistent across the state and sufficient to serve the needs of persons subject to guardianship; new text end
new text begin (3) securing ongoing funding for guardianships and less restrictive alternatives; new text end
new text begin (4) establishing guardian certification or licensure; new text end
new text begin (5) identifying standards of practice for guardians and options for providing education to guardians on standards and less restrictive alternatives; new text end
new text begin (6) securing ongoing funding for the guardian and conservator administrative complaint process; new text end
new text begin (7) identifying and understanding alternatives to guardianship whenever possible to meet the needs of patients and the challenges of providers in the delivery of health care, behavioral health care, and residential and home-based care services; new text end
new text begin (8) expanding supported decision-making alternatives to guardianships and conservatorships; new text end
new text begin (9) reducing the removal of civil rights when appointing a guardian, including by ensuring guardianship is only used as a last resort; and new text end
new text begin (10) identifying ways to preserve and to maximize the civil rights of the person, including due process considerations. new text end
new text begin (b) The task force must seek input from the public, the judiciary, people subject to guardianship, guardians, advocacy groups, and attorneys. The task force must hold hearings to gather information to fulfill the purpose of the task force. new text end
new text begin Subd. 4. new text end
new text begin Compensation; expenses. new text end
new text begin Members of the task force may receive compensation and expense reimbursement as provided in Minnesota Statutes, section 15.059, subdivision 3. new text end
new text begin Subd. 5. new text end
new text begin Report; expiration. new text end
new text begin The task force shall submit a report to the chairs and ranking minority members of the legislative committees with jurisdiction over guardianship issues no later than January 15, 2027. The report must describe any concerns about the current guardianship system identified by the task force and recommend policy options to address those concerns and to promote less restrictive alternatives to guardianship. The report must include draft legislation to implement recommended policy. new text end
new text begin Subd. 6. new text end
new text begin Expiration. new text end
new text begin The task force expires upon submission of its report, or January 16, 2027, whichever is earlier. new text end
new text begin EFFECTIVE DATE. new text end
new text begin This section is effective the day following final enactment. new text end
Laws 2024, chapter 127, article 50, section 40
Sec. 40. new text begin DIRECT CARE AND TREATMENT ADVISORY COMMITTEE.new text end
new text begin (a) The Direct Care and Treatment executive board under Minnesota Statutes, section 246C.07, shall establish an advisory committee to provide state legislators, counties, union representatives, the National Alliance on Mental Illness Minnesota, people being served by direct care and treatment programs, and other stakeholders the opportunity to advise the executive board regarding the operation of Direct Care and Treatment. new text end
new text begin (b) The members of the advisory committee must be appointed as follows: new text end
new text begin (1) one member appointed by the speaker of the house; new text end
new text begin (2) one member appointed by the minority leader of the house of representatives; new text end
new text begin (3) two members appointed by the senate Committee on Committees, one member representing the majority caucus and one member representing the minority caucus; new text end
new text begin (4) one member appointed by the Association of Minnesota Counties; new text end
new text begin (5) one member appointed by joint representatives of the American Federation of State and Municipal Employees, the Minnesota Association of Professional Employees, the Minnesota Nurses Association, the Middle Management Association, and the State Residential Schools Education Association; new text end
new text begin (6) one member appointed by the National Alliance on Mental Illness Minnesota; and new text end
new text begin (7) two members representing people with lived experience being served by state-operated treatment programs or their families, appointed by the governor. new text end
new text begin (c) Appointing authorities under paragraph (b) shall make appointments by January 1, 2026. new text end
new text begin (d) The first meeting of the advisory committee must be held no later than January 15, 2026. The members of the advisory committee shall elect a chair from among their membership at the first meeting. The advisory committee shall meet as frequently as it determines necessary. new text end
new text begin (e) The executive board shall regularly consult with the advisory committee. new text end
new text begin (f) The advisory committee under this section expires December 31, 2027. new text end
Laws 2024, chapter 127, article 50, section 41 Subdivisions 1, 3,
Sec. 41. new text begin INITIAL APPOINTMENTS AND COMPENSATION OF THE DIRECT CARE AND TREATMENT EXECUTIVE BOARD AND CHIEF EXECUTIVE OFFICER.new text end
new text begin Subdivision 1. new text end
new text begin Executive board. new text end
new text begin (a) The initial appointments of the members of the Direct Care and Treatment executive board under Minnesota Statutes, section 246C.06, must be made by January 1, 2025. new text end
new text begin (b) Prior to the first Compensation Council determination of the daily compensation rate for voting members of the executive board under Minnesota Statutes, section 246C.06, subdivision 4, paragraph (b), voting members of the executive board must be paid the per diem rate provided for in Minnesota Statutes, section 15.0575, subdivision 3, paragraph (a). new text end
new text begin (c) The executive board is exempt from Minnesota Statutes, section 13D.01, until the authority and responsibilities for Direct Care and Treatment are transferred to the executive board in accordance with Minnesota Statutes, section 246C.04. new text end
new text begin Subd. 3. new text end
new text begin Commissioner of human services to consult. new text end
new text begin In preparing the budget estimates required under Minnesota Statutes, section 16A.10, for the direct care and treatment division for the 2026-2027 biennial budget and any legislative proposals for the 2025 legislative session that involve direct care and treatment operations, the commissioner of human services must consult with the Direct Care and Treatment executive board before submitting the budget estimates or legislative proposals. If the executive board is not appointed by the date the budget estimates must be submitted to the commissioner of management and budget, the commissioner of human services must provide the executive board with a summary of the budget estimates that were submitted. new text end
Laws 2024, chapter 79, article 1, section 20
Sec. 20.
Minnesota Statutes 2023 Supplement, section 246C.03, subdivision 2, is amended to read:
Subd. 2.
Development of Department of Direct Care and Treatment Board.
deleted text begin (a)deleted text end The commissioner of human services shall prepare legislation for introduction during the 2024 legislative session, with input from stakeholders the commissioner deems necessary, proposing legislation for the creation and implementation of the Direct Care and Treatment executive board and defining the responsibilities, powers, and function of the deleted text begin Department of Direct Care and Treatmentdeleted text end executive board.
deleted text begin (b) The Department of Direct Care and Treatment executive board shall consist of no more than five members, all appointed by the governor. deleted text end
deleted text begin (c) An executive board member's qualifications must be appropriate for overseeing a complex behavioral health system, such as experience serving on a hospital or non-profit board, serving as a public sector labor union representative, experience in delivery of behavioral health services or care coordination, or working as a licensed health care provider, in an allied health profession, or in health care administration. deleted text end