Minnesota Legislature
HF 2435
1st Unofficial Engrossment - 94th Legislature (2025 - 2026) Posted on 05/15/2025 08:47am
3.28 3.29
3.30 3.31 3.32 3.33 3.34 3.35 3.36 3.37 3.38 3.39 3.40 3.41
4.1
4.2 4.3 4.4 4.5 4.6 4.7 4.8
4.9
4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 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 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 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 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
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 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10
14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25
16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 17.1 17.2
17.3 17.4
17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15
17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26
17.27 17.28 17.29
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 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 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13
21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25
21.26 21.27 21.28 21.29 21.30 21.31 21.32 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12
22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 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 23.19 23.18 23.21 23.20 23.23 23.22 23.25 23.24 23.27 23.26 23.29 23.28 23.30 23.31 23.32 23.33 23.34 23.35 23.36 23.37 23.38 24.2 24.1 24.4 24.3 24.6 24.5 24.8 24.7 24.10 24.9 24.12 24.11 24.14 24.13 24.15 24.16 24.17 24.18 24.20 24.19 24.21 24.22 24.23 24.24 24.26 24.25 24.27 24.28 24.29 24.30 24.31 24.32 24.34 24.33 24.36 24.35 24.37 24.38 24.39 24.40 24.42 24.41 24.43 24.44 24.45 24.46 25.2 25.1 25.4 25.3 25.6 25.5 25.8 25.7 25.10 25.9 25.12 25.11 25.14 25.13 25.16 25.15 25.18 25.17 25.20 25.19 25.22 25.21 25.24 25.23 25.26 25.25 25.27 25.28 25.30 25.29 25.32 25.31 25.34 25.33 25.35 25.36 25.37 25.38 25.40 25.39 25.42 25.41 25.44 25.43 25.46 25.45 26.1 26.2 26.3 26.4 26.6 26.5 26.8 26.7
26.9 26.10 26.11 26.12 26.14 26.13 26.16 26.15 26.17 26.18 26.19 26.21 26.20 26.23 26.22 26.25 26.24 26.27 26.26 26.29 26.28 26.31 26.30 26.32 26.33 26.35 26.34 26.36 26.37 26.39 26.38 26.40 26.41 26.43 26.42 27.2 27.1 27.4 27.3 27.6 27.5 27.8 27.7 27.10 27.9 27.12 27.11 27.14 27.13 27.16 27.15 27.18 27.17 27.20 27.19 27.22 27.21 27.24 27.23 27.26 27.25 27.28 27.27 27.30 27.29 27.32 27.31 27.34 27.33 27.36 27.35 27.38 27.37 27.39 27.40 27.41 27.42 27.44 27.43 27.46 27.45
28.1 28.2 28.3 28.4 28.5 28.6
28.7 28.8 28.9 28.10 28.11 28.12 28.13
28.14 28.15 28.16 28.17
28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 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
30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25
31.26 31.27 31.28 31.29 31.30 31.31 31.32 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 33.29
34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25
34.26 34.27 34.28 34.29 34.30 35.1 35.2 35.3 35.4
35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22
35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 36.1 36.2 36.3 36.4 36.5 36.6
36.7 36.8 36.9 36.10 36.11 36.12
36.13 36.14 36.15
36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32 37.33 37.34
38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 38.34 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 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 42.32 42.33 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 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 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28
45.29 45.30 45.31 45.32 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9
46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 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 48.30 48.31 48.32 48.33
49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9
49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 49.33 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 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 51.25 51.24 51.27 51.26 51.29 51.28 51.31 51.30 51.33 51.32 51.35 51.34 51.37 51.36 52.2 52.1 52.4 52.3 52.6 52.5 52.8 52.7 52.10 52.9 52.12 52.11 52.14 52.13 52.16 52.15 52.17 52.18 52.19 52.20 52.21 52.23 52.22 52.25 52.24 52.27 52.26 52.29 52.28 52.31 52.30 52.33 52.32 52.35 52.34 52.37 52.36 52.39 52.38 52.41 52.40 52.43 52.42 53.2 53.1 53.4 53.3 53.6 53.5 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14
53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22
53.23 53.24 53.25 53.26 53.27 53.28
53.29 53.30 53.31 53.32 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21
54.22 54.23 54.24
54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22
55.23 55.24 55.25
55.26 55.27 55.28 55.29 55.30 55.31 55.32 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16
57.17 57.18 57.19 57.20 57.21
57.22 57.23 57.24
57.25 57.26 57.27 57.28 57.29 57.30 57.31 58.1 58.2 58.3 58.4 58.5 58.6 58.7
58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15
58.16 58.17 58.18 58.19 58.20
58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 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 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
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 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28
63.29 63.30 63.31 63.32 64.1 64.2 64.3 64.4 64.5 64.6
64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 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 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12
69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20
69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 70.1 70.2 70.3 70.4 70.5 70.6 70.7
70.8 70.9 70.10 70.11 70.12
70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27
71.28 71.29 71.30 71.31 71.32 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 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 73.33 74.1 74.2 74.3 74.4
74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30
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
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 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 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 82.32 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30
84.1 84.2 84.3 84.4 84.5
84.6 84.7 84.8 84.9 84.10 84.11
84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 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 85.29 85.30 86.1 86.2 86.3 86.4 86.5
86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28
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
88.1 88.2 88.3 88.4
88.5 88.6 88.7 88.8 88.9 88.10
88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23
88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 89.1 89.2 89.3 89.4
89.5 89.6 89.7 89.8
89.9 89.10 89.11 89.12 89.13 89.14
89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22
89.23 89.24 89.25 89.26 89.27 89.28 89.29 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
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 92.31 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13
93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23
93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 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 95.30
96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16
96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 97.1 97.2 97.3 97.4 97.5 97.6
97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 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 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
100.32
101.1 101.2 101.3 101.4
101.5 101.6 101.7 101.8
101.9 101.10 101.11
101.12 101.13
101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23
101.24
101.25 101.26 101.27 101.28
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
103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16
106.17
106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22
107.23 107.24 107.25 107.26 107.27 107.28
107.29 107.30 107.31
107.32
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
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
109.23 109.24 109.25 109.26 109.27 109.28 110.1 110.2 110.3 110.4
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
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
114.27 114.28 114.29 115.1 115.2
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
115.28 115.29 115.30 116.1 116.2 116.3 116.4
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
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
118.28 118.29 118.30 118.31 118.32 118.33 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25
119.26 119.27 119.28 119.29 119.30 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28
121.29 121.30 121.31 121.32 122.1 122.2 122.3
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
123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18
123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30
123.31 123.32 124.1 124.2 124.3
124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29
125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24
126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16
128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 129.1 129.2 129.3 129.4 129.5
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
129.24 129.25 129.26 129.27 129.28 129.29 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19
130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 131.1 131.2 131.3 131.4 131.5 131.6
131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14
131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24
131.25 131.26 131.27 131.28
131.29 131.30 131.31 132.1 132.2
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
132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14
133.15 133.16 133.17 133.18 133.19 133.20 133.21
133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11
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
135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14
136.15 136.16 136.17 136.18 136.19 136.20 136.21
136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 137.1 137.2 137.3
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
138.30 138.31 138.32 138.33
139.1 139.2 139.3 139.4
139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 141.1 141.2 141.3 141.4 141.5 141.6 141.7
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
141.26 141.27 141.28 141.29 142.1 142.2 142.3 142.4 142.5 142.6
142.7 142.8 142.9 142.10 142.11 142.12 142.13
142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 143.1 143.2
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
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
144.24 144.25 144.26 144.27 144.28 145.1 145.2 145.3 145.4
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
146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12
148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17
149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 149.33 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10
150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19
150.20 150.21 150.22 150.23 150.24
150.25 150.26 150.27 150.28 150.29
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
152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 153.1 153.2 153.3 153.4 153.5 153.6
153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 153.33 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29
157.30 157.31 157.32 157.33 157.34 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23
159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 159.34 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 160.33 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12
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
162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 163.1 163.2 163.3 163.4 163.5
163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 164.1 164.2
164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10
164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20
164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9
165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22
165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17
166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14
167.15 167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 168.1 168.2 168.3 168.4 168.5 168.6
168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29
170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12
170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 171.1 171.2 171.3 171.4
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
171.24 171.25 171.26 171.27 171.28 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16
172.17
172.18 172.19 172.20 172.21 172.22
172.23
172.24 172.25 172.26 172.27
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
173.27 173.28 173.29 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28
174.29 174.30 174.31 174.32 174.33 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17
176.18 176.19 176.20 176.21
176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20
177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 177.34 178.1 178.2 178.3 178.4 178.5 178.6 178.7
178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 178.34 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31 179.32 179.33 179.34 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 180.34 181.1 181.2 181.3 181.4 181.5
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
181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8
182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19
182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 182.33 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11
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
184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8
185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 186.1 186.2 186.3 186.4 186.5 186.6 186.7
186.8 186.9 186.10 186.11 186.12 186.13 186.14
186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33 187.1 187.2 187.3 187.4
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
187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 188.34 188.35 189.1 189.2 189.3
189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23
189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 189.33
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
191.1 191.2
191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 192.1
192.2 192.3
192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 192.32 192.33 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 193.33 193.34 193.35 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24
194.25 194.26 194.27
194.28 194.29 194.30 194.31 194.32 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 195.34 195.35 195.36 196.1 196.2 196.3
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
197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 198.33 198.34 198.35 198.36 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33 199.34 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 200.34 200.35 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22
201.23 201.24 201.25
201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 201.34 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17
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
204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23
208.24 208.25 208.26 208.27
209.1 209.2
209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 209.33 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16
210.17
210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 210.33 210.34 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17
211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 211.33 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29
214.30 214.31 214.32 215.1 215.2 215.3
215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 215.32 215.33 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 217.34 217.35 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20
219.21
219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 219.32 219.33 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 220.32 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21
221.22 221.23 221.24
221.25 221.26 221.27 221.28 221.29 221.30 221.31 221.32 221.33 221.34 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 223.1 223.2 223.3 223.4
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
224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 230.33 230.34
231.1
231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19
232.20 232.21 232.22
232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24
233.25 233.26 233.27
233.28 233.29 233.30 233.31 233.32 234.1 234.2 234.3 234.4
234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 234.34
235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14
235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22
235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 237.33 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 238.33 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23
239.24 239.25 239.26 239.27 239.28 239.29 239.30
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
240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 241.1 241.2 241.3 241.4 241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 241.33 241.34 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19
242.20 242.21 242.22 242.23
242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18
243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 243.33 243.34 244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 244.32 244.33 244.34 244.35 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32
247.1 247.2 247.3
247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 247.33 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 248.33 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 250.33 250.34 251.1 251.2 251.3 251.4 251.5 251.6 251.7
251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9
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
252.31 252.32
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
254.1 254.2
254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 257.31 257.32 257.33 258.1 258.2 258.3 258.4 258.5 258.6 258.7
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
258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 258.32 258.33 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13
259.14
259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23
259.24
259.25 259.26 259.27 259.28 259.29 259.30 259.31 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15
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
261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10
262.11 262.12
262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23
263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32 264.1 264.2 264.3
264.4 264.5 264.6
264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18
264.19
264.20 264.21
264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19
266.20 266.21
266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8
267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 268.1 268.2 268.3 268.4 268.5 268.6
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
268.26 268.27 268.28 268.29 268.30 268.31 269.1 269.2 269.3 269.4 269.5
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
269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12
270.13 270.14
270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22
271.23 271.24
271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32
272.1 272.2 272.3 272.4
272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 274.1 274.2
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
275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 276.34 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12
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
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
280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22
283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21
284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 286.32 287.1 287.2 287.3 287.4 287.5 287.6
287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32 289.1 289.2 289.3 289.4 289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27 289.28 289.29 289.30 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13
290.14
290.15 290.16 290.17 290.18 290.19 290.20 290.21
290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 291.1 291.2 291.3 291.4
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
291.27 291.28 291.29 291.30 291.31 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22
293.23 293.24 293.25 293.26 293.27
293.28 293.29 293.30 293.31 294.1 294.2 294.3 294.4
294.5
294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13
294.14
294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 296.1 296.2 296.3
296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19
296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 297.1
297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22
297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19
298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 299.34 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15
300.16 300.17 300.18 300.19 300.20 300.21
300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 300.32 300.33 301.1 301.2 301.3 301.4
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
302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32 303.33 304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28 304.29 304.30 304.31 304.32 305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13 305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22
305.23 305.24
305.25 305.26 305.27 305.28 305.29 305.30 305.31 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17
306.18 306.19 306.20
306.21 306.22
306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30
307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19
307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10
308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28
309.29 309.30 309.31 309.32 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16
310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24
310.25 310.26 310.27 310.28 310.29 310.30 310.31 310.32 311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13
311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 312.1 312.2 312.3 312.4 312.5
312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 314.32
315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20
317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14
318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 318.32 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10
319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19 319.20 319.21 319.22 319.23 319.24 319.25
319.26 319.27 319.28 319.29 319.30 319.31 319.32 319.33 320.1 320.2 320.3 320.4
320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 321.32 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 323.1 323.2 323.3 323.4 323.5 323.6
323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26
323.27 323.28 323.29 323.30 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10
324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20
324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10
325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25
325.26 325.27 325.28 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12
326.13 326.14 326.15 326.16
326.17 326.18 326.19 326.20
326.21 326.22 326.23 326.24 326.25 326.26 326.27
326.28 326.29 326.30 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17
327.18 327.19 327.20 327.21 327.22 327.23 327.24
327.25 327.26 327.27 327.28 327.29 327.30 327.31
328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14
328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 330.32 331.1 331.2
331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 332.1 332.2 332.3
332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17
332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 332.32 332.33 333.1 333.2 333.3
333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20
333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12
334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20
334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11
335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 335.32 336.1 336.2
336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15
336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24
336.25 336.26 336.27 336.28 336.29 336.30 336.31 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11 337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 338.32 338.33 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16
339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 339.33 339.34 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 340.33 341.1 341.2 341.3 341.4 341.5 341.6 341.7
341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 343.1 343.2
343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14
343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 344.1 344.2 344.3 344.4
344.5 344.6 344.7 344.8 344.9
344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14
345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9
346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26
346.27 346.28 346.29 346.30 346.31 346.32 346.33
347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10
347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24
347.25 347.26 347.27 347.28 347.29 347.30 347.31 347.32 347.33 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 348.34 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19
349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21
351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 352.1 352.2
352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22
352.23 352.24 352.25 352.26 352.27 352.28 352.29
353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9
353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 354.1 354.2 354.3 354.4
354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32 355.33 355.34 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28
356.29 356.30 356.31 356.32 356.33 357.1 357.2 357.3
357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11
357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 358.33 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27
359.28 359.29 359.30 359.31 359.32 359.33 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12
360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 360.31 360.32 360.33 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 361.32 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 362.33 362.34 363.1 363.2 363.3
363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29
364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9
364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 364.32 364.33 365.1 365.2 365.3
365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26
366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 367.1 367.2
367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 367.32 367.33 367.34 367.35 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 368.31 368.32 368.33 368.34 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26
369.27 369.28 369.29 369.30 369.31 369.32 369.33 369.34 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14
370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 370.32 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21
371.22 371.23 371.24 371.25
371.26 371.27 371.28 371.29 371.30 371.31 371.32 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21
372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29
373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 373.33 373.34 373.35 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 374.33 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12
375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 376.32 376.33 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 377.32 377.33 377.34 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16 378.17 378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 378.29 378.30 378.31 378.32 378.33 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18
379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29 379.30 379.31 379.32 379.33 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25
381.26 381.27 381.28 381.29 381.30 381.31 381.32 381.33 382.1 382.2 382.3 382.4
382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19 382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 382.31 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11 383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24 383.25 383.26 383.27 383.28 383.29 383.30 383.31 383.32 383.33 384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30
384.31 384.32 384.33 385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11
385.12 385.13 385.14 385.15
385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23
385.24 385.25 385.26 385.27 385.28 385.29 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12
386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29 386.30 386.31 387.1 387.2 387.3 387.4 387.5 387.6 387.7 387.8 387.9 387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21 387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29
389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9 389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18 389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14 390.15 390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 391.31
392.1 392.2 392.3 392.4 392.5 392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14 392.15
392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14 393.15 393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28 393.29 393.30 393.31 393.32
394.1 394.2 394.3
394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11 394.12 394.13
394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 394.32 394.33 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28 395.29 395.30 395.31 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11 396.12 396.13 396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29 396.30 396.31 396.32 396.33 397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8 397.9 397.10 397.11
397.12 397.13 397.14 397.15
397.16 397.17 397.18 397.19 397.20
397.21 397.22 397.23 397.24 397.25 397.26 397.27 397.28 397.29 397.30 397.31 398.1 398.2 398.3 398.4 398.5 398.6 398.7 398.8 398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16 398.17 398.18 398.19 398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27 398.28 398.29 398.30 398.31 398.32 398.33 398.34 399.1 399.2 399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 399.30 399.31 399.32 400.1 400.2 400.3 400.4 400.5 400.6 400.7 400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 400.32 401.1 401.2 401.3 401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12
401.13 401.14
401.15 401.16 401.17
401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 401.29 401.30 401.31 401.32 402.1 402.2 402.3 402.4 402.5 402.6 402.7 402.8 402.9 402.10 402.11 402.12 402.13
402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25
402.26 402.27 402.28 402.29 402.30 402.31 402.32
403.1 403.2 403.3 403.4 403.5 403.6 403.7 403.8 403.9 403.10 403.11 403.12 403.13 403.14 403.15 403.16 403.17 403.18 403.19 403.20 403.21 403.22 403.23 403.24 403.25 403.26 403.27 403.28 403.29 403.30 403.31 403.32 404.1 404.2 404.3 404.4 404.5 404.6 404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14 404.15 404.16 404.17 404.18 404.19
404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21 405.22 405.23 405.24 405.25 405.26 405.27 405.28
405.29 405.30 405.31 406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12 406.13 406.14 406.15 406.16 406.17 406.18 406.19
406.20 406.21 406.22 406.23 406.24 406.25
406.26 406.27 406.28 406.29 406.30
407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8 407.9 407.10 407.11 407.12 407.13
407.14 407.15 407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27 407.28 407.29 407.30 407.31 407.32 408.1 408.2 408.3 408.4 408.5 408.6 408.7 408.8 408.9 408.10 408.11 408.12 408.13 408.14 408.15 408.16 408.17 408.18 408.19 408.20 408.21 408.22 408.23 408.24 408.25 408.26 408.27 408.28 408.29 408.30 409.1 409.2 409.3 409.4 409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16 409.17
409.18 409.19
409.20 409.21 409.22 409.23 409.24 409.25 409.26 409.27 409.28 409.29 409.30 409.31 409.32 410.1 410.2 410.3 410.4 410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14 410.15 410.16 410.17 410.18 410.19 410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27 410.28 410.29 410.30 410.31 410.32 411.1 411.2
411.3
411.4 411.5 411.6 411.7 411.8 411.9
411.10
411.11 411.12 411.13 411.14 411.15
411.16
411.17 411.18
411.19 411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28 411.29 412.1 412.2 412.3 412.4 412.5 412.6 412.7 412.8 412.9 412.10 412.11 412.12 412.13 412.14 412.15 412.16 412.17 412.18
412.19
412.20 412.21 412.22 412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 412.31 412.32 412.33 413.1 413.2 413.3 413.4 413.5 413.6 413.7 413.8 413.9 413.10 413.11 413.12 413.13 413.14 413.15 413.16 413.17 413.18 413.19 413.20 413.21 413.22 413.23 413.24 413.25 413.26 413.27 413.28 413.29 413.30 413.31 413.32 414.1 414.2 414.3 414.4 414.5 414.6 414.7 414.8 414.9 414.10 414.11 414.12
414.13
414.14 414.15 414.16 414.17 414.18 414.19
414.20 414.21 414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29 414.30 414.31 414.32 415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8 415.9 415.10 415.11 415.12 415.13 415.14 415.15 415.16 415.17 415.18 415.19 415.20 415.21 415.22 415.23 415.24 415.25 415.26 415.27 415.28 415.29 415.30 415.31 415.32 415.33 415.34 416.1 416.2 416.3 416.4 416.5 416.6 416.7 416.8 416.9 416.10 416.11 416.12 416.13 416.14 416.15 416.16 416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24 416.25 416.26 416.27 416.28 416.29 416.30 416.31 417.1 417.2 417.3 417.4 417.5 417.6 417.7 417.8 417.9 417.10 417.11 417.12 417.13 417.14 417.15 417.16 417.17 417.18 417.19 417.20 417.21 417.22 417.23 417.24 417.25 417.26 417.27 417.28 417.29 417.30 417.31 418.1 418.2 418.3 418.4 418.5
418.6 418.7 418.8 418.9 418.10 418.11 418.12 418.13 418.14 418.15 418.16 418.17 418.18 418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26 418.27 418.28 418.29 418.30 419.1 419.2 419.3 419.4 419.5 419.6 419.7 419.8 419.9 419.10 419.11 419.12 419.13 419.14 419.15
419.16 419.17 419.18 419.19 419.20 419.21 419.22 419.23 419.24 419.25 419.26 419.27 419.28 419.29 419.30 419.31 419.32 419.33 420.1 420.2 420.3 420.4 420.5 420.6 420.7 420.8 420.9 420.10 420.11 420.12 420.13
420.14 420.15 420.16 420.17 420.18 420.19 420.20 420.21 420.22 420.23 420.24 420.25 420.26
420.27
420.28 420.29 420.30 420.31 420.32 421.1 421.2 421.3 421.4 421.5 421.6 421.7 421.8 421.9 421.10 421.11 421.12 421.13 421.14 421.15
421.16
421.17 421.18 421.19 421.20 421.21 421.22 421.23 421.24 421.25 421.26 421.27 421.28 421.29 421.30 421.31 421.32 422.1 422.2 422.3 422.4 422.5 422.6 422.7 422.8 422.9 422.10 422.11 422.12 422.13 422.14 422.15 422.16 422.17 422.18 422.19 422.20 422.21 422.22 422.23 422.24 422.25 422.26 422.27 422.28 422.29 422.30 422.31 422.32 423.1 423.2 423.3 423.4 423.5 423.6 423.7 423.8 423.9 423.10 423.11 423.12 423.13 423.14 423.15 423.16 423.17 423.18 423.19 423.20 423.21 423.22 423.23 423.24 423.25 423.26 423.27 423.28 423.29 423.30 423.31 423.32 423.33 424.1 424.2 424.3 424.4 424.5 424.6 424.7 424.8 424.9 424.10 424.11 424.12 424.13 424.14 424.15 424.16 424.17 424.18 424.19 424.20 424.21 424.22 424.23 424.24 424.25 424.26 424.27 424.28 424.29 424.30 424.31 424.32 424.33 424.34 424.35 425.1 425.2 425.3 425.4 425.5 425.6 425.7 425.8 425.9 425.10 425.11 425.12 425.13
425.14
425.15 425.16 425.17 425.18 425.19 425.20 425.21 425.22 425.23 425.24 425.25 425.26 425.27 425.28 425.29 425.30 425.31 425.32 426.1 426.2 426.3 426.4 426.5 426.6 426.7 426.8 426.9 426.10 426.11 426.12 426.13 426.14 426.15 426.16 426.17 426.18 426.19 426.20 426.21 426.22 426.23 426.24 426.25 426.26 426.27 426.28 426.29 426.30 426.31 426.32 427.1 427.2 427.3 427.4 427.5 427.6 427.7 427.8 427.9 427.10 427.11 427.12 427.13 427.14 427.15 427.16 427.17 427.18 427.19 427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 427.32 427.33 427.34 427.35 428.1 428.2 428.3 428.4 428.5 428.6 428.7 428.8 428.9 428.10 428.11 428.12
428.13
428.14 428.15 428.16 428.17 428.18 428.19 428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 428.30 428.31 428.32 428.33 429.1 429.2 429.3 429.4 429.5 429.6 429.7 429.8 429.9 429.10 429.11 429.12 429.13 429.14 429.15 429.16 429.17 429.18 429.19 429.20 429.21 429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30 429.31 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16
430.17
430.18 430.19 430.20
430.21 430.22 430.23 430.24 430.25 430.26 430.27 430.28 430.29 430.30 430.31 430.32 430.33 430.34 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17 431.18 431.19 431.20 431.21 431.22 431.23 431.24 431.25 431.26
431.27 431.28 431.29 431.30 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11 432.12 432.13 432.14 432.15 432.16
432.17 432.18 432.19 432.20 432.21 432.22 432.23 432.24 432.25 432.26 432.27 432.28 432.29 432.30 432.31 432.32 433.1 433.2 433.3 433.4 433.5 433.6 433.7 433.8 433.9 433.10 433.11 433.12 433.13 433.14 433.15 433.16 433.17 433.18 433.19 433.20 433.21 433.22 433.23 433.24 433.25 433.26 433.27 433.28 433.29 433.30 433.31 433.32 433.33 433.34 433.35 434.1 434.2 434.3 434.4 434.5 434.6 434.7 434.8 434.9 434.10 434.11 434.12 434.13 434.14 434.15 434.16 434.17 434.18 434.19 434.20 434.21 434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29 434.30 434.31 434.32 435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8 435.9 435.10 435.11 435.12 435.13 435.14 435.15 435.16 435.17 435.18 435.19 435.20 435.21 435.22 435.23 435.24 435.25 435.26 435.27 435.28 435.29 435.30
436.1 436.2 436.3 436.4 436.5 436.6 436.7 436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 437.1 437.2 437.3 437.4 437.5 437.6 437.7 437.8 437.9 437.10 437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19 437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27 437.28 437.29 437.30 437.31 437.32 437.33 437.34 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16 438.17 438.18 438.19 438.20 438.21 438.22
438.23 438.24 438.25 438.26 438.27 438.28 438.29 438.30 438.31 438.32 439.1 439.2 439.3 439.4 439.5 439.6 439.7 439.8 439.9 439.10 439.11 439.12 439.13 439.14 439.15 439.16 439.17 439.18 439.19 439.20 439.21 439.22 439.23 439.24 439.25 439.26 439.27 439.28 439.29 439.30 439.31 439.32 440.1 440.2 440.3 440.4 440.5 440.6 440.7 440.8 440.9 440.10
440.11 440.12 440.13 440.14 440.15 440.16 440.17 440.18 440.19 440.20 440.21 440.22 440.23 440.24 440.25 440.26 440.27 440.28 440.29 440.30 440.31 440.32 440.33 441.1 441.2 441.3
441.4 441.5 441.6 441.7 441.8
441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19 441.20 441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9
442.10 442.11 442.12 442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24 442.25 442.26 442.27 442.28 442.29 442.30 442.31 442.32 442.33 443.1 443.2 443.3 443.4 443.5 443.6 443.7 443.8 443.9 443.10 443.11 443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19 443.20 443.21
443.22 443.23 443.24 443.25 443.26 443.27 443.28
443.29
443.30 443.31 443.32 444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12 444.13 444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23
444.24 444.25 444.26 444.27 444.28 444.29 444.30 444.31 444.32 444.33 444.34 445.1 445.2 445.3 445.4 445.5 445.6 445.7 445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16
445.17 445.18 445.19 445.20 445.21 445.22 445.23 445.24 445.25
445.26 445.27 445.28 445.29 445.30 445.31 445.32 446.1 446.2 446.3 446.4 446.5 446.6 446.7 446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 446.32 446.33 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16
447.17 447.18
447.19 447.20
447.21 447.22
447.23 447.24
447.25
448.1 448.2
448.3 448.4 448.5 448.6 448.7 448.8 448.9
448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21 448.22 448.23 448.24 448.25 448.26 448.27 448.28 448.29 448.30 448.31 449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14 449.15 449.16 449.17 449.18 449.19 449.20 449.21 449.22 449.23
449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16 450.17 450.18 450.19 450.20 450.21 450.22 450.23 450.24
450.25 450.26 450.27 450.28 450.29 450.30 450.31 450.32 451.1 451.2 451.3 451.4 451.5 451.6 451.7 451.8 451.9 451.10 451.11 451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30 451.31 451.32 452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10
452.11 452.12
452.13 452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28 452.29 452.30 453.1 453.2 453.3 453.4 453.5 453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 454.1 454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 454.32 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 455.32 455.33 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8 456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19 456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 456.31 456.32 456.33 457.1 457.2 457.3 457.4 457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26 457.27 457.28 457.29 457.30 457.31 457.32 457.33 457.34 458.1 458.2 458.3 458.4 458.5 458.6 458.7 458.8 458.9 458.10 458.11 458.12 458.13 458.14 458.15 458.16 458.17 458.18 458.19 458.20 458.21 458.22 458.23 458.24 458.25 458.26 458.27 458.28 458.29 458.30 458.31 458.32 459.1 459.2 459.3 459.4 459.5 459.6 459.7 459.8 459.9 459.10 459.11 459.12 459.13 459.14 459.15 459.16 459.17 459.18 459.19 459.20 459.21 459.22 459.23 459.24 459.25 459.26 459.27 459.28
459.29 459.30 459.31 459.32 459.33
460.1 460.2 460.3 460.4 460.5 460.6 460.7 460.8 460.9 460.10 460.11 460.12 460.13
460.14 460.15 460.16 460.17 460.18 460.19
460.20 460.21 460.22 460.23 460.24 460.25 460.26 460.27 460.28 460.29 460.30 460.31 460.32 461.1 461.2 461.3 461.4 461.5 461.6 461.7 461.8 461.9 461.10 461.11 461.12 461.13 461.14 461.15 461.16 461.17 461.18 461.19 461.20 461.21 461.22 461.23 461.24 461.25 461.26 461.27 461.28
461.29 461.30 461.31 461.32 462.1 462.2 462.3 462.4 462.5 462.6 462.7 462.8 462.9 462.10 462.11 462.12 462.13 462.14 462.15 462.16 462.17 462.18 462.19 462.20 462.21 462.22 462.23 462.24 462.25 462.26 462.27 462.28 462.29 462.30
463.1 463.2
463.3 463.4 463.5 463.6 463.7 463.8 463.9 463.10 463.11 463.12 463.13 463.14 463.15 463.16 463.17 463.18 463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27 463.28 463.29 463.30 463.31 463.32 464.1 464.2 464.3 464.4 464.5 464.6 464.7 464.8 464.9 464.10 464.11 464.12 464.13 464.14 464.15 464.16 464.17 464.18 464.19 464.20
464.21 464.22 464.23 464.24 464.25 464.26 464.27 464.28 464.29 464.30 464.31 464.32 464.33 465.1 465.2 465.3 465.4 465.5 465.6 465.7 465.8 465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23 465.24 465.25 465.26 465.27 465.28 465.29 465.30 466.1 466.2 466.3
466.4 466.5 466.6 466.7 466.8 466.9 466.10 466.11 466.12
466.13 466.14 466.15 466.16 466.17 466.18 466.19 466.20 466.21 466.22
466.23 466.24 466.25 466.26 466.27 466.28 466.29 466.30
467.1 467.2 467.3 467.4 467.5 467.6 467.7 467.8 467.9 467.10 467.11 467.12 467.13 467.14 467.15 467.16 467.17 467.18 467.19 467.20 467.21 467.22 467.23 467.24 467.25 467.26 467.27
467.28
467.29 467.30 467.31 467.32 468.1 468.2 468.3 468.4 468.5 468.6 468.7 468.8 468.9 468.10 468.11 468.12 468.13 468.14 468.15 468.16 468.17 468.18 468.19 468.20 468.21 468.22 468.23 468.24 468.25 468.26 468.27 468.28 468.29 468.30 468.31 468.32
468.33
469.1 469.2 469.3 469.4 469.5 469.6 469.7 469.8 469.9 469.10 469.11 469.12 469.13 469.14 469.15 469.16
469.17
469.18 469.19 469.20 469.21 469.22 469.23 469.24 469.25 469.26
469.27
469.28 469.29 469.30 469.31 470.1 470.2
470.3 470.4 470.5 470.6 470.7 470.8 470.9 470.10 470.11 470.12 470.13 470.14 470.15 470.16 470.17 470.18 470.19 470.20 470.21 470.22 470.23 470.24 470.25 470.26 470.27 470.28 470.29 470.30 470.31 470.32 470.33 470.34 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18 471.19 471.20 471.21 471.22 471.23 471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 471.32 472.1 472.2 472.3 472.4 472.5 472.6 472.7 472.8 472.9 472.10 472.11 472.12 472.13 472.14 472.15 472.16 472.17 472.18 472.19 472.20 472.21 472.22 472.23 472.24 472.25 472.26 472.27 472.28 472.29 472.30 472.31 472.32 472.33 472.34 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11 473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19 473.20 473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29 473.30 473.31 473.32 473.33 474.1 474.2 474.3 474.4 474.5 474.6
474.7 474.8 474.9 474.10 474.11 474.12 474.13 474.14 474.15 474.16 474.17 474.18 474.19 474.20 474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29
474.30 474.31 474.32 474.33 475.1 475.2
475.3 475.4 475.5 475.6 475.7 475.8 475.9 475.10 475.11 475.12 475.13 475.14 475.15 475.16 475.17 475.18 475.19 475.20 475.21 475.22 475.23 475.24 475.25 475.26 475.27 475.28 475.29 475.30 475.31 475.32 475.33 476.1 476.2 476.3 476.4 476.5 476.6 476.7 476.8 476.9 476.10 476.11 476.12 476.13 476.14 476.15 476.16 476.17 476.18 476.19 476.20 476.21
476.22 476.23 476.24 476.25 476.26 476.27 476.28 476.29 476.30 476.31 476.32 477.1 477.2 477.3 477.4 477.5 477.6 477.7 477.8 477.9 477.10 477.11 477.12 477.13 477.14 477.15 477.16 477.17 477.18 477.19 477.20 477.21 477.22 477.23 477.24 477.25 477.26 477.27 477.28 477.29 477.30 477.31 477.32 477.33 477.34 478.1 478.2 478.3 478.4 478.5 478.6 478.7 478.8 478.9 478.10 478.11 478.12 478.13 478.14 478.15 478.16 478.17 478.18 478.19 478.20 478.21 478.22 478.23 478.24 478.25 478.26 478.27 478.28 478.29 478.30 478.31 478.32
479.1 479.2 479.3 479.4 479.5 479.6 479.7 479.8 479.9 479.10 479.11 479.12 479.13 479.14 479.15 479.16 479.17 479.18 479.19 479.20 479.21 479.22 479.23 479.24 479.25 479.26 479.27 479.28 479.29 479.30 479.31 479.32 480.1 480.2 480.3 480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20
480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 480.32 481.1 481.2
481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10 481.11 481.12 481.13 481.14 481.15 481.16 481.17 481.18 481.19 481.20 481.21 481.22 481.23 481.24 481.25 481.26 481.27 481.28 481.29 481.30 481.31 481.32 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10 482.11
482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21 482.22 482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31 482.32 482.33 483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10 483.11 483.12
483.13 483.14 483.15 483.16 483.17 483.18
483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28 483.29 483.30 483.31 484.1 484.2 484.3 484.4 484.5 484.6 484.7 484.8 484.9 484.10 484.11 484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21 484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 484.30 484.31 484.32 485.1 485.2 485.3 485.4 485.5 485.6 485.7 485.8 485.9 485.10 485.11 485.12 485.13 485.14 485.15 485.16 485.17 485.18 485.19 485.20 485.21 485.22 485.23 485.24 485.25 485.26 485.27 485.28 485.29 485.30 485.31 485.32 485.33 486.1 486.2
486.3 486.4 486.5 486.6 486.7 486.8 486.9 486.10 486.11 486.12 486.13 486.14 486.15 486.16 486.17 486.18 486.19 486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29 486.30 486.31 486.32 487.1 487.2 487.3 487.4 487.5 487.6 487.7 487.8 487.9 487.10 487.11 487.12 487.13 487.14 487.15 487.16 487.17 487.18 487.19 487.20 487.21 487.22 487.23 487.24 487.25 487.26
487.27
487.28 487.29 487.30 487.31 487.32 488.1 488.2 488.3 488.4 488.5 488.6 488.7 488.8 488.9 488.10
488.11 488.12 488.13 488.14 488.15 488.16 488.17 488.18 488.19 488.20 488.21 488.22 488.23 488.24 488.25 488.26 488.27 488.28 488.29 488.30 489.1 489.2
489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14 489.15 489.16 489.17 489.18 489.19 489.20 489.21 489.22 489.23 489.24 489.25 489.26 489.27 489.28 489.29 489.30 489.31 489.32 489.33 490.1 490.2 490.3 490.4 490.5 490.6 490.7 490.8 490.9 490.10 490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27 490.28 490.29 490.30 490.31 490.32 491.1 491.2 491.3 491.4 491.5 491.6 491.7 491.8 491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20
491.21 491.22 491.23 491.24 491.25 491.26 491.27 491.28 491.29 491.30 491.31 491.32 491.33 491.34 492.1 492.2 492.3 492.4 492.5 492.6 492.7 492.8 492.9 492.10 492.11 492.12 492.13 492.14 492.15 492.16 492.17 492.18 492.19 492.20 492.21 492.22 492.23
492.24 492.25 492.26 492.27 492.28 492.29 492.30 492.31 493.1 493.2 493.3 493.4 493.5 493.6 493.7 493.8 493.9 493.10 493.11 493.12 493.13 493.14 493.15 493.16 493.17 493.18 493.19 493.20 493.21 493.22 493.23 493.24 493.25 493.26 493.27 493.28 493.29 493.30 493.31 493.32 493.33 494.1 494.2 494.3
494.4 494.5 494.6 494.7 494.8 494.9 494.10 494.11 494.12 494.13 494.14 494.15 494.16 494.17 494.18 494.19 494.20 494.21 494.22 494.23 494.24 494.25 494.26
494.27 494.28 494.29 494.30 494.31 494.32 495.1 495.2 495.3 495.4 495.5 495.6 495.7 495.8 495.9 495.10 495.11 495.12 495.13 495.14 495.15 495.16 495.17 495.18 495.19 495.20 495.21 495.22 495.23 495.24 495.25 495.26 495.27 495.28 495.29 495.30 495.31
496.1 496.2 496.3 496.4 496.5 496.6
496.7 496.8 496.9 496.10 496.11 496.12 496.13 496.14
496.15 496.16 496.17 496.18 496.19 496.20 496.21 496.22 496.23 496.24 496.25 496.26 496.27 496.28 496.29 496.30 496.31 496.32 496.33 497.1 497.2 497.3 497.4 497.5 497.6 497.7 497.8 497.9 497.10 497.11 497.12 497.13 497.14 497.15 497.16 497.17 497.18 497.19 497.20
497.21 497.22 497.23 497.24 497.25 497.26
497.27 497.28
497.29 497.30 497.31 497.32
498.1 498.2 498.3 498.4 498.5 498.6 498.7 498.8 498.9 498.10 498.11 498.12 498.13 498.14 498.15 498.16
498.17 498.18 498.19 498.20 498.21 498.22 498.23 498.24 498.25 498.26 498.27 498.28 498.29 498.30 499.1 499.2 499.3 499.4 499.5 499.6 499.7 499.8 499.9 499.10 499.11 499.12 499.13 499.14 499.15 499.16 499.17
499.18 499.19 499.20
499.21 499.22 499.23 499.24 499.25 499.26 499.27 499.28 499.29 499.30
500.1 500.2 500.3
500.4 500.5 500.6 500.7 500.8 500.9 500.10 500.11 500.12 500.13 500.14 500.15 500.16 500.17 500.18 500.19 500.20 500.21 500.22 500.23
500.24 500.25 500.26 500.27 500.28 500.29 500.30 500.31 501.1 501.2 501.3 501.4 501.5 501.6 501.7 501.8 501.9 501.10 501.11 501.12 501.13 501.14 501.15 501.16 501.17 501.18
501.19 501.20 501.21 501.22 501.23 501.24 501.25 501.26 501.27 501.28 501.29 501.30 501.31 502.1 502.2
502.3 502.4 502.5 502.6 502.7 502.8 502.9 502.10 502.11 502.12 502.13 502.14 502.15 502.16 502.17 502.18 502.19 502.20 502.21 502.22 502.23 502.24 502.25 502.26 502.27
502.28 502.29 502.30 502.31 503.1 503.2 503.3 503.4 503.5 503.6 503.7 503.8 503.9 503.10 503.11 503.12 503.13
503.14
503.15 503.16 503.17 503.18 503.19 503.20 503.21 503.22 503.23 503.24 503.25 503.26 503.27 503.28 503.29 503.30 503.31 503.32 503.33 503.34 503.35 503.36 504.1 504.2 504.3 504.4 504.5 504.6 504.7 504.8 504.9 504.10 504.11 504.12 504.13 504.14 504.15 504.16 504.17 504.18 504.19 504.20 504.21 504.22 504.23 504.24 504.25 504.26 504.27 504.28 504.29 504.30 504.31 504.32 504.33 504.34 504.35 504.36
504.37
505.1 505.2 505.3 505.4 505.5 505.6 505.7 505.8 505.9 505.10 505.11 505.12 505.13 505.14 505.15 505.16
505.17
505.18 505.19 505.20 505.21 505.22 505.23 505.24 505.25 505.26 505.27 505.28 505.29 505.30 505.31 505.32 506.1 506.2 506.3 506.4 506.5 506.6 506.7 506.8 506.9 506.10 506.11 506.12 506.13 506.14 506.15 506.16 506.17 506.18 506.19
506.20
506.21 506.22 506.23 506.24 506.25
506.26 506.27 506.28 506.29 506.30 506.31 507.1 507.2
507.3 507.4 507.5 507.6 507.7 507.8 507.9 507.10 507.11 507.12 507.13 507.14 507.15 507.16 507.17 507.18 507.19 507.20 507.21 507.22 507.23 507.24 507.25 507.26 507.27 507.28 507.29 507.30 507.31 507.32 507.33 508.1 508.2 508.3 508.4 508.5 508.6 508.7 508.8 508.9 508.10 508.11 508.12 508.13 508.14 508.15 508.16 508.17 508.18 508.19
508.20 508.21 508.22 508.23 508.24 508.25 508.26 508.27
508.28 508.29 508.30 508.31
508.32
509.1 509.2 509.3 509.4
509.5 509.6 509.7 509.8
509.9 509.10
509.11 509.12 509.13 509.14 509.15 509.16 509.17 509.18 509.19 509.20 509.21 509.22 509.23 509.24 509.25 509.26 509.27 509.28 510.1 510.2 510.3 510.4 510.5 510.6 510.7 510.8 510.9 510.10 510.11 510.12 510.13 510.14 510.15 510.16 510.17 510.18 510.19 510.20 510.21 510.22 510.23 510.24 510.25 510.26 510.27 510.28 510.29 510.30 510.31 510.32 510.33 511.1 511.2 511.3 511.4 511.5 511.6 511.7 511.8 511.9 511.10 511.11 511.12 511.13 511.14 511.15 511.16 511.17 511.18 511.19 511.20 511.21 511.22 511.23 511.24 511.25 511.26 511.27 511.28 511.29 511.30 511.31 511.32 511.33 511.34 512.1 512.2 512.3 512.4 512.5
512.6 512.7 512.8 512.9 512.10 512.11 512.12 512.13 512.14 512.15 512.16 512.17 512.18 512.19 512.20 512.21 512.22 512.23
512.24 512.25 512.26 512.27 512.28 512.29 512.30 512.31 513.1 513.2 513.3 513.4 513.5 513.6 513.7 513.8 513.9 513.10 513.11 513.12 513.13 513.14 513.15 513.16 513.17 513.18 513.19 513.20 513.21 513.22 513.23 513.24 513.25 513.26 513.27 513.28 513.29 513.30 513.31 513.32 514.1 514.2 514.3 514.4 514.5 514.6 514.7 514.8
514.9 514.10 514.11 514.12 514.13 514.14 514.15 514.16 514.17 514.18 514.19
514.20
514.21 514.22 514.23 514.24 514.25 514.26 514.27 514.28 514.29 514.30 514.31 515.1 515.2 515.3 515.4 515.5 515.6 515.7 515.8 515.9 515.10 515.11 515.12 515.13 515.14 515.15 515.16 515.17 515.18 515.19 515.20 515.21 515.22
515.23
515.24 515.25 515.26 515.27 515.28 515.29 515.30 515.31 515.32 516.1 516.2 516.3 516.4 516.5 516.6 516.7 516.8 516.9 516.10
516.11
516.12 516.13 516.14 516.15 516.16 516.17 516.18 516.19 516.20 516.21 516.22 516.23 516.24 516.25 516.26 516.27 516.28 516.29 516.30 516.31 516.32 517.1 517.2 517.3 517.4 517.5 517.6 517.7 517.8 517.9 517.10 517.11 517.12 517.13 517.14 517.15 517.16 517.17 517.18 517.19 517.20 517.21 517.22 517.23 517.24 517.25 517.26 517.27 517.28 518.1 518.2 518.3 518.4 518.5 518.6 518.7 518.8 518.9 518.10 518.11 518.12 518.13 518.14 518.15 518.16 518.17 518.18 518.19 518.20 518.21 518.22 518.23 518.24 518.25 518.26 518.27
518.28 518.29 518.30 518.31 519.1 519.2 519.3 519.4 519.5 519.6 519.7 519.8 519.9 519.10 519.11 519.12 519.13 519.14 519.15 519.16 519.17 519.18 519.19 519.20 519.21 519.22 519.23 519.24 519.25 519.26 519.27 519.28
520.1 520.2 520.3 520.4 520.5 520.6 520.7 520.8 520.9 520.10 520.11 520.12 520.13 520.14 520.15 520.16 520.17 520.18 520.19 520.20 520.21 520.22 520.23 520.24 520.25
520.26
520.27 520.28 520.29 520.30 520.31 520.32 520.33 521.1 521.2 521.3 521.4 521.5 521.6 521.7 521.8 521.9 521.10 521.11 521.12 521.13 521.14 521.15 521.16 521.17 521.18 521.19 521.20 521.21 521.22 521.23 521.24 521.25 521.26 521.27 521.28 521.29 521.30
522.1 522.2 522.3 522.4 522.5 522.6 522.7 522.8 522.9 522.10
522.11 522.12 522.13
522.14 522.15 522.16 522.17 522.18 522.19 522.20 522.21 522.22 522.23 522.24 522.25 522.26 522.27 522.28 522.29
522.30
523.1 523.2 523.3 523.4 523.5 523.6 523.7 523.8 523.9
523.10 523.11 523.12 523.13 523.14
523.15
523.16 523.17
523.18 523.19 523.20 523.21 523.22 523.23 523.24 523.25 523.26 523.27 523.28 523.29 524.1 524.2 524.3 524.4 524.5 524.6 524.7 524.8 524.9 524.10 524.11 524.12 524.13 524.14
524.15 524.16 524.17 524.18 524.19 524.20 524.21 524.22 524.23 524.24 524.25 524.26 524.27 524.28 524.29 524.30 524.31 525.1 525.2 525.3 525.4 525.5 525.6 525.7 525.8 525.9 525.10
525.11 525.12 525.13 525.14 525.15 525.16 525.17 525.18 525.19 525.20 525.21 525.22 525.23 525.24 525.25 525.26 525.27 525.28 525.29 525.30 525.31 525.32 526.1 526.2 526.3 526.4 526.5 526.6 526.7 526.8 526.9 526.10 526.11 526.12 526.13 526.14 526.15 526.16 526.17 526.18 526.19 526.20 526.21 526.22 526.23 526.24 526.25 526.26 526.27 526.28 526.29 526.30 526.31 526.32 526.33 527.1 527.2 527.3 527.4
527.5 527.6 527.7 527.8
527.9 527.10 527.11 527.12 527.13 527.14 527.15 527.16 527.17 527.18 527.19 527.20
527.21 527.22 527.23 527.24 527.25 527.26 527.27
527.28
528.1 528.2 528.3 528.4 528.5 528.6 528.7 528.8 528.9 528.10 528.11 528.12 528.13 528.14 528.15 528.16 528.17 528.18 528.19 528.20
528.21 528.22 528.23 528.24 528.25 528.26 528.27 528.28 528.29 528.30 528.31 528.32 528.33 529.1 529.2 529.3 529.4 529.5 529.6 529.7 529.8 529.9 529.10 529.11 529.12 529.13 529.14
529.15
529.16 529.17 529.18 529.19 529.20 529.21 529.22 529.23 529.24 529.25 529.26 529.27 529.28 529.29 529.30 529.31 530.1 530.2
530.3 530.4 530.5 530.6 530.7 530.8 530.9 530.10 530.11 530.12 530.13 530.14 530.15 530.16 530.17 530.18 530.19 530.20 530.21 530.22 530.23 530.24 530.25 530.26 530.27 530.28 530.29 531.1 531.2 531.3 531.4 531.5 531.6 531.7 531.8
531.9
531.10 531.11 531.12 531.13 531.14 531.15 531.16 531.17 531.18
531.19
531.20 531.21 531.22 531.23 531.24 531.25 531.26 531.27 531.28 532.1 532.2 532.3 532.4 532.5 532.6 532.7 532.8 532.9 532.10 532.11 532.12 532.13 532.14 532.15 532.16 532.17 532.18 532.19 532.20 532.21 532.22 532.23 532.24 532.25
532.26
532.27 532.28 532.29 532.30 533.1 533.2 533.3 533.4
533.5
533.6 533.7 533.8 533.9 533.10 533.11 533.12 533.13 533.14 533.15 533.16 533.17 533.18 533.19 533.20 533.21 533.22 533.23 533.24 533.25 533.26 533.27 533.28 533.29 533.30 533.31 533.32 534.1 534.2
534.3 534.4 534.5 534.6 534.7 534.8 534.9 534.10 534.11 534.12 534.13
534.14 534.15 534.16 534.17 534.18
534.19 534.20 534.21 534.22 534.23 534.24 534.25 534.26 534.27 534.28 534.29 534.30 534.31 534.32 535.1 535.2 535.3 535.4 535.5 535.6
535.7 535.8 535.9 535.10 535.11 535.12 535.13 535.14 535.15 535.16
535.17 535.18 535.19 535.20 535.21 535.22 535.23 535.24 535.25 535.26 535.27 535.28 535.29 535.30 535.31 536.1 536.2 536.3 536.4 536.5 536.6 536.7 536.8 536.9 536.10 536.11 536.12 536.13 536.14 536.15 536.16
536.17 536.18 536.19 536.20 536.21 536.22 536.23
536.24 536.25 536.26
536.27
536.28 536.29
536.30 537.1 537.2 537.3 537.4 537.5 537.6 537.7 537.8 537.9 537.10
537.11 537.12 537.13 537.14 537.15 537.16 537.17 537.18 537.19 537.20 537.21 537.22 537.23 537.24 537.25 537.26 537.27 537.28 537.29 537.30 537.31 537.32 537.33 537.34 538.1 538.2 538.3 538.4 538.5 538.6 538.7
538.8 538.9
538.10 538.11
538.12 538.13 538.14 538.15 538.16 538.17 538.18 538.19 538.20 538.21 538.22 538.23
538.24 538.25 538.26 538.27 538.28 538.29 538.30 538.31 539.1 539.2 539.3 539.4 539.5 539.6 539.7 539.8 539.9 539.10 539.11 539.12 539.13 539.14 539.15 539.16 539.17 539.18 539.19 539.20 539.21 539.22 539.23 539.24 539.25 539.26 539.27 539.28 539.29 539.30 539.31 539.32 539.33
539.34 539.35 540.1 540.2 540.3 540.4 540.5 540.6 540.7 540.8 540.9 540.10 540.11 540.12 540.13 540.14 540.15 540.16 540.17 540.18 540.19 540.20 540.21 540.22 540.23 540.24 540.25 540.26 540.27 540.28 540.29 540.30 540.31 540.32 540.33 540.34 541.1 541.2 541.3 541.4 541.5 541.6 541.7 541.8 541.9 541.10
541.11 541.12 541.13 541.14 541.15 541.16 541.17 541.18 541.19
541.20 541.21 541.22 541.23 541.24 541.25
541.26 541.27 541.28 541.29 541.30 541.31 542.1 542.2 542.3 542.4 542.5 542.6 542.7 542.8 542.9 542.10 542.11 542.12 542.13 542.14 542.15 542.16 542.17 542.18 542.19
542.20 542.21
542.22 542.23 542.24 542.25 542.26 542.27 542.28 542.29 542.30 542.31 542.32 542.33
542.34 542.35 543.1 543.2 543.3 543.4 543.5 543.6 543.7 543.8 543.9 543.10
543.11 543.12 543.13
543.14 543.15
543.16 543.17 543.18 543.19
543.20 543.21 543.22 543.23 543.24 543.25 543.26 543.27
543.28 543.29
543.30 543.31
543.32 543.33 544.1 544.2 544.3
544.4 544.5
544.6 544.7 544.8 544.9 544.10 544.11 544.12 544.13 544.14 544.15 544.16 544.17 544.18 544.19 544.20 544.21 544.22
544.23 544.24 544.25 544.26 544.27 544.28 544.29
544.30 544.31 544.32 544.33 544.34 544.35 545.1 545.2 545.3 545.4 545.5 545.6 545.7 545.8 545.9 545.10 545.11 545.12 545.13 545.14 545.15 545.16 545.17 545.18 545.19 545.20 545.21 545.22 545.23 545.24 545.25 545.26 545.27 545.28 545.29
545.30 545.31 545.32 545.33 545.34 545.35
546.1 546.2 546.3 546.4 546.5 546.6 546.7 546.8 546.9 546.10 546.11 546.12 546.13 546.14 546.15 546.16 546.17 546.18 546.19 546.20 546.21 546.22
546.23 546.24 546.25 546.26 546.27 546.28 546.29 546.30 546.31 546.32 547.1 547.2 547.3 547.4 547.5 547.6 547.7 547.8 547.9 547.10 547.11 547.12 547.13 547.14 547.15 547.16 547.17 547.18 547.19 547.20 547.21 547.22
547.23 547.24
547.25 547.26 547.27
547.28 547.29 547.30
548.1 548.2 548.3 548.4 548.5 548.6 548.7 548.8 548.9 548.10 548.11 548.12 548.13 548.14 548.15 548.16 548.17 548.18 548.19 548.20 548.21 548.22 548.23
548.24 548.25
548.26 548.27 548.28 548.29 548.30 548.31 548.32 548.33 549.1 549.2 549.3 549.4
549.5 549.6 549.7 549.8 549.9 549.10 549.11 549.12 549.13 549.14 549.15 549.16
549.17 549.18 549.19 549.20 549.21 549.22 549.23 549.24 549.25 549.26 549.27 549.28 549.29 549.30 549.31 549.32 550.1 550.2 550.3 550.4 550.5 550.6 550.7 550.8 550.9 550.10 550.11 550.12 550.13 550.14 550.15 550.16 550.17 550.18 550.19 550.20 550.21 550.22 550.23 550.24 550.25 550.26 550.27 550.28 550.29 550.30 550.31 551.1 551.2 551.3 551.4 551.5 551.6 551.7 551.8 551.9 551.10 551.11 551.12 551.13 551.14 551.15 551.16 551.17 551.18 551.19 551.20 551.21 551.22 551.23 551.24 551.25 551.26 551.27 551.28 551.29 551.30 551.31 551.32 551.33 551.34 552.1 552.2 552.3 552.4 552.5 552.6 552.7 552.8 552.9 552.10 552.11 552.12 552.13 552.14 552.15 552.16 552.17 552.18
552.19 552.20 552.21 552.22 552.23 552.24 552.25 552.26 552.27 552.28 552.29 552.30 552.31 552.32 552.33 552.34 552.35 553.1 553.2 553.3 553.4 553.5 553.6 553.7 553.8 553.9 553.10 553.11 553.12 553.13 553.14 553.15 553.16 553.17
553.18 553.19 553.20
553.21 553.22 553.23 553.24 553.25 553.26 553.27 553.28 553.29 553.30 553.31 553.32 553.33
554.1 554.2 554.3 554.4 554.5 554.6 554.7 554.8 554.9 554.10 554.11 554.12 554.13
554.14 554.15 554.16 554.17 554.18 554.19
554.20 554.21 554.22 554.23 554.24 554.25
554.26 554.27
554.28 554.29
554.30 554.31 554.32 554.33 554.34 554.35
555.1 555.2 555.3
555.4 555.5 555.6 555.7 555.8 555.9 555.10 555.11 555.12 555.13 555.14 555.15 555.16 555.17 555.18 555.19
555.20 555.21
555.22 555.23 555.24 555.25 555.26 555.27 555.28 555.29 555.30 555.31 555.32 555.33 555.34 555.35 555.36 556.1 556.2 556.3 556.4 556.5 556.6 556.7 556.8 556.9 556.10
556.11 556.12
556.13 556.14 556.15 556.16 556.17 556.18 556.19 556.20 556.21 556.22 556.23 556.24 556.25 556.26 556.27 556.28 556.29 556.30 556.31 556.32 557.1 557.2 557.3 557.4
557.5 557.6 557.7 557.8 557.9 557.10 557.11 557.12 557.13 557.14 557.15 557.16 557.17 557.18 557.19 557.20 557.21 557.22 557.23 557.24 557.25 557.26 557.27 557.28 557.29 557.30 557.31 557.32 557.33 558.1 558.2 558.3 558.4
558.5 558.6 558.7 558.8 558.9 558.10 558.11 558.12 558.13 558.14 558.15 558.16 558.17 558.18 558.19 558.20 558.21 558.22 558.23 558.24 558.25 558.26 558.27 558.28 558.29 558.30
558.31 558.32 558.33
559.1 559.2 559.3 559.4 559.5 559.6 559.7 559.8 559.9 559.10 559.11 559.12 559.13 559.14 559.15 559.16 559.17 559.18 559.19 559.20 559.21 559.22 559.23 559.24 559.25
559.26 559.27 559.28 559.29
559.30 559.31
560.1 560.2 560.3
560.4 560.5 560.6
560.7 560.8
560.9 560.10 560.11 560.12 560.13 560.14 560.15 560.16 560.17 560.18 560.19 560.20
560.21 560.22 560.23 560.24 560.25 560.26 560.27 560.28 560.29 560.30
560.31 561.1 561.2 561.3 561.4 561.5 561.6 561.7 561.8 561.9 561.10 561.11 561.12 561.13 561.14 561.15 561.16 561.17 561.18 561.19 561.20 561.21 561.22 561.23 561.24 561.25 561.26 561.27 561.28 561.29 561.30 561.31 561.32 561.33 561.34 561.35 561.36 561.37 562.1 562.2 562.3 562.4 562.5 562.6 562.7 562.8 562.9 562.10 562.11 562.12 562.13 562.14 562.15 562.16 562.17 562.18 562.19 562.20 562.21 562.22 562.23 562.24 562.25 562.26 562.27 562.28 562.29 562.30 562.31 562.32 562.33 562.34 563.1 563.2 563.3 563.4 563.5 563.6 563.7 563.8 563.9 563.10 563.11 563.12 563.13 563.14 563.15 563.16 563.17 563.18 563.19 563.20 563.21 563.22 563.23 563.24 563.25 563.26 563.27 563.28 563.29 563.30 563.31 563.32 563.33 563.34 564.1 564.2 564.3 564.4 564.5 564.6 564.7 564.8 564.9 564.10 564.11 564.12 564.13 564.14 564.15 564.16 564.17 564.18 564.19 564.20 564.21 564.22 564.23 564.24 564.25 564.26 564.27 564.28 564.29 564.30 564.31 564.32 564.33 564.34
565.1 565.2 565.3 565.4 565.5 565.6 565.7 565.8 565.9 565.10 565.11 565.12 565.13 565.14 565.15 565.16 565.17 565.18 565.19 565.20 565.21 565.22 565.23 565.24 565.25 565.26 565.27 565.28 565.29 565.30 565.31 565.32 566.1 566.2 566.3 566.4 566.5 566.6 566.7 566.8 566.9 566.10 566.11 566.12 566.13 566.14 566.15 566.16 566.17 566.18 566.19 566.20 566.21 566.22 566.23 566.24 566.25 566.26 566.27 566.28 566.29 566.30 566.31 567.1 567.2 567.3 567.4 567.5 567.6 567.7 567.8 567.9 567.10 567.11 567.12 567.13
567.14 567.15 567.16 567.17
567.18 567.19 567.20 567.21 567.22 567.23
567.24 567.25 567.26
567.27 567.28 567.29
568.1 568.2 568.3
568.4 568.5
568.6 568.7 568.8 568.9 568.10 568.11 568.12 568.13 568.14 568.15 568.16 568.17
568.18 568.19 568.20 568.21 568.22 568.23 568.24 568.25 568.26 568.27 568.28 568.29 568.30 568.31 569.1 569.2 569.3 569.4 569.5 569.6 569.7 569.8 569.9 569.10 569.11 569.12 569.13 569.14 569.15 569.16 569.17 569.18 569.19 569.20 569.21 569.22 569.23 569.24 569.25 569.26 569.27 569.28 569.29 569.30 569.31 569.32 569.33 569.34 569.35 570.1 570.2 570.3 570.4 570.5 570.6 570.7 570.8 570.9 570.10 570.11 570.12 570.13 570.14 570.15 570.16 570.17 570.18 570.19 570.20 570.21 570.22 570.23 570.24 570.25 570.26 570.27 570.28 570.29 570.30 570.31 570.32 570.33 570.34 570.35 571.1 571.2 571.3 571.4 571.5 571.6 571.7 571.8 571.9 571.10 571.11 571.12 571.13 571.14 571.15 571.16 571.17 571.18 571.19
571.20 571.21 571.22 571.23 571.24 571.25 571.26 571.27 571.28 571.29 571.30 571.31 571.32 572.1 572.2 572.3 572.4 572.5
572.6
572.7 572.8
572.9 572.10
572.11 572.12
572.13
572.14 572.15 572.16 572.17 572.18 572.19
572.20 572.21 572.22
572.23 572.24 572.25
572.26 572.27 572.28 572.29 572.30 572.31 573.1 573.2 573.3 573.4 573.5 573.6 573.7 573.8
573.9
A bill for an act
relating to state government; establishing budget provisions for the Departments
of Human Services, Health, and Children, Youth, and Families; modifying
provisions relating to health, health licensing boards, health and education facilities,
pharmacy benefits, health care finance, behavioral health, children's mental health
terminology, assertive community treatment and intensive residential treatment
services, background studies, Department of Human Services program integrity,
human services licensing, economic supports, child protection and welfare, early
care and learning, and children and families licensing; making conforming changes
for the statutory establishment of the Department of Children, Youth, and Families;
making forecast adjustments; requiring reports; establishing criminal penalties;
permitting rulemaking; appropriating money; amending Minnesota Statutes 2024,
sections 3.732, subdivision 1; 10A.01, subdivision 35; 13.46, subdivision 3;
62A.673, subdivision 2; 62D.21; 62D.211; 62E.23, subdivision 1; 62J.461,
subdivisions 3, 4, 5; 62J.51, subdivision 19a; 62J.581; 62J.84, subdivisions 2, 3,
6, 10, 11, 12, 13, 14, 15; 62K.10, subdivisions 2, 5, 6; 62M.17, subdivision 2;
62Q.522, subdivision 1; 62Q.527, subdivisions 1, 2, 3; 62U.04, by adding a
subdivision; 103I.005, subdivision 17b; 103I.101, subdivisions 2, 5, 6, by adding
a subdivision; 103I.208, subdivisions 1, 1a, 2; 103I.235, subdivision 1; 103I.525,
subdivisions 2, 6, 8; 103I.531, subdivisions 2, 6, 8; 103I.535, subdivisions 2, 6,
8; 103I.541, subdivisions 2b, 2c, 4; 103I.545, subdivisions 1, 2; 103I.601,
subdivisions 2, 4; 121A.61, subdivision 3; 128C.02, subdivision 5; 136A.25;
136A.26; 136A.27; 136A.28; 136A.29, subdivisions 1, 3, 6, 9, 10, 14, 19, 20, 21,
22, by adding a subdivision; 136A.32, subdivisions 1, 4, by adding a subdivision;
136A.33; 136A.34, subdivisions 3, 4; 136A.36; 136A.38; 136A.41; 136A.42;
136F.67, subdivision 1; 138.912, subdivisions 1, 2, 3, 4, 6; 142A.03, subdivision
2, by adding a subdivision; 142A.609, subdivisions 11, 12; 142A.76, subdivisions
2, 3; 142B.01, subdivision 15; 142B.05, subdivision 3; 142B.10, subdivision 14;
142B.16, subdivision 2; 142B.171, subdivision 2; 142B.30, subdivision 1, by
adding a subdivision; 142B.41, by adding a subdivision; 142B.47; 142B.51,
subdivision 2; 142B.65, subdivisions 8, 9; 142B.66, subdivision 3; 142B.70,
subdivisions 7, 8; 142B.80; 142C.06, by adding a subdivision; 142C.11, subdivision
8; 142C.12, subdivisions 1, 6; 142D.31, subdivision 2; 142E.03, subdivision 3;
142E.11, subdivisions 1, 2; 142E.13, subdivision 2; 142E.15, subdivision 1;
142E.16, subdivisions 3, 7; 142E.51, subdivisions 5, 6; 142G.02, subdivision 56;
142G.27, subdivision 4; 142G.42, subdivision 3; 144.064, subdivision 3; 144.0758,
subdivision 3; 144.1205, subdivisions 2, 4, 8, 9, 10; 144.121, subdivisions 1a, 2,
5, by adding subdivisions; 144.1215, by adding a subdivision; 144.1222,
subdivisions 1a, 2d; 144.125, subdivisions 1, 2; 144.3831, subdivision 1; 144.50,
by adding a subdivision; 144.55, subdivision 1a; 144.554; 144.555, subdivisions
1a, 1b; 144.562, subdivisions 2, 3; 144.563; 144.608, subdivision 2; 144.651,
subdivision 2; 144.966, subdivision 2; 144.99, subdivision 1; 144A.43, subdivision
15; 144E.123, subdivision 3; 144E.35; 144G.08, subdivision 45; 144G.45,
subdivision 6; 145.8811; 145.901, subdivision 1; 145.987, subdivisions 1, 2;
147.01, subdivision 7; 147.037, by adding a subdivision; 147A.02; 147D.03,
subdivision 1; 148.108, subdivision 1, by adding subdivisions; 148.191, subdivision
2; 148.241; 148.512, subdivision 17a; 148.5192, subdivision 3; 148.5194,
subdivision 3b; 148.56, subdivision 1; 148.6401; 148.6402, subdivisions 1, 7, 8,
13, 14, 16, 16a, 19, 20, 23, 25, by adding subdivisions; 148.6403; 148.6404;
148.6405; 148.6408, subdivision 2, by adding a subdivision; 148.6410, subdivision
2, by adding a subdivision; 148.6412, subdivisions 2, 3; 148.6415; 148.6418;
148.6420, subdivision 1; 148.6423, subdivisions 1, 2, by adding a subdivision;
148.6425, subdivision 2, by adding subdivisions; 148.6428; 148.6432, subdivisions
1, 2, 3, 4, by adding a subdivision; 148.6435; 148.6438; 148.6443, subdivisions
3, 4, 5, 6, 7, 8; 148.6445, by adding subdivisions; 148.6448, subdivisions 1, 2, 4,
6; 148.6449, subdivisions 1, 2, 7; 148B.53, subdivision 3; 148E.180, subdivisions
1, 5, 7, by adding subdivisions; 148F.11, subdivision 1; 149A.02, by adding a
subdivision; 150A.105, by adding a subdivision; 151.01, subdivisions 15, 23;
151.065, subdivisions 1, 3, 6; 151.101; 151.555, subdivisions 6, 10; 151.741,
subdivision 5; 152.12, subdivision 1; 153B.85, subdivisions 1, 3; 156.015, by
adding subdivisions; 157.16, subdivisions 2, 2a, 3, 3a, by adding a subdivision;
245.095, subdivision 5, by adding a subdivision; 245.0962, subdivision 1; 245.462,
subdivisions 4, 20; 245.4661, subdivisions 2, 6, 7, 9; 245.4662, subdivision 1;
245.467, subdivision 4; 245.4682, subdivision 3; 245.469; 245.4711, subdivisions
1, 4; 245.4712, subdivisions 1, 3; 245.4835, subdivision 2; 245.4863; 245.487,
subdivision 2; 245.4871, subdivisions 3, 4, 5, 6, 13, 15, 17, 19, 21, 22, 28, 29, 31,
32, 34, by adding a subdivision; 245.4873, subdivision 2; 245.4874, subdivision
1; 245.4875, subdivision 5; 245.4876, subdivisions 4, 5; 245.4877; 245.488,
subdivisions 1, 3; 245.4881, subdivisions 1, 3, 4; 245.4882, subdivisions 1, 5;
245.4884; 245.4885, subdivision 1; 245.4889, subdivision 1; 245.4901, subdivision
3; 245.4905; 245.4906, subdivision 2; 245.4907, subdivisions 2, 3; 245.491,
subdivision 2; 245.492, subdivision 3; 245.50, subdivision 3, by adding a
subdivision; 245.697, subdivision 2a; 245.814, subdivision 3; 245.826; 245.91,
subdivisions 2, 4; 245.92; 245.94, subdivision 1; 245.975, subdivision 1; 245A.03,
subdivision 2; 245A.04, subdivisions 1, 7; 245A.05; 245A.07, subdivision 2;
245A.16, subdivision 1; 245A.18, subdivision 1; 245A.242, subdivision 2; 245A.26,
subdivisions 1, 2; 245C.02, by adding a subdivision; 245C.05, by adding a
subdivision; 245C.08, subdivision 3; 245C.13, subdivision 2; 245C.14, by adding
a subdivision; 245C.15, subdivision 4a, by adding a subdivision; 245C.22,
subdivision 5; 245D.02, subdivision 4a; 245I.05, subdivisions 3, 5; 245I.06,
subdivision 3; 245I.11, subdivision 5; 245I.12, subdivision 5; 245I.23, subdivision
7; 246C.12, subdivision 4; 252.27, subdivision 1; 254B.04, subdivision 1a; 254B.05,
subdivision 1a; 254B.06, by adding a subdivision; 256.01, by adding a subdivision;
256.478, subdivision 2; 256.9657, by adding a subdivision; 256.969, subdivision
2b; 256.98, subdivision 1; 256.983, subdivision 4; 256B.02, subdivision 11;
256B.0371, subdivision 3; 256B.04, subdivision 21; 256B.051, subdivision 3;
256B.055, subdivision 12; 256B.0615, subdivisions 1, 3; 256B.0616, subdivisions
1, 4, 5; 256B.0622, subdivisions 1, 3a, 7a, 8, 11, 12; 256B.0625, subdivisions 2,
3b, 13, 13c, 13d, 13e, 17a, 20, 25c, 30, 54, by adding subdivisions; 256B.064,
subdivision 1a; 256B.0659, subdivision 21; 256B.0757, subdivisions 2, 5, by
adding a subdivision; 256B.0943, subdivisions 1, 3, 9, 12, 13; 256B.0945,
subdivision 1; 256B.0946, subdivision 6; 256B.0947, subdivision 3a; 256B.12;
256B.1973, by adding a subdivision; 256B.69, subdivisions 6d, 23, by adding a
subdivision; 256B.692, subdivision 2; 256B.76, subdivisions 1, 6, by adding a
subdivision; 256B.761; 256B.766; 256B.77, subdivision 7a; 256B.82; 256B.85,
subdivision 12; 256D.44, subdivision 5; 256L.03, subdivision 5; 256R.01, by
adding a subdivision; 260.65; 260.66, subdivision 1; 260.691, subdivision 1;
260.692; 260.810, subdivisions 1, 2; 260.821, subdivision 2; 260B.157, subdivision
3; 260C.001, subdivision 2; 260C.007, subdivisions 16, 19, 26d, 27b; 260C.150,
subdivision 3; 260C.157, subdivision 3; 260C.201, subdivisions 1, 2; 260C.202,
subdivision 2, by adding a subdivision; 260C.204; 260C.221, subdivision 2;
260C.223, subdivisions 1, 2; 260C.301, subdivision 4; 260C.331, subdivision 1;
260C.452, subdivision 4; 260D.01; 260D.02, subdivisions 5, 9; 260D.03,
subdivision 1; 260D.04; 260D.06, subdivision 2; 260D.07; 260E.03, subdivision
15; 260E.09; 260E.11, subdivision 3; 260E.20, subdivision 1; 260E.24, subdivisions
1, 2; 295.50, subdivisions 3, 9b; 295.52, subdivisions 1, 1a, 2, 3, 4; 326.72,
subdivision 1; 326.75, subdivisions 3, 3a; 327.15, subdivisions 2, 3, 4, by adding
a subdivision; 354B.20, subdivision 7; Laws 2021, First Special Session chapter
7, article 2, section 81; Laws 2023, chapter 70, article 7, section 34; article 20,
section 2, subdivision 30; Laws 2024, chapter 127, article 67, sections 4; 6;
proposing coding for new law in Minnesota Statutes, chapters 62J; 62Q; 62V;
142B; 142F; 144; 144E; 145; 148; 153; 245; 256B; 260E; 295; 306; 307; 609;
proposing coding for new law as Minnesota Statutes, chapter 148G; repealing
Minnesota Statutes 2024, sections 62E.21; 62E.22; 62E.23; 62E.24; 62E.25;
62J.824; 62K.10, subdivision 3; 103I.550; 136A.29, subdivision 4; 138.912,
subdivision 7; 148.108, subdivisions 2, 3, 4; 148.6402, subdivision 22a; 148.6420,
subdivisions 2, 3, 4; 148.6423, subdivisions 4, 5, 7, 8, 9; 148.6425, subdivision 3;
148.6430; 148.6445, subdivisions 5, 6, 8; 156.015, subdivision 1; 245A.11,
subdivision 8; 256B.0622, subdivision 4; 256B.0625, subdivision 38; Minnesota
Rules, parts 2500.1150; 2500.2030; 4695.2900; 6800.5100, subpart 5; 6800.5400,
subparts 5, 6; 6900.0250, subparts 1, 2; 9100.0400, subparts 1, 3; 9100.0500;
9100.0600.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
DEPARTMENT OF HEALTH FINANCE
Section 1.
Minnesota Statutes 2024, section 62D.21, is amended to read:
62D.21 FEES.
Every health maintenance organization subject to sections 62D.01 to 62D.30 shall pay
to the commissioner of healthnew text begin the followingnew text end fees deleted text begin as prescribed by the commissioner of health
pursuant to section 144.122 for the followingdeleted text end :
(1) filing an application for a certificate of authoritynew text begin : $10,000new text end ;
(2) filing an amendment to a certificate of authoritynew text begin : $125new text end ;
(3) filing each annual reportnew text begin : $400new text end ; deleted text begin and
deleted text end
deleted text begin
(4) other filings, as specified by rule.
deleted text end
new text begin
(4) filing each quarterly report: $200; and
new text end
new text begin
(5) filing annual plan review documents, amendments to plan documents, and quality
plans: $125.
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. 2.
Minnesota Statutes 2024, section 62D.211, is amended to read:
62D.211 RENEWAL FEE.
Each health maintenance organization subject to sections 62D.01 to 62D.30 shall submit
to the commissioner of health each year before June 15 a certificate of authority renewal
fee in the amount of deleted text begin $10,000deleted text end new text begin $30,000new text end each plus deleted text begin 20deleted text end new text begin 88new text end cents per person enrolled in the health
maintenance organization on December 31 of the preceding year. deleted text begin The commissioner may
adjust the renewal fee in rule under the provisions of chapter 14.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 3.
new text begin
[62J.8241] FACILITY FEES PROHIBITED.
new text end
new text begin Subdivision 1. 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) "Control" has the meaning given in section 145D.01.
new text end
new text begin
(c) "Facility fee" means any separate charge or billing by a provider-based clinic in
addition to a professional fee for physicians' services that is intended to cover building,
electronic medical records systems, billing, and other administrative and operational
expenses.
new text end
new text begin
(d) "Health care clearinghouse" has the meaning given in Code of Federal Regulations,
title 45, section 160.103.
new text end
new text begin
(e) "Health care provider" has the meaning given in section 145B.02. Health care provider
does not include any hospital that:
new text end
new text begin
(1) is certified by the Centers for Medicare and Medicaid Services as a Medicare critical
access hospital; and
new text end
new text begin
(2) is not affiliated, by governance or control, with a health system or other hospital.
new text end
new text begin
(f) "NPI" means the standard, unique health identifier for health care providers that is
issued by the national provider system in accordance with Code of Federal Regulations,
title 45, section 162.
new text end
new text begin
(g) "Provider-based clinic" means the site of an off-campus clinic or provider office,
located at least 250 yards from the main hospital buildings or as determined by the Centers
for Medicare and Medicaid Services, that is owned by a hospital licensed under chapter 144
or a health system that operates one or more hospitals licensed under chapter 144 and is
primarily engaged in providing diagnostic and therapeutic care, including medical history,
physical examinations, assessment of health status, and treatment monitoring. This definition
does not include clinics that are exclusively providing laboratory, x-ray, testing, therapy,
pharmacy, or educational services and does not include facilities designated as rural health
clinics.
new text end
new text begin Subd. 2. new text end
new text begin Provider-based clinic prohibition. new text end
new text begin
(a) Health care providers are prohibited
from charging, billing, or collecting a facility fee for the following when provided at a
provider-based clinic: (1) services provided by telehealth as defined in section 62A.673,
subdivision 2, paragraph (h), when the patient is located outside the facility; and (2) the
provision of preventive items and services, as defined in section 62Q.46, subdivision 1.
new text end
new text begin
(b) Health care providers are prohibited from charging, billing, or collecting a facility
fee directly from a patient for those services set forth in paragraph (a), clause (2).
new text end
new text begin Subd. 3. new text end
new text begin Unique NPI. new text end
new text begin
(a) Provider-based clinics must apply for, obtain, and use on all
claims for reimbursement or payment for health services provided at the provider-based
clinic, a unique NPI that is distinct from the hospital's NPI.
new text end
new text begin
(b) The provider-based clinic's unique NPI must be included on any claim for
reimbursement or payment for health services provided at the provider-based clinic,
regardless of whether the claim is filed or submitted by or through a central office of the
hospital or a health care clearinghouse.
new text end
new text begin Subd. 4. new text end
new text begin Notification. new text end
new text begin
(a) If a hospital or health system charges a facility fee utilizing
a CPT evaluation and management code or assessment and management code for outpatient
services provided at a provider-based clinic where a professional fee is also expected to be
charged, the hospital or health system must provide the patient with a written notice that
includes the following information:
new text end
new text begin
(1) that the provider-based clinic is part of a hospital or health system and that the hospital
or health system charges a facility fee that is in addition to and separate from the professional
fee charged by the provider;
new text end
new text begin
(2) the amount of the patient's potential financial liability, including any facility fee
likely to be charged, and, where professional medical services are provided by an affiliated
provider, any professional fee likely to be charged, or, if the exact type and extent of the
professional medical services needed are not known or the terms of a patient's health
insurance coverage are not known with reasonable certainty, an estimate of the patient's
financial liability based on typical or average charges for visits to the provider-based clinic,
including the facility fee;
new text end
new text begin
(3) a statement that the patient's actual financial liability will depend on the professional
medical services actually provided to the patient;
new text end
new text begin
(4) an explanation that the patient may incur financial liability that is greater than the
patient would incur if the professional medical services were not provided by a
provider-based clinic;
new text end
new text begin
(5) a telephone number the patient may call for additional information regarding the
patient's potential financial liability, including an estimate of the facility fee likely to be
charged based on the scheduled professional medical services; and
new text end
new text begin
(6) that a patient covered by a health insurance policy should contact the health insurer
for additional information regarding the hospital's or health system's charges and fees,
including the patient's potential financial liability, if any, for the charges and fees.
new text end
new text begin
(b) If a hospital or health system charges a facility fee without utilizing a CPT evaluation
and management code for outpatient services provided at a provider-based clinic, the hospital
or health system must provide the patient with a written notice that includes the following
information:
new text end
new text begin
(1) that the provider-based clinic is part of a hospital or health system and that the hospital
or health system charges a facility fee that may be in addition to and separate from the
professional fee charged by a provider;
new text end
new text begin
(2) a statement that the patient's actual financial liability will depend on the professional
medical services actually provided to the patient;
new text end
new text begin
(3) an explanation that the patient may incur financial liability that is greater than the
patient would incur if the provider-based clinic was not hospital-based;
new text end
new text begin
(4) a telephone number the patient may call for additional information regarding the
patient's potential financial liability, including an estimate of the facility fee likely to be
charged based on the scheduled professional medical services; and
new text end
new text begin
(5) that a patient covered by a health insurance policy should contact the health insurer
for additional information regarding the hospital's or health system's charges and fees,
including the patient's potential financial liability, if any, for the charges and fees.
new text end
new text begin
(c) Each initial billing statement that includes a facility fee must:
new text end
new text begin
(1) clearly identify the fee as a facility fee that is billed in addition to, or separately from,
any professional fee billed by the provider;
new text end
new text begin
(2) provide the corresponding Medicare facility fee reimbursement rate for the same
service as a comparison or, if there is no corresponding Medicare facility fee for the service:
new text end
new text begin
(i) the approximate amount Medicare would have paid the hospital for the facility fee
on the billing statement; or
new text end
new text begin
(ii) the percentage of the hospital's charges that Medicare would have paid the hospital
for the facility fee;
new text end
new text begin
(3) include a statement that the facility fee is intended to cover the hospital's or health
system's operational expenses;
new text end
new text begin
(4) inform the patient that the patient's financial liability may have been less if the services
had been provided at a facility not owned or operated by the hospital or health system; and
new text end
new text begin
(5) include written notice of the patient's right to request a reduction in the facility fee
or any other portion of the bill and a telephone number that the patient may use to request
such a reduction without regard to whether the patient qualifies for, or is likely to be granted,
any reduction.
new text end
new text begin
No later than October 15, 2025, and annually thereafter, each hospital, health system, and
provider-based clinic must submit to the commissioner of health a sample of a billing
statement issued by the hospital, health system, or provider-based clinic that complies with
the provisions of this paragraph and which represents the format of billing statements
received by patients. The billing statement must not contain patient identifying information.
new text end
new text begin
(d) The written notices described in paragraphs (a) to (c) and (g) to (i) must be in plain
language and in a form that may be reasonably understood by a patient who does not possess
special knowledge regarding hospital or health system facility fee charges. On and after
October 1, 2025, the notices must include tag lines in at least the top 15 languages spoken
in Minnesota indicating that the notice is available in each of those top 15 languages. The
15 languages must be either the languages in the list published by the Department of Health
and Human Services in connection with section 1557 of the Patient Protection and Affordable
Care Act, P.L. 111-148, or, as determined by the hospital or health system, the top 15
languages in the geographic area of the provider-based clinic.
new text end
new text begin
(e) For nonemergency care, if a patient's appointment is scheduled to occur ten or more
days after the appointment is made, such written notice must be sent to the patient by first
class mail, encrypted electronic mail, or a secure patient Internet portal not more than three
days after the appointment is made. If an appointment is scheduled to occur less than ten
days after the appointment is made or if the patient arrives without an appointment, such
notice must be hand-delivered to the patient when the patient arrives at the provider-based
clinic. For emergency care, such written notice must be provided to the patient as soon as
practicable after the patient is stabilized in accordance with the federal Emergency Medical
Treatment and Active Labor Act, United States Code, title 42, section 1395dd, as amended
from time to time, or is determined not to have an emergency medical condition and before
the patient leaves the provider-based clinic. If the patient is unconscious, under great duress,
or for any other reason unable to read the notice and understand and act on the patient's
rights, the notice must be provided to the patient's representative as soon as practicable.
new text end
new text begin
(f) Paragraphs (a) to (e) do not apply if a patient is insured by Medicare or the medical
assistance program under chapter 256B or is receiving services under a workers'
compensation plan established to provide medical services.
new text end
new text begin
(g) A provider-based clinic must prominently display written notice in locations that are
readily accessible to and visible by patients, including patient waiting or appointment
check-in areas, stating the following:
new text end
new text begin
(1) that the provider-based clinic is part of a hospital or health system;
new text end
new text begin
(2) the name of the hospital or health system; and
new text end
new text begin
(3) that if the provider-based clinic charges a facility fee, the patient may incur a financial
liability greater than the patient would incur if the provider-based clinic was not
hospital-based.
new text end
new text begin
On and after October 1, 2025, such notices must include tag lines in at least the top 15
languages spoken in Minnesota indicating that the notice is available in each of those top
15 languages. The 15 languages must be either the languages in the list published by the
Department of Health and Human Services in connection with section 1557 of the Patient
Protection and Affordable Care Act, P.L. 111-148, or, as determined by the hospital or
health system, the top 15 languages in the geographic area of the provider-based clinic. No
later than October 1, 2025, and annually thereafter, each provider-based clinic must submit
a copy of the written notice required by this paragraph to the commissioner of health.
new text end
new text begin
(h) A provider-based clinic must identify itself to the public and payers as being
hospital-based, including, at a minimum, by stating the name of the hospital or health system
in its signage, marketing materials, websites, and stationery.
new text end
new text begin
(i) A provider-based clinic must, when scheduling services for which a facility fee may
be charged, inform the patient:
new text end
new text begin
(1) that the provider-based clinic is part of a hospital or health system;
new text end
new text begin
(2) of the name of the hospital or health system;
new text end
new text begin
(3) that the hospital or health system may charge a facility fee in addition to and separate
from the professional fee charged by the provider; and
new text end
new text begin
(4) of the telephone number the patient may call for additional information regarding
such patient's potential financial liability.
new text end
new text begin
(j) If any transaction described in section 145D.01, subdivision 2, results in the
establishment of a provider-based clinic where facility fees may be billed, the hospital or
health system that is the purchaser in the transaction must, no later than 30 days after the
transaction, provide written notice by first class mail of the transaction to each patient served
within the three years preceding the date of the transaction by the health care facility that
has been purchased as part of the transaction. The notice must include the following
information:
new text end
new text begin
(1) a statement that the health care facility is now a provider-based clinic and is part of
a hospital or health system, the health care facility's full legal and business name, and the
date of the facility's acquisition by a hospital or health system;
new text end
new text begin
(2) the name, business address, and telephone number of the hospital or health system
that is the purchaser of the health care facility;
new text end
new text begin
(3) a statement that the provider-based clinic bills, or is likely to bill, patients a facility
fee that may be in addition to, and separate from, any professional fee billed by a health
care provider at the provider-based clinic;
new text end
new text begin
(4) a statement that the patient's actual financial liability will depend on the professional
medical services actually provided to the patient and an explanation that the patient may
incur financial liability that is greater than the patient would incur if the provider-based
clinic were not a provider-based clinic;
new text end
new text begin
(5) the estimated amount or range of amounts the provider-based clinic may bill for a
facility fee or an example of the average facility fee billed at the provider-based clinic for
the most common services provided at the provider-based clinic; and
new text end
new text begin
(6) a statement that, before seeking services at the provider-based clinic, a patient covered
by a health insurance policy should contact the patient's health insurer for additional
information regarding the provider-based clinic fees, including the patient's potential financial
liability, if any, for the fees.
new text end
new text begin
A copy of the written notice provided to patients in accordance with this subdivision must
be filed with the commissioner of health. The Department of Health must post a link to the
notice on its website. A hospital, health system, or provider-based clinic must not collect a
facility fee for services provided at a provider-based clinic that is subject to the provisions
of this subdivision from the date of the transaction until at least 30 days after the written
notice required pursuant to this subdivision is mailed to the patient or a copy of the notice
is filed with the commissioner of health, whichever is later. By July 1, 2026, and annually
thereafter, each provider-based clinic that was the subject of a transaction, as described in
section 145D.01, subdivision 2, during the preceding calendar year must report to the
commissioner of health the number of patients served by the provider-based clinic in the
preceding three years.
new text end
new text begin Subd. 5. new text end
new text begin Reporting. new text end
new text begin
(a) By January 15, 2027, and each year thereafter, hospitals licensed
under chapter 144 and health systems operating one or more hospitals licensed under chapter
144 must submit a report to the commissioner of health identifying facility fees charged,
billed, and collected during the preceding calendar year. The commissioner must publish
the information reported on a publicly accessible website. The report shall be in the format
prescribed by the commissioner of health.
new text end
new text begin
(b) The report under this subdivision must include the following information for each
facility owned or operated by the hospital or health system providing services for which a
facility fee is charged, billed, or collected:
new text end
new text begin
(1) the name and full address of each facility;
new text end
new text begin
(2) the number of patient visits at each facility; and
new text end
new text begin
(3) the number, total amount, and range of allowable facility fees paid at each facility
by Medicare, medical assistance, MinnesotaCare, and private insurance.
new text end
new text begin
(c) The report under this subdivision must include the following information for the
entire hospital or health system:
new text end
new text begin
(1) the total amount charged and billed for facility fees;
new text end
new text begin
(2) the total amount collected from facility fees;
new text end
new text begin
(3) the top ten procedures or services provided by the hospital or health system that
generated the greatest amount of facility fee gross revenue, the volume of each of these ten
procedures or services and the gross and net revenue totals for each procedure or service,
and the total net amount of revenue received by the hospital or health system derived from
facility fees;
new text end
new text begin
(4) the top ten procedures or services, based on patient volume, provided by the hospital
or health system for which facility fees are charged, billed, or collected, based on patient
volume, including the gross and net revenue totals received for each such procedure or
service; and
new text end
new text begin
(5) any other information related to facility fees that the commissioner of health may
require.
new text end
new text begin Subd. 6. new text end
new text begin Interaction with medical assistance. new text end
new text begin
The medical assistance program in chapter
256B is not required to comply with any provision of this section if compliance with the
provision would:
new text end
new text begin
(1) prevent the state from receiving federal financial participation for medical assistance
coverage; or
new text end
new text begin
(2) result in a lower level of coverage or reduced access to coverage for medical assistance
enrollees.
new text end
new text begin Subd. 7. new text end
new text begin Enforcement. new text end
new text begin
(a) A violation of this section is an unlawful business practice
for purposes of section 8.31. The attorney general may enforce this section pursuant to
section 8.31.
new text end
new text begin
(b) In addition to penalties provided in paragraph (a), the commissioner of health may,
pursuant to the procedures in sections 144.99 and 144.991, impose an administrative penalty
on a health care provider for failure to comply with subdivision 6. The penalty must not
exceed $1,000 per occurrence.
new text end
new text begin
(c) The commissioner of health or the commissioner's designee may audit any health
care provider for compliance with the requirements of this section. A health care provider
must make available, upon written request of the commissioner or the commissioner's
designee, copies of any books, documents, records, or data that are necessary for the purposes
of completing the audit for four years after the furnishing of any services for which a facility
fee was charged, billed, or collected.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, except that subdivision
2 is effective January 1, 2027.
new text end
Sec. 4.
Minnesota Statutes 2024, section 62U.04, is amended by adding a subdivision to
read:
new text begin Subd. 14. new text end
new text begin Unique NPI. new text end
new text begin
Data submitted under this section relating to a provider-based
clinic, as defined in section 62J.8241, and that includes an NPI, as defined in section
62J.8241, must include the provider-based clinic's unique NPI that is distinct from the
hospital's NPI.
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. 5.
Minnesota Statutes 2024, section 103I.101, subdivision 6, is amended to read:
Subd. 6.
Fees for variances.
The commissioner shall charge a nonrefundable application
fee of deleted text begin $275deleted text end new text begin $325new text end to cover the deleted text begin administrativedeleted text end cost of processing a request for a variance or
modification of rules adopted by the commissioner under this chapter.
Sec. 6.
Minnesota Statutes 2024, section 103I.208, subdivision 1, is amended to read:
Subdivision 1.
Well notification fee.
The well notification fee to be paid by a property
owner is:
(1) for construction of a water supply well, deleted text begin $275deleted text end new text begin $325new text end , which includes the state core
function fee;
(2) for a well sealing, deleted text begin $75deleted text end new text begin $125new text end for each well or temporary boring, which includes the
state core function fee, except that: (i) a single notification and fee of deleted text begin $75deleted text end new text begin $125new text end is required
for all temporary borings on a single property and sealed within 72 hours of start of
construction; and (ii) temporary borings less than 25 feet in depth are exempt from the
notification and fee requirements in this chapter;
(3) for construction of a dewatering well, deleted text begin $275deleted text end new text begin $330new text end , which includes the state core
function fee, for each dewatering wellnew text begin ,new text end except a dewatering project comprising five or more
dewatering wells shall be assessed a single fee of deleted text begin $1,375deleted text end new text begin $1,620new text end for the dewatering wells
recorded on the notification; and
(4) for construction of an environmental well, deleted text begin $275deleted text end new text begin $330new text end , which includes the state core
function fee, deleted text begin except that a single fee of $275 is required for all environmental wells recorded
on the notification that are located on a single property, and except that no fee is required
for construction of a temporary boringdeleted text end new text begin for each environmental well, except an environmental
well site project comprising five or more environmental wells shall be assessed a single fee
of $1,620 for the environmental wells recorded on the notificationnew text end .
Sec. 7.
Minnesota Statutes 2024, section 103I.208, subdivision 1a, is amended to read:
Subd. 1a.
State core function fee.
The state core function fee to be collected by the
state and delegated community health boards and used to support state core functions is:
(1) for a new well, deleted text begin $20deleted text end new text begin $40new text end ; and
(2) for a well sealing, deleted text begin $5deleted text end new text begin $15new text end .
Sec. 8.
Minnesota Statutes 2024, section 103I.208, subdivision 2, is amended to read:
Subd. 2.
Permit fee.
new text begin (a) new text end The permit fee to be paid by a property owner is:
(1) for a water supply well that is not in use under a maintenance permit, deleted text begin $175deleted text end new text begin $225new text end
annually;
(2) for an environmental well that is unsealed under a maintenance permit, deleted text begin $175 annually
exceptdeleted text end no fee is required for an environmental well owned by a federal agency, state agency,
or local unit of government that is unsealed under a maintenance permit. "Local unit of
government" means a statutory or home rule charter city, town, county, or soil and water
conservation district, new text begin a new text end watershed district, an organization formed for the joint exercise of
powers under section 471.59, a community health board, or other special purpose district
or authority with local jurisdiction in water and related land resources management;
(3) for environmental wellsnew text begin on an environmental well sitenew text end that are unsealed under a
maintenance permitdeleted text begin ,deleted text end new text begin :
new text end
deleted text begin $175deleted text end new text begin (i) $225new text end annuallynew text begin for one to ten environmental wellsnew text end per site deleted text begin regardless of the
number of environmental wells located on sitedeleted text end ;
new text begin
(ii) $325 annually for 11 to 20 environmental wells per site; and
new text end
new text begin
(iii) $425 annually for 21 or more environmental wells per site;
new text end
(4) for a groundwater thermal exchange device, in addition to the notification fee for
water supply wells, deleted text begin $275deleted text end new text begin $350 for systems using 20 gallons per minute or less and $590
for systems using over 20 gallons per minutenew text end , which includes the state core function fee;
(5) for a bored geothermal heat exchanger with less than ten tons of heating/cooling
capacity, deleted text begin $275deleted text end new text begin $350new text end ;
(6) for a bored geothermal heat exchanger with ten to 50 tons of heating/cooling capacity,
deleted text begin $515deleted text end new text begin $590new text end ;
(7) for a bored geothermal heat exchanger with greater than 50 tons of heating/cooling
capacity, deleted text begin $740deleted text end new text begin $815new text end ;
(8) for a dewatering well that is unsealed under a maintenance permit, deleted text begin $175deleted text end new text begin $330new text end annually
for each dewatering well, except a dewatering project comprising deleted text begin more thandeleted text end fivenew text begin or morenew text end
dewatering wells shall be issued a single permit for deleted text begin $875deleted text end new text begin $1,620new text end annually for dewatering
wells recorded on the permit;
(9) for an elevator boring, deleted text begin $275deleted text end new text begin $325new text end for each boring; and
(10) for a submerged closed loop heat exchanger system, in addition to the notification
fee for water supply wells, $3,250, which includes the state core function fee.
new text begin
(b) For purposes of this subdivision, an environmental well site includes all of the
environmental wells on a single property. A single property is considered one tax parcel or
multiple contiguous parcels with the same owner.
new text end
Sec. 9.
Minnesota Statutes 2024, section 103I.235, subdivision 1, is amended to read:
Subdivision 1.
Disclosure of wells to buyer.
(a) Before signing an agreement to sell or
transfer real property, the seller must disclose in writing to the buyer information about the
status and location of all known wells on the property, by delivering to the buyer either a
statement by the seller that the seller does not know of any wells on the property, or a
disclosure statement indicating the legal description and county, and a map drawn from
available information showing the location of each well to the extent practicable. In the
disclosure statement, the seller must indicate, for each well, whether the well is in use, not
in use, or sealed.
(b) At the time of closing of the sale, the disclosure statement information, name and
mailing address of the buyer, and the quartile, section, township, and range in which each
well is located must be provided on a well disclosure certificate signed by the seller or a
person authorized to act on behalf of the seller.
(c) A well disclosure certificate need not be provided if the seller does not know of any
wells on the property and the deed or other instrument of conveyance contains the statement:
"The Seller certifies that the Seller does not know of any wells on the described real
property."
(d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
required by this subdivision shall be signed by the buyer or a person authorized to act on
behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
certificate is not required if the following statement appears on the deed followed by the
signature of the grantee or, if there is more than one grantee, the signature of at least one
of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
described real property." The statement and signature of the grantee may be on the front or
back of the deed or on an attached sheet and an acknowledgment of the statement by the
grantee is not required for the deed to be recordable.
(e) This subdivision does not apply to the sale, exchange, or transfer of real property:
(1) that consists solely of a sale or transfer of severed mineral interests; or
(2) that consists of an individual condominium unit as described in chapters 515 and
515B.
(f) For an area owned in common under chapter 515 or 515B the association or other
responsible person must report to the commissioner by July 1, 1992, the location and status
of all wells in the common area. The association or other responsible person must notify
the commissioner within 30 days of any change in the reported status of wells.
(g) If the seller fails to provide a required well disclosure certificate, the buyer, or a
person authorized to act on behalf of the buyer, may sign a well disclosure certificate based
on the information provided on the disclosure statement required by this section or based
on other available information.
(h) A county recorder or registrar of titles may not record a deed or other instrument of
conveyance dated after October 31, 1990, for which a certificate of value is required under
section 272.115, or any deed or other instrument of conveyance dated after October 31,
1990, from a governmental body exempt from the payment of state deed tax, unless the
deed or other instrument of conveyance contains the statement made in accordance with
paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all the
information required by paragraph (b) or (d). The county recorder or registrar of titles must
not accept a certificate unless it contains all the required information. The county recorder
or registrar of titles shall note on each deed or other instrument of conveyance accompanied
by a well disclosure certificate that the well disclosure certificate was received. The notation
must include the statement "No wells on property" if the disclosure certificate states there
are no wells on the property. The well disclosure certificate shall not be filed or recorded
in the records maintained by the county recorder or registrar of titles. After noting "No wells
on property" on the deed or other instrument of conveyance, the county recorder or registrar
of titles shall destroy or return to the buyer the well disclosure certificate. The county
recorder or registrar of titles shall collect from the buyer or the person seeking to record a
deed or other instrument of conveyance, a fee of deleted text begin $50deleted text end new text begin $54new text end for receipt of a completed well
disclosure certificate. By the tenth day of each month, the county recorder or registrar of
titles shall transmit the well disclosure certificates to the commissioner of health. By the
tenth day after the end of each calendar quarter, the county recorder or registrar of titles
shall transmit to the commissioner of health deleted text begin $42.50deleted text end new text begin $46.50new text end of the fee for each well disclosure
certificate received during the quarter. The commissioner shall maintain the well disclosure
certificate for at least six years. The commissioner may store the certificate as an electronic
image. A copy of that image shall be as valid as the original.
(i) No new well disclosure certificate is required under this subdivision if the buyer or
seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed or
other instrument of conveyance that the status and number of wells on the property have
not changed since the last previously filed well disclosure certificate. The following
statement, if followed by the signature of the person making the statement, is sufficient to
comply with the certification requirement of this paragraph: "I am familiar with the property
described in this instrument and I certify that the status and number of wells on the described
real property have not changed since the last previously filed well disclosure certificate."
The certification and signature may be on the front or back of the deed or on an attached
sheet and an acknowledgment of the statement is not required for the deed or other instrument
of conveyance to be recordable.
(j) The commissioner in consultation with county recorders shall prescribe the form for
a well disclosure certificate and provide well disclosure certificate forms to county recorders
and registrars of titles and other interested persons.
(k) Failure to comply with a requirement of this subdivision does not impair:
(1) the validity of a deed or other instrument of conveyance as between the parties to
the deed or instrument or as to any other person who otherwise would be bound by the deed
or instrument; or
(2) the record, as notice, of any deed or other instrument of conveyance accepted for
filing or recording contrary to the provisions of this subdivision.
Sec. 10.
Minnesota Statutes 2024, section 103I.525, subdivision 2, is amended to read:
Subd. 2.
Certification fee.
(a) The application fee for certification as a representative
of a well contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an application until the
application fee is paid.
(b) The renewal fee for certification as a representative of a well contractor is deleted text begin $75deleted text end new text begin $100new text end .
The commissioner may not renew a certification until the renewal fee is paid.
(c) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
Sec. 11.
Minnesota Statutes 2024, section 103I.525, subdivision 6, is amended to read:
Subd. 6.
License fee.
The fee for a well contractor's license is deleted text begin $250deleted text end new text begin $300new text end .
Sec. 12.
Minnesota Statutes 2024, section 103I.525, subdivision 8, is amended to read:
Subd. 8.
Renewal.
(a) A licensee must file an application and a renewal application fee
to renew the license by the date stated in the license.
(b) The renewal application fee for a well contractor's license is deleted text begin $250deleted text end new text begin $300new text end .
(c) The renewal application must include information that the certified representative
of the applicant has met continuing education requirements established by the commissioner
by rule.
(d) At the time of the renewal, the commissioner must have on file all properly completed
well and boring construction reports, well and boring sealing reports, reports of elevator
borings, water sample analysis reports, well and boring permits, and well notifications for
work conducted by the licensee since the last license renewal.
Sec. 13.
Minnesota Statutes 2024, section 103I.531, subdivision 2, is amended to read:
Subd. 2.
Certification fee.
(a) The application fee for certification as a representative
of a limited well/boring contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an
application until the application fee is paid.
(b) The renewal fee for certification as a representative of a limited well/boring contractor
is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not renew a certification until the renewal fee is paid.
(c) The fee for three or more limited well/boring contractor certifications is deleted text begin $225deleted text end new text begin $275new text end .
(d) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
Sec. 14.
Minnesota Statutes 2024, section 103I.531, subdivision 6, is amended to read:
Subd. 6.
License fee.
The fee for a limited well/boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end .
The fee for three or more limited well/boring contractor licenses is deleted text begin $225deleted text end new text begin $275new text end .
Sec. 15.
Minnesota Statutes 2024, section 103I.531, subdivision 8, is amended to read:
Subd. 8.
Renewal.
(a) A person must file an application and a renewal application fee
to renew the limited well/boring contractor's license by the date stated in the license.
(b) The renewal application fee for a limited well/boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end .
(c) The renewal application must include information that the certified representative
of the applicant has met continuing education requirements established by the commissioner
by rule.
(d) At the time of the renewal, the commissioner must have on file all properly completed
well and boring construction reports, well and boring sealing reports, well and boring
permits, water quality sample reports, and well notifications for work conducted by the
licensee since the last license renewal.
Sec. 16.
Minnesota Statutes 2024, section 103I.535, subdivision 2, is amended to read:
Subd. 2.
Certification fee.
(a) The application fee for certification as a representative
of an elevator boring contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an application
until the application fee is paid.
(b) The renewal fee for certification as a representative of an elevator boring contractor
is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not renew a certification until the renewal fee is paid.
(c) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
Sec. 17.
Minnesota Statutes 2024, section 103I.535, subdivision 6, is amended to read:
Subd. 6.
License fee.
The fee for an elevator boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end .
Sec. 18.
Minnesota Statutes 2024, section 103I.535, subdivision 8, is amended to read:
Subd. 8.
Renewal.
(a) A person must file an application and a renewal application fee
to renew the license by the date stated in the license.
(b) The renewal application fee for an elevator boring contractor's license is deleted text begin $75deleted text end new text begin $100new text end .
(c) The renewal application must include information that the certified representative
of the applicant has met continuing education requirements established by the commissioner
by rule.
(d) At the time of renewal, the commissioner must have on file all reports and permits
for elevator boring work conducted by the licensee since the last license renewal.
Sec. 19.
Minnesota Statutes 2024, section 103I.541, subdivision 2b, is amended to read:
Subd. 2b.
Issuance of license.
If a person employs a certified representative, submits
the bond under subdivision 3, and pays the license fee of deleted text begin $75deleted text end new text begin $100new text end for an environmental
well contractor license, the commissioner shall issue an environmental well contractor
license to the applicant. The fee for an individual registration is deleted text begin $75deleted text end new text begin $100new text end . The commissioner
may not act on an application until the application fee is paid.
Sec. 20.
Minnesota Statutes 2024, section 103I.541, subdivision 2c, is amended to read:
Subd. 2c.
Certification fee.
(a) The application fee for certification as a representative
of an environmental well contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not act on an
application until the application fee is paid.
(b) The renewal fee for certification as a representative of an environmental well
contractor is deleted text begin $75deleted text end new text begin $100new text end . The commissioner may not renew a certification until the renewal
fee is paid.
(c) A certified representative must file an application and a renewal application fee to
renew the certification by the date stated in the certification. The renewal application must
include information that the certified representative has met continuing education
requirements established by the commissioner by rule.
Sec. 21.
Minnesota Statutes 2024, section 103I.541, subdivision 4, is amended to read:
Subd. 4.
License renewal.
(a) A person must file an application and a renewal application
fee to renew the license by the date stated in the license.
(b) The renewal application fee for an environmental well contractor's license is deleted text begin $75deleted text end new text begin
$100new text end .
(c) The renewal application must include information that the certified representative
of the applicant has met continuing education requirements established by the commissioner
by rule.
(d) At the time of the renewal, the commissioner must have on file all well and boring
construction reports, well and boring sealing reports, well permits, and notifications for
work conducted by the licensed person since the last license renewal.
Sec. 22.
Minnesota Statutes 2024, section 103I.545, subdivision 1, is amended to read:
Subdivision 1.
Drilling machine.
(a) A person may not use a drilling machine such as
a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license
under this chapter unless the drilling machine is registered with the commissioner.
(b) A person must apply for the registration on forms prescribed by the commissioner
and submit a deleted text begin $75deleted text end new text begin $125new text end registration fee.
(c) A registration is valid for one year.
Sec. 23.
Minnesota Statutes 2024, section 103I.545, subdivision 2, is amended to read:
Subd. 2.
Hoist.
(a) A person may not use a machine such as a hoist for an activity
requiring a license under this chapter to repair wells or borings, seal wells or borings, or
install pumps unless the machine is registered with the commissioner.
(b) A person must apply for the registration on forms prescribed by the commissioner
and submit a deleted text begin $75deleted text end new text begin $125new text end registration fee.
(c) A registration is valid for one year.
Sec. 24.
Minnesota Statutes 2024, section 103I.601, subdivision 2, is amended to read:
Subd. 2.
License required to make borings.
(a) Except as provided in paragraph (d),
a person must not make an exploratory boring without an explorer's license. The fee for an
explorer's license is deleted text begin $75deleted text end new text begin $100new text end . The explorer's license is valid until the date prescribed in the
license by the commissioner.
(b) A person must file an application and renewal application fee to renew the explorer's
license by the date stated in the license. The renewal application fee is deleted text begin $75deleted text end new text begin $100new text end .
(c) If the licensee submits an application fee after the required renewal date, the licensee:
(1) must include a late fee of $75; and
(2) may not conduct activities authorized by an explorer's license until the renewal
application, renewal application fee, late fee, and sealing reports required in subdivision 9
are submitted.
(d) An explorer must designate a responsible individual to supervise and oversee the
making of exploratory borings.
(1) Before an individual supervises or oversees an exploratory boring, the individual
must file an application and application fee of deleted text begin $75deleted text end new text begin $100new text end to qualify as a certified responsible
individual.
(2) The individual must take and pass an examination relating to construction, location,
and sealing of exploratory borings. A professional engineer or geoscientist licensed under
sections 326.02 to 326.15 or a professional geologist certified by the American Institute of
Professional Geologists is not required to take the examination required in this subdivision,
but must be certified as a responsible individual to supervise an exploratory boring.
(3) The individual must file an application and a renewal fee of deleted text begin $75deleted text end new text begin $100new text end to renew the
responsible individual's certification by the date stated in the certification. If the certified
responsible individual submits an application fee after the renewal date, the certified
responsible individual must include a late fee of $75 and may not supervise or oversee
exploratory borings until the renewal application, application fee, and late fee are submitted.
Sec. 25.
Minnesota Statutes 2024, section 103I.601, subdivision 4, is amended to read:
Subd. 4.
Notification and map of borings.
(a) By ten days before beginning exploratory
boring, an explorer must submit to the commissioner of health a notification of the proposed
boring map and a fee of deleted text begin $275deleted text end new text begin $325 for each boring constructednew text end .
(b) By ten days before beginning exploratory boring, an explorer must submit to the
commissioners of health and natural resources a county road map on a single sheet of paper
that is 8-1/2 by 11 inches in size and having a scale of one-half inch equal to one mile, as
prepared by the Department of Transportation, or a 7.5 minute series topographic map
(1:24,000 scale), as prepared by the United States Geological Survey, showing the location
of each proposed exploratory boring to the nearest estimated 40 acre parcel. Exploratory
boring that is proposed on the map may not be commenced later than 180 days after
submission of the map, unless a new map is submitted.
Sec. 26.
new text begin
[144.063] DEMENTIA SERVICES PROGRAM ESTABLISHED.
new text end
new text begin
The commissioner of health shall establish the dementia services program to:
new text end
new text begin
(1) facilitate the coordination and support of:
new text end
new text begin
(i) state-funded policies and programs that relate to Alzheimer's disease and related
forms of dementia;
new text end
new text begin
(ii) outreach programs and services between state agencies, local public health
departments, Tribal Nations, educational institutions, and community groups for the purpose
of fostering public awareness and education regarding Alzheimer's disease and related forms
of dementia; and
new text end
new text begin
(iii) services and activities between groups that are interested in dementia research,
programs, and services, including area agencies on aging, service providers, advocacy
groups, legal services, emergency personnel, law enforcement, local public health
departments, Tribal Nations, and state colleges and universities;
new text end
new text begin
(2) facilitate the coordination, review, publication, and implementation of and updates
to the Minnesota Dementia Strategic Plan;
new text end
new text begin
(3) use and share data related to the impact of Alzheimer's disease and related forms of
dementia in Minnesota to guide statewide action; and
new text end
new text begin
(4) incorporate early detection and risk reduction strategies into existing department-led
public health programs.
new text end
Sec. 27.
Minnesota Statutes 2024, section 144.064, subdivision 3, is amended to read:
Subd. 3.
Commissioner duties.
(a) The commissioner shall make available to health
care practitioners, women who may become pregnant, expectant parents, and parents of
infants up-to-date and evidence-based information about congenital CMV that has been
reviewed by experts with knowledge of the disease. The information shall include the
following:
(1) the recommendation to consider testing for congenital CMV if the parent or legal
guardian of the infant elected not to have newborn screening performed under section
144.125, the infant failed a newborn hearing screening, or pregnancy history suggests
increased risk for congenital CMV infection;
(2) the incidence of CMV;
(3) the transmission of CMV to pregnant women and women who may become pregnant;
(4) birth defects caused by congenital CMV;
(5) available preventative measures to avoid the infection of women who are pregnant
or may become pregnant; and
(6) resources available for families of children born with congenital CMV.
(b) The commissioner shall follow existing department practice, inclusive of community
engagement, to ensure that the information in paragraph (a) is culturally and linguistically
appropriate for all recipients.
(c) The commissioner shall establish an outreach program to:
(1) educate women who may become pregnant, expectant parents, and parents of infants
about CMV; and
(2) raise awareness for CMV among health care practitioners.
(d) The Advisory Committee on Heritable and Congenital Disorders established under
section 144.1255 shall review congenital CMV for inclusion on the list of tests to be
performed under section 144.125. If the committee recommends and the commissioner
approves the recommendation of adding congenital CMV to the newborn screening panel,
the commissioner shall publish the addition in the State Register and the per specimen fee
for screening under section 144.125, subdivision 1, paragraph (c), shall be increased by
$43deleted text begin , for a total of $220 per specimen,deleted text end effective upon publication in the State Register.
Sec. 28.
Minnesota Statutes 2024, section 144.1205, subdivision 2, is amended to read:
Subd. 2.
Initial and annual fee.
(a) A licensee must pay an initial fee that is equivalent
to the annual fee upon issuance of the initial license.
(b) A licensee must pay an annual fee at least 60 days before the anniversary date of the
issuance of the license. The annual fee is as follows:
| TYPE |
LICENSE FEE |
||
| Academic broad scope - type A, B, or C |
deleted text begin
$25,896 deleted text end new text begin $34,500 new text end |
||
| Academic broad scope - type A, B, or C (4-8 locations) |
deleted text begin
$31,075
deleted text end
new text begin
$41,400 new text end |
||
| Academic broad scope - type A, B, or C (9 or more locations) |
deleted text begin
$36,254 deleted text end new text begin $48,300 new text end |
||
| Medical broad scope - type A |
deleted text begin
$25,896 deleted text end new text begin $34,500 new text end |
||
| Medical broad scope - type A (4-8 locations) |
deleted text begin
$31,075 deleted text end new text begin $41,400 new text end |
||
| Medical broad scope - type A (9 or more locations) |
deleted text begin
$36,254 deleted text end new text begin $48,300 new text end |
||
| Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies |
deleted text begin
$4,784 deleted text end new text begin $6,600 new text end |
||
| Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (4-8 locations) |
deleted text begin
$5,740 deleted text end new text begin $7,900 new text end |
||
| Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies (9 or more locations) |
deleted text begin
$6,697 deleted text end new text begin $9,200 new text end |
||
| Teletherapy |
deleted text begin
$11,648 deleted text end new text begin $15,500 new text end |
||
| Gamma knife |
deleted text begin
$11,648 deleted text end new text begin $15,500 new text end |
||
| Veterinary medicine |
deleted text begin
$2,600 deleted text end new text begin $3,500 new text end |
||
| In vitro testing lab |
deleted text begin
$2,600 deleted text end new text begin $3,500 new text end |
||
| Nuclear pharmacy |
deleted text begin
$11,440 deleted text end new text begin $15,300 new text end |
||
| Nuclear pharmacy (5 or more locations) |
deleted text begin
$13,728 deleted text end new text begin $18,300 new text end |
||
| Radiopharmaceutical distribution (10 CFR 32.72) |
deleted text begin
$4,992 deleted text end new text begin $6,700 new text end |
||
| Radiopharmaceutical processing and distribution (10 CFR 32.72) |
deleted text begin
$11,440 deleted text end new text begin $15,300 new text end |
||
| Radiopharmaceutical processing and distribution (10 CFR 32.72) (5 or more locations) |
deleted text begin
$13,728 deleted text end new text begin $18,300 new text end |
||
| Medical sealed sources - distribution (10 CFR 32.74) |
deleted text begin
$4,992 deleted text end new text begin $6,700 new text end |
||
| Medical sealed sources - processing and distribution (10 CFR 32.74) |
deleted text begin
$11,440 deleted text end new text begin $15,300 new text end |
||
| Medical sealed sources - processing and distribution (10 CFR 32.74) (5 or more locations) |
deleted text begin
$13,728 deleted text end new text begin $18,300 new text end |
||
| Well logging - sealed sources |
deleted text begin
$4,888 deleted text end new text begin $6,600 new text end |
||
| Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) |
deleted text begin
$2,600 deleted text end new text begin $3,800 new text end |
||
| Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (4-8 locations) |
deleted text begin
$3,120 deleted text end new text begin $4,500 new text end |
||
| Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) (9 or more locations) |
deleted text begin
$3,640 deleted text end new text begin $5,200 new text end |
||
| X-ray fluorescent analyzer |
deleted text begin
$1,976 deleted text end new text begin $2,700 new text end |
||
| Manufacturing and distribution - type A broad scope |
deleted text begin
$25,896 deleted text end new text begin $34,500 new text end |
||
| Manufacturing and distribution - type A broad scope (4-8 locations) |
deleted text begin
$31,075 deleted text end new text begin $41,400 new text end |
||
| Manufacturing and distribution - type A broad scope (9 or more locations) |
deleted text begin
$36,254 deleted text end new text begin $48,300 new text end |
||
| Manufacturing and distribution - type B or C broad scope |
deleted text begin
$22,880 deleted text end new text begin $30,500 new text end |
||
| Manufacturing and distribution - type B or C broad scope (4-8 locations) |
deleted text begin
$27,456 deleted text end new text begin $36,600 new text end |
||
| Manufacturing and distribution - type B or C broad scope (9 or more locations) |
deleted text begin
$32,032 deleted text end new text begin $42,700 new text end |
||
| Manufacturing and distribution - other |
deleted text begin
$6,864 deleted text end new text begin $9,200 new text end |
||
| Manufacturing and distribution - other (4-8 locations) |
deleted text begin
$8,236 deleted text end new text begin $11,000 new text end |
||
| Manufacturing and distribution - other (9 or more locations) |
deleted text begin
$9,609 deleted text end new text begin $12,800 new text end |
||
| Nuclear laundry |
deleted text begin
$24,232 deleted text end new text begin $32,300 new text end |
||
| Decontamination services |
deleted text begin
$6,448 deleted text end new text begin $8,600 new text end |
||
| Leak test services only |
deleted text begin
$2,600 deleted text end new text begin $3,500 new text end |
||
| Instrument calibration service only |
deleted text begin
$2,600 deleted text end new text begin $3,500 new text end |
||
| Service, maintenance, installation, source changes, etc. |
deleted text begin
$6,448 deleted text end new text begin $8,600 new text end |
||
| Waste disposal service, prepackaged only |
deleted text begin
$7,800 deleted text end new text begin $10,400 new text end |
||
| Waste disposal |
deleted text begin
$10,816 deleted text end new text begin $14,400 new text end |
||
| Distribution - general licensed devices (sealed sources) |
deleted text begin
$2,288 deleted text end new text begin $3,100 new text end |
||
| Distribution - general licensed material (unsealed sources) |
deleted text begin
$1,456 deleted text end new text begin $2,000 new text end |
||
| Industrial radiography - fixed or temporary location |
deleted text begin
$12,792 deleted text end new text begin $17,200 new text end |
||
| Industrial radiography - fixed or temporary location (5 or more locations) |
deleted text begin
$16,629 deleted text end new text begin $22,300 new text end |
||
| Irradiators, self-shielding |
deleted text begin
$3,744 deleted text end new text begin $5,000 new text end |
||
| Irradiators, other, less than 10,000 curies |
deleted text begin
$6,968 deleted text end new text begin $9,300 new text end |
||
| Research and development - type A, B, or C broad scope |
deleted text begin
$12,376 deleted text end new text begin $16,500 new text end |
||
| Research and development - type A, B, or C broad scope (4-8 locations) |
deleted text begin
$14,851 deleted text end new text begin $19,800 new text end |
||
| Research and development - type A, B, or C broad scope (9 or more locations) |
deleted text begin
$17,326 deleted text end new text begin $23,100 new text end |
||
| Research and development - other |
deleted text begin
$5,824 deleted text end new text begin $7,800 new text end |
||
| Storage - no operations |
deleted text begin
$2,600 deleted text end new text begin $3,500 new text end |
||
| Source material - shielding |
deleted text begin
$759 deleted text end new text begin $1,100 new text end |
||
| Special nuclear material plutonium - neutron source in device |
deleted text begin
$4,784 deleted text end new text begin $6,400 new text end |
||
| Pacemaker by-product and/or special nuclear material - medical (institution) |
deleted text begin
$4,784 deleted text end new text begin $6,400 new text end |
||
| Pacemaker by-product and/or special nuclear material - manufacturing and distribution |
deleted text begin
$6,864 deleted text end new text begin $9,200 new text end |
||
| Accelerator-produced radioactive material |
deleted text begin
$4,992 deleted text end new text begin $6,700 new text end |
||
| Nonprofit educational institutions |
deleted text begin
$500 deleted text end new text begin $700 new text end |
||
Sec. 29.
Minnesota Statutes 2024, section 144.1205, subdivision 4, is amended to read:
Subd. 4.
Initial and renewal application fee.
A licensee must pay an initial and a
renewal application fee according to this subdivision.
| TYPE |
APPLICATION FEE |
||
| Academic broad scope - type A, B, or C |
deleted text begin
$6,808 deleted text end new text begin $9,100 new text end |
||
| Medical broad scope - type A |
deleted text begin
$4,508 deleted text end new text begin $6,000 new text end |
||
| Medical - diagnostic, diagnostic and therapeutic, mobile nuclear medicine, eye applicators, high dose rate afterloaders, and medical therapy emerging technologies |
deleted text begin
$1,748 deleted text end new text begin $2,350 new text end |
||
| Teletherapy |
deleted text begin
$6,348 deleted text end new text begin $8,450 new text end |
||
| Gamma knife |
deleted text begin
$6,348 deleted text end new text begin $8,450 new text end |
||
| Veterinary medicine |
deleted text begin
$1,104 deleted text end new text begin $1,500 new text end |
||
| In vitro testing lab |
deleted text begin
$1,104 deleted text end new text begin $1,500 new text end |
||
| Nuclear pharmacy |
deleted text begin
$5,612 deleted text end new text begin $7,500 new text end |
||
| Radiopharmaceutical distribution (10 CFR 32.72) |
deleted text begin
$2,484 deleted text end new text begin $3,350 new text end |
||
| Radiopharmaceutical processing and distribution (10 CFR 32.72) |
deleted text begin
$5,612 deleted text end new text begin $7,500 new text end |
||
| Medical sealed sources - distribution (10 CFR 32.74) |
deleted text begin
$2,484 deleted text end new text begin $3,350 new text end |
||
| Medical sealed sources - processing and distribution (10 CFR 32.74) |
deleted text begin
$5,612 deleted text end new text begin $7,500 new text end |
||
| Well logging - sealed sources |
deleted text begin
$1,840 deleted text end new text begin $2,450 new text end |
||
| Measuring systems - (fixed gauge, portable gauge, gas chromatograph, other) |
deleted text begin
$1,104 deleted text end new text begin $1,500 new text end |
||
| X-ray fluorescent analyzer |
deleted text begin
$671 deleted text end new text begin $900 new text end |
||
| Manufacturing and distribution - type A, B, and C broad scope |
deleted text begin
$6,854 deleted text end new text begin $9,150 new text end |
||
| Manufacturing and distribution - other |
deleted text begin
$2,668 deleted text end new text begin $3,550 new text end |
||
| Nuclear laundry |
deleted text begin
$11,592 deleted text end new text begin $15,450 new text end |
||
| Decontamination services |
deleted text begin
$3,036 deleted text end new text begin $4,050 new text end |
||
| Leak test services only |
deleted text begin
$1,104 deleted text end new text begin $1,500 new text end |
||
| Instrument calibration service only |
deleted text begin
$1,104 deleted text end new text begin $1,500 new text end |
||
| Service, maintenance, installation, source changes, etc. |
deleted text begin
$3,036 deleted text end new text begin $4,050 new text end |
||
| Waste disposal service, prepackaged only |
deleted text begin
$2,576 deleted text end new text begin $3,450 new text end |
||
| Waste disposal |
deleted text begin
$1,748 deleted text end new text begin $2,350 new text end |
||
| Distribution - general licensed devices (sealed sources) |
deleted text begin
$1,012 deleted text end new text begin $1,350 new text end |
||
| Distribution - general licensed material (unsealed sources) |
deleted text begin
$598 deleted text end new text begin $800 new text end |
||
| Industrial radiography - fixed or temporary location |
deleted text begin
$3,036 deleted text end new text begin $4,050 new text end |
||
| Irradiators, self-shielding |
deleted text begin
$1,656 deleted text end new text begin $2,250 new text end |
||
| Irradiators, other, less than 10,000 curies |
deleted text begin
$3,404 deleted text end new text begin $4,550 new text end |
||
| Research and development - type A, B, or C broad scope |
deleted text begin
$5,704 deleted text end new text begin $7,600 new text end |
||
| Research and development - other |
deleted text begin
$2,760 deleted text end new text begin $3,700 new text end |
||
| Storage - no operations |
deleted text begin
$1,104 deleted text end new text begin $1,500 new text end |
||
| Source material - shielding |
deleted text begin
$156 deleted text end new text begin $250 new text end |
||
| Special nuclear material plutonium - neutron source in device |
deleted text begin
$1,380 deleted text end new text begin $1,850 new text end |
||
| Pacemaker by-product and/or special nuclear material - medical (institution) |
deleted text begin
$1,380 deleted text end new text begin $1,850 new text end |
||
| Pacemaker by-product and/or special nuclear material - manufacturing and distribution |
deleted text begin
$2,668 deleted text end new text begin $3,550 new text end |
||
| Accelerator-produced radioactive material |
deleted text begin
$4,715 deleted text end new text begin $6,300 new text end |
||
| Nonprofit educational institutions |
deleted text begin
$345 deleted text end new text begin $500 new text end |
||
Sec. 30.
Minnesota Statutes 2024, section 144.1205, subdivision 8, is amended to read:
Subd. 8.
Reciprocity fee.
A licensee submitting an application for reciprocal recognition
of a materials license issued by another agreement state or the United States Nuclear
Regulatory Commission for a period of 180 days or less during a calendar year must pay
deleted text begin $2,400deleted text end new text begin $3,200new text end . For a period of 181 days or more, the licensee must obtain a license under
subdivision 4.
Sec. 31.
Minnesota Statutes 2024, section 144.1205, subdivision 9, is amended to read:
Subd. 9.
Fees for license amendments.
A licensee must pay a fee of deleted text begin $600deleted text end new text begin $800new text end to
amend a license as follows:
(1) to amend a license requiring review including, but not limited to, addition of isotopes,
procedure changes, new authorized users, or a new radiation safety officer; or
(2) to amend a license requiring review and a site visit including, but not limited to,
facility move or addition of processes.
Sec. 32.
Minnesota Statutes 2024, section 144.1205, subdivision 10, is amended to read:
Subd. 10.
Fees for general license registrations.
A person required to register generally
licensed devices according to Minnesota Rules, part 4731.3215, must pay an annual
registration fee of deleted text begin $450deleted text end new text begin $600new text end .
Sec. 33.
Minnesota Statutes 2024, section 144.121, subdivision 1a, is amended to read:
Subd. 1a.
Fees for ionizing radiation-producing equipment.
(a) A facility with ionizing
radiation-producing equipment and other sources of ionizing radiation must pay an initial
or annual renewal registration fee consisting of a base facility fee of deleted text begin $100deleted text end new text begin $155new text end and an
additional fee for each x-ray tube, as follows:
| (1) |
medical or veterinary equipment |
$ |
deleted text begin
100
deleted text end
new text begin
130 new text end |
|
| (2) |
dental x-ray equipment |
$ |
deleted text begin
40
deleted text end
new text begin
60 new text end |
|
| (3) |
x-ray equipment not used on humans or animals |
$ |
deleted text begin
100
deleted text end
new text begin
130 new text end |
|
| (4) |
devices with sources of ionizing radiation not used on humans or animals |
$ |
deleted text begin
100
deleted text end
new text begin
130 new text end |
|
| (5) |
security screening system |
$ |
deleted text begin
100
deleted text end
new text begin
160 new text end |
|
|
new text begin
(6) new text end |
new text begin
radiation therapy and accelerator x-ray equipment new text end |
new text begin
$ new text end |
new text begin
1,000 new text end |
|
|
new text begin
(7) new text end |
new text begin
industrial accelerator x-ray equipment new text end |
new text begin
$ new text end |
new text begin
300 new text end |
deleted text begin
(b) A facility with radiation therapy and accelerator equipment must pay an initial or
annual registration fee of $500. A facility with an industrial accelerator must pay an initial
or annual registration fee of $150.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end Electron microscopy equipment is exempt from the registration fee requirements
of this section.
deleted text begin (d)deleted text end new text begin (c)new text end For purposes of this section, a security screening system means ionizing
radiation-producing equipment designed and used for security screening of humans who
are in the custody of a correctional or detention facility, and used by the facility to image
and identify contraband items concealed within or on all sides of a human body. For purposes
of this section, a correctional or detention facility is a facility licensed under section 241.021
and operated by a state agency or political subdivision charged with detection, enforcement,
or incarceration in respect to state criminal and traffic laws.new text begin The commissioner shall adopt
rules to establish requirements for the use of security screening systems. Notwithstanding
section 14.125, the authority to adopt these rules does not expire.
new text end
Sec. 34.
Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
to read:
new text begin Subd. 1e. new text end
new text begin Fee for service provider of ionizing radiation-producing equipment. new text end
new text begin
A
service provider of ionizing radiation-producing equipment and other sources of ionizing
radiation must pay an initial or annual renewal fee of $115.
new text end
Sec. 35.
Minnesota Statutes 2024, section 144.121, subdivision 2, is amended to read:
Subd. 2.
Inspections.
Periodic radiation safety inspections of the x-ray equipment and
other sources of ionizing radiation shall be made by the commissioner of health. The
frequency of safety inspections shall be prescribed by the commissioner deleted text begin on the basis ofdeleted text end new text begin
based onnew text end the deleted text begin frequency ofdeleted text end new text begin radiation exposure risk to occupational and public health fromnew text end
use of deleted text begin thedeleted text end x-ray equipment and other source of ionizing radiationdeleted text begin , provided that each source
shall be inspected at least once every four yearsdeleted text end .
Sec. 36.
Minnesota Statutes 2024, section 144.121, subdivision 5, is amended to read:
Subd. 5.
Examination for individual operating x-ray systems.
(a) An individual in a
facility with x-ray systems for use on living humans that is registered under subdivision 1
may not operate, nor may the facility allow the individual to operate, x-ray systems unless
the individual has passed a national or state examination.
(b) Individuals who may operate x-ray systems include:
(1) an individual who has passed the American Registry of Radiologic Technologists
(ARRT) registry for radiography examination;
(2) an individual who has passed the American Chiropractic Registry of Radiologic
Technologists (ACRRT) registry examination and is limited to radiography of spines and
extremities;
(3) a registered limited scope x-ray operator and a registered bone densitometry equipment
operator who passed the examination requirements in paragraphs (d) and (e) and practices
according to subdivision 5a;
(4) an x-ray operator who has the original certificate or the original letter of passing the
examination that was required before January 1, 2008, under Minnesota Statutes 2008,
section 144.121, subdivision 5a, paragraph (b), clause (1);
(5) an individual who has passed the American Registry of Radiologic Technologists
(ARRT) registry for radiation therapy examination according to subdivision 5e;
(6) a cardiovascular technologist according to subdivision 5c;
(7) a nuclear medicine technologist according to subdivision 5d;
(8) an individual who has passed the examination for a dental hygienist under section
150A.06 and only operates dental x-ray systems;
(9) an individual who has passed the examination for a dental therapist under section
150A.06 and only operates dental x-ray systems;
(10) an individual who has passed the examination for a dental assistant under section
150A.06 and only operates dental x-ray systems;
(11) an individual who has passed the examination under Minnesota Rules, part
deleted text begin 3100.8500, subpart 3deleted text end new text begin 3100.1320new text end , and only operates dental x-ray systems; and
(12) a qualified practitioner who is licensed by a health-related licensing board with
active practice authority and is working within the practitioner's scope of practice.
(c) Except for individuals under clauses (3) and (4), an individual who is participating
in a training or educational program in any of the occupations listed in paragraph (b) is
exempt from the examination requirement within the scope and for the duration of the
training or educational program.
(d) The Minnesota examination for limited scope x-ray operators must include:
(1) radiation protection, radiation physics and radiobiology, equipment operation and
quality assurance, image acquisition and technical evaluation, and patient interactions and
management; and
(2) at least one of the following regions of the human anatomy: chest, extremities, skull
and sinus, spine, or podiatry. The examinations must include the anatomy of, and radiographic
positions and projections for, the specific regions.
(e) The examination for bone densitometry equipment operators must include:
(1) osteoporosis, bone physiology, bone health and patient education, patient preparation,
fundamental principals, biological effects of radiation, units of measurements, radiation
protection in bone densitometry, fundamentals of x-ray production, quality control, measuring
bone mineral testing, determining quality in bone mineral testing, file and database
management; and
(2) dual x-ray absorptiometry scanning of the lumbar spine, proximal femur, and forearm.
The examination must include the anatomy, scan acquisition, and scan analysis for these
three procedures.
(f) A limited scope x-ray operator, and a bone densitometry equipment operator, who
are required to take an examination under this subdivision must submit to the commissioner
a registration application for the examination and a $25 processing fee. The processing fee
shall be deposited in the state treasury and credited to the state government special revenue
fund.
Sec. 37.
Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Service provider practice; service technician. new text end
new text begin
(a) A service technician is a
service provider who performs one or more of the following, including but not limited to:
assembly, installation, calibration, equipment performance evaluation, preventive
maintenance, repair, replacement, or disabling of ionizing radiation-producing equipment
and other sources of ionizing radiation. A service technician may not perform an equipment
performance evaluation on computed tomography, medical cone beam computed tomography,
and fluoroscopy equipment.
new text end
new text begin
(b) In order to provide service technician services, a service provider must register with
the commissioner as a service technician, meet the applicable requirements in Minnesota
Rules, chapter 4732, and pay the fee in subdivision 1e.
new text end
Sec. 38.
Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Service provider practice; vendor. new text end
new text begin
(a) A vendor is a service provider who
performs one or more of the following services, including but not limited to: sales, leasing,
lending, transferring, disposal, or demonstration of ionizing radiation-producing equipment
and other sources of ionizing radiation.
new text end
new text begin
(b) In order to provide vendor services, a service provider must register with the
commissioner as a vendor, meet the applicable requirements in Minnesota Rules, chapter
4732, and pay the fee in subdivision 1e.
new text end
Sec. 39.
Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
to read:
new text begin Subd. 12. new text end
new text begin Service provider practice; qualified medical physicist. new text end
new text begin
(a) A qualified
medical physicist is a service provider who provides medical physics services and must be
certified in diagnostic medical physics, diagnostic radiological physics, radiological physics,
diagnostic imaging physics, or diagnostic radiology physics by the American Board of
Radiology, the American Board of Medical Physics, or the Canadian College of Physicists
in Medicine.
new text end
new text begin
(b) In order to provide medical physics services a service provider must register with
the commissioner as a qualified medical physicist, meet the applicable requirements in
Minnesota Rules, chapter 4732, and pay the fee in subdivision 1e.
new text end
Sec. 40.
Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
to read:
new text begin Subd. 13. new text end
new text begin Service provider practice; qualified expert. new text end
new text begin
(a) A qualified expert is a service
provider who provides expert physics services, and must be certified in the appropriate
fields or specialties in which physics services are provided by the American Board of Health
Physics, the American Board of Medical Physics, the American Board of Radiology, the
American Board of Science in Nuclear Medicine, or the Canadian College of Physicists in
Medicine.
new text end
new text begin
(b) In order to provide health physics services, a service provider must register with the
commissioner as a qualified expert, meet the applicable requirements in Minnesota Rules,
chapter 4732, and pay the fee in subdivision 1e.
new text end
Sec. 41.
Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
to read:
new text begin Subd. 14. new text end
new text begin Service provider practice; physicist assistant. new text end
new text begin
(a) A physicist assistant is a
service provider who provides expert physics or medical physics services under the
supervision of a qualified expert or a qualified medical physicist and must be deemed
competent by a qualified expert or a qualified medical physicist in the appropriate fields or
specialties in which services are provided.
new text end
new text begin
(b) In order to provide health physics or medical physics services under the supervision
of a qualified expert or a qualified medical physicist, a physicist assistant must register with
the commissioner as a physicist assistant, meet the applicable requirements in Minnesota
Rules, chapter 4732, and pay the fee under subdivision 1e.
new text end
new text begin
(c) Supervision as used in this subdivision refers to either personal or general supervision
of a physicist assistant by a qualified expert or a qualified medical physicist according to
Minnesota Rules, chapter 4732.
new text end
Sec. 42.
Minnesota Statutes 2024, section 144.121, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Service provider compliance. new text end
new text begin
A service provider registered with the
commissioner under Minnesota Rules, chapter 4732, must, upon renewal of registration,
comply with the applicable requirements under this section and submit the fee under
subdivision 1e.
new text end
Sec. 43.
Minnesota Statutes 2024, section 144.1215, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Rulemaking authority. new text end
new text begin
The commissioner shall adopt rules to implement this
section. Notwithstanding section 14.125, the authority to adopt these rules does not expire.
new text end
Sec. 44.
Minnesota Statutes 2024, section 144.1222, subdivision 1a, is amended to read:
Subd. 1a.
Fees.
All plans and specifications for public pool and spa construction,
installation, or alteration or requests for a variance that are submitted to the commissioner
according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate
fees. All public pool construction plans submitted for review after January 1, 2009, must
be certified by a professional engineer registered in the state of Minnesota. If the
commissioner determines, upon review of the plans, that inadequate fees were paid, the
necessary additional fees shall be paid before plan approval. For purposes of determining
fees, a project is defined as a proposal to construct or install a public pool, spa, special
purpose pool, or wading pool and all associated water treatment equipment and drains,
gutters, decks, water recreation features, spray pads, and those design and safety features
that are within five feet of any pool or spa.new text begin Plans submitted less than 30 days prior to
construction are subject to 50 percent of the original plan review fee.new text end The commissioner
shall charge the following fees for plan review and inspection of public pools and spas and
for requests for variance from the public pool and spa rules:
(1) each pool, deleted text begin $1,500deleted text end new text begin $1,600new text end ;
(2) each spa pool, deleted text begin $800deleted text end new text begin $900new text end ;
(3) each slide, deleted text begin $600deleted text end new text begin $650new text end ;
(4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses (1),
(2), and (3) or 0.5 percent of the documented estimated project cost to a maximum fee of
$15,000;
(5) alterations to an existing pool without changing the size or configuration of the pool,
deleted text begin $600deleted text end new text begin $700new text end ;
(6) removal or replacement of pool disinfection equipment only, deleted text begin $100deleted text end new text begin $200new text end ; and
(7) request for variance from the public pool and spa rules, deleted text begin $500deleted text end new text begin $550new text end .
Sec. 45.
new text begin
[144.1223] REGISTERED SANITARIANS AND REGISTERED
ENVIRONMENTAL HEALTH SPECIALIST APPLICATION FEES.
new text end
new text begin
(a) Fees to be submitted with initial or renewal applications are as follows:
new text end
new text begin
(1) initial application fee, $55;
new text end
new text begin
(2) biennial renewal application fee, $55; and
new text end
new text begin
(3) penalty for late submission of renewal application, $20, if not renewed by designated
renewal date.
new text end
new text begin
(b) Additionally, a $5 technology fee must be paid with the initial registration or
registration renewal.
new text end
Sec. 46.
Minnesota Statutes 2024, section 144.125, subdivision 1, is amended to read:
Subdivision 1.
Duty to perform testing.
(a) It is the duty of (1) the administrative officer
or other person in charge of each institution caring for infants 28 days or less of age, (2) the
person required in pursuance of the provisions of section 144.215, to register the birth of a
child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have
administered to every infant or child in its care tests for heritable and congenital disorders
according to subdivision 2 and rules prescribed by the state commissioner of health.
(b) Testing, recording of test results, reporting of test results, and follow-up of infants
with heritable congenital disorders, including hearing loss detected through the early hearing
detection and intervention program in section 144.966, shall be performed at the times and
in the manner prescribed by the commissioner of health.
(c) The fee to support the newborn screening program, including tests administered
under this section and section 144.966, shall be deleted text begin $177deleted text end new text begin $184new text end per specimen. This fee amount
shall be deposited in the state treasury and credited to the state government special revenue
fund.
(d) The fee to offset the cost of the support services provided under section 144.966,
subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
and credited to the general fund.
Sec. 47.
Minnesota Statutes 2024, section 144.125, subdivision 2, is amended to read:
Subd. 2.
Determination of tests to be administered.
new text begin (a) new text end The commissioner shall
periodically revise the list of tests to be administered for determining the presence of a
heritable or congenital disorder. Revisions to the list shall reflect advances in medical
science, new and improved testing methods, or other factors that will improve the public
health. In determining whether a test must be administered, the commissioner shall take
into consideration the adequacy of analytical methods to detect the heritable or congenital
disorder, the ability to treat or prevent medical conditions caused by the heritable or
congenital disorder, and the severity of the medical conditions caused by the heritable or
congenital disorder. The list of tests to be performed may be revised if the changes are
recommended by the advisory committee established under section 144.1255, approved by
the commissioner, and published in the State Register. The revision is exempt from the
rulemaking requirements in chapter 14, and sections 14.385 and 14.386 do not apply.
new text begin
(b) The commissioner shall revise the list of tests to be administered for determining
the presence of a heritable or congenital disorder to include metachromatic leukodystrophy
(MLD).
new text end
Sec. 48.
Minnesota Statutes 2024, section 144.3831, subdivision 1, is amended to read:
Subdivision 1.
Fee setting.
The commissioner of health may assess an annual fee of
deleted text begin $9.72deleted text end new text begin $15.22new text end for every service connection to a public water supply that is owned or operated
by a home rule charter city, a statutory city, a city of the first class, or a town. The
commissioner of health may also assess an annual fee for every service connection served
by a water user district defined in section 110A.02.
Sec. 49.
Minnesota Statutes 2024, section 144.55, subdivision 1a, is amended to read:
Subd. 1a.
License fee.
The annual license fee for outpatient surgical centers is deleted text begin $1,512deleted text end new text begin
$1,966new text end .
Sec. 50.
Minnesota Statutes 2024, section 144.554, is amended to read:
144.554 HEALTH FACILITIES CONSTRUCTION PLAN SUBMITTAL AND
FEES.
For hospitals, nursing homes,new text begin assisted living facilities,new text end boarding care homes, residential
hospices, supervised living facilities, freestanding outpatient surgical centers, and end-stage
renal disease facilities, the commissioner shall collect a fee for the review and approval of
architectural, mechanical, and electrical plans and specifications submitted before
construction begins for each project relative to construction of new buildings, additions to
existing buildings, or remodeling or alterations of existing buildings. All fees collected in
this section shall be deposited in the state treasury and credited to the state government
special revenue fund. Fees must be paid at the time of submission of final plans for review
and are not refundable. The fee is calculated as follows:
| Construction project total estimated cost |
Fee |
| $0 - $10,000 |
deleted text begin
$30
deleted text end
new text begin
$45 new text end |
| $10,001 - $50,000 |
deleted text begin
$150
deleted text end
new text begin
$225 new text end |
| $50,001 - $100,000 |
deleted text begin
$300
deleted text end
new text begin
$450 new text end |
| $100,001 - $150,000 |
deleted text begin
$450
deleted text end
new text begin
$675 new text end |
| $150,001 - $200,000 |
deleted text begin
$600
deleted text end
new text begin
$900 new text end |
| $200,001 - $250,000 |
deleted text begin
$750
deleted text end
new text begin
$1,125 new text end |
| $250,001 - $300,000 |
deleted text begin
$900
deleted text end
new text begin
$1,350 new text end |
| $300,001 - $350,000 |
deleted text begin
$1,050
deleted text end
new text begin
$1,575 new text end |
| $350,001 - $400,000 |
deleted text begin
$1,200
deleted text end
new text begin
$1,800 new text end |
| $400,001 - $450,000 |
deleted text begin
$1,350
deleted text end
new text begin
$2,025 new text end |
| $450,001 - $500,000 |
deleted text begin
$1,500
deleted text end
new text begin
$2,250 new text end |
| $500,001 - $550,000 |
deleted text begin
$1,650
deleted text end
new text begin
$2,475 new text end |
| $550,001 - $600,000 |
deleted text begin
$1,800
deleted text end
new text begin
$2,700 new text end |
| $600,001 - $650,000 |
deleted text begin
$1,950
deleted text end
new text begin
$2,925 new text end |
| $650,001 - $700,000 |
deleted text begin
$2,100
deleted text end
new text begin
$3,150 new text end |
| $700,001 - $750,000 |
deleted text begin
$2,250
deleted text end
new text begin
$3,375 new text end |
| $750,001 - $800,000 |
deleted text begin
$2,400
deleted text end
new text begin
$3,600 new text end |
| $800,001 - $850,000 |
deleted text begin
$2,550
deleted text end
new text begin
$3,825 new text end |
| $850,001 - $900,000 |
deleted text begin
$2,700
deleted text end
new text begin
$4,050 new text end |
| $900,001 - $950,000 |
deleted text begin
$2,850
deleted text end
new text begin
$4,275 new text end |
| $950,001 - $1,000,000 |
deleted text begin
$3,000
deleted text end
new text begin
$4,500 new text end |
| $1,000,001 - $1,050,000 |
deleted text begin
$3,150
deleted text end
new text begin
$4,725 new text end |
| $1,050,001 - $1,100,000 |
deleted text begin
$3,300
deleted text end
new text begin
$4,950 new text end |
| $1,100,001 - $1,150,000 |
deleted text begin
$3,450
deleted text end
new text begin
$5,175 new text end |
| $1,150,001 - $1,200,000 |
deleted text begin
$3,600
deleted text end
new text begin
$5,400 new text end |
| $1,200,001 - $1,250,000 |
deleted text begin
$3,750
deleted text end
new text begin
$5,625 new text end |
| $1,250,001 - $1,300,000 |
deleted text begin
$3,900
deleted text end
new text begin
$5,850 new text end |
| $1,300,001 - $1,350,000 |
deleted text begin
$4,050
deleted text end
new text begin
$6,075 new text end |
| $1,350,001 - $1,400,000 |
deleted text begin
$4,200
deleted text end
new text begin
$6,300 new text end |
| $1,400,001 - $1,450,000 |
deleted text begin
$4,350
deleted text end
new text begin
$6,525 new text end |
| $1,450,001 - $1,500,000 |
deleted text begin
$4,500
deleted text end
new text begin
$6,750 new text end |
| $1,500,001 deleted text begin and overdeleted text end new text begin - $2,000,000 new text end |
deleted text begin
$4,800
deleted text end
new text begin
$7,200 new text end |
|
new text begin
$2,000,001 - $3,000,000 new text end |
new text begin
$7,650 new text end |
|
new text begin
$3,000,001 - $4,000,000 new text end |
new text begin
$8,100 new text end |
|
new text begin
$4,000,001 - $7,000,000 new text end |
new text begin
$8,550 new text end |
|
new text begin
$7,000,001 - $15,000,000 new text end |
new text begin
$9,000 new text end |
|
new text begin
$15,000,001 - $50,000,000 new text end |
new text begin
$9,450 new text end |
|
new text begin
$50,000,001 and over new text end |
new text begin
$9,900 new text end |
Sec. 51.
Minnesota Statutes 2024, section 144.562, subdivision 2, is amended to read:
Subd. 2.
Eligibility for license condition.
(a) A hospital is not eligible to receive a
license condition for swing beds unless (1) it either has a licensed bed capacity of less than
50 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42,
section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that
were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed
capacity of less than 65 beds and the available nursing homes within 50 miles have had, in
the aggregate, an average occupancy rate of 96 percent or higher in the most recent two
years as documented on the statistical reports to the Department of Health; and (2) it is
located in a rural area as defined in the federal Medicare regulations, Code of Federal
Regulations, title 42, section 482.66.
(b) Except for those critical access hospitals established under section 144.1483, clause
(9), and section 1820 of the federal Social Security Act, United States Code, title 42, section
1395i-4, that have an attached nursing home or that owned a nursing home located in the
same municipality as of May 1, 2005, eligible hospitals are allowed a total number of days
of swing bed use per year as provided in paragraph (c). Critical access hospitals that have
an attached nursing home or that owned a nursing home located in the same municipality
as of May 1, 2005, are allowed swing bed use as provided in federal law.new text begin A critical access
hospital described in section 144.5621 is allowed an unlimited number of days of swing
bed use per year.
new text end
(c) An eligible hospital is allowed a total of 3,000 days of swing bed use in calendar
year 2020. Beginning in calendar year 2021, and for each subsequent calendar year until
calendar year 2027, the total number of days of swing bed use per year is increased by 200
swing bed use days. Beginning in calendar year 2028, an eligible hospital is allowed a total
of 4,500 days of swing bed use per year.
(d) Days of swing bed use for medical care that an eligible hospital has determined are
charity care shall not count toward the applicable limit in paragraph (b) or (c). For purposes
of this paragraph, "charity care" means care that an eligible hospital provided for free or at
a discount to persons who cannot afford to pay and for which the eligible hospital did not
expect payment.
(e) Days of swing bed use for care of a person who has been denied admission to every
Medicare-certified skilled nursing facility within 25 miles of the eligible hospital shall not
count toward the applicable limit in paragraphs (b) and (c). Eligible hospitals must maintain
documentation that they have contacted each skilled nursing facility within 25 miles to
determine if any skilled nursing facility beds are available and if the skilled nursing facilities
are willing to admit the patient. Skilled nursing facilities that are contacted must admit the
patient or deny admission within 24 hours of being contacted by the eligible hospital. Failure
to respond within 24 hours is deemed a denial of admission.
deleted text begin
(f) Except for critical access hospitals that have an attached nursing home or that owned
a nursing home located in the same municipality as of May 1, 2005, the commissioner of
health may approve swing bed use beyond 2,000 days as long as there are no Medicare
certified skilled nursing facility beds available within 25 miles of that hospital that are
willing to admit the patient and the patient agrees to the referral being sent to the skilled
nursing facility. Critical access hospitals exceeding 2,000 swing bed days must maintain
documentation that they have contacted skilled nursing facilities within 25 miles to determine
if any skilled nursing facility beds are available that are willing to admit the patient and the
patient agrees to the referral being sent to the skilled nursing facility. This paragraph expires
January 1, 2020.
deleted text end
deleted text begin
(g) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which
this limit applies may admit six additional patients to swing beds each year without seeking
approval from the commissioner or being in violation of this subdivision. These six swing
bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals
subject to this limit. This paragraph expires January 1, 2020.
deleted text end
deleted text begin
(h) A health care system that is in full compliance with this subdivision may allocate its
total limit of swing bed days among the hospitals within the system, provided that no hospital
in the system without an attached nursing home may exceed 2,000 swing bed days per year.
This paragraph expires January 1, 2020.
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 commissioners of health and human services shall inform the revisor
of statutes when federal approval is obtained.
new text end
Sec. 52.
Minnesota Statutes 2024, section 144.562, subdivision 3, is amended to read:
Subd. 3.
Approval of license condition.
(a) The commissioner of health shall approve
a license condition for swing beds if the hospital meets all of the criteria of this subdivision.
(b) The hospital must meet the eligibility criteria in subdivision 2.
(c) The hospital must be in compliance with the Medicare conditions of participation
for swing beds under Code of Federal Regulations, title 42, section 482.66.
(d)new text begin Except as provided in section 144.5621,new text end the hospital must agree, in writing, to limit
the length of stay of a patient receiving services in a swing bed to not more than 40 days,
or the duration of Medicare eligibility, unless the commissioner of health approves a greater
length of stay in an emergency situation. To determine whether an emergency situation
exists, the commissioner shall require the hospital to provide documentation that continued
services in the swing bed are required by the patient; that no skilled nursing facility beds
are available within 25 miles from the patient's home, or in some more remote facility of
the resident's choice, that can provide the appropriate level of services required by the
patient; and that other alternative services are not available to meet the needs of the patient.
If the commissioner approves a greater length of stay, the hospital shall develop a plan
providing for the discharge of the patient upon the availability of a nursing home bed or
other services that meet the needs of the patient. Permission to extend a patient's length of
stay must be requested by the hospital at least ten days prior to the end of the maximum
length of stay.
(e)new text begin Except as provided in section 144.5621,new text end the hospital must agree, in writing, to limit
admission to a swing bed only to (1) patients who have been hospitalized and not yet
discharged from the facility, or (2) patients who are transferred directly from an acute care
hospital.
(f) The hospital must agree, in writing, to report to the commissioner of health by
December 1, 1985, and annually thereafter, in a manner required by the commissioner (1)
the number of patients readmitted to a swing bed within 60 days of a patient's discharge
from the facility, (2) the hospital's charges for care in a swing bed during the reporting
period with a description of the care provided for the rate charged, and (3) the number of
beds used by the hospital for transitional care and similar subacute inpatient care.
(g) The hospital must agree, in writing, to report statistical data on the utilization of the
swing beds on forms supplied by the commissioner. The data must include the number of
swing beds, the number of admissions to and discharges from swing beds, Medicare
reimbursed patient days, total patient days, and other information required by the
commissioner to assess the utilization of swing beds.
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 commissioners of health and human services shall inform the revisor
of statutes when federal approval is obtained.
new text end
Sec. 53.
new text begin
[144.5621] SWING BED APPROVAL; EXCEPTIONS.
new text end
new text begin
The conditions and limitations in section 144.562, paragraphs (d) and (e), do not apply
to any hospital located in Cook County that:
new text end
new text begin
(1) is designated as a critical access hospital under section 144.1483, clause (9), and
United States Code, title 42, section 1395i-4; and
new text end
new text begin
(2) has an attached nursing home.
new text end
new text begin
Any swing bed located in a hospital described in this section may be used to provide nursing
care without requiring a prior hospital stay. The nursing care provided to a patient in a swing
bed is a covered medical assistance service under section 256B.0625, subdivision 2b.
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 commissioners of health and human services shall inform the revisor
of statutes when federal approval is obtained.
new text end
Sec. 54.
Minnesota Statutes 2024, section 144.563, is amended to read:
144.563 NURSING SERVICES PROVIDED IN A HOSPITAL; PROHIBITED
PRACTICES.
A hospital that has been granted a license condition under section 144.562 new text begin or 144.5621
new text end must not provide to patients not reimbursed by Medicare or medical assistance the types of
services that would be usually and customarily provided and reimbursed under medical
assistance or Medicare as services of a skilled nursing facility or intermediate care facility
for more than 42 days and only for patients who have been hospitalized and no longer require
an acute level of care. Permission to extend a patient's length of stay may be granted by the
commissioner if requested by the physician at least ten days prior to the end of the maximum
length of stay.
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 commissioners of health and human services shall inform the revisor
of statutes when federal approval is obtained.
new text end
Sec. 55.
Minnesota Statutes 2024, section 144E.35, is amended to read:
144E.35 REIMBURSEMENT TO AMBULANCE SERVICES FOR deleted text begin VOLUNTEERdeleted text end
EDUCATION COSTS.
Subdivision 1.
deleted text begin Repayment for volunteerdeleted text end new text begin Reimbursement fornew text end educationnew text begin costs;
ambulance service eligibilitynew text end .
deleted text begin A licensed ambulance service shall be reimbursed by the
director for the necessary expense of the initial education of a volunteer ambulance attendant
upon successful completion by the attendant of an EMT education course, or a continuing
education course for EMT care, or both, which has been approved by the director, pursuant
to section 144E.285deleted text end new text begin (a) Except as provided in subdivision 3, the director must reimburse
all eligible Minnesota licensed ambulance services that apply for reimbursement under this
section for the necessary expenses of initial EMR and EMT education and EMR and EMT
continuing education for ambulance attendants who satisfy the criteria in subdivision 2new text end .
Reimbursement may include tuition, transportation, food, lodging, hourly payment for the
time spent in the education course, and other necessary expenditures, except that in no
instance shall a deleted text begin volunteerdeleted text end new text begin licensednew text end ambulance deleted text begin attendantdeleted text end new text begin servicenew text end be reimbursed more than
deleted text begin $900deleted text end new text begin :
new text end
new text begin (1) $1,200new text end fornew text begin an ambulance attendant'snew text end successful completion of an initial new text begin EMT new text end education
coursedeleted text begin , and $375deleted text end new text begin ;
new text end
new text begin (2) $400new text end fornew text begin an ambulance attendant'snew text end successful completion of deleted text begin adeleted text end new text begin an EMTnew text end continuing
education coursenew text begin ;
new text end
new text begin
(3) $600 for an ambulance attendant's successful completion of an initial EMR education
course; and
new text end
new text begin (4) $200 for an ambulance attendant's successful completion of an EMR continuing
education coursenew text end .
new text begin
(b) To be eligible for reimbursement, a licensed ambulance service must have responded
to 5,000 or fewer calls in the most recent calendar year.
new text end
Subd. 2.
deleted text begin Reimbursement provisionsdeleted text end new text begin Ambulance attendant criterianew text end .
Reimbursement
must be paid under deleted text begin provisions ofdeleted text end this section when documentation is provided to the director
that the deleted text begin individualdeleted text end new text begin ambulance attendant:
new text end
new text begin
(1) successfully completed an initial EMR or EMT education course approved by the
director under section 144E.285, a continuing education course for EMR or EMT care
approved by the director under section 144E.285, or both; and
new text end
new text begin (2) new text end has served for one year from the date of the final certification exam as an active
member of a Minnesota licensed ambulance service.
new text begin Subd. 3. new text end
new text begin Discontinuance of reimbursement. new text end
new text begin
If the state is unable to meet its financial
obligations under subdivision 1 as the obligations become due, the director must discontinue
reimbursing ambulance services for education costs until the state is again able to meet the
financial obligations under subdivision 1 as the obligations become due. An ambulance
service whose application is not approved due to lack of funding may resubmit the application
in the next fiscal year.
new text end
Sec. 56.
new text begin
[144E.38] AMBULANCE SERVICE TRAINING AND STAFFING GRANT
PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
For purposes of this section, "employee" has the meaning
given in section 181.960, subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Grant program. new text end
new text begin
The director must establish and administer a program to award
grants to eligible ambulance services for certain costs to train ambulance service employees
as emergency medical technicians and staff the ambulance service.
new text end
new text begin Subd. 3. new text end
new text begin Eligible ambulance services. new text end
new text begin
To be eligible for a grant under this section, an
ambulance service must:
new text end
new text begin
(1) be licensed under this chapter; and
new text end
new text begin
(2) in the calendar year prior to the year in which the ambulance service first applies for
a grant under this section, have had at least 50 percent of its staffing provided by emergency
medical technicians.
new text end
new text begin Subd. 4. new text end
new text begin Application. new text end
new text begin
An eligible ambulance service seeking a grant under this section
must apply to the director in a form and manner and according to a timeline specified by
the director. In its application, the eligible ambulance service must specify the number of
individuals it plans to hire using the grant money, the number of employee training hours
it plans to fund using the grant money, and other information required by the director.
new text end
new text begin Subd. 5. new text end
new text begin Allowable uses of grant money; maximum grant amount. new text end
new text begin
(a) An ambulance
service must use grant money awarded under this section only for one or more of the
following:
new text end
new text begin
(1) tuition for employees attending an emergency medical technician (EMT) education
program approved by the director;
new text end
new text begin
(2) employee examination fees for EMT certification;
new text end
new text begin
(3) fees for background studies for new EMT employees; and
new text end
new text begin
(4) incurred wage and benefit costs of employees while attending an EMT education
program or program-related activities. Wage and benefit costs under this clause must be
commensurate with the wages and benefits the ambulance service provides to an entry-level
EMT and must not exceed $26 per hour.
new text end
new text begin
(b) The grant amount awarded to an ambulance service must not exceed the amount
needed for the costs in paragraph (a).
new text end
new text begin Subd. 6. new text end
new text begin Grant program oversight. new text end
new text begin
An ambulance service receiving a grant under this
section must provide the director with information necessary for the director to administer
and evaluate the grant program.
new text end
new text begin Subd. 7. new text end
new text begin Reporting to municipalities. new text end
new text begin
(a) In order to be eligible to receive a grant under
this section, an ambulance service must collect and report to each respective municipality
in the licensee's primary service area prehospital care data for all emergency responses
provided by the licensee within the boundaries of each respective municipality. For purposes
of this subdivision, "municipality" means a city or town.
new text end
new text begin
(b) A licensee must collect and report the following prehospital care data items as
provided in paragraph (a):
new text end
new text begin
(1) total number of emergency ambulance calls;
new text end
new text begin
(2) dispatch reason;
new text end
new text begin
(3) type of emergency service requested for each emergency ambulance call;
new text end
new text begin
(4) response mode to scene;
new text end
new text begin
(5) fee schedule for service;
new text end
new text begin
(6) percent transport disposition;
new text end
new text begin
(7) transport destination;
new text end
new text begin
(8) unit hour utilization by service area; and
new text end
new text begin
(9) mutual aid given and received by municipality.
new text end
new text begin
(c) A licensee must provide the report of prehospital care data of all data items listed in
paragraph (b) to the governing body of the municipality by February 15 of each year.
new text end
Sec. 57.
Minnesota Statutes 2024, section 144G.45, subdivision 6, is amended to read:
Subd. 6.
New construction; plans.
(a) For all new licensure and construction beginning
on or after August 1, 2021, the following must be provided to the commissioner:
(1) architectural and engineering plans and specifications for new construction must be
prepared and signed by architects and engineers who are registered in Minnesota. Final
working drawings and specifications for proposed construction must be submitted to the
commissioner for review and approval;
(2) final architectural plans and specifications must include elevations and sections
through the building showing types of construction, and must indicate dimensions and
assignments of rooms and areas, room finishes, door types and hardware, elevations and
details of nurses' work areas, utility rooms, toilet and bathing areas, and large-scale layouts
of dietary and laundry areas. Plans must show the location of fixed equipment and sections
and details of elevators, chutes, and other conveying systems. Fire walls and smoke partitions
must be indicated. The roof plan must show all mechanical installations. The site plan must
indicate the proposed and existing buildings, topography, roadways, walks and utility service
lines; and
(3) final mechanical and electrical plans and specifications must address the complete
layout and type of all installations, systems, and equipment to be provided. Heating plans
must include heating elements, piping, thermostatic controls, pumps, tanks, heat exchangers,
boilers, breeching, and accessories. Ventilation plans must include room air quantities,
ducts, fire and smoke dampers, exhaust fans, humidifiers, and air handling units. Plumbing
plans must include the fixtures and equipment fixture schedule; water supply and circulating
piping, pumps, tanks, riser diagrams, and building drains; the size, location, and elevation
of water and sewer services; and the building fire protection systems. Electrical plans must
include fixtures and equipment, receptacles, switches, power outlets, circuits, power and
light panels, transformers, and service feeders. Plans must show location of nurse call signals,
cable lines, fire alarm stations, and fire detectors and emergency lighting.
(b) Unless construction is begun within one year after approval of the final working
drawing and specifications, the drawings must be resubmitted for review and approval.
(c) The commissioner must be notified within 30 days before completion of construction
so that the commissioner can make arrangements for a final inspection by the commissioner.
(d) At least one set of complete life safety plans, including changes resulting from
remodeling or alterations, must be kept on file in the facility.
new text begin
(e) For new construction beginning on or after July 1, 2025, the licensee must comply
with section 144.554 to submit applicable construction plans and fees to the commissioner.
new text end
Sec. 58.
new text begin
[145.9231] EPILEPSY AND RELATED SEIZURE DISORDERS; DATA
COLLECTION AND STATE COORDINATION PLAN.
new text end
new text begin Subdivision 1. new text end
new text begin Data collection. new text end
new text begin
The commissioner of health must collect, analyze, and
report data on epilepsy and related seizure disorders in Minnesota. The data must include
number of diagnoses, clinical outcomes, mortality rates, and related population health data
for each calendar year. Deidentified data must be made publicly available.
new text end
new text begin Subd. 2. new text end
new text begin State coordination plan. new text end
new text begin
The commissioner of health must use the data on
epilepsy and seizure disorders to inform statewide efforts and build coordinated systems
and partnerships to support community-led and culturally responsive strategies to ensure
that Minnesotans at risk for or living with epilepsy and seizure disorders and their caregivers
have equitable access to opportunities and resources to support their well-being and quality
of life. The commissioner of health must use the data to identify areas of need and
recommend strategies to address gaps.
new text end
Sec. 59.
Minnesota Statutes 2024, section 151.555, subdivision 6, is amended to read:
Subd. 6.
Standards and procedures for accepting donations of drugs and suppliesnew text begin
and purchasing drugs from licensed wholesalersnew text end .
(a) Notwithstanding any other law or
rule, a donor may donate drugs or medical supplies to the central repository or a local
repository if the drug or supply meets the requirements of this section as determined by a
pharmacist or practitioner who is employed by or under contract with the central repository
or a local repository.
(b) A drug is eligible for donation under the medication repository program if the
following requirements are met:
(1) the drug's expiration date is at least six months after the date the drug was donated.
If a donated drug bears an expiration date that is less than six months from the donation
date, the drug may be accepted and distributed if the drug is in high demand and can be
dispensed for use by a patient before the drug's expiration date;
(2) the drug is in its original, sealed, unopened, tamper-evident packaging that includes
the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging
is unopened;
(3) the drug or the packaging does not have any physical signs of tampering, misbranding,
deterioration, compromised integrity, or adulteration;
(4) the drug does not require storage temperatures other than normal room temperature
as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being
donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located
in Minnesota; and
(5) the drug is not a controlled substance.
(c) A medical supply is eligible for donation under the medication repository program
if the following requirements are met:
(1) the supply has no physical signs of tampering, misbranding, or alteration and there
is no reason to believe it has been adulterated, tampered with, or misbranded;
(2) the supply is in its original, unopened, sealed packaging; and
(3) if the supply bears an expiration date, the date is at least six months later than the
date the supply was donated. If the donated supply bears an expiration date that is less than
six months from the date the supply was donated, the supply may be accepted and distributed
if the supply is in high demand and can be dispensed for use by a patient before the supply's
expiration date.
(d) The board shall develop the medication repository donor form and make it available
on the board's website. Prior to the first donation from a new donor, a central repository or
local repository shall verify and record the following information on the donor form:
(1) the donor's name, address, phone number, and license number, if applicable;
(2) that the donor will only make donations in accordance with the program;
(3) to the best of the donor's knowledge, only drugs or supplies that have been properly
stored under appropriate temperature and humidity conditions will be donated; and
(4) to the best of the donor's knowledge, only drugs or supplies that have never been
opened, used, tampered with, adulterated, or misbranded will be donated.
(e) Notwithstanding any other law or rule, a central repository or a local repository may
receive donated drugs from donors. Donated drugs and supplies may be shipped or delivered
to the premises of the central repository or a local repository, and shall be inspected by a
pharmacist or an authorized practitioner who is employed by or under contract with the
repository and who has been designated by the repository prior to dispensing. A drop box
must not be used to deliver or accept donations.
(f) The central repository and local repository shall maintain a written or electronic
inventory of all drugs and supplies donated to the repository upon acceptance of each drug
or supply. For each drug, the inventory must include the drug's name, strength, quantity,
manufacturer, expiration date, and the date the drug was donated. For each medical supply,
the inventory must include a description of the supply, its manufacturer, the date the supply
was donated, and, if applicable, the supply's brand name and expiration date. The board
may waive the requirement under this paragraph if an entity is under common ownership
or control with a central repository or local repository and either the entity or the repository
maintains an inventory containing all the information required under this paragraph.
new text begin
(g) The central repository may purchase a drug from a wholesaler licensed by the Board
of Pharmacy to fill prescriptions for eligible patients when the repository does not have a
sufficient supply of donated drugs to fill the prescription. The central repository may use
any purchased drugs remaining after filling the prescriptions for which the drugs were
initially purchased to fill other prescriptions. Whenever possible, the repository must use
donated drugs to fill prescriptions.
new text end
Sec. 60.
Minnesota Statutes 2024, section 151.555, subdivision 10, is amended to read:
Subd. 10.
Distribution of donated drugs and supplies.
(a) The central repository and
local repositories may distribute drugs and supplies donated under the medication repository
program to other participating repositories for use pursuant to this program.
(b) A local repository that elects not to dispense donated drugs or supplies new text begin that are
suitable for donation and dispensing new text end must transfer deleted text begin alldeleted text end new text begin thosenew text end donated drugs and supplies to
the central repository. A copy of the donor form that was completed by the original donor
under subdivision 6 must be provided to the central repository at the time of transfer.new text begin A
local repository must dispose of drugs and supplies in its possession that are not suitable
for donation or dispensing pursuant to subdivision 7.
new text end
Sec. 61.
Minnesota Statutes 2024, section 157.16, subdivision 2, is amended to read:
Subd. 2.
License renewal.
Initial and renewal licenses for all food and beverage service
establishments, youth camps, hotels, motels, lodging establishments, public pools, and
resorts shall be issued on an annual basis. Any person who operates a place of business after
the expiration date of a license or without having submitted an application and paid the fee
shall be deemed to have violated the provisions of this chapter and shall be subject to
enforcement action, as provided in the Health Enforcement Consolidation Act, sections
144.989 to 144.993. In addition, a penalty of deleted text begin $60deleted text end new text begin $100new text end shall be added to the total of the
license fee for any food and beverage service establishment operating without a license as
a mobile food unit, a seasonal temporary or seasonal permanent food stand, or a special
event food stand, and a penalty of deleted text begin $120deleted text end new text begin $200new text end shall be added to the total of the license fee
for all restaurants, food carts, hotels, motels, lodging establishments, youth camps, public
pools, and resorts operating without a license for a period of up to 30 days. A late fee of
deleted text begin $360deleted text end new text begin $450new text end shall be added to the license fee for establishments operating more than 30 days
without a license.
Sec. 62.
Minnesota Statutes 2024, section 157.16, subdivision 2a, is amended to read:
Subd. 2a.
Food manager certification.
An applicant for certification or certification
renewal as a food manager must submit to the commissioner a deleted text begin $35deleted text end new text begin $45new text end nonrefundable
certification fee payable to the Department of Health. The commissioner shall issue a
duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant
submits a completed application on a form provided by the commissioner for a duplicate
certificate and pays deleted text begin $20deleted text end new text begin $25new text end to the department for the cost of duplication.new text begin In addition, a $5
technology fee must be paid with the initial certification, certification renewal, or duplicate
certificate application.
new text end
Sec. 63.
Minnesota Statutes 2024, section 157.16, subdivision 3, is amended to read:
Subd. 3.
Establishment fees; definitions.
(a) The following fees are required for food
and beverage service establishments, youth camps, hotels, motels, lodging establishments,
public pools, and resorts licensed under this chapter. Food and beverage service
establishments must pay the highest applicable fee under paragraph (d), clause (1), (2), (3),
or (4). The license fee for new operators previously licensed under this chapter for the same
calendar year is one-half of the appropriate annual license fee, plus any penalty that may
be required. The license fee for operators opening on or after October 1 is one-half of the
appropriate annual license fee, plus any penalty that may be required.
(b) All food and beverage service establishments, except special event food stands, and
all hotels, motels, lodging establishments, public pools, and resorts shall pay an annual base
fee of deleted text begin $165deleted text end new text begin $300new text end .
(c) A special event food stand shall pay a flat fee of deleted text begin $55deleted text end new text begin $75new text end annually. "Special event
food stand" means a fee category where food is prepared or served in conjunction with
celebrations, county fairs, or special events from a special event food stand as defined in
section 157.15.
(d) In addition to the base fee in paragraph (b), each food and beverage service
establishment, other than a special event food stand and a school concession stand, and each
hotel, motel, lodging establishment, public pool, and resort shall pay an additional annual
fee for each fee category, additional food service, or required additional inspection specified
in this paragraph:
(1) Category 1 establishment, deleted text begin $110deleted text end new text begin $185new text end . "Category 1 establishment" means a fee
category that provides one or more of the following items or is one of the listed
establishments or facilities:
(i) serves prepackaged food that is served in the package;
(ii) serves a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
(iii) serves soft drinks, coffee, or nonalcoholic beverages;
(iv) provides cleaning for eating, drinking, or cooking utensils, when the only food
served is prepared off site;
(v) a food establishment where the method of food preparation meets the definition of
a low-risk establishment in section 157.20; or
(vi) operates as a child care facility licensed under section 142B.05 and Minnesota Rules,
chapter 9503.
(2) Category 2 establishment, deleted text begin $245deleted text end new text begin $430new text end . "Category 2 establishment" means an
establishment that is not a Category 1 establishment and is either:
(i) a food establishment where the method of food preparation meets the definition of a
medium-risk establishment in section 157.20; or
(ii) an elementary or secondary school as defined in section 120A.05.
(3) Category 3 establishment, deleted text begin $385deleted text end new text begin $670new text end . "Category 3 establishment" means an
establishment that is not a Category 1 or Category 2 establishment and is either:
(i) a food establishment where the method of food preparation meets the definition of a
high-risk establishment in section 157.20; or
(ii) an establishment where 500 or more meals are prepared per day and served at one
or more separate locations.
(4) Other food and beverage service, including food carts, mobile food units, seasonal
temporary food stands, and seasonal permanent food stands, deleted text begin $85deleted text end new text begin $150new text end .
(5) Lodging per sleeping accommodation unit, deleted text begin $11deleted text end new text begin $15new text end , including hotels, motels, lodging
establishments, and resorts, up to a maximum of deleted text begin $1,100deleted text end new text begin $1,500new text end . "Lodging per sleeping
accommodation unit" means a fee category including the number of guest rooms, cottages,
or other rental units of a hotel, motel, lodging establishment, or resort; or the number of
beds in a dormitory.
(6) First public pool, deleted text begin $355deleted text end new text begin $455new text end ; each additional public pool, deleted text begin $200deleted text end new text begin $300new text end . "Public pool"
means a fee category that has the meaning given in section 144.1222, subdivision 4.
(7) First spa, deleted text begin $200deleted text end new text begin $300new text end ; each additional spa, deleted text begin $110deleted text end new text begin $200new text end . "Spa pool" means a fee category
that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
(8) Private sewer or water, deleted text begin $60deleted text end new text begin $85new text end . "Individual private water" means a fee category
with a water supply other than a community public water supply as defined in Minnesota
Rules, chapter 4720. "Individual private sewer" means a fee category with an individual
sewage treatment system which uses subsurface treatment and disposal.
(9) Additional food service, deleted text begin $175deleted text end new text begin $250new text end . "Additional food service" means a location at
a food service establishment, other than the primary food preparation and service area, used
to prepare or serve beverages or food to the public. Additional food service does not apply
to school concession stands.
(10) Additional inspection fee, deleted text begin $250deleted text end new text begin $350new text end . "Additional inspection fee" means a fee to
conduct the second inspection each year for elementary and secondary education facility
school lunch programs when required by the Richard B. Russell National School Lunch
Act.
(11) HACCP verification, deleted text begin $175deleted text end new text begin $225new text end . "HACCP verification" means an annual fee
category for a business that performs one or more specialized process that requires an
HACCP plan as required in chapter 31 and Minnesota Rules, chapter 4626.
(e) A fee for review of construction plans must accompany the initial license application
for restaurants, hotels, motels, lodging establishments, resorts, seasonal food stands, and
mobile food units.new text begin Plans submitted less than 30 days prior to construction are subject to 50
percent of the original plan review fee.new text end A fee for review of an HACCP plan for specialized
processing must be submitted and approved prior to preparing and serving the specialized
processed food for human consumption. The fees for construction plan reviews and HACCP
plan reviews are as follows:
|
Service Area |
Type |
Fee |
| Food |
category 1 establishment |
deleted text begin
$400
deleted text end
new text begin
$550 new text end |
| category 2 establishment |
deleted text begin
$450
deleted text end
new text begin
$750 new text end |
|
| category 3 food establishment |
deleted text begin
$500
deleted text end
new text begin
$800 new text end |
|
| additional food service |
deleted text begin
$250
deleted text end
new text begin
$400 new text end |
|
| HACCP Plan Review |
deleted text begin
$500
deleted text end
new text begin
$600 new text end |
|
| Transient food service |
food cart |
deleted text begin
$250
deleted text end
new text begin
$500 new text end |
| seasonal permanent food stand |
deleted text begin
$250
deleted text end
new text begin
$500 new text end |
|
| seasonal temporary food stand |
deleted text begin
$250
deleted text end
new text begin
$500 new text end |
|
| mobile food unit |
deleted text begin
$350
deleted text end
new text begin
$700 new text end |
|
| Lodging |
less than 25 rooms |
deleted text begin
$375
deleted text end
new text begin
$450 new text end |
| 25 to less than 100 rooms |
deleted text begin
$400
deleted text end
new text begin
$500 new text end |
|
| 100 rooms or more |
deleted text begin
$500
deleted text end
new text begin
$600 new text end |
|
| less than five cabins |
deleted text begin
$350
deleted text end
new text begin
$400 new text end |
|
| five to less than ten cabins |
deleted text begin
$400
deleted text end
new text begin
$450 new text end |
|
| ten cabins or more |
deleted text begin
$450
deleted text end
new text begin
$500 new text end |
(f) When existing food and beverage service establishments, hotels, motels, lodging
establishments, resorts, seasonal food stands, and mobile food units are extensively
remodeled, a fee must be submitted with the remodeling plans. The fee for this construction
plan review is as follows:
|
Service Area |
Type |
Fee |
| Food |
category 1 establishment |
deleted text begin
$300
deleted text end
new text begin
$450 new text end |
| category 2 establishment |
deleted text begin
$350
deleted text end
new text begin
$500 new text end |
|
| category 3 establishment |
deleted text begin
$400
deleted text end
new text begin
$550 new text end |
|
| additional food service |
deleted text begin
$250
deleted text end
new text begin
$400 new text end |
|
| Transient food service |
food cart |
deleted text begin
$250
deleted text end
new text begin
$400 new text end |
| seasonal permanent food stand |
deleted text begin
$250
deleted text end
new text begin
$400 new text end |
|
| seasonal temporary food stand |
deleted text begin
$250
deleted text end
new text begin
$400 new text end |
|
| mobile food unit |
deleted text begin
$250
deleted text end
new text begin
$400 new text end |
|
| Lodging |
less than 25 rooms |
deleted text begin
$250
deleted text end
new text begin
$300 new text end |
| 25 to less than 100 rooms |
deleted text begin
$300
deleted text end
new text begin
$350 new text end |
|
| 100 rooms or more |
deleted text begin
$450
deleted text end
new text begin
$500 new text end |
|
| less than five cabins |
deleted text begin
$250
deleted text end
new text begin
$300 new text end |
|
| five to less than ten cabins |
deleted text begin
$350
deleted text end
new text begin
$400 new text end |
|
| ten cabins or more |
deleted text begin
$400
deleted text end
new text begin
$450 new text end |
(g) Special event food stands are not required to submit construction or remodeling plans
for review.
(h) Youth camps shall pay an annual single fee for food and lodging as follows:
(1) camps with up to 99 campers, deleted text begin $325deleted text end new text begin $375new text end ;
(2) camps with 100 to 199 campers, deleted text begin $550deleted text end new text begin $600new text end ; and
(3) camps with 200 or more campers, deleted text begin $750deleted text end new text begin $800new text end .
(i) A youth camp which pays fees under paragraph (d) is not required to pay fees under
paragraph (h).
Sec. 64.
Minnesota Statutes 2024, section 157.16, subdivision 3a, is amended to read:
Subd. 3a.
Statewide hospitality fee.
Every person, firm, or corporation that operates a
licensed boarding establishment, food and beverage service establishment, seasonal temporary
or permanent food stand, special event food stand, mobile food unit, food cart, resort, hotel,
motel, or lodging establishment in Minnesota must submit to the commissioner a deleted text begin $40deleted text end new text begin $50new text end
annual statewide hospitality fee for each licensed activity. The fee for establishments licensed
by the Department of Health is required at the same time the licensure fee is due. For
establishments licensed by local governments, the fee is due by July 1 of each year.
Sec. 65.
Minnesota Statutes 2024, section 157.16, is amended by adding a subdivision to
read:
new text begin Subd. 3b. new text end
new text begin Technology fee. new text end
new text begin
Every food and beverage service establishment, youth camp,
hotel, motel, lodging establishment, public pool, and resort licensed under this chapter must
pay a $5 technology fee for each licensed activity for the initial license and with each
renewal.
new text end
Sec. 66.
Minnesota Statutes 2024, section 256B.0625, subdivision 2, is amended to read:
Subd. 2.
Skilled and intermediate nursing care.
deleted text begin (a)deleted text end Medical assistance covers skilled
nursing home services and services of intermediate care facilities, including training and
habilitation services, as defined in section 252.41, subdivision 3, for persons with
developmental disabilities who are residing in intermediate care facilities for persons with
developmental disabilities. deleted text begin Medical assistance must not be used to pay the costs of nursing
care provided to a patient in a swing bed as defined in section 144.562, unless (1) the facility
in which the swing bed is located is eligible as a sole community provider, as defined in
Code of Federal Regulations, title 42, section 412.92, or the facility is a public hospital
owned by a governmental entity with 15 or fewer licensed acute care beds; (2) the Centers
for Medicare and Medicaid Services approves the necessary state plan amendments; (3) the
patient was screened as provided by law; (4) the patient no longer requires acute care
services; and (5) no nursing home beds are available within 25 miles of the facility. The
commissioner shall exempt a facility from compliance with the sole community provider
requirement in clause (1) if, as of January 1, 2004, the facility had an agreement with the
commissioner to provide medical assistance swing bed services.
deleted text end
deleted text begin
(b) Medical assistance also covers up to ten days of nursing care provided to a patient
in a swing bed if: (1) the patient's physician, advanced practice registered nurse, or physician
assistant certifies that the patient has a terminal illness or condition that is likely to result
in death within 30 days and that moving the patient would not be in the best interests of the
patient and patient's family; (2) no open nursing home beds are available within 25 miles
of the facility; and (3) no open beds are available in any Medicare hospice program within
50 miles of the facility. The daily medical assistance payment for nursing care for the patient
in the swing bed is the statewide average medical assistance skilled nursing care per diem
as computed annually by the commissioner on July 1 of each year.
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 commissioners of health and human services shall inform the revisor
of statutes when federal approval is obtained.
new text end
Sec. 67.
Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 2b. new text end
new text begin Nursing care provided to a patient in a swing bed. new text end
new text begin
(a) Medical assistance
must not be used to pay the costs of nursing care provided to a patient in a swing bed as
defined in section 144.562, unless:
new text end
new text begin
(1) the facility where the swing bed is located is eligible as a sole community provider,
as defined in Code of Federal Regulations, title 42, section 412.92, or the facility is a public
hospital owned by a governmental entity with 15 or fewer licensed acute care beds;
new text end
new text begin
(2) the Centers for Medicare and Medicaid Services approves the necessary state plan
amendments;
new text end
new text begin
(3) the patient was screened as provided by law;
new text end
new text begin
(4) the patient no longer requires acute care services; and
new text end
new text begin
(5) no nursing home beds are available within 25 miles of the facility.
new text end
new text begin
(b) The commissioner shall exempt a facility from compliance with the sole community
provider requirement in paragraph (a), clause (1), if, as of January 1, 2004, the facility had
an agreement with the commissioner to provide medical assistance swing bed services.
new text end
new text begin
(c) Medical assistance also covers up to ten days of nursing care provided to a patient
in a swing bed if:
new text end
new text begin
(1) the patient's physician, advanced practice registered nurse, or physician assistant
certifies that the patient has a terminal illness or condition that is likely to result in death
within 30 days and that moving the patient would not be in the best interests of the patient
and patient's family;
new text end
new text begin
(2) no open nursing home beds are available within 25 miles of the facility; and
new text end
new text begin
(3) no open beds are available in any Medicare hospice program within 50 miles of the
facility.
new text end
new text begin
(d) The commissioner shall exempt any facility described under section 144.5621 from
compliance with the requirements of paragraph (a), clauses (3) and (5), and paragraph (c),
and medical assistance covers an unlimited number of days of nursing care provided to a
patient in a swing bed at a facility described under section 144.5621.
new text end
new text begin
(e) The daily medical assistance payment for nursing care for the patient in the swing
bed is the statewide average medical assistance skilled nursing care per diem as computed
annually by the commissioner on July 1 of each year.
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 commissioners of health and human services shall inform the revisor
of statutes when federal approval is obtained.
new text end
Sec. 68.
Minnesota Statutes 2024, section 256B.692, subdivision 2, is amended to read:
Subd. 2.
Duties of commissioner of health.
(a) Notwithstanding chapters 62D and 62N,
a county that elects to purchase medical assistance in return for a fixed sum without regard
to the frequency or extent of services furnished to any particular enrollee is not required to
obtain a certificate of authority under chapter 62D or 62N. The county board of
commissioners is the governing body of a county-based purchasing program. In a multicounty
arrangement, the governing body is a joint powers board established under section 471.59.
(b) A county that elects to purchase medical assistance services under this section must
satisfy the commissioner of health that the requirements for assurance of consumer protection,
provider protection, and fiscal solvency of chapter 62D, applicable to health maintenance
organizations will be met according to the following schedule:
(1) for a county-based purchasing plan approved on or before June 30, 2008, the plan
must have in reserve:
(i) at least 50 percent of the minimum amount required under chapter 62D as of January
1, 2010;
(ii) at least 75 percent of the minimum amount required under chapter 62D as of January
1, 2011;
(iii) at least 87.5 percent of the minimum amount required under chapter 62D as of
January 1, 2012; and
(iv) at least 100 percent of the minimum amount required under chapter 62D as of January
1, 2013; and
(2) for a county-based purchasing plan first approved after June 30, 2008, the plan must
have in reserve:
(i) at least 50 percent of the minimum amount required under chapter 62D at the time
the plan begins enrolling enrollees;
(ii) at least 75 percent of the minimum amount required under chapter 62D after the first
full calendar year;
(iii) at least 87.5 percent of the minimum amount required under chapter 62D after the
second full calendar year; and
(iv) at least 100 percent of the minimum amount required under chapter 62D after the
third full calendar year.
(c) Until a plan is required to have reserves equaling at least 100 percent of the minimum
amount required under chapter 62D, the plan may demonstrate its ability to cover any losses
by satisfying the requirements of chapter 62N. A county-based purchasing plan must also
assure the commissioner of health that the requirements of sections 62J.041; 62J.48; 62J.71
to 62J.73; all applicable provisions of chapter 62Q, including sections 62Q.075; 62Q.1055;
62Q.106; 62Q.12; 62Q.135; 62Q.14; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47;
62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.
(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62N,
and 62Q are hereby granted to the commissioner of health with respect to counties that
purchase medical assistance services under this section.
(e) The commissioner, in consultation with county government, shall develop
administrative and financial reporting requirements for county-based purchasing programs
relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31,
and other sections as necessary, that are specific to county administrative, accounting, and
reporting systems and consistent with other statutory requirements of counties.
(f) The commissioner shall collect from a county-based purchasing plan under this
section the following fees:
(1) fees attributable to the costs of audits and other examinations of plan financial
operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800,
subpart 1, item F; and
(2) an annual fee of deleted text begin $21,500deleted text end new text begin $30,000new text end , to be paid by June 15 of each calendar year.
All fees collected under this paragraph shall be deposited in the state government special
revenue fund.
Sec. 69.
Minnesota Statutes 2024, section 256R.01, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin
Payment rates for nursing care provided to a patient in a swing
bed.
new text end
new text begin
Payment rates paid to any hospital for nursing care provided to a patient in a swing
bed must be those rates established pursuant to section 256B.0625, subdivision 2b.
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 commissioners of health and human services shall inform the revisor
of statutes when federal approval is obtained.
new text end
Sec. 70.
Minnesota Statutes 2024, section 326.72, subdivision 1, is amended to read:
Subdivision 1.
When license required.
deleted text begin
A person within the state intending to directly
perform or cause to be performed through subcontracting or similar delegation any
asbestos-related work either for financial gain or with respect to the person's own property
shall first apply for and obtain a license from the commissioner. The license shall be in
writing, be dated when issued, contain an expiration date, be signed by the commissioner,
and give the name and address of the person to whom it is issued.
deleted text end
deleted text begin
The domiciled owner of a single family residence is not required to hold a license or
pay a project permit fee to conduct asbestos-related work in the domiciled residence.
deleted text end
new text begin
Any person performing any asbestos-related work within the state must be licensed by
the commissioner, whether directly performing asbestos work or causing it to be performed
through subcontracting or similar delegation. A domiciled owner of a single-family residence
is not required to hold a license or pay a project permit fee to conduct asbestos-related work
in the domiciled residence.
new text end
Sec. 71.
Minnesota Statutes 2024, section 326.75, subdivision 3, is amended to read:
Subd. 3.
Permit fee.
Five calendar days before beginning asbestos-related work, a person
shall pay a project permit fee to the commissioner equal to deleted text begin twodeleted text end new text begin threenew text end percent of the total
costs of the asbestos-related work. For asbestos-related work performed in single or
multifamily residences, of greater than ten but less than 260 linear feet of asbestos-containing
material on pipes, or greater than six but less than 160 square feet of asbestos-containing
material on other facility components, a person shall pay a project permit fee of $35 to the
commissioner.
Sec. 72.
Minnesota Statutes 2024, section 326.75, subdivision 3a, is amended to read:
Subd. 3a.
Asbestos-related training course permit fee.
deleted text begin The commissioner shall establish
by rule a permit fee to be paid bydeleted text end A training course providernew text begin shall pay the commissioner a
fee of $500new text end on application for a training course permit deleted text begin ordeleted text end new text begin and $250 for thenew text end renewal of a
permit of each asbestos-related training course required for certification or registration.
Sec. 73.
Minnesota Statutes 2024, section 327.15, subdivision 2, is amended to read:
Subd. 2.
License renewal.
Initial and renewal licenses for all manufactured home parks
and recreational camping areas shall be issued annually and shall have an expiration date
included on the license. Any person who operates a manufactured home park or recreational
camping area after the expiration date of a license or without having submitted an application
and paid the fee shall be deemed to have violated the provisions of this chapter and shall
be subject to enforcement action, as provided in the Health Enforcement Consolidation Act,
sections 144.989 to 144.993. In addition, a penalty of deleted text begin $120deleted text end new text begin $200new text end shall be added to the total
of the license fee for any manufactured home park or recreational camping area operating
without a license for a period of up to 30 days. A late fee of deleted text begin $360deleted text end new text begin $450new text end shall be added to
the license fee for any manufactured home park or recreational camping area operating
more than 30 days without a license.
Sec. 74.
Minnesota Statutes 2024, section 327.15, subdivision 3, is amended to read:
Subd. 3.
Fees, manufactured home parks and recreational camping areas.
(a) The
following fees are required for manufactured home parks and recreational camping areas
licensed under this chapter. Fees collected under this section shall be deposited in the state
government special revenue fund. Recreational camping areas and manufactured home
parks shall pay the highest applicable base fee under paragraph (b). The license fee for new
operators of a manufactured home park or recreational camping area previously licensed
under this chapter for the same calendar year is one-half of the appropriate annual license
fee, plus any penalty that may be required. The license fee for operators opening on or after
October 1 is one-half of the appropriate annual license fee, plus any penalty that may be
required.
(b) All manufactured home parks and recreational camping areas shall pay the following
annual base fee:
(1) a manufactured home park, deleted text begin $165deleted text end new text begin $280new text end ; and
(2) a recreational camping area with:
(i) 24 or less sites, deleted text begin $55deleted text end new text begin $100new text end ;
(ii) 25 to 99 sites, deleted text begin $230deleted text end new text begin $410new text end ; and
(iii) 100 or more sites, deleted text begin $330deleted text end new text begin $610new text end .
In addition to the base fee, manufactured home parks and recreational camping areas shall
pay deleted text begin $5deleted text end new text begin $8new text end for each licensed site. This paragraph does not apply to special event recreational
camping areas. Operators of a manufactured home park or a recreational camping area also
licensed under section 157.16 for the same location shall pay only one base fee, whichever
is the highest of the base fees found in this section or section 157.16.
(c) In addition to the fee in paragraph (b), each manufactured home park or recreational
camping area shall pay an additional annual fee for each fee category specified in this
paragraph:
(1) Manufactured home parks and recreational camping areas with public swimming
pools and spas shall pay the appropriate fees specified in section 157.16.
(2) Individual private sewer or water, deleted text begin $60deleted text end new text begin $85new text end . "Individual private water" means a fee
category with a water supply other than a community public water supply as defined in
Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with a
subsurface sewage treatment system which uses subsurface treatment and disposal.
(d) The following fees must accompany a plan review application for initial construction
of a manufactured home park or recreational camping area:
(1) for initial construction of less than 25 sites, deleted text begin $375deleted text end new text begin $400new text end ;
(2) for initial construction of 25 to 99 sites, deleted text begin $400deleted text end new text begin $425new text end ; and
(3) for initial construction of 100 or more sites, deleted text begin $500deleted text end new text begin $525new text end .
(e) The following fees must accompany a plan review application when an existing
manufactured home park or recreational camping area is expanded:
(1) for expansion of less than 25 sites, deleted text begin $250deleted text end new text begin $300new text end ;
(2) for expansion of 25 to 99 sites, deleted text begin $300deleted text end new text begin $350new text end ; and
(3) for expansion of 100 or more sites, deleted text begin $450deleted text end new text begin $500new text end .
Sec. 75.
Minnesota Statutes 2024, section 327.15, subdivision 4, is amended to read:
Subd. 4.
Fees, special event recreational camping areas.
(a) The following fees are
required for special event recreational camping areas licensed under this chapter.
(b) All special event recreational camping areas shall pay an annual fee of deleted text begin $150deleted text end new text begin $250new text end
plus deleted text begin $1deleted text end new text begin $4new text end for each licensed site.
(c) A special event recreational camping area shall pay a late fee of deleted text begin $360deleted text end new text begin $450new text end for failing
to obtain a license prior to operating.
(d) The following fees must accompany a plan review application for initial construction
of a special event recreational camping area:
(1) for initial construction of less than 25 special event recreational camping sites, deleted text begin $375deleted text end new text begin
$475new text end ;
(2) for initial construction of 25 to 99 sites, deleted text begin $400deleted text end new text begin $500new text end ; and
(3) for initial construction of 100 or more sites, deleted text begin $500deleted text end new text begin $600new text end .
(e) The following fees must accompany a plan review application for expansion of a
special event recreational camping area:
(1) for expansion of less than 25 sites, deleted text begin $250deleted text end new text begin $300new text end ;
(2) for expansion of 25 to 99 sites, deleted text begin $300deleted text end new text begin $350new text end ; and
(3) for expansion of 100 or more sites, deleted text begin $450deleted text end new text begin $500new text end .
Sec. 76.
Minnesota Statutes 2024, section 327.15, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Technology fee. new text end
new text begin
All manufactured home parks, recreational camping areas,
and special event camping areas must pay a $5 technology fee at initial licensing and upon
each renewal.
new text end
Sec. 77. new text begin SPOKEN LANGUAGE HEALTH CARE INTERPRETER WORK GROUP.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the following terms have
the meanings given.
new text end
new text begin
(b) "Commissioner" means the commissioner of health.
new text end
new text begin
(c) "Common languages" means the 15 most frequent languages without regard to dialect
in Minnesota.
new text end
new text begin
(d) "Registered interpreter" means a spoken language interpreter who is listed on the
Department of Health's spoken language health care interpreter roster.
new text end
new text begin
(e) "Work group" means the spoken language health care interpreter work group
established in subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Composition. new text end
new text begin
The commissioner shall, after receiving work group candidate
applications, appoint 15 members to the work group consisting of the following members:
new text end
new text begin
(1) three members who are interpreters listed on the Department of Health's spoken
language health care interpreter roster and who are Minnesota residents. Of these members:
(i) each must be an interpreter for a different language; (ii) at least one must have a national
certification credential; and (iii) at least one must have been listed on the roster as an
interpreter in a language other than the common languages and must have completed a
nationally recognized training program for health care interpreters that is, at a minimum,
40 hours in length;
new text end
new text begin
(2) three members representing limited English proficiency (LEP) individuals. Of these
members, two must represent LEP individuals who are not proficient in a common language
and one must represent LEP individuals who are proficient in a language that is not one of
the common languages;
new text end
new text begin
(3) one member representing a health plan company;
new text end
new text begin
(4) one member representing a Minnesota health system who is not an interpreter;
new text end
new text begin
(5) two members representing interpreter agencies, including one member representing
agencies whose main office is located outside the seven-county metropolitan area and one
member representing agencies whose main office is located within the seven-county
metropolitan area;
new text end
new text begin
(6) one member representing the Department of Health;
new text end
new text begin
(7) one member representing the Department of Human Services;
new text end
new text begin
(8) one member representing an interpreter training program or postsecondary educational
institution program providing interpreter courses or skills assessment;
new text end
new text begin
(9) one member who is affiliated with a Minnesota-based or Minnesota chapter of a
national or international organization representing interpreters; and
new text end
new text begin
(10) one member who is a licensed direct care health provider.
new text end
new text begin Subd. 3. new text end
new text begin Duties. new text end
new text begin
The work group must compile a list of recommendations to support
and improve access to the critical health care interpreting services provided across the state,
including but not limited to:
new text end
new text begin
(1) changing requirements for registered and certified interpreters to reflect changing
needs of the Minnesota health care community and emerging national standards of training,
competency, and testing;
new text end
new text begin
(2) addressing barriers for interpreters to gain access to the roster, including barriers to
interpreters of uncommon languages and interpreters in rural areas;
new text end
new text begin
(3) reimbursing spoken language health care interpreting;
new text end
new text begin
(4) identifying gaps in interpreter services in rural areas and recommending ways to
address interpreter training and funding needs;
new text end
new text begin
(5) providing training, certification, and continuing education programs;
new text end
new text begin
(6) convening a meeting of public and private sector representatives of the spoken
language health care interpreters community to identify ongoing sources of financial
assistance to aid individual interpreters in meeting interpreter training and testing registry
requirements;
new text end
new text begin
(7) conducting surveys of people receiving and providing interpreter services to
understand changing needs and consumer quality care; and
new text end
new text begin
(8) suggesting changes in requirements and qualifications on telehealth or remote
interpreting.
new text end
new text begin Subd. 4. new text end
new text begin Compensation; expense reimbursement. new text end
new text begin
Compensation shall be offered to
work group members not being compensated for their participation in work group activities
as part of their existing job duties. Work group members shall be compensated and
reimbursed for expenses for work group activities under section 15.059, subdivision 3.
new text end
new text begin Subd. 5. new text end
new text begin Administrative support; meeting space; meeting facilitation. new text end
new text begin
The
commissioner must provide meeting space and administrative support for the work group.
The commissioner may contract with a neutral independent consultant to provide this
administrative support and to facilitate and lead the meetings of the work group.
new text end
new text begin Subd. 6. new text end
new text begin Deadline for appointments. new text end
new text begin
The commissioner must appoint members to the
work group by August 15, 2025.
new text end
new text begin Subd. 7. new text end
new text begin Expiration. new text end
new text begin
This section expires on November 2, 2026, or upon submission
of the report required under subdivision 9, whichever is earlier.
new text end
new text begin Subd. 8. new text end
new text begin Initial spoken language health care interpreter work group meetings. new text end
new text begin
The
commissioner shall convene the first meeting of the work group by October 1, 2025. Prior
to the first meeting, work group members must receive results from previously conducted
surveys and gather evidence-based research on interpreter services in Minnesota. During
the first meetings, work group members may consult with subject matter experts, including
but not limited to signed language interpreting experts, academic experts with knowledge
of interpreting research, and academic health experts to address specific gaps in spoken
language health care interpreting. The work group shall provide a minimum of two
opportunities for public comment. These opportunities shall be announced with at least four
weeks' notice, with publicity in the five most common languages in Minnesota. Interpreters
for those same languages shall be provided during the public comment opportunities.
new text end
new text begin Subd. 9. new text end
new text begin Report. new text end
new text begin
The commissioner must provide the chairs and ranking minority
members of the legislative committees with jurisdiction over health care interpreter services
with recommendations, including draft legislation and any statutory changes needed to
implement the recommendations, to improve and support access to health care interpreting
services statewide by November 1, 2026.
new text end
Sec. 78. new text begin AFRICAN AMERICAN-FOCUSED HOMEPLACE GRANT PROGRAM.
new text end
new text begin
(a) The commissioner of health must establish a grant program to strengthen and
implement the current model of the African American-focused Homeplace in Hennepin
County. The purpose of the model is to improve access to culturally centered healing and
care during pregnancy and the postpartum period, with the goal of improving maternal and
child health outcomes.
new text end
new text begin
(b) By December 15, 2026, the grantee must submit a report to the commissioner of
health on the implementation and progress of Homeplace in Hennepin County. The report
must outline outcomes achieved and recommendations for future funding and program
expansion.
new text end
Sec. 79. new text begin EMERGENCY AMBULANCE SERVICE GRANTS.
new text end
new text begin Subdivision 1. 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) "Ambulance service" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 3.
new text end
new text begin
(c) "Capital expenses" means expenses that are incurred by a licensed ambulance service
provider for the purchase, improvement, or maintenance of long-term assets to improve the
efficiency or capability of the ambulance services, with an expected useful life of greater
than five years.
new text end
new text begin
(d) "Director" means the director of the Office of Emergency Medical Services.
new text end
new text begin
(e) "EMS responses" means the number of responses provided within a primary service
area during calendar year 2024 by the licensed ambulance service provider designated to
serve the primary service area.
new text end
new text begin
(f) "Licensed ambulance service provider" or "provider" means a natural person,
partnership, association, corporation, Tribal government, or unit of government that possesses
an ambulance service license under Minnesota Statutes, chapter 144E.
new text end
new text begin
(g) "Metropolitan county" means a metropolitan county listed in Minnesota Statutes,
section 473.121, subdivision 4.
new text end
new text begin
(h) "Multiple license holder" means a licensed ambulance service provider, a licensed
ambulance service provider's parent company, a subsidiary of the licensed ambulance service
provider, or a subsidiary of the licensed ambulance service provider's parent company that
collectively holds more than one license.
new text end
new text begin
(i) "Nonexcluded license" means a license that is not excluded under subdivision 3 from
receiving grants under this section.
new text end
new text begin
(j) "Operational expenses" means costs related to personnel expenses, supplies and
equipment, fuel, vehicle maintenance, travel, education, fundraising, and expenses associated
with obtaining advanced life support intercepts.
new text end
new text begin
(k) "Primary service area" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 10.
new text end
new text begin
(l) "Response density" means the quotient of EMS responses divided by the square
mileage of the primary service area.
new text end
new text begin
(m) "Unit of government" means a county, a statutory or home rule charter city, or a
township.
new text end
new text begin Subd. 2. new text end
new text begin Excluded services. new text end
new text begin
The director must exclude EMS responses by a specialized
life support service as described in Minnesota Statutes, section 144E.101, subdivision 9,
when calculating EMS responses, response density, and grant payments under this section.
new text end
new text begin Subd. 3. new text end
new text begin Certain multiple license holders excluded. new text end
new text begin
(a) Except as provided under
paragraph (b), all licenses held by a multiple license holder are ineligible for grant payments
under this section if any license held by a multiple license holder is designated to serve a
primary service area, any portion of which is located within the cities of Duluth, Mankato,
Moorhead, Rochester, or St. Cloud, or a metropolitan county.
new text end
new text begin
(b) For a multiple license holder affiliated with a private, nonprofit adult hospital that
is located in Hennepin County and designated by the commissioner of health as a level I
trauma hospital, only the licenses held by the multiple license holder and located entirely
within one or more metropolitan counties are ineligible for grant payments under this section.
new text end
new text begin Subd. 4. new text end
new text begin Eligibility. new text end
new text begin
A licensed ambulance service provider is eligible for grants under
this section if the licensed ambulance service provider:
new text end
new text begin
(1) possessed a nonexcluded license in calendar year 2023;
new text end
new text begin
(2) continues to operate under the nonexcluded license during calendar year 2025; and
new text end
new text begin
(3) completes the requirements under subdivision 5.
new text end
new text begin Subd. 5. new text end
new text begin Application process. new text end
new text begin
(a) An eligible licensed ambulance service provider may
apply to the director, in the form and manner determined by the director, for a grant under
this section. Applications must be submitted by September 16, 2025. The director may
require an eligible licensed ambulance service provider to submit any information necessary,
including financial statements, to make the calculations under subdivision 6. An eligible
licensed ambulance service provider who applies for a grant under this section must provide
a copy of the application to the executive director of the board by September 16, 2025.
new text end
new text begin
(b) The director must establish a process for verifying the data submitted with applications
under this section. By September 20, 2025, for each eligible licensed ambulance service
provider that applies for a grant under paragraph (a), the director must certify the following
information:
new text end
new text begin
(1) EMS responses by primary service area reported for calendar year 2024;
new text end
new text begin
(2) EMS responses by primary service area reported for calendar year 2024 that were
provided by a specialized life support service;
new text end
new text begin
(3) information necessary to determine the location of each primary service area, including
municipalities served; and
new text end
new text begin
(4) the square mileage of each primary service area as of January 1, 2025.
new text end
new text begin Subd. 6. new text end
new text begin Director calculations. new text end
new text begin
(a) Prior to determining a grant amount for eligible
licensed ambulance service providers, the director must make the calculations in paragraphs
(b) to (d).
new text end
new text begin
(b) The director must determine the amount equal to dividing 20 percent of the amount
appropriated for grant payments under this section equally among all eligible licensed
ambulance service providers who possess at least one nonexcluded license. Eligible licensed
ambulance service providers who possess only one nonexcluded license do not qualify for
a payment under this paragraph if the nonexcluded license has a response density greater
than 30.
new text end
new text begin
(c) For each nonexcluded license with a response density less than or equal to 30 held
by an eligible licensed ambulance service provider, the director must determine the amount
equal to the product of 40 percent of the amount appropriated for grants under this section
multiplied by the quotient of the square mileage of the primary service area served under
the nonexcluded license divided by the total square mileage of all primary service areas
served under nonexcluded licenses.
new text end
new text begin
(d) For each nonexcluded license with a response density less than or equal to 30 held
by an eligible licensed ambulance service provider, the director must determine the amount
equal to the product of 40 percent of the amount appropriated for grants under this section
multiplied by the quotient of the number of points determined under clauses (1) to (4) for
each nonexcluded license with a response density less than or equal to 30 divided by the
total points determined under clauses (1) to (4) for all nonexcluded licenses with a response
density less than or equal to 30 held by eligible licensed ambulance service providers. For
calculations under this paragraph, the director must determine points as follows:
new text end
new text begin
(1) for EMS response one to EMS response 500, a nonexcluded license is awarded ten
points for each EMS response;
new text end
new text begin
(2) for EMS response 501 to EMS response 1,500, a nonexcluded license is awarded
five points for each EMS response;
new text end
new text begin
(3) for EMS response 1,501 to EMS response 2,500, a nonexcluded license is awarded
zero points for each EMS response; and
new text end
new text begin
(4) for EMS response 2,501 and each subsequent EMS response, a nonexcluded license's
points are reduced by two points for each EMS response, except a nonexcluded license's
total awarded points must not be reduced below zero.
new text end
new text begin Subd. 7. new text end
new text begin Grant amount. new text end
new text begin
The director must make a grant award to each eligible licensed
ambulance service provider in the amount equal to the sum of the amounts calculated in
subdivision 6, paragraphs (b) to (d), for each nonexcluded license held by the eligible
licensed ambulance service.
new text end
new text begin Subd. 8. new text end
new text begin Eligible uses. new text end
new text begin
A licensed ambulance service provider must spend grant money
received under this section on operational expenses and capital expenses incurred to provide
ambulance services within the licensed ambulance service provider's primary service area
that is located in Minnesota.
new text end
new text begin Subd. 9. new text end
new text begin Administration. new text end
new text begin
(a) The director must certify the grant amount to each licensed
ambulance service provider by December 1, 2025.
new text end
new text begin
(b) The director must award the full grant amount to each eligible licensed ambulance
service provider by December 26, 2025.
new text end
new text begin
(c) Any money not spent on or encumbered for eligible uses by December 31, 2026,
must be returned to the director.
new text end
new text begin Subd. 10. new text end
new text begin Report. new text end
new text begin
By February 15, 2027, each licensed ambulance service provider that
receives a grant under this section must submit a report to the director and the chairs and
ranking minority members of the legislative committees with jurisdiction over health finance
and policy. The report must include the grant amount that each licensed ambulance service
provider received, the grant amount that was spent on or encumbered for operational
expenses, the grant amount that was spent on or encumbered for capital expenses, and
documentation sufficient to establish that grant money was spent on or encumbered for
eligible uses as defined in subdivision 8. The director may request financial statements or
other information necessary to verify that grants were spent on eligible uses.
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. 80. new text begin RULEMAKING.
new text end
new text begin
The Department of Health must adopt rules using the expedited process under Minnesota
Statutes, section 14.389, to amend certain parts in Minnesota Rules, chapter 4695, to conform
with the changes made in this act.
new text end
Sec. 81. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2024, sections 62J.824; and 103I.550,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, part 4695.2900,
new text end
new text begin
is repealed.
new text end
ARTICLE 2
DEPARTMENT OF HEALTH POLICY
Section 1.
Minnesota Statutes 2024, section 62J.461, subdivision 3, is amended to read:
Subd. 3.
Reporting by covered entities to the commissioner.
(a) Each 340B covered
entity shall report to the commissioner by April 1 of each year the following information
for transactions conducted by the 340B covered entity or on its behalf, and related to its
participation in the federal 340B program for the previous calendar year:
(1) the aggregated acquisition cost for prescription drugs obtained under the 340B
program;
(2) the aggregated payment amount received for drugs obtained under the 340B program
and dispensed or administered to patientsdeleted text begin ;deleted text end new text begin :
new text end
new text begin
(i) that are net of the contracted price for insurance claims payments; and
new text end
new text begin
(ii) that reflect the portion of payment received from grants, cash, or other payment types
that relate to the dispensing or administering of drugs obtained under the 340B program;
new text end
(3) the number of pricing units dispensed or administered for prescription drugs described
in clause (2); and
(4) the aggregated payments made:
(i) to contract pharmacies to dispense drugs obtained under the 340B program;
(ii) to any other entity that is not the covered entity and is not a contract pharmacy for
managing any aspect of the covered entity's 340B program; and
(iii) for deleted text begin alldeleted text end other new text begin internal, direct new text end expenses related to administering the 340B programnew text begin
with a detailed description of the direct costs includednew text end .
The information under clauses (2) and (3) must be reported by payer type, including but
not limited to commercial insurance, medical assistance, MinnesotaCare, and Medicare, in
the form and manner prescribed by the commissioner.
(b) For covered entities that are hospitals, the information required under paragraph (a),
clauses (1) to (3), must also be reported at the national drug code level for the 50 most
frequently dispensed or administered drugs by the facility under the 340B program.
(c) Data submitted to the commissioner under paragraphs (a) and (b) are classified as
nonpublic data, as defined in section 13.02, subdivision 9.
Sec. 2.
Minnesota Statutes 2024, section 62J.461, subdivision 4, is amended to read:
Subd. 4.
Enforcement and exceptions.
(a) Any deleted text begin health caredeleted text end new text begin coverednew text end entity subject to
reporting under this section that fails to provide data in the form and manner prescribed by
the commissioner is subject tonew text begin the levy ofnew text end a fine deleted text begin paid to the commissionerdeleted text end of up to $500 for
each day the data are past due. Any fine levied against the entity under this subdivision is
subject to the contested case and judicial review provisions of sections 14.57 deleted text begin anddeleted text end new text begin tonew text end 14.69.
(b) The commissioner may grant an entity an extension of or exemption from the reporting
obligations under this deleted text begin subdivisiondeleted text end new text begin sectionnew text end , upon a showing of good cause by the entity.
Sec. 3.
Minnesota Statutes 2024, section 62J.461, subdivision 5, is amended to read:
Subd. 5.
Reports to the legislature.
By November 15, 2024, and by November 15 of
each year thereafter, the commissioner shall submit to the chairs and ranking minority
members of the legislative committees with jurisdiction over health care finance and policy,
a report that aggregates the data submitted under subdivision 3, paragraphs (a) and (b). deleted text begin The
following information must be included in the reportdeleted text end For all 340B entities whose net 340B
revenue constitutes a significant share, as determined by the commissioner, of all net 340B
revenue across all 340B covered entities in Minnesotanew text begin , the following information must also
be included in the reportnew text end :
(1) the information submitted under subdivision 2; and
(2) for each 340B entity identified in subdivision 2, that entity's 340B net revenue as
calculated using the data submitted under subdivision 3, paragraph (a), with net revenue
being subdivision 3, paragraph (a), clause (2), less the sum of subdivision 3, paragraph (a),
clauses (1) and (4).
For all other entities, the data in the report must be aggregated to the entity type or groupings
of entity types in a manner that prevents the identification of an individual entity and any
entity's specific data value reported for an individual data element.
Sec. 4.
Minnesota Statutes 2024, section 62J.51, subdivision 19a, is amended to read:
Subd. 19a.
Uniform explanation of benefits deleted text begin documentdeleted text end .
"Uniform explanation of
benefits deleted text begin documentdeleted text end " means new text begin either new text end the document associated with and explaining the details
of a group purchaser's claim adjudication for services renderednew text begin or its electronic equivalent
under section 62J.581new text end , which is sent to a patient.
Sec. 5.
Minnesota Statutes 2024, section 62J.581, is amended to read:
62J.581 STANDARDS FOR MINNESOTA UNIFORM HEALTH CARE
REIMBURSEMENT DOCUMENTS.
Subdivision 1.
Minnesota uniform remittance advice.
All group purchasers shall
provide a uniform claim payment/advice transaction to health care providers when a claim
is adjudicated. The uniform claim payment/advice transaction shall comply with section
62J.536, subdivision 1, paragraph (b), and rules adopted under section 62J.536, subdivision
2.
Subd. 2.
Minnesota uniform explanation of benefits deleted text begin documentdeleted text end .
(a) All group
purchasers shall provide a uniform explanation of benefits deleted text begin documentdeleted text end to health care patients
when an explanation of benefits deleted text begin documentdeleted text end is provided as otherwise required or permitted
by law. The uniform explanation of benefits deleted text begin documentdeleted text end shall comply with the standards
prescribed in this section.
(b) Notwithstanding paragraph (a), this section does not apply to group purchasers not
included as covered entities under United States Code, title 42, sections 1320d to 1320d-8,
as amended from time to time, and the regulations promulgated under those sections.
Subd. 3.
Scope.
For purposes of sections 62J.50 to 62J.61, the deleted text begin uniform claim
payment/advice transaction anddeleted text end uniform explanation of benefits deleted text begin documentdeleted text end format specified
in subdivision 4 shall apply to all health care services delivered by a health care provider
or health care provider organization in Minnesota, regardless of the location of the payer.
Health care services not paid on an individual claims basis, such as capitated payments, are
not included in this section. A health plan company is excluded from the requirements in
deleted text begin subdivisions 1 anddeleted text end new text begin subdivisionnew text end 2 if they comply with section 62A.01, subdivisions 2 and
3.
Subd. 4.
Specifications.
new text begin (a) new text end The uniform explanation of benefits deleted text begin documentdeleted text end shall be
provided by use of a paper document conforming to the specifications in this sectionnew text begin or its
electronic equivalent under paragraph (b)new text end .
new text begin
(b) Group purchasers may make the uniform explanation of benefits available in a version
that can be accessed by health care patients electronically if:
new text end
new text begin
(1) the group purchaser making the uniform explanation of benefits available
electronically provides health care patients the ability to choose whether to receive paper,
electronic, or both paper and electronic versions of their uniform explanation of benefits;
new text end
new text begin
(2) the group purchaser provides clear, readily accessible information and instructions
for the patient to communicate their choice; and
new text end
new text begin
(3) health care patients not responding to the opportunity to make a choice will receive
at a minimum a paper uniform explanation of benefits.
new text end
new text begin (c) new text end The commissioner, after consulting with the Administrative Uniformity Committee,
shall specify the data elements and definitions for the new text begin paper new text end uniform explanation of benefits
deleted text begin documentdeleted text end . deleted text begin The commissioner and the Administrative Uniformity Committee must consult
with the Minnesota Dental Association and Delta Dental Plan of Minnesota before requiring
under this section the use of a paper document for the uniform explanation of benefits
document or the uniform claim payment/advice transaction for dental care services.deleted text end new text begin Any
electronic version of the uniform explanation of benefits must use the same data elements
and definitions as the paper uniform explanation of benefits.
new text end
deleted text begin Subd. 5. deleted text end
deleted text begin Effective date. deleted text end
deleted text begin
The requirements in subdivisions 1 and 2 are effective June 30,
2007. The requirements in subdivisions 1 and 2 apply regardless of when the health care
service was provided to the patient.
deleted text end
Sec. 6.
Minnesota Statutes 2024, section 62J.84, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For purposes of this section, the terms defined in this subdivision
have the meanings given.
(b) "Biosimilar" means a drug that is produced or distributed pursuant to a biologics
license application approved under United States Code, title 42, section 262(K)(3).
(c) "Brand name drug" means a drug that is produced or distributed pursuant to:
(1) a new drug application approved under United States Code, title 21, section 355(c),
except for a generic drug as defined under Code of Federal Regulations, title 42, section
447.502; or
(2) a biologics license application approved under United States Code, title 42, section
262(a)(c).
(d) "Commissioner" means the commissioner of health.
(e) "Generic drug" means a drug that is marketed or distributed pursuant to:
(1) an abbreviated new drug application approved under United States Code, title 21,
section 355(j);
(2) an authorized generic as defined under Code of Federal Regulations, title 42, section
447.502; or
(3) a drug that entered the market the year before 1962 and was not originally marketed
under a new drug application.
(f) "Manufacturer" means a drug manufacturer licensed under section 151.252.
(g) "New prescription drug" or "new drug" means a prescription drug approved for
marketing by the United States Food and Drug Administration (FDA) for which no previous
wholesale acquisition cost has been established for comparison.
(h) "Patient assistance program" means a program that a manufacturer offers to the public
in which a consumer may reduce the consumer's out-of-pocket costs for prescription drugs
by using coupons, discount cards, prepaid gift cards, manufacturer debit cards, or by other
means.
(i) "Prescription drug" or "drug" has the meaning provided in section 151.441, subdivision
8.
(j) "Price" means the wholesale acquisition cost as defined in United States Code, title
42, section 1395w-3a(c)(6)(B).
(k) "30-day supply" means the total daily dosage units of a prescription drug
recommended by the prescribing label approved by the FDA for 30 days. If the
FDA-approved prescribing label includes more than one recommended daily dosage, the
30-day supply is based on the maximum recommended daily dosage on the FDA-approved
prescribing label.
(l) "Course of treatment" means the total dosage of a single prescription for a prescription
drug recommended by the FDA-approved prescribing label. If the FDA-approved prescribing
label includes more than one recommended dosage for a single course of treatment, the
course of treatment is the maximum recommended dosage on the FDA-approved prescribing
label.
(m) "Drug product family" means a group of one or more prescription drugs that share
a unique generic drug description or nontrade name and dosage form.
deleted text begin
(n) "Individual salable unit" means the smallest container of product introduced into
commerce by the manufacturer or repackager that is intended by the manufacturer or
repackager for individual sale to a dispenser.
deleted text end
deleted text begin (o)deleted text end new text begin (n)new text end "National drug code" means the three-segment code maintained by the federal
Food and Drug Administration that includes a labeler code, a product code, and a package
code for a drug product and that has been converted to an 11-digit format consisting of five
digits in the first segment, four digits in the second segment, and two digits in the third
segment. A three-segment code shall be considered converted to an 11-digit format when,
as necessary, at least one "0" has been added to the front of each segment containing less
than the specified number of digits such that each segment contains the specified number
of digits.
deleted text begin (p)deleted text end new text begin (o)new text end "Pharmacy" or "pharmacy provider" means a community/outpatient pharmacy
as defined in Minnesota Rules, part 6800.0100, subpart 2, that is also licensed as a pharmacy
by the Board of Pharmacy under section 151.19.
deleted text begin (q)deleted text end new text begin (p)new text end "Pharmacy benefit manager" or "PBM" means an entity licensed to act as a
pharmacy benefit manager under section 62W.03.
deleted text begin (r)deleted text end new text begin (q)new text end "Pricing unit" means the smallest dispensable amount of a prescription drug
product that could be dispensednew text begin or administerednew text end .
deleted text begin (s)deleted text end new text begin (r)new text end "Rebate" means a discount, chargeback, or other price concession that affects the
price of a prescription drug product, regardless of whether conferred through regular
aggregate payments, on a claim-by-claim basis at the point of sale, as part of retrospective
financial reconciliations, including reconciliations that also reflect other contractual
arrangements, or by any other method. "Rebate" does not mean a bona fide service fee as
defined in Code of Federal Regulations, title 42, section 447.502.
deleted text begin (t)deleted text end new text begin (s)new text end "Reporting entity" means any manufacturer, pharmacy, pharmacy benefit manager,
wholesale drug distributor, or any other entity required to submit data under this section.
deleted text begin (u)deleted text end new text begin (t)new text end "Wholesale drug distributor" or "wholesaler" means an entity thatdeleted text begin :
deleted text end
deleted text begin (1)deleted text end is licensed to act as a wholesale drug distributor under section 151.47deleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(2) distributes prescription drugs, for which it is not the manufacturer, to persons or
entities, or both, other than a consumer or patient in the state.
deleted text end
Sec. 7.
Minnesota Statutes 2024, section 62J.84, subdivision 3, is amended to read:
Subd. 3.
Prescription drug price increases reporting.
(a) Beginning January 1, 2022,
a drug manufacturer must submit to the commissioner the information described in paragraph
(b) for each prescription drug for which the price was $100 or greater for a 30-day supply
or for a course of treatment lasting less than 30 days and:
(1) for brand name drugs where there is an increase of ten percent or greater in the price
over the previous 12-month period or an increase of 16 percent or greater in the price over
the previous 24-month period; and
(2) for generic or biosimilar drugs where there is an increase of 50 percent or greater in
the price over the previous 12-month period.
(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
the commissioner no later than 60 days after the price increase goes into effect, in the form
and manner prescribed by the commissioner, the following information, if applicable:
(1) the description and price of the drug and the net increase, expressed as a percentage,
with the following listed separately:
(i) the national drug code;
(ii) the product name;
(iii) the dosage form;
(iv) the strength; and
(v) the package size;
(2) the factors that contributed to the price increase;
(3) the name of any generic version of the prescription drug available on the market;
new text begin
(4) the year the prescription drug was introduced for sale in the United States;
new text end
deleted text begin (4)deleted text end new text begin (5)new text end the introductory price of the prescription drug when it was introduced for sale in
the United States and the price of the drug on the last day of each of the five calendar years
preceding the price increase;
deleted text begin (5)deleted text end new text begin (6)new text end the direct costs incurred during the previous 12-month period by the manufacturer
that are associated with the prescription drug, listed separately:
(i) to manufacture the prescription drug;
(ii) to market the prescription drug, including advertising costs; and
(iii) to distribute the prescription drug;
new text begin
(7) the number of units of the prescription drug sold during the previous 12-month period;
new text end
deleted text begin (6)deleted text end new text begin (8)new text end the total sales revenue for the prescription drug during the previous 12-month
period;
new text begin
(9) the total rebate payable amount accrued for the prescription drug during the previous
12-month period;
new text end
deleted text begin (7)deleted text end new text begin (10)new text end the manufacturer's net profit attributable to the prescription drug during the
previous 12-month period;
deleted text begin (8)deleted text end new text begin (11)new text end the total amount of financial assistance the manufacturer has provided through
patient prescription assistance programs during the previous 12-month period, if applicable;
deleted text begin (9)deleted text end new text begin (12)new text end any agreement between a manufacturer and another entity contingent upon any
delay in offering to market a generic version of the prescription drug;
deleted text begin (10)deleted text end new text begin (13)new text end the patent expiration date of the prescription drug if it is under patent;
deleted text begin (11)deleted text end new text begin (14)new text end the name and location of the company that manufactured the drug;
deleted text begin (12)deleted text end new text begin (15)new text end if a brand name prescription drug, the highest price paid for the prescription
drug during the previous calendar year in the ten countries, excluding the United States,
that charged the highest single price for the prescription drug; and
deleted text begin (13)deleted text end new text begin (16)new text end if the prescription drug was acquired by the manufacturer during the previous
12-month period, all of the following information:
(i) price at acquisition;
(ii) price in the calendar year prior to acquisition;
(iii) name of the company from which the drug was acquired;
(iv) date of acquisition; and
(v) acquisition price.
(c) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.
Sec. 8.
Minnesota Statutes 2024, section 62J.84, subdivision 6, is amended to read:
Subd. 6.
Public posting of prescription drug price information.
(a) The commissioner
shall post on the department's website, or may contract with a private entity or consortium
that satisfies the standards of section 62U.04, subdivision 6, to meet this requirement, the
following information:
(1) a list of the prescription drugs reported under subdivisions 3, 4, and 11 to 14 and the
manufacturers of those prescription drugs; deleted text begin and
deleted text end
new text begin
(2) a list of reporting entities that reported prescription drug price information under
subdivisions 3, 4, and 11 to 14; and
new text end
deleted text begin (2)deleted text end new text begin (3)new text end information reported to the commissioner under subdivisions 3, 4, and 11 to 14new text begin ,
aggregated on a per-drug basis in a manner that does not allow the identification of a reporting
entity that is not the manufacturer of the drugnew text end .
(b) The information must be published in an easy-to-read format and in a manner that
identifies the information that is disclosed on a per-drug basis and must not be aggregated
in a manner that prevents the identification of the prescription drug.
(c) The commissioner shall not post to the department's website or a private entity
contracting with the commissioner shall not post any information described in this section
if the information is not public data under section 13.02, subdivision 8a; or is trade secret
information under section 13.37, subdivision 1, paragraph (b); or is trade secret information
pursuant to the Defend Trade Secrets Act of 2016, United States Code, title 18, section
1836, as amended. If a reporting entity believes information should be withheld from public
disclosure pursuant to this paragraph, the reporting entity must clearly and specifically
identify that information and describe the legal basis in writing when the reporting entity
submits the information under this section. If the commissioner disagrees with the reporting
entity's request to withhold information from public disclosure, the commissioner shall
provide the reporting entity written notice that the information will be publicly posted 30
days after the date of the notice.
(d) If the commissioner withholds any information from public disclosure pursuant to
this subdivision, the commissioner shall post to the department's website a report describing
the nature of the information and the commissioner's basis for withholding the information
from disclosure.
(e) To the extent the information required to be posted under this subdivision is collected
and made available to the public by another state, by the University of Minnesota, or through
an online drug pricing reference and analytical tool, the commissioner may reference the
availability of this drug price data from another source including, within existing
appropriations, creating the ability of the public to access the data from the source for
purposes of meeting the reporting requirements of this subdivision.
Sec. 9.
Minnesota Statutes 2024, section 62J.84, subdivision 10, is amended to read:
Subd. 10.
Notice of prescription drugs of substantial public interest.
(a) No later than
January 31, 2024, and quarterly thereafter, the commissioner shall produce and post on the
department's website a list of prescription drugs that the commissioner determines to represent
a substantial public interest and for which the commissioner intends to request data under
subdivisions 11 to 14, subject to paragraph (c). The commissioner shall base its inclusion
of prescription drugs on any information the commissioner determines is relevant to providing
greater consumer awareness of the factors contributing to the cost of prescription drugs in
the state, and the commissioner shall consider drug product families that include prescription
drugs:
(1) that triggered reporting under subdivision 3 or 4 during the previous calendar quarter;
(2) for which average claims paid amounts exceeded 125 percent of the price as of the
claim incurred date during the most recent calendar quarter for which claims paid amounts
are available; or
(3) that are identified by members of the public during a public comment process.
(b) Not sooner than 30 days after publicly posting the list of prescription drugs under
paragraph (a), the department shall notify, via email, reporting entities registered with the
department ofnew text begin :
new text end
new text begin (1)new text end the requirement to report under subdivisions 11 to 14deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(2) the reporting period for which data must be provided.
new text end
(c) The commissioner must not designate more than 500 prescription drugs as having a
substantial public interest in any one notice.
(d) Notwithstanding subdivision 16, the commissioner is exempt from chapter 14,
including section 14.386, in implementing this subdivision.
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 62J.84, subdivision 11, is amended to read:
Subd. 11.
Manufacturer prescription drug substantial public interest reporting.
(a)
Beginning January 1, 2024, a manufacturer must submit to the commissioner the information
described in paragraph (b) for any prescription drug:
(1) included in a notification to report issued to the manufacturer by the department
under subdivision 10;
(2) which the manufacturer manufactures or repackages;
(3) for which the manufacturer sets the wholesale acquisition cost; and
(4) for which the manufacturer has not submitted data under subdivision 3 during the
120-day period prior to the date of the notification to report.
(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
the commissioner no later than 60 days after the date of the notification to report, in the
form and manner prescribed by the commissioner, the following information, if applicable:
(1) a description of the drug with the following listed separately:
(i) the national drug code;
(ii) the product name;
(iii) the dosage form;
(iv) the strength; and
(v) the package size;
(2) the price of the drug product on the later of:
(i) the day one year prior to the date of the notification to report;
(ii) the introduced to market date; or
(iii) the acquisition date;
(3) the price of the drug product on the date of the notification to report;
new text begin
(4) the year the prescription drug was introduced for sale in the United States;
new text end
deleted text begin (4)deleted text end new text begin (5)new text end the introductory price of the prescription drug when it was introduced for sale in
the United States and the price of the drug on the last day of each of the five calendar years
preceding the date of the notification to report;
deleted text begin (5)deleted text end new text begin (6)new text end the direct costs incurred during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting
period specified innew text end the notification to report by the manufacturers that are associated with
the prescription drug, listed separately:
(i) to manufacture the prescription drug;
(ii) to market the prescription drug, including advertising costs; and
(iii) to distribute the prescription drug;
deleted text begin (6)deleted text end new text begin (7)new text end the number of units of the prescription drug sold during the deleted text begin 12-month period
prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
deleted text begin (7)deleted text end new text begin (8)new text end the total sales revenue for the prescription drug during the deleted text begin 12-month period prior
to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
deleted text begin (8)deleted text end new text begin (9)new text end the total rebate payable amount accrued for the prescription drug during the
deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
deleted text begin (9)deleted text end new text begin (10)new text end the manufacturer's net profit attributable to the prescription drug during the
deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
deleted text begin (10)deleted text end new text begin (11)new text end the total amount of financial assistance the manufacturer has provided through
patient prescription assistance programs during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin
reporting period specified innew text end the notification to report, if applicable;
deleted text begin (11)deleted text end new text begin (12)new text end any agreement between a manufacturer and another entity contingent upon
any delay in offering to market a generic version of the prescription drug;
deleted text begin (12)deleted text end new text begin (13)new text end the patent expiration date of the prescription drug if the prescription drug is
under patent;
deleted text begin (13)deleted text end new text begin (14)new text end the name and location of the company that manufactured the drug;
deleted text begin (14)deleted text end new text begin (15)new text end if the prescription drug is a brand name prescription drug, the ten countries
other than the United States that paid the highest prices for the prescription drug during the
previous calendar year and their prices; and
deleted text begin (15)deleted text end new text begin (16)new text end if the prescription drug was acquired by the manufacturer within deleted text begin a 12-month
period prior to the date ofdeleted text end new text begin the reporting period specified innew text end the notification to report, all of
the following information:
(i) the price at acquisition;
(ii) the price in the calendar year prior to acquisition;
(iii) the name of the company from which the drug was acquired;
(iv) the date of acquisition; and
(v) the acquisition price.
(c) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.
Sec. 11.
Minnesota Statutes 2024, section 62J.84, subdivision 12, is amended to read:
Subd. 12.
Pharmacy prescription drug substantial public interest reporting.
(a)
Beginning January 1, 2024, a pharmacy must submit to the commissioner the information
described in paragraph (b) for any prescription drugnew text begin :
new text end
new text begin (1)new text end included in a notification to report issued to the pharmacy by the department under
subdivision 10deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(2) that the pharmacy dispensed in Minnesota or mailed to a Minnesota address.
new text end
(b) For each of the drugs described in paragraph (a), the pharmacy shall submit to the
commissioner no later than 60 days after the date of the notification to report, in the form
and manner prescribed by the commissioner, the following information, if applicable:
(1) a description of the drug with the following listed separately:
(i) the national drug code;
(ii) the product name;
(iii) the dosage form;
(iv) the strength; and
(v) the package size;
(2) the number of units of the drug acquired during the deleted text begin 12-month period prior to the date
ofdeleted text end new text begin reporting period specified innew text end the notification to report;
(3) the total spent before rebates by the pharmacy to acquire the drug during the deleted text begin 12-month
period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
(4) the total rebate receivable amount accrued by the pharmacy for the drug during the
deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
(5) the number of pricing units of the drug dispensed by the pharmacy during the
deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
(6) the total payment receivable by the pharmacy for dispensing the drug including
ingredient cost, dispensing fee, and administrative fees during the deleted text begin 12-month period prior
to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
(7) the total rebate payable amount accrued by the pharmacy for the drug during the
deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
and
(8) the average cash price paid by consumers per pricing unit for prescriptions dispensed
where no claim was submitted to a health care service plan or health insurer during the
deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report.
(c) The pharmacy may submit any documentation necessary to support the information
reported under this subdivision.
(d) The commissioner may grant extensions, exemptions, or both to compliance with
the requirements of paragraphs (a) and (b) by small or independent pharmacies, if compliance
with paragraphs (a) and (b) would represent a hardship or undue burden to the pharmacy.
The commissioner may establish procedures for small or independent pharmacies to request
extensions or exemptions under this paragraph.
Sec. 12.
Minnesota Statutes 2024, section 62J.84, subdivision 13, is amended to read:
Subd. 13.
PBM prescription drug substantial public interest reporting.
(a) Beginning
January 1, 2024, a PBM must submit to the commissioner the information described in
paragraph (b) for any prescription drugnew text begin :
new text end
new text begin (1)new text end included in a notification to report issued to the PBM by the department under
subdivision 10deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(2) for which the PBM fulfilled pharmacy benefit management duties for Minnesota
residents.
new text end
(b) For each of the drugs described in paragraph (a), the PBM shall submit to the
commissioner no later than 60 days after the date of the notification to report, in the form
and manner prescribed by the commissioner, the following information, if applicable:
(1) a description of the drug with the following listed separately:
(i) the national drug code;
(ii) the product name;
(iii) the dosage form;
(iv) the strength; and
(v) the package size;
(2) the number of pricing units of the drug product filled deleted text begin for which the PBM administered
claimsdeleted text end during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the
notification to report;
(3) the total reimbursement amount accrued and payable to pharmacies for pricing units
of the drug product filled deleted text begin for which the PBM administered claimsdeleted text end during the deleted text begin 12-month
period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to report;
(4) the total reimbursement deleted text begin or administrative feedeleted text end amountdeleted text begin , or both,deleted text end accrued and receivable
from payers for pricing units of the drug product filled deleted text begin for which the PBM administered
claimsdeleted text end during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the
notification to report;
new text begin
(5) the total administrative fee amount accrued and receivable from payers for pricing
units of the drug product filled during the reporting period specified in the notification to
report;
new text end
deleted text begin (5)deleted text end new text begin (6)new text end the total rebate receivable amount accrued by the PBM for the drug product
during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification
to report; and
deleted text begin (6)deleted text end new text begin (7)new text end the total rebate payable amount accrued by the PBM for the drug product during
the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to
report.
(c) The PBM may submit any documentation necessary to support the information
reported under this subdivision.
Sec. 13.
Minnesota Statutes 2024, section 62J.84, subdivision 14, is amended to read:
Subd. 14.
Wholesale drug distributor prescription drug substantial public interest
reporting.
(a) Beginning January 1, 2024, a wholesale drug distributornew text begin that distributes
prescription drugs, for which it is not the manufacturer, to persons or entities, or both, other
than a consumer or patient in the state,new text end must submit to the commissioner the information
described in paragraph (b) for any prescription drugnew text begin :
new text end
new text begin (1)new text end included in a notification to report issued to the wholesale drug distributor by the
department under subdivision 10deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(2) that the wholesale drug distributor distributed within or into Minnesota.
new text end
(b) For each of the drugs described in paragraph (a), the wholesale drug distributor shall
submit to the commissioner no later than 60 days after the date of the notification to report,
in the form and manner prescribed by the commissioner, the following information, if
applicable:
(1) a description of the drug with the following listed separately:
(i) the national drug code;
(ii) the product name;
(iii) the dosage form;
(iv) the strength; and
(v) the package size;
(2) the number of units of the drug product acquired by the wholesale drug distributor
during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification
to report;
(3) the total spent before rebates by the wholesale drug distributor to acquire the drug
product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the
notification to report;
(4) the total rebate receivable amount accrued by the wholesale drug distributor for the
drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end
the notification to report;
(5) the number of units of the drug product sold by the wholesale drug distributor during
the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the notification to
report;
(6) gross revenue from sales in the United States generated by the wholesale drug
distributor for deleted text begin thisdeleted text end new text begin thenew text end drug product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting
period specified innew text end the notification to report; and
(7) total rebate payable amount accrued by the wholesale drug distributor for the drug
product during the deleted text begin 12-month period prior to the date ofdeleted text end new text begin reporting period specified innew text end the
notification to report.
(c) The wholesale drug distributor may submit any documentation necessary to support
the information reported under this subdivision.
Sec. 14.
Minnesota Statutes 2024, section 62J.84, subdivision 15, is amended to read:
Subd. 15.
Registration requirements.
deleted text begin Beginningdeleted text end new text begin Effectivenew text end January 1, deleted text begin 2024deleted text end new text begin 2026new text end , a
reporting entity subject to this chapter shall registernew text begin , or update existing registration
information,new text end with the department in a form and manner prescribed by the commissionernew text begin by
January 30 each yearnew text end .
Sec. 15.
Minnesota Statutes 2024, section 62K.10, subdivision 2, is amended to read:
Subd. 2.
deleted text begin Primary care; mental health services; general hospital servicesdeleted text end new text begin Time and
distance standardsnew text end .
deleted text begin The maximum travel distance or time shall be the lesser of 30 miles
or 30 minutes to the nearest provider of each of the following services: primary care services,
mental health services, and general hospital servicesdeleted text end new text begin Health carriers must meet the time and
distance standards under Code of Federal Regulations, title 45, section 155.1050new text end .
Sec. 16.
Minnesota Statutes 2024, section 62K.10, subdivision 5, is amended to read:
Subd. 5.
Waiver.
(a) A health carrier may apply to the commissioner of health for a
waiver of the requirements in subdivision 2 deleted text begin or 3deleted text end if it is unable to meet the statutory
requirements. A waiver application must be submitted on a form provided by the
commissioner, must be accompanied by an application fee of $500 for each application to
waive the requirements in subdivision 2 deleted text begin or 3deleted text end for one or more provider types per county, and
must:
(1) demonstrate with specific data that the requirement of subdivision 2 deleted text begin or 3deleted text end is not
feasible in a particular service area or part of a service area; and
(2) include specific information as to the steps that were and will be taken to address
the network inadequacy, and, for steps that will be taken prospectively to address network
inadequacy, the time frame within which those steps will be taken.
(b) The commissioner shall establish guidelines for evaluating waiver applications,
standards governing approval or denial of a waiver application, and standards for steps that
health carriers must take to address the network inadequacy and allow the health carrier to
meet network adequacy requirements within a reasonable time period. The commissioner
shall review each waiver application using these guidelines and standards and shall approve
a waiver application only if:
(1) the standards for approval established by the commissioner are satisfied; and
(2) the steps that were and will be taken to address the network inadequacy and the time
frame for taking these steps satisfy the standards established by the commissioner.
(c) If, in its waiver application, a health carrier demonstrates to the commissioner that
there are no providers of a specific type or specialty in a county, the commissioner may
approve a waiver in which the health carrier is allowed to address network inadequacy in
that county by providing for patient access to providers of that type or specialty via telehealth,
as defined in section 62A.673, subdivision 2.
(d) The waiver shall automatically expire after one year. Upon or prior to expiration of
a waiver, a health carrier unable to meet the requirements in subdivision 2 deleted text begin or 3deleted text end must submit
a new waiver application under paragraph (a) and must also submit evidence of steps the
carrier took to address the network inadequacy. When the commissioner reviews a waiver
application for a network adequacy requirement which has been waived for the carrier for
the most recent one-year period, the commissioner shall also examine the steps the carrier
took during that one-year period to address network inadequacy, and shall only approve a
subsequent waiver application that satisfies the requirements in paragraph (b), demonstrates
that the carrier took the steps it proposed to address network inadequacy, and explains why
the carrier continues to be unable to satisfy the requirements in subdivision 2 deleted text begin or 3deleted text end .
(e) Application fees collected under this subdivision shall be deposited in the state
government special revenue fund in the state treasury.
Sec. 17.
Minnesota Statutes 2024, section 62K.10, subdivision 6, is amended to read:
Subd. 6.
Referral centers.
deleted text begin Subdivisionsdeleted text end new text begin Subdivisionnew text end 2 deleted text begin and 3deleted text end shall not apply if an enrollee
is referred to a referral center for health care services. A referral center is a medical facility
that provides highly specialized medical care, including but not limited to organ transplants.
A health carrier or preferred provider organization may consider the volume of services
provided annually, case mix, and severity adjusted mortality and morbidity rates in
designating a referral center.
Sec. 18.
Minnesota Statutes 2024, section 103I.005, subdivision 17b, is amended to read:
Subd. 17b.
Temporary boring.
"Temporary boring" means an excavation that is 15
feet or more in depth, is sealed within 72 hours of the time of construction, and is drilled,
cored, washed, driven, dug, jetted, or otherwise constructed to:
(1) conduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoring;
(2) monitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistance;
(3) measure groundwater levels, including use of a piezometer; deleted text begin anddeleted text end new text begin or
new text end
(4) determine groundwater flow direction or velocity.
Sec. 19.
Minnesota Statutes 2024, section 103I.101, subdivision 2, is amended to read:
Subd. 2.
Duties.
The commissioner shall:
(1) regulate the drilling, construction, modification, repair, and sealing of wells and
borings;
(2) examine and license:
(i) well contractors;
(ii) persons constructing, repairing, and sealing bored geothermal heat exchangers;
(iii) persons modifying or repairing well casings above the pitless unit or adaptor, well
screens, well diameters, and installing well pumps or pumping equipment;
(iv) persons constructing, repairing, and sealing dewatering wells;
(v) persons sealing wells or borings; deleted text begin and
deleted text end
(vi) persons excavating or drilling holes for the installation of elevator borings;new text begin and
new text end
new text begin
(vii) persons installing, removing, or maintaining groundwater thermal exchange devices
and submerged closed loop heat exchangers;
new text end
(3) examine and license environmental well contractors;
(4) license explorers engaged in exploratory boring and examine individuals who
supervise or oversee exploratory boring;
(5) after consultation with the commissioner of natural resources and the Pollution
Control Agency, establish standards for the design, location, construction, repair, and sealing
of wells and borings within the state; and
(6) issue permits for wells, groundwater thermal devices, bored geothermal heat
exchangers,new text begin installation of submerged closed loop heat exchanger systems,new text end and elevator
borings.
Sec. 20.
Minnesota Statutes 2024, section 103I.101, subdivision 5, is amended to read:
Subd. 5.
Commissioner to adopt rules.
The commissioner shall adopt rules including:
(1) issuance of licenses for:
(i) qualified well contractors;
(ii) persons constructing, repairing, and sealing dewatering wells;
(iii) persons sealing wells or borings;
(iv) persons installing, modifying, or repairing well casings, well screens, well diameters,
and well pumps or pumping equipment;
(v) persons constructing, repairing, and sealing bored geothermal heat exchangers;
(vi) persons constructing, repairing, and sealing elevator borings; deleted text begin and
deleted text end
(vii) persons constructing, repairing, and sealing environmental wells;new text begin and
new text end
new text begin
(viii) persons installing, removing, or maintaining groundwater thermal exchange devices
and submerged closed loop heat exchangers;
new text end
(2) establishment of conditions for examination and review of applications for license
and certification;
(3) establishment of conditions for revocation and suspension of license and certification;
(4) establishment of minimum standards for design, location, construction, repair, and
sealing of wells and borings to implement the purpose and intent of this chapter;
(5) establishment of a system for reporting on wells and borings drilled and sealed;
(6) establishment of standards for the construction, maintenance, sealing, and water
quality monitoring of wells in areas of known or suspected contamination;
(7) establishment of wellhead protection measures for wells serving public water supplies;
(8) establishment of procedures to coordinate collection of well and boring data with
other state and local governmental agencies;
(9) establishment of criteria and procedures for submission of well and boring logs,
formation samples or well or boring cuttings, water samples, or other special information
required for and water resource mapping; and
(10) establishment of minimum standards for design, location, construction, maintenance,
repair, sealing, safety, and resource conservation related to borings, including exploratory
borings as defined in section 103I.005, subdivision 9.
Sec. 21.
Minnesota Statutes 2024, section 103I.101, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Inspection. new text end
new text begin
At a minimum, the commissioner of health shall inspect at least
25 percent of well construction notifications each year under this section.
new text end
Sec. 22.
Minnesota Statutes 2024, section 138.912, subdivision 1, is amended to read:
Subdivision 1.
Establishment.
The healthy eating, here at home program is established
to provide incentives for low-income Minnesotans to use federal Supplemental Nutrition
Assistance Program (SNAP)new text begin or SUN bucks (Summer EBT)new text end benefits for healthy purchases
at Minnesota-based farmers' markets, mobile markets, and direct-farmer sales, including
community-supported agriculture shares.
Sec. 23.
Minnesota Statutes 2024, section 138.912, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) The definitions in this subdivision apply to this section.
(b) "Healthy eating, here at home" means a program administered by the deleted text begin Minnesota
Humanities Centerdeleted text end new text begin Department of Healthnew text end to provide incentives for low-income Minnesotans
to use SNAPnew text begin or SUN bucks (Summer EBT)new text end benefits for healthy purchases at Minnesota-based
farmers' markets.
(c) "Healthy purchases" means SNAP-eligible foods.
(d) "Minnesota-based farmers' market" means a physical market as defined in section
28A.151, subdivision 1, paragraph (b), and also includes mobile markets and direct-farmer
sales, including through a community-supported agriculture model.
(e) "Voucher" means a physical or electronic credit.
(f) "Eligible household" means an individual or family that is determined to be a recipient
of SNAPnew text begin or SUN bucks (Summer EBT)new text end .
Sec. 24.
Minnesota Statutes 2024, section 138.912, subdivision 3, is amended to read:
Subd. 3.
Grants.
The deleted text begin Minnesota Humanities Centerdeleted text end new text begin commissionernew text end shall allocate grant
funds to nonprofit organizations that work with Minnesota-based farmers' markets to provide
up to $10 vouchers to SNAPnew text begin or SUN bucks (Summer EBT)new text end participants who use electronic
benefits transfer (EBT) cards for healthy purchases. Funds may also be provided for vouchers
distributed through nonprofit organizations engaged in healthy cooking and food education
outreach to eligible households for use at farmers' markets. Funds appropriated under this
section may not be used for healthy cooking classes or food education outreach. When
awarding grants, the deleted text begin Minnesota Humanities Centerdeleted text end new text begin commissionernew text end must consider how the
nonprofit organizations will achieve geographic balance, including specific efforts to reach
eligible households across the state, and the organizations' capacity to manage the
programming and outreach.
Sec. 25.
Minnesota Statutes 2024, section 138.912, subdivision 4, is amended to read:
Subd. 4.
Household eligibility; participation.
To be eligible for a healthy eating, here
at home voucher, an eligible household must meet the Minnesota SNAPnew text begin or SUN bucks
(Summer EBT)new text end eligibility requirements deleted text begin under section deleted text end .
Sec. 26.
Minnesota Statutes 2024, section 138.912, subdivision 6, is amended to read:
Subd. 6.
Program reporting.
The nonprofit organizations that receive grant funds must
report annually to the deleted text begin Minnesota Humanities Centerdeleted text end new text begin commissionernew text end with information regarding
the operation of the program, including the number of vouchers issued and the number of
people served. To the extent practicable, the nonprofit organizations must report on the
usage of the vouchers and evaluate the program's effectiveness.
Sec. 27.
Minnesota Statutes 2024, section 144.0758, subdivision 3, is amended to read:
Subd. 3.
Eligible grantees.
new text begin (a) new text end Organizations eligible to receive grant funding under
this section are Minnesota's Tribal Nationsnew text begin in accordance with paragraph (b)new text end and urban
American Indian community-based organizationsnew text begin in accordance with paragraph (c)new text end .
new text begin
(b) Minnesota's Tribal Nations may choose to receive funding under this section according
to a noncompetitive funding formula specified by the commissioner.
new text end
new text begin
(c) Urban American Indian community-based organizations are eligible to apply for
funding under this section by submitting a proposal for consideration by the commissioner.
new text end
Sec. 28.
Minnesota Statutes 2024, section 144.1222, subdivision 2d, is amended to read:
Subd. 2d.
deleted text begin Hot tubsdeleted text end new text begin Spa poolsnew text end on rental deleted text begin houseboatsdeleted text end new text begin propertynew text end .
new text begin
(a) For the purposes of
this subdivision, "spa pool" has the meaning given in Minnesota Rules, part 4717.0250,
subpart 9.
new text end
deleted text begin (a)deleted text end new text begin (b) Except as provided in paragraph (c), new text end a deleted text begin hot waterdeleted text end new text begin spanew text end pool intended for seated
recreational use, including a hot tub or whirlpool, that is located on deleted text begin a houseboat that is rented
to the publicdeleted text end new text begin the property of a stand-alone, single-unit rental property, offered for rent by
the property owner or through a resort, and only intended to be used by the occupants of
the rental property:
new text end
new text begin (1)new text end is not a public pool deleted text begin anddeleted text end new text begin ;
new text end
new text begin (2)new text end is exempt from the requirements for public pools under new text begin subdivisions 1 to 2c, 4, and
5 and new text end Minnesota Rules, chapter 4717new text begin , except as otherwise provided in this paragraph; and
new text end
new text begin
(3) may be used by renters so long as:
new text end
new text begin
(i) the water temperature in the spa pool does not exceed 106 degrees Fahrenheit; and
new text end
new text begin (ii) prior to check-in by each new rental party, the resort or property owner tests the
water in the spa pool for the concentration of chlorine or bromine, pH, and alkalinity, and
the water in the spa pool meets the requirements for disinfection residue, pH, and alkalinity
in Minnesota Rules, part 4717.1750, subparts 4, 5, and 6new text end .
deleted text begin
(b)
deleted text end
new text begin
(c) A spa pool intended for seated recreational use, including a hot tub or whirlpool,
that is located on a houseboat that is rented to the public:
new text end
new text begin
(1) is not a public pool;
new text end
new text begin
(2) is exempt from the requirements for public pools under subdivisions 1 to 2c, 4, and
5 and Minnesota Rules, chapter 4717; and
new text end
new text begin
(3) is exempt from the requirements under paragraph (b), clause (3).
new text end
new text begin
(d) A political subdivision must not adopt a local law, rule, or ordinance that prohibits
the operation of, or establishes additional requirements for, a spa pool that meets the criteria
in paragraph (b) or (c).
new text end
new text begin (e)new text end A deleted text begin hot waterdeleted text end new text begin spanew text end pool under this subdivision must be conspicuously posted with the
following noticenew text begin and must be providednew text end to rentersnew text begin upon check innew text end :
"NOTICE
This spa is exempt from state and local new text begin anti-entrapment and new text end sanitary requirements that
prevent deleted text begin disease transmissiondeleted text end new text begin waterborne diseases such as Legionnaires' disease, Pseudomonas
folliculitis (hot tub rash), and chemical burns and is not subject to inspectionnew text end .
USE AT YOUR OWN RISK
This notice is required under Minnesota Statutes, section 144.1222, subdivision 2d."
Sec. 29.
Minnesota Statutes 2024, section 144.50, is amended by adding a subdivision to
read:
new text begin Subd. 8. new text end
new text begin Controlling person. new text end
new text begin
(a) "Controlling person" includes the following individuals,
if applicable, as deemed appropriate by the hospital:
new text end
new text begin
(1) any officer of the organization;
new text end
new text begin
(2) any hospital administrator; and
new text end
new text begin
(3) any managerial official.
new text end
new text begin
(b) Controlling person does not include:
new text end
new text begin
(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 hospital;
new text end
new text begin
(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;
new text end
new text begin
(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 hospitals, unless the individual is also an officer,
owner, or managerial official of the hospital, receives any remuneration from a hospital, or
who is a controlling person not otherwise excluded in this subdivision;
new text end
new text begin
(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
new text end
new text begin
(5) a natural person who owns less than five percent of the outstanding common shares
of a corporation:
new text end
new text begin
(i) whose securities are exempt by virtue of section 80A.45, clause (6); or
new text end
new text begin
(ii) whose transactions are exempt by virtue of section 80A.46, clause (7).
new text end
Sec. 30.
Minnesota Statutes 2024, section 144.555, subdivision 1a, is amended to read:
Subd. 1a.
Notice of closing, curtailing operations, relocating services, or ceasing to
offer certain services; hospitals.
(a) The controlling persons of a hospital licensed under
sections 144.50 to 144.56 or a hospital campus must notify the commissioner of health, the
public, and others at least 182 days before the hospital or hospital campus voluntarily plans
to implement one of the scheduled actions listed in paragraph (b), unless the controlling
persons can demonstrate to the commissioner that meeting the advanced notice requirement
is not feasible and the commissioner approves a shorter advanced notice.
(b) The following scheduled actions require advanced notice under paragraph (a):
(1) ceasing operations;
(2) curtailing operations to the extent that deleted text begin patientsdeleted text end new text begin inpatients or emergency department
servicesnew text end must be relocated;
(3) relocating the provision ofnew text begin inpatientnew text end health servicesnew text begin or emergency department servicesnew text end
to another hospital or deleted text begin anotherdeleted text end hospital campus; or
(4) ceasing to offernew text begin inpatientnew text end maternity care andnew text begin inpatientnew text end newborn care services,new text begin inpatientnew text end
intensive care unit services, inpatient mental health services, or inpatient substance use
disorder treatment services.
(c) A notice required under this subdivision must comply with the requirements in
subdivision 1d.
(d) The commissioner shall cooperate with the controlling persons and advise them
about relocating the patients.
new text begin
(e) For purposes of this subdivision, "inpatient" means services that are provided to a
person who has been admitted to a hospital for bed occupancy.
new text end
Sec. 31.
Minnesota Statutes 2024, section 144.555, subdivision 1b, is amended to read:
Subd. 1b.
Public hearing.
Within 30 days after receiving notice under subdivision 1a,
the commissioner shall conduct a public hearing on the scheduled cessation of operations,
curtailment of operations, relocation of health services, or cessation in offering health
services. The commissioner must provide adequate public notice of the hearing in a time
and manner determined by the commissioner.new text begin The commissioner must ensure that video
conferencing technology will be used to allow members of the public to view and participate
in the hearing.new text end The controlling persons of the hospital or hospital campus must participate
in the public hearing. The public hearing must be held at a location that is within ten miles
of the hospital or hospital campusnew text begin and can accommodate anticipated public attendancenew text end or
with the commissioner's approval as close as is practicable, and that is provided or arranged
by the hospital or hospital campus. deleted text begin Video conferencing technology must be used to allow
members of the public to view and participate in the hearing.deleted text end The public hearing must
include:
(1) an explanation by the controlling persons of the reasons for ceasing or curtailing
operations, relocating health services, or ceasing to offer any of the listed health services;
(2) a description of the actions that controlling persons will take to ensure that residents
in the hospital's or campus's service area have continued access to the health services being
eliminated, curtailed, or relocated;
(3) an opportunity for public testimonynew text begin for at least one hournew text end on the scheduled cessation
or curtailment of operations, relocation of health services, or cessation in offering any of
the listed health services, and on the hospital's or campus's plan to ensure continued access
to those health services being eliminated, curtailed, or relocated; and
(4) an opportunity for the controlling persons to respond to questions from interested
persons.
Sec. 32.
Minnesota Statutes 2024, section 144.608, subdivision 2, is amended to read:
Subd. 2.
Council administration.
(a) The council must meet at least twice a year but
may meet more frequently at the call of the chair, a majority of the council members, or the
commissioner.
(b) The terms, compensation, and removal of members of the council are governed by
section 15.059. The council expires June 30, deleted text begin 2025deleted text end new text begin 2035new text end .
(c) The council may appoint subcommittees and work groups. Subcommittees shall
consist of council members. Work groups may include noncouncil members. Noncouncil
members shall be compensated for work group activities under section 15.059, subdivision
3, but shall receive expenses only.
Sec. 33.
Minnesota Statutes 2024, section 144.966, subdivision 2, is amended to read:
Subd. 2.
Newborn Hearing Screening Advisory Committee.
(a) The commissioner
of health shall establish a Newborn Hearing Screening Advisory Committee to advise and
assist the Department of Health; Department of Children, Youth, and Families; and the
Department of Education in:
(1) developing protocols and timelines for screening, rescreening, and diagnostic
audiological assessment and early medical, audiological, and educational intervention
services for children who are deaf or hard-of-hearing;
(2) designing protocols for tracking children from birth through age three that may have
passed newborn screening but are at risk for delayed or late onset of permanent hearing
loss;
(3) designing a technical assistance program to support facilities implementing the
screening program and facilities conducting rescreening and diagnostic audiological
assessment;
(4) designing implementation and evaluation of a system of follow-up and tracking; and
(5) evaluating program outcomes to increase effectiveness and efficiency and ensure
culturally appropriate services for children with a confirmed hearing loss and their families.
(b) The commissioner of health shall appoint at least one member from each of the
following groups with no less than two of the members being deaf or hard-of-hearing:
(1) a representative from a consumer organization representing culturally deaf persons;
(2) a parent with a child with hearing loss representing a parent organization;
(3) a consumer from an organization representing oral communication options;
(4) a consumer from an organization representing cued speech communication options;
(5) an audiologist who has experience in evaluation and intervention of infants and
young children;
(6) a speech-language pathologist who has experience in evaluation and intervention of
infants and young children;
(7) two primary care providers who have experience in the care of infants and young
children, one of which shall be a pediatrician;
(8) a representative from the early hearing detection intervention teams;
(9) a representative from the Department of Education resource center for the deaf and
hard-of-hearing or the representative's designee;
(10) a representative of the Commission of the Deaf, DeafBlind and Hard of Hearing;
(11) a representative from the Department of Human Services Deaf and Hard-of-Hearing
Services Division;
(12) one or more of the Part C coordinators from the Department of Education; the
Department of Health; the Department of Children, Youth, and Families; or the Department
of Human Services or the department's designees;
(13) the Department of Health early hearing detection and intervention coordinators;
(14) two birth hospital representatives from one rural and one urban hospital;
(15) a pediatric geneticist;
(16) an otolaryngologist;
(17) a representative from the Newborn Screening Advisory Committee under this
subdivision;
(18) a representative of the Department of Education regional low-incidence facilitators;
(19) a representative from the deaf mentor program; and
(20) a representative of the Minnesota State Academy for the Deaf from the Minnesota
State Academies staff.
The commissioner must complete the initial appointments required under this subdivision
by September 1, 2007, and the initial appointments under clauses (19) and (20) by September
1, 2019.
(c) The Department of Health member shall chair the first meeting of the committee. At
the first meeting, the committee shall elect a chair from its membership. The committee
shall meet at the call of the chair, at least four times a year. The committee shall adopt
written bylaws to govern its activities. The Department of Health shall provide technical
and administrative support services as required by the committee. These services shall
include technical support from individuals qualified to administer infant hearing screening,
rescreening, and diagnostic audiological assessments.
Members of the committee shall receive no compensation for their service, but shall be
reimbursed as provided in section 15.059 for expenses incurred as a result of their duties
as members of the committee.
(d) By February 15, 2015, and by February 15 of the odd-numbered years after that date,
the commissioner shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and data privacy on the activities of the committee
that have occurred during the past two years.
deleted text begin
(e) This subdivision expires June 30, 2025.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment or
June 30, 2025, whichever is earlier.
new text end
Sec. 34.
Minnesota Statutes 2024, section 144E.123, subdivision 3, is amended to read:
Subd. 3.
Review.
Prehospital care data may be reviewed by the director or its designees.
The data shall be classified as private data on individuals under chapter 13, the Minnesota
Government Data Practices Act.new text begin The director may share with the Washington/Baltimore
High Intensity Drug Trafficking Area's Overdose Detection Mapping Application Program
(ODMAP) data that identifies where and when an overdose incident happens, fatality status,
suspected drug type, naloxone administration, and first responder type. ODMAP may:
new text end
new text begin
(1) allow secure access to the system by authorized users to report information about an
overdose incident;
new text end
new text begin
(2) allow secure access to the system by authorized users to view, in near real time,
information about overdose incidents reported;
new text end
new text begin
(3) produce a map in near real time of the approximate locations of confirmed or
suspected overdose incidents reported; and
new text end
new text begin
(4) enable access to overdose incident information that assists in state and local decisions
regarding the allocation of public health, public safety, and educational resources for the
purposes of monitoring and reporting data related to suspected overdoses.
new text end
Sec. 35.
new text begin
[145.076] INFORMED CONSENT REQUIRED FOR SENSITIVE
EXAMINATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
For purposes of this section, "sensitive examination" means
a pelvic, breast, urogenital, or rectal examination.
new text end
new text begin Subd. 2. new text end
new text begin Informed consent required; exceptions. new text end
new text begin
A health professional, or a student
or resident participating in a course of instruction, clinical training, or a residency program
for a health profession, shall not perform a sensitive examination on an anesthetized or
unconscious patient unless:
new text end
new text begin
(1) the patient or the patient's legally authorized representative provided prior, written,
informed consent to the sensitive examination and the sensitive examination is necessary
for preventive, diagnostic, or treatment purposes;
new text end
new text begin
(2) the patient or the patient's legally authorized representative provided prior, written,
informed consent to a surgical procedure or diagnostic examination and the sensitive
examination is within the scope of care ordered for that surgical procedure or diagnostic
examination;
new text end
new text begin
(3) the patient is unconscious and incapable of providing informed consent and the
sensitive examination is necessary for diagnostic or treatment purposes; or
new text end
new text begin
(4) a court ordered a sensitive examination to be performed for purposes of collection
of evidence.
new text end
new text begin Subd. 3. new text end
new text begin Penalty; ground for disciplinary action. new text end
new text begin
A person who violates this section
is subject to disciplinary action by the health-related licensing board regulating the person.
new text end
Sec. 36.
Minnesota Statutes 2024, section 145.8811, is amended to read:
145.8811 MATERNAL AND CHILD HEALTH ADVISORY deleted text begin TASK FORCEdeleted text end new text begin
COMMITTEEnew text end .
Subdivision 1.
Composition of deleted text begin task forcedeleted text end new text begin committeenew text end .
The commissioner shall establish
and appoint a Maternal and Child Health Advisory deleted text begin Task Forcedeleted text end new text begin Committeenew text end consisting of 15
members who will provide equal representation from:
(1) professionals with expertise in maternal and child health services;
(2) representatives of community health boards as defined in section 145A.02, subdivision
5; and
(3) consumer representatives interested in the health of mothers and children.
No members shall be employees of the Minnesota Department of Health. Section 15.059
governs the Maternal and Child Health Advisory deleted text begin Task Forcedeleted text end new text begin Committeenew text end . Notwithstanding
section 15.059, the Maternal and Child Health Advisory deleted text begin Task Forcedeleted text end new text begin Committeenew text end does not
expire.
Subd. 2.
Duties.
The advisory deleted text begin task forcedeleted text end new text begin committeenew text end shall meet on a regular basis to
perform the following duties:
(1) review and report on the health care needs of mothers and children throughout the
state of Minnesota;
(2) review and report on the type, frequency, and impact of maternal and child health
care services provided to mothers and children under existing maternal and child health
care programs, including programs administered by the commissioner of health;
(3) establish, review, and report to the commissioner a list of program guidelines and
criteria deleted text begin whichdeleted text end the advisory deleted text begin task forcedeleted text end new text begin committeenew text end considers essential to providing an effective
maternal and child health care program to low-income populations and high-risk persons
and fulfilling the purposes defined in section 145.88;
(4) make recommendations to the commissioner for the use of other federal and state
funds available to meet maternal and child health needs;
(5) make recommendations to the commissioner of health on priorities for funding the
following maternal and child health services:
(i) prenatal, delivery, and postpartum care;
(ii) comprehensive health care for children, especially from birth through five years of
age;
(iii) adolescent health services;
(iv) family planning services;
(v) preventive dental care;
(vi) special services for chronically ill and disabled children; and
(vii) any other services that promote the health of mothers and children; and
(6) establish in consultation with the commissioner statewide outcomes that will improve
the health status of mothers and children.
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 145.901, subdivision 1, is amended to read:
Subdivision 1.
Purpose.
new text begin Within the limits of available funding, new text end the commissioner of
health deleted text begin maydeleted text end new text begin mustnew text end conduct maternal death studies to assist the planning, implementation, and
evaluation of medical, health, and welfare service systems and to reduce the numbers of
preventable maternal deaths in Minnesota.
Sec. 38.
Minnesota Statutes 2024, section 145.987, subdivision 1, is amended to read:
Subdivision 1.
Establishment; composition of advisory council.
The health equity
advisory and leadership (HEAL) council consists of 18 members appointed by the
commissioner of healthnew text begin , including but not limited to membersnew text end who will provide representation
from the following groups:
(1) African American and African heritage communities;
(2) Asian American and Pacific Islander communities;
(3) Latina/o/x communities;
(4) American Indian communities and Tribal governments and nations;
(5) disability communities;
(6) lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities; and
(7) representatives who reside outside the seven-county metropolitan area.
Sec. 39.
Minnesota Statutes 2024, section 145.987, subdivision 2, is amended to read:
Subd. 2.
Organization and meetings.
(a) Terms, compensation, and removal of members
of the advisory council shall be as provided in section 15.059, subdivisions 2 to 4, except
that terms for advisory council members shall be for two years. Members may be reappointed
to serve up to two additional terms. Notwithstanding section 15.059, subdivision 6, the
advisory council shall not expire. deleted text begin The commissioner shall recommend appointments to
replace members vacating their positions in a timely manner, no more than three months
after the advisory council reviews panel recommendations.
deleted text end
(b) The commissioner must convene meetings at least quarterly and must provide meeting
space and administrative support to the advisory council. Subcommittees may be convened
as necessary. Advisory council meetings are subject to the Open Meeting Law under chapter
13D.
Sec. 40.
new text begin
[148.781] CENTRAL SERVICE TECHNICIAN.
new text end
new text begin Subdivision 1. new text end
new text begin Application. new text end
new text begin
This section applies to persons who perform the functions
of a central service technician in a health care facility.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
For purposes of this section, the following terms have the meanings
given:
new text end
new text begin
(1) "central service technician" means a person who decontaminates, inspects, assembles,
packages, and sterilizes reusable medical instruments or devices used by a health care
facility;
new text end
new text begin
(2) "health care facility" means a hospital or ambulatory surgical center; and
new text end
new text begin
(3) "health care practitioner" means an individual regulated by a health-related licensing
board as defined in section 214.01, subdivision 2, or by the commissioner of health under
sections 148.511 to 148.5198, to the extent the individual provides services in a health care
facility and the tasks of a central service technician are within the individual's scope of
practice. Health care practitioner includes an intern, resident, or fellow who performs or
assists with surgery.
new text end
new text begin Subd. 3. new text end
new text begin Requirements for central service technician. new text end
new text begin
(a) A health care facility shall
employ or otherwise retain the services of a central service technician only if the central
service technician:
new text end
new text begin
(1) has successfully passed a nationally accredited examination for central service
technicians and holds and maintains one of the following credentials administered by a
nationally accredited central service technician credentialing organization: a certified
registered central service technician credential, a certified endoscope reprocessor credential,
a certified sterile processing and distribution technician credential, or a certified flexible
endoscope reprocessor credential; or
new text end
new text begin
(2) provides evidence that the person was employed by or was retained as a central
service technician by a health care facility on or before December 31, 2027.
new text end
new text begin
(b) A central service technician who does not meet the requirements of paragraph (a),
clause (1), shall have 24 months from the date of hire to obtain a certified registered central
service technician credential, a certified endoscope reprocessor credential, a certified sterile
processing and distribution technician credential, or a certified flexible endoscope reprocessor
credential.
new text end
new text begin
(c) A person who qualifies to operate as a central service technician in a health care
facility under paragraph (a) must annually complete ten hours of continuing education
credits to remain qualified to operate as a central service technician. The continuing education
required under this paragraph must be related to the functions of a central service technician.
new text end
new text begin
(d) Nothing in this subdivision shall prohibit the following persons from performing the
tasks or functions of a central service technician:
new text end
new text begin
(1) a health care practitioner;
new text end
new text begin
(2) a person who holds or maintains a registration, certification, or license by a nationally
accredited credentialing organization to perform health care services; or
new text end
new text begin
(3) a student or intern performing the functions of a central service technician under the
direct supervision of a health care practitioner as part of the student's or intern's training or
internship.
new text end
new text begin
(e) A health care facility shall, upon the written request of a central service technician,
verify in writing the central service technician's dates of employment or the contract period
during which the central service technician provided services to the health care facility.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective 180 days after final enactment.
new text end
Sec. 41. new text begin TRANSFER OF PROGRAM.
new text end
new text begin
The healthy eating, here at home program is transferred from the Minnesota Humanities
Center to the Department of Health on July 1, 2025. The provisions of Minnesota Statutes,
section 15.039, apply to this transfer.
new text end
Sec. 42. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber Minnesota Statutes, section 138.912, as section
144.0554. The revisor shall make any cross-reference changes necessary resulting from the
renumbering of the healthy eating, here at home program.
new text end
Sec. 43. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, sections 62K.10, subdivision 3; and 138.912, subdivision 7,
new text end
new text begin
are repealed.
new text end
ARTICLE 3
HEALTH LICENSING BOARDS
Section 1.
Minnesota Statutes 2024, section 144.99, subdivision 1, is amended to read:
Subdivision 1.
Remedies available.
The provisions of chapters 103I and 157 and sections
115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14),
and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385;
144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98;
144.992; new text begin 147.037, subdivision 1b, paragraph (d); new text end 326.70 to 326.785; 327.10 to 327.131;
and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance
agreements, licenses, registrations, certificates, and permits adopted or issued by the
department or under any other law now in force or later enacted for the preservation of
public health may, in addition to provisions in other statutes, be enforced under this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 2.
Minnesota Statutes 2024, section 144A.43, subdivision 15, is amended to read:
Sec. 3.
Minnesota Statutes 2024, section 144G.08, subdivision 45, is amended to read:
Sec. 4.
Minnesota Statutes 2024, section 147.01, subdivision 7, is amended to read:
Subd. 7.
Physician application and license fees.
(a) The board may charge the following
nonrefundable application and license fees processed pursuant to sections 147.02, 147.03,
147.037, 147.0375, and 147.38:
(1) physician application fee, $200;
(2) physician annual registration renewal fee, $192;
(3) physician endorsement to other states, $40;
(4) physician emeritus license, $50;
(5) physician late fee, $60;
new text begin
(6) nonrenewable 24-month limited license, $392;
new text end
new text begin
(7) initial physician license for limited license holder, $192;
new text end
deleted text begin (6)deleted text end new text begin (8)new text end duplicate license fee, $20;
deleted text begin (7)deleted text end new text begin (9)new text end certification letter fee, $25;
deleted text begin (8)deleted text end new text begin (10)new text end education or training program approval fee, $100;
deleted text begin (9)deleted text end new text begin (11)new text end report creation and generation fee, $60 per hour;
deleted text begin (10)deleted text end new text begin (12)new text end examination administration fee (half day), $50;
deleted text begin (11)deleted text end new text begin (13)new text end examination administration fee (full day), $80;
deleted text begin (12)deleted text end new text begin (14)new text end fees developed by the Interstate Commission for determining physician
qualification to register and participate in the interstate medical licensure compact, as
established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and
deleted text begin (13)deleted text end new text begin (15)new text end verification fee, $25.
(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fee must be deposited
in an account in the state government special revenue fund.
Sec. 5.
Minnesota Statutes 2024, section 147.037, is amended by adding a subdivision to
read:
new text begin Subd. 1b. new text end
new text begin Limited license. new text end
new text begin
(a) A limited license under this section is valid for one
24-month period and is not renewable or eligible for reapplication. The board may issue a
limited license, valid for 24 months, to any person who satisfies the requirements of
subdivision 1, paragraphs (a) to (c) and (e) to (g), and who:
new text end
new text begin
(1) pursuant to a license or other authorization to practice, has practiced medicine, as
defined in section 147.081, subdivision 3, clauses (2) to (4), for at least 60 months in the
previous 12 years outside of the United States;
new text end
new text begin
(2) submits sufficient evidence of an offer to practice within the context of a collaborative
agreement within a hospital or clinical setting where the limited license holder and physicians
work together to provide patient care;
new text end
new text begin
(3) provides services in a designated rural area or underserved urban community as
defined in section 144.1501; and
new text end
new text begin
(4) submits two letters of recommendation in support of a limited license, which must
include one letter from a physician with whom the applicant previously worked and one
letter from an administrator of the hospital or clinical setting in which the applicant previously
worked. The letters of recommendation must attest to the applicant's good medical standing.
The board may accept alternative forms of proof that demonstrate good medical standing
where there are extenuating circumstances that prevent an applicant from providing letters.
new text end
new text begin
(b) For purposes of this subdivision, a person has satisfied the requirements of subdivision
1, paragraph (e), if the person has passed steps or levels one and two of the USMLE or the
COMLEX-USA with passing scores as recommended by the USMLE program or National
Board of Osteopathic Medical Examiners within three attempts.
new text end
new text begin
(c) A person issued a limited license under this subdivision must not be required to
present evidence satisfactory to the board of the completion of one year of graduate clinical
medical training in a program accredited by a national accrediting organization approved
by the board.
new text end
new text begin
(d) An employer of a limited license holder must pay the limited license holder at least
an amount equivalent to a medical resident in a comparable field. The employer must carry
medical malpractice insurance covering a limited license holder for the duration of the
employment. The commissioner of health may issue a correction order under section 144.99,
subdivision 3, requiring an employer to comply with this paragraph. An employer must not
retaliate against or discipline an employee for raising a complaint or pursuing enforcement
relating to this paragraph.
new text end
new text begin
(e) The board may issue a full and unrestricted license to practice medicine to a person
who holds a limited license issued pursuant to paragraph (a) and who has:
new text end
new text begin
(1) held the limited license for two years and is in good standing to practice medicine
in Minnesota;
new text end
new text begin
(2) practiced for a minimum of 1,692 hours per year for each of the previous two years;
new text end
new text begin
(3) submitted a letter of recommendation in support of a full and unrestricted license
containing all attestations required under paragraph (i) from any physician who participated
in the collaborative agreement;
new text end
new text begin
(4) passed steps or levels one, two, and three of the USMLE or COMLEX-USA with
passing scores as recommended by the USMLE program or National Board of Osteopathic
Medical Examiners within three attempts; and
new text end
new text begin
(5) completed 20 hours of continuing medical education.
new text end
new text begin
(f) A limited license holder must submit to the board, every six months or upon request,
a statement certifying whether the person is still employed as a physician in Minnesota and
whether the person has been subjected to professional discipline as a result of the person's
practice. The board may suspend or revoke a limited license if a majority of the board
determines that the licensee is no longer employed as a physician in Minnesota by an
employer. The licensee must be granted an opportunity to be heard prior to the board's
determination. Upon request by the limited license holder, the limited license holder may
have 90 days to regain employment. A licensee may change employers during the duration
of the limited license if the licensee has another offer of employment. In the event that a
change of employment occurs, the licensee must still work the number of hours required
under paragraph (e), clause (2), to be eligible for a full and unrestricted license to practice
medicine.
new text end
new text begin
(g) In addition to any other remedy provided by law, the board may, without a hearing,
temporarily suspend the license of a limited license holder if the board finds that the limited
license holder has violated a statute or rule that the board is empowered to enforce and
continued practice by the limited license holder would create a serious risk of harm to the
public. The suspension shall take effect upon written notice to the limited license holder
specifying the statute or rule violated. The suspension shall remain in effect until the board
issues a final order in the matter after a hearing. At the time it issues the suspension notice,
the board shall schedule a disciplinary hearing to be held pursuant to the Administrative
Procedure Act. The limited license holder shall be provided with at least 20 days' notice of
any hearing held pursuant to this subdivision. The hearing shall be scheduled to begin no
later than 30 days after the issuance of the suspension order.
new text end
new text begin
(h) For purposes of this subdivision, "collaborative agreement" means a mutually agreed
upon plan for the overall working relationship and collaborative arrangement between a
holder of a limited license and one or more physicians licensed under this chapter that
designates the scope of services that can be provided to manage the care of patients. The
limited license holder and one of the collaborating physicians must have experience in
providing care to patients with the same or similar medical conditions. Under the
collaborative agreement, the limited license holder must shadow the collaborating physician
for four weeks, after which time the limited license holder must staff all patient encounters
with the collaborating physician for an additional four weeks. After that time, the
collaborating physician has discretion to allow the limited license holder to see patients
independently and will require the limited license holder to present patients at their discretion.
However, the limited license holder must be supervised by the collaborating physician for
a minimum of two hours per week. A limited license holder may practice medicine without
a collaborating physician physically present, but the limited license holder and collaborating
physicians must be able to easily contact each other by radio, telephone, or other
telecommunication device while the limited license holder practices medicine. The limited
license holder must have one-on-one practice reviews with each collaborating physician,
provided in person or through eye-to-eye electronic media while maintaining visual contact,
for at least two hours per week.
new text end
new text begin
(i) At least one collaborating physician must submit a letter to the board, after the limited
license holder has practiced under the license for 12 months, attesting that:
new text end
new text begin
(1) the limited license holder has a basic understanding of federal and state laws regarding
the provision of health care, including but not limited to:
new text end
new text begin
(i) medical licensing obligations and standards; and
new text end
new text begin
(ii) the Health Insurance Portability and Accountability Act, Public Law 104-191;
new text end
new text begin
(2) the limited license holder has a basic understanding of documentation standards;
new text end
new text begin
(3) the limited license holder has a thorough understanding of which medications are
available and unavailable in the United States;
new text end
new text begin
(4) the limited license holder has a thorough understanding of American medical standards
of care;
new text end
new text begin
(5) the limited license holder has demonstrated mastery of each of the following:
new text end
new text begin
(i) gathering a history and performing a physical exam;
new text end
new text begin
(ii) developing and prioritizing a differential diagnosis following a clinical encounter
and selecting a working diagnosis;
new text end
new text begin
(iii) recommending and interpreting common diagnostic and screening tests;
new text end
new text begin
(iv) entering and discussing orders and prescriptions;
new text end
new text begin
(v) providing an oral presentation of a clinical encounter;
new text end
new text begin
(vi) giving a patient handover to transition care responsibly;
new text end
new text begin
(vii) recognizing a patient requiring urgent care and initiating an evaluation; and
new text end
new text begin
(viii) obtaining informed consent for tests, procedures, and treatments; and
new text end
new text begin
(6) the limited license holder is providing appropriate medical care.
new text end
new text begin
(j) The board must not grant a license under this section unless the applicant possesses
federal immigration status that allows the applicant to practice as a physician in the United
States.
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. 6.
Minnesota Statutes 2024, section 147A.02, is amended to read:
147A.02 QUALIFICATIONS FOR LICENSURE.
(a) The board may grant a license as a physician assistant to an applicant who:
(1) submits an application on forms approved by the board;
(2) pays the appropriate fee as determined by the board;
(3) has current certification from the National Commission on Certification of Physician
Assistants, or its successor agency as approved by the board;
(4) certifies that the applicant is mentally and physically able to engage safely in practice
as a physician assistant;
(5) has no licensure, certification, or registration as a physician assistant under current
discipline, revocation, suspension, or probation for cause resulting from the applicant's
practice as a physician assistant, unless the board considers the condition and agrees to
licensure;
(6) submits any other information the board deems necessary to evaluate the applicant's
qualifications; and
(7) has been approved by the board.
(b) All persons registered as physician assistants as of June 30, 1995, are eligible for
continuing license renewal. All persons applying for licensure after that date shall be licensed
according to this chapter.
(c) A physician assistant who qualifies for licensure must practice for at least 2,080
hours, within the context of a collaborative agreement, within a hospital or integrated clinical
setting where physician assistants and physicians work together to provide patient care. The
physician assistant shall submit written evidence to the board with the application, or upon
completion of the required collaborative practice experience. For purposes of this paragraph,
a collaborative agreement is a mutually agreed upon plan for the overall working relationship
deleted text begin and collaborative arrangementdeleted text end between a physician assistantdeleted text begin ,deleted text end and one or more physicians
licensed under chapter 147new text begin or licensed in another state or United States territorynew text end , that
designates the scope of deleted text begin services that can be provideddeleted text end new text begin collaboration necessarynew text end to manage the
care of patients. The physician assistant and one of the collaborative physicians must have
experience in providing care to patients with the same or similar medical conditions. The
collaborating physician is not required to be physically present so long as the collaborating
physician and physician assistant are or can be easily in contact with each other by radio,
telephone, or other telecommunication device.
Sec. 7.
Minnesota Statutes 2024, section 147D.03, subdivision 1, is amended to read:
Subdivision 1.
General.
Within the meaning of sections 147D.01 to 147D.27, a person
who shall publicly profess to be a traditional midwife and who, for a fee, shall assist or
attend to a woman in pregnancy, childbirth outside a hospital, and postpartum, shall be
regarded as practicing traditional midwifery.new text begin A certified midwife licensed by the Board of
Nursing under chapter 148G is not subject to the provisions of this chapter.
new text end
Sec. 8.
Minnesota Statutes 2024, section 148.108, subdivision 1, is amended to read:
Subdivision 1.
Fees.
deleted text begin In addition to the fees established in Minnesota Rules, chapter
2500,deleted text end The board is authorized to charge the fees in this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 9.
Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision to
read:
new text begin Subd. 5. new text end
new text begin Chiropractic license fees. new text end
new text begin
Fees for chiropractic licensure are the following
amounts but may be adjusted lower by board action:
new text end
new text begin
(1) initial application for licensure fee, $600;
new text end
new text begin
(2) annual renewal of an active license fee, $250;
new text end
new text begin
(3) annual renewal of an inactive license fee, 75 percent of the current active license
renewal fee under clause (2);
new text end
new text begin
(4) late renewal penalty fee, $150 per month late; and
new text end
new text begin
(5) application for reinstatement of a voluntarily retired or inactive license fee, $100.
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 148.108, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Acupuncture registration fees. new text end
new text begin
Fees for acupuncture registration are the
following amounts but may be adjusted lower by board action:
new text end
new text begin
(1) initial application acupuncture registration fee, $400;
new text end
new text begin
(2) annual renewal of active acupuncture registration fee, $200;
new text end
new text begin
(3) annual renewal of inactive acupuncture registration fee, 75 percent of the current
active acupuncture registration renewal fee under clause (2); and
new text end
new text begin
(4) reinstatement of nonrenewed acupuncture registration fee, $400.
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. 11.
Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
to read:
new text begin Subd. 7. new text end
new text begin Independent examiner registration fees. new text end
new text begin
Fees for independent examiner
registration are the following amounts but may be adjusted lower by board action:
new text end
new text begin
(1) initial application independent examiner registration fee, $400;
new text end
new text begin
(2) annual renewal of independent examiner registration fee, $200; and
new text end
new text begin
(3) reinstatement of nonrenewed independent examiner registration fee, $400.
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 148.108, is amended by adding a subdivision
to read:
new text begin Subd. 8. new text end
new text begin Animal chiropractic registration fees. new text end
new text begin
Fees for animal chiropractic registration
are the following amounts but may be adjusted lower by board action:
new text end
new text begin
(1) initial application animal chiropractic registration fee, $400;
new text end
new text begin
(2) annual renewal of active animal chiropractic registration fee, $200;
new text end
new text begin
(3) annual renewal of inactive animal chiropractic registration fee, 75 percent of the
current active animal chiropractic renewal fee under clause (2); and
new text end
new text begin
(4) reinstatement of nonrenewed animal chiropractic registration fee, $400.
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. 13.
Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
to read:
new text begin Subd. 9. new text end
new text begin Graduate preceptorship registration fee. new text end
new text begin
The application fee for graduate
preceptorship registration is $500, but may be adjusted lower by board action.
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. 14.
Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
to read:
new text begin Subd. 10. new text end
new text begin Professional firm registration fees. new text end
new text begin
In addition to fees authorized under
chapter 319B, the late renewal penalty fee for professional firm registration is $5 per month
late.
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. 15.
Minnesota Statutes 2024, section 148.108, is amended by adding a subdivision
to read:
new text begin Subd. 11. new text end
new text begin Miscellaneous fees. new text end
new text begin
Fees under this subdivision are the following amounts
but may be adjusted lower by board action:
new text end
new text begin
(1) annual continuing education sponsorship fee, $1,000;
new text end
new text begin
(2) individual continuing education seminar sponsorship fee, $400;
new text end
new text begin
(3) mailing list request fee, $500;
new text end
new text begin
(4) license verification fee, $50;
new text end
new text begin
(5) duplicate certificate fee, $50; and
new text end
new text begin
(6) document copies fee, $0.25 per side of document page.
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. 16.
Minnesota Statutes 2024, section 148.191, subdivision 2, is amended to read:
Subd. 2.
Powers.
(a) The board is authorized to adopt and, from time to time, revise
rules not inconsistent with the law, as may be necessary to enable it to carry into effect the
provisions of sections 148.171 to 148.285new text begin and chapter 148Gnew text end . The board shall prescribe by
rule curricula and standards for schools and courses preparing persons for licensure under
sections 148.171 to 148.285new text begin and 148G.12new text end . It shall conduct or provide for surveys of such
schools and courses at such times as it may deem necessary. It shall approve such schools
and courses as meet the requirements of sections 148.171 to 148.285new text begin or section 148G.12,new text end
and board rules. It shall examine, license, and renew the license of duly qualified applicants.
It shall hold examinations at least once in each year at such time and place as it may
determine. It shall by rule adopt, evaluate, and periodically revise, as necessary, requirements
for licensure and for registration and renewal of registration as defined in section 148.231new text begin
and chapter 148Gnew text end . It shall maintain a record of all persons licensed by the board to practice
advanced practice, professional, or practical nursingnew text begin , or certified as a midwifenew text end . It shall cause
the prosecution of all persons violating sections 148.171 to 148.285new text begin or chapter 148G,new text end and
have power to incur such necessary expense therefor. It shall register public health nurses
who meet educational and other requirements established by the board by rule, including
payment of a fee. It shall have power to issue subpoenas, and to compel the attendance of
witnesses and the production of all necessary documents and other evidentiary material.
Any board member may administer oaths to witnesses, or take their affirmation. It shall
keep a record of all its proceedings.
(b) The board shall have access to hospital, nursing home, and other medical records of
a patient cared for by a nursenew text begin or certified midwifenew text end under review. If the board does not have
a written consent from a patient permitting access to the patient's records, the nursenew text begin , certified
midwife,new text end or facility shall delete any data in the record that identifies the patient before
providing it to the board. The board shall have access to such other records as reasonably
requested by the board to assist the board in its investigation. Nothing herein may be
construed to allow access to any records protected by section 145.64. The board shall
maintain any records obtained pursuant to this paragraph as investigative data under chapter
13.
(c) The board may accept and expend grants or gifts of money or in-kind services from
a person, a public or private entity, or any other source for purposes consistent with the
board's role and within the scope of its statutory authority.
(d) The board may accept registration fees for meetings and conferences conducted for
the purposes of board activities that are within the scope of its authority.
Sec. 17.
Minnesota Statutes 2024, section 148.241, is amended to read:
148.241 EXPENSES.
Subdivision 1.
Appropriation.
The expenses of administering sections 148.171 to
148.285 new text begin and chapter 148G new text end shall be paid from the appropriation made to the Minnesota
Board of Nursing.
Subd. 2.
Expenditure.
All amounts appropriated to the board shall be held subject to
the order of the board to be used only for the purpose of meeting necessary expenses incurred
in the performance of the purposes of sections 148.171 to 148.285new text begin and chapter 148Gnew text end , and
the duties imposed thereby as well as the promotion of nursing new text begin or certified midwifery
new text end education and standards of nursing new text begin or certified midwifery new text end care in this state.
Sec. 18.
Minnesota Statutes 2024, section 148.512, subdivision 17a, is amended to read:
Subd. 17a.
Speech-language pathology assistant.
"Speech-language pathology assistant"
means a person who meets the qualifications under section 148.5181 and provides
speech-language pathology services under the supervision of a licensed speech-language
pathologistnew text begin under sections 122A.183 and 122A.184 ornew text end in accordance with section 148.5192.
Sec. 19.
Minnesota Statutes 2024, section 148.5192, subdivision 3, is amended to read:
Subd. 3.
Supervision requirements.
(a) A supervising speech-language pathologist
shall authorize and accept full responsibility for the performance, practice, and activity of
a speech-language pathology assistant. The amount and type of supervision required must
be based on the skills and experience of the speech-language pathology assistant. A minimum
of one hour every 30 days of consultative supervision time must be documented for each
speech-language pathology assistant.
(b) A supervising speech-language pathologist must:
(1) be licensed under sections new text begin 122A.183, 122A.184, or new text end 148.511 to 148.5198;
(2) hold a certificate of clinical competence from the American Speech-Language-Hearing
Association or its equivalent as approved by the commissioner; and
(3) have completed at least ten hours of continuing education in supervision.
(c) Once every 60 days, the supervising speech-language pathologist must treat or cotreat
with the speech-language pathology assistant each client on the speech-language pathology
assistant's caseload.
(d) For purposes of this section, "direct supervision" means observation and guidance
by the supervising speech-language pathologist during the performance of a delegated duty
that occurs either on-site and in-view or through the use of real-time, two-way interactive
audio and visual communication. The supervision requirements described in this section
are minimum requirements. Additional supervision requirements may be imposed at the
discretion of the supervising speech-language pathologist.
(e) A supervising speech-language pathologist must be available to communicate with
a speech-language pathology assistant at any time the assistant is in direct contact with a
client.
(f) A supervising speech-language pathologist must document activities performed by
the assistant that are directly supervised by the supervising speech-language pathologist.
At a minimum, the documentation must include:
(1) information regarding the quality of the speech-language pathology assistant's
performance of the delegated duties; and
(2) verification that any delegated clinical activity was limited to duties authorized to
be performed by the speech-language pathology assistant under this section.
(g) A supervising speech-language pathologist must review and cosign all informal
treatment notes signed or initialed by the speech-language pathology assistant.
(h) A full-time, speech-language pathologist may supervise no more than two full-time,
speech-language pathology assistants or the equivalent of two full-time assistants.
Sec. 20.
Minnesota Statutes 2024, section 148.5194, subdivision 3b, is amended to read:
Subd. 3b.
Speech-language pathology assistant licensure fees.
The fee for initial
licensure as a speech-language pathology assistant deleted text begin is $493deleted text end new text begin must not exceed $220new text end . The fee
for licensure renewal for a speech-language pathology assistant deleted text begin is $493deleted text end new text begin must not exceed
$220new text end .
Sec. 21.
Minnesota Statutes 2024, section 148.56, subdivision 1, is amended to read:
Subdivision 1.
Optometry defined.
(a) Any person shall be deemed to be practicing
optometry within the meaning of sections 148.52 to 148.62 who shall in any way:
(1) advertise as an optometrist;
(2) employ any means, including the use of autorefractors or other automated testing
devices, for the measurement of the powers of vision or the adaptation of lenses or prisms
for the aid thereof;
(3) possess testing appliances for the purpose of the measurement of the powers of vision;
(4) diagnose any disease, optical deficiency or deformity, or visual or muscular anomaly
of the visual system consisting of the human eye and its accessory or subordinate anatomical
parts;
(5) prescribe lenses, including plano or cosmetic contact lenses, or prisms for the
correction or the relief of same;
(6) employ or prescribe ocular exercises, orthoptics, or habilitative and rehabilitative
therapeutic vision care; or
(7) prescribe or administer legend drugs to aid in the diagnosis, cure, mitigation,
prevention, treatment, or management of disease, deficiency, deformity, or abnormality of
the human eye and adnexa included in the curricula of accredited schools or colleges of
optometry, and as limited by Minnesota statute and adopted rules by the Board of Optometry,
or who holds oneself out as being able to do so.
(b) In the course of treatment, nothing in this section shall allow:
(1) legend drugs to be administered intravenouslydeleted text begin , intramuscularly, or by injection,
deleted text end deleted text begin except for treatment of anaphylaxisdeleted text end new text begin or by sub-Tenon, retrobulbar, or intravitreal injectionnew text end ;
(2) invasive surgery including, but not limited to, surgery using lasers;
(3) Schedule II and III oral legend drugs deleted text begin and oral steroidsdeleted text end to be administered or
prescribed;new text begin or
new text end
(4) oral deleted text begin antivirals to be prescribed or administered for more than ten days; ordeleted text end new text begin steroids
to be administered or prescribed for more than 14 days without consultation with a physician.
new text end
deleted text begin
(5) oral carbonic anhydrase inhibitors to be prescribed or administered for more than
seven days.
deleted text end
Sec. 22.
Minnesota Statutes 2024, section 148.6401, is amended to read:
148.6401 SCOPE.
Sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end apply to persons who are applicants for licensure,
who are licensed, who use protected titles, or who represent that they are licensed as
deleted text begin occupational therapists ordeleted text end occupational therapy deleted text begin assistantsdeleted text end new text begin practitionersnew text end .
Sec. 23.
Minnesota Statutes 2024, section 148.6402, subdivision 1, is amended to read:
Sec. 24.
Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin
Accreditation Council for Occupational Therapy Education or
ACOTE.
new text end
new text begin
"Accreditation Council for Occupational Therapy Education" or "ACOTE" means
the entity that accredits occupational therapy education programs in the United States and
its territories and establishes, approves, and administers educational standards ensuring
consistency across all occupational therapy education.
new text end
Sec. 25.
Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
to read:
new text begin Subd. 5a. new text end
new text begin Continuing competence. new text end
new text begin
"Continuing competence" means the process in
which an occupational therapy practitioner develops and maintains the knowledge, critical
reasoning, interpersonal skills, performance skills, and ethical practice necessary to perform
their occupational therapy responsibilities.
new text end
Sec. 26.
Minnesota Statutes 2024, section 148.6402, subdivision 7, is amended to read:
Subd. 7.
deleted text begin Credentialingdeleted text end new text begin Certificationnew text end examination for occupational
therapist.
"deleted text begin Credentialingdeleted text end new text begin Certificationnew text end examination for occupational therapist" means the
examination sponsored by the National Board for Certification in Occupational Therapy
for deleted text begin credentialingdeleted text end new text begin certificationnew text end as deleted text begin andeleted text end new text begin a registerednew text end occupational therapistdeleted text begin , registereddeleted text end .
Sec. 27.
Minnesota Statutes 2024, section 148.6402, subdivision 8, is amended to read:
Subd. 8.
deleted text begin Credentialingdeleted text end new text begin Certification new text end examination for occupational therapy
assistant.
"deleted text begin Credentialingdeleted text end new text begin Certificationnew text end examination for occupational therapy assistant"
means the examination sponsored by the National Board for Certification in Occupational
Therapy for deleted text begin credentialingdeleted text end new text begin certificationnew text end as a certified occupational therapy assistant.
Sec. 28.
Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
to read:
new text begin Subd. 12a. new text end
new text begin Face-to-face supervision. new text end
new text begin
"Face-to-face supervision" means supervision
occurring between a supervisor and a supervisee within each other's sight or presence.
Face-to-face supervision includes real-time audio and video communication where the
supervisor and supervisee can see each other and clearly visualize the services being provided.
new text end
Sec. 29.
Minnesota Statutes 2024, section 148.6402, subdivision 13, is amended to read:
Subd. 13.
Licensed health care professional.
"Licensed health care professional" means
a person licensed in good standing in Minnesota to practice medicine, osteopathic medicine,
chiropractic, podiatry, advanced practice registered nursing, deleted text begin ordeleted text end dentistry, or deleted text begin is a person
registereddeleted text end as anew text begin licensednew text end physician assistant in Minnesota.
Sec. 30.
Minnesota Statutes 2024, section 148.6402, is amended by adding a subdivision
to read:
new text begin Subd. 13a. new text end
new text begin
National Board for Certification in Occupational Therapy or
NBCOT.
new text end
new text begin
"National Board for Certification in Occupational Therapy" or "NBCOT" means
the entity that administers the certification examination and provides initial and renewal
board certification for occupational therapy practitioners providing services in the United
States, or any successor entity performing the certification examination and initial and
renewal board certification.
new text end
Sec. 31.
Minnesota Statutes 2024, section 148.6402, subdivision 14, is amended to read:
Subd. 14.
Occupational therapist.
"Occupational therapist" means an individual deleted text begin who
meets the qualifications in sections 148.6401 to 148.6449 and is licensed by the boarddeleted text end new text begin
licensed to practice occupational therapy under sections 148.6401 to 148.645 who is
responsible for and directs the evaluation process, discharge planning process, development
of intervention plans, and provision of occupational therapy servicesnew text end .
Sec. 32.
Minnesota Statutes 2024, section 148.6402, subdivision 16, is amended to read:
Subd. 16.
Occupational therapy assistant.
"Occupational therapy assistant" means an
individual deleted text begin who meets the qualifications for an occupational therapy assistant in sections
148.6401 to 148.6449 and is licensed by the boarddeleted text end new text begin licensed to assist in the practice of
occupational therapy under sections 148.6401 to 148.645 who works under the appropriate
supervision of and in partnership with an occupational therapist, unless exempted under
section 148.6432new text end .
Sec. 33.
Minnesota Statutes 2024, section 148.6402, subdivision 16a, is amended to read:
Sec. 34.
Minnesota Statutes 2024, section 148.6402, subdivision 19, is amended to read:
Sec. 35.
Minnesota Statutes 2024, section 148.6402, subdivision 20, is amended to read:
Sec. 36.
Minnesota Statutes 2024, section 148.6402, subdivision 23, is amended to read:
Subd. 23.
Service competency.
(a) "Service competency" of an occupational therapy
assistant in performing evaluation tasks means the ability of an occupational therapy assistant
to obtain the same information as the supervising occupational therapist when evaluating
a client's function.
(b) "Service competency" of an occupational therapy assistant in performing treatment
procedures means the ability of an occupational therapy assistant to perform treatment
procedures in a manner such that the outcome, documentation, and follow-up are equivalent
to that which would have been achieved had the supervising occupational therapist performed
the treatment procedure.
(c) "Service competency" of an occupational therapist means the ability of an occupational
therapist to consistently perform an assessment task or intervention procedure with the level
of skill recognized as satisfactory within the deleted text begin appropriate acceptable prevailing practicedeleted text end
new text begin national practice standards new text end of occupational therapy.
Sec. 37.
Minnesota Statutes 2024, section 148.6402, subdivision 25, is amended to read:
Subd. 25.
Temporary licensure.
"Temporary licensure" means a method of licensure
described in section 148.6418, by which an individual who (1) has completed an approved
or accredited education program but has not met the examination requirement; or (2)
possesses a credential from another jurisdiction or the National Board for Certification in
Occupational Therapy but who has not submitted the documentation required by section
148.6420deleted text begin , subdivisions 3 and 4,deleted text end may qualify for Minnesota licensure for a limited time
period.
Sec. 38.
Minnesota Statutes 2024, section 148.6403, is amended to read:
148.6403 LICENSURE; PROTECTED TITLES AND RESTRICTIONS ON USE;
EXEMPT PERSONS; SANCTIONS.
Subdivision 1.
Unlicensed practice prohibited.
A person must not engage in the practice
of occupational therapy unless the person is licensed as an occupational therapy practitioner
in accordance with sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end .
Subd. 2.
Protected titles and restrictions on use.
Use of the phrase "occupational
therapynew text begin ,new text end " deleted text begin ordeleted text end "occupational therapist," new text begin or "occupational therapy assistant," new text end or the initials
"OT"new text begin or "OTA"new text end alone or in combination with any other words or initials to form an
occupational title, or to indicate or imply that the person is licensed by the state as an
occupational therapist or occupational therapy assistant, is prohibited unless that person is
licensed under sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end .
Subd. 3.
Use of "Minnesota licensed."
Use of the term "Minnesota licensed" in
conjunction with titles protected under this section by any person is prohibited unless that
person is licensed under sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end .
Subd. 4.
Persons licensed or certified in other states.
A person who is licensed in
Minnesota and licensed or certified in another deleted text begin statedeleted text end new text begin jurisdictionnew text end may use the designation
"licensed" or "certified" with a protected title only if the deleted text begin statedeleted text end new text begin jurisdictionnew text end of licensure or
certification is clearly indicated.
Subd. 5.
Exempt persons.
This section does not apply to:
(1) a person employed as an occupational therapy practitioner by the government of the
United States or any agency of it. However, use of the protected titles under those
circumstances is allowed only in connection with performance of official duties for the
federal government;
(2) a student participating in supervised fieldwork or supervised coursework that is
necessary to meet the requirements of section 148.6408, subdivision 1, or 148.6410,
subdivision 1, if the person is designated by a title which clearly indicates the person's status
as a student trainee. Any use of the protected titles under these circumstances is allowed
only while the person is performing the duties of the supervised fieldwork or supervised
coursework; deleted text begin or
deleted text end
deleted text begin
(3) a person visiting and then leaving the state and performing occupational therapy
services while in the state, if the services are performed no more than 30 days in a calendar
year as part of a professional activity that is limited in scope and duration and is in association
with an occupational therapist licensed under sections 148.6401 to 148.6449, and
deleted text end
deleted text begin (i) thedeleted text end new text begin (3) anew text end person new text begin who new text end is credentialed under the law of another state deleted text begin whichdeleted text end new text begin thatnew text end has
credentialing requirements at least as stringent as the requirements of sections 148.6401 to
deleted text begin 148.6449deleted text end new text begin 148.645new text end ; or
deleted text begin (ii) thedeleted text end new text begin (4) anew text end personnew text begin whonew text end meets the requirements for certification as an occupational
therapist registered (OTR) or a certified occupational therapy assistant (COTA), established
by the National Board for Certification in Occupational Therapydeleted text begin .deleted text end new text begin ; or
new text end
new text begin
(5) an occupational therapy practitioner who possesses an active compact privilege under
section 148.645.
new text end
Subd. 6.
Sanctions.
A person who practices occupational therapy or holds out as an
occupational therapy practitioner by or through the use of any title described in subdivision
2 without prior licensure according to sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end is subject to
sanctions or action against continuing the activity according to section 148.6448, chapter
214, or other statutory authority.
Subd. 7.
Exemption.
Nothing in sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end shall prohibit
the practice of any profession or occupation licensed or registered by the state by any person
duly licensed or registered to practice the profession or occupation or to perform any act
that falls within the scope of practice of the profession or occupation.
Sec. 39.
Minnesota Statutes 2024, section 148.6404, is amended to read:
148.6404 SCOPE OF PRACTICE.
(a) The practice of occupational therapy means the therapeutic use of everyday deleted text begin activitiesdeleted text end
new text begin life occupations new text end with individuals deleted text begin ordeleted text end new text begin ,new text end groupsnew text begin , or populationsnew text end for the purpose of enhancing
or enabling participationnew text begin in those occupationsnew text end . deleted text begin It is the promotion ofdeleted text end new text begin The practice of
occupational therapy promotesnew text end health and well-being through the use of occupational therapy
services that includes screening, evaluation, intervention, and consultation to develop,
recover, and maintain a client's:
(1) sensory integrative, neuromuscular, motor, emotional, motivational, cognitive, or
psychosocial components of performance;
(2) daily living skills;
(3) feeding and swallowing skills;
(4) play and leisure skills;
(5) educational participation skills;
(6) functional performance and work participation skills;
(7) community mobility; and
(8) health and wellness.
(b) Occupational therapy services include but are not limited to:
(1) designing, fabricating, or applying rehabilitative technology, such as selected orthotic
and prosthetic devices, and providing training in the functional use of these devices;
(2) designing, fabricating, or adapting assistive technology and providing training in the
functional use of assistive devices;
(3) adapting environments using assistive technology such as environmental controls,
wheelchair modifications, and positioning; deleted text begin and
deleted text end
(4) deleted text begin employingdeleted text end new text begin applyingnew text end physical agentnew text begin , manual, and mechanicalnew text end modalities in preparation
for or as an adjunct to purposeful activity to meet established functional occupational therapy
goalsnew text begin ; and
new text end
new text begin (5) educating and training individuals, including families, caregivers, groups, and
populationsnew text end .
(c) Occupational therapy services must be based on nationally established standards of
practice.
Sec. 40.
Minnesota Statutes 2024, section 148.6405, is amended to read:
148.6405 LICENSURE APPLICATION REQUIREMENTS: PROCEDURES AND
QUALIFICATIONS.
(a) An applicant for licensure must comply with the application requirements in section
148.6420. To qualify for licensure, an applicant must satisfy one of the requirements in
deleted text begin paragraphs (b) to (f)deleted text end new text begin sections 148.6408 to 148.6415, or section 148.645new text end and not be subject
to denial of licensure under section 148.6448.
deleted text begin
(b) A person who applies for licensure as an occupational therapist and who has not
been credentialed by the National Board for Certification in Occupational Therapy or another
jurisdiction must meet the requirements in section 148.6408.
deleted text end
deleted text begin
(c) A person who applies for licensure as an occupational therapy assistant and who has
not been credentialed by the National Board for Certification in Occupational Therapy or
another jurisdiction must meet the requirements in section 148.6410.
deleted text end
deleted text begin
(d) A person who is certified by the National Board for Certification in Occupational
Therapy may apply for licensure by equivalency and must meet the requirements in section
148.6412.
deleted text end
deleted text begin
(e) A person who is credentialed in another jurisdiction and who was previously certified
by the National Board for Certification in Occupational Therapy may apply for licensure
by reciprocity and must meet the requirements in section 148.6415.
deleted text end
deleted text begin (f)deleted text end new text begin (b)new text end A person who applies for temporary licensure must meet the requirements in
section 148.6418.
new text begin
(c) A person who applies for licensure under section 148.6408 or 148.6410 more than
two years after the person's initial NBCOT certification was issued and who has not practiced
in any jurisdiction must submit:
new text end
new text begin
(1) a completed and signed application for licensure on forms provided by the board
that meet the requirements of section 148.6420, subdivision 1, paragraph (a), clauses (1)
and (2); and
new text end
new text begin
(2) proof of a minimum of 24 continuing education contact hours by an occupational
therapist applicant, or a minimum of 18 hours by an occupational therapy assistant applicant,
completed within the two years proceeding the application and meeting the requirements
of section 148.6443.
new text end
deleted text begin (g)deleted text end new text begin (d)new text end A person who applies for licensure under deleted text begin paragraph (b), (c), or (f) more than two
and less than four years after meeting the examination requirements in section 148.6408,
subdivision 2, or 148.6410, subdivision 2,deleted text end new text begin section 148.6408 or 148.6410 after the person's
initial NBCOT certification has expirednew text end must submit deleted text begin the followingdeleted text end :
(1) a completed and signed application for licensure on forms provided by the boardnew text begin
that meet the requirements of section 148.6420, subdivision 1, paragraph (a), clauses (1)
and (2)new text end ;new text begin and
new text end
(2) deleted text begin the license application fee required under section 148.6445;deleted text end new text begin evidence of:
new text end
new text begin
(i) completion of an occupational therapy refresher program that contains both theoretical
and clinical components completed within the last year; or
new text end
new text begin
(ii) current NBCOT certification.
new text end
deleted text begin
(3) if applying for occupational therapist licensure, proof of having met a minimum of
24 contact hours of continuing education in the two years preceding licensure application,
or if applying for occupational therapy assistant licensure, proof of having met a minimum
of 18 contact hours of continuing education in the two years preceding licensure application;
deleted text end
deleted text begin
(4) verified documentation of successful completion of 160 hours of supervised practice
approved by the board under a limited license specified in section 148.6425, subdivision 3,
paragraph (c); and
deleted text end
deleted text begin
(5) additional information as requested by the board to clarify information in the
application, including information to determine whether the individual has engaged in
conduct warranting disciplinary action under section 148.6448. The information must be
submitted within 30 calendar days from the date of the board's request.
deleted text end
deleted text begin
(h) A person who applies for licensure under paragraph (b), (c), or (f) four years or more
after meeting the examination requirements in section 148.6408, subdivision 2, or 148.6410,
subdivision 2, must:
deleted text end
deleted text begin
(1) meet all the requirements in paragraph (g) except clauses (3) and (4);
deleted text end
deleted text begin
(2) submit documentation of having retaken and achieved a qualifying score on the
credentialing examination for occupational therapists or occupational therapy assistants, or
of having completed an occupational therapy refresher program that contains both a
theoretical and clinical component approved by the board; and
deleted text end
deleted text begin
(3) submit verified documentation of successful completion of 480 hours of supervised
practice approved by the board under a limited license specified in section 148.6425,
subdivision 3, paragraph (c). The 480 hours of supervised practice must be completed in
six months and may be completed at the applicant's place of work. Only refresher courses
completed within one year prior to the date of application qualify for approval.
deleted text end
Sec. 41.
Minnesota Statutes 2024, section 148.6408, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Qualifications. new text end
new text begin
To be licensed as an occupational therapist, an applicant must:
new text end
new text begin
(1) satisfy the education and examination requirements of subdivisions 1b and 2; or
new text end
new text begin
(2) satisfy the requirements for licensure by equivalency under section 148.6412 or
licensure by reciprocity under section 148.6415 as applicable based on the current status of
the applicant's NBCOT certification.
new text end
Sec. 42.
Minnesota Statutes 2024, section 148.6408, subdivision 2, is amended to read:
Subd. 2.
Qualifying examination score required.
(a) An applicant must achieve a
qualifying score on the deleted text begin credentialingdeleted text end new text begin certificationnew text end examination for occupational therapist.
(b) The board shall determine the qualifying score for the deleted text begin credentialingdeleted text end new text begin certificationnew text end
examination for occupational therapistdeleted text begin . In determining the qualifying score, the board shall
consider the cut scoredeleted text end new text begin as new text end recommended by the National Board for Certification in
Occupational Therapy, or other national deleted text begin credentialingdeleted text end new text begin certificationnew text end organization approved
by the boarddeleted text begin , using the modified Angoff method for determining cut score or another method
for determining cut score that is recognized as appropriate and acceptable by industry
standardsdeleted text end .
(c) deleted text begin The applicant is responsible fordeleted text end new text begin Applicants for licensure mustnew text end :
(1) deleted text begin makingdeleted text end new text begin makenew text end arrangements to take the deleted text begin credentialingdeleted text end new text begin certificationnew text end examination for
new text begin an new text end occupational therapist;
(2) deleted text begin bearingdeleted text end new text begin bearnew text end all expenses associated with taking the examination; and
(3) deleted text begin having the examination scores sent directly to the board from the testing service that
administers the examinationdeleted text end new text begin submit an application and other materials as required by the
board under section 148.6420new text end .
Sec. 43.
Minnesota Statutes 2024, section 148.6410, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Qualifications. new text end
new text begin
To be licensed as an occupational therapist assistant, an
applicant must:
new text end
new text begin
(1) satisfy the education and examination requirements of subdivisions 1b and 2; or
new text end
new text begin
(2) satisfy the requirements for licensure by equivalency under section 148.6412 or
licensure by reciprocity under section 148.6415 as applicable based on the current status of
the applicant's NBCOT certification.
new text end
Sec. 44.
Minnesota Statutes 2024, section 148.6410, subdivision 2, is amended to read:
Subd. 2.
Qualifying examination score required.
(a) An applicant for licensure must
achieve a qualifying score on the deleted text begin credentialingdeleted text end new text begin certificationnew text end examination for occupational
therapy assistants.
(b) The board shall determine the qualifying score for the deleted text begin credentialingdeleted text end new text begin certificationnew text end
examination for occupational therapy assistantsdeleted text begin . In determining the qualifying score, the
board shall consider the cut scoredeleted text end new text begin asnew text end recommended by the National Board for Certification
in Occupational Therapy, or other national deleted text begin credentialingdeleted text end new text begin certificationnew text end organization approved
by the boarddeleted text begin , using the modified Angoff method for determining cut score or another method
for determining cut score that is recognized as appropriate and acceptable by industry
standardsdeleted text end .
(c) deleted text begin The applicant is responsible fordeleted text end new text begin Applicants for licensure mustnew text end :
(1) deleted text begin makingdeleted text end new text begin makenew text end all arrangements to take the deleted text begin credentialingdeleted text end new text begin certificationnew text end examination
for occupational therapy assistants;
(2) deleted text begin bearingdeleted text end new text begin bearnew text end all expense associated with taking the examination; and
(3) deleted text begin having the examination scores sent directly to the board from the testing service that
administers the examinationdeleted text end new text begin submit an application and other materials as required by the
board under section 148.6420new text end .
Sec. 45.
Minnesota Statutes 2024, section 148.6412, subdivision 2, is amended to read:
Subd. 2.
Persons new text begin currently new text end certified by deleted text begin National Board for Certification in
Occupational Therapydeleted text end new text begin NBCOTnew text end .
The board may license any person deleted text begin certified by the National
Board for Certification in Occupational Therapydeleted text end new text begin who holds current NBCOT certificationnew text end
as an occupational deleted text begin therapist if the board determines the requirements for certification are
equivalent to or exceed the requirements for licensure as an occupational therapist under
section 148.6408deleted text end new text begin therapy practitionernew text end . deleted text begin The board may license any person certified by the
National Board for Certification in Occupational Therapy as an occupational therapy assistant
if the board determines the requirements for certification are equivalent to or exceed the
requirements for licensure as an occupational therapy assistant under section 148.6410.deleted text end
Nothing in this section limits the board's authority to deny licensure based upon the grounds
for discipline in sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end .
Sec. 46.
Minnesota Statutes 2024, section 148.6412, subdivision 3, is amended to read:
Subd. 3.
Application procedures.
Applicants for licensure by equivalency must providedeleted text begin :
deleted text end
deleted text begin (1)deleted text end the application materials as required by section 148.6420, deleted text begin subdivisionsdeleted text end new text begin subdivisionnew text end
1deleted text begin , 3, and 4deleted text end deleted text begin ; anddeleted text end new text begin .
new text end
deleted text begin
(2) the fees required by section 148.6445.
deleted text end
Sec. 47.
Minnesota Statutes 2024, section 148.6415, is amended to read:
148.6415 LICENSURE BY RECIPROCITY.
deleted text begin A person who is not certified by the National Board for Certification in Occupational
Therapydeleted text end new text begin The board may license any person who does not hold current NBCOT certificationnew text end
but who holds a new text begin compact privilege or a new text end current credential as an occupational deleted text begin therapistdeleted text end new text begin therapy
practitionernew text end in the District of Columbia or a state or territory of the United States whose
standards for credentialing are determined by the board to be equivalent to or exceed the
requirements for licensure under section 148.6408 deleted text begin may be eligible for licensure by reciprocity
as an occupational therapist. A person who is not certified by the National Board for
Certification in Occupational Therapy but who holds a current credential as an occupational
therapy assistant in the District of Columbia or a state or territory of the United States whose
standards for credentialing are determined by the board to be equivalent to or exceed the
requirements for licensure under section 148.6410 may be eligible for licensure by reciprocity
as an occupational therapy assistant.deleted text end new text begin or 148.6410 as an occupational therapy practitioner.new text end
Nothing in this section limits the board's authority to deny licensure based upon the grounds
for discipline in sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end . An applicant must provide:
(1) the application materials as required by section 148.6420, deleted text begin subdivisionsdeleted text end new text begin subdivisionnew text end
1deleted text begin , 3, and 4deleted text end ;new text begin and
new text end
deleted text begin
(2) the fees required by section 148.6445;
deleted text end
deleted text begin
(3) a copy of a current and unrestricted credential for the practice of occupational therapy
as either an occupational therapist or occupational therapy assistant;
deleted text end
deleted text begin
(4) a letter from the jurisdiction that issued the credential describing the applicant's
qualifications that entitled the applicant to receive the credential; and
deleted text end
deleted text begin (5)deleted text end new text begin (2)new text end other information necessary to determine whether the credentialing standards of
the jurisdiction that issued the credential are equivalent to or exceed the requirements for
licensure under sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end .
Sec. 48.
Minnesota Statutes 2024, section 148.6418, is amended to read:
148.6418 TEMPORARY LICENSURE.
Subdivision 1.
Application.
The board shall issue temporary licensure as an occupational
deleted text begin therapist or occupationaldeleted text end therapy deleted text begin assistantdeleted text end new text begin practitionernew text end to applicants who are not the subject
of a disciplinary action or past disciplinary action, nor disqualified on the basis of items
listed in section 148.6448, subdivision 1.
Subd. 2.
Procedures.
To be eligible for temporary licensure, an applicant must submit
a completed application for temporary licensure on forms provided by the board, the fees
required by section 148.6445, and one of the following:
(1) evidence of successful completion of the requirements in section 148.6408,
subdivision 1, or 148.6410, subdivision 1;
(2) a copy of a current and unrestricted credential for the practice of occupational therapy
as deleted text begin eitherdeleted text end an occupational deleted text begin therapist or occupationaldeleted text end therapy deleted text begin assistantdeleted text end new text begin practitionernew text end in another
jurisdiction; or
(3) a copy of a current and unrestricted deleted text begin certificatedeleted text end new text begin certificationnew text end from the National Board
for Certification in Occupational Therapy stating that the applicant is certified as an
occupational deleted text begin therapist or occupationaldeleted text end therapy deleted text begin assistantdeleted text end new text begin practitionernew text end .
Subd. 3.
Additional documentation.
Persons who are deleted text begin credentialeddeleted text end new text begin certifiednew text end by the
National Board for Certification in Occupational Therapy ornew text begin credentialed bynew text end another
jurisdiction must provide deleted text begin an affidavitdeleted text end new text begin a statementnew text end with the application for temporary licensure
stating that they are not the subject of a pending investigation or disciplinary action and
have not been the subject of a disciplinary action in the past.
Subd. 4.
Supervision required.
An applicant who has graduated from an accredited
occupational therapy program, as required by section 148.6408, subdivision 1, or 148.6410,
subdivision 1, and who has not passed the examination required by section 148.6408,
subdivision 2, or 148.6410, subdivision 2, must practice under the supervision of a licensed
occupational therapist. The supervising therapist must, at a minimum, supervise the person
working under temporary licensure in the performance of the initial evaluation, determination
of the appropriate intervention plan, and periodic review and modification of the intervention
plan. The supervising therapist must observe the person working under temporary licensure
in order to ensure service competency in carrying out evaluation, intervention planning,
and intervention implementation. The frequency of face-to-face collaboration between the
person working under temporary licensure and the supervising therapist must be based on
the condition of each patient or client, the complexity of intervention and evaluation
procedures, and the proficiencies of the person practicing under temporary licensure.
Following demonstrated service competency of the applicant, supervision must occur no
less than every ten intervention days or every 30 calendar days, whichever occurs first. The
occupational deleted text begin therapist or occupationaldeleted text end therapy deleted text begin assistantdeleted text end new text begin practitionernew text end working under temporary
licensure must provide verification of supervision on the application form provided by the
board.new text begin Supervising occupational therapists must have a minimum of six months of fully
licensed practice to supervise a temporary licensee. The occupational therapy practitioner
working under temporary licensure must notify the board before changing supervision.
new text end
Subd. 5.
Qualifying examination requirement; expiration and renewability.
(a) A
person issued a temporary license pursuant to subdivision 2, clause (1), must demonstrate
to the board within the temporary licensure period successful completion of the qualifying
examination requirement under section 148.6408, subdivision 2, or section 148.6410,
subdivision 2. A temporary license holder who fails the qualifying examination for a second
time shall have their temporary license revoked effective upon notification to the temporary
license holder of the examination score. It is the temporary license holder's obligation to
submit to the board their qualifying examination scores and to refrain from practice if their
temporary license is revoked. Failure to do so subjects the temporary license holder to
disciplinary action pursuant to section 148.6448, subdivision 1, clause deleted text begin (5)deleted text end new text begin (6)new text end .new text begin The board
must not issue a temporary license to a person with two or more certification examination
failures.
new text end
(b) A temporary license expires six months from the date of issuance or on the date the
board grants or denies licensure, whichever occurs first.
(c) A temporary license is not renewable.
Sec. 49.
Minnesota Statutes 2024, section 148.6420, subdivision 1, is amended to read:
Subdivision 1.
Applications for new text begin initial new text end licensure.
new text begin (a) new text end An applicant for new text begin initial new text end licensure
must:
(1) submit a completed application for licensure on forms provided by the board and
must supply deleted text begin thedeleted text end new text begin allnew text end information new text begin and documentation new text end requested on the application, including:
(i) the applicant's name, business address and business telephone number, deleted text begin business
setting,deleted text end primary email address, and deleted text begin daytimedeleted text end new text begin home or mobilenew text end telephone number;
deleted text begin
(ii) the name and location of the occupational therapy program the applicant completed;
deleted text end
deleted text begin (iii)deleted text end new text begin (ii)new text end a description of the applicant's education and training, including new text begin the name and
location of the occupational therapy program the applicant completed and new text end a list of deleted text begin degrees
received fromdeleted text end new text begin all othernew text end educational institutionsnew text begin attendednew text end ;
deleted text begin (iv)deleted text end new text begin (iii)new text end the applicant's work history for the six years preceding the application;
deleted text begin (v)deleted text end new text begin (iv)new text end a list of all credentials currently and previously held in Minnesota and other
jurisdictions;
deleted text begin (vi)deleted text end new text begin (v)new text end a description of any jurisdiction's refusal to credential the applicant;
deleted text begin (vii)deleted text end new text begin (vi)new text end a description of all professional disciplinary actions initiated against the applicant
in any jurisdiction;
deleted text begin (viii)deleted text end new text begin (vii)new text end information on any physical or mental condition or substance use disorder
that impairs the person's ability to engage in the practice of occupational therapy with
reasonable judgment or safety;
deleted text begin (ix)deleted text end new text begin (viii)new text end a description of any misdemeanor or felony deleted text begin conviction that relates to honesty
or to the practice of occupational therapydeleted text end new text begin charges or convictionsnew text end ; deleted text begin and
deleted text end
deleted text begin (x)deleted text end new text begin (ix)new text end a description of any state or federal court order, including a conciliation court
judgment or a disciplinary order, related to the individual's occupational therapy practice;
deleted text begin
(2) submit with the application all fees required by section 148.6445;
deleted text end
deleted text begin
(3) sign a statement that the information in the application is true and correct to the best
of the applicant's knowledge and belief;
deleted text end
deleted text begin
(4) sign a waiver authorizing the board to obtain access to the applicant's records in this
or any other state in which the applicant holds or previously held a credential for the practice
of an occupation, has completed an accredited occupational therapy education program, or
engaged in the practice of occupational therapy;
deleted text end
new text begin
(x) any legal information required under chapter 214;
new text end
new text begin
(xi) either documentation to demonstrate the completion of the required education and
examination requirements under section 148.6408, subdivisions 1b and 2, or 148.6410,
subdivisions 1b and 2; for applicants for licensure by equivalency under section 148.6412,
documentation of current NBCOT certification; for applicants for licensure by reciprocity
under section 148.6415, documentation submitted directly by the appropriate commission
or government body verifying the license or credential; or verification from the Compact
Commission of the applicant's practice status in Compact Commission states;
new text end
new text begin
(xii) all application fees required by section 148.6445;
new text end
new text begin
(xiii) evidence of completing a criminal background check according to section 214.075;
and
new text end
new text begin
(xiv) a signed statement affirming that the information in the application is true and
correct to the best of the applicant's knowledge and belief;
new text end
deleted text begin (5)deleted text end new text begin (2) new text end submit additional information as requested by the board; and
deleted text begin (6)deleted text end new text begin (3)new text end submit deleted text begin thedeleted text end new text begin anynew text end additional information required for licensure by equivalency,
licensure by reciprocity,new text begin licensure by compact privilege,new text end and temporary licensure as specified
in sections 148.6408 to 148.6418deleted text begin .deleted text end new text begin and 148.645. An applicant applying under section 148.6418
is exempt from providing documentation related to a criminal background check under
clause (1), item (xiii). An applicant applying under section 148.6418, subdivision 4, is
exempt from providing documentation related to previously held licenses or credentials
under clause (1), item (iv).
new text end
new text begin
(b) The board must not verify the status of an applicant under paragraph (a), clause (1),
item (xi), by using another jurisdiction's publicly available website unless the other
jurisdiction fails to provide the requested documentation after the applicant provides
documentation of making the request.
new text end
Sec. 50.
Minnesota Statutes 2024, section 148.6423, subdivision 1, is amended to read:
Subdivision 1.
Renewal requirements.
To be eligible for licensure renewal, a licensee
must:
(1) submit a completed and signed application for licensure renewaldeleted text begin ;deleted text end new text begin on forms provided
by the board, including:
new text end
new text begin
(i) updated personal information, including the renewal applicant's name, business
address and business telephone number, primary email address, and home or mobile telephone
number;
new text end
new text begin
(ii) information regarding any change to the renewal applicant's responses to section
148.6420, subdivision 1, paragraph (a), clause (1), items (v) to (ix);
new text end
new text begin
(iii) a signed statement affirming that the information in the renewal application is true
and correct to the best of the applicant's knowledge and belief; and
new text end
new text begin
(iv) any legal information required under chapter 214;
new text end
(2) submit the renewal fee required under section 148.6445;
(3) new text begin if audited, new text end submit proof of having met the continuing education requirement of section
148.6443; and
(4) submit additional information as requested by the board to clarify information
presented in the renewal application. The information must be submitted within 30 calendar
days of the board's request.
Sec. 51.
Minnesota Statutes 2024, section 148.6423, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin License period. new text end
new text begin
Following the initial license period, a license period begins
on the first day of the month after the licensee's birth month and must be renewed biennially.
new text end
Sec. 52.
Minnesota Statutes 2024, section 148.6423, subdivision 2, is amended to read:
Subd. 2.
Renewal deadline.
(a) Except as provided in paragraph (c), licenses must be
renewed every two yearsnew text begin on or before the first day of the month after the licensee's birth
monthnew text end . Licensees must comply with the following procedures in paragraphs (b) to (e).
(b) Each license must state an expiration date. An application for licensure renewal must
be received by the board deleted text begin at least 30 calendar daysdeleted text end new text begin on ornew text end before the expiration date.
(c) If the board changes the renewal schedule and the expiration date is less than two
years, the fee and the continuing education contact hours to be reported at the next renewal
must be prorated.
(d) An application for licensure renewal not received within the time required under
paragraph (b)deleted text begin , but received on or before the expiration date,deleted text end must be accompanied by a late
fee in addition to the renewal fee specified by section 148.6445.
(e) Licensure renewals received after the expiration date must comply with the
requirements of section 148.6425.
Sec. 53.
Minnesota Statutes 2024, section 148.6425, subdivision 2, is amended to read:
Subd. 2.
Licensure renewalnew text begin within one yearnew text end after licensure expiration date.
A licensee
whose application for licensure renewal is received after the licensure expiration date new text begin but
within one year of the expiration date new text end must submit the following:
(1) a completed and signed new text begin renewal new text end application for licensure following lapse in licensed
statusdeleted text begin ;deleted text end new text begin on forms provided by the board, including:
new text end
new text begin
(i) updated personal information, including the renewal applicant's name, business
address and business telephone number, primary email address, and home or mobile telephone
number;
new text end
new text begin
(ii) information regarding any change to the renewal applicant's responses to section
148.6420, subdivision 1, paragraph (a), clause (1), items (v) to (ix);
new text end
new text begin
(iii) a signed statement affirming that the information in the renewal application is true
and correct to the best of the applicant's knowledge and belief;
new text end
new text begin
(iv) information regarding any change to the renewal applicant's responses to section
148.6420, subdivision 1, paragraph (a), clause (1), item (xi);
new text end
new text begin
(v) NBCOT verification of certification documentation; and
new text end
new text begin
(vi) any legal information required under chapter 214;
new text end
(2) the renewal fee and the late fee required under section 148.6445;
(3) proof of having met the continuing education requirements in section 148.6443deleted text begin ,
subdivision 1deleted text end ; deleted text begin and
deleted text end
new text begin
(4) an employment verification form; and
new text end
deleted text begin (4)deleted text end new text begin (5)new text end additional information as requested by the board to clarify information in the
application, including information to determine whether the licensee has engaged in conduct
warranting disciplinary action as set forth in section 148.6448. The information must be
submitted within 30 calendar days from the date of the board's request.
Sec. 54.
Minnesota Statutes 2024, section 148.6425, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Licensure renewal within two years after license expiration date. new text end
new text begin
A licensee
whose application for license renewal is received more than one year but less than two years
after the expiration date must submit the following:
new text end
new text begin
(1) a completed and signed renewal application for licensure following lapse in licensed
status on forms provided by the board, including all information listed in subdivision 2,
clause (1);
new text end
new text begin
(2) the renewal fee and the late fee required under section 148.6445;
new text end
new text begin
(3) proof of having met the continuing education requirements in section 148.6443;
new text end
new text begin
(4) an employment verification form;
new text end
new text begin
(5) evidence of completion of a criminal background check as required under section
214.075 and the associated fee; and
new text end
new text begin
(6) additional information as requested by the board to clarify information in the
application, including information to determine whether the licensee has engaged in conduct
warranting disciplinary action as set forth in section 148.6448. The information must be
submitted within 30 calendar days from the date of the board's request.
new text end
Sec. 55.
Minnesota Statutes 2024, section 148.6425, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Expiration due to nonrenewal after two years. new text end
new text begin
The board shall not renew,
reissue, reinstate, or restore a license that is not subject to a pending review, investigation,
or disciplinary action and has not been renewed within one biennial renewal cycle of the
license expiration. An individual whose license has expired under this subdivision for
nonrenewal must obtain a new license by applying for licensure and fulfilling all requirements
then in existence for an initial license to practice occupational therapy in Minnesota.
new text end
Sec. 56.
Minnesota Statutes 2024, section 148.6428, is amended to read:
148.6428 CHANGE OF CONTACT INFORMATION OR EMPLOYMENT.
A licensee who changes a name, primary email address, address, employment, business
address, or business telephone number must inform the board of the change deleted text begin of name, primary
email address, address, employment, business address, or business telephone numberdeleted text end within
30 calendar days from the effective date of the change. A change in name must be
accompanied by a copy of a marriage certificatenew text begin , government-issued identification card,
Social Security card,new text end or court order. All notices or other correspondence served on a licensee
by the board at the licensee's contact information on file with the board must be considered
as having been received by the licensee.
Sec. 57.
new text begin
[148.6431] JURISPRUDENCE EXAMINATION.
new text end
new text begin
The board may require occupational therapy practitioners to take an open-book
jurisprudence examination on state laws and rules regarding the practice of occupational
therapy and occupational therapy assisting.
new text end
Sec. 58.
Minnesota Statutes 2024, section 148.6432, subdivision 1, is amended to read:
Subdivision 1.
Applicability.
If the professional standards identified in deleted text begin section 148.6430deleted text end new text begin
subdivision 1anew text end permit an occupational therapist to delegate an evaluation, reevaluation, or
treatment procedure, the occupational therapist must provide supervision consistent with
this section.
Sec. 59.
Minnesota Statutes 2024, section 148.6432, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Delegation of duties. new text end
new text begin
(a) The occupational therapist may delegate to an
occupational therapy assistant those portions of the client's evaluation, reevaluation, and
intervention that, according to prevailing national practice standards, can be performed by
an occupational therapy assistant.
new text end
new text begin
(b) The occupational therapist is responsible for all duties delegated to the occupational
therapy assistant.
new text end
new text begin
(c) The occupational therapist may not delegate portions of an evaluation or reevaluation
of a person whose condition is changing rapidly.
new text end
Sec. 60.
Minnesota Statutes 2024, section 148.6432, subdivision 2, is amended to read:
Subd. 2.
Evaluations.
The occupational therapist shall determine the frequency of
evaluations and reevaluations for each client. The occupational therapy assistant shall inform
the occupational therapist of the need for more frequent reevaluation if indicated by the
client's condition or response to treatment. Before delegating a portion of a client's evaluation
pursuant to deleted text begin section 148.6430deleted text end new text begin subdivision 1anew text end , the occupational therapist shall ensure the
service competency of the occupational therapy assistant in performing the evaluation
procedure and shall provide supervision consistent with the condition of the patient or client
and the complexity of the evaluation procedure.
Sec. 61.
Minnesota Statutes 2024, section 148.6432, subdivision 3, is amended to read:
Subd. 3.
Intervention.
(a) The occupational therapist must determine the frequency and
manner of supervision of an occupational therapy assistant performing intervention
procedures delegated pursuant to deleted text begin section 148.6430deleted text end new text begin subdivision 1anew text end based on the condition
of the patient or client, the complexity of the intervention procedure, and the service
competency of the occupational therapy assistant.
(b) Face-to-face collaboration between the occupational therapist and the occupational
therapy assistant must occurnew text begin for all clientsnew text end every ten intervention days or every 30 days,
whichever comes first, during which time the occupational therapist is responsible for:
(1) planning and documenting an initial intervention plan and discharge from
interventions;
(2) reviewing intervention goals, therapy programs, and client progress;
(3) supervising changes in the intervention plan;
(4) conducting or observing intervention procedures for selected clients and documenting
appropriateness of intervention procedures. Clients must be selected based on the
occupational therapy services provided to the client and the role of the occupational therapist
and the occupational therapy assistant in those services; and
(5) ensuring the service competency of the occupational therapy assistant in performing
delegated intervention procedures.
(c) Face-to-face collaboration must occur more frequently if necessary to meet the
requirements of paragraph (a) or (b).
(d) The occupational therapist must document compliance with this subdivision in the
client's file or chart.
Sec. 62.
Minnesota Statutes 2024, section 148.6432, subdivision 4, is amended to read:
Subd. 4.
Exception.
new text begin (a) new text end The supervision requirements of this section do not apply to an
occupational therapy assistant who:
(1) works in an activities program; and
(2) does not perform occupational therapy services.
new text begin (b) new text end The occupational therapy assistant must meet all other applicable requirements of
sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end .
Sec. 63.
Minnesota Statutes 2024, section 148.6435, is amended to read:
148.6435 COORDINATION OF SERVICES.
An occupational therapist must:
(1) collect information necessary to ensure that the provision of occupational therapy
services are consistent with the client's physical and mental health status. The information
required to make this determination may include, but is not limited to, contacting the client's
licensed health care professional for health history, current health status, current medications,
and precautions;
deleted text begin
(2) modify or terminate occupational therapy intervention of a client that is not beneficial
to the client, not tolerated by the client, or refused by the client, and if intervention was
terminated for a medical reason, notify the client's licensed health care professional by
correspondence postmarked or delivered to the licensed health care professional within one
week of the termination of intervention;
deleted text end
deleted text begin (3)deleted text end new text begin (2)new text end refer a client to an appropriate health care, social service, or education practitioner
if the client's condition requires services not within the occupational therapist's service
competency or not within the practice of occupational therapy generallynew text begin , or if the client's
acuity warrants alternative carenew text end ; and
deleted text begin (4)deleted text end new text begin (3)new text end participate and cooperate in the coordination of occupational therapy services
with other related services, as a member of the professional community serving the client.
Sec. 64.
Minnesota Statutes 2024, section 148.6438, is amended to read:
148.6438 RECIPIENT NOTIFICATION.
Subdivision 1.
Required notification.
new text begin (a) new text end In the absence of a deleted text begin physician, advanced
practice registered nurse, or physician assistantdeleted text end new text begin licensed health care provider new text end referral or
prior authorization, and before providing occupational therapy services for remuneration
or expectation of payment from the client, an occupational therapist must provide the
following deleted text begin writtendeleted text end notification deleted text begin in all capital letters of 12-point or larger boldface type,deleted text end to new text begin the
client, parent, or guardian in a format meeting national accessibility standards and the needs
of new text end the client, parent, or guardian:
"Your health care provider, insurer, or plan may require a deleted text begin physician, advanced practice
registered nurse, or physician assistantdeleted text end new text begin licensed health care providernew text end referral or prior
authorization and you may be obligated for partial or full payment for occupational therapy
services rendered."
new text begin (b) new text end Information other than this notification may be included as long as the notification
remains conspicuous on the face of the document. deleted text begin A nonwritten disclosure format may be
used to satisfy the recipient notification requirement when necessary to accommodate the
physical condition of a client or client's guardian.
deleted text end
Subd. 2.
Evidence of recipient notification.
The occupational therapist is responsible
for providing evidence of compliance with the recipient notification requirement of this
sectionnew text begin with documentation of the client, parent, or guardian agreementnew text end .
Sec. 65.
Minnesota Statutes 2024, section 148.6443, subdivision 3, is amended to read:
Subd. 3.
Activities qualifying for continuing education contact hours.
(a) The activities
in this subdivision qualify for continuing education contact hours if they meet all other
requirements of this section.
(b) A minimum of one-half of the required contact hours must be directly related to
occupational therapy practice. The remaining contact hours may be related to occupational
therapy practice, the delivery of occupational therapy services, or to the practitioner's current
professional role.
(c) A licensee may obtain an unlimited number of contact hours in any two-year
continuing education period through participation in the following:
(1) attendance at educational programs of annual conferences, lectures, panel discussions,
workshops, in-service training, seminars, and symposiums;
(2) successful completion of college or university courses. The licensee must obtain a
grade of at least a "C" or a pass in a pass/fail course in order to receive credit. One college
credit equals six continuing education contact hours; or
(3) successful completion of deleted text begin home studydeleted text end courses that deleted text begin require the participant to
demonstrate the participant's knowledge following completion of the coursedeleted text end new text begin provide
documentation that the course was completed and that meet the requirements in subdivision
2new text end .
(d) A licensee may obtain a maximum of one-half of the required contact hours in any
two-year continuing education period for:
(1) teaching continuing education or occupational therapy related courses that meet the
requirements of this section. A licensee is entitled to earn a maximum of two contact hours
as preparation time for each contact hour of presentation time. Contact hours may be claimed
only once for teaching the same course in any two-year continuing education period. A
course schedule or brochure must be maintained for audit;
(2) supervising occupational therapist or occupational therapy assistant students. A
licensee may earn one contact hour for every eight hours of student supervision. Licensees
must ensure they receive documentation regarding each student supervised and the dates
and hours each student was supervised. Contact hours obtained by student supervision must
be obtained by supervising students from an occupational therapy education program
accredited by the Accreditation Council for Occupational Therapy Education;new text begin and
new text end
deleted text begin
(3) teaching or participating in courses related to leisure activities, recreational activities,
or hobbies if the practitioner uses these interventions within the practitioner's current practice
or employment; and
deleted text end
deleted text begin (4)deleted text end new text begin (3) new text end engaging in research activities or outcome studies that are related to the practice
of occupational therapy and associated with grants, postgraduate studies, or publications in
professional journals or books.
(e) A licensee may obtain a maximum of two contact hours in any two-year continuing
education period for continuing education activities in the following areas:
(1) personal skill topics: career burnout, communication skills, human relations, and
similar topics;
(2) deleted text begin training that is obtained in conjunction with a licensee's employment, occurs during
a licensee's normal workday, and does not include subject matter specific to the fundamentals
of occupational therapydeleted text end new text begin basic life support and CPR trainingnew text end ; and
(3) participation for a minimum of one year on a professional committee or board.
Sec. 66.
Minnesota Statutes 2024, section 148.6443, subdivision 4, is amended to read:
Subd. 4.
Activities not qualifying for continuing education contact hours.
Credit
must not be granted for the following activities: hospital new text begin patient new text end roundsdeleted text begin ,deleted text end new text begin ;new text end entertainment or
recreational activitiesdeleted text begin ,deleted text end new text begin ; volunteering;new text end noneducational association meetingsdeleted text begin ,deleted text end new text begin ;new text end and employment
orientation sessionsnew text begin and meetings, including but not limited to training required at the
beginning of employment, annually, or routinely that is related to the employer's organization
requirementsnew text end .
Sec. 67.
Minnesota Statutes 2024, section 148.6443, subdivision 5, is amended to read:
Subd. 5.
Reporting continuing education contact hours.
Each licensee must use the
continuing education reporting form to verify meeting the continuing education requirements
of this section. The licensee must maintain documentation, including but not limited to a
signed certificate, transcript, or similar evidence of participation in an activity. The
documentation must include deleted text begin adeleted text end :
(1) new text begin the new text end title of the continuing education activity;
(2) new text begin a new text end brief description of the continuing education activity prepared by the presenter or
sponsor;
(3) new text begin the name of the new text end sponsor, presenter, or author;
(4) new text begin the new text end location and attendance dates;
(5) new text begin the new text end number of contact hours; and
(6) new text begin the new text end licensee's name.
Sec. 68.
Minnesota Statutes 2024, section 148.6443, subdivision 6, is amended to read:
Subd. 6.
Auditing continuing education reports.
(a) The board may audit a percentage
of the continuing education reports based on random selection. A licensee shall maintain
all documentation required by this section for two years after the last day of the biennial
licensure period in which the contact hours were earned.
(b) All renewal applications that are received after the expiration date may be subject
to a continuing education report audit.
(c) Any licensee against whom a complaint is filed may be subject to a continuing
education report audit.
(d) The licensee shall make the following information available to the board for auditing
purposes:
(1) a copy of the completed continuing education reporting form for the continuing
education reporting period that is the subject of the audit including all supporting
documentation required by subdivision 5;
(2) documentation of university, college, or vocational school courses by a transcript
and a course syllabus, listing in a course bulletin, or equivalent documentation that includes
the course title, instructor's name, course dates, number of contact hours, and course content,
objectives, or goals; and
(3) verification of attendance deleted text begin bydeleted text end new text begin that meets the requirements of subdivision 5 by
submittingnew text end :
(i) a deleted text begin signature ofdeleted text end new text begin certificate of attendance, or if a certificate is not available, other
documentation from new text end the presenter or a designee deleted text begin at the continuing education activity on the
continuing education report form or a certificate of attendance with the course name, course
date, and licensee's namedeleted text end new text begin submitted directly to the board confirming the requirementsnew text end ;new text begin or
new text end
deleted text begin
(ii) a summary or outline of the educational content of an audio or video educational
activity to verify the licensee's participation in the activity if a designee is not available to
sign the continuing education report form; or
deleted text end
deleted text begin (iii)deleted text end new text begin (ii)new text end verification of self-study programs by a certificate of completion deleted text begin or other
documentation indicating that the individual has demonstrated knowledge and has
successfully completed the programdeleted text end .
Sec. 69.
Minnesota Statutes 2024, section 148.6443, subdivision 7, is amended to read:
Subd. 7.
deleted text begin Waiverdeleted text end new text begin Deferralnew text end of continuing education requirements.
The board may
deleted text begin waive ordeleted text end defer all or part of the continuing education requirements of this section if the
licensee submits a written request and provides satisfactory evidence to the board of illness,
injury, financial hardship, family hardship, or other similar extenuating circumstances that
preclude completion of the requirements during the licensure period. The request for a
deleted text begin waiverdeleted text end new text begin deferralnew text end must be in writing, state the circumstances that constitute hardship, state
the period of time the licensee wishes to have the continuing education requirement deleted text begin waiveddeleted text end new text begin
deferrednew text end , and state the alternative measures that will be taken if a deleted text begin waiverdeleted text end new text begin deferralnew text end is granted.
The board must set forth, in writing, the reasons for granting or denying the deleted text begin waiverdeleted text end new text begin deferralnew text end .
deleted text begin Waiversdeleted text end new text begin Deferralsnew text end granted by the board must specify, in writing, the time limitation and
required alternative measures to be taken by the licensee. A request for deleted text begin waiverdeleted text end new text begin deferralnew text end must
be denied if the board finds that the circumstances stated by the licensee do not support a
claim of hardship, the requested time period for deleted text begin waiverdeleted text end new text begin deferralnew text end is unreasonable, the
alternative measures proposed by the licensee are not equivalent to the continuing education
activity being deleted text begin waiveddeleted text end new text begin deferrednew text end , or the request for deleted text begin waiverdeleted text end new text begin deferralnew text end is not submitted to the
board within 60 calendar days of the expiration date.
Sec. 70.
Minnesota Statutes 2024, section 148.6443, subdivision 8, is amended to read:
Subd. 8.
Penalties for noncompliance.
The board shall refuse to renew or grant, or
shall suspend, condition, limit, or new text begin otherwise new text end qualify the license of any person who the board
determines has failed to comply with the continuing education requirements of this section.
A licensee may request reconsideration of the board's determination of noncompliance or
the penalty imposed under this section by making a written request to the board within 30
calendar days of the date of notification to the applicant. Individuals requesting
reconsideration may submit information that the licensee wants considered in the
reconsideration.
Sec. 71.
Minnesota Statutes 2024, section 148.6445, is amended by adding a subdivision
to read:
new text begin Subd. 5a. new text end
new text begin Compact privilege fee. new text end
new text begin
The fee for interstate licensure compact privilege to
practice is $150.
new text end
Sec. 72.
Minnesota Statutes 2024, section 148.6445, is amended by adding a subdivision
to read:
new text begin Subd. 7a. new text end
new text begin Active mailing list. new text end
new text begin
The fee for the standard active licensee mailing list
delivered electronically is $500.
new text end
Sec. 73.
Minnesota Statutes 2024, section 148.6448, subdivision 1, is amended to read:
Subdivision 1.
Grounds for denial of licensure or discipline.
The board may deny an
application for licensure, may approve licensure with conditions, or may discipline a licensee
using any disciplinary actions listed in subdivision 3 on proof that the individual has:
(1) intentionally submitted false or misleading information to the board;
(2) new text begin obtained a license by means of fraud, misrepresentation, or concealment of material
facts;
new text end
new text begin (3) new text end failed, within 30 days, to provide information in response to a written request by the
board;
deleted text begin (3)deleted text end new text begin (4)new text end performed services of an occupational deleted text begin therapist or occupationaldeleted text end therapy deleted text begin assistantdeleted text end new text begin
practitionernew text end in an incompetent manner or in a manner that falls below the community standard
of carenew text begin or national practice standards of carenew text end ;
deleted text begin (4)deleted text end new text begin (5)new text end failed to satisfactorily perform occupational therapy services during a period of
temporary licensure;
deleted text begin (5)deleted text end new text begin (6)new text end violated sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end ;
deleted text begin (6)deleted text end new text begin (7)new text end failed to perform services with reasonable judgment, skill, or safety due to the
use of alcohol or drugs, or other physical or mental impairment;
deleted text begin (7)deleted text end new text begin (8)new text end been convicted of violating any state or federal law, rule, or regulation deleted text begin which
directlydeleted text end new text begin that reasonablynew text end relates to the practice of occupational therapy;
new text begin
(9) failed to report other licensees that have violated sections 148.6401 to 148.645;
new text end
deleted text begin (8)deleted text end new text begin (10)new text end aided or abetted another person in violating any provision of sections 148.6401
to deleted text begin 148.6449deleted text end new text begin 148.645new text end ;
deleted text begin (9)deleted text end new text begin (11)new text end been disciplined for conduct in the practice of an occupation by the state of
Minnesota, another jurisdiction, or a national professional association, if any of the grounds
for discipline are the same or substantially equivalent to those in sections 148.6401 to
deleted text begin 148.6449deleted text end new text begin 148.645new text end ;
deleted text begin (10)deleted text end new text begin (12)new text end not cooperated with the board in an investigation conducted according to
subdivision 2;
deleted text begin (11)deleted text end new text begin (13)new text end advertised in a manner that is false or misleading;
deleted text begin (12)deleted text end new text begin (14)new text end engaged in dishonest, unethical, or unprofessional conduct in connection with
the practice of occupational therapy that is likely to deceive, defraud, or harm the public;
new text begin
(15) improperly managed client records, including but not limited to failure to maintain
client records in a manner that meets community standards of care or nationally accepted
practice standards;
new text end
deleted text begin (13)deleted text end new text begin (16) new text end demonstrated a willful or careless disregard for the health, welfare, or safety
of a client;
new text begin
(17) inappropriately supervised or delegated or assigned tasks to an occupational therapy
assistant, occupational therapy student, rehabilitation aide, or other licensed professional;
new text end
deleted text begin (14)deleted text end new text begin (18)new text end performed medical diagnosis or provided intervention, other than occupational
therapy, without being licensed to do so under the laws of this state;
deleted text begin (15)deleted text end new text begin (19)new text end paid or promised to pay a commission or part of a fee to any person who
contacts the occupational deleted text begin therapistdeleted text end new text begin therapy practitionernew text end for consultation or sends patients to
the occupational deleted text begin therapistdeleted text end new text begin therapy practitionernew text end for intervention;
deleted text begin (16)deleted text end new text begin (20)new text end engaged in an incentive payment arrangement, other than that prohibited by
clause deleted text begin (15)deleted text end new text begin (19)new text end , that promotes occupational therapy overutilization, whereby the referring
person or person who controls the availability of occupational therapy services to a client
profits unreasonably as a result of client intervention;
deleted text begin (17)deleted text end new text begin (21)new text end engaged in abusive or fraudulent billing practicesdeleted text begin , including violations of
federal Medicare and Medicaid laws, Food and Drug Administration regulations, or state
medical assistance lawsdeleted text end ;
deleted text begin (18)deleted text end new text begin (22)new text end obtained money, property, or services from a consumer through the use of
undue influence, high pressure sales tactics, harassment, duress, deception, or fraud;
deleted text begin (19)deleted text end new text begin (23)new text end performed services for a client who had no possibility of benefiting from the
services;
deleted text begin (20)deleted text end new text begin (24)new text end failed to refer a client for medical evaluation when appropriate or when a client
indicated symptoms associated with diseases that could be medically or surgically treated;
deleted text begin (21)deleted text end new text begin (25)new text end engaged in conduct with a client that is sexual or may reasonably be interpreted
by the client as sexual, or in any verbal behavior that is seductive or sexually demeaning to
a patient;
deleted text begin (22)deleted text end new text begin (26)new text end violated a federal or state court order, including a conciliation court judgment,
or a disciplinary order issued by the board, related to the person's occupational therapy
practice; or
deleted text begin (23)deleted text end new text begin (27) new text end any other just cause related to the practice of occupational therapy.
Sec. 74.
Minnesota Statutes 2024, section 148.6448, subdivision 2, is amended to read:
Subd. 2.
Investigation of complaints.
The board may initiate an investigation upon
receiving a complaint or other oral or written communication that alleges or implies that a
person has violated sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end . In the receipt, investigation,
and hearing of a complaint that alleges or implies a person has violated sections 148.6401
to deleted text begin 148.6449deleted text end new text begin 148.645new text end , the board must follow the procedures in sections 214.10 and 214.103.
Sec. 75.
Minnesota Statutes 2024, section 148.6448, subdivision 4, is amended to read:
Subd. 4.
Effect of specific disciplinary action on use of title.
Upon notice from the
board denying licensure renewal or upon notice that disciplinary actions have been imposed
and the person is no longer entitled to practice occupational therapy and use the occupational
therapy and licensed titles, the person shall cease to practice occupational therapy, to use
titles protected by sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end , and to represent to the public
that the person is licensed by the board.
Sec. 76.
Minnesota Statutes 2024, section 148.6448, subdivision 6, is amended to read:
Subd. 6.
Authority to contract.
The board shall contract with the health professionals
services program as authorized by sections 214.31 to 214.37 to provide these services to
practitioners under this chapter. The health professionals services program does not affect
the board's authority to discipline violations of sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end .
Sec. 77.
Minnesota Statutes 2024, section 148.6449, subdivision 1, is amended to read:
Subdivision 1.
Creation.
The Board of Occupational Therapy Practice consists of 11
members appointed by the governor. The members are:
(1) five occupational therapists licensed under sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end ;
(2) three occupational therapy assistants licensed under sections 148.6401 to deleted text begin 148.6449deleted text end new text begin
148.645new text end ; and
(3) three public members, including two members who have received occupational
therapy services or have a family member who has received occupational therapy services,
and one member who is a health care professional or health care provider licensed in
Minnesota.
Sec. 78.
Minnesota Statutes 2024, section 148.6449, subdivision 2, is amended to read:
Subd. 2.
Qualifications of board members.
(a) The occupational therapy practitioners
appointed to the board must represent a variety of practice areas and settings.
(b) At least deleted text begin two occupational therapy practitionersdeleted text end new text begin three members of the boardnew text end must be
employed new text begin or reside new text end outside the seven-county metropolitan area.
(c) Board members must not serve for more than two full consecutive terms.
new text begin
(d) Interstate licensure compact privilege holders are not eligible to serve on the board.
new text end
Sec. 79.
Minnesota Statutes 2024, section 148.6449, subdivision 7, is amended to read:
Subd. 7.
Duties of the Board of Occupational Therapy Practice.
(a) The board shall:
(1) adopt and enforce rules and laws necessary for licensing occupational therapy
practitioners;
(2) adopt and enforce rules for regulating the professional conduct of the practice of
occupational therapy;
(3) issue licenses to qualified individuals in accordance with sections 148.6401 to
deleted text begin 148.6449deleted text end new text begin 148.645new text end ;
(4) assess and collect fees for the issuance and renewal of licenses;
(5) educate the public about the requirements for licensing occupational therapy
practitioners, educate occupational therapy practitioners about the rules of conduct, and
enable the public to file complaints against applicants and licensees who may have violated
sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end ; and
(6) investigate individuals engaging in practices that violate sections 148.6401 to
deleted text begin 148.6449deleted text end new text begin 148.645new text end and take necessary disciplinary, corrective, or other action according to
section 148.6448.
(b) The board may adopt rules necessary to define standards or carry out the provisions
of sections 148.6401 to deleted text begin 148.6449deleted text end new text begin 148.645new text end . Rules shall be adopted according to chapter 14.
Sec. 80.
Minnesota Statutes 2024, section 148B.53, subdivision 3, is amended to read:
Subd. 3.
deleted text begin Feedeleted text end new text begin Feesnew text end .
Nonrefundable fees are as follows:
(1) initial license application fee for licensed professional counseling (LPC) - $150;
(2) initial license fee for LPC - $250;
(3) annual active license renewal fee for LPC - $250 or equivalent;
(4) annual inactive license renewal fee for LPC - $125;
(5) initial license application fee for licensed professional clinical counseling (LPCC) -
$150;
(6) initial license fee for LPCC - $250;
(7) annual active license renewal fee for LPCC - $250 or equivalent;
(8) annual inactive license renewal fee for LPCC - $125;
(9) license renewal late fee - $100 per month or portion thereof;
(10) copy of board order or stipulation - $10;
(11) certificate of good standing or license verification - $25;
(12) duplicate certificate fee - $25;
(13) professional firm renewal fee - $25;
(14) sponsor application for approval of a continuing education course - $60;
(15) initial registration fee - $50;
(16) annual registration renewal fee - $25;
(17) approved supervisor application processing fee - $30; deleted text begin and
deleted text end
(18) temporary license for members of the military - $250new text begin ; and
new text end
new text begin (19) interstate compact privilege to practice fee - not to exceed $100new 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. 81.
Minnesota Statutes 2024, section 148E.180, subdivision 1, is amended to read:
Subdivision 1.
Application fees.
new text begin (a) new text end Nonrefundable application fees for licensure may
not exceed the following amounts but may be adjusted lower by board action:
(1) for a licensed social worker, $75;
(2) for a licensed graduate social worker, $75;
(3) for a licensed independent social worker, $75;
(4) for a licensed independent clinical social worker, $75;
(5) for a temporary license, $50; deleted text begin and
deleted text end
(6) for a license by endorsement, $115new text begin ; and
new text end
new text begin (7) for a compact multistate license, $75new text end .
new text begin (b) new text end The fee for criminal background checks is the fee charged by the Bureau of Criminal
Apprehension. The criminal background check fee must be included with the application
fee as required according to section 148E.055.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 82.
Minnesota Statutes 2024, section 148E.180, is amended by adding a subdivision
to read:
new text begin Subd. 2a. new text end
new text begin Compact multistate license fees. new text end
new text begin
Nonrefundable compact multistate license
fees must not exceed the following amounts but may be adjusted lower by board action:
new text end
new text begin
(1) for a licensed social worker, $115;
new text end
new text begin
(2) for a licensed graduate social worker, $210;
new text end
new text begin
(3) for a licensed independent social worker, $305; and
new text end
new text begin
(4) for a licensed independent clinical social worker, $335.
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. 83.
Minnesota Statutes 2024, section 148E.180, is amended by adding a subdivision
to read:
new text begin Subd. 3a. new text end
new text begin Compact multistate renewal fees. new text end
new text begin
Nonrefundable renewal fees for compact
multistate licensure must not exceed the following amounts but may be adjusted lower by
board action:
new text end
new text begin
(1) for a licensed social worker, $115;
new text end
new text begin
(2) for a licensed graduate social worker, $210;
new text end
new text begin
(3) for a licensed independent social worker, $305; and
new text end
new text begin
(4) for a licensed independent clinical social worker, $335.
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. 84.
Minnesota Statutes 2024, section 148E.180, subdivision 5, is amended to read:
Subd. 5.
Late fees.
Late fees are the following nonrefundable amounts:
(1) renewal late fee, one-fourth of the new text begin applicable new text end renewal fee specified in deleted text begin subdivisiondeleted text end new text begin
subdivisionsnew text end 3new text begin and 3anew text end ;
(2) supervision plan late fee, $40; and
(3) license late fee, $100 plus the prorated share of thenew text begin applicablenew text end license deleted text begin feedeleted text end new text begin feesnew text end specified
in deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 2new text begin and 2anew text end for the number of months during which the individual
practiced social work without a license.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 85.
Minnesota Statutes 2024, section 148E.180, subdivision 7, is amended to read:
Subd. 7.
Reactivation fees.
Reactivation fees are the following nonrefundable amounts:
(1) reactivation from a temporary leave or emeritus status, the prorated share of the
renewal fee specified in subdivision 3; and
(2) reactivation of an expired license, 1-1/2 times the new text begin applicable new text end renewal fees specified
in deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 3new text begin and 3anew 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. 86.
new text begin
[148G.01] TITLE.
new text end
new text begin
This chapter shall be referred to as the Minnesota Certified Midwife Practice Act.
new text end
Sec. 87.
new text begin
[148G.02] SCOPE.
new text end
new text begin
This chapter applies to all applicants and licensees, all persons who use the title certified
midwife, and all persons in or out of this state who provide certified midwifery services to
patients who reside in this state, unless there are specific applicable exemptions provided
by law.
new text end
Sec. 88.
new text begin
[148G.03] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
For purposes of this chapter, the definitions in this section have
the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Board. new text end
new text begin
"Board" means the Minnesota Board of Nursing.
new text end
new text begin Subd. 3. new text end
new text begin Certification. new text end
new text begin
"Certification" means the formal recognition by the American
Midwifery Certification Board of the knowledge, skills, and experience demonstrated by
the achievement of standards identified by the American College of Nurse Midwives or any
successor organization.
new text end
new text begin Subd. 4. new text end
new text begin Certified midwife. new text end
new text begin
"Certified midwife" means an individual who holds a current
and valid national certification as a certified midwife from the American Midwifery
Certification Board or any successor organization and who is licensed by the board under
this chapter.
new text end
new text begin Subd. 5. new text end
new text begin Certified midwifery practice. new text end
new text begin
"Certified midwifery practice" means:
new text end
new text begin
(1) managing, diagnosing, and treating women's primary health care beginning in
adolescence, including pregnancy, childbirth, the postpartum period, care of the newborn,
family planning, partner care management relating to sexual health, and gynecological care
of women;
new text end
new text begin
(2) ordering, performing, supervising, and interpreting diagnostic studies within the
scope of certified midwifery practice, excluding:
new text end
new text begin
(i) interpreting and performing specialized ultrasound examinations; and
new text end
new text begin
(ii) interpreting computed tomography scans, magnetic resonance imaging scans, positron
emission tomography scans, nuclear scans, and mammography;
new text end
new text begin
(3) prescribing pharmacologic and nonpharmacologic therapies appropriate to midwifery
practice;
new text end
new text begin
(4) consulting with, collaborating with, or referring to other health care providers as
warranted by the needs of the patient; and
new text end
new text begin
(5) performing the role of educator in the theory and practice of midwifery.
new text end
new text begin Subd. 6. new text end
new text begin Collaborating. new text end
new text begin
"Collaborating" means the process in which two or more health
care professionals work together to meet the health care needs of a patient, as warranted by
the needs of the patient.
new text end
new text begin Subd. 7. new text end
new text begin Consulting. new text end
new text begin
"Consulting" means the process in which a certified midwife who
maintains primary management responsibility for a patient's care seeks advice or opinion
of a physician, an advanced practice registered nurse, or another member of the health care
team.
new text end
new text begin Subd. 8. new text end
new text begin Encumbered. new text end
new text begin
"Encumbered" means:
new text end
new text begin
(1) a license or other credential that is revoked, is suspended, or contains limitations on
the full and unrestricted practice of certified midwifery when the revocation, suspension,
or limitation is imposed by a state licensing board or other state regulatory entity; or
new text end
new text begin
(2) a license or other credential that is voluntarily surrendered.
new text end
new text begin Subd. 9. new text end
new text begin Licensure period. new text end
new text begin
"Licensure period" means the interval of time during which
the certified midwife is authorized to engage in certified midwifery. The initial licensure
period is from six to 29 full calendar months starting on the day of licensure and ending on
the last day of the certified midwife's month of birth in an even-numbered year if the year
of birth is an even-numbered year, or in an odd-numbered year if the year of birth is an
odd-numbered year. Subsequent licensure renewal periods are 24 months. For licensure
renewal, the period starts on the first day of the month following expiration of the previous
licensure period. The period ends the last day of the certified midwife's month of birth in
an even- or odd-numbered year according to the certified midwife's year of birth.
new text end
new text begin Subd. 10. new text end
new text begin Licensed practitioner. new text end
new text begin
"Licensed practitioner" means a physician licensed
under chapter 147, an advanced practice registered nurse licensed under sections 148.171
to 148.235, or a certified midwife licensed under this chapter.
new text end
new text begin Subd. 11. new text end
new text begin Midwifery education program. new text end
new text begin
"Midwifery education program" means a
program of theory and practice offered by a university or college that leads to the preparation
and eligibility for certification in midwifery and is accredited by the Accreditation
Commission for Midwifery Education or any successor organization recognized by the
United States Department of Education or the Council for Higher Education Accreditation.
new text end
new text begin Subd. 12. new text end
new text begin Patient. new text end
new text begin
"Patient" means a recipient of care provided by a certified midwife
within the scope of certified midwifery practice, including an individual, family, group, or
community.
new text end
new text begin Subd. 13. new text end
new text begin Prescribing. new text end
new text begin
"Prescribing" means the act of generating a prescription for the
preparation of, use of, or manner of using a drug or therapeutic device under section 148G.09.
Prescribing does not include recommending the use of a drug or therapeutic device that is
not required by the federal Food and Drug Administration to meet the labeling requirements
for prescription drugs and devices.
new text end
new text begin Subd. 14. new text end
new text begin Prescription. new text end
new text begin
"Prescription" means a written direction or an oral direction
reduced to writing provided to or for a patient for the preparation or use of a drug or
therapeutic device. The requirements of section 151.01, subdivisions 16, 16a, and 16b, apply
to prescriptions for drugs.
new text end
new text begin Subd. 15. new text end
new text begin Referral. new text end
new text begin
"Referral" means the process in which a certified midwife directs
a patient to a physician or another health care professional for management of a particular
problem or aspect of the patient's care.
new text end
new text begin Subd. 16. new text end
new text begin Supervision. new text end
new text begin
"Supervision" means monitoring and establishing the initial
direction of, setting expectations for, directing activities in, evaluating, and changing a
course of action in certified midwifery care.
new text end
Sec. 89.
new text begin
[148G.04] CERTIFIED MIDWIFE LICENSING.
new text end
new text begin Subdivision 1. new text end
new text begin Licensure. new text end
new text begin
(a) No person shall practice as a certified midwife or serve
as the faculty of record for clinical instruction in a midwifery distance learning program
unless the person is licensed by the board under this chapter.
new text end
new text begin
(b) An applicant for a license to practice as a certified midwife must apply to the board
in a format prescribed by the board and pay a fee in an amount determined under section
148G.11.
new text end
new text begin
(c) To be eligible for licensure, an applicant must:
new text end
new text begin
(1) not hold an encumbered license or other credential as a certified midwife or equivalent
professional designation in any state or territory;
new text end
new text begin
(2) hold a current and valid certification as a certified midwife from the American
Midwifery Certification Board or any successor organization acceptable to the board and
provide primary source verification of certification to the board in a format prescribed by
the board;
new text end
new text begin
(3) have completed a graduate-level midwifery education program that includes clinical
experience, is accredited by the Accreditation Commission for Midwifery Education or any
successor organization recognized by the United States Department of Education or the
Council for Higher Education Accreditation, and leads to a graduate degree. The applicant
must submit primary source verification of program completion to the board in a format
prescribed by the board. The primary source verification must verify the applicant completed
three separate graduate-level courses in physiology and pathophysiology; advanced health
assessment; and advanced pharmacology, including pharmacodynamics, pharmacokinetics,
and pharmacotherapeutics of all broad categories of agents;
new text end
new text begin
(4) report any criminal conviction, nolo contendere plea, Alford plea, or other plea
arrangement in lieu of conviction; and
new text end
new text begin
(5) not have committed any acts or omissions that are grounds for disciplinary action in
another jurisdiction or, if these acts were committed and would be grounds for disciplinary
action as set forth in section 148G.13, the board has found after an investigation that sufficient
remediation was made.
new text end
new text begin Subd. 2. new text end
new text begin Clinical practice component. new text end
new text begin
If more than five years have elapsed since the
applicant has practiced in the certified midwife role, the applicant must complete a
reorientation plan as a certified midwife. The plan must include supervision during the
clinical component by a licensed practitioner with experience in providing care to patients
with the same or similar health care needs. The applicant must submit the plan and the name
of the practitioner to the board. The plan must include a minimum of 500 hours of supervised
certified midwifery practice. The certified midwife must submit verification of completion
of the clinical reorientation to the board when the reorientation is complete.
new text end
Sec. 90.
new text begin
[148G.05] LICENSURE RENEWAL; RELICENSURE.
new text end
new text begin Subdivision 1. new text end
new text begin Renewal; current applicants. new text end
new text begin
(a) A certified midwife must apply for
renewal of the certified midwife's license before the certified midwife's licensure period
ends. To be considered timely, the board must receive the certified midwife's application
on or before the last day of the certified midwife's licensure period. A certified midwife's
license lapses if the certified midwife's application is untimely.
new text end
new text begin
(b) An applicant for license renewal must provide the board evidence of current
certification or recertification as a certified midwife by the American Midwifery Certification
Board or any successor organization.
new text end
new text begin
(c) An applicant for license renewal must submit to the board the fee under section
148G.11, subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Clinical practice component. new text end
new text begin
If more than five years have elapsed since the
applicant has practiced as a certified midwife, the applicant must complete a reorientation
plan as a certified midwife. The plan must include supervision during the clinical component
by a licensed practitioner with experience in providing care to patients with the same or
similar health care needs. The licensee must submit the plan and the name of the practitioner
to the board. The plan must include a minimum of 500 hours of supervised certified
midwifery practice. The certified midwife must submit verification of completion of the
clinical reorientation to the board when the reorientation is complete.
new text end
new text begin Subd. 3. new text end
new text begin Relicensure; lapsed applicants. new text end
new text begin
A person whose license has lapsed who desires
to resume practice as a certified midwife must apply for relicensure, submit to the board
satisfactory evidence of compliance with the procedures and requirements established by
the board, and pay the board the relicensure fee under section 148G.11, subdivision 4, for
the current licensure period. A penalty fee under section 148G.11, subdivision 4, is required
from a person who practiced certified midwifery without current licensure. The board must
relicense a person who meets the requirements of this subdivision.
new text end
Sec. 91.
new text begin
[148G.06] FAILURE OR REFUSAL TO PROVIDE INFORMATION.
new text end
new text begin Subdivision 1. new text end
new text begin Notification requirement. new text end
new text begin
An individual licensed as a certified midwife
must notify the board when the individual renews their certification. If a licensee fails to
provide notification, the licensee is prohibited from practicing as a certified midwife.
new text end
new text begin Subd. 2. new text end
new text begin Denial of license. new text end
new text begin
Refusal of an applicant to supply information necessary to
determine the applicant's qualifications, failure to demonstrate qualifications, or failure to
satisfy the requirements for a license contained in this chapter or rules of the board may
result in denial of a license. The burden of proof is upon the applicant to demonstrate the
qualifications and satisfaction of the requirements.
new text end
Sec. 92.
new text begin
[148G.07] NAME CHANGE AND CHANGE OF ADDRESS.
new text end
new text begin
A certified midwife must maintain a current name and address with the board and must
notify the board in writing within 30 days of any change in name or address. All notices or
other correspondence mailed to or served upon a certified midwife by the board at the
licensee's address on file with the board are considered received by the licensee.
new text end
Sec. 93.
new text begin
[148G.08] IDENTIFICATION OF CERTIFIED MIDWIVES.
new text end
new text begin
Only those persons who hold a current license to practice certified midwifery in
Minnesota may use the title of certified midwife. A certified midwife licensed by the board
must use the designation of "CM" for professional identification and in documentation of
services provided.
new text end
Sec. 94.
new text begin
[148G.09] PRESCRIBING DRUGS AND THERAPEUTIC DEVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Diagnosing, prescribing, and ordering. new text end
new text begin
Certified midwives, within the
scope of certified midwifery practice, are authorized to:
new text end
new text begin
(1) diagnose, prescribe, and institute therapy or referrals of patients to health care agencies
and providers;
new text end
new text begin
(2) prescribe, procure, sign for, record, administer, and dispense over-the-counter, legend,
and controlled substances, including sample drugs; and
new text end
new text begin
(3) plan and initiate a therapeutic regimen that includes ordering and prescribing durable
medical devices and equipment, nutrition, diagnostic services, and supportive services,
including but not limited to home health care, physical therapy, and occupational therapy.
new text end
new text begin Subd. 2. new text end
new text begin Drug Enforcement Administration requirements. new text end
new text begin
(a) Certified midwives
must:
new text end
new text begin
(1) comply with federal Drug Enforcement Administration (DEA) requirements related
to controlled substances; and
new text end
new text begin
(2) file the certified midwife's DEA registrations and numbers, if any, with the board.
new text end
new text begin
(b) The board must maintain current records of all certified midwives with a DEA
registration and number.
new text end
Sec. 95.
new text begin
[148G.10] FEES.
new text end
new text begin
The fees specified in section 148G.11 are nonrefundable and must be deposited in the
state government special revenue fund.
new text end
Sec. 96.
new text begin
[148G.11] FEE AMOUNTS.
new text end
new text begin Subdivision 1. new text end
new text begin Licensure. new text end
new text begin
The fee for licensure is $105.
new text end
new text begin Subd. 2. new text end
new text begin Renewal. new text end
new text begin
The fee for licensure renewal is $85.
new text end
new text begin Subd. 3. new text end
new text begin Practicing without current certification. new text end
new text begin
The penalty fee for a person who
practices certified midwifery without a current certification or recertification, or who practices
certified midwifery without current certification or recertification on file with the board, is
$200 for the first month or part of a month and an additional $100 for each subsequent
month or parts of months of practice. The penalty fee must be calculated from the first day
the certified midwife practiced without a current certification to the last day of practice
without a current certification, or from the first day the certified midwife practiced without
a current certification or recertification on file with the board until the day the current
certification or recertification is filed with the board.
new text end
new text begin Subd. 4. new text end
new text begin Relicensure. new text end
new text begin
The fee for relicensure is $105. The fee for practicing without
current licensure is two times the amount of the current renewal fee for any part of the first
calendar month, plus the current renewal fee for any part of each subsequent month up to
24 months.
new text end
new text begin Subd. 5. new text end
new text begin Dishonored check fee. new text end
new text begin
The service fee for a dishonored check is as provided
in section 604.113.
new text end
Sec. 97.
new text begin
[148G.12] APPROVED MIDWIFERY EDUCATION PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Initial approval. new text end
new text begin
A university or college desiring to conduct a certified
midwifery education program must submit evidence to the board that the university or
college is prepared to:
new text end
new text begin
(1) provide a program of theory and practice in certified midwifery leading to eligibility
for certification in midwifery;
new text end
new text begin
(2) achieve preaccreditation and eventual full accreditation by the American Commission
for Midwifery Education or any successor organization recognized by the United States
Department of Education or the Council for Higher Education Accreditation. Instruction
and required experience may be obtained in one or more institutions or agencies outside
the applying university or college if the program retains accountability for all clinical and
nonclinical teaching; and
new text end
new text begin
(3) meet other standards established by law and by the board.
new text end
new text begin Subd. 2. new text end
new text begin Continuing approval. new text end
new text begin
The board must, through the board's representative,
annually survey all midwifery education programs in Minnesota for current accreditation
status by the American Commission for Midwifery Education or any successor organization
recognized by the United States Department of Education or the Council for Higher Education
Accreditation. If the results of the survey show that a certified midwifery education program
meets all standards for continuing accreditation, the board must continue approval of the
certified midwifery education program.
new text end
new text begin Subd. 3. new text end
new text begin Loss of approval. new text end
new text begin
If the board determines that an accredited certified midwifery
education program is not maintaining the standards required by the American Commission
on Midwifery Education or any successor organization, the board must obtain the defect in
writing from the accrediting body. If a program fails to correct the defect to the satisfaction
of the accrediting body and the accrediting body revokes the program's accreditation, the
board must remove the program from the list of approved certified midwifery education
programs.
new text end
new text begin Subd. 4. new text end
new text begin Reinstatement of approval. new text end
new text begin
The board must reinstate approval of a certified
midwifery education program upon submission of satisfactory evidence that the certified
midwifery education program of theory and practice meets the standards required by the
accrediting body.
new text end
Sec. 98.
new text begin
[148G.13] GROUNDS FOR DISCIPLINARY ACTION.
new text end
new text begin Subdivision 1. new text end
new text begin Grounds listed. new text end
new text begin
The board may deny, revoke, suspend, limit, or condition
the license of any person to practice certified midwifery under this chapter or otherwise
discipline a licensee or applicant as described in section 148G.14. The following are grounds
for disciplinary action:
new text end
new text begin
(1) failure to demonstrate the qualifications or satisfy the requirements for a license
contained in this chapter or rules of the board. In the case of an applicant for licensure, the
burden of proof is upon the applicant to demonstrate the qualifications or satisfaction of the
requirements;
new text end
new text begin
(2) employing fraud or deceit in procuring or attempting to procure a license to practice
certified midwifery;
new text end
new text begin
(3) conviction of a felony or gross misdemeanor reasonably related to the practice of
certified midwifery. Conviction, as used in this subdivision, includes a conviction of an
offense that if committed in this state would be considered a felony or gross misdemeanor
without regard to its designation elsewhere, or a criminal proceeding where a finding or
verdict of guilt is made or returned, but the adjudication of guilt is either withheld or not
entered;
new text end
new text begin
(4) revocation, suspension, limitation, conditioning, or other disciplinary action against
the person's certified midwife credential in another state, territory, or country; failure to
report to the board that charges regarding the person's certified midwifery license,
certification, or other credential are pending in another state, territory, or country; or failure
to report to the board having been refused a license or other credential by another state,
territory, or country;
new text end
new text begin
(5) failure or inability to practice as a certified midwife with reasonable skill and safety,
or departure from or failure to conform to standards of acceptable and prevailing certified
midwifery practice, including failure of a certified midwife to adequately supervise or
monitor the performance of acts by any person working at the certified midwife's direction;
new text end
new text begin
(6) engaging in unprofessional conduct, including but not limited to a departure from
or failure to conform to statutes relating to certified midwifery practice or to the minimal
standards of acceptable and prevailing certified midwifery practice, or engaging in any
certified midwifery practice that may create unnecessary danger to a patient's life, health,
or safety. Actual injury to a patient need not be established under this clause;
new text end
new text begin
(7) supervision or accepting the supervision of a midwifery function or a prescribed
health care function when the acceptance could reasonably be expected to result in unsafe
or ineffective patient care;
new text end
new text begin
(8) actual or potential inability to practice certified midwifery with reasonable skill and
safety to patients by reason of illness; by the reason of use of alcohol, drugs, chemicals, or
any other material; or as a result of any mental or physical condition;
new text end
new text begin
(9) adjudication as mentally incompetent, mentally ill, a chemically dependent person,
or a person dangerous to the public by a court of competent jurisdiction, within or outside
of Minnesota;
new text end
new text begin
(10) engaging in any unethical conduct, including but not limited to conduct likely to
deceive, defraud, or harm the public, or demonstrating a willful or careless disregard for
the health, welfare, or safety of a patient. Actual injury need not be established under this
clause;
new text end
new text begin
(11) engaging in conduct with a patient that is sexual or may reasonably be interpreted
by the patient as sexual, in any verbal behavior that is seductive or sexually demeaning to
a patient, or in sexual exploitation of a patient or former patient;
new text end
new text begin
(12) obtaining money, property, or services from a patient, other than reasonable fees
for services provided to the patient, through the use of undue influence, harassment, duress,
deception, or fraud;
new text end
new text begin
(13) revealing a privileged communication from or relating to a patient except when
otherwise required or permitted by law;
new text end
new text begin
(14) engaging in abusive or fraudulent billing practices, including violations of federal
Medicare and Medicaid laws or state medical assistance laws;
new text end
new text begin
(15) improper management of patient records, including failure to maintain adequate
patient records, to comply with a patient's request made pursuant to sections 144.291 to
144.298, or to furnish a patient record or report required by law;
new text end
new text begin
(16) knowingly aiding, assisting, advising, or allowing an unlicensed person to engage
in the unlawful practice of certified midwifery;
new text end
new text begin
(17) violating a rule adopted by the board, an order of the board, a state or federal law
relating to the practice of certified midwifery, or a state or federal narcotics or controlled
substance law;
new text end
new text begin
(18) knowingly providing false or misleading information to a patient that is directly
related to the care of that patient unless done for an accepted therapeutic purpose such as
the administration of a placebo;
new text end
new text begin
(19) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:
new text end
new text begin
(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;
new text end
new text begin
(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;
new text end
new text begin
(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or
new text end
new text begin
(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board must investigate any complaint of a violation of section 609.215, subdivision 1
or 2;
new text end
new text begin
(20) practicing outside the scope of certified midwifery practice as defined under section
148G.03, subdivision 5;
new text end
new text begin
(21) making a false statement or knowingly providing false information to the board,
failing to make reports as required by section 148G.15, or failing to cooperate with an
investigation of the board as required by section 148G.17;
new text end
new text begin
(22) engaging in false, fraudulent, deceptive, or misleading advertising;
new text end
new text begin
(23) failure to inform the board of the person's certification or recertification status as
a certified midwife;
new text end
new text begin
(24) engaging in certified midwifery practice without a license and current certification
or recertification by the American Midwifery Certification Board or any successor
organization; or
new text end
new text begin
(25) failure to maintain appropriate professional boundaries with a patient. A certified
midwife must not engage in practices that create an unacceptable risk of patient harm or of
the impairment of a certified midwife's objectivity or professional judgment. A certified
midwife must not act or fail to act in a way that, as judged by a reasonable and prudent
certified midwife, inappropriately encourages the patient to relate to the certified midwife
outside of the boundaries of the professional relationship or in a way that interferes with
the patient's ability to benefit from certified midwife services. A certified midwife must not
use the professional relationship with a patient, student, supervisee, or intern to further the
certified midwife's personal, emotional, financial, sexual, religious, political, or business
benefit or interests.
new text end
new text begin Subd. 2. new text end
new text begin Conviction of a felony-level criminal sexual offense. new text end
new text begin
(a) Except as provided
in paragraph (e), the board must not grant or renew a license to practice certified midwifery
to any person who has been convicted on or after August 1, 2014, of any of the provisions
of section 609.342, subdivision 1 or 1a; 609.343, subdivision 1 or 1a; 609.344, subdivision
1 or 1a, paragraphs (c) to (g); or 609.345, subdivision 1 or 1a, paragraphs (c) to (g); or a
similar statute in another jurisdiction.
new text end
new text begin
(b) A license to practice certified midwifery is automatically revoked if the licensee is
convicted of an offense listed in paragraph (a).
new text end
new text begin
(c) A license to practice certified midwifery that has been denied or revoked under this
subdivision is not subject to chapter 364.
new text end
new text begin
(d) For purposes of this subdivision, "conviction" means a plea of guilty, a verdict of
guilty by a jury, or a finding of guilty by the court, unless the court stays imposition or
execution of the sentence and final disposition of the case is accomplished at a nonfelony
level.
new text end
new text begin
(e) The board may establish criteria whereby an individual convicted of an offense listed
in paragraph (a) may become licensed if the criteria:
new text end
new text begin
(1) utilize a rebuttable presumption that the applicant is not suitable for licensing;
new text end
new text begin
(2) provide a standard for overcoming the presumption; and
new text end
new text begin
(3) require that a minimum of ten years has elapsed since the applicant's sentence was
discharged.
new text end
new text begin
(f) The board must not consider an application under paragraph (e) if the board determines
that the victim involved in the offense was a patient or a client of the applicant at the time
of the offense.
new text end
new text begin Subd. 3. new text end
new text begin Evidence. new text end
new text begin
In disciplinary actions alleging a violation of subdivision 1, clause
(3) or (4), or 2, a copy of the judgment or proceeding under the seal of the court administrator
or of the administrative agency that entered the same is admissible into evidence without
further authentication and constitutes prima facie evidence of the violation concerned.
new text end
new text begin Subd. 4. new text end
new text begin Examination; access to medical data. new text end
new text begin
(a) If the board has probable cause to
believe that grounds for disciplinary action exist under subdivision 1, clause (8) or (9), it
may direct the applicant or certified midwife to submit to a mental or physical examination
or chemical dependency evaluation. For the purpose of this subdivision, when a certified
midwife licensed under this chapter is directed in writing by the board to submit to a mental
or physical examination or chemical dependency evaluation, that person is considered to
have consented and to have waived all objections to admissibility on the grounds of privilege.
Failure of the applicant or certified midwife to submit to an examination when directed
constitutes an admission of the allegations against the applicant or certified midwife, unless
the failure was due to circumstances beyond the person's control, and the board may enter
a default and final order without taking testimony or allowing evidence to be presented. A
certified midwife affected under this paragraph must, at reasonable intervals, be given an
opportunity to demonstrate that the competent practice of certified midwifery can be resumed
with reasonable skill and safety to patients. Neither the record of proceedings nor the orders
entered by the board in a proceeding under this paragraph may be used against a certified
midwife in any other proceeding.
new text end
new text begin
(b) Notwithstanding sections 13.384, 144.651, and 595.02, or any other law limiting
access to medical or other health data, the board may obtain medical data and health records
relating to a certified midwife or applicant for a license without that person's consent if the
board has probable cause to believe that grounds for disciplinary action exist under
subdivision 1, clause (8) or (9). The medical data may be requested from a provider, as
defined in section 144.291, subdivision 2; an insurance company; or a government agency,
including the Department of Human Services or Direct Care and Treatment. A provider,
insurance company, or government agency must comply with any written request of the
board under this subdivision and is not liable in any action for damages for releasing the
data requested by the board if the data are released pursuant to a written request under this
subdivision, unless the information is false and the provider giving the information knew
or had reason to believe the information was false. Information obtained under this
subdivision is classified as private data on individuals as defined in section 13.02.
new text end
Sec. 99.
new text begin
[148G.14] FORMS OF DISCIPLINARY ACTION; AUTOMATIC
SUSPENSION; TEMPORARY SUSPENSION; REISSUANCE.
new text end
new text begin Subdivision 1. new text end
new text begin Forms of disciplinary action. new text end
new text begin
If the board finds that grounds for
disciplinary action exist under section 148G.13, it may take one or more of the following
actions:
new text end
new text begin
(1) deny the license application or application for license renewal;
new text end
new text begin
(2) revoke the license;
new text end
new text begin
(3) suspend the license;
new text end
new text begin
(4) impose limitations on the certified midwife's practice of certified midwifery, including
but not limited to limitation of scope of practice or the requirement of practice under
supervision;
new text end
new text begin
(5) impose conditions on the retention of the license, including but not limited to the
imposition of retraining or rehabilitation requirements or the conditioning of continued
practice on demonstration of knowledge or skills by appropriate examination, monitoring,
or other review;
new text end
new text begin
(6) impose a civil penalty not exceeding $10,000 for each separate violation. The amount
of the civil penalty must be fixed so as to deprive the certified midwife of any economic
advantage gained by reason of the violation charged; to reimburse the board for the cost of
counsel, investigation, and proceeding; and to discourage repeated violations;
new text end
new text begin
(7) order the certified midwife to provide unremunerated service;
new text end
new text begin
(8) censure or reprimand the certified midwife; or
new text end
new text begin
(9) any other action justified by the facts in the case.
new text end
new text begin Subd. 2. new text end
new text begin Automatic suspension of license. new text end
new text begin
(a) Unless the board orders otherwise, a
license to practice certified midwifery is automatically suspended if:
new text end
new text begin
(1) a guardian of a certified midwife is appointed by order of a court under sections
524.5-101 to 524.5-502;
new text end
new text begin
(2) the certified midwife is committed by order of a court under chapter 253B; or
new text end
new text begin
(3) the certified midwife is determined to be mentally incompetent, mentally ill,
chemically dependent, or a person dangerous to the public by a court of competent
jurisdiction within or outside of Minnesota.
new text end
new text begin
(b) The license remains suspended until the certified midwife is restored to capacity by
a court and, upon petition by the certified midwife, the suspension is terminated by the
board after a hearing or upon agreement between the board and the certified midwife.
new text end
new text begin Subd. 3. new text end
new text begin Temporary suspension of license. new text end
new text begin
In addition to any other remedy provided
by law, the board may, through its designated board member under section 214.10,
subdivision 2, temporarily suspend the license of a certified midwife without a hearing if
the board finds that there is probable cause to believe the certified midwife has violated a
statute or rule the board is empowered to enforce and continued practice by the certified
midwife would create a serious risk of harm to others. The suspension takes effect upon
written notice to the certified midwife, served by first-class mail, specifying the statute or
rule violated. The suspension must remain in effect until the board issues a temporary stay
of suspension or a final order in the matter after a hearing or upon agreement between the
board and the certified midwife. At the time it issues the suspension notice, the board must
schedule a disciplinary hearing to be held under the Administrative Procedure Act. The
board must provide the certified midwife at least 20 days' notice of any hearing held under
this subdivision. The board must schedule the hearing to begin no later than 30 days after
the issuance of the suspension order.
new text end
new text begin Subd. 4. new text end
new text begin Reissuance. new text end
new text begin
The board may reinstate and reissue a license to practice certified
midwifery, but as a condition may impose any disciplinary or corrective measure that it
might originally have imposed. Any person whose license has been revoked, suspended, or
limited may have the license reinstated and a new license issued when, at the discretion of
the board, the action is warranted, provided that the board must require the person to pay
the costs of the proceedings resulting in the revocation, suspension, or limitation of the
license; the relicensure fee; and the fee for the current licensure period. The cost of
proceedings includes but is not limited to the cost paid by the board to the Office of
Administrative Hearings and the Office of the Attorney General for legal and investigative
services; the costs of a court reporter and witnesses, reproduction of records, board staff
time, travel, and expenses; and the costs of board members' per diem reimbursements, travel
costs, and expenses.
new text end
Sec. 100.
new text begin
[148G.15] REPORTING OBLIGATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Permission to report. new text end
new text begin
A person who has knowledge of any conduct
constituting grounds for discipline under section 148G.13 may report the alleged violation
to the board.
new text end
new text begin Subd. 2. new text end
new text begin Institutions. new text end
new text begin
The chief nursing executive or chief administrative officer of any
hospital, clinic, prepaid medical plan, or other health care institution or organization located
in Minnesota must report to the board any action taken by the institution or organization or
any of its administrators or committees to revoke, suspend, limit, or condition a certified
midwife's privilege to practice in the institution or as part of the organization, any denial of
privileges, any dismissal from employment, or any other disciplinary action. The institution
or organization must also report the resignation of any certified midwife before the conclusion
of any disciplinary proceeding or before commencement of formal charges, but after the
certified midwife had knowledge that formal charges were contemplated or in preparation.
The reporting described by this subdivision is required only if the action pertains to grounds
for disciplinary action under section 148G.13.
new text end
new text begin Subd. 3. new text end
new text begin Licensed professionals. new text end
new text begin
A person licensed by a health-related licensing board
as defined in section 214.01, subdivision 2, must report to the board personal knowledge
of any conduct the person reasonably believes constitutes grounds for disciplinary action
under section 148G.13 by any certified midwife, including conduct indicating that the
certified midwife may be incompetent, may have engaged in unprofessional or unethical
conduct, or may be mentally or physically unable to engage safely in the practice of certified
midwifery.
new text end
new text begin Subd. 4. new text end
new text begin Insurers. new text end
new text begin
(a) By the first day of February, May, August, and November each
year, each insurer authorized to sell insurance described in section 60A.06, subdivision 1,
clause (13), and providing professional liability insurance to certified midwives must submit
to the board a report concerning any certified midwife against whom a malpractice award
has been made or who has been a party to a settlement. The report must contain at least the
following information:
new text end
new text begin
(1) the total number of settlements or awards;
new text end
new text begin
(2) the date a settlement or award was made;
new text end
new text begin
(3) the allegations contained in the claim or complaint leading to the settlement or award;
new text end
new text begin
(4) the dollar amount of each malpractice settlement or award and whether that amount
was paid as a result of a settlement or of an award; and
new text end
new text begin
(5) the name and address of the practice of the certified midwife against whom an award
was made or with whom a settlement was made.
new text end
new text begin
(b) An insurer must also report to the board any information it possesses that tends to
substantiate a charge that a certified midwife may have engaged in conduct in violation of
this chapter.
new text end
new text begin Subd. 5. new text end
new text begin Courts. new text end
new text begin
The court administrator of district court or another court of competent
jurisdiction must report to the board any judgment or other determination of the court that
adjudges or includes a finding that a certified midwife is a person who is mentally ill,
mentally incompetent, chemically dependent, dangerous to the public, guilty of a felony or
gross misdemeanor, guilty of a violation of federal or state narcotics laws or controlled
substances act, guilty of operating a motor vehicle while under the influence of alcohol or
a controlled substance, or guilty of an abuse or fraud under Medicare or Medicaid; or if the
court appoints a guardian of the certified midwife under sections 524.5-101 to 524.5-502
or commits a certified midwife under chapter 253B.
new text end
new text begin Subd. 6. new text end
new text begin Deadlines; forms. new text end
new text begin
Reports required by subdivisions 2, 3, and 5 must be
submitted no later than 30 days after the occurrence of the reportable event or transaction.
The board may provide forms for the submission of reports required under this section, may
require that the reports be submitted on the forms provided, and may adopt rules necessary
to ensure prompt and accurate reporting. The board must review all reports, including those
submitted after the deadline.
new text end
new text begin Subd. 7. new text end
new text begin Failure to report. new text end
new text begin
Any person, institution, insurer, or organization that fails to
report as required under subdivisions 2 to 6 is subject to civil penalties for failing to report
as required by law.
new text end
Sec. 101.
new text begin
[148G.16] IMMUNITY.
new text end
new text begin Subdivision 1. new text end
new text begin Reporting. new text end
new text begin
Any person, health care facility, business, or organization is
immune from civil liability and criminal prosecution for submitting in good faith a report
to the board under section 148G.15 or for otherwise reporting in good faith to the board
violations or alleged violations of this chapter. All such reports are investigative data as
defined in chapter 13.
new text end
new text begin Subd. 2. new text end
new text begin Investigation. new text end
new text begin
(a) Members of the board, persons employed by the board or
engaged in the investigation of violations and in the preparation and management of charges
of violations of this chapter on behalf of the board, or persons participating in the
investigation or testifying regarding charges of violations are immune from civil liability
and criminal prosecution for any actions, transactions, or publications in the execution of,
or relating to, their duties under this chapter.
new text end
new text begin
(b) Members of the board and persons employed by the board or engaged in maintaining
records and making reports regarding adverse health care events are immune from civil
liability and criminal prosecution for any actions, transactions, or publications in the
execution of, or relating to, their duties under this chapter.
new text end
Sec. 102.
new text begin
[148G.17] CERTIFIED MIDWIFE COOPERATION.
new text end
new text begin
A certified midwife who is the subject of an investigation by or on behalf of the board
must cooperate fully with the investigation. Cooperation includes responding fully and
promptly to any question raised by or on behalf of the board relating to the subject of the
investigation and providing copies of patient or other records in the certified midwife's
possession, as reasonably requested by the board, to assist the board in its investigation and
to appear at conferences and hearings scheduled by the board. The board must pay for copies
requested. If the board does not have written consent from a patient permitting access to
the patient's records, the certified midwife must delete any data in the record that identify
the patient before providing it to the board. The board must maintain any records obtained
pursuant to this section as investigative data under chapter 13. The certified midwife must
not be excused from giving testimony or producing any documents, books, records, or
correspondence on the grounds of self-incrimination, but the testimony or evidence must
not be used against the certified midwife in any criminal case.
new text end
Sec. 103.
new text begin
[148G.18] DISCIPLINARY RECORD ON JUDICIAL REVIEW.
new text end
new text begin
Upon judicial review of any board disciplinary action taken under this chapter, the
reviewing court must seal the administrative record, except for the board's final decision,
and must not make the administrative record available to the public.
new text end
Sec. 104.
new text begin
[148G.19] EXEMPTIONS.
new text end
new text begin
The provisions of this chapter do not prohibit:
new text end
new text begin
(1) the furnishing of certified midwifery assistance in an emergency;
new text end
new text begin
(2) the practice of certified midwifery by any legally qualified certified midwife of
another state who is employed by the United States government or any bureau, division, or
agency thereof while in the discharge of official duties;
new text end
new text begin
(3) the practice of any profession or occupation licensed by Minnesota, other than
certified midwifery, by any person licensed to practice the profession or occupation, or the
performance by a person of any acts properly coming within the scope of the profession,
occupation, or license;
new text end
new text begin
(4) the practice of traditional midwifery as specified under section 147D.03;
new text end
new text begin
(5) certified midwifery practice by a student practicing under the supervision of an
instructor while the student is enrolled in an approved certified midwifery education program;
or
new text end
new text begin
(6) certified midwifery practice by a certified midwife licensed in another state, territory,
or jurisdiction who is in Minnesota temporarily:
new text end
new text begin
(i) providing continuing or in-service education;
new text end
new text begin
(ii) serving as a guest lecturer;
new text end
new text begin
(iii) presenting at a conference; or
new text end
new text begin
(iv) teaching didactic content via distance education to a student located in Minnesota
who is enrolled in a formal, structured course of study, such as a course leading to a higher
degree in midwifery.
new text end
Sec. 105.
new text begin
[148G.20] VIOLATIONS; PENALTY.
new text end
new text begin Subdivision 1. new text end
new text begin Violations described. new text end
new text begin
It is unlawful for any person, corporation, firm,
or association to:
new text end
new text begin
(1) sell or fraudulently obtain or furnish any certified midwifery diploma, license, or
record, or aid or abet therein;
new text end
new text begin
(2) practice certified midwifery under cover of any diploma, permit, license, certified
midwife credential, or record illegally or fraudulently obtained or signed or issued unlawfully
or under fraudulent representation;
new text end
new text begin
(3) practice certified midwifery unless the person is licensed to do so under this chapter;
new text end
new text begin
(4) use the professional title certified midwife or licensed certified midwife unless
licensed to practice certified midwifery under this chapter;
new text end
new text begin
(5) use any abbreviation or other designation tending to imply licensure as a certified
midwife unless licensed to practice certified midwifery under this chapter;
new text end
new text begin
(6) practice certified midwifery in a manner prohibited by the board in any limitation
of a license issued under this chapter;
new text end
new text begin
(7) practice certified midwifery during the time a license issued under this chapter is
suspended or revoked;
new text end
new text begin
(8) knowingly employ persons in the practice of certified midwifery who have not been
issued a current license to practice as a certified midwife in this state; or
new text end
new text begin
(9) conduct a certified midwifery program for the education of persons to become certified
midwives unless the program has been approved by the board.
new text end
new text begin Subd. 2. new text end
new text begin Penalty. new text end
new text begin
Any person, corporation, firm, or association violating any provision
of subdivision 1 is guilty of a gross misdemeanor and must be punished according to law.
new text end
new text begin Subd. 3. new text end
new text begin Penalty; certified midwives. new text end
new text begin
In addition to subdivision 2, a person who practices
certified midwifery without a current license and certification or recertification, or without
current certification or recertification on file with the board, is subject to the applicable
penalties in section 148G.11.
new text end
Sec. 106.
new text begin
[148G.21] UNAUTHORIZED PRACTICE OF MIDWIFERY.
new text end
new text begin
The practice of certified midwifery by any person who is not licensed to practice certified
midwifery under this chapter, whose license has been suspended or revoked, or whose
national certification credential has expired is inimical to the public health and welfare and
constitutes a public nuisance. Upon a complaint being made by the board or any prosecuting
officer and upon a proper showing of the facts, the district court of the county where the
practice occurred may enjoin such acts and practice. The injunction proceeding is in addition
to, and not in lieu of, all other penalties and remedies provided by law.
new text end
Sec. 107.
Minnesota Statutes 2024, section 150A.105, is amended by adding a subdivision
to read:
new text begin Subd. 3a. new text end
new text begin Collaborative management agreement under armed forces. new text end
new text begin
(a) While
practicing under the auspices of the Minnesota National Guard or any branch of the armed
forces, including the Navy, Marines, Army, Coast Guard, or Space Force, the collaborating
dentist may be determined by the command structure of the armed service for which the
dental therapist is a member assigned or contracted.
new text end
new text begin
(b) A collaborating dentist for a dental therapist when in civilian practice will not be
responsible for supervising the dental services performed by the dental therapist while the
dental therapist is practicing under the auspices of the armed forces.
new text end
Sec. 108.
Minnesota Statutes 2024, section 151.01, subdivision 15, is amended to read:
Subd. 15.
Pharmacist internnew text begin or internnew text end .
"Pharmacist intern" new text begin or "intern" new text end meansnew text begin :
new text end
(1) a natural person new text begin who has completed college or school of pharmacy orientation or is
otherwise enrolled in a doctor of pharmacy program accredited by the Accreditation Council
for Pharmacy Education (ACPE) and is new text end satisfactorily progressing toward the degree in
pharmacy required for licensuredeleted text begin , ordeleted text end new text begin ;
new text end
(2) a graduate of deleted text begin the University of Minnesota College of Pharmacy, or other pharmacy
college approved by the board,deleted text end new text begin a doctor of pharmacy program accredited by ACPEnew text end who is
registered by the Board of Pharmacy for the purpose of obtaining practical experience as a
requirement for licensure as a pharmacistdeleted text begin , ordeleted text end new text begin ;
new text end
(3) a qualified applicant awaiting examination for licensuredeleted text begin .deleted text end new text begin ;
new text end
new text begin
(4) a participant in a residency or fellowship program who is not licensed to practice
pharmacy in Minnesota but is:
new text end
new text begin
(i) licensed to practice pharmacy in another state; or
new text end
new text begin
(ii) a graduate of a doctor of pharmacy program accredited by ACPE and not registered
by the board under clause (2); or
new text end
new text begin
(5) a foreign pharmacy graduate who:
new text end
new text begin
(i) has passed the Foreign Pharmacy Graduate Equivalency Examination;
new text end
new text begin
(ii) is certified by the Foreign Pharmacy Graduate Equivalency Commission; and
new text end
new text begin
(iii) is seeking internship experience in accordance with Minnesota Rules, part 6800.1250.
new text end
Sec. 109.
Minnesota Statutes 2024, section 151.01, subdivision 23, is amended to read:
Subd. 23.
Practitioner.
"Practitioner" means a licensed doctor of medicine, licensed
doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of
dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed
advanced practice registered nurse, new text begin licensed certified midwife, new text end or licensed physician assistant.
For purposes of sections 151.15, subdivision 4; 151.211, subdivision 3; 151.252, subdivision
3; 151.37, subdivision 2, paragraph (b); and 151.461, "practitioner" also means a dental
therapist authorized to dispense and administer under chapter 150A. For purposes of sections
151.252, subdivision 3, and 151.461, "practitioner" also means a pharmacist authorized to
prescribe self-administered hormonal contraceptives, nicotine replacement medications, or
opiate antagonists under section 151.37, subdivision 14, 15, or 16, or authorized to prescribe
drugs to prevent the acquisition of human immunodeficiency virus (HIV) under section
151.37, subdivision 17.
Sec. 110.
Minnesota Statutes 2024, section 151.065, subdivision 1, is amended to read:
Subdivision 1.
Application fees.
Application fees for licensure and registration are as
follows:
(1) pharmacist licensed by examination, $225;
(2) pharmacist licensed by reciprocity, $300;
(3) pharmacy intern, deleted text begin $75deleted text end new text begin $25new text end ;
(4) pharmacy technician, $60;
(5) pharmacy, $450;
(6) drug wholesaler, legend drugs only, $5,500;
(7) drug wholesaler, legend and nonlegend drugs, $5,500;
(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,500;
(9) drug wholesaler, medical gases, $5,500 for the first facility and $500 for each
additional facility;
(10) third-party logistics provider, $300;
(11) drug manufacturer, nonopiate legend drugs only, $5,500;
(12) drug manufacturer, nonopiate legend and nonlegend drugs, $5,500;
(13) drug manufacturer, nonlegend or veterinary legend drugs, $5,500;
(14) drug manufacturer, medical gases, $5,500 for the first facility and $500 for each
additional facility;
(15) drug manufacturer, also licensed as a pharmacy in Minnesota, $5,500;
(16) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, $55,500;
(17) medical gas dispenser, $400;
(18) controlled substance researcher, $150; and
(19) pharmacy professional corporation, $150.
Sec. 111.
Minnesota Statutes 2024, section 151.065, subdivision 3, is amended to read:
Subd. 3.
Annual renewal fees.
Annual licensure and registration renewal fees are as
follows:
(1) pharmacist, $225;
(2) pharmacy technician, $60;
new text begin
(3) beginning January 1, 2026, pharmacy intern, $25;
new text end
deleted text begin (3)deleted text end new text begin (4)new text end pharmacy, $450;
deleted text begin (4)deleted text end new text begin (5)new text end drug wholesaler, legend drugs only, $5,500;
deleted text begin (5)deleted text end new text begin (6)new text end drug wholesaler, legend and nonlegend drugs, $5,500;
deleted text begin (6)deleted text end new text begin (7)new text end drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, $5,500;
deleted text begin (7)deleted text end new text begin (8)new text end drug wholesaler, medical gases, $5,500 for the first facility and $500 for each
additional facility;
deleted text begin (8)deleted text end new text begin (9)new text end third-party logistics provider, $300;
deleted text begin (9)deleted text end new text begin (10)new text end drug manufacturer, nonopiate legend drugs only, $5,500;
deleted text begin (10)deleted text end new text begin (11)new text end drug manufacturer, nonopiate legend and nonlegend drugs, $5,500;
deleted text begin (11)deleted text end new text begin (12)new text end drug manufacturer, nonlegend, veterinary legend drugs, or both, $5,500;
deleted text begin (12)deleted text end new text begin (13)new text end drug manufacturer, medical gases, $5,500 for the first facility and $500 for
each additional facility;
deleted text begin (13)deleted text end new text begin (14)new text end drug manufacturer, also licensed as a pharmacy in Minnesota, $5,500;
deleted text begin (14)deleted text end new text begin (15)new text end drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, $55,500;
deleted text begin (15)deleted text end new text begin (16)new text end medical gas dispenser, $400;
deleted text begin (16)deleted text end new text begin (17)new text end controlled substance researcher, $150; and
deleted text begin (17)deleted text end new text begin (18)new text end pharmacy professional corporation, $150.
Sec. 112.
Minnesota Statutes 2024, section 151.065, subdivision 6, is amended to read:
Subd. 6.
Reinstatement fees.
(a) A pharmacist who has allowed the pharmacist's license
to lapse may reinstate the license with board approval and upon payment of any fees and
late fees in arrears, up to a maximum of $1,000.
(b) A pharmacy technician who has allowed the technician's registration to lapse may
reinstate the registration with board approval and upon payment of any fees and late fees
in arrears, up to a maximum of $250.
new text begin
(c) A pharmacy intern who has allowed the intern's registration to lapse may reinstate
the registration with board approval and upon payment of any fees and late fees in arrears,
up to a maximum of $100.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end An owner of a pharmacy, a drug wholesaler, a drug manufacturer, third-party
logistics provider, or a medical gas dispenser who has allowed the license of the establishment
to lapse may reinstate the license with board approval and upon payment of any fees and
late fees in arrears.
deleted text begin (d)deleted text end new text begin (e)new text end A controlled substance researcher who has allowed the researcher's registration
to lapse may reinstate the registration with board approval and upon payment of any fees
and late fees in arrears.
deleted text begin (e)deleted text end new text begin (f)new text end A pharmacist owner of a professional corporation who has allowed the corporation's
registration to lapse may reinstate the registration with board approval and upon payment
of any fees and late fees in arrears.
Sec. 113.
Minnesota Statutes 2024, section 151.101, is amended to read:
151.101 INTERNSHIP.
new text begin Subdivision 1. new text end
new text begin Registration requirements. new text end
new text begin (a) new text end Upon payment of the fee specified in
section 151.065, the board may register as an intern any natural persons who have satisfied
the board that they are of good moral character, not physically or mentally unfit, and who
have successfully completed the educational requirements for intern registration prescribed
by the board. deleted text begin The board shall prescribe standards and requirements for interns,
pharmacist-preceptors, and internship training but may not require more than one year of
such training.
deleted text end
new text begin (b) new text end The board in its discretion may accept internship experience obtained in another
state provided the internship requirements in such other state are in the opinion of the board
equivalent to those herein provided.
new text begin Subd. 2. new text end
new text begin Renewal requirements. new text end
new text begin
(a) Beginning January 1, 2026, an intern registration
expires on September 30 each year or when the intern receives a pharmacist license,
whichever is earlier.
new text end
new text begin
(b) To renew an intern registration, the intern must file an application for renewal and
submit the fee established under section 151.065 on or before September 1 each year.
new text end
new text begin
(c) If the board does not receive the intern's registration renewal application on or before
September 1 each year, the intern is subject to a late filing fee equal to 50 percent of the
renewal fee under section 151.065 in addition to the renewal fee.
new text end
new text begin
(d) An individual who received an intern registration under the criteria in section 151.01,
subdivision 15, clause (1), and paid $75 for the individual's application fee between May
1, 2024, and June 30, 2025, is not subject to the $25 renewal fee for the first two renewal
cycles following the $75 fee payment.
new text end
new text begin
(e) If an individual is no longer enrolled in a doctor of pharmacy program accredited by
the Accreditation Council for Pharmacy Education, the board must terminate that individual's
intern registration effective the last date the individual was enrolled in a qualifying program.
new text end
new text begin
(f) The board must not renew an intern registration unless the individual:
new text end
new text begin
(1) has maintained current notices of employment for internship training with the board;
new text end
new text begin
(2) submitted a progress report affidavit of the intern credit hours completed by June 15
each year;
new text end
new text begin
(3) meets all other eligibility criteria for a pharmacist intern; and
new text end
new text begin
(4) demonstrates to the board's satisfaction the individual is in good faith and with
reasonable diligence pursuing a degree in pharmacy or is completing a pharmacy residency
or fellowship.
new text end
new text begin
(g) An intern whose registration has lapsed may renew the intern registration within one
year of expiration, subject to the fees in paragraph (c). An intern whose registration has
lapsed for more than one year must meet the registration requirements for an initial intern
applicant in effect at the time the individual applies for reinstatement and pay any fees and
late fees in arrears in accordance with section 151.065.
new text end
new text begin
(h) If the board receives a late renewal, reinstatement, or initial intern application from
an eligible individual within 90 days before September 30, the board may extend the
registration expiration date for that applicant to September 30 of the subsequent calendar
year and prorate the application fee accordingly.
new text end
new text begin Subd. 3. new text end
new text begin Internship credit hour requirements. new text end
new text begin
(a) To apply for licensure as a pharmacist
under section 151.10, an individual must complete at least 1,600 intern credit hours under
the direction and supervision of a preceptor.
new text end
new text begin
(b) Of the 1,600 credit hours required under this subdivision, an intern may earn:
new text end
new text begin
(1) a maximum of 80 credit hours in the individual's first professional academic year
for a structured experience directed by the college of pharmacy that the individual attends
and is overseen by college faculty, registered preceptors, or supervising licensed pharmacists;
new text end
new text begin
(2) a maximum of 400 credit hours of concurrent time internship; and
new text end
new text begin
(3) a maximum of 54 credit hours per week that may be earned from more than one site.
new text end
Sec. 114.
Minnesota Statutes 2024, section 152.12, subdivision 1, is amended to read:
Subdivision 1.
Prescribing, dispensing, administering controlled substances in
Schedules II through V.
A licensed doctor of medicine, a doctor of osteopathic medicine,
duly licensed to practice medicine, a doctor of dental surgery, a doctor of dental medicine,
a licensed doctor of podiatry, a licensed advanced practice registered nurse, new text begin a licensed
certified midwife, new text end a licensed physician assistant, or a licensed doctor of optometry limited
to Schedules IV and V, and in the course of professional practice only, may prescribe,
administer, and dispense a controlled substance included in Schedules II through V of section
152.02, may cause the same to be administered by a nurse, an intern or an assistant under
the direction and supervision of the doctor, and may cause a person who is an appropriately
certified and licensed health care professional to prescribe and administer the same within
the expressed legal scope of the person's practice as defined in Minnesota Statutes.
Sec. 115.
new text begin
[153.30] FEES.
new text end
new text begin Subdivision 1. new text end
new text begin Nonrefundable fees. new text end
new text begin
The fees in this section are nonrefundable.
new text end
new text begin Subd. 2. new text end
new text begin Fee amounts. new text end
new text begin
The amount of fees must be set by the board so that the total
fees collected by the board equals as closely as possible the anticipated expenditures during
the fiscal biennium, as provided in section 16A.1285. Fees must not exceed the following
amounts but may be adjusted lower by board action:
new text end
new text begin
(1) application for licensure fee, $1,000;
new text end
new text begin
(2) renewal licensure fee, $1,000;
new text end
new text begin
(3) late renewal fee, $250;
new text end
new text begin
(4) temporary permit fee, $250;
new text end
new text begin
(5) duplicate license fee or duplicate renewal certificate fee, $25;
new text end
new text begin
(6) reinstatement fee, $1,250;
new text end
new text begin
(7) examination administration fee for persons who have not applied for a license or
permit, $50;
new text end
new text begin
(8) verification of licensure fee, $50;
new text end
new text begin
(9) label fee, $50;
new text end
new text begin
(10) list of licensees fee, $50; and
new text end
new text begin
(11) copies fee, $0.50 per page.
new text end
new text begin Subd. 3. new text end
new text begin Current fee information. new text end
new text begin
Information about fees in effect at any time must
be available from the board office.
new text end
new text begin Subd. 4. new text end
new text begin Deposit of fees. new text end
new text begin
The license fees collected under this section must be deposited
in the state government special revenue fund.
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. 116.
Minnesota Statutes 2024, section 153B.85, subdivision 1, is amended to read:
Subdivision 1.
Fees.
(a) The application fee for initial licensure shall not exceed $600.
(b) The biennial renewal fee for a license to practice as an orthotist, prosthetist, prosthetist
orthotist, or pedorthist shall not exceed $600.
(c) The biennial renewal fee for a license to practice as an assistant or a fitter shall not
exceed $300.
(d) The fee for license restoration shall not exceed $600.
(e) The fee for license verification shall not exceed deleted text begin $30deleted text end new text begin $50new text end .
(f) The fee to obtain a list of licensees shall not exceed deleted text begin $25deleted text end new text begin $50new 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. 117.
Minnesota Statutes 2024, section 153B.85, subdivision 3, is amended to read:
Subd. 3.
Late fee.
The fee for late license renewal is the license renewal fee in effect at
the time of renewal plus deleted text begin $100deleted text end new text begin $250new 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. 118.
Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
to read:
new text begin Subd. 1a. new text end
new text begin Nonrefundable fees. new text end
new text begin
All fees are nonrefundable.
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. 119.
Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
to read:
new text begin Subd. 3. new text end
new text begin Fee amounts. new text end
new text begin
Fees must not exceed the following amounts but may be adjusted
lower by board action:
new text end
new text begin
(1) initial application fee, $75;
new text end
new text begin
(2) state examination fee, $75;
new text end
new text begin
(3) duplicate license fee, $25;
new text end
new text begin
(4) continuing education sponsor application fee, $75;
new text end
new text begin
(5) mailing list fee, $250;
new text end
new text begin
(6) initial veterinary license fee, $300;
new text end
new text begin
(7) initial veterinary technician fee, $100;
new text end
new text begin
(8) active veterinary renewal fee, $300;
new text end
new text begin
(9) active veterinary technician renewal fee, $100;
new text end
new text begin
(10) inactive veterinary renewal fee, $150;
new text end
new text begin
(11) inactive veterinary technician renewal fee, $50;
new text end
new text begin
(12) institutional license fee, $300;
new text end
new text begin
(13) active late veterinary renewal fee, $150;
new text end
new text begin
(14) active late veterinary technician renewal fee, $50;
new text end
new text begin
(15) inactive late veterinary renewal fee, $100;
new text end
new text begin
(16) inactive late veterinary technician renewal fee, $25; and
new text end
new text begin
(17) institutional late renewal fee, $150.
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. 120.
Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin License verification. new text end
new text begin
The board may charge a fee not to exceed $25 per license
verification to a licensee for verification of licensure status provided to other veterinary
licensing boards.
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. 121.
Minnesota Statutes 2024, section 156.015, is amended by adding a subdivision
to read:
new text begin Subd. 5. new text end
new text begin Deposit of fees. new text end
new text begin
The license fees collected under this section must be deposited
in the state government special revenue fund.
new text end
Sec. 122.
Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 28c. new text end
new text begin Certified midwifery practice services. new text end
new text begin
Medical assistance covers services
performed by a licensed certified midwife if:
new text end
new text begin
(1) the service provided on an inpatient basis is not included as part of the cost for
inpatient services included in the facility payment;
new text end
new text begin
(2) the service is otherwise covered under this chapter as a physician service; and
new text end
new text begin
(3) the service is within the scope of practice of the certified midwife's license as defined
under chapter 148G.
new text end
Sec. 123. new text begin REVISOR INSTRUCTION.
new text end
new text begin
(a) The revisor of statutes shall renumber Minnesota Statutes, section 148.6408,
subdivision 1, as Minnesota Statutes, section 148.6408, subdivision 1b.
new text end
new text begin
(b) The revisor of statutes shall renumber Minnesota Statutes, section 148.6410,
subdivision 1, as Minnesota Statutes, section 148.6410, subdivision 1b.
new text end
Sec. 124. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2024, sections 148.108, subdivisions 2, 3, and 4; 148.6402,
subdivision 22a; 148.6420, subdivisions 2, 3, and 4; 148.6423, subdivisions 4, 5, 7, 8, and
9; 148.6425, subdivision 3; 148.6430; 148.6445, subdivisions 5, 6, and 8; and 156.015,
subdivision 1,
new text end
new text begin
are repealed.
new text end
new text begin
(b)
new text end
new text begin
Minnesota Rules, parts 2500.1150; 2500.2030; 6800.5100, subpart 5; 6800.5400,
subparts 5 and 6; 9100.0400, subparts 1 and 3; 9100.0500; and 9100.0600,
new text end
new text begin
are repealed.
new text end
new text begin
(c)
new text end
new text begin
Minnesota Rules, part 6900.0250, subparts 1 and 2,
new text end
new text begin
are repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraphs (a) and (b) are effective July 1, 2025. Paragraph (c)
is effective the day following final enactment.
new text end
ARTICLE 4
MINNESOTA HEALTH AND EDUCATION FACILITIES AUTHORITY
Section 1.
Minnesota Statutes 2024, section 3.732, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
As used in this section and section 3.736 the terms defined
in this section have the meanings given them.
(1) "State" includes each of the departments, boards, agencies, commissions, courts, and
officers in the executive, legislative, and judicial branches of the state of Minnesota and
includes but is not limited to the Housing Finance Agency, the Minnesota Office of Higher
Education, the deleted text begin Higherdeleted text end new text begin Health andnew text end Education Facilities Authority, the Health Technology
Advisory Committee, the Armory Building Commission, the Zoological Board, the
Department of Iron Range Resources and Rehabilitation, the Minnesota Historical Society,
the State Agricultural Society, the University of Minnesota, the Minnesota State Colleges
and Universities, state hospitals, and state penal institutions. It does not include a city, town,
county, school district, or other local governmental body corporate and politic.
(2) "Employee of the state" means all present or former officers, members, directors, or
employees of the state, members of the Minnesota National Guard, members of a bomb
disposal unit approved by the commissioner of public safety and employed by a municipality
defined in section 466.01 when engaged in the disposal or neutralization of bombs or other
similar hazardous explosives, as defined in section 299C.063, outside the jurisdiction of the
municipality but within the state, or persons acting on behalf of the state in an official
capacity, temporarily or permanently, with or without compensation. It does not include
either an independent contractor except, for purposes of this section and section 3.736 only,
a guardian ad litem acting under court appointment, or members of the Minnesota National
Guard while engaged in training or duty under United States Code, title 10, or title 32,
section 316, 502, 503, 504, or 505, as amended through December 31, 1983. Notwithstanding
sections 43A.02 and 611.263, for purposes of this section and section 3.736 only, "employee
of the state" includes a district public defender or assistant district public defender in the
Second or Fourth Judicial District, a member of the Health Technology Advisory Committee,
and any officer, agent, or employee of the state of Wisconsin performing work for the state
of Minnesota pursuant to a joint state initiative.
(3) "Scope of office or employment" means that the employee was acting on behalf of
the state in the performance of duties or tasks lawfully assigned by competent authority.
(4) "Judicial branch" has the meaning given in section 43A.02, subdivision 25.
Sec. 2.
Minnesota Statutes 2024, section 10A.01, subdivision 35, is amended to read:
Subd. 35.
Public official.
"Public official" means any:
(1) member of the legislature;
(2) individual employed by the legislature as secretary of the senate, legislative auditor,
director of the Legislative Budget Office, chief clerk of the house of representatives, revisor
of statutes, or researcher, legislative analyst, fiscal analyst, or attorney in the Office of
Senate Counsel, Research and Fiscal Analysis, House Research, or the House Fiscal Analysis
Department;
(3) constitutional officer in the executive branch and the officer's chief administrative
deputy;
(4) solicitor general or deputy, assistant, or special assistant attorney general;
(5) commissioner, deputy commissioner, or assistant commissioner of any state
department or agency as listed in section 15.01 or 15.06, or the state chief information
officer;
(6) member, chief administrative officer, or deputy chief administrative officer of a state
board or commission that has either the power to adopt, amend, or repeal rules under chapter
14, or the power to adjudicate contested cases or appeals under chapter 14;
(7) individual employed in the executive branch who is authorized to adopt, amend, or
repeal rules under chapter 14 or adjudicate contested cases under chapter 14;
(8) executive director of the State Board of Investment;
(9) deputy of any official listed in clauses (7) and (8);
(10) judge of the Workers' Compensation Court of Appeals;
(11) administrative law judge or compensation judge in the State Office of Administrative
Hearings or unemployment law judge in the Department of Employment and Economic
Development;
(12) member, regional administrator, division director, general counsel, or operations
manager of the Metropolitan Council;
(13) member or chief administrator of a metropolitan agency;
(14) director of the Division of Alcohol and Gambling Enforcement in the Department
of Public Safety;
(15) member or executive director of the deleted text begin Higherdeleted text end new text begin Health andnew text end Education Facilities
Authority;
(16) member of the board of directors or president of Enterprise Minnesota, Inc.;
(17) member of the board of directors or executive director of the Minnesota State High
School League;
(18) member of the Minnesota Ballpark Authority established in section 473.755;
(19) citizen member of the Legislative-Citizen Commission on Minnesota Resources;
(20) manager of a watershed district, or member of a watershed management organization
as defined under section 103B.205, subdivision 13;
(21) supervisor of a soil and water conservation district;
(22) director of Explore Minnesota Tourism;
(23) citizen member of the Lessard-Sams Outdoor Heritage Council established in section
97A.056;
(24) citizen member of the Clean Water Council established in section 114D.30;
(25) member or chief executive of the Minnesota Sports Facilities Authority established
in section 473J.07;
(26) district court judge, appeals court judge, or supreme court justice;
(27) county commissioner;
(28) member of the Greater Minnesota Regional Parks and Trails Commission;
(29) member of the Destination Medical Center Corporation established in section
469.41; or
(30) chancellor or member of the Board of Trustees of the Minnesota State Colleges
and Universities.
Sec. 3.
Minnesota Statutes 2024, section 136A.25, is amended to read:
136A.25 CREATION.
A state agency known as the Minnesota deleted text begin Higherdeleted text end new text begin Health and new text end Education Facilities Authority
is hereby created.
Sec. 4.
Minnesota Statutes 2024, section 136A.26, is amended to read:
136A.26 MEMBERSHIPS; OFFICERS; COMPENSATION; REMOVAL.
Subdivision 1.
Membership.
The Minnesota deleted text begin Higherdeleted text end new text begin Health andnew text end Education Facilities
Authority shall consist of deleted text begin eightdeleted text end new text begin ninenew text end members appointed by the governor with the advice
and consent of the senate, and a representative of the deleted text begin officedeleted text end new text begin Office of Higher Educationnew text end .
All members to be appointed by the governor shall be residents of the state. At least two
members must reside outside the metropolitan area as defined in section 473.121, subdivision
2. At least one of the members shall be a person having a favorable reputation for skill,
knowledge, and experience in the field of state and municipal finance; deleted text begin anddeleted text end at least one shall
be a person having a favorable reputation for skill, knowledge, and experience in the building
construction field; deleted text begin anddeleted text end at least one of the members shall be a trustee, director, officer, or
employee of an institution of higher educationnew text begin ; and at least one of the members shall be a
trustee, director, officer, or employee of a health care organizationnew text end .
Subd. 1a.
Private College Council member.
The president of the Minnesota Private
College Council, or the president's designee, shall serve without compensation as an advisory,
nonvoting member of the authority.
new text begin Subd. 1b. new text end
new text begin Nonprofit health care association member. new text end
new text begin
The chief executive officer of
a Minnesota nonprofit membership association whose members are primarily nonprofit
health care organizations, or the chief executive officer's designee, shall serve without
compensation as an advisory, nonvoting member of the authority. The identity of the
Minnesota nonprofit membership association shall be determined and may be changed from
time to time by the members of the authority in accordance with and as shall be provided
in the bylaws of the authority.
new text end
Subd. 2.
Term; compensation; removal.
The membership terms, compensation, removal
of members, and filling of vacancies for authority members other than the representative
of the office, deleted text begin anddeleted text end the president of the Private College Council,new text begin or the chief executive officer
of the Minnesota nonprofit membership association described in subdivision 1bnew text end shall be as
provided in section 15.0575.
Sec. 5.
Minnesota Statutes 2024, section 136A.27, is amended to read:
136A.27 POLICY.
It is hereby declared that for the benefit of the people of the state, the increase of their
commerce, welfare and prosperity and the improvement of their health and living conditions
it is essential that new text begin health care organizations in Minnesota be provided with appropriate
additional means to establish, acquire, construct, improve, and expand health care facilities
in furtherance of their purposes; that new text end this and future generations of youth be given the fullest
opportunity to learn and to develop their intellectual and mental capacities; deleted text begin that it is essentialdeleted text end
that institutions of higher education within the state be provided with appropriate additional
means to assist deleted text begin suchdeleted text end youth in achieving the required levels of learning and development of
their intellectual and mental capacitiesnew text begin ;new text end andnew text begin that health care organizations and institutions
of higher educationnew text end be enabled to refinance outstanding indebtedness incurred to provide
existing facilities used for deleted text begin suchdeleted text end new text begin thosenew text end purposes in order to preserve and enhance the utilization
of facilities for purposes of new text begin health care and new text end higher education, to extend or adjust maturities
in relation to the resources available for their payment, and to save interest costs and thereby
reduce new text begin health care costs or higher education new text end tuition, feesnew text begin ,new text end and chargesdeleted text begin ; anddeleted text end new text begin . It is hereby
further declarednew text end that it is the purpose of sections 136A.25 to 136A.42 to provide a measure
of assistance and an alternative method to enable new text begin health care organizations and new text end institutions
of higher education in the state to provide the facilities and structures which are sorely
needed to accomplish the purposes of sections 136A.25 to 136A.42, all to the public benefit
and good, to the extent and manner provided herein.
Sec. 6.
Minnesota Statutes 2024, section 136A.28, is amended to read:
136A.28 DEFINITIONS.
Subdivision 1.
Scope.
In sections 136A.25 to 136A.42, the following words and terms
shall, unless the context otherwise requires, have the meanings ascribed to them.
new text begin Subd. 1a. new text end
new text begin Affiliate. new text end
new text begin
"Affiliate" means an entity that directly or indirectly controls, is
controlled by, or is under common control with another entity. For purposes of this
subdivision, "control" means either the power to elect a majority of the members of the
governing body of an entity or the power, whether by contract or otherwise, to direct the
management and policies of the entity. Affiliate also means an entity whose business or
substantially all of whose property is operated under a lease, management agreement, or
operating agreement by another entity, or an entity who operates the business or substantially
all of the property of another entity under a lease, management agreement, or operating
agreement.
new text end
Subd. 2.
Authority.
"Authority" means the deleted text begin Higherdeleted text end new text begin Health and new text end Education Facilities
Authority created by sections 136A.25 to 136A.42.
Subd. 3.
Project.
"Project" means deleted text begin a structure or structures available for use as a dormitory
or other student housing facility, a dining hall, student union, administration building,
academic building, library, laboratory, research facility, classroom, athletic facility, health
care facility, child care facility, and maintenance, storage, or utility facility and other
structures or facilities related thereto or required or useful for the instruction of students or
the conducting of research or the operation of an institution of higher education, whether
proposed, under construction, or completed, including parking and other facilities or
structures essential or convenient for the orderly conduct of such institution for higher
education, and shall also include landscaping, site preparation, furniture, equipment and
machinery, and other similar items necessary or convenient for the operation of a particular
facility or structure in the manner for which its use is intended but shall not include such
items as books, fuel, supplies, or other items the costs of which are customarily deemed to
result in a current operating charge, and shalldeleted text end new text begin a health care facility or an education facility
whether proposed, under construction, or completed, and includes land or interests in land,
appurtenances, site preparation, landscaping, buildings and structures, systems, fixtures,
furniture, machinery, equipment, and parking. Project also includes other structures, facilities,
improvements, machinery, equipment, and means of transport of a capital nature that are
necessary or convenient for the operation of the facility. Project does new text end not includenew text begin : (1)new text end any
facility used or to be used for sectarian instruction or as a place of religious worship deleted text begin nordeleted text end new text begin ;
(2)new text end any facility which is used or to be used primarily in connection with any part of the
program of a school or department of divinity for any religious denominationnew text begin ; or (3) any
books, supplies, medicine, medical supplies, fuel, or other items, the cost of which are
customarily deemed to result in a current operating chargenew text end .
Subd. 4.
Cost.
"Cost," as applied to a project or any portion deleted text begin thereofdeleted text end financed under the
provisions of sections 136A.25 to 136A.42, means all or any part of the cost of construction,
acquisition, alteration, enlargement, reconstruction and remodeling of a project including
all lands, structures, real or personal property, rights, rights-of-way, franchises, easements
and interests acquired or used for or in connection with a project, the cost of demolishing
or removing any buildings or structures on land so acquired, including the cost of acquiring
any lands to which deleted text begin suchdeleted text end new text begin thenew text end buildings or structures may be moved, the cost of all machinery
and equipment, financing charges, interest prior to, during and for a period after completion
of deleted text begin suchdeleted text end construction and acquisition, provisions for reserves for principal and interest and
for extensions, enlargements, additions and improvements, the cost of architectural,
engineering, financial and legal services, plans, specifications, studies, surveys, estimates
of cost and of revenues, administrative expenses, expenses necessary or incident to
determining the feasibility or practicability of constructing the project and deleted text begin suchdeleted text end other
expenses as may be necessary or incident to the construction and acquisition of the project,
the financing of deleted text begin suchdeleted text end construction and acquisition and the placing of the project in operation.
Subd. 5.
Bonds.
"Bonds," or "revenue bonds" means revenue bonds of the authority
issued under the provisions of sections 136A.25 to 136A.42, including revenue refunding
bonds, notwithstanding that the same may be secured by mortgage or the full faith and credit
of a participating institution deleted text begin for higher educationdeleted text end or any other lawfully pledged security of
a participating institution deleted text begin for higher educationdeleted text end .
Subd. 6.
Institution of higher education.
"Institution of higher education" means a
nonprofit educational institution within the state authorized to provide a program of education
beyond the high school level.
new text begin Subd. 6a. new text end
new text begin Health care organization. new text end
new text begin
(a) "Health care organization" means a nonprofit
organization located within the state and authorized by law to operate a nonprofit health
care facility in the state. Health care organization also means a nonprofit affiliate of a health
care organization as defined under this paragraph, provided the affiliate is located within
the state or within a state that is geographically contiguous to Minnesota.
new text end
new text begin
(b) Health care organization also means a nonprofit organization located in another state
that is geographically contiguous to Minnesota and authorized by law to operate a nonprofit
health care facility in that state, provided that the nonprofit organization located in the
contiguous state is an affiliate of a health care organization located in Minnesota.
new text end
new text begin Subd. 6b. new text end
new text begin Education facility. new text end
new text begin
"Education facility" means a structure or structures
available for use as a dormitory or other student housing facility, dining hall, student union,
administration building, academic building, library, laboratory, research facility, classroom,
athletic facility, student health care facility, or child care facility, and includes other facilities
or structures related to the essential or convenient orderly conduct of an institution of higher
education.
new text end
new text begin Subd. 6c. new text end
new text begin Health care facility. new text end
new text begin
(a) "Health care facility" means a structure or structures
available for use in Minnesota as a hospital, clinic, psychiatric residential treatment facility,
birth center, outpatient surgical center, comprehensive outpatient rehabilitation facility,
outpatient physical therapy or speech pathology facility, end-stage renal dialysis facility,
medical laboratory, pharmacy, radiation therapy facility, diagnostic imaging facility, medical
office building, residence for nurses or interns, nursing home, boarding care home, assisted
living facility, residential hospice, intermediate care facility for persons with developmental
disabilities, supervised living facility, housing with services establishment, board and lodging
establishment with special services, adult day care center, day services facility, prescribed
pediatric extended care facility, community residential setting, adult foster home, or other
facility related to medical or health care research, or the delivery or administration of health
care services and includes other structures or facilities related to the essential or convenient
orderly conduct of a health care organization.
new text end
new text begin
(b) Health care facility also means a facility in a state that is geographically contiguous
to Minnesota operated by a health care organization that corresponds by purpose, function,
or use with a facility listed in paragraph (a).
new text end
Subd. 7.
Participating institution deleted text begin of higher educationdeleted text end .
"Participating institution deleted text begin of
higher educationdeleted text end " meansnew text begin a health care organization ornew text end an institution of higher education
that, under the provisions of sections 136A.25 to 136A.42, undertakes the financing and
construction or acquisition of a project or undertakes the refunding or refinancing of
obligations or of a mortgage or of advances as provided in sections 136A.25 to 136A.42.
Community colleges and technical colleges may be considered participating institutions deleted text begin of
higher educationdeleted text end for the purpose of financing and constructing child care facilities and
parking facilities.
Sec. 7.
Minnesota Statutes 2024, section 136A.29, subdivision 1, is amended to read:
Subdivision 1.
Purpose.
The purpose of the authority shall be to assist new text begin health care
organizations and new text end institutions of higher education in the construction, financing, and
refinancing of projects. The exercise by the authority of the powers conferred by sections
136A.25 to 136A.42, shall be deemed and held to be the performance of an essential public
function. For the purpose of sections 136A.25 to 136A.42, the authority shall have the
powers and duties set forth in subdivisions 2 to 23.
Sec. 8.
Minnesota Statutes 2024, section 136A.29, subdivision 3, is amended to read:
Subd. 3.
Employeesnew text begin ; office spacenew text end .
The authority is authorized and empowered to appoint
and employ employees as it may deem necessary to carry out its duties, determine the title
of the employees so employed, and fix the salary of deleted text begin saiddeleted text end new text begin thenew text end employees. Employees of the
authority shall participate in retirement and other benefits in the same manner that employees
in the deleted text begin unclassified service of the officedeleted text end new text begin managerial plan under section 43A.18, subdivision
3,new text end participate.new text begin The authority may maintain an office space as it may designate.
new text end
Sec. 9.
Minnesota Statutes 2024, section 136A.29, subdivision 6, is amended to read:
Subd. 6.
Projects; generally.
new text begin (a) new text end The authority is authorized and empowered to determine
the location and character of any project to be financed under the provisions of sections
136A.25 to 136A.42, and to construct, reconstruct, remodel, maintain, manage, enlarge,
alter, add to, repair, operate, lease, as lessee or lessor, and regulate the same, to enter into
contracts for any or all of deleted text begin suchdeleted text end new text begin thesenew text end purposes, to enter into contracts for the management
and operation of a project, and to designate a participating institution deleted text begin of higher educationdeleted text end
as its agent to determine the location and character of a project undertaken by deleted text begin suchdeleted text end new text begin anew text end
participating institution deleted text begin of higher educationdeleted text end under the provisions of sections 136A.25 to
136A.42 and as the agent of the authority, to construct, reconstruct, remodel, maintain,
manage, enlarge, alter, add to, repair, operate, lease, as lessee or lessor, and regulate the
same, and as the agent of the authority, to enter into contracts for any or all of deleted text begin suchdeleted text end new text begin thesenew text end
purposes, including contracts for the management and operation of deleted text begin suchdeleted text end new text begin thenew text end project.
new text begin
(b) Notwithstanding paragraph (a), a project involving a health care facility in Minnesota
financed under sections 136A.25 to 136A.42 must comply with all applicable requirements
in state law related to authorizing construction of or modifications to a health care facility,
including the requirements in sections 144.5509, 144.551, 144A.071, and 252.291.
new text end
new text begin (c) new text end Contracts of the authority or of a participating institution deleted text begin of higher educationdeleted text end to
acquire or to construct, reconstruct, remodel, maintain, enlarge, alter, add to, or repair
projects shall not be subject to the provisions of chapter 16C or section 574.26, or any other
public contract or competitive bid law.
Sec. 10.
Minnesota Statutes 2024, section 136A.29, subdivision 9, is amended to read:
Subd. 9.
Revenue bonds; limit.
new text begin (a) new text end The authority is authorized and empowered to issue
revenue bonds whose aggregate principal amount at any time shall not exceed deleted text begin $2,000,000,000deleted text end new text begin
$5,000,000,000new text end and to issue notes, bond anticipation notes, and revenue refunding bonds
of the authority under the provisions of sections 136A.25 to 136A.42, to provide funds for
acquiring, constructing, reconstructing, enlarging, remodeling, renovating, improving,
furnishing, or equipping one or more projects or parts thereof.
new text begin
(b) Of the $5,000,000,000 limit in paragraph (a), the aggregate principal amount used
to fund education facilities may not exceed $2,250,000,000 at any time and the aggregate
principal amount used to fund health care facilities may not exceed $2,750,000,000 at any
time.
new text end
Sec. 11.
Minnesota Statutes 2024, section 136A.29, subdivision 10, is amended to read:
Subd. 10.
Revenue bonds; issuance, purpose, conditions.
The authority is authorized
and empowered to issue revenue bonds to acquire projects from or to make loans to
participating institutions deleted text begin of higher educationdeleted text end and thereby refinance outstanding indebtedness
incurred by participating institutions deleted text begin of higher educationdeleted text end to provide funds for the acquisition,
construction or improvement of a facility before or after the enactment of sections 136A.25
to 136A.42, but otherwise eligible to be and being a project thereunder, whenever the
authority finds that deleted text begin suchdeleted text end new text begin thenew text end refinancing will enhance or preserve deleted text begin suchdeleted text end new text begin thenew text end participating
institutions and deleted text begin suchdeleted text end new text begin thenew text end facilities or utilization deleted text begin thereofdeleted text end new text begin that isnew text end for new text begin health care or new text end educational
purposes or extend or adjust maturities to correspond to the resources available for their
payment, or reduce new text begin charges or fees imposed on patients or occupants, or new text end the tuition, chargesnew text begin ,new text end
or fees imposed on students for the use new text begin or occupancy new text end of the facilities of deleted text begin suchdeleted text end new text begin thenew text end participating
institutions deleted text begin of higher educationdeleted text end or costs met by federal or state public funds, or enhance or
preserve new text begin health care or new text end educational programs and research or the acquisition or improvement
of other facilities eligible to be a project or part thereof by the participating institution deleted text begin of
higher educationdeleted text end . The amount of revenue bonds to be issued to refinance outstanding
indebtedness of a participating institution deleted text begin of higher educationdeleted text end shall not exceed the lesser of
(a) the fair value of the project to be acquired by the authority from the institution or
mortgaged to the authority by the institution or (b) the amount of the outstanding indebtedness
including any premium thereon and any interest accrued or to accrue to the date of redemption
and any legal, fiscal and related costs in connection with deleted text begin suchdeleted text end new text begin thenew text end refinancing and reasonable
reserves, as determined by the authority. The provisions of this subdivision do not prohibit
the authority from issuing revenue bonds within and charged against the limitations provided
in subdivision 9 to provide funds for improvements, alteration, renovation, or extension of
the project refinanced.
Sec. 12.
Minnesota Statutes 2024, section 136A.29, subdivision 14, is amended to read:
Subd. 14.
Rules for use of projects.
The authority is authorized and empowered to
establish rules for the use of a project or any portion thereof and to designate a participating
institution deleted text begin of higher educationdeleted text end as its agent to establish rules for the use of a project undertaken
for deleted text begin suchdeleted text end new text begin anew text end participating institution deleted text begin of higher educationdeleted text end .
Sec. 13.
Minnesota Statutes 2024, section 136A.29, subdivision 19, is amended to read:
Subd. 19.
Surety.
Before the issuance of any revenue bonds under the provisions of
sections 136A.25 to 136A.42, any member or officer of the authority authorized by resolution
of the authority to handle funds or sign checks of the authority shall be covered under a
surety or fidelity bond in an amount to be determined by the authority. Each deleted text begin suchdeleted text end bond shall
be conditioned upon the faithful performance of the duties of the office of the member or
officerdeleted text begin ,deleted text end new text begin andnew text end shall be executed by a surety company authorized to transact business in the
state of Minnesota as surety. The cost of each deleted text begin suchdeleted text end bond shall be paid by the authority.
Sec. 14.
Minnesota Statutes 2024, section 136A.29, subdivision 20, is amended to read:
Subd. 20.
Sale, lease, and disposal of property.
The authority is authorized and
empowered to sell, lease, releasenew text begin ,new text end or otherwise dispose of real and personal property or
interests therein, or a combination thereof, acquired by the authority under authority of
sections 136A.25 to 136A.42 and no longer needed for the purposes of deleted text begin suchdeleted text end new text begin thisnew text end chapter or
of the authority, and grant deleted text begin suchdeleted text end easements and other rights in, over, under, or across a project
as will not interfere with its use of deleted text begin suchdeleted text end new text begin thenew text end property. deleted text begin Suchdeleted text end new text begin Thenew text end sale, lease, release,
disposition, or grant may be made without competitive bidding and in deleted text begin suchdeleted text end new text begin thenew text end mannernew text begin andnew text end
for such consideration as the authority in its judgment deems appropriate.
Sec. 15.
Minnesota Statutes 2024, section 136A.29, subdivision 21, is amended to read:
Subd. 21.
Loans.
The authority is authorized and empowered to make loans to any
participating institution deleted text begin of higher educationdeleted text end for the cost of a project in accordance with an
agreement between the authority and the participating institution deleted text begin of higher education;deleted text end new text begin ,new text end
provided that no deleted text begin suchdeleted text end loan shall exceed the total cost of the project as determined by the
participating institution deleted text begin of higher educationdeleted text end and approved by the authority.
Sec. 16.
Minnesota Statutes 2024, section 136A.29, subdivision 22, is amended to read:
Subd. 22.
Costs, expenses, and other charges.
The authority is authorized and
empowered to charge to and apportion among participating institutions deleted text begin of higher educationdeleted text end
its administrative costs and expenses incurred in the exercise of the powers and duties
conferred by sections 136A.25 to 136A.42new text begin in the manner as the authority in its judgment
deems appropriatenew text end .
Sec. 17.
Minnesota Statutes 2024, section 136A.29, is amended by adding a subdivision
to read:
new text begin Subd. 24. new text end
new text begin Determination of affiliate status. new text end
new text begin
The authority is authorized and empowered
to determine whether an entity is an affiliate as defined in section 136A.28, subdivision 1a.
A determination by the authority of affiliate status shall be deemed conclusive for the
purposes of sections 136A.25 to 136A.42.
new text end
Sec. 18.
Minnesota Statutes 2024, section 136A.32, subdivision 1, is amended to read:
Subdivision 1.
Bonds; generally.
new text begin (a) new text end The authority may from time to time issue revenue
bonds for purposes of sections 136A.25 to 136A.42, and all deleted text begin suchdeleted text end revenue bonds, notes,
bond anticipation notes or other obligations of the authority issued pursuant to sections
136A.25 to 136A.42 shall be and are hereby declared to be negotiable for all purposes
notwithstanding their payment from a limited source and without regard to any other law
or laws. In anticipation of the sale of deleted text begin suchdeleted text end revenue bonds, the authority may issue negotiable
bond anticipation notes and may renew the same from time to time, but the maximum
maturity of any deleted text begin suchdeleted text end note, including renewals deleted text begin thereofdeleted text end , shall not exceed five years from the
date of issue of the original note. deleted text begin Suchdeleted text end Notes shall be paid from any revenues of the authority
available therefor and not otherwise pledged, or from the proceeds of sale of the revenue
bonds of the authority in anticipation of which they were issued. The notes shall be issued
in the same manner as the revenue bonds. deleted text begin Suchdeleted text end new text begin Thenew text end notes and the resolution or resolutions
authorizing the same may contain any provisions, conditions or limitations which a bond
resolution or the authority may contain.
new text begin
(b) Before issuing revenue bonds, notes, or other obligations under paragraph (a) on
behalf of a health care organization to finance health care facilities, the authority must obtain
consent by resolution from each city or town where the project is located, except that consent
need not be obtained in the case of a city or town with a population of less than 100,000.
The consent by resolution requirement does not apply to financing under paragraph (a) on
behalf of a participating institution that is primarily an institution of higher education.
new text end
Sec. 19.
Minnesota Statutes 2024, section 136A.32, subdivision 4, is amended to read:
Subd. 4.
Provisions of resolution authorizing bonds.
Any resolution or resolutions
authorizing any revenue bonds or any issue of revenue bonds may contain provisions, which
shall be a part of the contract with the holders of the revenue bonds to be authorized, as to:
(1) pledging all or any part of the revenues of a project or projects, any revenue producing
contract or contracts made by the authority with deleted text begin any individual partnership, corporation or
association or other bodydeleted text end new text begin one or more partnerships, corporations or associations, or other
bodiesnew text end , public or private, to secure the payment of the revenue bonds or of any particular
issue of revenue bonds, subject to deleted text begin suchdeleted text end agreements with bondholders as may then exist;
(2) the rentals, fees and other charges to be charged, and the amounts to be raised in
each year thereby, and the use and disposition of the revenues;
(3) the setting aside of reserves or sinking funds, and the regulation and disposition
deleted text begin thereofdeleted text end new text begin of themnew text end ;
(4) limitations on the right of the authority or its agent to restrict and regulate the use of
the project;
(5) limitations on the purpose to which the proceeds of sale of any issue of revenue
bonds then or thereafter to be issued may be applied and pledging deleted text begin suchdeleted text end new text begin thenew text end proceeds to
secure the payment of the revenue bonds or any issue of the revenue bonds;
(6) limitations on the issuance of additional bonds, the terms upon which additional
bonds may be issued and secured and the refunding of outstanding bonds;
(7) the procedure, if any, by which the terms of any contract with bondholders may be
amended or abrogated, the amount of bonds the holders of which must consent deleted text begin theretodeleted text end new text begin tonew text end ,
and the manner in which deleted text begin suchdeleted text end consent may be given;
(8) limitations on the amount of moneys derived from the project to be expended for
operating, administrative or other expenses of the authority;
(9) defining the acts or omissions to act which shall constitute a default in the duties of
the authority to holders of its obligations and providing the rights and remedies of deleted text begin suchdeleted text end new text begin thenew text end
holders in the event of a default;new text begin or
new text end
(10) the mortgaging of a project and the site thereof for the purpose of securing the
bondholders.
Sec. 20.
Minnesota Statutes 2024, section 136A.32, is amended by adding a subdivision
to read:
new text begin Subd. 4a. new text end
new text begin Health care certification. new text end
new text begin
Health care organizations must provide the authority
with a signed certificate from the health care organization stating that so long as authority
financing for the health care organization remains outstanding, none of the proceeds of the
bonds to the health care organization may be directly or indirectly used to benefit a private
party or private equity-funded entity.
new text end
Sec. 21.
Minnesota Statutes 2024, section 136A.33, is amended to read:
136A.33 TRUST AGREEMENT.
In the discretion of the authority any revenue bonds issued under the provisions of
sections 136A.25 to 136A.42, may be secured by a trust agreement by and between the
authority and a corporate trustee or trustees, which may be any trust company or bank having
the powers of a trust company within the state. deleted text begin Suchdeleted text end new text begin Thenew text end trust agreement or the resolution
providing for the issuance of deleted text begin suchdeleted text end revenue bonds may pledge or assign the revenues to be
received or proceeds of any contract or contracts pledged and may convey or mortgage the
project or any portion deleted text begin thereofdeleted text end new text begin of the projectnew text end . deleted text begin Suchdeleted text end new text begin Thenew text end trust agreement or resolution providing
for the issuance of deleted text begin suchdeleted text end revenue bonds may contain deleted text begin suchdeleted text end provisions for protecting and
enforcing the rights and remedies of the bondholders as may be reasonable and proper and
not in violation of laws, including deleted text begin particularly suchdeleted text end new text begin particularnew text end provisions deleted text begin as have hereinabovedeleted text end new text begin
that havenew text end been specifically authorized to be included in any resolution or resolutions of the
authority authorizing revenue bonds deleted text begin thereofdeleted text end . Any bank or trust company incorporated under
the laws of the state deleted text begin whichdeleted text end new text begin thatnew text end may act as depository of the proceeds of bonds or of revenues
or other moneys may furnish deleted text begin suchdeleted text end indemnifying bonds or deleted text begin pledges suchdeleted text end new text begin pledge new text end securities as
may be required by the authority. Any deleted text begin suchdeleted text end trust agreement may set forth the rights and
remedies of the bondholders and of the trustee or trustees and may restrict the individual
right of action by bondholders. In addition to the foregoing, any deleted text begin suchdeleted text end trust agreement or
resolution may contain deleted text begin suchdeleted text end other provisions as the authority may deem reasonable and
proper for the security of the bondholders. All expenses incurred in carrying out the
provisions of deleted text begin suchdeleted text end new text begin thenew text end trust agreement or resolution may be treated as a part of the cost of
the operation of a project.
Sec. 22.
Minnesota Statutes 2024, section 136A.34, subdivision 3, is amended to read:
Subd. 3.
Investment.
Any deleted text begin suchdeleted text end escrowed proceeds, pending deleted text begin suchdeleted text end use, may be invested
and reinvested in direct obligations of the United States of America, or in certificates of
deposit or time deposits secured by direct obligations of the United States of America, new text begin or
in shares or units in any money market mutual fund whose investment portfolio consists
solely of direct obligations of the United States of America, new text end maturing at deleted text begin suchdeleted text end new text begin anew text end time or times
as shall be appropriate to assure the prompt payment, as to principal, interest and redemption
premium, if any, of the outstanding revenue bonds to be so refunded. The interest, income
and profits, if any, earned or realized on any deleted text begin suchdeleted text end investment may also be applied to the
payment of the outstanding revenue bonds to be so refunded. After the terms of the escrow
have been fully satisfied and carried out, any balance of deleted text begin suchdeleted text end new text begin thenew text end proceeds and interest,
income and profits, if any, earned or realized on the investments deleted text begin thereofdeleted text end may be returned
to the authority for use by it in any lawful manner.
Sec. 23.
Minnesota Statutes 2024, section 136A.34, subdivision 4, is amended to read:
Subd. 4.
Additional purpose; improvements.
The portion of the proceeds of any deleted text begin suchdeleted text end
revenue bonds issued for the additional purpose of paying all or any part of the cost of
constructing and acquiring additions, improvements, extensions or enlargements of a project
may be invested or deposited deleted text begin in time depositsdeleted text end as provided in section 136A.32, subdivision
7.
Sec. 24.
Minnesota Statutes 2024, section 136A.36, is amended to read:
136A.36 REVENUES.
The authority may fix, revise, charge and collect rates, rents, fees and charges for the
use of and for the services furnished or to be furnished by each project and deleted text begin todeleted text end new text begin maynew text end contract
with any person, partnership, association or corporation, or other body, public or private,
in respect thereof. deleted text begin Suchdeleted text end new text begin Thenew text end rates, rents, feesnew text begin ,new text end and charges new text begin may vary between projects
involving an education facility and projects involving a health care facility and new text end shall be
fixed and adjusted in respect of the aggregate of rates, rents, feesnew text begin ,new text end and charges from deleted text begin suchdeleted text end new text begin
thenew text end project so as to provide funds sufficient with other revenues, if any:
(1) to pay the cost of maintaining, repairing and operating the project and each and every
portion deleted text begin thereofdeleted text end new text begin of the projectnew text end , to the extent that the payment of deleted text begin suchdeleted text end new text begin thenew text end cost has not otherwise
been adequately provided for;
(2) to pay the principal of and the interest on outstanding revenue bonds of the authority
issued in respect of deleted text begin suchdeleted text end new text begin thenew text end project as the same shall become due and payable; and
(3) to create and maintain reserves required or provided for in any resolution authorizing,
or trust agreement securing, deleted text begin suchdeleted text end revenue bonds of the authority. deleted text begin Suchdeleted text end new text begin Thenew text end rates, rents, fees
and charges shall not be subject to supervision or regulation by any department, commission,
board, body, bureau or agency of this state other than the authority. A sufficient amount of
the revenues derived in respect of a project, except deleted text begin suchdeleted text end part of deleted text begin suchdeleted text end new text begin thenew text end revenues as may
be necessary to pay the cost of maintenance, repair and operation and to provide reserves
and for renewals, replacements, extensions, enlargements and improvements as may be
provided for in the resolution authorizing the issuance of any revenue bonds of the authority
or in the trust agreement securing the same, shall be set aside at deleted text begin suchdeleted text end regular intervals as
may be provided in deleted text begin suchdeleted text end new text begin thenew text end resolution or trust agreement in a sinking or other similar fund
deleted text begin whichdeleted text end new text begin thatnew text end is hereby pledged to, and charged with, the payment of the principal of and the
interest on deleted text begin suchdeleted text end revenue bonds as the same shall become due, and the redemption price or
the purchase price of bonds retired by call or purchase as therein provided. deleted text begin Suchdeleted text end new text begin Thenew text end pledge
shall be valid and binding from the time when the pledge is made; the rates, rents, fees and
charges and other revenues or other moneys so pledged and thereafter received by the
authority shall immediately be subject to the lien of deleted text begin suchdeleted text end new text begin thenew text end pledge without physical delivery
deleted text begin thereofdeleted text end or further act, and the lien of any deleted text begin suchdeleted text end pledge shall be valid and binding as against
all parties having claims of any kind against the authority, irrespective of whether deleted text begin suchdeleted text end new text begin thenew text end
parties have notice deleted text begin thereofdeleted text end new text begin of the pledgenew text end . Neither the resolution nor any trust agreement by
which a pledge is created need be filed or recorded except in the records of the authority.
The use and disposition of moneys to the credit of deleted text begin suchdeleted text end new text begin anew text end sinking or other similar fund shall
be subject to the provisions of the resolution authorizing the issuance of deleted text begin suchdeleted text end bonds or of
deleted text begin suchdeleted text end new text begin anew text end trust agreement. Except as may otherwise be provided in deleted text begin suchdeleted text end new text begin thenew text end resolution or deleted text begin suchdeleted text end
trust agreement, deleted text begin suchdeleted text end new text begin thenew text end sinking or other similar fund shall be a fund for all deleted text begin suchdeleted text end revenue
bonds issued to finance a project or projects at one or more participating institutions deleted text begin of
higher educationdeleted text end without distinction or priority of one over another; provided the authority
in any deleted text begin suchdeleted text end resolution or trust agreement may provide that deleted text begin suchdeleted text end new text begin thenew text end sinking or other similar
fund shall be the fund for a particular project at deleted text begin andeleted text end new text begin a participatingnew text end institution deleted text begin of higher
educationdeleted text end and for the revenue bonds issued to finance a particular project and may,
additionally, permit and provide for the issuance of revenue bonds having a subordinate
lien in respect of the security herein authorized to other revenue bonds of the authority and,
in such case, the authority may create separate or other similar funds in respect of deleted text begin suchdeleted text end new text begin thenew text end
subordinate lien bonds.
Sec. 25.
Minnesota Statutes 2024, section 136A.38, is amended to read:
136A.38 BONDS ELIGIBLE FOR INVESTMENT.
Bonds issued bynew text begin thenew text end authority under the provisions of sections 136A.25 to 136A.42, are
hereby made securities in which all public officers and public bodies of the state and its
political subdivisions, all insurance companies, trust companies, banking associations,
investment companies, executors, administrators, trustees and other fiduciaries may properly
and legally invest funds, including capital in their control or belonging to them; it being the
purpose of this section to authorize the investment in deleted text begin suchdeleted text end bonds of all sinking, insurance,
retirement, compensation, pension and trust funds, whether owned or controlled by private
or public persons or officers; provided, however, that nothing contained in this section may
be construed as relieving any person, firm, or corporation from any duty of exercising due
care in selecting securities for purchase or investment; and provide further, that in no event
shall assets of pension funds of public employees of the state of Minnesota or any of its
agencies, boards or subdivisions, whether publicly or privately administered, be invested
in bonds issued under the provisions of sections 136A.25 to 136A.42. deleted text begin Suchdeleted text end new text begin Thenew text end bonds are
hereby constituted "authorized securities" within the meaning and for the purposes of
Minnesota Statutes 1969, section 50.14. deleted text begin Suchdeleted text end new text begin Thenew text end bonds are hereby made securities deleted text begin whichdeleted text end new text begin
thatnew text end may properly and legally be deposited with and received by any state or municipal
officer or any agency or political subdivision of the state for any purpose for which the
deposit of bonds or obligations of the state now or may hereafter be authorized by law.
Sec. 26.
Minnesota Statutes 2024, section 136A.41, is amended to read:
136A.41 CONFLICT OF INTEREST.
Notwithstanding any other law to the contrary it shall not be or constitute a conflict of
interest for a trustee, director, officer or employee of any participating institution deleted text begin of higher
educationdeleted text end , financial institution, investment banking firm, brokerage firm, commercial bank
or trust company, architecture firm, insurance company, construction company, or any other
firm, person or corporation to serve as a member of the authority, provided deleted text begin suchdeleted text end new text begin thenew text end trustee,
director, officer or employee shall abstain from deliberation, action and vote by the authority
in each instance where the business affiliation of any deleted text begin suchdeleted text end trustee, director, officer or
employee is involved.
Sec. 27.
Minnesota Statutes 2024, section 136A.42, is amended to read:
136A.42 ANNUAL REPORT.
The authority shall keep an accurate account of all of its activities and all of its receipts
and expenditures deleted text begin and shall annually report to the officedeleted text end .new text begin Each year, the authority shall submit
to the Minnesota Historical Society and the Legislative Reference Library a report of the
authority's activities in the previous year, including all financial activities.
new text end
Sec. 28.
Minnesota Statutes 2024, section 136F.67, subdivision 1, is amended to read:
Subdivision 1.
Authorization.
A technical college or a community college must not
seek financing for child care facilities or parking facilities through the deleted text begin Higherdeleted text end new text begin Health andnew text end
Education Facilities Authority, as provided in section 136A.28, subdivision 7, without the
explicit authorization of the board.
Sec. 29.
Minnesota Statutes 2024, section 354B.20, subdivision 7, is amended to read:
Subd. 7.
Employing unit.
"Employing unit," if the agency employs any persons covered
by the individual retirement account plan under section 354B.211, means:
(1) the board;
(2) the Minnesota Office of Higher Education; and
(3) the deleted text begin Higherdeleted text end new text begin Health andnew text end Education Facilities Authority.
Sec. 30. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber the law establishing and governing the Minnesota
Higher Education Facilities Authority, renamed the Minnesota Health and Education
Facilities Authority in this act, as Minnesota Statutes, chapter 15D, coded in Minnesota
Statutes, sections 136A.25 to 136A.42, as amended or repealed in this act. The revisor of
statutes shall also duplicate any required definitions from Minnesota Statutes, chapter 136A,
revise any statutory cross-references consistent with the recoding, and report the history in
Minnesota Statutes, chapter 15D. The revisor of statutes shall change "Minnesota Higher
Education Facilities Authority" to "Minnesota Health and Higher Education Facilities
Authority" where it appears in Minnesota Statutes.
new text end
Sec. 31. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 136A.29, subdivision 4,
new text end
new text begin
is repealed.
new text end
ARTICLE 5
PHARMACY BENEFITS
Section 1.
new text begin
[62Q.83] FORMULARY CHANGES.
new text end
new text begin Subdivision 1. 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) "Drug" has the meaning given in section 151.01, subdivision 5.
new text end
new text begin
(c) "Enrollee" has the meaning given in section 62Q.01, subdivision 2b.
new text end
new text begin
(d) "Formulary" means a current list of covered prescription drug products that is subject
to periodic review and update.
new text end
new text begin
(e) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
new text end
new text begin
(f) "Pharmacy benefit manager" has the meaning given in section 62W.02, subdivision
15.
new text end
new text begin
(g) "Prescription" has the meaning given in section 151.01, subdivision 16a.
new text end
new text begin Subd. 2. new text end
new text begin Formulary changes. new text end
new text begin
(a) Except as provided in paragraphs (b) and (c), a health
plan must not, with respect to an enrollee who was previously prescribed the drug during
the plan year, remove a drug from the health plan's formulary or place a drug in a benefit
category that increases the enrollee's cost for the duration of the enrollee's plan year.
new text end
new text begin
(b) Paragraph (a) does not apply if a health plan changes the health plan's formulary:
new text end
new text begin
(1) for a drug that has been deemed unsafe by the United States Food and Drug
Administration (FDA);
new text end
new text begin
(2) for a drug that has been withdrawn by the FDA or the drug manufacturer; or
new text end
new text begin
(3) when an independent source of research, clinical guidelines, or evidence-based
standards has issued drug-specific warnings or recommended changes with respect to a
drug's use for reasons related to previously unknown and imminent patient harm.
new text end
new text begin
(c) Paragraph (a) does not apply if a health plan removes a brand name drug from the
health plan's formulary or places a brand name drug in a benefit category that increases the
enrollee's cost if the health plan:
new text end
new text begin
(1) adds to the health plan's formulary a generic or multisource brand name drug rated
as therapeutically equivalent according to the FDA Orange Book, a biologic drug rated as
interchangeable according to the FDA Purple Book, or a biosimilar at the same or lower
cost to the enrollee; and
new text end
new text begin
(2) provides at least a 60-day notice to prescribers, pharmacists, and affected enrollees.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2024, section 256B.0625, subdivision 13, is amended to read:
Subd. 13.
Drugs.
(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, a physician assistant, or an advanced practice
registered nurse employed by or under contract with a community health board as defined
in section 145A.02, subdivision 5, for the purposes of communicable disease control.
(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply unless
authorized by the commissioner or as provided in paragraph (h) or the drug appears on the
90-day supply list published by the commissioner. The 90-day supply list shall be published
by the commissioner on the department's website. The commissioner may add to, delete
from, and otherwise modify the 90-day supply list after providing public notice and the
opportunity for a 15-day public comment period. The 90-day supply list may include
cost-effective generic drugs and shall not include controlled substances.
(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:
(1) is not a therapeutic option for the patient;
(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and
(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.
(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.
(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.
(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.
(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
pharmacist in accordance with section 151.37, subdivision 16.
(h) Medical assistance coverage for a prescription contraceptive must provide a 12-month
supply for any prescription contraceptive if a 12-month supply is prescribed by the
prescribing health care provider. The prescribing health care provider must determine the
appropriate duration for which to prescribe the prescription contraceptives, up to 12 months.
For purposes of this paragraph, "prescription contraceptive" means any drug or device that
requires a prescription and is approved by the Food and Drug Administration to prevent
pregnancy. Prescription contraceptive does not include an emergency contraceptive drug
approved to prevent pregnancy when administered after sexual contact. For purposes of this
paragraph, "health plan" has the meaning provided in section 62Q.01, subdivision 3.
new text begin
(i) Notwithstanding a removal of a drug from the drug formulary under subdivision 13d,
except as provided in paragraphs (j) and (k), medical assistance covers a drug, with respect
to an enrollee who was previously prescribed the drug during the calendar year when the
drug was on the formulary, at the same level until January 1 of the calendar year following
the year in which the commissioner removed the drug from the formulary.
new text end
new text begin
(j) Paragraph (i) does not apply if the commissioner changes the drug formulary:
new text end
new text begin
(1) for a drug that has been deemed unsafe by the United States Food and Drug
Administration (FDA);
new text end
new text begin
(2) for a drug that has been withdrawn by the FDA or the drug manufacturer; or
new text end
new text begin
(3) when an independent source of research, clinical guidelines, or evidence-based
standards has issued drug-specific warnings or recommended changes with respect to a
drug's use for reasons related to previously unknown and imminent patient harm.
new text end
new text begin
(k) Paragraph (i) does not apply if the commissioner removes a brand name drug from
the formulary if the commissioner:
new text end
new text begin
(1) adds to the formulary a generic or multisource brand name drug rated as
therapeutically equivalent according to the FDA Orange Book, or a biologic drug rated as
interchangeable according to the FDA Purple Book, at the same or lower cost to the enrollee;
and
new text end
new text begin
(2) provides at least a 60-day notice to prescribers, pharmacists, and affected enrollees.
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. 3.
Minnesota Statutes 2024, section 256B.0625, subdivision 13c, is amended to read:
Subd. 13c.
Formulary Committee.
The commissioner, after receiving recommendations
from professional medical associations and professional pharmacy associations, and consumer
groups shall designate a Formulary Committee to carry out duties as described in subdivisions
13 to 13g. The Formulary Committee shall be comprised of at least five licensed physicians
actively engaged in the practice of medicine in Minnesota, one of whom is an actively
practicing psychiatrist, one of whom specializes in the diagnosis and treatment of rare
diseases, one of whom specializes in pediatrics, and one of whom actively treats persons
with disabilities; at least three licensed pharmacists actively engaged in the practice of
pharmacy in Minnesota, one of whom practices outside the metropolitan counties listed in
section 473.121, subdivision 4, one of whom practices in the metropolitan counties listed
in section 473.121, subdivision 4, and one of whom is a practicing hospital pharmacist; at
least two consumer representatives, all of whom must have a personal or professional
connection to medical assistance; and one representative designated by the Minnesota Rare
Disease Advisory Council established under section 256.4835; the remainder to be made
up of health care professionals who are licensed in their field and have recognized knowledge
in the clinically appropriate prescribing, dispensing, and monitoring of covered outpatient
drugs. Members of the Formulary Committee shall not be employed by the Department of
Human Services or have a personal interest in a pharmaceutical company, pharmacy benefits
manager, health plan company, or their affiliate organizations, but the committee shall be
staffed by an employee of the department who shall serve as an ex officio, nonvoting member
of the committee. For the purposes of this subdivision, "personal interest" means that a
person owns at least five percent of the voting interest or equity interest in the entity, the
equity interest owned by a person represents at least five percent of that person's net worth,
or more than five percent of a person's gross income for the preceding year was derived
from the entity. A committee member must notify the committee of any potential conflict
of interest and recuse themselves from any communications, discussion, or vote on any
matter where a conflict of interest exists. A conflict of interest alone, without a personal
interest, does not preclude an applicant from serving as a member of the Formulary
Committee. Members may be removed from the committee for cause after a recommendation
for removal by a majority of the committee membership. For the purposes of this subdivision,
"cause" does not include offering a differing or dissenting clinical opinion on a drug or drug
class. The department's medical director shall also serve as an ex officio, nonvoting member
for the committee. Committee members shall serve three-year terms and may be reappointed
twice by the commissioner. The committee members shall vote on a chair and vice chair
from among their membership. The chair shall preside over all committee meetings, and
the vice chair shall preside over the meetings if the chair is not present. The Formulary
Committee shall meet at least three times per year. The commissioner may require more
frequent Formulary Committee meetings as needed. An honorarium of $100 per meeting
and reimbursement for mileage shall be paid to each committee member in attendance. The
Formulary Committee expires June 30, deleted text begin 2027deleted text end new text begin 2029new text end . The Formulary Committee is subject to
the Open Meeting Law under chapter 13D. For purposes of establishing a quorum to transact
business, vacant committee member positions do not count in the calculation as long as at
least 60 percent of the committee member positions are filled.
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 256B.0625, subdivision 13d, is amended to read:
Subd. 13d.
Drug formulary.
(a) The commissioner shall establish a drug formulary. Its
establishment and publication shall not be subject to the requirements of the Administrative
Procedure Act, but the Formulary Committee shall review and comment on the formulary
contents.
(b) The formulary shall not include:
(1) drugs, active pharmaceutical ingredients, or products for which there is no federal
funding;
(2) over-the-counter drugs, except as provided in subdivision 13;
(3) drugs or active pharmaceutical ingredients when used for the treatment of impotence
or erectile dysfunction;
(4) drugs or active pharmaceutical ingredients for which medical value has not been
established;
(5) drugs from manufacturers who have not signed a rebate agreement with the
Department of Health and Human Services pursuant to section 1927 of title XIX of the
Social Security Act; and
(6) medical cannabis flower as defined in section 342.01, subdivision 54, or medical
cannabinoid products as defined in section 342.01, subdivision 52.
(c) If a single-source drug used by at least two percent of the fee-for-service medical
assistance recipients is removed from the formulary due to the failure of the manufacturer
to sign a rebate agreement with the Department of Health and Human Services, the
commissioner shall notify prescribing practitioners within 30 days of receiving notification
from the Centers for Medicare and Medicaid Services (CMS) that a rebate agreement was
not signed.
new text begin
(d) Within ten calendar days of any commissioner determination to change the drug
formulary, the commissioner must provide written notice to all enrollees affected by the
change. The notice must include a description of the change, the reason for the change, and
the date the change will become effective.
new text end
new text begin
(e) By January 15, 2026, and annually thereafter, the commissioner of human services
must provide a report with data and information related to the effects on enrollees of drug
formulary changes made in the prior calendar year to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance. The report must include but is not limited to data and information on:
new text end
new text begin
(1) the number of times the formulary was changed;
new text end
new text begin
(2) the reasons for the formulary changes and how frequently the formulary was changed
for each reason;
new text end
new text begin
(3) the drugs that were removed from the formulary;
new text end
new text begin
(4) for each drug that was removed from the formulary, the number of enrollees who
were prescribed that drug when it was removed;
new text end
new text begin
(5) for each drug that was removed from the formulary, whether a therapeutically
equivalent drug was added;
new text end
new text begin
(6) the drugs that were added to the formulary;
new text end
new text begin
(7) the fiscal impacts to the Department of Human Services resulting from the changes
to the formulary; and
new text end
new text begin
(8) enrollee populations or medical conditions disproportionately affected by the
formulary changes.
new text end
Sec. 5.
Minnesota Statutes 2024, section 256B.0625, subdivision 13e, is amended to read:
Subd. 13e.
Payment rates.
(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain, unless the prescription savings club or prescription discount club is one
in which an individual pays a recurring monthly access fee for unlimited access to a defined
list of drugs for which the pharmacy does not bill the member or a payer on a
per-standard-transaction basis. The amount of payment basis must be reduced to reflect all
discount amounts applied to the charge by any third-party provider/insurer agreement or
contract for submitted charges to medical assistance programs. The net submitted charge
may not be greater than the patient liability for the service. The professional dispensing fee
shall be $11.55 for prescriptions filled with legend drugs meeting the definition of "covered
outpatient drugs" according to United States Code, title 42, section 1396r-8(k)(2). The
dispensing fee for intravenous solutions that must be compounded by the pharmacist shall
be $11.55 per claim. The professional dispensing fee for prescriptions filled with
over-the-counter drugs meeting the definition of covered outpatient drugs shall be $11.55
for dispensed quantities equal to or greater than the number of units contained in the
manufacturer's original package. The professional dispensing fee shall be prorated based
on the percentage of the package dispensed when the pharmacy dispenses a quantity less
than the number of units contained in the manufacturer's original package. The pharmacy
dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
outpatient drugs shall be $3.65 for quantities equal to or greater than the number of units
contained in the manufacturer's original package and shall be prorated based on the
percentage of the package dispensed when the pharmacy dispenses a quantity less than the
number of units contained in the manufacturer's original package. Thenew text begin ingredient cost for
a drug is the lower of thenew text end National Average Drug Acquisition Cost (NADAC) deleted text begin shall be used
to determine the ingredient cost of a drugdeleted text end new text begin , the Minnesota actual acquisition cost (MNAAC)
as defined in paragraph (i), or the maximum allowable costnew text end . For drugs for which a NADACnew text begin ,
a MNAAC, or a maximum allowable costnew text end is not reported, the commissioner shall estimate
the ingredient cost at the wholesale acquisition cost minus two percent. The ingredient cost
of a drug for a provider participating in the federal 340B Drug Pricing Program shall be
deleted text begin eitherdeleted text end the 340B Drug Pricing Program ceiling price established by the Health Resources
and Services Administration deleted text begin ordeleted text end new text begin , thenew text end NADAC,new text begin the MNAAC, or the maximum allowable
cost,new text end whichever is lower. Wholesale acquisition cost is defined as the manufacturer's list
price for a drug or biological to wholesalers or direct purchasers in the United States, not
including prompt pay or other discounts, rebates, or reductions in price, for the most recent
month for which information is available, as reported in wholesale price guides or other
publications of drug or biological pricing data. The maximum allowable cost of a deleted text begin multisourcedeleted text end
drug may be set by the commissioner and it shall be comparable to the actual acquisition
cost of the drug product and no higher than the NADAC of the generic product. Establishment
of the amount of payment for drugs shall not be subject to the requirements of the
Administrative Procedure Act.
(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.
(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.
(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be thenew text begin lesser
of thenew text end NADAC of the generic productnew text begin , the MNAAC of the generic product,new text end or the maximum
allowable costnew text begin of the generic productnew text end established by the commissioner unless prior
authorization for the brand name product has been granted according to the criteria
established by the Drug Formulary Committee as required by subdivision 13f, paragraph
(a), and the prescriber has indicated "dispense as written" on the prescription in a manner
consistent with section 151.21, subdivision 2.new text begin If prior authorization is granted, the ingredient
cost shall be the lesser of the NADAC of the brand name product, the MNAAC of the brand
name product, or the maximum allowable cost of the brand name product. A generic product
includes a generic drug, an authorized generic drug, and a biosimilar biological product as
defined in Code of Federal Regulations, title 42, section 423.4. A brand name product
includes a brand name drug, a brand name biological product, and an unbranded biological
product as defined in Code of Federal Regulations, title 42, section 423.4.
new text end
(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the deleted text begin specialty pharmacy ratedeleted text end new text begin MNAACnew text end , or the maximum allowable
cost set by the commissioner. Ifnew text begin thenew text end average sales price deleted text begin isdeleted text end new text begin , the MNAAC, and the maximum
allowable cost arenew text end unavailable, the amount of payment must be lower of the usual and
customary cost submitted by the providerdeleted text begin ,deleted text end new text begin ornew text end the wholesale acquisition costdeleted text begin , the specialty
pharmacy rate, or the maximum allowable cost set by the commissionerdeleted text end . The commissioner
shall discount the payment rate for drugs obtained through the federal 340B Drug Pricing
Program by 28.6 percent. The payment for drugs administered in an outpatient setting shall
be made to the administering facility or practitioner. A retail or specialty pharmacy dispensing
a drug for administration in an outpatient setting is not eligible for direct reimbursement.
deleted text begin
(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.
deleted text end
deleted text begin (g)deleted text end new text begin (f)new text end Home infusion therapy services provided by home infusion therapy pharmacies
must be paid at rates according to subdivision 8d.
deleted text begin (h)deleted text end new text begin (g)new text end The commissioner shall contract with a vendor to conduct a cost of dispensing
survey for all pharmacies that are physically located in the state of Minnesota that dispense
outpatient drugs under medical assistance. The commissioner shall ensure that the vendor
has prior experience in conducting cost of dispensing surveys. Each pharmacy enrolled with
the department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for specialty prescription drugs and a single
statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies
to measure the mean, mean weighted by total prescription volume, mean weighted by
medical assistance prescription volume, median, median weighted by total prescription
volume, and median weighted by total medical assistance prescription volume. The
commissioner shall post a copy of the final cost of dispensing survey report on the
department's website. The initial survey must be completed no later than January 1, 2021,
and repeated every deleted text begin threedeleted text end new text begin twonew text end years. The commissioner shall provide a summary of the
results of each cost of dispensing survey and provide recommendations for any changes to
the dispensing fee to the chairs and ranking minority members of the legislative committees
with jurisdiction over medical assistance pharmacy reimbursement. Notwithstanding section
256.01, subdivision 42, this paragraph does not expire.
deleted text begin (i)deleted text end new text begin (h)new text end The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and deleted text begin (f)deleted text end new text begin (e)new text end by deleted text begin 1.8 percentdeleted text end new text begin the amount of the wholesale drug distributor taxnew text end
for prescription and nonprescription drugs subject to the wholesale drug distributor tax
under section 295.52.
new text begin
(i) The commissioner shall contract with a vendor to create MNAAC through a periodic
survey of enrolled pharmacy providers. Each pharmacy enrolled with the department to
dispense outpatient prescription drugs must respond to the periodic surveys. The
commissioner may sanction a pharmacy under section 256B.064 for failure to respond. The
current MNAAC rates must be publicly available on the department's or vendor's website.
The commissioner must require that the MNAAC is measured and calculated at least
quarterly, but the MNAAC can be measured and calculated more frequently. The
commissioner must ensure that the vendor has an appeal process available to providers for
the time between the measurement and calculation of the periodically updated MNAAC
rates if price fluctuations result in a MNAAC that is lower than the price at which enrolled
providers can purchase a drug. Establishment of the MNAAC and survey reporting
requirements shall not be subject to the requirements of the Administrative Procedure Act.
Data provided by pharmacies for the measurement and calculation of the MNAAC are
nonpublic data as defined in section 13.02, subdivision 9.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, or upon federal approval,
whichever is later. The commissioner of human services must notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 6.
Minnesota Statutes 2024, section 256B.064, subdivision 1a, is amended to read:
Subd. 1a.
Grounds for sanctions.
(a) The commissioner may impose sanctions against
any individual or entity that receives payments from medical assistance or provides goods
or services for which payment is made from medical assistance for any of the following:
(1) fraud, theft, or abuse in connection with the provision of goods and services to recipients
of public assistance for which payment is made from medical assistance; (2) a pattern of
presentment of false or duplicate claims or claims for services not medically necessary; (3)
a pattern of making false statements of material facts for the purpose of obtaining greater
compensation than that to which the individual or entity is legally entitled; (4) suspension
or termination as a Medicare vendor; (5) refusal to grant the state agency access during
regular business hours to examine all records necessary to disclose the extent of services
provided to program recipients and appropriateness of claims for payment; (6) failure to
repay an overpayment or a fine finally established under this section; (7) failure to correct
errors in the maintenance of health service or financial records for which a fine was imposed
or after issuance of a warning by the commissioner; and (8) any reason for which an
individual or entity could be excluded from participation in the Medicare program under
section 1128, 1128A, or 1866(b)(2) of the Social Security Act. For the purposes of this
section, goods or services for which payment is made from medical assistance includes but
is not limited to care and services identified in section 256B.0625 or provided pursuant to
any federally approved waiver.
(b) The commissioner may impose sanctions against a pharmacy provider for failure to
respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph
deleted text begin (h)deleted text end new text begin (g)new text end .
new text begin
(c) The commissioner may impose sanctions against a pharmacy provider for failure to
respond to a Minnesota drug acquisition cost survey under section 256B.0625, subdivision
13e, paragraph (i).
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, or upon federal approval,
whichever is later. The commissioner of human services must notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 7.
Minnesota Statutes 2024, section 256B.69, subdivision 6d, is amended to read:
Subd. 6d.
Prescription drugs.
new text begin (a)new text end The commissioner may exclude or modify coverage
for prescription drugs from the prepaid managed care contracts entered into under this
section in order to increase savings to the state by collecting additional prescription drug
rebates.
new text begin (b) new text end The contracts must maintain incentives for the managed care plan to manage drug
costs and utilization and may require that the managed care plans maintain an open drug
formulary. In order to manage drug costs and utilization, the contracts may authorize the
managed care plans to use preferred drug lists and prior authorization. new text begin The contracts must
require that the managed care plans enter into contracts with the state's selected pharmacy
benefit manager vendor to administer the pharmacy benefit.
new text end
new text begin (c) new text end This subdivision is contingent on federal approval of the managed care contract
changes and the collection of additional prescription drug rebates.
Sec. 8.
Minnesota Statutes 2024, section 256B.69, is amended by adding a subdivision to
read:
new text begin Subd. 6i. new text end
new text begin Directed pharmacy dispensing payment. new text end
new text begin
(a) The commissioner shall provide
a directed pharmacy dispensing payment of $4.50 per filled prescription to eligible outpatient
retail pharmacies in Minnesota to improve and maintain access to pharmaceutical services
in rural and underserved areas of Minnesota. Managed care and county-based purchasing
plans delivering services under section 256B.69 or 256B.692, and any pharmacy benefit
managers under contract with these entities, must pay the directed pharmacy dispensing
payment to eligible outpatient retail pharmacies for drugs dispensed to medical assistance
enrollees. The directed pharmacy dispensing payment is in addition to, and must not supplant
or reduce, any other dispensing fee paid by these entities to the pharmacy. Entities paying
the directed pharmacy dispensing payment must not reduce other payments to the pharmacy
as a result of payment of the directed pharmacy dispensing payment.
new text end
new text begin
(b) For purposes of this subdivision, "eligible outpatient retail pharmacy" means an
outpatient retail pharmacy licensed under chapter 151 that is not owned, either directly or
indirectly or through an affiliate or subsidiary, by a pharmacy benefit manager licensed
under chapter 62W or a health carrier, as defined in section 62A.011, subdivision 2, and
that:
new text end
new text begin
(1) is located in a medically underserved area or primarily serves a medically underserved
population, as defined by the United States Department of Health and Human Services
Health Resources and Services Administration under United States Code, title 42, section
254; or
new text end
new text begin
(2) shares common ownership with 12 or fewer Minnesota pharmacies.
new text end
new text begin
(c) In order to receive the directed pharmacy dispensing payment, a pharmacy must
submit to the commissioner a form, developed by the commissioner, attesting that the
pharmacy meets the requirements of paragraph (b).
new text end
new text begin
(d) Managed care and county-based purchasing plans, and any pharmacy benefit managers
under contract with these entities, shall pay the directed pharmacy dispensing payment to
eligible outpatient retail pharmacies. The commissioner shall monitor the effect of this
requirement on access to pharmaceutical services in rural and underserved areas of
Minnesota. If, for any contract year, federal approval is not received for this subdivision,
the commissioner must adjust the capitation rates paid to managed care plans and
county-based purchasing plans for that contract year to reflect removal of this subdivision.
Contracts between managed care plans and county-based purchasing plans, and any pharmacy
benefit managers under contract with these entities, and providers to whom this subdivision
applies, must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this subdivision. This subdivision expires if federal
approval is not received for this subdivision at any time.
new text end
new text begin
(e) This subdivision expires on December 31, 2026.
new text end
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. 9.
new text begin
[256B.696] PRESCRIPTION DRUGS; STATE PHARMACY BENEFIT
MANAGER.
new text end
new text begin Subdivision 1. 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) "Managed care plans" means health plans and county-based purchasing organizations
providing coverage to medical assistance and MinnesotaCare enrollees under the managed
care delivery system.
new text end
new text begin
(c) "Managed care enrollees" means medical assistance and MinnesotaCare enrollees
receiving coverage from managed care plans.
new text end
new text begin
(d) "State pharmacy benefit manager" means the pharmacy benefit manager selected
pursuant to the procurement process in subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Procurement process. new text end
new text begin
(a) The commissioner must, through a competitive
procurement process in compliance with paragraph (b), select a single pharmacy benefit
manager to comply with the requirements set forth in subdivision 3. The single pharmacy
benefit manager selected under this subdivision must be a prepaid ambulatory health plan,
as defined in Code of Federal Regulations, title 42, section 438.2.
new text end
new text begin
(b) When selecting the single pharmacy benefit manager, the commissioner must:
new text end
new text begin
(1) accept applications for entities seeking to become the single pharmacy benefit
manager;
new text end
new text begin
(2) establish eligibility criteria an entity must meet in order to become the single pharmacy
benefit manager; and
new text end
new text begin
(3) enter into a master contract with a single pharmacy benefit manager.
new text end
new text begin
(c) The contract required under paragraph (b), clause (3), must include provisions that
prohibit the single pharmacy benefit manager from:
new text end
new text begin
(1) requiring, enticing, or coercing an enrollee to obtain pharmacy services, including
a prescription drug, from a pharmacy owned or otherwise affiliated with the single pharmacy
benefit manager;
new text end
new text begin
(2) communicating to an enrollee, in any manner, that the enrollee is required to obtain
pharmacy services or have a prescription dispensed at, or pharmacy services provided by,
a particular pharmacy owned or affiliated with the single pharmacy benefit manager if there
are other nonaffiliated pharmacies that have the ability to dispense the medication or provide
the services and are also in network;
new text end
new text begin
(3) requiring an enrollee to obtain pharmacy services, including a prescription drug,
exclusively through a mail order pharmacy;
new text end
new text begin
(4) directly or indirectly retroactively denying or reducing a claim or aggregate of claims
for pharmacy services, including prescription drugs, after adjudication of the claim or
aggregate of claims;
new text end
new text begin
(5) paying or reimbursing a pharmacy or pharmacist for the ingredient drug product
component of pharmacist services, including a prescription drug, less than the lesser of
national average drug acquisition cost; the Minnesota actual acquisition cost (MNAAC) as
defined in section 256B.0625, subdivision 13e, paragraph (i); or the maximum allowable
cost as defined in section 62W.08 of that pharmacy service or prescription drug, or, if the
national average drug acquisition cost is unavailable, the wholesale acquisition cost minus
two percent at the time the drug is administered or dispensed, plus a professional dispensing
fee equal to the amount of the dispensing fee if it were determined pursuant to section
256B.0625, subdivision 13e; and
new text end
new text begin
(6) denying a pharmacy or pharmacist the right to participate as a contract provider under
the health plan if the pharmacy or pharmacist agrees to provide pharmacy services, including
but not limited to prescription drugs that meet the terms and requirements set forth by the
health plan and agrees to the terms of reimbursement set forth by the health plan company.
new text end
new text begin
(d) Applicants for the single pharmacy benefit manager must disclose to the commissioner
the following during the procurement process:
new text end
new text begin
(1) any activity, policy, practice, contract, or arrangement of the single pharmacy benefit
manager that may directly or indirectly present any conflict of interest with the pharmacy
benefit manager's relationship with or obligation to the Department of Human Services, a
health plan company, or a county-based purchasing organization;
new text end
new text begin
(2) all common ownership, members of a board of directors, managers, or other control
of the pharmacy benefit manager or any of the pharmacy benefit manager's affiliated
companies with:
new text end
new text begin
(i) a health plan company administering medical assistance or MinnesotaCare benefits
in Minnesota or an affiliate of the health plan company;
new text end
new text begin
(ii) a county-based purchasing organization;
new text end
new text begin
(iii) an entity that contracts on behalf of a pharmacy or any pharmacy services
administration organization and its affiliates;
new text end
new text begin
(iv) a drug wholesaler or distributor and its affiliates;
new text end
new text begin
(v) a third-party payer and its affiliates; or
new text end
new text begin
(vi) a pharmacy and its affiliates;
new text end
new text begin
(3) any direct or indirect fees, charges, or any kind of assessments imposed by the
pharmacy benefit manager on pharmacies licensed in Minnesota with which the pharmacy
benefit manager shares common ownership, management, or control, or that are owned,
managed, or controlled by any of the pharmacy benefit manager's affiliated companies;
new text end
new text begin
(4) any direct or indirect fees, charges, or any kind of assessments imposed by the
pharmacy benefit manager on pharmacies licensed in Minnesota; and
new text end
new text begin
(5) any financial terms and arrangements between the pharmacy benefit manager and a
prescription drug manufacturer or labeler, including formulary management, drug substitution
programs, educational support claims processing, or data sales fees.
new text end
new text begin Subd. 3. new text end
new text begin Drug coverage. new text end
new text begin
(a) The commissioner may require the state pharmacy benefit
manager to modify utilization review limitations, requirements, and strategies imposed by
managed care plans on prescription drug coverage.
new text end
new text begin
(b) The state pharmacy benefit manager is responsible for processing all point of sale
outpatient pharmacy claims under the managed care delivery system. Managed care plans
must use the state pharmacy benefit manager pursuant to the terms of the master contract
required under subdivision 2, paragraph (b), clause (3). The pharmacy benefit manager
selected is the exclusive pharmacy benefit manager used by health plan companies and
county-based purchasing organizations when providing coverage to enrollees. The
commissioner may require the managed care plans and state pharmacy benefit manager to
directly exchange data and files for members enrolled with managed care plans.
new text end
new text begin
(c) All payment arrangements between the Department of Human Services, managed
care plans, and the state pharmacy benefit manager must comply with state and federal
statutes, regulations adopted by the Centers for Medicare and Medicaid Services, and any
other agreement between the department and the Centers for Medicare and Medicaid Services.
The commissioner may change a payment arrangement to comply with this paragraph.
new text end
new text begin
(d) The commissioner must administer and oversee this section to:
new text end
new text begin
(1) ensure proper administration of prescription drug benefits for managed care enrollees;
and
new text end
new text begin
(2) increase the transparency of prescription drug prices and other information for the
benefit of pharmacies.
new text end
new text begin Subd. 4. new text end
new text begin Prescription drug disclosures. new text end
new text begin
(a) The state pharmacy benefit manager must,
on request from the commissioner, disclose to the commissioner all sources of payment the
pharmacy benefit manager receives for prescribed drugs, including drug rebates, discounts,
credits, clawbacks, fees, grants, chargebacks, reimbursements, or other financial benefits
or payments related to services provided for a managed care plan.
new text end
new text begin
(b) Each managed care plan must disclose to the commissioner, in the format specified
by the commissioner, the entity's administrative costs associated with providing pharmacy
services under the managed care delivery system.
new text end
new text begin
(c) The state pharmacy benefit manager must provide a written quarterly report to the
commissioner containing the following information from the immediately preceding quarter:
new text end
new text begin
(1) the prices the state pharmacy benefit manager negotiated for prescribed drugs under
the managed care delivery system. The prices must include any rebates the state pharmacy
benefit manager received from the drug manufacturer;
new text end
new text begin
(2) unredacted copies of contracts between the state pharmacy benefit manager and
enrolled pharmacies;
new text end
new text begin
(3) any rebate amounts the state pharmacy benefit manager passed on to individual
pharmacies;
new text end
new text begin
(4) any changes to the information previously disclosed in accordance with subdivision
2, paragraph (d); and
new text end
new text begin
(5) any other information required by the commissioner.
new text end
new text begin
(d) The commissioner may request and collect additional information and clinical data
from the state pharmacy benefit manager.
new text end
new text begin
(e) At the time of contract execution, renewal, or modification, the commissioner must
modify the reporting requirements under its managed care contracts as necessary to meet
the requirements of this subdivision.
new text end
new text begin Subd. 5. new text end
new text begin Program authority. new text end
new text begin
(a) To accomplish the requirements of subdivision 3,
paragraph (d), the commissioner, in consultation with the Formulary Committee established
under section 256B.0625, subdivision 13c, has the authority to:
new text end
new text begin
(1) adopt or develop a preferred drug list for managed care plans;
new text end
new text begin
(2) at the commissioner's discretion, engage in price negotiations with prescription drug
manufacturers, wholesalers, or group purchasing organizations in place of the state pharmacy
benefit manager to obtain price discounts and rebates for prescription drugs for managed
care enrollees; and
new text end
new text begin
(3) develop and manage a drug formulary for managed care plans.
new text end
new text begin
(b) The commissioner may contract with one or more entities to perform any of the
functions described in paragraph (a).
new text end
new text begin Subd. 6. new text end
new text begin Pharmacies. new text end
new text begin
The commissioner may review contracts between the state
pharmacy benefit manager and pharmacies for compliance with this section and the master
contract required under subdivision 2, paragraph (b), clause (3). The commissioner may
amend any term or condition of a contract that does not comply with this section or the
master contract.
new text end
new text begin Subd. 7. new text end
new text begin Federal approval. new text end
new text begin
The commissioner must seek any necessary federal approvals
to implement this section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, or upon federal approval,
whichever is later, except that subdivision 7 is effective the day following final enactment.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end
ARTICLE 6
HUMAN SERVICES HEALTH CARE FINANCE
Section 1.
Minnesota Statutes 2024, section 62A.673, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For purposes of this section, the terms defined in this subdivision
have the meanings given.
(b) "Distant site" means a site at which a health care provider is located while providing
health care services or consultations by means of telehealth.
(c) "Health care provider" means a health care professional who is licensed or registered
by the state to perform health care services within the provider's scope of practice and in
accordance with state law. A health care provider includes a mental health professional
under section 245I.04, subdivision 2; a mental health practitioner under section 245I.04,
subdivision 4; a clinical trainee under section 245I.04, subdivision 6; a treatment coordinator
under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11,
subdivision 5; and a recovery peer under section 245G.11, subdivision 8.
(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.
(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
to pay benefits directly to the policy holder.
(f) "Originating site" means a site at which a patient is located at the time health care
services are provided to the patient by means of telehealth. For purposes of store-and-forward
technology, the originating site also means the location at which a health care provider
transfers or transmits information to the distant site.
(g) "Store-and-forward technology" means the asynchronous electronic transfer or
transmission of a patient's medical information or data from an originating site to a distant
site for the purposes of diagnostic and therapeutic assistance in the care of a patient.
(h) "Telehealth" means the delivery of health care services or consultations through the
use of real time two-way interactive audio and visual communications to provide or support
health care delivery and facilitate the assessment, diagnosis, consultation, treatment,
education, and care management of a patient's health care. Telehealth includes the application
of secure video conferencing, store-and-forward technology, and synchronous interactions
between a patient located at an originating site and a health care provider located at a distant
site. Until July 1, deleted text begin 2025deleted text end new text begin 2028new text end , telehealth also includes audio-only communication between
a health care provider and a patient deleted text begin in accordance with subdivision 6, paragraph (b)deleted text end new text begin if the
communication is a scheduled appointment and the standard of care for that particular
service can be met through the use of audio-only communication or if, for substance use
disorder treatment services and mental health care services delivered through telehealth by
means of audio-only communication, the communication was initiated by the enrollee while
in an emergency or crisis situation and a scheduled appointment was not possible due to
the need of an immediate responsenew text end . Telehealth does not include communication between
health care providers that consists solely of a telephone conversation, email, or facsimile
transmission. Telehealth does not include communication between a health care provider
and a patient that consists solely of an email or facsimile transmission. Telehealth does not
include telemonitoring services as defined in paragraph (i).
(i) "Telemonitoring services" means the remote monitoring of clinical data related to
the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
the data electronically to a health care provider for analysis. Telemonitoring is intended to
collect an enrollee's health-related data for the purpose of assisting a health care provider
in assessing and monitoring the enrollee's medical condition or status.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 2.
Minnesota Statutes 2024, section 62M.17, subdivision 2, is amended to read:
Subd. 2.
Effect of change in prior authorization clinical criteria.
(a) If, during a plan
year, new text begin or a calendar year for fee-for-service providers under chapters 256B and 256L, new text end a
utilization review organization changes coverage terms for a health care service or the
clinical criteria used to conduct prior authorizations for a health care service, the change in
coverage terms or change in clinical criteria shall not apply until the next plan yearnew text begin , or the
next calendar year for fee-for-service providers under chapters 256B and 256L,new text end for any
enrollee who received prior authorization for a health care service using the coverage terms
or clinical criteria in effect before the effective date of the change.
(b) Paragraph (a) does not apply if a utilization review organization changes coverage
terms for a drug or device that has been deemed unsafe by the United States Food and Drug
Administration (FDA); that has been withdrawn by either the FDA or the product
manufacturer; or when an independent source of research, clinical guidelines, or
evidence-based standards has issued drug- or device-specific warnings or recommended
changes in drug or device usage.
(c) Paragraph (a) does not apply if a utilization review organization changes coverage
terms for a service or the clinical criteria used to conduct prior authorizations for a service
when an independent source of research, clinical guidelines, or evidence-based standards
has recommended changes in usage of the service for reasons related to patient harm. This
paragraph expires December 31, 2025, for health benefit plans offered, sold, issued, or
renewed on or after that date.
(d) Effective January 1, 2026, and applicable to health benefit plans offered, sold, issued,
or renewed on or after that date, paragraph (a) does not apply if a utilization review
organization changes coverage terms for a service or the clinical criteria used to conduct
prior authorizations for a service when an independent source of research, clinical guidelines,
or evidence-based standards has recommended changes in usage of the service for reasons
related to previously unknown and imminent patient harm.
(e) Paragraph (a) does not apply if a utilization review organization removes a brand
name drug from its formulary or places a brand name drug in a benefit category that increases
the enrollee's cost, provided the utilization review organization (1) adds to its formulary a
generic or multisource brand name drug rated as therapeutically equivalent according to
the FDA Orange Book, or a biologic drug rated as interchangeable according to the FDA
Purple Book, at a lower cost to the enrollee, and (2) provides at least a 60-day notice to
prescribers, pharmacists, and affected enrollees.
Sec. 3.
Minnesota Statutes 2024, section 256.9657, is amended by adding a subdivision
to read:
new text begin Subd. 2b. new text end
new text begin Hospital assessment. new text end
new text begin
(a) For purposes of this subdivision, the following terms
have the meanings given:
new text end
new text begin
(1) "eligible hospital" means a hospital licensed under section 144.50 and located in
Minnesota;
new text end
new text begin
(2) "net outpatient revenue" means the value reflecting total outpatient revenue less
Medicare revenue as calculated from Worksheet G of the hospital's most recent Medicare
cost report filed and showing in the Healthcare Cost Report Information System (HCRIS)
as of August 1 of each year; and
new text end
new text begin
(3) "total patient days" means the value reflecting total hospital inpatient days as reported
on Worksheet S-3 of the hospital's most recent Medicare cost report filed and showing in
HCRIS as of August 1 of each year.
new text end
new text begin
(b) Subject to paragraphs (m) to (o), each eligible hospital must pay to the hospital
directed payment program account assessments in an aggregate annual amount equal to the
sum of the following:
new text end
new text begin
(1) $120.22 multiplied by total patient days; and
new text end
new text begin
(2) 5.96 percent of the hospital's net outpatient revenue.
new text end
new text begin
(c) The assessment amount for calendar years 2026 and 2027 must be based on the total
patient days and net outpatient revenue in 2021 for each eligible hospital.
new text end
new text begin
(d) The commissioner may, after consultation with the Minnesota Hospital Association,
modify the rates of assessment in paragraph (b) as necessary to comply with federal law,
obtain or maintain a waiver under Code of Federal Regulations, title 42, section 433.72, or
to otherwise maximize under this section federal financial participation for medical assistance.
Notwithstanding the foregoing authorization to maximize federal financial participation for
medical assistance, the commissioner must reduce the rates of assessment in paragraph (b)
as necessary to ensure:
new text end
new text begin
(1) the state's aggregated health care-related taxes on inpatient hospital services do not
exceed five percent of the net patient revenue attributable to those services; and
new text end
new text begin
(2) the state's aggregated health care-related taxes on outpatient hospital services do not
exceed five percent of the net patient revenue attributable to those services.
new text end
new text begin
(e) Eligible hospitals must pay the annual assessment amount under paragraph (b) to the
commissioner by paying four equal quarterly assessments. Eligible hospitals must pay the
quarterly assessments by January 1, April 1, July 1, and October 1 each year. Eligible
hospitals must pay the assessments in the form and manner specified by the commissioner.
An eligible hospital is prohibited from paying a quarterly assessment until the eligible
hospital has received the applicable invoice under paragraph (f). The commissioner may
make the assessment retroactive to the first quarter for which federal approval is effective.
new text end
new text begin
(f) The commissioner must provide eligible hospitals with an invoice by December 1
for the assessment due January 1, March 1 for the assessment due April 1, June 1 for the
assessment due July 1, and September 1 for the assessment due October 1 each year.
new text end
new text begin
(g) The commissioner must notify each eligible hospital of its estimated annual assessment
amount for the subsequent calendar year by October 15 each year.
new text end
new text begin
(h) If any of the dates for assessments or invoices in paragraphs (e) to (g) fall on a
holiday, the applicable date is the next business day.
new text end
new text begin
(i) A hospital is not required to pay an assessment under this subdivision until the start
of the first full fiscal year the hospital is an eligible hospital. A hospital that has merged
with another hospital must have the hospital's assessment revised at the start of the first full
fiscal year after the merger is complete. A closed hospital is retroactively responsible for
assessments owed for services provided through the final date of operations.
new text end
new text begin
(j) If the commissioner determines that a hospital has underpaid or overpaid an
assessment, the commissioner must notify the hospital of the unpaid assessment or of any
refund due.
new text end
new text begin
(k) Revenue from an assessment under this subdivision must only be used by the
commissioner to pay the nonfederal share of the directed payment program under section
256B.1974.
new text end
new text begin
(l) The commissioner is prohibited from collecting any assessment under this subdivision
during any period of time when:
new text end
new text begin
(1) federal financial participation is unavailable, disallowed, or reduced by at least 15
percent relative to the state's share of medical assistance as of April 1, 2025; or
new text end
new text begin
(2) a directed payment under section 256B.1974 is not approved by the Centers for
Medicare and Medicaid Services.
new text end
new text begin
(m) The commissioner must make the following discounts from the inpatient portion of
the assessment under paragraph (b), clause (1), in the stated amount or as necessary to
achieve federal approval of the assessment in this section:
new text end
new text begin
(1) for Hennepin Healthcare, a discount of 25 percent off the inpatient portion of the
assessment rate;
new text end
new text begin
(2) for Mayo Rochester, a discount of ten percent off the inpatient portion of the
assessment rate; and
new text end
new text begin
(3) for Gillette Children's Hospital, a discount of 90 percent off the inpatient portion of
the assessment rate.
new text end
new text begin
(n) The commissioner must make the following discounts from the outpatient portion
of the assessment under paragraph (b), clause (2), in the stated amount or as necessary to
achieve federal approval of the assessment in this section:
new text end
new text begin
(1) for each critical access hospital or independent hospital located outside a city of the
first class and paid under the Medicare prospective payment system, a discount of 40 percent
off the outpatient portion of the assessment rate;
new text end
new text begin
(2) for Gillette Children's Hospital, a discount of 90 percent off the outpatient portion
of the assessment rate;
new text end
new text begin
(3) for Hennepin Healthcare, a discount of 60 percent off the outpatient portion of the
assessment rate; and
new text end
new text begin
(4) for Mayo Rochester, a discount of 20 percent off the outpatient portion of the
assessment rate.
new text end
new text begin
(o) The commissioner must fully exempt the following from the assessment in this
section:
new text end
new text begin
(1) federal Indian Health Service facilities;
new text end
new text begin
(2) state-owned or state-operated regional treatment centers and all state-operated services;
new text end
new text begin
(3) federal Veterans Administration Medical Centers; and
new text end
new text begin
(4) long-term acute care hospitals.
new text end
new text begin
(p) If the federal share of the hospital directed payment program under section 256B.1974
is increased as the result of an increase to the federal medical assistance percentage, then
the commissioner must reduce the assessment on a uniform percentage basis across eligible
hospitals on which the assessment is imposed, such that the aggregate amount collected
from hospitals under this subdivision does not exceed the total amount needed to maintain
the same aggregate state and federal funding level for the directed payments authorized by
section 256B.1974.
new text end
new text begin
(q) Hospitals subject to the assessment under this subdivision must submit to the
commissioner on an annual basis, in the form and manner specified by the commissioner
in consultation with the Minnesota Hospital Association, all documentation necessary to
determine the assessment amounts under this subdivision.
new text end
new text begin
(r) Any disproportionate share hospital payments that are supplanted due to the
implementation of the hospital directed payment program under section 256B.1974 must
be redirected into the hospital directed payment program as an offset to the assessment
under this section owed by all medical assistance disproportionate share hospitals as defined
in section 256.969, subdivision 9, and reduce their assessments on a uniform basis.
new text end
new text begin
(s) Any future state funding sources identified and used toward the hospital directed
payment program under section 256B.1974 may be used to offset the assessment under this
section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
(a) This section is effective the later of January 1, 2026, or federal
approval of all of the following:
new text end
new text begin
(1) this section; and
new text end
new text begin
(2) the amendments in this act to Minnesota Statutes, sections 256B.1973 and 256B.1974.
new text end
new text begin
(b) The commissioner of human services shall notify the revisor of statutes when federal
approval for all amendments set forth in paragraph (a) is obtained.
new text end
Sec. 4.
Minnesota Statutes 2024, section 256.969, subdivision 2b, is amended to read:
Subd. 2b.
Hospital payment rates.
(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:
(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;
(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;
(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and
(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.
(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base year or years for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.
(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).
(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:
(1) pediatric services;
(2) behavioral health services;
(3) trauma services as defined by the National Uniform Billing Committee;
(4) transplant services;
(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;
(6) outlier admissions;
(7) low-volume providers; and
(8) services provided by small rural hospitals that are not critical access hospitals.
(f) Hospital payment rates established under paragraph (c) must incorporate the following:
(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;
(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;
(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and
(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.
(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.
(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base year or years and the next base year or years. In
any year that inpatient claims volume falls below the threshold required to ensure a
statistically valid sample of claims, the commissioner may combine claims data from two
consecutive years to serve as the base year. Years in which inpatient claims volume is
reduced or altered due to a pandemic or other public health emergency shall not be used as
a base year or part of a base year if the base year includes more than one year. Changes in
costs between base years shall be measured using the lower of the hospital cost index defined
in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
claim. The commissioner shall establish the base year for each rebasing period considering
the most recent year or years for which filed Medicare cost reports are available, except
that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019.
The estimated change in the average payment per hospital discharge resulting from a
scheduled rebasing must be calculated and made available to the legislature by January 15
of each year in which rebasing is scheduled to occur, and must include by hospital the
differential in payment rates compared to the individual hospital's costs.
(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:
(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;
(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and
(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.
(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:
(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;
(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;
(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and
(6) geographic location.
(k) Subject to subdivision 2g, effective for discharges occurring on or after January 1,
2024, the rates paid to hospitals described in paragraph (a), clauses (2) to (4), must include
a rate factor specific to each hospital that qualifies for a medical education and research
cost distribution under section 62J.692, subdivision 4, paragraph (a).
new text begin
(l) Effective for discharges occurring on or after January 1, 2028, or on or after the date
of federal approval, whichever is later, the commissioner must increase by an annual
aggregate amount of $10,000,000:
new text end
new text begin
(1) payments for inpatient behavioral health services provided by hospitals paid under
the DRG methodology by increasing the adjustment for behavioral health services under
section 256.969, subdivision 2b, paragraph (e); and
new text end
new text begin
(2) capitation payments made to managed care plans and county-based purchasing plans
to reflect the rate increase provided under this paragraph. Managed care and county-based
purchasing plans must use the capitation rate increase provided under this clause to increase
payment rates for inpatient behavioral health services provided by hospitals paid under the
DRG methodology. 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 clause, 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 clause. 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 clause. Payment recoveries
must not exceed the amount equal to any increase in rates that results from this paragraph.
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. 5.
Minnesota Statutes 2024, section 256B.0625, subdivision 3b, is amended to read:
Subd. 3b.
Telehealth services.
(a) Medical assistance covers medically necessary services
and consultations delivered by a health care provider through telehealth in the same manner
as if the service or consultation was delivered through in-person contact. Services or
consultations delivered through telehealth shall be paid at the full allowable rate.
(b) The commissioner may establish criteria that a health care provider must attest to in
order to demonstrate the safety or efficacy of delivering a particular service through
telehealth. The attestation may include that the health care provider:
(1) has identified the categories or types of services the health care provider will provide
through telehealth;
(2) has written policies and procedures specific to services delivered through telehealth
that are regularly reviewed and updated;
(3) has policies and procedures that adequately address patient safety before, during,
and after the service is delivered through telehealth;
(4) has established protocols addressing how and when to discontinue telehealth services;
and
(5) has an established quality assurance process related to delivering services through
telehealth.
(c) As a condition of payment, a licensed health care provider must document each
occurrence of a health service delivered through telehealth to a medical assistance enrollee.
Health care service records for services delivered through telehealth must meet the
requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must
document:
(1) the type of service delivered through telehealth;
(2) the time the service began and the time the service ended, including an a.m. and p.m.
designation;
(3) the health care provider's basis for determining that telehealth is an appropriate and
effective means for delivering the service to the enrollee;
(4) the mode of transmission used to deliver the service through telehealth and records
evidencing that a particular mode of transmission was utilized;
(5) the location of the originating site and the distant site;
(6) if the claim for payment is based on a physician's consultation with another physician
through telehealth, the written opinion from the consulting physician providing the telehealth
consultation; and
(7) compliance with the criteria attested to by the health care provider in accordance
with paragraph (b).
(d) Telehealth visits provided through audio and visual communication or accessible
video-based platforms may be used to satisfy the face-to-face requirement for reimbursement
under the payment methods that apply to a federally qualified health center, rural health
clinic, Indian health service, 638 tribal clinic, and certified community behavioral health
clinic, if the service would have otherwise qualified for payment if performed in person.
(e) For purposes of this subdivision, unless otherwise covered under this chapter:
(1) "telehealth" means the delivery of health care services or consultations using real-time
two-way interactive audio and visual communication or accessible telehealth video-based
platforms to provide or support health care delivery and facilitate the assessment, diagnosis,
consultation, treatment, education, and care management of a patient's health care. Telehealth
includes: the application of secure video conferencing consisting of a real-time, full-motion
synchronized video; store-and-forward technology; and synchronous interactions, between
a patient located at an originating site and a health care provider located at a distant site.
Telehealth does not include communication between health care providers, or between a
health care provider and a patient that consists solely of an audio-only communication,
email, or facsimile transmission or as specified by lawnew text begin , except that from July 1, 2025, to
July 1, 2028, telehealth includes communication between a health care provider and a patient
that solely consists of audio-only communicationnew text end ;
(2) "health care provider" means a health care provider as defined under section 62A.673;
a community paramedic as defined under section 144E.001, subdivision 5f; a community
health worker who meets the criteria under subdivision 49, paragraph (a); a mental health
certified peer specialist under section 245I.04, subdivision 10; a mental health certified
family peer specialist under section 245I.04, subdivision 12; a mental health rehabilitation
worker under section 245I.04, subdivision 14; a mental health behavioral aide under section
245I.04, subdivision 16; a treatment coordinator under section 245G.11, subdivision 7; an
alcohol and drug counselor under section 245G.11, subdivision 5; or a recovery peer under
section 245G.11, subdivision 8; and
(3) "originating site," "distant site," and "store-and-forward technology" have the
meanings given in section 62A.673, subdivision 2.
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. 6.
Minnesota Statutes 2024, section 256B.0625, subdivision 17a, is amended to read:
Subd. 17a.
Payment for ambulance services.
(a) Medical assistance covers ambulance
services. Providers shall bill ambulance services according to Medicare criteria.
Nonemergency ambulance services shall not be paid as emergencies. Effective for services
rendered on or after July 1, 2001, medical assistance payments for ambulance services shall
be paid at the Medicare reimbursement rate or at the medical assistance payment rate in
effect on July 1, 2000, whichever is greater.
(b) Effective for services provided on or after July 1, 2016, medical assistance payment
rates for ambulance services identified in this paragraph are increased by five percent.
Capitation payments made to managed care plans and county-based purchasing plans for
ambulance services provided on or after January 1, 2017, shall be increased to reflect this
rate increase. The increased rate described in this paragraph applies to ambulance service
providers whose base of operations as defined in section 144E.10 is located:
(1) outside the metropolitan counties listed in section 473.121, subdivision 4, and outside
the cities of Duluth, Mankato, Moorhead, St. Cloud, and Rochester; or
(2) within a municipality with a population of less than 1,000.
new text begin
(c) Effective for services provided statewide on or after January 1, 2026, medical
assistance payment rates for ambulance services are increased by 15 percent. Capitation
payments made to managed care plans and county-based purchasing plans for ambulance
services provided on or after January 1, 2026, must be increased to reflect this rate increase.
new text end
new text begin
(d) Effective for services provided on or after January 1, 2026, medical assistance
payment rates for ambulance services identified in this paragraph are increased by ten
percent. Capitation payments made to managed care plans and county-based purchasing
plans for ambulance services provided on or after January 1, 2026, must be increased to
reflect this rate increase. The increased rate described in this paragraph applies to ambulance
service providers whose base of operations, as defined in section 144E.001, is located:
new text end
new text begin
(1) outside the metropolitan counties listed in section 473.121, subdivision 4, and outside
the cities of Duluth, Mankato, Moorhead, St. Cloud, and Rochester; or
new text end
new text begin
(2) within a municipality with a population of less than 1,000.
new text end
deleted text begin (c)deleted text end new text begin (e)new text end 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 (a) 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.
deleted text begin (d)deleted text end new text begin (f)new text end Managed care plans and county-based purchasing plans must provide a fuel
adjustment for ambulance services rates when fuel exceeds $3 per gallon. 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 paragraph. This paragraph expires if federal approval is not
received for this paragraph at any time.
Sec. 7.
Minnesota Statutes 2024, section 256B.0625, subdivision 25c, is amended to read:
Subd. 25c.
Applicability of utilization review provisions.
new text begin (a) new text end Effective January 1,
2026, the following provisions of chapter 62M apply to the commissioner when delivering
services under chapters 256B and 256L: 62M.02, subdivisions 1 to 5, 7 to 12, 13, 14 to 18,
and 21; 62M.04; 62M.05, subdivisions 1 to 4; 62M.06, subdivisions 1 to 3; 62M.07;
62M.072; 62M.09; 62M.10; 62M.12; new text begin and new text end 62M.17, subdivision 2deleted text begin ; and 62M.18deleted text end .
new text begin
(b) By April 1, 2026, and each April 1 thereafter, managed care plans and county-based
purchasing plans when the plan is providing coverage to enrollees under chapter 256B or
256L, and the commissioner when delivering services under chapters 256B and 256L, must
post on the entity's public website the following data for the immediately preceding calendar
year for each health plan or program:
new text end
new text begin
(1) the number of prior authorization requests for which an authorization was issued;
new text end
new text begin
(2) the number of prior authorization requests for which an adverse determination was
issued and sorted by:
new text end
new text begin
(i) health care service;
new text end
new text begin
(ii) whether the adverse determination was appealed; and
new text end
new text begin
(iii) whether the adverse determination was upheld or reversed on appeal;
new text end
new text begin
(3) the number of prior authorization requests that were submitted electronically and
not by facsimile or email or other method pursuant to section 62J.497; and
new text end
new text begin
(4) the reasons for prior authorization denial, including but not limited to:
new text end
new text begin
(i) the patient did not meet prior authorization criteria;
new text end
new text begin
(ii) the provider submitted incomplete information to the utilization review organization;
new text end
new text begin
(iii) a change in treatment program; and
new text end
new text begin
(iv) the patient is no longer covered by the plan or program.
new text end
new text begin
(c) All information posted under paragraph (b) must be written in easily understandable
language.
new text end
Sec. 8.
Minnesota Statutes 2024, section 256B.0625, subdivision 30, is amended to read:
Subd. 30.
Other clinic services.
(a) Medical assistance covers rural health clinic services,
federally qualified health center services, nonprofit community health clinic services, and
public health clinic services. Rural health clinic services and federally qualified health center
services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and
(C). Payment for rural health clinic and federally qualified health center services shall be
made according to applicable federal law and regulation.
(b) A federally qualified health center (FQHC) that is beginning initial operation shall
submit an estimate of budgeted costs and visits for the initial reporting period in the form
and detail required by the commissioner. An FQHC that is already in operation shall submit
an initial report using actual costs and visits for the initial reporting period. Within 90 days
of the end of its reporting period, an FQHC shall submit, in the form and detail required by
the commissioner, a report of its operations, including allowable costs actually incurred for
the period and the actual number of visits for services furnished during the period, and other
information required by the commissioner. FQHCs that file Medicare cost reports shall
provide the commissioner with a copy of the most recent Medicare cost report filed with
the Medicare program intermediary for the reporting year which support the costs claimed
on their cost report to the state.
(c) In order to continue cost-based payment under the medical assistance program
according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation
as an essential community provider within six months of final adoption of rules by the
Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and
rural health clinics that have applied for essential community provider status within the
six-month time prescribed, medical assistance payments will continue to be made according
to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural
health clinics that either do not apply within the time specified above or who have had
essential community provider status for three years, medical assistance payments for health
services provided by these entities shall be according to the same rates and conditions
applicable to the same service provided by health care providers that are not FQHCs or rural
health clinics.
(d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural
health clinic to make application for an essential community provider designation in order
to have cost-based payments made according to paragraphs (a) and (b) no longer apply.
(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall
be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
(f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health
clinic may elect to be paid either under the prospective payment system established in United
States Code, title 42, section 1396a(aa), or under an alternative payment methodology
consistent with the requirements of United States Code, title 42, section 1396a(aa), and
approved by the Centers for Medicare and Medicaid Services. The alternative payment
methodology shall be 100 percent of cost as determined according to Medicare cost
principles.
(g) Effective for services provided on or after January 1, 2021, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner, according to an annual election by the FQHC or rural health clinic, under
the current prospective payment system described in paragraph (f) or the alternative payment
methodology described in paragraph (l), or, upon federal approval, for FQHCs that are also
urban Indian organizations under Title V of the federal Indian Health Improvement Act, as
provided under paragraph (k).
(h) For purposes of this section, "nonprofit community clinic" is a clinic that:
(1) has nonprofit status as specified in chapter 317A;
(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
(3) is established to provide health services to low-income population groups, uninsured,
high-risk and special needs populations, underserved and other special needs populations;
(4) employs professional staff at least one-half of which are familiar with the cultural
background of their clients;
(5) charges for services on a sliding fee scale designed to provide assistance to
low-income clients based on current poverty income guidelines and family size; and
(6) does not restrict access or services because of a client's financial limitations or public
assistance status and provides no-cost care as needed.
(i) Effective for services provided on or after January 1, 2015, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner. the commissioner shall determine the most feasible method for paying claims
from the following options:
(1) FQHCs and rural health clinics submit claims directly to the commissioner for
payment, and the commissioner provides claims information for recipients enrolled in a
managed care or county-based purchasing plan to the plan, on a regular basis; or
(2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed
care or county-based purchasing plan to the plan, and those claims are submitted by the
plan to the commissioner for payment to the clinic.
(j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate
and pay monthly the proposed managed care supplemental payments to clinics, and clinics
shall conduct a timely review of the payment calculation data in order to finalize all
supplemental payments in accordance with federal law. Any issues arising from a clinic's
review must be reported to the commissioner by January 1, 2017. Upon final agreement
between the commissioner and a clinic on issues identified under this subdivision, and in
accordance with United States Code, title 42, section 1396a(bb), no supplemental payments
for managed care plan or county-based purchasing plan claims for services provided prior
to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are
unable to resolve issues under this subdivision, the parties shall submit the dispute to the
arbitration process under section 14.57.
(k) The commissioner shall establish an encounter payment rate that is equivalent to the
all inclusive rate (AIR) payment established by the Indian Health Service and published in
the Federal Register. The encounter rate must be updated annually and must reflect the
changes in the AIR established by the Indian Health Service each calendar year. FQHCs
that are also urban Indian organizations under Title V of the federal Indian Health
Improvement Act may elect to be paid: (1) at the encounter rate established under this
paragraph; (2) under the alternative payment methodology described in paragraph (l); or
(3) under the federally required prospective payment system described in paragraph (f).
FQHCs that elect to be paid at the encounter rate established under this paragraph must
continue to meet all state and federal requirements related to FQHCs and urban Indian
organizations, and must maintain their statuses as FQHCs and urban Indian organizations.
(l) All claims for payment of clinic services provided by FQHCs and rural health clinics,
that have elected to be paid under this paragraph, shall be paid by the commissioner according
to the following requirements:
(1) the commissioner shall establish a single medical and single dental organization
encounter rate for each FQHC and rural health clinic when applicable;
(2) each FQHC and rural health clinic is eligible for same day reimbursement of one
medical and one dental organization encounter rate if eligible medical and dental visits are
provided on the same day;
(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance
with current applicable Medicare cost principles, their allowable costs, including direct
patient care costs and patient-related support services. Nonallowable costs include, but are
not limited to:
(i) general social services and administrative costs;
(ii) retail pharmacy;
(iii) patient incentives, food, housing assistance, and utility assistance;
(iv) external lab and x-ray;
(v) navigation services;
(vi) health care taxes;
(vii) advertising, public relations, and marketing;
(viii) office entertainment costs, food, alcohol, and gifts;
(ix) contributions and donations;
(x) bad debts or losses on awards or contracts;
(xi) fines, penalties, damages, or other settlements;
(xii) fundraising, investment management, and associated administrative costs;
(xiii) research and associated administrative costs;
(xiv) nonpaid workers;
(xv) lobbying;
(xvi) scholarships and student aid; and
(xvii) nonmedical assistance covered services;
(4) the commissioner shall review the list of nonallowable costs in the years between
the rebasing process established in clause (5), in consultation with the Minnesota Association
of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall
publish the list and any updates in the Minnesota health care programs provider manual;
(5) the initial applicable base year organization encounter rates for FQHCs and rural
health clinics shall be computed for services delivered on or after January 1, 2021, and:
(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports
from 2017 and 2018;
(ii) must be according to current applicable Medicare cost principles as applicable to
FQHCs and rural health clinics without the application of productivity screens and upper
payment limits or the Medicare prospective payment system FQHC aggregate mean upper
payment limit;
(iii) must be subsequently rebased every two years thereafter using the Medicare cost
reports that are three and four years prior to the rebasing year. Years in which organizational
cost or claims volume is reduced or altered due to a pandemic, disease, or other public health
emergency shall not be used as part of a base year when the base year includes more than
one year. The commissioner may use the Medicare cost reports of a year unaffected by a
pandemic, disease, or other public health emergency, or previous two consecutive years,
inflated to the base year as established under item (iv);
(iv) must be inflated to the base year using the inflation factor described in clause (6);
and
(v) the commissioner must provide for a 60-day appeals process under section 14.57;
(6) the commissioner shall annually inflate the applicable organization encounter rates
for FQHCs and rural health clinics from the base year payment rate to the effective date by
using the CMS FQHC Market Basket inflator established under United States Code, title
42, section 1395m(o), less productivity;
(7) FQHCs and rural health clinics that have elected the alternative payment methodology
under this paragraph shall submit all necessary documentation required by the commissioner
to compute the rebased organization encounter rates no later than six months following the
date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid
Services;
(8) the commissioner shall reimburse FQHCs and rural health clinics an additional
amount relative to their medical and dental organization encounter rates that is attributable
to the tax required to be paid according to section 295.52, if applicable;
(9) FQHCs and rural health clinics may submit change of scope requests to the
commissioner if the change of scope would result in an increase or decrease of 2.5 percent
or higher in the medical or dental organization encounter rate currently received by the
FQHC or rural health clinic;
(10) for FQHCs and rural health clinics seeking a change in scope with the commissioner
under clause (9) that requires the approval of the scope change by the federal Health
Resources Services Administration:
(i) FQHCs and rural health clinics shall submit the change of scope request, including
the start date of services, to the commissioner within seven business days of submission of
the scope change to the federal Health Resources Services Administration;
(ii) the commissioner shall establish the effective date of the payment change as the
federal Health Resources Services Administration date of approval of the FQHC's or rural
health clinic's scope change request, or the effective start date of services, whichever is
later; and
(iii) within 45 days of one year after the effective date established in item (ii), the
commissioner shall conduct a retroactive review to determine if the actual costs established
under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in
the medical or dental organization encounter rate, and if this is the case, the commissioner
shall revise the rate accordingly and shall adjust payments retrospectively to the effective
date established in item (ii);
(11) for change of scope requests that do not require federal Health Resources Services
Administration approval, the FQHC and rural health clinic shall submit the request to the
commissioner before implementing the change, and the effective date of the change is the
date the commissioner received the FQHC's or rural health clinic's request, or the effective
start date of the service, whichever is later. The commissioner shall provide a response to
the FQHC's or rural health clinic's request within 45 days of submission and provide a final
approval within 120 days of submission. This timeline may be waived at the mutual
agreement of the commissioner and the FQHC or rural health clinic if more information is
needed to evaluate the request;
(12) the commissioner, when establishing organization encounter rates for new FQHCs
and rural health clinics, shall consider the patient caseload of existing FQHCs and rural
health clinics in a 60-mile radius for organizations established outside of the seven-county
metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan
area. If this information is not available, the commissioner may use Medicare cost reports
or audited financial statements to establish base rates;
new text begin
(13) the commissioner, when establishing organization encounter rates under this section
for FQHCs and rural health clinics resulting from a merger of existing clinics or the
acquisition of an existing clinic by another existing clinic, must use the combined costs and
caseloads from the clinics participating in the merger or acquisition to set the encounter rate
for the new clinic organization resulting from the merger or acquisition. The scope of services
for the newly formed clinic must be inclusive of the scope of services of the clinics
participating in the merger or acquisition;
new text end
deleted text begin (13)deleted text end new text begin (14)new text end the commissioner shall establish a quality measures workgroup that includes
representatives from the Minnesota Association of Community Health Centers, FQHCs,
and rural health clinics, to evaluate clinical and nonclinical measures; and
deleted text begin (14)deleted text end new text begin (15)new text end the commissioner shall not disallow or reduce costs that are related to an
FQHC's or rural health clinic's participation in health care educational programs to the extent
that the costs are not accounted for in the alternative payment methodology encounter rate
established in this paragraph.
(m) Effective July 1, 2023, an enrolled Indian health service facility or a Tribal health
center operating under a 638 contract or compact may elect to also enroll as a Tribal FQHC.
Requirements that otherwise apply to an FQHC covered in this subdivision do not apply to
a Tribal FQHC enrolled under this paragraph, except that any requirements necessary to
comply with federal regulations do apply to a Tribal FQHC. The commissioner shall establish
an alternative payment method for a Tribal FQHC enrolled under this paragraph that uses
the same method and rates applicable to a Tribal facility or health center that does not enroll
as a Tribal FQHC.
new text begin
(n) FQHC reimbursement for mental health targeted case management services is limited
to:
new text end
new text begin
(1) only those services described under section 256B.0625, subdivision 20, and provided
in accordance with contracts executed with counties authorized to subcontract for mental
health targeted case management services; and
new text end
new text begin
(2) an FQHC's actual incurred costs as separately reported on the cost report submitted
to the Centers for Medicare and Medicaid Services and further identified in reports submitted
to the commissioner.
new text end
new text begin
(o) Counties contracting with FQHCs for mental health targeted case management remain
responsible for the nonfederal share of the cost of the provided mental health targeted case
management services. The commissioner must bill each county for the nonfederal share of
the mental health targeted case management costs as reported by the FQHC.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 9.
Minnesota Statutes 2024, section 256B.0625, subdivision 54, is amended to read:
Subd. 54.
Services provided in birth centers.
(a) Medical assistance covers services
provided in a licensed birth center by a licensed health professional if the service would
otherwise be covered if provided in a hospital.
(b) Facility services provided by a birth center shall be paid at the lower of billed charges
or deleted text begin 70deleted text end new text begin 100new text end percent of the deleted text begin statewide average for a facility payment rate made to a hospitaldeleted text end new text begin
hospital facility fee cost trended to currentnew text end for an uncomplicated vaginal birth as determined
using the most recent calendar year for which complete claims data is available. If a recipient
is transported from a birth center to a hospital prior to the delivery, the payment for facility
services to the birth center shall be the lower of billed charges or deleted text begin 15deleted text end new text begin 100new text end percent of the
deleted text begin averagedeleted text end new text begin hospitalnew text end facility deleted text begin payment made to a hospital for the services provideddeleted text end new text begin fee cost
trended to currentnew text end for an uncomplicated vaginal delivery as determined using the most recent
calendar year for which complete claims data is available.
(c) deleted text begin Nursery caredeleted text end new text begin Facilitynew text end services providednew text begin to a newbornnew text end by a birth center shall be paid
the lower of billed charges or deleted text begin 70deleted text end new text begin 100new text end percent of deleted text begin the statewide average for a payment rate
paid to a hospital for nursery care as determined by using the most recent calendar year for
which complete claims data is availabledeleted text end new text begin the hospital facility fee for a normal newborn as
determined using the most recent calendar year for which complete claims data is available,
cost trended to currentnew text end .
(d) Professional services provided by traditional midwives licensed under chapter 147D
shall be paid at the lower of billed charges or 100 percent of the rate paid to a physician
performing the same services. If a recipient is transported from a birth center to a hospital
prior to the delivery, a licensed traditional midwife who does not perform the delivery may
not bill for any delivery services. Services are not covered if provided by an unlicensed
traditional midwife.
new text begin
(e) Licensed health professionals working in licensed birth centers shall be reimbursed
for the full range of maternity care and newborn care services within their scope of practice,
regardless of place of service. The commissioner shall review current birth center
reimbursement and, in consultation with birth centers currently licensed in the state, develop
revisions to current payment practices in order to ensure reimbursement for the full range
of maternity care and newborn care services, including but not limited to:
new text end
new text begin
(1) professional services for intrapartum care when a recipient is transferred from a birth
center to a hospital prior to delivery;
new text end
new text begin
(2) professional services billed with a home place of service code by a licensed health
professional within their scope of practice;
new text end
new text begin
(3) professional services when a licensed health professional provides any
Minnesota-mandated newborn screening, including but not limited to the newborn metabolic
screen, CCHD screening, hearing screen, or any other medically necessary newborn
screening, test, or assessment; and
new text end
new text begin
(4) telehealth services provided by any licensed health professional working in a birth
center.
new text end
new text begin
(f) Managed care organizations and county-based purchasing plans contracted to provide
medical assistance coverage under section 256B.69 shall reimburse licensed birth centers
and licensed health professionals working in licensed birth centers for the full range of
maternity care services within their scope of practice, regardless of place of service, as
determined in paragraph (e) at no less than the medical assistance fee for service fee schedule
for the year in which the service is provided.
new text end
deleted text begin (e)deleted text end new text begin (g)new text end The commissioner shall apply for any necessary waivers from the Centers for
Medicare and Medicaid Services to allow birth centers and birth center providers to be
reimbursed.
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. 10.
Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 54a. new text end
new text begin Home birth. new text end
new text begin
(a) For purposes of this subdivision, the following terms have
the meanings given:
new text end
new text begin
(1) "birth services" means prenatal, labor, birth, and postpartum services;
new text end
new text begin
(2) "eligible provider" means a licensed or certified health care professional eligible for
reimbursement under the medical assistance program; and
new text end
new text begin
(3) "low-risk patient for birth services" means a person undergoing a normal,
uncomplicated prenatal course as determined by documentation of adequate prenatal care
who anticipates a normal, uncomplicated labor and birth, as defined by reasonable and
generally accepted criteria adopted by professional groups for maternal, fetal, and neonatal
health care.
new text end
new text begin
(b) Medical assistance covers birth services provided at home when the following
conditions are met:
new text end
new text begin
(1) the birth services are provided by an eligible provider whose scope of practice and
experience includes home birth;
new text end
new text begin
(2) the recipient is a low-risk patient for birth services; and
new text end
new text begin
(3) the recipient has a plan of care that includes:
new text end
new text begin
(i) a consent form detailing the risks and benefits of home birth signed by the recipient;
new text end
new text begin
(ii) sufficient visits, test results, and follow-up consultations as needed to establish that
the recipient is a low-risk patient for birth services; and
new text end
new text begin
(iii) a plan for transfer to a hospital as needed.
new text end
new text begin
(c) Services provided under this subdivision by an eligible provider must be paid at a
rate at least equal to 100 percent of the rate paid to a physician performing the same services.
An eligible provider who does not perform the delivery must not bill for any delivery
services.
new text end
new text begin
(d) Supplies used for birth services under this subdivision must be paid at 70 percent of
the statewide average for a facility payment rate made to a hospital for an uncomplicated
vaginal delivery as determined using the most recent calendar year for which complete
claims data are available. If a recipient is transported from a home to a hospital prior to the
delivery, the payment for the supplies used for birth services under this subdivision must
be the lower of billed charges or 15 percent of the statewide average for a facility payment
rate made to a hospital for the services provided for an uncomplicated vaginal delivery as
determined using the most recent calendar year for which complete claims data are available.
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. 11.
Minnesota Statutes 2024, section 256B.0757, subdivision 5, is amended to read:
Subd. 5.
Payments.
new text begin (a) new text end The commissioner shall make payments to each designated
provider for the provision of health home services described in subdivision 3 to each eligible
individual under subdivision 2 that selects the health home as a provider.new text begin This paragraph
expires on the date that paragraph (b) becomes effective.
new text end
new text begin
(b) Effective January 1, 2028, or upon federal approval, whichever is later, the
commissioner shall make payments to each designated provider for the provision of health
home services described in subdivision 3, except for behavioral health services, to each
eligible individual under subdivision 2 who selects the health home as a provider.
new text end
Sec. 12.
Minnesota Statutes 2024, section 256B.0757, is amended by adding a subdivision
to read:
new text begin Subd. 5a. new text end
new text begin Payments for behavioral health home services. new text end
new text begin
(a) Notwithstanding
subdivision 5, the commissioner must implement a single statewide reimbursement rate for
behavioral health home services under this section. The rate must be no less than $425 per
member per month. The commissioner must adjust the reimbursement rate for behavioral
health home services annually 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
new text begin
(b) The commissioner must review and update the behavioral health home services rate
under paragraph (a) at least every four years. The updated rate must account for the average
hours required for behavioral health home team members spent providing services and the
Department of Labor prevailing wage for required behavioral health home team members.
The updated rate must ensure that behavioral health home services rates are sufficient to
allow providers to meet required certifications, training, and practice transformation
standards; staff qualification requirements; and service delivery standards.
new text end
new text begin
(c) Managed care plans and county-based purchasing plans must reimburse providers
at an amount that is at least equal to the fee-for-service rate for services under this
subdivision. The commissioner must monitor the effect of this rate increase on enrollee
access to services under this subdivision. 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 paragraph. 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
paragraph.
new text end
new text begin
(d) This subdivision is effective January 1, 2028, or upon federal approval, whichever
is later.
new text end
Sec. 13.
Minnesota Statutes 2024, section 256B.1973, is amended by adding a subdivision
to read:
new text begin Subd. 9. new text end
new text begin Interaction with other directed payments. new text end
new text begin
An eligible provider under
subdivision 3 may participate in the hospital directed payment program under section
256B.1974 for inpatient hospital services, outpatient hospital services, or both. A provider
participating in the hospital directed payment program must not receive a directed payment
under this section for any provider classes paid via the hospital directed payment program.
A hospital subject to this section must notify the commissioner in writing no later than 30
days after enactment of this subdivision of its intention to participate in the hospital directed
payment program under section 256B.1974 for inpatient hospital services, outpatient hospital
services, or both. The election under this subdivision is a onetime election, except that if
an eligible provider elects to participate in the hospital directed payment program, and the
hospital directed payment program expires, then the eligible provider may thereafter elect
to participate in the directed payment program under this section.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
(a) This section is effective on the later of January 1, 2026, or
federal approval of all of the following:
new text end
new text begin
(1) this section;
new text end
new text begin
(2) the amendments in this act to add Minnesota Statutes, section 256.9657, subdivision
2b; and
new text end
new text begin
(3) the amendments in this act to Minnesota Statutes, section 256B.1974.
new text end
new text begin
(b) The commissioner of human services shall notify the revisor of statutes when federal
approval for all amendments set forth in paragraph (a) is obtained.
new text end
Sec. 14.
new text begin
[256B.1974] HOSPITAL DIRECTED PAYMENT PROGRAM.
new text end
new text begin Subdivision 1. 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) "Health plan" means a managed care plan or county-based purchasing plan that is
under contract with the commissioner to deliver services to medical assistance enrollees
under section 256B.69.
new text end
new text begin
(c) "Hospital" means a hospital licensed under section 144.50.
new text end
new text begin Subd. 2. new text end
new text begin Required conditions for program. new text end
new text begin
The hospital directed payment program is
contingent on the satisfaction of all requirements necessary for the collection of an assessment
under section 256.9657, and must conform with the requirements for permissible directed
managed care organization expenditures under section 256B.6928, subdivision 5.
new text end
new text begin Subd. 3. new text end
new text begin Commissioner's duties; state-directed fee schedule requirement. new text end
new text begin
(a) For
each federally approved directed payment program that is a state-directed fee schedule
requirement that includes a quarterly payment amount to be submitted by each health plan
to each hospital, the commissioner must determine the quarterly payment amount using the
average commercial payer rate, or using another method acceptable to the Centers for
Medicare and Medicaid Services if the average commercial payer rate is not approved. The
commissioner must ensure that the application of the quarterly payment amounts maximizes
the amount generated by the hospital assessment in section 256.9657, subdivision 2b, for
allowable directed payments and does not result in payments exceeding federal limits.
new text end
new text begin
(b) The commissioner must use an annual settle-up process that occurs within the time
period allowed for medical assistance managed care claims adjustments.
new text end
new text begin
(c) On and after January 1, 2028, if the federal regulations set forth in Code of Federal
Regulations, title 42, parts 430, 438, and 457, remain effective, the hospital directed payment
program must be specific to each health plan and prospectively incorporated into capitation
payments for that plan.
new text end
new text begin
(d) For each federally approved directed payment program that is a state-directed fee
schedule requirement, the commissioner must develop a plan for the initial implementation
of the state-directed fee schedule requirement to ensure that hospitals receive the entire
permissible value of the federally approved directed payment. If federal approval of a
directed payment under this subdivision is retroactive, the commissioner must make a
onetime pro rata increase to the quarterly payment amount and the initial payments to include
claims submitted between the retroactive federal approval date and the period captured by
the initial payments.
new text end
new text begin
(e) Directed payments under this section must only be used to supplement, and not
supplant, medical assistance reimbursement to hospitals. The directed payment program
must not modify, reduce, or offset the medical assistance payment rates determined for each
hospital as required by section 256.969.
new text end
new text begin
(f) The commissioner must require health plans to make quarterly directed payments
according to this section.
new text end
new text begin
(g) Health plans must make quarterly directed payments using electronic funds transfers,
if the hospital provides the information necessary to process such transfers, and in accordance
with directions provided by the commissioner. Health plans must make quarterly directed
payments:
new text end
new text begin
(1) for the first two quarters for which such payments are due, within 30 calendar days
of the date the commissioner issued sufficient payments to the health plan to make the
directed payments according to this section; and
new text end
new text begin
(2) for all subsequent quarters, within ten calendar days of the date the commissioner
issued sufficient payments to the health plan to make the directed payments according to
this section.
new text end
new text begin
(h) The commissioner must publish on the Department of Human Services' website, on
a quarterly basis, the dates that the health plans completed their required quarterly payments
under this section.
new text end
new text begin
(i) Payments to health plans that would be paid consistent with actuarial certification
and enrollment in the absence of the increased capitation payments under this section must
not be reduced as a result of this section.
new text end
new text begin
(j) The commissioner must publish all directed payments owed to each hospital from
each health plan on the department's website for at least two years. All calculations and
reports must be posted no later than the first day of the quarter for which the payments are
to be issued.
new text end
new text begin
(k) By December 1 each year, the commissioner must notify each hospital of any changes
to the payment methodologies in this section, including but not limited to changes in the
directed payment rates, the aggregate directed payment amount for all hospitals, and the
hospital's directed payment amount for the upcoming calendar year.
new text end
new text begin
(l) The commissioner must distribute payments required under this section for each
hospital within 30 days of a quarterly assessment under section 256.9657, subdivision 2b,
being received. The commissioner must pay the directed payments to health plans under
contract no later than January 1, April 1, July 1, and October 1 each year.
new text end
new text begin
(m) A hospital is not entitled to payments under this section until the start of the first
full fiscal year it is an eligible hospital. A hospital that has merged with another hospital
must have its payments under this section revised at the start of the first full fiscal year after
the merger is complete. A closed hospital is entitled to the payments under this section for
services provided through the final date of operations.
new text end
new text begin Subd. 4. new text end
new text begin Health plan duties; submission of claims. new text end
new text begin
Each health plan must submit to
the commissioner, in accordance with its contract with the commissioner to serve as a
managed care organization in medical assistance, payment information for each claim paid
to a hospital for services provided to a medical assistance enrollee. Health plans must allow
each hospital to review the health plan's own paid claims detail to enable proper validation
that the medical assistance managed care claims volume and content is consistent with the
hospital's internal records. To support the validation process for the directed payment
program, health plans must permit the commissioner to share inpatient and outpatient
claims-level details with hospitals identifying only those claims where the prepaid medical
assistance program under section 256B.69 is the payer source. Hospitals must provide notice
of discrepancies in claims paid to the commissioner in a form determined by the
commissioner. The commissioner is authorized to determine the final disposition of the
validation process for disputed claims.
new text end
new text begin Subd. 5. new text end
new text begin Health plan duties; directed payment add-on. new text end
new text begin
(a) Each health plan must
make, in accordance with its contract with the commissioner to serve as a managed care
organization in medical assistance, a directed payment to each hospital. The amount of the
directed payment to the hospital must be equal to the payment amounts the plan received
from the commissioner for the hospital.
new text end
new text begin
(b) Health plans are prohibited from:
new text end
new text begin
(1) setting, establishing, or negotiating reimbursement rates with a hospital in a manner
that directly or indirectly takes into account a directed payment that a hospital receives
under this section;
new text end
new text begin
(2) unnecessarily delaying a directed payment to a hospital; or
new text end
new text begin
(3) recouping or offsetting a directed payment for any reason, except as expressly
authorized by the commissioner.
new text end
new text begin Subd. 6. new text end
new text begin Hospital duties; quarterly supplemental directed payment add-on. new text end
new text begin
(a) A
hospital receiving a directed payment under this section is prohibited from:
new text end
new text begin
(1) setting, establishing, or negotiating reimbursement rates with a managed care
organization in a manner that directly or indirectly takes into account a directed payment
that a hospital receives under this section; or
new text end
new text begin
(2) directly passing on the cost of an assessment to patients or nonmedical assistance
payers, including as a fee or rate increase.
new text end
new text begin
(b) A hospital that violates this subdivision is prohibited from receiving a directed
payment under this section for the remainder of the rate year. This subdivision does not
prohibit a hospital from negotiating with a payer for a rate increase.
new text end
new text begin
(c) Any hospital receiving a directed payment under this section must meet the
commissioner's standards for directed payments as described in subdivision 7.
new text end
new text begin Subd. 7. new text end
new text begin State minimum policy goals established. new text end
new text begin
(a) The effect of the directed
payments under this section must align with the state's policy goals for medical assistance
enrollees. The directed payments must be used to maintain quality and access to a full range
of health care delivery mechanisms for medical assistance enrollees, and specifically provide
improvement for one of the following quality measures:
new text end
new text begin
(1) overall well child visit rates;
new text end
new text begin
(2) maternal depression screening rates; or
new text end
new text begin
(3) colon cancer screening rates.
new text end
new text begin
(b) The commissioner, in consultation with the Minnesota Hospital Association, must
submit to the Centers for Medicare and Medicaid Services quality measures performance
evaluation criteria and a methodology to regularly measure access to care and the
achievement of state policy goals described in this subdivision.
new text end
new text begin
(c) The quality measures evaluation data, as determined by paragraph (b), must be
reported to the Centers for Medicare and Medicaid Services after at least 12 months of
directed payments to hospitals.
new text end
new text begin Subd. 8. new text end
new text begin Administrative review. new text end
new text begin
Before making the payments required under this
section, and on at least an annual basis, the commissioner must consult with and provide
for review of the payment amounts by a permanent select committee established by the
Minnesota Hospital Association. Any data or information reviewed by members of the
committee are data not on individuals, as defined in section 13.02. The committee's members
must not include any current employee or paid consultant of any hospital.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
(a) This section is effective the later of January 1, 2026, or federal
approval for all of the following:
new text end
new text begin
(1) the amendments in this act to add Minnesota Statutes, section 256.9657, subdivision
2b; and
new text end
new text begin
(2) the amendments in this act to this section.
new text end
new text begin
(b) The commissioner of human services shall notify the revisor of statutes when federal
approval for all amendments set forth in paragraph (a) is obtained.
new text end
Sec. 15.
new text begin
[256B.1975] HOSPITAL DIRECTED PAYMENT PROGRAM ACCOUNT.
new text end
new text begin Subdivision 1. new text end
new text begin Account established; appropriation. new text end
new text begin
(a) The hospital directed payment
program account is created in the special revenue fund in the state treasury.
new text end
new text begin
(b) Money in the account, including interest earned, is annually appropriated to the
commissioner for the purposes specified in section 256B.1974.
new text end
new text begin
(c) Transfers from this account to another fund are prohibited, except as necessary to
make the payments required under section 256B.1974.
new text end
new text begin Subd. 2. new text end
new text begin Reports to the legislature. new text end
new text begin
By January 15, 2027, and each January 15 thereafter,
the commissioner must submit a report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance
that details the activities and uses of money in the hospital directed payment program
account, including the metrics and outcomes of the policy goals established by section
256B.1974, subdivision 7.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective on the later of January 1, 2026, or federal
approval of the amendments in this act to add Minnesota Statutes, section 256.9657,
subdivision 2b. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 16.
Minnesota Statutes 2024, section 256B.76, subdivision 1, is amended to read:
Subdivision 1.
deleted text begin Physician and professional servicesdeleted text end Reimbursementnew text begin adjustmentsnew text end .
deleted text begin
(a)
Effective for services rendered on or after October 1, 1992, the commissioner shall make
payments for physician services as follows:
deleted text end
deleted text begin
(1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care," "critical
care," cesarean delivery and pharmacologic management provided to psychiatric patients,
and level three codes for enhanced services for prenatal high risk, shall be paid at the lower
of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;
deleted text end
deleted text begin
(2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
deleted text end
deleted text begin
(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect on
September 30, 1992.
deleted text end
deleted text begin
(b) Effective for services rendered on or after January 1, 2000, payment rates for physician
and professional services shall be increased by three percent over the rates in effect on
December 31, 1999, except for home health agency and family planning agency services.
The increases in this paragraph shall be implemented January 1, 2000, for managed care.
deleted text end
deleted text begin
(c) Effective for services rendered on or after July 1, 2009, payment rates for physician
and professional services shall be reduced by five percent, except that for the period July
1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical
assistance and general assistance medical care programs, over the rates in effect on June
30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other
outpatient visits, preventive medicine visits and family planning visits billed by physicians,
advanced practice registered nurses, or physician assistants in a family planning agency or
in one of the following primary care practices: general practice, general internal medicine,
general pediatrics, general geriatrics, and family medicine. This reduction and the reductions
in paragraph (d) do not apply to federally qualified health centers, rural health centers, and
Indian health services. Effective October 1, 2009, payments made to managed care plans
and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall
reflect the payment reduction described in this paragraph.
deleted text end
deleted text begin
(d) Effective for services rendered on or after July 1, 2010, payment rates for physician
and professional services shall be reduced an additional seven percent over the five percent
reduction in rates described in paragraph (c). This additional reduction does not apply to
physical therapy services, occupational therapy services, and speech pathology and related
services provided on or after July 1, 2010. This additional reduction does not apply to
physician services billed by a psychiatrist or an advanced practice registered nurse with a
specialty in mental health. Effective October 1, 2010, payments made to managed care plans
and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall
reflect the payment reduction described in this paragraph.
deleted text end
deleted text begin
(e) Effective for services rendered on or after September 1, 2011, through June 30, 2013,
payment rates for physician and professional services shall be reduced three percent from
the rates in effect on August 31, 2011. This reduction does not apply to physical therapy
services, occupational therapy services, and speech pathology and related services.
deleted text end
deleted text begin
(f) Effective for services rendered on or after September 1, 2014, payment rates for
physician and professional services, including physical therapy, occupational therapy, speech
pathology, and mental health services shall be increased by five percent from the rates in
effect on August 31, 2014. In calculating this rate increase, the commissioner shall not
include in the base rate for August 31, 2014, the rate increase provided under section
256B.76, subdivision 7. This increase does not apply to federally qualified health centers,
rural health centers, and Indian health services. Payments made to managed care plans and
county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
deleted text end
deleted text begin (g)deleted text end new text begin (a)new text end Effective for services rendered on or after July 1, 2015, payment rates for physical
therapy, occupational therapy, and speech pathology and related services provided by 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. Payments
made to managed care plans and county-based purchasing plans shall not be adjusted to
reflect payments under this paragraph.
deleted text begin (h)deleted text end new text begin (b)new text end Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.
deleted text begin (i)deleted text end new text begin (c)new text end The commissioner may reimburse physicians and other licensed professionals for
costs incurred to pay the fee for testing newborns who are medical assistance enrollees for
heritable and congenital disorders under section 144.125, subdivision 1, paragraph (c), when
the sample is collected outside of an inpatient hospital deleted text begin or freestanding birth centerdeleted text end and the
cost is not recognized by another payment source.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or upon federal approval
of the amendments in this act to Minnesota Statutes, sections 256B.76, subdivision 6, and
256B.768, 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 256B.76, subdivision 6, is amended to read:
Subd. 6.
Medicare relative value units.
(a) Effective for services rendered on or after
January 1, 2007, the commissioner shall make payments for physician and professional
services based on the Medicare relative value units (RVUs). This change shall be budget
neutral and the cost of implementing RVUs will be incorporated in the established conversion
factor.new text begin This paragraph expires on the date that paragraph (b) becomes effective.
new text end
new text begin
(b) Effective January 1, 2026, or upon federal approval, whichever is later, and effective
for services rendered on or after January 1, 2007, the commissioner must make payments
for physician and professional services based on the Medicare relative value units (RVUs).
new text end
deleted text begin (b)deleted text end new text begin (c)new text end Effective for services rendered on or after January 1, 2025, rates for mental health
services reimbursed under the resource-based relative value scale (RBRVS) must be equal
to 83 percent of the Medicare Physician Fee Schedule.new text begin This paragraph expires on the date
that section 256B.768 becomes effective.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end Effective for services rendered on or after January 1, 2025, the commissioner
shall increase capitation payments made to managed care plans and county-based purchasing
plans to reflect the rate increases provided under this subdivision. Managed care plans and
county-based purchasing plans must use the capitation rate increase provided under this
paragraph to increase payment rates to the providers corresponding to the rate increases.
The commissioner must monitor the effect of this rate increase on enrollee access to services
under this subdivision. 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
paragraph. 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
paragraph.new text begin This paragraph expires on the date that section 256B.768 becomes effective.
new text end
Sec. 18.
Minnesota Statutes 2024, section 256B.761, is amended to read:
256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
new text begin Subdivision 1. new text end
new text begin Rates effective 2026. new text end
deleted text begin
(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.
deleted text end
deleted text begin
(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation services in the most recent
calendar year who are medical assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient rehabilitation facility and
provided to residents of nursing facilities owned by the entity.
deleted text end
deleted text begin
(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.
deleted text end
deleted text begin
(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.
deleted text end
deleted text begin
(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 18; early intensive developmental behavioral intervention services under section
deleted text end
deleted text begin
256B.0949; and substance use disorder services under chapter 254B, 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.
deleted text end
deleted text begin
(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.
deleted text end
new text begin
(a) Effective for services rendered on or after January 1, 2026, the commissioner must
establish market-based payment rates for the following services:
new text end
new text begin
(1) children's therapeutic services and supports under section 256B.0943;
new text end
new text begin
(2) child and family psychoeducation services under section 256B.0671, subdivision 5;
new text end
new text begin
(3) clinical care consultation services under section 256B.0671, subdivision 7; and
new text end
new text begin
(4) mental health certified family peer specialist services under section 256B.0616.
new text end
new text begin
(b) Rates established under paragraph (a) must not be lower than:
new text end
new text begin
(1) the payment rates recommended in the rate analysis required by Laws 2021, First
Special Session chapter 7, article 17, section 18, and published by the Department of Human
Services on January 22, 2024; or
new text end
new text begin
(2) the payment rates in effect on December 31, 2025.
new text end
new text begin Subd. 2. new text end
new text begin Rates effective 2027. new text end
new text begin
(a) Effective for services rendered on or after January 1,
2027, the commissioner must establish market-based payment rates for the following services:
new text end
new text begin
(1) adult day treatment services under section 256B.0671, subdivision 3;
new text end
new text begin
(2) adult rehabilitative mental health services under section 256B.0623;
new text end
new text begin
(3) adult mental health peer support specialist services under section 256B.0615;
new text end
new text begin
(4) dialectical behavioral therapy under section 256B.0671, subdivision 6;
new text end
new text begin
(5) explanation of findings under section 256B.0671, subdivision 4;
new text end
new text begin
(6) mental health crisis response services under section 256B.0624;
new text end
new text begin
(7) mental health provider travel time under section 256B.0625, subdivision 43;
new text end
new text begin
(8) neuropsychological testing under section 256B.0671, subdivision 9;
new text end
new text begin
(9) partial hospitalization services under section 256B.0671, subdivision 12; and
new text end
new text begin
(10) psychotherapy services under section 256B.0671, subdivision 11, incorporating
biofeedback.
new text end
new text begin
(b) Rates established under paragraph (a) must not be lower than:
new text end
new text begin
(1) the payments rates recommended in the rate analysis required by Laws 2021, First
Special Session chapter 7, article 17, section 18, and published by the Department of Human
Services on January 22, 2024; or
new text end
new text begin
(2) the payment rates in effect on December 31, 2026.
new text end
new text begin Subd. 3. new text end
new text begin Capitation payments. new text end
new text begin
The commissioner must adjust capitation payments
made to managed care plans and county-based purchasing plans to reflect the behavioral
health service rates provided in this section. Managed care and county-based purchasing
plans must reimburse providers at an amount that is at least equal to the fee-for-service rate
for services under this section. The commissioner must monitor the effect of this rate
adjustment on enrollee access to behavioral health services. If for any contract year federal
approval is not received for this subdivision, the commissioner must adjust the capitation
rates paid to managed care plans and county-based purchasing plans for that contract year
to reflect the removal of this provision. Contracts between managed care plans and
county-based purchasing plans and providers to whom this subdivision applies must allow
recovery of payments from those providers if capitation rates are adjusted in accordance
with this subdivision. Payment recoveries must not exceed the amount equal to any increase
in rates that results from this subdivision.
new text end
new text begin Subd. 4. new text end
new text begin Inflation adjustment. new text end
new text begin
The commissioner must adjust the reimbursement rate
for services under this section annually 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
new text begin Subd. 5. new text end
new text begin Exceptions. new text end
new text begin
(a) This section does not apply to federally qualified health centers,
rural health centers, Indian health services, or certified community behavioral health clinics
or to cost-based rates or rates that are negotiated with the county.
new text end
new text begin
(b) This section does not apply to services with reimbursement rates established pursuant
to section 256B.768.
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
of this section and Minnesota Statutes, section 256B.768, whichever is later. The
commissioner shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 19.
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, 2025, 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, 2025.
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, 2025, 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.
new text begin Subd. 15. new text end
new text begin Rates for phototherapy services. new text end
new text begin
For dates of service on or after July 1,
2025, the payment rate for phototherapy services provided to newborns in the home setting
must include a service fee in the amount of $520 per patient episode, in addition to the daily
rental rate for the medical equipment in subdivision 12. The commissioner shall provide an
annual inflation adjustment for the phototherapy service fee. The index for the inflation
adjustment must be based on the Consumer Price Index for All Urban Consumers increase
published by the Bureau of Labor Statistics.
new text end
Sec. 20.
new text begin
[256B.768] MEDICARE RATE ALIGNMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Medicare physician fee schedule rates. new text end
new text begin
(a) Effective January 1, 2026,
or upon federal approval, whichever is later, and effective for services rendered on or after
January 1, 2026, or the date of federal approval, whichever is later, the commissioner must
make payments based on the resource-based relative value scale for all services:
new text end
new text begin
(1) covered in medical assistance; and
new text end
new text begin
(2) with a corresponding rate and procedure code in the Medicare Physician Fee Schedule.
new text end
new text begin
(b) Effective January 1, 2026, or upon federal approval, whichever is later, and effective
for services rendered on or after January 1, 2026, or the date of federal approval, whichever
is later, rates must be at least equal to 100 percent of the Medicare Physician Fee Schedule
if the service:
new text end
new text begin
(1) is reimbursed in medical assistance under the resource-based relative value scale;
and
new text end
new text begin
(2) has a corresponding rate and procedural code in the Medicare Physician Fee Schedule.
new text end
new text begin
(c) For services rendered on or after January 1, 2026, the commissioner shall increase
capitation payments made to managed care plans and county-based purchasing plans to
reflect the rate increases provided under this subdivision. Managed care plans and
county-based purchasing plans must reimburse providers at an amount that is at least equal
to the fee-for-service rate for services under this subdivision. The commissioner must
monitor the effect of this rate increase on enrollee access to services under this subdivision.
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 paragraph. 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 paragraph.
new text end
new text begin Subd. 2. new text end
new text begin Applicable fee schedule. new text end
new text begin
For purposes of this section, the applicable Medicare
Physician Fee Schedule is the most recent Medicare Physician Fee Schedule Final Rule
issued by the Centers for Medicare and Medicaid Services in effect at the time the service
was rendered.
new text end
new text begin Subd. 3. new text end
new text begin Exceptions. new text end
new text begin
This section 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.
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. 21.
Minnesota Statutes 2024, section 295.50, subdivision 3, is amended to read:
Subd. 3.
Gross revenues.
new text begin (a) new text end "Gross revenues" are total amounts received in money or
otherwise by:
(1) a hospital for patient services;
(2) a surgical center for patient services;
(3) a health care provider, other than a staff model health plan company, for patient
services;
(4) a wholesale drug distributor for sale or distribution of legend drugs that are delivered
in Minnesota by the wholesale drug distributor, by common carrier, or by mail, unless the
legend drugs are delivered to another wholesale drug distributor who sells legend drugs
exclusively at wholesale; and
(5) a staff model health plan company as gross premiums for enrollees, co-payments,
deductibles, coinsurance, and fees for patient services.
new text begin
(b) For purposes of paragraph (a), clause (4), "gross revenues" includes the amount of
any rebate provided by the wholesale drug distributor to a customer, however provided,
including a rebate provided under a contractual obligation. "Rebate" means any price
concession provided by a wholesale drug distributor, including any price concession based
on the actual or estimated utilization, sale volume, or effectiveness of a legend drug.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for gross revenues received after June
30, 2025.
new text end
Sec. 22.
Minnesota Statutes 2024, section 295.52, subdivision 1, is amended to read:
Subdivision 1.
Hospital tax.
A tax is imposed on each hospital equal to deleted text begin 1.8deleted text end new text begin twonew text end percent
of its gross revenues.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for gross revenues received after June
30, 2025.
new text end
Sec. 23.
Minnesota Statutes 2024, section 295.52, subdivision 1a, is amended to read:
Subd. 1a.
Surgical center tax.
A tax is imposed on each surgical center equal to deleted text begin 1.8deleted text end new text begin
twonew text end percent of its gross revenues.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for gross revenues received after June
30, 2025.
new text end
Sec. 24.
Minnesota Statutes 2024, section 295.52, subdivision 2, is amended to read:
Subd. 2.
Provider tax.
A tax is imposed on each health care provider equal to deleted text begin 1.8deleted text end new text begin twonew text end
percent of its gross revenues.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for gross revenues received after June
30, 2025.
new text end
Sec. 25.
Minnesota Statutes 2024, section 295.52, subdivision 3, is amended to read:
Subd. 3.
Wholesale drug distributor tax.
A tax is imposed on each wholesale drug
distributor equal to deleted text begin 1.8deleted text end new text begin twonew text end percent of its gross revenues.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for gross revenues received after June
30, 2025.
new text end
Sec. 26.
Minnesota Statutes 2024, section 295.52, subdivision 4, is amended to read:
Subd. 4.
Use tax; legend drugs.
(a) A person that receives legend drugs for resale or
use in Minnesota, other than from a wholesale drug distributor that is subject to tax under
subdivision 3, is subject to a tax equal to the price paid for the legend drugs multiplied by
deleted text begin 1.8deleted text end new text begin twonew text end percent. Liability for the tax is incurred when legend drugs are received or delivered
in Minnesota by the person.
(b) A tax imposed under this subdivision does not apply to purchases by an individual
for personal consumption.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective for gross revenues received after June
30, 2025.
new text end
Sec. 27.
new text begin
[295.525] MCO ASSESSMENT ON HEALTH PLAN COMPANIES.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) For purposes of this section, the definitions in this
subdivision have the meanings given.
new text end
new text begin
(b) "Commissioner" means the commissioner of human services.
new text end
new text begin
(c) "Enrollee" has the meaning given in section 62Q.01, except that enrollee does not
include:
new text end
new text begin
(1) an individual enrolled in a Medicare plan;
new text end
new text begin
(2) a plan-to-plan enrollee; or
new text end
new text begin
(3) an individual enrolled in a health plan pursuant to the Federal Employees Health
Benefits Act of 1959, Public Law 86-382, as amended, to the extent the imposition of the
assessment under this section is preempted pursuant to United States Code, title 5, section
8909, subsection (f).
new text end
new text begin
(d) "Health plan" has the meaning given in section 62Q.01.
new text end
new text begin
(e) "Health plan company" has the meaning given in section 62Q.01.
new text end
new text begin
(f) "Medical assistance" means the medical assistance program established under chapter
256B.
new text end
new text begin
(g) "Medical assistance enrollee" means an enrollee in medical assistance or
MinnesotaCare for whom the Department of Human Services directly pays the health plan
company a capitated payment.
new text end
new text begin
(h) "MinnesotaCare" means the MinnesotaCare program established under chapter 256L.
new text end
new text begin
(i) "Plan-to-plan enrollee" means an individual who receives coverage for health care
services through a health plan pursuant to a subcontract from another health plan.
new text end
new text begin Subd. 2. new text end
new text begin MCO assessment. new text end
new text begin
(a) An annual assessment is imposed on health plan
companies for each calendar year beginning in calendar year 2026. The total annual
assessment amount is equal to the sum of the amounts assessed for medical assistance
enrollees under paragraph (b) and for nonmedical assistance enrollees under paragraph (c).
new text end
new text begin
(b) The amount assessed for medical assistance enrollees is equal to the sum of the
following:
new text end
new text begin
(1) for medical assistance enrollees 0 to 60,000, $0 per enrollee;
new text end
new text begin
(2) for medical assistance enrollees 60,001 to 100,000, $340 per enrollee;
new text end
new text begin
(3) for medical assistance enrollees 100,001 to 200,000, $365 per enrollee; and
new text end
new text begin
(4) for medical assistance enrollees 200,001 to 350,000, $380 per enrollee.
new text end
new text begin
(c) The amount assessed for nonmedical assistance enrollees is equal to the sum of the
following:
new text end
new text begin
(1) for nonmedical assistance enrollees 0 to 60,000, $0 per enrollee;
new text end
new text begin
(2) for nonmedical assistance enrollees 60,001 to 100,000, 50 cents per enrollee;
new text end
new text begin
(3) for nonmedical assistance enrollees 100,001 to 200,000, 75 cents per enrollee; and
new text end
new text begin
(4) for nonmedical assistance enrollees 200,001 to 350,000, $1 per enrollee.
new text end
new text begin
(d) The commissioner must annually use the commissioner's authority as necessary to
modify the rate of assessment, provided under paragraph (e), such that the annual assessment
imposed under this subdivision does not exceed the lesser of:
new text end
new text begin
(1) 2.8 percent of the health plan companies' aggregate gross revenue; and
new text end
new text begin
(2) the cumulative costs attributable to:
new text end
new text begin
(i) the program changes in section 295.525, subdivision 4, paragraph (b), clauses (1) to
(6); and
new text end
new text begin
(ii) the appropriation under section 144E.54, subdivision 10.
new text end
new text begin
(e) The commissioner may, after consultation with health plan companies likely to be
affected, modify the rate of assessment, as set forth in paragraphs (a) to (d), as necessary
to:
new text end
new text begin
(1) comply with federal law, obtain or maintain a waiver under Code of Federal
Regulations, title 42, section 433.72, or to otherwise maximize under this section federal
financial participation for medical assistance; and
new text end
new text begin
(2) comply with paragraph (d).
new text end
new text begin
(f) Unpaid assessment amounts accrue interest at a rate of ten percent per annum,
beginning the day following the assessment payment's due date. A penalty, equal to the
total accrued interest charge, is imposed monthly on payments 60 days or more overdue
until the payment, penalty, and interest are paid in full.
new text end
new text begin Subd. 3. new text end
new text begin Assessment computation; collection. new text end
new text begin
(a) The commissioner must annually
determine the following for each health plan company:
new text end
new text begin
(1) total enrollment for the calendar year;
new text end
new text begin
(2) total Medicare enrollment for the calendar year;
new text end
new text begin
(3) total medical assistance enrollment for the calendar year;
new text end
new text begin
(4) total plan-to-plan enrollment for the calendar year;
new text end
new text begin
(5) total enrollment through the Federal Employees Health Benefits Act of 1959, Public
Law 86-382, as amended, for the calendar year; and
new text end
new text begin
(6) total other enrollment for the calendar year that is not otherwise counted in clauses
(2) to (5).
new text end
new text begin
(b) Health plan companies must provide any information requested by the commissioner
for the purpose of this subdivision, provided that the commissioner determines such
information is necessary to accurately determine the information in paragraph (a).
new text end
new text begin
(c) The commissioner may correct errors in data provided to the commissioner by a
health plan company to the extent necessary to accurately determine the information in
paragraph (a).
new text end
new text begin
(d) For purposes of calculating the information in paragraph (a) for a health plan company,
the commissioner must count any individual that was an enrollee of a health plan at any
point of the calendar year, regardless of the enrollee's duration as an enrollee of the health
plan.
new text end
new text begin
(e) The commissioner must annually use the information in paragraph (a) to compute
the assessment for each health plan company.
new text end
new text begin
(f) The commissioner must collect the annual assessment for each health plan company
in four equal installments, in the manner and on the schedule determined by the
commissioner. The commissioner is prohibited from collecting any amount under this section
until 20 days after the commissioner has notified the health plan company of:
new text end
new text begin
(1) the effective date of this section;
new text end
new text begin
(2) the assessment due dates for the applicable calendar year; and
new text end
new text begin
(3) the annual assessment amount.
new text end
new text begin
(g) The commissioner may waive all or part of the interest or penalty imposed on a
health plan company under subdivision 2, paragraph (f), if the commissioner determines
the interest or penalty is likely to create an undue financial hardship on the health plan
company or a significant financial difficulty in providing necessary services to medical
assistance enrollees. A waiver under this paragraph must be contingent on the health plan
company's agreement to make assessment payments on an alternative schedule, determined
by the commissioner, that accounts for the health plan company's finances and the potential
impact on the delivery of services to medical assistance enrollees.
new text end
new text begin
(h) In the event of a merger, acquisition, or other transaction that results in the transfer
of health plan responsibility to another health plan company or similar entity during calendar
years 2026 to 2029, the surviving, acquiring, or controlling health plan company or similar
entity shall be responsible for paying the full assessment amount as provided in this section
that would have been the responsibility of the health plan company to which that full
assessment amount was assessed upon the effective date of the transaction. If a transaction
results in the transfer of health plan responsibility for only some of a health plan's enrollees
under this section but not all enrollees, the full assessment amount as provided in this section
remains the responsibility of that health plan company to which that full assessment amount
was assessed.
new text end
new text begin Subd. 4. new text end
new text begin MCO assessment expenditures. new text end
new text begin
(a) All amounts collected by the commissioner
under this section must be deposited in the health care access fund.
new text end
new text begin
(b) Of the total amount collected by the commissioner under this section, $18,000,000
annually is for the appropriation under section 144E.54, subdivision 10. All other amounts
collected by the commissioner under this section are annually appropriated to the
commissioner to provide nonfederal money for medical assistance and MinnesotaCare
program rate changes made in this act related to:
new text end
new text begin
(1) ambulance services under section 256B.0625, subdivision 17a;
new text end
new text begin
(2) behavioral health home services under section 256B.0757;
new text end
new text begin
(3) mental health services under section 256B.761;
new text end
new text begin
(4) services reimbursed under the resource-based relative value scale and with a
corresponding rate and procedural code in the Medicare Physician Fee Schedule under
section 256B.768;
new text end
new text begin
(5) inpatient behavioral health services provided by hospitals paid under the DRG
methodology under section 256.969, subdivision 2b, paragraph (l); and
new text end
new text begin
(6) mental health services provided by masters-prepared mental health professionals
and physician assistants resulting from the repeal of section 256B.0625, subdivision 38.
new text end
new text begin
(c) Except for the amount necessary for the appropriation under section 144E.54,
subdivision 10, the assessment money must be used to supplement money for medical
assistance from the general fund.
new text end
new text begin
(d) The commissioner must provide an annual report to all health plan companies, in a
time and manner determined by the commissioner. The report must identify the assessments
imposed on each health plan company pursuant to this section, account for all money raised
by the MCO assessment, and provide an itemized accounting of expenditures from the fund.
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
for the assessment established in this section to be considered a permissible health
care-related tax under Code of Federal Regulations, title 42, section 433.68, eligible for
federal financial participation, including but not limited to federal approval of a waiver
under Code of Federal Regulations, title 42, section 433.72, if such waiver is necessary to
receive health care-related taxes without a reduction in federal financial participation,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 28. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; ENHANCED
FEDERAL REIMBURSEMENT FOR FAMILY PLANNING SERVICES IN
MEDICAL ASSISTANCE.
new text end
new text begin
The commissioner of human services must make the systems modification necessary to
claim enhanced federal reimbursement for all family planning services under the medical
assistance program.
new text end
Sec. 29. new text begin IMPLEMENTATION OF HOSPITAL ASSESSMENT AND DIRECTED
PAYMENT PROGRAM.
new text end
new text begin
(a) The commissioner of human services must immediately begin all necessary claims
analysis to calculate the assessment and payments required under Minnesota Statutes, section
256.9657, subdivision 2b, and the hospital directed payment program described in Minnesota
Statutes, section 256B.1974.
new text end
new text begin
(b) The commissioner of human services, in consultation with the Minnesota Hospital
Association, must submit to the Centers for Medicare and Medicaid Services a request for
federal approval to implement the hospital assessment described in Minnesota Statutes,
section 256.9657, subdivision 2b, and the hospital directed payment program under
Minnesota Statutes, section 256B.1974. At least 15 days before submitting the request for
approval, the commissioner must make available to the public the draft assessment
requirements, draft directed payment details, and an estimate of each assessment amount
for each hospital without an exemption from the assessment pursuant to Minnesota Statutes,
section 256.9657, subdivision 2b, paragraph (k).
new text end
new text begin
(c) During the design and prior to submission of the request for approval under paragraph
(b), the commissioner of human services must consult with the Minnesota Hospital
Association and any hospitals without an exemption from the assessment pursuant to
Minnesota Statutes, section 256.9657, subdivision 2b, paragraph (k), and that are not
members of the Minnesota Hospital Association.
new text end
new text begin
(d) If federal approval is received for the request under paragraph (b), the commissioner
of human services must provide at least 15 days of public posting and review of the federally
approved terms and conditions for the assessment and the directed payment program prior
to any assessment under Minnesota Statutes, section 256.9657, subdivision 2b, becoming
due from a hospital.
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. 30. new text begin FEDERAL APPROVAL; WAIVERS.
new text end
new text begin
(a) The commissioner must request, as the commissioner determines necessary, federal
approval for the MCO assessment on health plan companies established in this act to be
considered a permissible health-care-related tax under Code of Federal Regulations, title
42, section 433.68, eligible for federal financial participation.
new text end
new text begin
(b) To obtain the federal approval under paragraph (a), the commissioner may apply for
a waiver of the federal broad-based requirement for health care-related taxes, uniform
requirement for health-care-related taxes, and any other provision of federal law necessary
to implement Minnesota Statutes, section 295.525.
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. new text begin BUDGET NEUTRALITY; RATE ADJUSTMENTS.
new text end
new text begin
(a) By October 1 of each year, the commissioner of human services must determine the
difference between the actual costs or forecasted costs to the medical assistance and
MinnesotaCare programs attributable to the program changes in Minnesota Statutes, section
295.525, subdivision 4, paragraph (b), clauses (1) to (6), and the revenue from the MCO
assessment imposed under Minnesota Statutes, section 295.525, subdivision 2, including
federal financial participation.
new text end
new text begin
(b) For each fiscal year, the commissioner of human services must certify the difference
between the actual costs or forecasted costs to the medical assistance and MinnesotaCare
programs determined under paragraph (a), and report the difference in costs to the
commissioner of management and budget at least four weeks prior to a forecast under
Minnesota Statutes, section 16A.103.
new text end
new text begin
(c) If for any fiscal year, the cumulative costs attributable to: (1) the program changes
in Minnesota Statutes, section 295.525, subdivision 4, paragraph (b), clauses (1) to (6), and
(2) the appropriation under section 144E.54, subdivision 10, exceed revenue from the MCO
assessment imposed under Minnesota Statutes, section 295.525, subdivision 2, as determined
under paragraph (a), the commissioner of human services must reduce the costs to the
medical assistance and MinnesotaCare programs attributable to the program changes in
Minnesota Statutes, section 295.525, subdivision 4, paragraph (b), clauses (1) to (6). The
commissioner's reduction under this paragraph must be on a uniform percentage basis across
the rate increases provided in Minnesota Statutes, section 295.525, subdivision 4, paragraph
(b), clauses (1) to (6).
new text end
Sec. 32. new text begin TREND LIMIT; CALCULATION.
new text end
new text begin
(a) Beginning January 1, 2027, and ending June 30, 2029, the commissioner of human
services may limit the trend increase in rates paid to managed care plans and county-based
purchasing plans under Minnesota Statutes, sections 256B.69 and 256B.692, by an amount
equal to the value of a 0.35 percent reduction in trend in medical assistance. Managed care
rates must meet actuarial soundness and rate development requirements under Code of
Federal Regulations, title 42, part 438, subpart A.
new text end
new text begin
(b) In the November 2025 forecast, the commissioner of human services, in consultation
with the commissioner of management and budget, must reduce the forecasted trend growth
in managed care for medical assistance expenditures in fiscal years 2027, 2028, and 2029.
The reduction must not be less than $7,784,000 in fiscal year 2027, $8,219,000 in fiscal
year 2028, and $8,446,000 in fiscal year 2029.
new text end
Sec. 33. new text begin PROGRAM FOR AMBULANCE SERVICE PROVIDER FUNDING.
new text end
new text begin
The commissioner of human services may implement a voluntary program to increase
funding to ambulance service providers licensed under Minnesota Statutes, chapter 144E,
for services delivered to enrollees of fee-for-service medical assistance and medical assistance
delivered by managed care and county-based purchasing plans. In developing the program,
the commissioner of human services must consider a range of approaches, including but
not limited to intergovernmental transfer and certified public expenditure programs, as
allowed under Code of Federal Regulations, title 42, section 433.51. The program must
supplement, and not supplant or replace, any existing programs operated by the commissioner
of human services to increase funding to ambulance service providers.
new text end
Sec. 34. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 256B.0625, subdivision 38,
new text end
new text begin
is repealed.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, or upon federal approval
of this section and the amendments in this act to Minnesota Statutes, sections 256B.76,
subdivision 6, and 256B.761, whichever is later. The commissioner of human services shall
notify the revisor of statutes when federal approval is obtained.
new text end
ARTICLE 7
HUMAN SERVICES HEALTH CARE POLICY
Section 1.
Minnesota Statutes 2024, section 62Q.522, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) The definitions in this subdivision apply to this section.
(b) "Contraceptive method" means a drug, device, or other product approved by the
Food and Drug Administration to prevent unintended pregnancy.
(c) "Contraceptive service" means consultation, examination, procedures, and medical
services related to the prevention of unintended pregnancydeleted text begin , excluding vasectomiesdeleted text end . This
includes but is not limited to voluntary sterilization procedures, patient education, counseling
on contraceptives, and follow-up services related to contraceptive methods or services,
management of side effects, counseling for continued adherence, and device insertion or
removal.
(d) "Medical necessity" includes but is not limited to considerations such as severity of
side effects, difference in permanence and reversibility of a contraceptive method or service,
and ability to adhere to the appropriate use of the contraceptive method or service, as
determined by the attending provider.
(e) "Therapeutic equivalent version" means a drug, device, or product that can be expected
to have the same clinical effect and safety profile when administered to a patient under the
conditions specified in the labeling, and that:
(1) is approved as safe and effective;
(2) is a pharmaceutical equivalent: (i) containing identical amounts of the same active
drug ingredient in the same dosage form and route of administration; and (ii) meeting
compendial or other applicable standards of strength, quality, purity, and identity;
(3) is bioequivalent in that:
(i) the drug, device, or product does not present a known or potential bioequivalence
problem and meets an acceptable in vitro standard; or
(ii) if the drug, device, or product does present a known or potential bioequivalence
problem, it is shown to meet an appropriate bioequivalence standard;
(4) is adequately labeled; and
(5) is manufactured in compliance with current manufacturing practice regulations.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, and applies to health
plans offered, issued, or renewed on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2024, section 256B.0371, subdivision 3, is amended to read:
Subd. 3.
Contingent contract with dental administrator.
(a) The commissioner shall
determine the extent to which managed care and county-based purchasing plans in the
aggregate meet the performance benchmark specified in subdivision 1 for coverage year
2024. If managed care and county-based purchasing plans in the aggregate fail to meet the
performance benchmark, the commissioner, after issuing a request for information followed
by a request for proposals, shall contract with a dental administrator to administer dental
services beginning January 1, deleted text begin 2026deleted text end new text begin 2030new text end , for all recipients of medical assistance and
MinnesotaCare, including persons served under fee-for-service and persons receiving
services through managed care and county-based purchasing plans.
(b) The dental administrator must provide administrative services, including but not
limited to:
(1) provider recruitment, contracting, and assistance;
(2) recipient outreach and assistance;
(3) utilization management and reviews of medical necessity for dental services;
(4) dental claims processing;
(5) coordination of dental care with other services;
(6) management of fraud and abuse;
(7) monitoring access to dental services;
(8) performance measurement;
(9) quality improvement and evaluation; and
(10) management of third-party liability requirements.
deleted text begin
(c) Dental administrator payments to contracted dental providers must be at the rates
established under sections 256B.76 and 256L.11.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end Recipients must be given a choice of dental provider, including any provider who
agrees to provider participation requirements and payment rates established by the
commissioner and dental administrator. The dental administrator must comply with the
network adequacy and geographic access requirements that apply to managed care and
county-based purchasing plans for dental services under section 62K.14.
deleted text begin (e)deleted text end new text begin (d)new text end The contract with the dental administrator must include a provision that states
that if the dental administrator fails to meet, by calendar year deleted text begin 2029deleted text end new text begin 2032new text end , a performance
benchmark under which at least 55 percent of children and adults who were continuously
enrolled for at least 11 months in either medical assistance or MinnesotaCare received at
least one dental visit during the calendar year, the contract must be terminated and the
commissioner must enter into a contract with a new dental administrator as soon as
practicable.
deleted text begin (f)deleted text end new text begin (e)new text end The commissioner shall implement this subdivision in consultation with
representatives of providers who provide dental services to patients enrolled in medical
assistance or MinnesotaCare, including but not limited to providers serving primarily
low-income and socioeconomically complex populations, and with representatives of
managed care plans and county-based purchasing plans.
Sec. 3.
Minnesota Statutes 2024, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 77. new text end
new text begin Vasectomies. new text end
new text begin
(a) Medical assistance covers vasectomies.
new text end
new text begin
(b) Medical assistance must meet the requirements with respect to coverage of
vasectomies that would otherwise apply to a health plan under section 62Q.522, except that
medical assistance is not required to comply with any provision of section 62Q.522 if
compliance with the provision would:
new text end
new text begin
(1) prevent the state from receiving federal financial participation for the coverage under
this subdivision;
new text end
new text begin
(2) result in a lower level of coverage or reduced access to coverage for medical assistance
enrollees; or
new text end
new text begin
(3) violate Code of Federal Regulations, title 42, part 441, subpart F.
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. 4.
Minnesota Statutes 2024, section 256B.76, is amended by adding a subdivision to
read:
new text begin Subd. 1a. new text end
new text begin Certain long-term ambulatory electrocardiogram monitoring services. new text end
new text begin
(a)
For the purpose of this subdivision, "long-term ambulatory electrocardiogram monitoring
services" means the provision of external cardiac patch monitoring devices to patients to
wear for 48 hours or greater and the interpretation of data gathered by such devices to detect
heart arrhythmias that can lead to stroke, cardiac arrest, or other comorbidities or medical
complications if not correctly diagnosed.
new text end
new text begin
(b) Effective January 1, 2026, or upon federal approval, whichever is later, the
commissioner must reimburse diagnostic testing facilities providing long-term ambulatory
electrocardiogram monitoring services at 100 percent of the Medicare Physician Fee Schedule
rate for such services or higher.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
ARTICLE 8
BEHAVIORAL HEALTH
Section 1.
Minnesota Statutes 2024, section 245.462, subdivision 20, is amended to read:
Subd. 20.
Mental illness.
(a) "Mental illness" means an organic disorder of the brain or
a clinically significant disorder of thought, mood, perception, orientation, memory, or
behavior that is detailed in a diagnostic codes list published by the commissioner, and that
seriously limits a person's capacity to function in primary aspects of daily living such as
personal relations, living arrangements, work, and recreation.
(b) An "adult with acute mental illness" means an adult who has a mental illness that is
serious enough to require prompt intervention.
(c) For purposes of new text begin enrolling in new text end case management and community support services, a
"person with serious and persistent mental illness" means an adult who has a mental illness
and meets at least one of the following criteria:
(1) the adult has undergone deleted text begin twodeleted text end new text begin onenew text end or more episodes of inpatientnew text begin , residential, or crisis
residentialnew text end care for a mental illness within the preceding deleted text begin 24deleted text end new text begin 12new text end months;
(2) the adult has experienced a continuous psychiatric hospitalization or residential
treatment exceeding six months' duration within the preceding 12 months;
(3) the adult has been treated by a crisis team two or more times within the preceding
24 months;
(4) the adult:
(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, schizoaffective
disorder, new text begin post-traumatic stress disorder, generalized anxiety disorder, panic disorder, eating
disorder, new text end or borderline personality disorder;
(ii) indicates a significant impairment in functioning; and
(iii) has a written opinion from a mental health professional, in the last three years,
stating that the adult is reasonably likely to have future episodes requiring inpatient or
residential treatment, of a frequency described in clause (1) or (2), new text begin or the need for in-home
services to remain in one's home, new text end unless ongoing case management or community support
services are provided;
(5) the adult has, in the last deleted text begin threedeleted text end new text begin five new text end years, been committed by a court as a person deleted text begin who
is mentally illdeleted text end new text begin with a mental illnessnew text end under chapter 253B, or the adult's commitment has been
stayed or continued;new text begin or
new text end
deleted text begin
(6) the adult (i) was eligible under clauses (1) to (5), but the specified time period has
expired or the adult was eligible as a child under section 245.4871, subdivision 6; and (ii)
has a written opinion from a mental health professional, in the last three years, stating that
the adult is reasonably likely to have future episodes requiring inpatient or residential
treatment, of a frequency described in clause (1) or (2), unless ongoing case management
or community support services are provided; or
deleted text end
deleted text begin (7)deleted text end new text begin (6)new text end the adult was eligible as a child under section 245.4871, subdivision 6, and is
age 21 or younger.
new text begin
(d) For purposes of enrolling in case management and community support services, a
"person with a complex post-traumatic stress disorder" or "C-PTSD" means an adult who
has a mental illness and meets the following criteria:
new text end
new text begin
(1) the adult has post-traumatic stress disorder (PTSD) symptoms that significantly
interfere with daily functioning related to intergenerational trauma, racial trauma, or
unresolved historical grief; and
new text end
new text begin
(2) the adult has a written opinion from a mental health professional that includes
documentation of:
new text end
new text begin
(i) culturally sensitive assessments or screenings and identification of intergenerational
trauma, racial trauma, or unresolved historical grief;
new text end
new text begin
(ii) significant impairment in functioning due to the PTSD symptoms that meet C-PTSD
condition eligibility; and
new text end
new text begin
(iii) increasing concerns within the last three years that indicates the adult is at a
reasonable likelihood of experiencing significant episodes of PTSD with increased frequency,
impacting daily functioning unless mitigated by targeted case management or community
support services.
new text end
new text begin
(e) Adults may continue to receive case management or community support services if,
in the written opinion of a mental health professional, the person needs case management
or community support services to maintain the person's recovery.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (d) is effective upon federal approval. 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 245.4661, subdivision 2, is amended to read:
Subd. 2.
Program design and implementation.
Adult mental health initiatives shall
be responsible for designing, planning, improving, and maintaining a mental health service
delivery system for adults with serious and persistent mental illness that would:
(1) provide an expanded array of services from which clients can choose services
appropriate to their needs;
(2) be based on purchasing strategies that improve access and coordinate services without
cost shifting;
(3) prioritize evidence-based services and implement services that are promising practices
or theory-based practices so that the service can be evaluated according to subdivision 5a;
(4) incorporate existing state facilities and resources into the community mental health
infrastructure through creative partnerships with local vendors; and
(5) utilize deleted text begin existing categorical funding streams and reimbursement sources in combined
and creative ways, exceptdeleted text end new text begin adult mental health initiative funding only after all other eligible
funding sources have been applied.new text end Appropriations and all funds that are attributable to the
operation of state-operated services under the control of the Direct Care and Treatment
executive board are excluded unless appropriated specifically by the legislature for a purpose
consistent with this section.
Sec. 3.
Minnesota Statutes 2024, section 245.4661, subdivision 6, is amended to read:
Subd. 6.
Duties of commissioner.
(a) For purposes of adult mental health initiatives,
the commissioner shall facilitate integration of funds or other resources as needed and
requested by each adult mental health initiative. These resources may include:
(1) community support services funds administered under Minnesota Rules, parts
9535.1700 to 9535.1760;
(2) other mental health special project funds;
(3) medical assistance, MinnesotaCare, and housing support under chapter 256I if
requested by the adult mental health initiative's managing entity and if the commissioner
determines this would be consistent with the state's overall health care reform efforts; and
(4) regional treatment center resources, with consent from the Direct Care and Treatment
executive board.
deleted text begin
(b) The commissioner shall consider the following criteria in awarding grants for adult
mental health initiatives:
deleted text end
deleted text begin
(1) the ability of the initiatives to accomplish the objectives described in subdivision 2;
deleted text end
deleted text begin
(2) the size of the target population to be served; and
deleted text end
deleted text begin
(3) geographical distribution.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end The commissioner shall review overall status of the initiatives at least every two
years and recommend any legislative changes needed by January 15 of each odd-numbered
year.
deleted text begin (d)deleted text end new text begin (c)new text end The commissioner may waive administrative rule requirements that are
incompatible with the implementation of the adult mental health initiative.
deleted text begin (e)deleted text end new text begin (d)new text end The commissioner may exempt the participating counties from fiscal sanctions
for noncompliance with requirements in laws and rules that are incompatible with the
implementation of the adult mental health initiative.
deleted text begin (f)deleted text end new text begin (e)new text end The commissioner may award grants to an entity designated by a county board
or group of county boards to pay for start-up and implementation costs of the adult mental
health initiative.
Sec. 4.
Minnesota Statutes 2024, section 245.4661, subdivision 7, is amended to read:
Subd. 7.
Duties of adult mental health initiative board.
The adult mental health
initiative board, or other entity which is approved to administer an adult mental health
initiative, shall:
(1) administer the initiative in a manner that is consistent with the objectives described
in subdivision 2 and the planning process described in subdivision 5;
(2) assure that no one is denied services that they would otherwise be eligible for; and
(3) provide the commissioner of human services with timely and pertinent information
through the deleted text begin following methods:
deleted text end
deleted text begin
(i) submission of mental health plans and plan amendments which are based on a format
and timetable determined by the commissioner;
deleted text end
deleted text begin
(ii) submission of social services expenditure and grant reconciliation reports, based on
a coding format to be determined by mutual agreement between the initiative's managing
entity and the commissioner; and
deleted text end
deleted text begin (iii)deleted text end submission of data and participation in an evaluation of the adult mental health
initiatives, to be designed cooperatively by the commissioner and the initiatives.new text begin For services
provided to American Indians in Tribal Nations or urban Indian communities, oral reports
using a system designed in partnership between the commissioner and the reporting
community satisfy the requirements of this clause.
new text end
Sec. 5.
Minnesota Statutes 2024, section 245.467, subdivision 4, is amended to read:
Subd. 4.
Referral for case management.
Each provider of emergency services, day
treatment services, outpatient treatment, community support services, residential treatment,
acute care hospital inpatient treatment, or regional treatment center inpatient treatment must
inform each of its clients with serious and persistent mental illness new text begin or a complex
post-traumatic stress disorder new text end of the availability and potential benefits to the client of case
management. If the client consents, the provider must refer the client by notifying the county
employee designated by the county board to coordinate case management activities of the
client's name and address and by informing the client of whom to contact to request case
management. The provider must document compliance with this subdivision in the client's
record.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. 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 245.4711, subdivision 1, is amended to read:
Subdivision 1.
Availability of case management services.
(a) deleted text begin By January 1, 1989,deleted text end The
county board shall provide case management services for all adults with serious and persistent
mental illness new text begin or a complex post-traumatic stress disorder new text end who are residents of the county
and who request or consent to the services and to each adult for whom the court appoints a
case manager. Staffing ratios must be sufficient to serve the needs of the clients. The case
manager must meet the requirements in section 245.462, subdivision 4.
(b) Case management services provided to adults with serious and persistent mental
illnessnew text begin or a complex post-traumatic stress disordernew text end eligible for medical assistance must be
billed to the medical assistance program under sections 256B.02, subdivision 8, and
256B.0625.
(c) Case management services are eligible for reimbursement under the medical assistance
program. Costs associated with mentoring, supervision, and continuing education may be
included in the reimbursement rate methodology used for case management services under
the medical assistance program.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. 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 245.4711, subdivision 4, is amended to read:
Subd. 4.
Individual community support plan.
(a) The case manager must develop an
individual community support plan for each adult that incorporates the client's individual
treatment plan. The individual treatment plan may not be a substitute for the development
of an individual community support plan. The individual community support plan must be
developed within 30 days of client intake and reviewed at least every 180 days after it is
developed, unless the case manager receives a written request from the client or the client's
family for a review of the plan every 90 days after it is developed. The case manager is
responsible for developing the individual community support plan based on a diagnostic
assessment and a functional assessment and for implementing and monitoring the delivery
of services according to the individual community support plan. To the extent possible, the
adult with serious and persistent mental illnessnew text begin or a complex post-traumatic stress disordernew text end ,
the person's family, advocates, service providers, and significant others must be involved
in all phases of development and implementation of the individual community support plan.
(b) The client's individual community support plan must state:
(1) the goals of each service;
(2) the activities for accomplishing each goal;
(3) a schedule for each activity; and
(4) the frequency of face-to-face contacts by the case manager, as appropriate to client
need and the implementation of the individual community support plan.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 8.
Minnesota Statutes 2024, section 245.4712, subdivision 1, is amended to read:
Subdivision 1.
Availability of community support services.
(a) County boards must
provide or contract for sufficient community support services within the county to meet the
needs of adults with serious and persistent mental illness new text begin or a complex post-traumatic stress
disorder new text end who are residents of the county. Adults may be required to pay a fee according to
section 245.481. The community support services program must be designed to improve
the ability of adults with serious and persistent mental illnessnew text begin or a complex post-traumatic
stress disordernew text end to:
(1) find and maintain competitive employment;
(2) handle basic activities of daily living;
(3) participate in leisure time activities;
(4) set goals and plans; and
(5) obtain and maintain appropriate living arrangements.
The community support services program must also be designed to reduce the need for
and use of more intensive, costly, or restrictive placements both in number of admissions
and length of stay.
(b) Community support services are those services that are supportive in nature and not
necessarily treatment oriented, and include:
(1) conducting outreach activities such as home visits, health and wellness checks, and
problem solving;
(2) connecting people to resources to meet their basic needs;
(3) finding, securing, and supporting people in their housing;
(4) attaining and maintaining health insurance benefits;
(5) assisting with job applications, finding and maintaining employment, and securing
a stable financial situation;
(6) fostering social support, including support groups, mentoring, peer support, and other
efforts to prevent isolation and promote recovery; and
(7) educating about mental illness, treatment, and recovery.
(c) Community support services shall use all available funding streams. The county shall
maintain the level of expenditures for this program, as required under section 245.4835.
County boards must continue to provide funds for those services not covered by other
funding streams and to maintain an infrastructure to carry out these services. The county is
encouraged to fund evidence-based practices such as Individual Placement and Supported
Employment and Illness Management and Recovery.
(d) The commissioner shall collect data on community support services programs,
including, but not limited to, demographic information such as age, sex, race, the number
of people served, and information related to housing, employment, hospitalization, symptoms,
and satisfaction with services.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 9.
Minnesota Statutes 2024, section 245.4712, subdivision 3, is amended to read:
Subd. 3.
Benefits assistance.
The county board must offer to help adults with serious
and persistent mental illnessnew text begin or a complex post-traumatic stress disordernew text end in applying for
state and federal benefits, including Supplemental Security Income, medical assistance,
Medicare, general assistance, and Minnesota supplemental aid. The help must be offered
as part of the community support program available to adults with serious and persistent
mental illnessnew text begin or a complex post-traumatic stress disordernew text end for whom the county is financially
responsible and who may qualify for these benefits.
Sec. 10.
Minnesota Statutes 2024, section 245.4871, subdivision 5, is amended to read:
Subd. 5.
Child.
"Child" means a person under 18 years of agenew text begin , or a person 18 years of
age or older and under 21 years of age receiving continuous children's mental health targeted
case management services as defined in section 245.4875, subdivision 8new text end .
Sec. 11.
Minnesota Statutes 2024, section 245.4889, subdivision 1, is amended to read:
Subdivision 1.
Establishment and authority.
(a) The commissioner is authorized to
make grants from available appropriations to assist:
(1) counties;
(2) Indian tribes;
(3) children's collaboratives under section 142D.15 or 245.493; or
(4) mental health service providers.
(b) The following services are eligible for grants under this section:
(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;
(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;
(3) respite care services for children with emotional disturbances or severe emotional
disturbances who are at risk of residential treatment or hospitalization, who are already in
out-of-home placement in family foster settings as defined in chapter 142B and at risk of
change in out-of-home placement or placement in a residential facility or other higher level
of care, who have utilized crisis services or emergency room services, or who have
experienced a loss of in-home staffing support. Allowable activities and expenses for respite
care services are defined under subdivision 4. A child is not required to have case
management services to receive respite care services. Counties must work to provide access
to regularly scheduled respite care;
(4) children's mental health crisis services;
(5) child-, youth-, and family-specific mobile response and stabilization services models;
(6) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;
(7) children's mental health screening and follow-up diagnostic assessment and treatment;
(8) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;
(9) school-linked mental health services under section 245.4901;
(10) building evidence-based mental health intervention capacity for children birth to
age five;
(11) suicide prevention and counseling services that use text messaging statewide;
(12) mental health first aid training;
(13) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
website to share information and strategies to promote resilience and prevent trauma;
(14) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;
(15) early childhood mental health consultation;
(16) evidence-based interventions for youth at risk of developing or experiencing a first
episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis;
(17) psychiatric consultation for primary care practitioners; deleted text begin and
deleted text end
(18) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grantsnew text begin ; and
new text end
new text begin (19) evidence-based interventions for youth and young adults at risk of developing or
experiencing an early episode of bipolar disordernew text end .
(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.
(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
reimbursement sources, if applicable.
(e) The commissioner may establish and design a pilot program to expand the mobile
response and stabilization services model for children, youth, and families. The commissioner
may use grant funding to consult with a qualified expert entity to assist in the formulation
of measurable outcomes and explore and position the state to submit a Medicaid state plan
amendment to scale the model statewide.
Sec. 12.
Minnesota Statutes 2024, section 245.4905, is amended to read:
245.4905 FIRST EPISODE OF PSYCHOSIS new text begin AND EARLY EPISODE OF
BIPOLAR DISORDER new text end GRANT PROGRAM.
Subdivision 1.
deleted text begin Creationdeleted text end new text begin Establishmentnew text end .
The new text begin commissioner of human services must
establish the new text end first episode of psychosis new text begin and early episode of bipolar disorder new text end grant program
deleted text begin is established in the Department of Human Servicesdeleted text end new text begin within the departmentnew text end to fundnew text begin : (1)new text end
evidence-based interventions for youth new text begin and young adults new text end at risk of developing or experiencing
a first episode of psychosis new text begin or an early episode of bipolar disorder; new text end andnew text begin (2)new text end a public awareness
campaign on the signs and symptoms of psychosis. deleted text begin First episode of psychosis services are
eligible for children's mental health grants as specified in section 245.4889, subdivision 1,
paragraph (b), clause (15)deleted text end new text begin For purposes of this section, "youth and young adults" means
individuals who are 15 years of age or older and under 41 years of agenew text end .
Subd. 2.
Activities.
(a) All first episode of psychosis deleted text begin grant programsdeleted text end new text begin or early episode
of bipolar disorder granteesnew text end must:
(1) provide intensive treatment and support for deleted text begin adolescents anddeleted text end new text begin youth and youngnew text end adults
experiencing or at risk of experiencing a first deleted text begin psychoticdeleted text end episodenew text begin of psychosis or early episodes
of bipolar disordernew text end . Intensive treatment and support deleted text begin includesdeleted text end new text begin may includenew text end medication
management, psychoeducation for an individual and an individual's family, case management,
employment support, education support, cognitive behavioral approaches, social skills
training, peer new text begin and family peer new text end support, crisis planning, and stress management;
(2) conduct outreach and provide training and guidance to mental health and health care
professionals, including postsecondary health clinicians, on early psychosis new text begin and bipolar
disorder new text end symptoms, screening tools, and best practices;
(3) ensure access for individuals to first deleted text begin psychoticdeleted text end episode new text begin of psychosis new text end services under
this section, including access for individuals who live in rural areas; and
(4) use all available funding streams.
(b) Grant money may deleted text begin alsodeleted text end be used to pay for housing or travel expenses for individuals
receiving services or to address other barriers preventing individuals and their families from
participating in first deleted text begin psychoticdeleted text end episode new text begin of psychosis new text end services.
Subd. 3.
deleted text begin Eligibilitydeleted text end new text begin Fundingnew text end .
deleted text begin Program activities must be provided to people 15 to 40
years old with early signs of psychosisdeleted text end new text begin First episode of psychosis services and early episode
of bipolar disorder services are eligible for children's mental health grants as specified in
section 245.4889, subdivision 1, paragraph (b), clauses (16) and (19)new text end .
Subd. 4.
Outcomes.
new text begin
(a) The commissioner must annually evaluate the first episode of
psychosis and early episode of bipolar disorder grant program.
new text end
new text begin (b) The new text end evaluation deleted text begin of program activitiesdeleted text end must utilize evidence-based practices and must
include the following outcome evaluation criteria:
(1) whether individuals experience a reduction in deleted text begin psychoticdeleted text end symptoms;
(2) whether individuals experience a decrease in inpatient mental health hospitalizationsnew text begin
or interactions with the criminal justice systemnew text end ; and
(3) whether individuals experience an increase in educational attainmentnew text begin or employmentnew text end .
new text begin
(c) By July 1, 2026, and every July 1 thereafter, the commissioner must provide a report
to the chairs and ranking minority members of the legislative committees with jurisdiction
over behavioral health, along with the chairs and ranking minority members of the senate
finance committee and house of representatives ways and means committee. The report
must include the number of grantees receiving funds under this section, the number of
individuals served under this section, data from the evaluation conducted under this
subdivision, and information on the use of state and federal funds for the services provided
under this section.
new text end
Subd. 5.
Federal aid or grants.
The commissioner of human services must comply with
all conditions and requirements necessary to receive federal aid or grants.
Sec. 13.
Minnesota Statutes 2024, section 256B.0625, subdivision 20, is amended to read:
Subd. 20.
Mental health case management.
(a) To the extent authorized by rule of the
state agency, medical assistance covers case management services to persons with serious
and persistent mental illnessnew text begin , persons with a complex post-traumatic stress disorder,new text end and
children with severe emotional disturbance. Services provided under this section must meet
the relevant standards in sections 245.461 to 245.4887, the Comprehensive Adult and
Children's Mental Health Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and
9505.0322, excluding subpart 10.
(b) Entities meeting program standards set out in rules governing family community
support services as defined in section 245.4871, subdivision 17, are eligible for medical
assistance reimbursement for case management services for children with severe emotional
disturbance when these services meet the program standards in Minnesota Rules, parts
9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
(c) Medical assistance and MinnesotaCare payment for mental health case management
shall be made on a monthly basis. In order to receive payment for an eligible child, the
provider must document at least a face-to-face contact either in person or by interactive
video that meets the requirements of subdivision 20b with the child, the child's parents, or
the child's legal representative. To receive payment for an eligible adult, the provider must
document:
(1) at least a face-to-face contact with the adult or the adult's legal representative either
in person or by interactive video that meets the requirements of subdivision 20b; or
(2) at least a telephone contact with the adult or the adult's legal representative and
document a face-to-face contact either in person or by interactive video that meets the
requirements of subdivision 20b with the adult or the adult's legal representative within the
preceding two months.
(d) Payment for mental health case management provided by county or state staff shall
be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
(b), with separate rates calculated for child welfare and mental health, and within mental
health, separate rates for children and adults.
(e) Payment for mental health case management provided by Indian health services or
by agencies operated by Indian tribes may be made according to this section or other relevant
federally approved rate setting methodology.
(f) Payment for mental health case management provided by vendors who contract with
a county must be calculated in accordance with section 256B.076, subdivision 2. Payment
for mental health case management provided by vendors who contract with a Tribe must
be based on a monthly rate negotiated by the Tribe. The rate must not exceed the rate charged
by the vendor for the same service to other payers. If the service is provided by a team of
contracted vendors, the team shall determine how to distribute the rate among its members.
No reimbursement received by contracted vendors shall be returned to the county or tribe,
except to reimburse the county or tribe for advance funding provided by the county or tribe
to the vendor.
(g) If the service is provided by a team which includes contracted vendors, tribal staff,
and county or state staff, the costs for county or state staff participation in the team shall be
included in the rate for county-provided services. In this case, the contracted vendor, the
tribal agency, and the county may each receive separate payment for services provided by
each entity in the same month. In order to prevent duplication of services, each entity must
document, in the recipient's file, the need for team case management and a description of
the roles of the team members.
(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
mental health case management shall be provided by the recipient's county of responsibility,
as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
without a federal share through fee-for-service, 50 percent of the cost shall be provided by
the recipient's county of responsibility.
(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
and MinnesotaCare include mental health case management. When the service is provided
through prepaid capitation, the nonfederal share is paid by the state and the county pays no
share.
(j) The commissioner may suspend, reduce, or terminate the 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, or, if applicable, the tribal agency,
is responsible for any federal disallowances. The county or tribe may share this responsibility
with its contracted vendors.
(k) The commissioner shall set aside a portion of the federal funds earned for county
expenditures under this section to repay the special revenue maximization account under
section 256.01, subdivision 2, paragraph (n). The repayment is limited to:
(1) the costs of developing and implementing this section; and
(2) programming the information systems.
(l) Payments to counties and tribal agencies for case management expenditures under
this section shall only be made from federal earnings from services provided under this
section. When this service is paid by the state without a federal share through fee-for-service,
50 percent of the cost shall be provided by the state. Payments to county-contracted vendors
shall include the federal earnings, the state share, and the county share.
(m) Case management services under this subdivision do not include therapy, treatment,
legal, or outreach services.
(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
and the recipient's institutional care is paid by medical assistance, payment for case
management services under this subdivision is limited to the lesser of:
(1) the last 180 days of the recipient's residency in that facility and may not exceed more
than six months in a calendar year; or
(2) the limits and conditions which apply to federal Medicaid funding for this service.
(o) Payment for case management services under this subdivision shall not duplicate
payments made under other program authorities for the same purpose.
(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
mental health targeted case management services must actively support identification of
community alternatives for the recipient and discharge planning.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 14. new text begin MENTAL HEALTH COLLABORATION HUB INNOVATION PILOT
PROGRAM.
new text end
new text begin
(a) The commissioner of human services must support the Mental Health Collaboration
Hub's pilot project to develop and implement innovative care pathways and care facility
decompression strategies by providing funding support and technical assistance and entering
into a data-sharing agreement with the Mental Health Collaboration Hub. The pilot project
must fund, track, and evaluate activities that expedite transitions of children from
inappropriate care settings to appropriate care settings. A steering committee of expert
Mental Health Collaboration Hub participants that represent the continuum of children's
behavioral health care must guide funding determinations to support the transition of up to
200 children per year.
new text end
new text begin
(b) On January 1, 2027, and January 1, 2028, the Mental Health Collaboration Hub must
submit a report to the commissioner and chairs and ranking minority members of the
legislative committees with jurisdiction over children's mental health and juvenile detention.
The report must describe how the grant money was spent and summarize the impact the
pilot project had on participating children, families, and providers.
new text end
Sec. 15. new text begin PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY REPORT.
new text end
new text begin
(a) By January 15, 2026, the commissioner of human services, in consultation with
organizations operating psychiatric residential treatment facilities, advocates, health care
experts, juvenile detention experts, and county representatives, must submit a report and
proposed legislative changes to the chairs and ranking minority members of the legislative
committees with jurisdiction over children's mental health and juvenile detention. The
submitted report must include recommendations on:
new text end
new text begin
(1) amending the state medical assistance plan to expand access to care provided in
psychiatric residential treatment facilities, with consideration being given to enhancing
flexibilities to serve a continuum of mental health needs;
new text end
new text begin
(2) developing licensing standards for psychiatric residential treatment facilities that
reflect needed flexibilities and the broad inclusion of settings where care can be delivered;
and
new text end
new text begin
(3) updating the rate methodology for services provided in psychiatric residential
treatment facilities to assure high quality of care with required individualization.
new text end
new text begin
(b) When developing the recommendations required under paragraph (a), the
commissioner must:
new text end
new text begin
(1) consider how best to meet the needs of children with high levels of complexity,
aggression, and other related barriers to being served by community providers; and
new text end
new text begin
(2) determine what would be required, including needed infrastructure, staffing, and
sustainable funding sources, to allow qualified residential treatment programs to transition
to a psychiatric residential treatment facility standard of care.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
ARTICLE 9
BEHAVIORAL HEALTH POLICY
Section 1.
Minnesota Statutes 2024, section 144.651, subdivision 2, is amended to read:
Subd. 2.
Definitions.
For the purposes of this section, "patient" means a person who is
admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for
the purpose of diagnosis or treatment bearing on the physical or mental health of that person.
For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, "patient" also means a
person who receives health care services at an outpatient surgical center or at a birth center
licensed under section 144.615. "Patient" also means a minor who is admitted to a residential
program as defined in section 253C.01. For purposes of subdivisions 1, 3 to 16, 18, 20 and
30, "patient" also means any person who is receiving mental health treatment on an outpatient
basis or in a community support program or other community-based program. "Resident"
means a person who is admitted to a nonacute care facility including extended care facilities,
nursing homes, and boarding care homes for care required because of prolonged mental or
physical illness or disability, recovery from injury or disease, or advancing age. For purposes
of all subdivisions except subdivisions 28 and 29, "resident" also means a person who is
admitted to a facility licensed as a board and lodging facility under Minnesota Rules, parts
4625.0100 to 4625.2355, a boarding care home under sections 144.50 to 144.56, or a
supervised living facility under Minnesota Rules, parts 4665.0100 to 4665.9900, and which
operates a rehabilitation program licensed under chapter 245G or 245I, or Minnesota Rules,
parts 9530.6510 to 9530.6590.new text begin For purposes of all subdivisions except subdivisions 20, 28,
29, 32, and 33, resident also means a person who is admitted to a facility licensed to provide
intensive residential treatment services or residential crisis stabilization under section
245I.23.
new text end
Sec. 2.
Minnesota Statutes 2024, section 245.462, subdivision 4, is amended to read:
Subd. 4.
Case management service provider.
(a) "Case management service provider"
means a case manager or case manager associate employed by the county or other entity
authorized by the county board to provide case management services specified in section
245.4711.
(b) A case manager must:
(1) be skilled in the process of identifying and assessing a wide range of client needs;
(2) be knowledgeable about local community resources and how to use those resources
for the benefit of the client;
(3) be a mental health practitioner as defined in section 245I.04, subdivision 4, or have
a bachelor's degree in one of the behavioral sciences or related fields including, but not
limited to, social work, psychology, or nursing from an accredited college or university. A
case manager who is not a mental health practitioner deleted text begin anddeleted text end new text begin ornew text end who does not have a bachelor's
degree in one of the behavioral sciences or related fields must meet the requirements of
paragraph (c); and
(4) meet the supervision and continuing education requirements described in paragraphs
(d), (e), and (f), as applicable.
(c) Case managers without a bachelor's degreenew text begin or with a bachelor's degree that is not in
one of the behavioral sciences or related fieldsnew text end must meet one of the requirements in clauses
(1) to deleted text begin (3)deleted text end new text begin (5)new text end :
(1) have three or four years of experience as a case manager associate as defined in this
section;
(2) be a registered nurse without a bachelor's degree and have a combination of
specialized training in psychiatry and work experience consisting of community interaction
and involvement or community discharge planning in a mental health setting totaling three
years; deleted text begin or
deleted text end
(3) be a person who qualified as a case manager under the 1998 Department of Human
Service waiver provision and meet the continuing education and mentoring requirements
in this sectiondeleted text begin .deleted text end new text begin ;
new text end
new text begin
(4) prior to direct service delivery, complete at least 80 hours of specific training on the
characteristics and needs of adults with serious and persistent mental illness that is consistent
with national practice standards; or
new text end
new text begin
(5) prior to direct service delivery, demonstrate competency in practice and knowledge
of the characteristics and needs of adults with serious and persistent mental illness, consistent
with national practice standards.
new text end
(d) A case manager with at least 2,000 hours of supervised experience in the delivery
of services to adults with mental illness must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year of which at least one hour per month must be clinical
supervision regarding individual service delivery with a case management supervisor. The
remaining 26 hours of supervision may be provided by a case manager with two years of
experience. Group supervision may not constitute more than one-half of the required
supervision hours. Clinical supervision must be documented in the client record.
(e) A case manager without 2,000 hours of supervised experience in the delivery of
services to adults with mental illness must:
(1) receive clinical supervision regarding individual service delivery from a mental
health professional at least one hour per week until the requirement of 2,000 hours of
experience is met; and
(2) complete 40 hours of training approved by the commissioner in case management
skills and the characteristics and needs of adults with serious and persistent mental illness.
(f) A case manager who is not licensed, registered, or certified by a health-related
licensing board must receive 30 hours of continuing education and training in mental illness
and mental health services every two years.
(g) A case manager associate (CMA) must:
(1) work under the direction of a case manager or case management supervisor;
(2) be at least 21 years of age;
(3) have at least a high school diploma or its equivalent; and
(4) meet one of the following criteria:
(i) have an associate of arts degree in one of the behavioral sciences or human services;
(ii) be a certified peer specialist under section 256B.0615;
(iii) be a registered nurse without a bachelor's degree;
(iv) within the previous ten years, have three years of life experience with serious and
persistent mental illness as defined in subdivision 20; or as a child had severe emotional
disturbance as defined in section 245.4871, subdivision 6; or have three years life experience
as a primary caregiver to an adult with serious and persistent mental illness within the
previous ten years;
(v) have 6,000 hours work experience as a nondegreed state hospital technician; or
(vi) have at least 6,000 hours of supervised experience in the delivery of services to
persons with mental illness.
Individuals meeting one of the criteria in items (i) to (v) may qualify as a case manager
after four years of supervised work experience as a case manager associate. Individuals
meeting the criteria in item (vi) may qualify as a case manager after three years of supervised
experience as a case manager associate.
(h) A case management associate must meet the following supervision, mentoring, and
continuing education requirements:
(1) have 40 hours of preservice training described under paragraph (e), clause (2);
(2) receive deleted text begin at least 40 hours ofdeleted text end new text begin annualnew text end continuing education in mental illness and mental
health services deleted text begin annually; anddeleted text end new text begin according to the following schedule, based on years of service
as a case management associate:
new text end
new text begin
(i) at least 40 hours in the first year;
new text end
new text begin
(ii) at least 30 hours in the second year;
new text end
new text begin
(iii) at least 20 hours in the third year; and
new text end
new text begin
(iv) at least 20 hours in the fourth year; and
new text end
(3) receive at least deleted text begin fivedeleted text end new text begin fournew text end hours of deleted text begin mentoringdeleted text end new text begin supervisionnew text end per deleted text begin weekdeleted text end new text begin monthnew text end from a case
management deleted text begin mentordeleted text end new text begin supervisornew text end .
deleted text begin
A "case management mentor" means a qualified, practicing case manager or case management
supervisor who teaches or advises and provides intensive training and clinical supervision
to one or more case manager associates. Mentoring may occur while providing direct services
to consumers in the office or in the field and may be provided to individuals or groups of
case manager associates. At least two mentoring hours per week must be individual and
face-to-face.
deleted text end
(i) A case management supervisor must meet the criteria for mental health professionals,
as specified in subdivision 18.
(j) An immigrant who does not have the qualifications specified in this subdivision may
provide case management services to adult immigrants with serious and persistent mental
illness who are members of the same ethnic group as the case manager if the person:
(1) is currently enrolled in and is actively pursuing credits toward the completion of a
bachelor's degree in one of the behavioral sciences or a related field including, but not
limited to, social work, psychology, or nursing from an accredited college or university;
(2) completes 40 hours of training as specified in this subdivision; and
(3) receives clinical supervision at least once a week until the requirements of this
subdivision are met.
Sec. 3.
Minnesota Statutes 2024, section 245.4661, subdivision 9, is amended to read:
Subd. 9.
Services and programs.
(a) The following three distinct grant programs are
funded under this section:
(1) mental health crisis services;
(2) housing with supports for adults with serious mental illness; and
(3) projects for assistance in transitioning from homelessness (PATH program).
(b) In addition, the following are eligible for grant funds:
(1) community education and prevention;
(2) client outreach;
(3) early identification and intervention;
(4) adult outpatient diagnostic assessment and psychological testing;
(5) peer support services;
(6) community support program services (CSP);
(7) adult residential crisis stabilization;
(8) supported employment;
(9) assertive community treatment (ACT);
(10) housing subsidies;
(11) basic living, social skills, and community intervention;
(12) emergency response services;
(13) adult outpatient psychotherapy;
(14) adult outpatient medication management;
(15) adult mobile crisis servicesnew text begin , including the purchase and renovation of vehicles by
mobile crisis teams in order to provide protected transport under section 256B.0625,
subdivision 17, paragraph (l), clause (6)new text end ;
(16) adult day treatment;
(17) partial hospitalization;
(18) adult residential treatment;
(19) adult mental health targeted case management; and
(20) transportation.
Sec. 4.
Minnesota Statutes 2024, section 245.469, is amended to read:
245.469 EMERGENCY SERVICES.
Subdivision 1.
Availability of emergency services.
(a) County boards must provide or
contract for enough emergency services within the county to meet the needs of adults,
children, and families in the county who are experiencing an emotional crisis or mental
illness. new text begin Clients must not be charged for services provided. new text end Emergency service providers
must deleted text begin not delay the timely provision of emergency services to a client because of the
unwillingness or inability of the client to pay for servicesdeleted text end new text begin meet the qualifications under
section 256B.0624, subdivision 4new text end . Emergency services must include assessment, crisis
intervention, and appropriate case disposition. Emergency services must:
(1) promote the safety and emotional stability of each client;
(2) minimize further deterioration of each client;
(3) help each client to obtain ongoing care and treatment;
(4) prevent placement in settings that are more intensive, costly, or restrictive than
necessary and appropriate to meet client needs; and
(5) provide support, psychoeducation, and referrals to each client's family members,
service providers, and other third parties on behalf of the client in need of emergency
services.
(b) If a county provides engagement services under section 253B.041, the county's
emergency service providers must refer clients to engagement services when the client
meets the criteria for engagement services.
Subd. 2.
Specific requirements.
(a) The county board shall require that all service
providers of emergency services to adults new text begin or children new text end with mental illness provide immediate
direct access to a mental health professional during regular business hours. For evenings,
weekends, and holidays, the service may be by direct toll-free telephone access to a mental
health professional, clinical trainee, or mental health practitioner.
(b) The commissioner may waive the requirement in paragraph (a) that the evening,
weekend, and holiday service be provided by a mental health professional, clinical trainee,
or mental health practitioner if the county documents that:
(1) mental health professionals, clinical trainees, or mental health practitioners are
unavailable to provide this service;
(2) services are provided by a designated person with training in human services who
receives treatment supervision from a mental health professional; and
(3) the service provider is not also the provider of fire and public safety emergency
services.
(c) The commissioner may waive the requirement in paragraph (b), clause (3), that the
evening, weekend, and holiday service not be provided by the provider of fire and public
safety emergency services if:
(1) every person who will be providing the first telephone contact has received at least
eight hours of training on emergency mental health services approved by the commissioner;
(2) every person who will be providing the first telephone contact will annually receive
at least four hours of continued training on emergency mental health services approved by
the commissioner;
(3) the local social service agency has provided public education about available
emergency mental health services and can assure potential users of emergency services that
their calls will be handled appropriately;
(4) the local social service agency agrees to provide the commissioner with accurate
data on the number of emergency mental health service calls received;
(5) the local social service agency agrees to monitor the frequency and quality of
emergency services; and
(6) the local social service agency describes how it will comply with paragraph (d).
(d) Whenever emergency service during nonbusiness hours is provided by anyone other
than a mental health professional, a mental health professional must be available on call for
an emergency assessment and crisis intervention services, and must be available for at least
telephone consultation within 30 minutes.
Subd. 3.
Mental health crisis services.
The commissioner of human services shall
increase access to mental health crisis services for children and adults. In order to increase
access, the commissioner must:
(1) deleted text begin develop a central phone number where calls can be routed to the appropriate crisis
servicesdeleted text end new text begin promote the 988 Lifelinenew text end ;
(2) provide telephone consultation 24 hours a day to mobile crisis teams who are serving
people with traumatic brain injury or intellectual disabilities who are experiencing a mental
health crisis;
(3) expand crisis services across the state, including rural areas of the state and examining
access per population;
(4) establish and implement state standards and requirements for crisis services as outlined
in section 256B.0624; and
(5) provide grants to adult mental health initiatives, counties, tribes, or community mental
health providers to establish new mental health crisis residential service capacity.
Priority will be given to regions that do not have a mental health crisis residential services
program, do not have an inpatient psychiatric unit within the region, do not have an inpatient
psychiatric unit within 90 miles, or have a demonstrated need based on the number of crisis
residential or intensive residential treatment beds available to meet the needs of the residents
in the region. At least 50 percent of the funds must be distributed to programs in rural
Minnesota. Grant funds may be used for start-up costs, including but not limited to
renovations, furnishings, and staff training. Grant applications shall provide details on how
the intended service will address identified needs and shall demonstrate collaboration with
crisis teams, other mental health providers, hospitals, and police.
Sec. 5.
Minnesota Statutes 2024, section 245.4871, subdivision 4, is amended to read:
Subd. 4.
Case management service provider.
(a) "Case management service provider"
means a case manager or case manager associate employed by the county or other entity
authorized by the county board to provide case management services specified in subdivision
3 for the child with severe emotional disturbance and the child's family.
(b) A case manager must:
(1) have experience and training in working with children;
(2) new text begin be a mental health practitioner under section 245I.04, subdivision 4, ornew text end have at least
a bachelor's degree in one of the behavioral sciences or a related field including, but not
limited to, social work, psychology, or nursing from an accredited college or university or
meet the requirements of paragraph (d);
(3) have experience and training in identifying and assessing a wide range of children's
needs;
(4) be knowledgeable about local community resources and how to use those resources
for the benefit of children and their families; and
(5) meet the supervision and continuing education requirements of paragraphs (e), (f),
and (g), as applicable.
(c) A case manager may be a member of any professional discipline that is part of the
local system of care for children established by the county board.
(d) A case manager deleted text begin without a bachelor's degreedeleted text end new text begin who is not a mental health practitioner
and does not have a bachelor's degree or who has a bachelor's degree that is not in one of
the behavioral sciences or related fieldsnew text end must meet one of the requirements in clauses (1)
to deleted text begin (3)deleted text end new text begin (5)new text end :
(1) have three or four years of experience as a case manager associate;
(2) be a registered nurse without a bachelor's degree who has a combination of specialized
training in psychiatry and work experience consisting of community interaction and
involvement or community discharge planning in a mental health setting totaling three years;
deleted text begin or
deleted text end
(3) be a person who qualified as a case manager under the 1998 Department of Human
Services waiver provision and meets the continuing education, supervision, and mentoring
requirements in this sectiondeleted text begin .deleted text end new text begin ;
new text end
new text begin
(4) prior to direct service delivery, complete at least 80 hours of specific training on the
characteristics and needs of children with severe emotional disturbance, consistent with
national practices standards; or
new text end
new text begin
(5) prior to direct service delivery, demonstrate competency in practice and knowledge
of the characteristics and needs of children with severe emotional disturbance, consistent
with national practices standards.
new text end
(e) A case manager with at least 2,000 hours of supervised experience in the delivery
of mental health services to children must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year, of which at least one hour per month must be clinical
supervision regarding individual service delivery with a case management supervisor. The
other 26 hours of supervision may be provided by a case manager with two years of
experience. Group supervision may not constitute more than one-half of the required
supervision hours.
(f) A case manager without 2,000 hours of supervised experience in the delivery of
mental health services to children with emotional disturbance must:
(1) begin 40 hours of training approved by the commissioner of human services in case
management skills and in the characteristics and needs of children with severe emotional
disturbance before beginning to provide case management services; and
(2) receive clinical supervision regarding individual service delivery from a mental
health professional at least one hour each week until the requirement of 2,000 hours of
experience is met.
(g) A case manager who is not licensed, registered, or certified by a health-related
licensing board must receive 30 hours of continuing education and training in severe
emotional disturbance and mental health services every two years.
(h) Clinical supervision must be documented in the child's record. When the case manager
is not a mental health professional, the county board must provide or contract for needed
clinical supervision.
(i) The county board must ensure that the case manager has the freedom to access and
coordinate the services within the local system of care that are needed by the child.
(j) A case manager associate (CMA) must:
(1) work under the direction of a case manager or case management supervisor;
(2) be at least 21 years of age;
(3) have at least a high school diploma or its equivalent; and
(4) meet one of the following criteria:
(i) have an associate of arts degree in one of the behavioral sciences or human services;
(ii) be a registered nurse without a bachelor's degree;
(iii) have three years of life experience as a primary caregiver to a child with serious
emotional disturbance as defined in subdivision 6 within the previous ten years;
(iv) have 6,000 hours work experience as a nondegreed state hospital technician; or
(v) have 6,000 hours of supervised work experience in the delivery of mental health
services to children with emotional disturbances; hours worked as a mental health behavioral
aide I or II under section 256B.0943, subdivision 7, may count toward the 6,000 hours of
supervised work experience.
Individuals meeting one of the criteria in items (i) to (iv) may qualify as a case manager
after four years of supervised work experience as a case manager associate. Individuals
meeting the criteria in item (v) may qualify as a case manager after three years of supervised
experience as a case manager associate.
(k) Case manager associates must meet the following supervision, mentoring, and
continuing education requirements;
(1) have 40 hours of preservice training described under paragraph (f), clause (1);
(2) receive at least 40 hours of continuing education in severe emotional disturbance
and mental health service annually; and
(3) receive at least five hours of mentoring per week from a case management mentor.
A "case management mentor" means a qualified, practicing case manager or case management
supervisor who teaches or advises and provides intensive training and clinical supervision
to one or more case manager associates. Mentoring may occur while providing direct services
to consumers in the office or in the field and may be provided to individuals or groups of
case manager associates. At least two mentoring hours per week must be individual and
face-to-face.
(l) A case management supervisor must meet the criteria for a mental health professional
as specified in subdivision 27.
(m) An immigrant who does not have the qualifications specified in this subdivision
may provide case management services to child immigrants with severe emotional
disturbance of the same ethnic group as the immigrant if the person:
(1) is currently enrolled in and is actively pursuing credits toward the completion of a
bachelor's degree in one of the behavioral sciences or related fields at an accredited college
or university;
(2) completes 40 hours of training as specified in this subdivision; and
(3) receives clinical supervision at least once a week until the requirements of obtaining
a bachelor's degree and 2,000 hours of supervised experience are met.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 6.
Minnesota Statutes 2024, section 245.4871, is amended by adding a subdivision
to read:
new text begin Subd. 7a. new text end
new text begin Clinical supervision. new text end
new text begin
"Clinical supervision" means the oversight responsibility
for individual treatment plans and individual mental health service delivery, including
oversight provided by the case manager. Clinical supervision must be provided by a mental
health professional. The supervising mental health professional must cosign an individual
treatment plan, and their name must be documented in the client's record.
new text end
Sec. 7.
Minnesota Statutes 2024, section 245.4881, subdivision 3, is amended to read:
Subd. 3.
Duties of case manager.
(a) Upon a determination of eligibility for case
management services, the case manager shall develop an individual family community
support plan for a child as specified in subdivision 4, review the child's progress, deleted text begin anddeleted text end monitor
the provision of servicesnew text begin , and if the child and parent or legal guardian consent, complete a
written functional assessment as defined by section 245.4871, subdivision 18anew text end . If services
are to be provided in a host county that is not the county of financial responsibility, the case
manager shall consult with the host county and obtain a letter demonstrating the concurrence
of the host county regarding the provision of services.
(b) The case manager shall note in the child's record the services needed by the child
and the child's family, the services requested by the family, services that are not available,
and the unmet needs of the child and child's family. The case manager shall note this
provision in the child's record.
Sec. 8.
Minnesota Statutes 2024, section 245.4901, subdivision 3, is amended to read:
Subd. 3.
Allowable grant activities and related expenses.
(a) Allowable grant activities
and related expenses may include but are not limited to:
(1) identifying and diagnosing mental health conditions and substance use disorders of
students;
(2) delivering mental health and substance use disorder treatment and services to students
and their families, including via telehealth consistent with section 256B.0625, subdivision
3b;
(3) supporting families in meeting their child's needs, including new text begin accessing needed mental
health services to support the parent in caregiving and new text end navigating health care, social service,
and juvenile justice systems;
(4) providing transportation for students receiving school-linked behavioral health
services when school is not in session;
(5) building the capacity of schools to meet the needs of students with mental health and
substance use disorder concerns, including school staff development activities for licensed
and nonlicensed staff; and
(6) purchasing equipment, connection charges, on-site coordination, set-up fees, and
site fees in order to deliver school-linked behavioral health services via telehealth.
(b) Grantees shall obtain all available third-party reimbursement sources as a condition
of receiving a grant. For purposes of this grant program, a third-party reimbursement source
excludes a public school as defined in section 120A.20, subdivision 1. Grantees shall serve
students regardless of health coverage status or ability to pay.
Sec. 9.
new text begin
[245.4904] INTERMEDIATE SCHOOL DISTRICT BEHAVIORAL HEALTH
GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of human services must establish a
grant program to improve behavioral health outcomes for youth attending a qualifying
school unit and to build the capacity of schools to support student and teacher needs in the
classroom. For purposes of this section, "qualifying school unit" means an intermediate
school district organized under section 136D.01.
new text end
new text begin Subd. 2. new text end
new text begin Eligible applicants. new text end
new text begin
An eligible applicant is an intermediate school district
organized under section 136D.01, and a partner entity or provider that has demonstrated
capacity to serve the youth identified in subdivision 1 that is:
new text end
new text begin
(1) a mental health clinic certified under section 245I.20;
new text end
new text begin
(2) a community mental health center under section 256B.0625, subdivision 5;
new text end
new text begin
(3) an Indian health service facility or a facility owned and operated by a Tribe or Tribal
organization operating under United States Code, title 25, section 5321;
new text end
new text begin
(4) a provider of children's therapeutic services and supports as defined in section
256B.0943;
new text end
new text begin
(5) enrolled in medical assistance as a mental health or substance use disorder provider
agency and employs at least two full-time equivalent mental health professionals qualified
according to section 245I.04, subdivision 2, or two alcohol and drug counselors licensed or
exempt from licensure under chapter 148F who are qualified to provide clinical services to
children and families;
new text end
new text begin
(6) licensed under chapter 245G and in compliance with the applicable requirements in
chapters 245A, 245C, and 260E; section 626.557; and Minnesota Rules, chapter 9544; or
new text end
new text begin
(7) a licensed professional in private practice as defined in section 245G.01, subdivision
17, who meets the requirements of section 254B.05, subdivision 1, paragraph (b).
new text end
new text begin Subd. 3. new text end
new text begin Allowable grant activities and related expenses. new text end
new text begin
(a) Allowable grant activities
and related expenses include but are not limited to:
new text end
new text begin
(1) identifying mental health conditions and substance use disorders of students;
new text end
new text begin
(2) delivering mental health and substance use disorder treatment and supportive services
to students and their families within the classroom, including via telehealth consistent with
section 256B.0625, subdivision 3b;
new text end
new text begin
(3) delivering therapeutic interventions and customizing an array of supplementary
learning experiences for students;
new text end
new text begin
(4) supporting families in meeting their child's needs, including navigating health care,
social service, and juvenile justice systems;
new text end
new text begin
(5) providing transportation for students receiving behavioral health services when school
is not in session;
new text end
new text begin
(6) building the capacity of schools to meet the needs of students with mental health and
substance use disorder concerns, including school staff development activities for licensed
and nonlicensed staff; and
new text end
new text begin
(7) purchasing equipment, connection charges, on-site coordination, set-up fees, and
site fees in order to deliver school-linked behavioral health services via telehealth.
new text end
new text begin
(b) Grantees must obtain all available third-party reimbursement sources as a condition
of receiving grant funds. For purposes of this grant program, a third-party reimbursement
source does not include a public school as defined in section 120A.20, subdivision 1. Grantees
shall serve students regardless of health coverage status or ability to pay.
new text end
new text begin Subd. 4. new text end
new text begin Calculating the share of the appropriation. new text end
new text begin
(a) Grants must be awarded to
qualifying school units proportionately.
new text end
new text begin
(b) The commissioner must calculate the share of the appropriation to be used in each
qualifying school unit by multiplying the total appropriation going to the grantees by the
qualifying school unit's average daily membership in a setting of federal instructional level
4 or higher and then dividing by the total average daily membership in a setting of federal
instructional level 4 or higher for the same year for all qualifying school units.
new text end
new text begin Subd. 5. new text end
new text begin Data collection and outcome measurement. new text end
new text begin
Grantees must provide data to
the commissioner for the purpose of evaluating the Intermediate School District Behavioral
Health Innovation grant program. The commissioner must consult with grantees to develop
outcome measures for program capacity and performance.
new text end
Sec. 10.
Minnesota Statutes 2024, section 245.4907, subdivision 3, is amended to read:
Subd. 3.
Allowable grant activities.
Grantees must use grant funding to provide training
for mental health deleted text begin certifieddeleted text end family peer deleted text begin specialistsdeleted text end new text begin specialist candidates and continuing
education to certified family peer specialistsnew text end as specified in section 256B.0616, subdivision
5.
Sec. 11.
Minnesota Statutes 2024, section 245.50, subdivision 3, is amended to read:
Subd. 3.
Exceptions.
A contract may not be entered into under this section for services
to persons who:
(1) are serving a sentence after conviction of a criminal offense;
deleted text begin
(2) are on probation or parole;
deleted text end
deleted text begin (3)deleted text end new text begin (2)new text end are the subject of a presentence investigation; or
deleted text begin (4)deleted text end new text begin (3)new text end have been committed involuntarily in Minnesota under chapter 253B for treatment
of mental illness or chemical dependency, except as provided under subdivision 5.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 12.
Minnesota Statutes 2024, section 245.50, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Contract notice. new text end
new text begin
A Minnesota mental health, chemical health, or detoxification
agency or facility entering into a contract with a bordering state under this section must,
within 30 days of the contract's effective date, provide the commissioner of human services
with a copy of the contract. If the contract is amended, the agency or facility must provide
the commissioner with a copy of each amendment within 30 days of the amendment's
effective date.
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. 13.
Minnesota Statutes 2024, section 245I.05, subdivision 3, is amended to read:
Subd. 3.
Initial training.
(a) A staff person must receive training about:
(1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and
(2) the maltreatment of minor reporting requirements and definitions in chapter 260E
within 72 hours of first providing direct contact services to a client.
(b) Before providing direct contact services to a client, a staff person must receive training
about:
(1) client rights and protections under section 245I.12;
(2) the Minnesota Health Records Act, including client confidentiality, family engagement
under section 144.294, and client privacy;
(3) emergency procedures that the staff person must follow when responding to a fire,
inclement weather, a report of a missing person, and a behavioral or medical emergency;
(4) specific activities and job functions for which the staff person is responsible, including
the license holder's program policies and procedures applicable to the staff person's position;
(5) professional boundaries that the staff person must maintain; and
(6) specific needs of each client to whom the staff person will be providing direct contact
services, including each client's developmental status, cognitive functioning, and physical
and mental abilities.
(c) Before providing direct contact services to a client, a mental health rehabilitation
worker, mental health behavioral aide, or mental health practitioner required to receive the
training according to section 245I.04, subdivision 4, must receive 30 hours of training about:
(1) mental illnesses;
(2) client recovery and resiliency;
(3) mental health de-escalation techniques;
(4) co-occurring mental illness and substance use disorders; and
(5) psychotropic medications and medication side effectsnew text begin , including tardive dyskinesianew text end .
(d) Within 90 days of first providing direct contact services to an adult client, mental
health practitioner, mental health certified peer specialist, or mental health rehabilitation
worker must receive training about:
(1) trauma-informed care and secondary trauma;
(2) person-centered individual treatment plans, including seeking partnerships with
family and other natural supports;
(3) co-occurring substance use disorders; and
(4) culturally responsive treatment practices.
(e) Within 90 days of first providing direct contact services to a child client, mental
health practitioner, mental health certified family peer specialist, mental health certified
peer specialist, or mental health behavioral aide must receive training about the topics in
clauses (1) to (5). This training must address the developmental characteristics of each child
served by the license holder and address the needs of each child in the context of the child's
family, support system, and culture. Training topics must include:
(1) trauma-informed care and secondary trauma, including adverse childhood experiences
(ACEs);
(2) family-centered treatment plan development, including seeking partnership with a
child client's family and other natural supports;
(3) mental illness and co-occurring substance use disorders in family systems;
(4) culturally responsive treatment practices; and
(5) child development, including cognitive functioning, and physical and mental abilities.
(f) For a mental health behavioral aide, the training under paragraph (e) must include
parent team training using a curriculum approved by the commissioner.
Sec. 14.
Minnesota Statutes 2024, section 245I.05, subdivision 5, is amended to read:
Subd. 5.
Additional training for medication administration.
(a) Prior to administering
medications to a client under delegated authority or observing a client self-administer
medications, a staff person who is not a licensed prescriber, registered nurse, or licensed
practical nurse qualified under section 148.171, subdivision 8, must receive training about
psychotropic medications, side effectsnew text begin including tardive dyskinesianew text end , and medication
management.
(b) Prior to administering medications to a client under delegated authority, a staff person
must successfully complete a:
(1) medication administration training program for unlicensed personnel through an
accredited Minnesota postsecondary educational institution with completion of the course
documented in writing and placed in the staff person's personnel file; or
(2) formalized training program taught by a registered nurse or licensed prescriber that
is offered by the license holder. A staff person's successful completion of the formalized
training program must include direct observation of the staff person to determine the staff
person's areas of competency.
Sec. 15.
Minnesota Statutes 2024, section 245I.06, subdivision 3, is amended to read:
Subd. 3.
Treatment supervision and direct observation of mental health
rehabilitation workers and mental health behavioral aides.
(a) A mental health behavioral
aide or a mental health rehabilitation worker must receive direct observation from a mental
health professional, clinical trainee, certified rehabilitation specialist, or mental health
practitioner while the mental health behavioral aide or mental health rehabilitation worker
provides treatment services to clients, no less than twice per month for the first six months
of employment and once per month thereafter. deleted text begin The staff person performing the direct
observation must approve of the progress note for the observed treatment service.
deleted text end
(b) For a mental health rehabilitation worker qualified under section 245I.04, subdivision
14, paragraph (a), clause (2), item (i), treatment supervision in the first 2,000 hours of work
must at a minimum consist of:
(1) monthly individual supervision; and
(2) direct observation twice per month.
Sec. 16.
Minnesota Statutes 2024, section 245I.11, subdivision 5, is amended to read:
Subd. 5.
Medication administration in residential programs.
If a license holder is
licensed as a residential program, the license holder must:
(1) assess and document each client's ability to self-administer medication. In the
assessment, the license holder must evaluate the client's ability to: (i) comply with prescribed
medication regimens; and (ii) store the client's medications safely and in a manner that
protects other individuals in the facility. Through the assessment process, the license holder
must assist the client in developing the skills necessary to safely self-administer medication;
(2) monitor the effectiveness of medications, side effects of medications, and adverse
reactions to medicationsnew text begin , including symptoms and signs of tardive dyskinesia,new text end for each
client. The license holder must address and document any concerns about a client's
medications;
(3) ensure that no staff person or client gives a legend drug supply for one client to
another client;
(4) have policies and procedures for: (i) keeping a record of each client's medication
orders; (ii) keeping a record of any incident of deferring a client's medications; (iii)
documenting any incident when a client's medication is omitted; and (iv) documenting when
a client refuses to take medications as prescribed; and
(5) document and track medication errors, document whether the license holder notified
anyone about the medication error, determine if the license holder must take any follow-up
actions, and identify the staff persons who are responsible for taking follow-up actions.
Sec. 17.
Minnesota Statutes 2024, section 245I.12, subdivision 5, is amended to read:
Subd. 5.
Client grievances.
(a) The license holder must have a grievance procedure
that:
(1) describes to clients how the license holder will meet the requirements in this
subdivision; and
(2) contains the current public contact information of the Department of Human Services,
Licensing Division; the Office of Ombudsman for Mental Health and Developmental
Disabilities; the Department of Health, Office of Health Facilities Complaints; and all
applicable health-related licensing boards.
(b) On the day of each client's admission, the license holder must explain the grievance
procedure to the client.
(c) The license holder must:
(1) post the grievance procedure in a place visible to clients and provide a copy of the
grievance procedure upon request;
(2) allow clients, former clients, and their authorized representatives to submit a grievance
to the license holder;
(3) within three business days of receiving a client's grievance, acknowledge in writing
that the license holder received the client's grievance. If applicable, the license holder must
include a notice of the client's separate appeal rights for a managed care organization's
reduction, termination, or denial of a covered service;
(4) within 15 business days of receiving a client's grievance, provide a written final
response to the client's grievance containing the license holder's official response to the
grievance; and
(5) allow the client to bring a grievance to the person with the highest level of authority
in the program.
new text begin
(d) Clients may voice grievances and recommend changes in policies and services to
staff and others of their choice, free from restraint, interference, coercion, discrimination,
or reprisal, including threat of discharge.
new text end
Sec. 18.
Minnesota Statutes 2024, section 245I.23, subdivision 7, is amended to read:
Subd. 7.
Intensive residential treatment services assessment and treatment
planning.
(a) Within 12 hours of a client's admission, the license holder must evaluate and
document the client's immediate needs, including the client's:
(1) health and safety, including the client's need for crisis assistance;
(2) responsibilities for children, family and other natural supports, and employers; and
(3) housing and legal issues.
(b) Within 24 hours of the client's admission, the license holder must complete an initial
treatment plan for the client. The license holder must:
(1) base the client's initial treatment plan on the client's referral information and an
assessment of the client's immediate needs;
(2) consider crisis assistance strategies that have been effective for the client in the past;
(3) identify the client's initial treatment goals, measurable treatment objectives, and
specific interventions that the license holder will use to help the client engage in treatment;
(4) identify the participants involved in the client's treatment planning. The client must
be a participant; and
(5) ensure that a treatment supervisor approves of the client's initial treatment plan if a
mental health practitioner or clinical trainee completes the client's treatment plan,
notwithstanding section 245I.08, subdivision 3.
(c) According to section 245A.65, subdivision 2, paragraph (b), the license holder must
complete an individual abuse prevention plan as part of a client's initial treatment plan.
(d) Within deleted text begin fivedeleted text end new text begin tennew text end days of the client's admission and again within 60 days after the
client's admission, the license holder must complete a level of care assessment of the client.
If the license holder determines that a client does not need a medically monitored level of
service, a treatment supervisor must document how the client's admission to and continued
services in intensive residential treatment services are medically necessary for the client.
(e) Within ten days of a client's admission, the license holder must complete or review
and update the client's standard diagnostic assessment.
(f) Within ten days of a client's admission, the license holder must complete the client's
individual treatment plan, notwithstanding section 245I.10, subdivision 8. Within 40 days
after the client's admission and again within 70 days after the client's admission, the license
holder must update the client's individual treatment plan. The license holder must focus the
client's treatment planning on preparing the client for a successful transition from intensive
residential treatment services to another setting. In addition to the required elements of an
individual treatment plan under section 245I.10, subdivision 8, the license holder must
identify the following information in the client's individual treatment plan: (1) the client's
referrals and resources for the client's health and safety; and (2) the staff persons who are
responsible for following up with the client's referrals and resources. If the client does not
receive a referral or resource that the client needs, the license holder must document the
reason that the license holder did not make the referral or did not connect the client to a
particular resource. The license holder is responsible for determining whether additional
follow-up is required on behalf of the client.
(g) Within 30 days of the client's admission, the license holder must complete a functional
assessment of the client. Within 60 days after the client's admission, the license holder must
update the client's functional assessment to include any changes in the client's functioning
and symptoms.
(h) For a client with a current substance use disorder diagnosis and for a client whose
substance use disorder screening in the client's standard diagnostic assessment indicates the
possibility that the client has a substance use disorder, the license holder must complete a
written assessment of the client's substance use within 30 days of the client's admission. In
the substance use assessment, the license holder must: (1) evaluate the client's history of
substance use, relapses, and hospitalizations related to substance use; (2) assess the effects
of the client's substance use on the client's relationships including with family member and
others; (3) identify financial problems, health issues, housing instability, and unemployment;
(4) assess the client's legal problems, past and pending incarceration, violence, and
victimization; and (5) evaluate the client's suicide attempts, noncompliance with taking
prescribed medications, and noncompliance with psychosocial treatment.
(i) On a weekly basis, a mental health professional or certified rehabilitation specialist
must review each client's treatment plan and individual abuse prevention plan. The license
holder must document in the client's file each weekly review of the client's treatment plan
and individual abuse prevention plan.
Sec. 19.
Minnesota Statutes 2024, section 256B.0616, subdivision 4, is amended to read:
Subd. 4.
new text begin Family new text end peer support deleted text begin specialistdeleted text end program providers.
The commissioner shall
develop a process to certify family peer support deleted text begin specialistdeleted text end programs, in accordance with the
federal guidelines, in order for the program to bill for reimbursable services. Family peer
support programs must operate within an existing mental health community provider or
center.
Sec. 20.
Minnesota Statutes 2024, section 256B.0616, subdivision 5, is amended to read:
Subd. 5.
Certified family peer specialist training and certification.
new text begin (a) new text end The
commissioner shall develop deleted text begin adeleted text end new text begin or approve the use of an existingnew text end training and certification
process for deleted text begin certifieddeleted text end new text begin certifyingnew text end family peer specialists. deleted text begin Thedeleted text end new text begin Family peer specialistnew text end candidates
must have raised or be currently raising a child with a mental illness, have deleted text begin haddeleted text end experience
navigating the children's mental health system, and deleted text begin mustdeleted text end demonstrate leadership and advocacy
skills and a strong dedication to family-driven and family-focused services. The training
curriculum must teach participating family peer deleted text begin specialistsdeleted text end new text begin specialist candidatesnew text end specific
skills relevant to providing peer support to other parentsnew text begin and youthnew text end .
new text begin (b) new text end In addition to initial training and certification, the commissioner shall develop ongoing
continuing educational workshops on pertinent issues related to family peer support
counseling.
new text begin
(c) Initial training leading to certification as a family peer specialist and continuing
education for certified family peer specialists must be delivered by the commissioner or a
third-party organization approved by the commissioner. An approved third-party organization
may also provide continuing education of certified family peer specialists.
new text end
Sec. 21.
Minnesota Statutes 2024, section 256B.0622, subdivision 3a, is amended to read:
Subd. 3a.
Provider certification and contract requirements for assertive community
treatment.
(a) The assertive community treatment provider must have each ACT team be
certified by the state following the certification process and procedures developed by the
commissioner. The certification process determines whether the ACT team meets the
standards for assertive community treatment under this section, the standards in chapter
245I as required in section 245I.011, subdivision 5, and minimum program fidelity standards
as measured by a nationally recognized fidelity tool approved by the commissioner.
Recertification must occur at least every three years.
(b) An ACT team certified under this subdivision must meet the following standards:
(1) have capacity to recruit, hire, manage, and train required ACT team members;
(2) have adequate administrative ability to ensure availability of services;
(3) ensure flexibility in service delivery to respond to the changing and intermittent care
needs of a client as identified by the client and the individual treatment plan;
(4) keep all necessary records required by law;
(5) be an enrolled Medicaid provider; deleted text begin and
deleted text end
(6) establish and maintain a quality assurance plan to determine specific service outcomes
and the client's satisfaction with servicesdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(7) ensure that overall treatment supervision to the ACT team is provided by a qualified
member of the ACT team and is available during and after regular business hours and on
weekends and holidays.
new text end
(c) The commissioner may intervene at any time and decertify an ACT team with cause.
The commissioner shall establish a process for decertification of an ACT team and shall
require corrective action, medical assistance repayment, or decertification of an ACT team
that no longer meets the requirements in this section or that fails to meet the clinical quality
standards or administrative standards provided by the commissioner in the application and
certification process. The decertification is subject to appeal to the state.
Sec. 22.
Minnesota Statutes 2024, section 256B.0622, subdivision 7a, is amended to read:
Subd. 7a.
Assertive community treatment team staff requirements and roles.
(a)
The required treatment staff qualifications and roles for an ACT team are:
(1) the team leader:
(i) deleted text begin shalldeleted text end new text begin mustnew text end be a mental health professionaldeleted text begin . Individuals who are not licensed but who
are eligible for licensure and are otherwise qualified may also fulfill this roledeleted text end new text begin , clinical trainee,
or mental health practitionernew text end ;
(ii) must be an active member of the ACT team and provide some direct services to
clients;
(iii) must be a single full-time staff member, dedicated to the ACT team, who is
responsible for overseeing the administrative operations of the team and supervising team
members to ensure delivery of best and ethical practices; and
(iv) must be available to ensure that overall treatment supervision to the ACT team is
available after regular business hours and on weekends and holidays and is provided by a
qualified member of the ACT team;
(2) the psychiatric care provider:
(i) must be a mental health professional permitted to prescribe psychiatric medications
as part of the mental health professional's scope of practice. The psychiatric care provider
must have demonstrated clinical experience working with individuals with serious and
persistent mental illness;
(ii) shall collaborate with the team leader in sharing overall clinical responsibility for
screening and admitting clients; monitoring clients' treatment and team member service
delivery; educating staff on psychiatric and nonpsychiatric medications, their side effects,
and health-related conditions; actively collaborating with nurses; and helping provide
treatment supervision to the team;
(iii) shall fulfill the following functions for assertive community treatment clients:
provide assessment and treatment of clients' symptoms and response to medications, including
side effects; provide brief therapy to clients; provide diagnostic and medication education
to clients, with medication decisions based on shared decision making; monitor clients'
nonpsychiatric medical conditions and nonpsychiatric medications; and conduct home and
community visits;
(iv) shall serve as the point of contact for psychiatric treatment if a client is hospitalized
for mental health treatment and shall communicate directly with the client's inpatient
psychiatric care providers to ensure continuity of care;
(v) shall have a minimum full-time equivalency that is prorated at a rate of 16 hours per
50 clients. Part-time psychiatric care providers shall have designated hours to work on the
team, with sufficient blocks of time on consistent days to carry out the provider's clinical,
supervisory, and administrative responsibilities. No more than two psychiatric care providers
may share this role; and
(vi) shall provide psychiatric backup to the program after regular business hours and on
weekends and holidays. The psychiatric care provider may delegate this duty to another
qualified psychiatric provider;
(3) the nursing staff:
(i) shall consist of one to three registered nurses or advanced practice registered nurses,
of whom at least one has a minimum of one-year experience working with adults with
serious mental illness and a working knowledge of psychiatric medications. No more than
two individuals can share a full-time equivalent position;
(ii) are responsible for managing medication, administering and documenting medication
treatment, and managing a secure medication room; and
(iii) shall develop strategies, in collaboration with clients, to maximize taking medications
as prescribed; screen and monitor clients' mental and physical health conditions and
medication side effects; engage in health promotion, prevention, and education activities;
communicate and coordinate services with other medical providers; facilitate the development
of the individual treatment plan for clients assigned; and educate the ACT team in monitoring
psychiatric and physical health symptoms and medication side effects;
(4) the co-occurring disorder specialist:
(i) shall be a full-time equivalent co-occurring disorder specialist who has received
specific training on co-occurring disorders that is consistent with national evidence-based
practices. The training must include practical knowledge of common substances and how
they affect mental illnesses, the ability to assess substance use disorders and the client's
stage of treatment, motivational interviewing, and skills necessary to provide counseling to
clients at all different stages of change and treatment. The co-occurring disorder specialist
may also be an individual who is a licensed alcohol and drug counselor as described in
section 148F.01, subdivision 5, or a counselor who otherwise meets the training, experience,
and other requirements in section 245G.11, subdivision 5. No more than two co-occurring
disorder specialists may occupy this role; and
(ii) shall provide or facilitate the provision of co-occurring disorder treatment to clients.
The co-occurring disorder specialist shall serve as a consultant and educator to fellow ACT
team members on co-occurring disorders;
(5) the vocational specialist:
(i) shall be a full-time vocational specialist who has at least one-year experience providing
employment services or advanced education that involved field training in vocational services
to individuals with mental illness. An individual who does not meet these qualifications
may also serve as the vocational specialist upon completing a training plan approved by the
commissioner;
(ii) shall provide or facilitate the provision of vocational services to clients. The vocational
specialist serves as a consultant and educator to fellow ACT team members on these services;
and
(iii) must not refer individuals to receive any type of vocational services or linkage by
providers outside of the ACT team;
(6) the mental health certified peer specialist:
(i) shall be a full-time equivalent. No more than two individuals can share this position.
The mental health certified peer specialist is a fully integrated team member who provides
highly individualized services in the community and promotes the self-determination and
shared decision-making abilities of clients. This requirement may be waived due to workforce
shortages upon approval of the commissioner;
(ii) must provide coaching, mentoring, and consultation to the clients to promote recovery,
self-advocacy, and self-direction, promote wellness management strategies, and assist clients
in developing advance directives; and
(iii) must model recovery values, attitudes, beliefs, and personal action to encourage
wellness and resilience, provide consultation to team members, promote a culture where
the clients' points of view and preferences are recognized, understood, respected, and
integrated into treatment, and serve in a manner equivalent to other team members;
(7) the program administrative assistant shall be a full-time office-based program
administrative assistant position assigned to solely work with the ACT team, providing a
range of supports to the team, clients, and families; and
(8) additional staff:
(i) shall be based on team size. Additional treatment team staff may include mental
health professionals; clinical trainees; certified rehabilitation specialists; mental health
practitioners; or mental health rehabilitation workers. These individuals shall have the
knowledge, skills, and abilities required by the population served to carry out rehabilitation
and support functions; and
(ii) shall be selected based on specific program needs or the population served.
(b) Each ACT team must clearly document schedules for all ACT team members.
(c) Each ACT team member must serve as a primary team member for clients assigned
by the team leader and are responsible for facilitating the individual treatment plan process
for those clients. The primary team member for a client is the responsible team member
knowledgeable about the client's life and circumstances and writes the individual treatment
plan. The primary team member provides individual supportive therapy or counseling, and
provides primary support and education to the client's family and support system.
(d) Members of the ACT team must have strong clinical skills, professional qualifications,
experience, and competency to provide a full breadth of rehabilitation services. Each staff
member shall be proficient in their respective discipline and be able to work collaboratively
as a member of a multidisciplinary team to deliver the majority of the treatment,
rehabilitation, and support services clients require to fully benefit from receiving assertive
community treatment.
(e) Each ACT team member must fulfill training requirements established by the
commissioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 23.
Minnesota Statutes 2024, section 256L.03, subdivision 5, is amended to read:
Subd. 5.
Cost-sharing.
(a) Co-payments, coinsurance, and deductibles do not apply to
children under the age of 21 and to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5.
(b) The commissioner must adjust co-payments, coinsurance, and deductibles for covered
services in a manner sufficient to maintain the actuarial value of the benefit to 94 percent.
The cost-sharing changes described in this paragraph do not apply to eligible recipients or
services exempt from cost-sharing under state law. The cost-sharing changes described in
this paragraph shall not be implemented prior to January 1, 2016.
(c) The cost-sharing changes authorized under paragraph (b) must satisfy the requirements
for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations,
title 42, sections 600.510 and 600.520.
(d) Cost-sharing for prescription drugs and related medical supplies to treat chronic
disease must comply with the requirements of section 62Q.481.
(e) Co-payments, coinsurance, and deductibles do not apply to additional diagnostic
services or testing that a health care provider determines an enrollee requires after a
mammogram, as specified under section 62A.30, subdivision 5.
(f) Cost-sharing must not apply to drugs used for tobacco and nicotine cessation or to
tobacco and nicotine cessation services covered under section 256B.0625, subdivision 68.
(g) Co-payments, coinsurance, and deductibles do not apply to pre-exposure prophylaxis
(PrEP) and postexposure prophylaxis (PEP) medications when used for the prevention or
treatment of the human immunodeficiency virus (HIV).
new text begin
(h) Co-payments, coinsurance, and deductibles do not apply to mobile crisis intervention,
as defined in section 256B.0624, subdivision 2, paragraph (d).
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
ARTICLE 10
CHILDREN'S MENTAL HEALTH TERMINOLOGY
Section 1.
Minnesota Statutes 2024, section 62Q.527, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given them.
deleted text begin
(b) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end "Mental illness" has the meaning given in deleted text begin sectiondeleted text end new text begin sectionsnew text end 245.462, subdivision
20, paragraph (a)new text begin , and 245.4871, subdivision 15new text end .
deleted text begin (d)deleted text end new text begin (c)new text end "Health plan" has the meaning given in section 62Q.01, subdivision 3, but includes
the coverages described in section 62A.011, subdivision 3, clauses (7) and (10).
Sec. 2.
Minnesota Statutes 2024, section 62Q.527, subdivision 2, is amended to read:
Subd. 2.
Required coverage for antipsychotic drugs.
(a) A health plan that provides
prescription drug coverage must provide coverage for an antipsychotic drug prescribed to
treat deleted text begin emotional disturbance ordeleted text end mental illness regardless of whether the drug is in the health
plan's drug formulary, if the health care provider prescribing the drug:
(1) indicates to the dispensing pharmacist, orally or in writing according to section
151.21, that the prescription must be dispensed as communicated; and
(2) certifies in writing to the health plan company that the health care provider has
considered all equivalent drugs in the health plan's drug formulary and has determined that
the drug prescribed will best treat the patient's condition.
(b) The health plan is not required to provide coverage for a drug if the drug was removed
from the health plan's drug formulary for safety reasons.
(c) For drugs covered under this section, no health plan company that has received a
certification from the health care provider as described in paragraph (a) may:
(1) impose a special deductible, co-payment, coinsurance, or other special payment
requirement that the health plan does not apply to drugs that are in the health plan's drug
formulary; or
(2) require written certification from the prescribing provider each time a prescription
is refilled or renewed that the drug prescribed will best treat the patient's condition.
Sec. 3.
Minnesota Statutes 2024, section 62Q.527, subdivision 3, is amended to read:
Subd. 3.
Continuing care.
(a) Enrollees receiving a prescribed drug to treat a diagnosed
mental illness deleted text begin or emotional disturbancedeleted text end may continue to receive the prescribed drug for up
to one year without the imposition of a special deductible, co-payment, coinsurance, or
other special payment requirements, when a health plan's drug formulary changes or an
enrollee changes health plans and the medication has been shown to effectively treat the
patient's condition. In order to be eligible for this continuing care benefit:
(1) the patient must have been treated with the drug for 90 days prior to a change in a
health plan's drug formulary or a change in the enrollee's health plan;
(2) the health care provider prescribing the drug indicates to the dispensing pharmacist,
orally or in writing according to section 151.21, that the prescription must be dispensed as
communicated; and
(3) the health care provider prescribing the drug certifies in writing to the health plan
company that the drug prescribed will best treat the patient's condition.
(b) The continuing care benefit shall be extended annually when the health care provider
prescribing the drug:
(1) indicates to the dispensing pharmacist, orally or in writing according to section
151.21, that the prescription must be dispensed as communicated; and
(2) certifies in writing to the health plan company that the drug prescribed will best treat
the patient's condition.
(c) The health plan company is not required to provide coverage for a drug if the drug
was removed from the health plan's drug formulary for safety reasons.
Sec. 4.
Minnesota Statutes 2024, section 121A.61, subdivision 3, is amended to read:
Subd. 3.
Policy components.
The policy must include at least the following components:
(a) rules governing student conduct and procedures for informing students of the rules;
(b) the grounds for removal of a student from a class;
(c) the authority of the classroom teacher to remove students from the classroom pursuant
to procedures and rules established in the district's policy;
(d) the procedures for removal of a student from a class by a teacher, school administrator,
or other school district employee;
(e) the period of time for which a student may be removed from a class, which may not
exceed five class periods for a violation of a rule of conduct;
(f) provisions relating to the responsibility for and custody of a student removed from
a class;
(g) the procedures for return of a student to the specified class from which the student
has been removed;
(h) the procedures for notifying a student and the student's parents or guardian of
violations of the rules of conduct and of resulting disciplinary actions;
(i) any procedures determined appropriate for encouraging early involvement of parents
or guardians in attempts to improve a student's behavior;
(j) any procedures determined appropriate for encouraging early detection of behavioral
problems;
(k) any procedures determined appropriate for referring a student in need of special
education services to those services;
(l) any procedures determined appropriate for ensuring victims of bullying who respond
with behavior not allowed under the school's behavior policies have access to a remedial
response, consistent with section 121A.031;
(m) the procedures for consideration of whether there is a need for a further assessment
or of whether there is a need for a review of the adequacy of a current individualized
education program of a student with a disability who is removed from class;
(n) procedures for detecting and addressing chemical abuse problems of a student while
on the school premises;
(o) the minimum consequences for violations of the code of conduct;
(p) procedures for immediate and appropriate interventions tied to violations of the code;
(q) a provision that states that a teacher, school employee, school bus driver, or other
agent of a district may use reasonable force in compliance with section 121A.582 and other
laws;
(r) an agreement regarding procedures to coordinate crisis services to the extent funds
are available with the county board responsible for implementing sections 245.487 to
245.4889 for students with a serious deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end or other students
who have an individualized education program whose behavior may be addressed by crisis
intervention;
(s) a provision that states a student must be removed from class immediately if the student
engages in assault or violent behavior. For purposes of this paragraph, "assault" has the
meaning given it in section 609.02, subdivision 10. The removal shall be for a period of
time deemed appropriate by the principal, in consultation with the teacher;
(t) a prohibition on the use of exclusionary practices for early learners as defined in
section 121A.425; and
(u) a prohibition on the use of exclusionary practices to address attendance and truancy
issues.
Sec. 5.
Minnesota Statutes 2024, section 128C.02, subdivision 5, is amended to read:
Subd. 5.
Rules for open enrollees.
(a) The league shall adopt league rules and regulations
governing the athletic participation of pupils attending school in a nonresident district under
section 124D.03.
(b) Notwithstanding other law or league rule or regulation to the contrary, when a student
enrolls in or is readmitted to a recovery-focused high school after successfully completing
a licensed program for treatment of alcohol or substance abusedeleted text begin ,deleted text end new text begin ornew text end mental illness, deleted text begin or emotional
disturbance,deleted text end the student is immediately eligible to participate on the same basis as other
district students in the league-sponsored activities of the student's resident school district.
Nothing in this paragraph prohibits the league or school district from enforcing a league or
district penalty resulting from the student violating a league or district rule.
(c) The league shall adopt league rules making a student with an individualized education
program who transfers from one public school to another public school as a reasonable
accommodation to reduce barriers to educational access immediately eligible to participate
in league-sponsored varsity competition on the same basis as other students in the school
to which the student transfers. The league also must establish guidelines, consistent with
this paragraph, for reviewing the 504 plan of a student who transfers between public schools
to determine whether the student is immediately eligible to participate in league-sponsored
varsity competition on the same basis as other students in the school to which the student
transfers.
Sec. 6.
Minnesota Statutes 2024, section 142G.02, subdivision 56, is amended to read:
Subd. 56.
Learning disabled.
"Learning disabled," for purposes of an extension to the
60-month time limit under section 142G.42, subdivision 4, clause (3), means the person has
a disorder in one or more of the psychological processes involved in perceiving,
understanding, or using concepts through verbal language or nonverbal means. Learning
disabled does not include learning problems that are primarily the result of visual, hearing,
or motor disabilities; developmental disability; deleted text begin emotional disturbance;deleted text end new text begin or mental illnessnew text end or
due to environmental, cultural, or economic disadvantage.
Sec. 7.
Minnesota Statutes 2024, section 142G.27, subdivision 4, is amended to read:
Subd. 4.
Good cause exemptions for not attending orientation.
(a) The county agency
shall not impose the sanction under section 142G.70 if it determines that the participant has
good cause for failing to attend orientation. Good cause exists when:
(1) appropriate child care is not available;
(2) the participant is ill or injured;
(3) a family member is ill and needs care by the participant that prevents the participant
from attending orientation. For a caregiver with a child or adult in the household who meets
the disability or medical criteria for home care services under section 256B.0659, or a home
and community-based waiver services program under chapter 256B, or meets the criteria
for deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end under section 245.4871, subdivision
6, or for serious and persistent mental illness under section 245.462, subdivision 20,
paragraph (c), good cause also exists when an interruption in the provision of those services
occurs which prevents the participant from attending orientation;
(4) the caregiver is unable to secure necessary transportation;
(5) the caregiver is in an emergency situation that prevents orientation attendance;
(6) the orientation conflicts with the caregiver's work, training, or school schedule; or
(7) the caregiver documents other verifiable impediments to orientation attendance
beyond the caregiver's control.
(b) Counties must work with clients to provide child care and transportation necessary
to ensure a caregiver has every opportunity to attend orientation.
Sec. 8.
Minnesota Statutes 2024, section 142G.42, subdivision 3, is amended to read:
Subd. 3.
Ill or incapacitated.
(a) An assistance unit subject to the time limit in section
142G.40, subdivision 1, is eligible to receive months of assistance under a hardship extension
if the participant who reached the time limit belongs to any of the following groups:
(1) participants who are suffering from an illness, injury, or incapacity which has been
certified by a qualified professional when the illness, injury, or incapacity is expected to
continue for more than 30 days and severely limits the person's ability to obtain or maintain
suitable employment. These participants must follow the treatment recommendations of the
qualified professional certifying the illness, injury, or incapacity;
(2) participants whose presence in the home is required as a caregiver because of the
illness, injury, or incapacity of another member in the assistance unit, a relative in the
household, or a foster child in the household when the illness or incapacity and the need
for a person to provide assistance in the home has been certified by a qualified professional
and is expected to continue for more than 30 days; or
(3) caregivers with a child or an adult in the household who meets the disability or
medical criteria for home care services under section 256B.0651, subdivision 1, paragraph
(c), or a home and community-based waiver services program under chapter 256B, or meets
the criteria for deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end under section 245.4871,
subdivision 6, or for serious and persistent mental illness under section 245.462, subdivision
20, paragraph (c). Caregivers in this category are presumed to be prevented from obtaining
or maintaining suitable employment.
(b) An assistance unit receiving assistance under a hardship extension under this
subdivision may continue to receive assistance as long as the participant meets the criteria
in paragraph (a), clause (1), (2), or (3).
Sec. 9.
Minnesota Statutes 2024, section 245.462, subdivision 4, is amended to read:
Subd. 4.
Case management service provider.
(a) "Case management service provider"
means a case manager or case manager associate employed by the county or other entity
authorized by the county board to provide case management services specified in section
245.4711.
(b) A case manager must:
(1) be skilled in the process of identifying and assessing a wide range of client needs;
(2) be knowledgeable about local community resources and how to use those resources
for the benefit of the client;
(3) be a mental health practitioner as defined in section 245I.04, subdivision 4, or have
a bachelor's degree in one of the behavioral sciences or related fields including, but not
limited to, social work, psychology, or nursing from an accredited college or university. A
case manager who is not a mental health practitioner and who does not have a bachelor's
degree in one of the behavioral sciences or related fields must meet the requirements of
paragraph (c); and
(4) meet the supervision and continuing education requirements described in paragraphs
(d), (e), and (f), as applicable.
(c) Case managers without a bachelor's degree must meet one of the requirements in
clauses (1) to (3):
(1) have three or four years of experience as a case manager associate as defined in this
section;
(2) be a registered nurse without a bachelor's degree and have a combination of
specialized training in psychiatry and work experience consisting of community interaction
and involvement or community discharge planning in a mental health setting totaling three
years; or
(3) be a person who qualified as a case manager under the 1998 Department of Human
Service waiver provision and meet the continuing education and mentoring requirements
in this section.
(d) A case manager with at least 2,000 hours of supervised experience in the delivery
of services to adults with mental illness must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year of which at least one hour per month must be clinical
supervision regarding individual service delivery with a case management supervisor. The
remaining 26 hours of supervision may be provided by a case manager with two years of
experience. Group supervision may not constitute more than one-half of the required
supervision hours. Clinical supervision must be documented in the client record.
(e) A case manager without 2,000 hours of supervised experience in the delivery of
services to adults with mental illness must:
(1) receive clinical supervision regarding individual service delivery from a mental
health professional at least one hour per week until the requirement of 2,000 hours of
experience is met; and
(2) complete 40 hours of training approved by the commissioner in case management
skills and the characteristics and needs of adults with serious and persistent mental illness.
(f) A case manager who is not licensed, registered, or certified by a health-related
licensing board must receive 30 hours of continuing education and training in mental illness
and mental health services every two years.
(g) A case manager associate (CMA) must:
(1) work under the direction of a case manager or case management supervisor;
(2) be at least 21 years of age;
(3) have at least a high school diploma or its equivalent; and
(4) meet one of the following criteria:
(i) have an associate of arts degree in one of the behavioral sciences or human services;
(ii) be a certified peer specialist under section 256B.0615;
(iii) be a registered nurse without a bachelor's degree;
(iv) within the previous ten years, have three years of life experience with serious and
persistent mental illness as defined in subdivision 20; deleted text begin ordeleted text end as a child had deleted text begin severe emotional
disturbancedeleted text end new text begin a serious mental illnessnew text end as defined in section 245.4871, subdivision 6; or have
three years life experience as a primary caregiver to an adult with serious and persistent
mental illness within the previous ten years;
(v) have 6,000 hours work experience as a nondegreed state hospital technician; or
(vi) have at least 6,000 hours of supervised experience in the delivery of services to
persons with mental illness.
Individuals meeting one of the criteria in items (i) to (v) may qualify as a case manager
after four years of supervised work experience as a case manager associate. Individuals
meeting the criteria in item (vi) may qualify as a case manager after three years of supervised
experience as a case manager associate.
(h) A case management associate must meet the following supervision, mentoring, and
continuing education requirements:
(1) have 40 hours of preservice training described under paragraph (e), clause (2);
(2) receive at least 40 hours of continuing education in mental illness and mental health
services annually; and
(3) receive at least five hours of mentoring per week from a case management mentor.
A "case management mentor" means a qualified, practicing case manager or case management
supervisor who teaches or advises and provides intensive training and clinical supervision
to one or more case manager associates. Mentoring may occur while providing direct services
to consumers in the office or in the field and may be provided to individuals or groups of
case manager associates. At least two mentoring hours per week must be individual and
face-to-face.
(i) A case management supervisor must meet the criteria for mental health professionals,
as specified in subdivision 18.
(j) An immigrant who does not have the qualifications specified in this subdivision may
provide case management services to adult immigrants with serious and persistent mental
illness who are members of the same ethnic group as the case manager if the person:
(1) is currently enrolled in and is actively pursuing credits toward the completion of a
bachelor's degree in one of the behavioral sciences or a related field including, but not
limited to, social work, psychology, or nursing from an accredited college or university;
(2) completes 40 hours of training as specified in this subdivision; and
(3) receives clinical supervision at least once a week until the requirements of this
subdivision are met.
Sec. 10.
Minnesota Statutes 2024, section 245.4682, subdivision 3, is amended to read:
Subd. 3.
Projects for coordination of care.
(a) Consistent with section 256B.69 and
chapter 256L, the commissioner is authorized to solicit, approve, and implement up to three
projects to demonstrate the integration of physical and mental health services within prepaid
health plans and their coordination with social services. The commissioner shall require
that each project be based on locally defined partnerships that include at least one health
maintenance organization, community integrated service network, or accountable provider
network authorized and operating under chapter 62D, 62N, or 62T, or county-based
purchasing entity under section 256B.692 that is eligible to contract with the commissioner
as a prepaid health plan, and the county or counties within the service area. Counties shall
retain responsibility and authority for social services in these locally defined partnerships.
(b) The commissioner, in consultation with consumers, families, and their representatives,
shall:
(1) determine criteria for approving the projects and use those criteria to solicit proposals
for preferred integrated networks. The commissioner must develop criteria to evaluate the
partnership proposed by the county and prepaid health plan to coordinate access and delivery
of services. The proposal must at a minimum address how the partnership will coordinate
the provision of:
(i) client outreach and identification of health and social service needs paired with
expedited access to appropriate resources;
(ii) activities to maintain continuity of health care coverage;
(iii) children's residential mental health treatment and treatment foster care;
(iv) court-ordered assessments and treatments;
(v) prepetition screening and commitments under chapter 253B;
(vi) assessment and treatment of children identified through mental health screening of
child welfare and juvenile corrections cases;
(vii) home and community-based waiver services;
(viii) assistance with finding and maintaining employment;
(ix) housing; and
(x) transportation;
(2) determine specifications for contracts with prepaid health plans to improve the plan's
ability to serve persons with mental health conditions, including specifications addressing:
(i) early identification and intervention of physical and behavioral health problems;
(ii) communication between the enrollee and the health plan;
(iii) facilitation of enrollment for persons who are also eligible for a Medicare special
needs plan offered by the health plan;
(iv) risk screening procedures;
(v) health care coordination;
(vi) member services and access to applicable protections and appeal processes;
(vii) specialty provider networks;
(viii) transportation services;
(ix) treatment planning; and
(x) administrative simplification for providers;
(3) begin implementation of the projects no earlier than January 1, 2009, with not more
than 40 percent of the statewide population included during calendar year 2009 and additional
counties included in subsequent years;
(4) waive any administrative rule not consistent with the implementation of the projects;
(5) allow potential bidders at least 90 days to respond to the request for proposals; and
(6) conduct an independent evaluation to determine if mental health outcomes have
improved in that county or counties according to measurable standards designed in
consultation with the advisory body established under this subdivision and reviewed by the
State Advisory Council on Mental Health.
(c) Notwithstanding any statute or administrative rule to the contrary, the commissioner
may enroll all persons eligible for medical assistance with serious mental illness deleted text begin or emotional
disturbancedeleted text end in the prepaid plan of their choice within the project service area unless:
(1) the individual is eligible for home and community-based services for persons with
developmental disabilities and related conditions under section 256B.092; or
(2) the individual has a basis for exclusion from the prepaid plan under section 256B.69,
subdivision 4, other than disability,new text begin ornew text end mental illnessdeleted text begin , or emotional disturbancedeleted text end .
(d) The commissioner shall involve organizations representing persons with mental
illness and their families in the development and distribution of information used to educate
potential enrollees regarding their options for health care and mental health service delivery
under this subdivision.
(e) If the person described in paragraph (c) does not elect to remain in fee-for-service
medical assistance, or declines to choose a plan, the commissioner may preferentially assign
that person to the prepaid plan participating in the preferred integrated network. The
commissioner shall implement the enrollment changes within a project's service area on the
timeline specified in that project's approved application.
(f) A person enrolled in a prepaid health plan under paragraphs (c) and (d) may disenroll
from the plan at any time.
(g) The commissioner, in consultation with consumers, families, and their representatives,
shall evaluate the projects begun in 2009, and shall refine the design of the service integration
projects before expanding the projects. The commissioner shall report to the chairs of the
legislative committees with jurisdiction over mental health services by March 1, 2008, on
plans for evaluation of preferred integrated networks established under this subdivision.
(h) The commissioner shall apply for any federal waivers necessary to implement these
changes.
(i) Payment for Medicaid service providers under this subdivision for the months of
May and June will be made no earlier than July 1 of the same calendar year.
Sec. 11.
Minnesota Statutes 2024, section 245.4835, subdivision 2, is amended to read:
Subd. 2.
Failure to maintain expenditures.
(a) If a county does not comply with
subdivision 1, the commissioner shall require the county to develop a corrective action plan
according to a format and timeline established by the commissioner. If the commissioner
determines that a county has not developed an acceptable corrective action plan within the
required timeline, or that the county is not in compliance with an approved corrective action
plan, the protections provided to that county under section 245.485 do not apply.
(b) The commissioner shall consider the following factors to determine whether to
approve a county's corrective action plan:
(1) the degree to which a county is maximizing revenues for mental health services from
noncounty sources;
(2) the degree to which a county is expanding use of alternative services that meet mental
health needs, but do not count as mental health services within existing reporting systems.
If approved by the commissioner, the alternative services must be included in the county's
base as well as subsequent years. The commissioner's approval for alternative services must
be based on the following criteria:
(i) the service must be provided to children deleted text begin with emotional disturbancedeleted text end or adults with
mental illness;
(ii) the services must be based on an individual treatment plan or individual community
support plan as defined in the Comprehensive Mental Health Act; and
(iii) the services must be supervised by a mental health professional and provided by
staff who meet the staff qualifications defined in sections 256B.0943, subdivision 7, and
256B.0623, subdivision 5.
(c) Additional county expenditures to make up for the prior year's underspending may
be spread out over a two-year period.
Sec. 12.
Minnesota Statutes 2024, section 245.4863, is amended to read:
245.4863 INTEGRATED CO-OCCURRING DISORDER TREATMENT.
(a) The commissioner shall require individuals who perform substance use disorder
assessments to screen clients for co-occurring mental health disorders, and staff who perform
mental health diagnostic assessments to screen for co-occurring substance use disorders.
Screening tools must be approved by the commissioner. If a client screens positive for a
co-occurring mental health or substance use disorder, the individual performing the screening
must document what actions will be taken in response to the results and whether further
assessments must be performed.
(b) Notwithstanding paragraph (a), screening is not required when:
(1) the presence of co-occurring disorders was documented for the client in the past 12
months;
(2) the client is currently receiving co-occurring disorders treatment;
(3) the client is being referred for co-occurring disorders treatment; or
(4) a mental health professional who is competent to perform diagnostic assessments of
co-occurring disorders is performing a diagnostic assessment to identify whether the client
may have co-occurring mental health and substance use disorders. If an individual is
identified to have co-occurring mental health and substance use disorders, the assessing
mental health professional must document what actions will be taken to address the client's
co-occurring disorders.
(c) The commissioner shall adopt rules as necessary to implement this section. The
commissioner shall ensure that the rules are effective on July 1, 2013, thereby establishing
a certification process for integrated dual disorder treatment providers and a system through
which individuals receive integrated dual diagnosis treatment if assessed as having both a
substance use disorder and deleted text begin eitherdeleted text end a serious mental illness deleted text begin or emotional disturbancedeleted text end .
(d) The commissioner shall apply for any federal waivers necessary to secure, to the
extent allowed by law, federal financial participation for the provision of integrated dual
diagnosis treatment to persons with co-occurring disorders.
Sec. 13.
Minnesota Statutes 2024, section 245.487, subdivision 2, is amended to read:
Subd. 2.
Findings.
The legislature finds there is a need for further development of
existing clinical services for deleted text begin emotionally disturbeddeleted text end childrennew text begin with mental illnessnew text end and their
families and the creation of new services for this population. Although the services specified
in sections 245.487 to 245.4889 are mental health services, sections 245.487 to 245.4889
emphasize the need for a child-oriented and family-oriented approach of therapeutic
programming and the need for continuity of care with other community agencies. At the
same time, sections 245.487 to 245.4889 emphasize the importance of developing special
mental health expertise in children's mental health services because of the unique needs of
this population.
Nothing in sections 245.487 to 245.4889 shall be construed to abridge the authority of
the court to make dispositions under chapter 260, but the mental health services due any
child with serious and persistent mental illness, as defined in section 245.462, subdivision
20, or with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end , as defined in section
245.4871, subdivision 6, shall be made a part of any disposition affecting that child.
Sec. 14.
Minnesota Statutes 2024, section 245.4871, subdivision 3, is amended to read:
Subd. 3.
Case management services.
"Case management services" means activities
that are coordinated with the family community support services and are designed to help
the child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end and the child's family
obtain needed mental health services, social services, educational services, health services,
vocational services, recreational services, and related services in the areas of volunteer
services, advocacy, transportation, and legal services. Case management services include
assisting in obtaining a comprehensive diagnostic assessment, developing an individual
family community support plan, and assisting the child and the child's family in obtaining
needed services by coordination with other agencies and assuring continuity of care. Case
managers must assess and reassess the delivery, appropriateness, and effectiveness of services
over time.
Sec. 15.
Minnesota Statutes 2024, section 245.4871, subdivision 4, is amended to read:
Subd. 4.
Case management service provider.
(a) "Case management service provider"
means a case manager or case manager associate employed by the county or other entity
authorized by the county board to provide case management services specified in subdivision
3 for the child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end and the child's
family.
(b) A case manager must:
(1) have experience and training in working with children;
(2) have at least a bachelor's degree in one of the behavioral sciences or a related field
including, but not limited to, social work, psychology, or nursing from an accredited college
or university or meet the requirements of paragraph (d);
(3) have experience and training in identifying and assessing a wide range of children's
needs;
(4) be knowledgeable about local community resources and how to use those resources
for the benefit of children and their families; and
(5) meet the supervision and continuing education requirements of paragraphs (e), (f),
and (g), as applicable.
(c) A case manager may be a member of any professional discipline that is part of the
local system of care for children established by the county board.
(d) A case manager without a bachelor's degree must meet one of the requirements in
clauses (1) to (3):
(1) have three or four years of experience as a case manager associate;
(2) be a registered nurse without a bachelor's degree who has a combination of specialized
training in psychiatry and work experience consisting of community interaction and
involvement or community discharge planning in a mental health setting totaling three years;
or
(3) be a person who qualified as a case manager under the 1998 Department of Human
Services waiver provision and meets the continuing education, supervision, and mentoring
requirements in this section.
(e) A case manager with at least 2,000 hours of supervised experience in the delivery
of mental health services to children must receive regular ongoing supervision and clinical
supervision totaling 38 hours per year, of which at least one hour per month must be clinical
supervision regarding individual service delivery with a case management supervisor. The
other 26 hours of supervision may be provided by a case manager with two years of
experience. Group supervision may not constitute more than one-half of the required
supervision hours.
(f) A case manager without 2,000 hours of supervised experience in the delivery of
mental health services to children with deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end must:
(1) begin 40 hours of training approved by the commissioner of human services in case
management skills and in the characteristics and needs of children with deleted text begin severe emotional
disturbancedeleted text end new text begin serious mental illnessnew text end before beginning to provide case management services;
and
(2) receive clinical supervision regarding individual service delivery from a mental
health professional at least one hour each week until the requirement of 2,000 hours of
experience is met.
(g) A case manager who is not licensed, registered, or certified by a health-related
licensing board must receive 30 hours of continuing education and training in deleted text begin severe
emotional disturbancedeleted text end new text begin serious mental illnessnew text end and mental health services every two years.
(h) Clinical supervision must be documented in the child's record. When the case manager
is not a mental health professional, the county board must provide or contract for needed
clinical supervision.
(i) The county board must ensure that the case manager has the freedom to access and
coordinate the services within the local system of care that are needed by the child.
(j) A case manager associate (CMA) must:
(1) work under the direction of a case manager or case management supervisor;
(2) be at least 21 years of age;
(3) have at least a high school diploma or its equivalent; and
(4) meet one of the following criteria:
(i) have an associate of arts degree in one of the behavioral sciences or human services;
(ii) be a registered nurse without a bachelor's degree;
(iii) have three years of life experience as a primary caregiver to a child with serious
deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end as defined in subdivision 6 within the previous ten
years;
(iv) have 6,000 hours work experience as a nondegreed state hospital technician; or
(v) have 6,000 hours of supervised work experience in the delivery of mental health
services to children with deleted text begin emotional disturbancesdeleted text end new text begin mental illnessnew text end ; hours worked as a mental
health behavioral aide I or II under section 256B.0943, subdivision 7, may count toward
the 6,000 hours of supervised work experience.
Individuals meeting one of the criteria in items (i) to (iv) may qualify as a case manager
after four years of supervised work experience as a case manager associate. Individuals
meeting the criteria in item (v) may qualify as a case manager after three years of supervised
experience as a case manager associate.
(k) Case manager associates must meet the following supervision, mentoring, and
continuing education requirements;
(1) have 40 hours of preservice training described under paragraph (f), clause (1);
(2) receive at least 40 hours of continuing education in deleted text begin severe emotional disturbancedeleted text end new text begin
serious mental illnessnew text end and mental health service annually; and
(3) receive at least five hours of mentoring per week from a case management mentor.
A "case management mentor" means a qualified, practicing case manager or case management
supervisor who teaches or advises and provides intensive training and clinical supervision
to one or more case manager associates. Mentoring may occur while providing direct services
to consumers in the office or in the field and may be provided to individuals or groups of
case manager associates. At least two mentoring hours per week must be individual and
face-to-face.
(l) A case management supervisor must meet the criteria for a mental health professional
as specified in subdivision 27.
(m) An immigrant who does not have the qualifications specified in this subdivision
may provide case management services to child immigrants with deleted text begin severe emotional
disturbancedeleted text end new text begin serious mental illnessnew text end of the same ethnic group as the immigrant if the person:
(1) is currently enrolled in and is actively pursuing credits toward the completion of a
bachelor's degree in one of the behavioral sciences or related fields at an accredited college
or university;
(2) completes 40 hours of training as specified in this subdivision; and
(3) receives clinical supervision at least once a week until the requirements of obtaining
a bachelor's degree and 2,000 hours of supervised experience are met.
Sec. 16.
Minnesota Statutes 2024, section 245.4871, subdivision 6, is amended to read:
Subd. 6.
Child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end .
For purposes
of eligibility for case management and family community support services, "child with
deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end " means a child who has deleted text begin an emotional
disturbancedeleted text end new text begin mental illnessnew text end and who meets one of the following criteria:
(1) the child has been admitted within the last three years or is at risk of being admitted
to inpatient treatment or residential treatment for deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end ;
or
(2) the child is a Minnesota resident and is receiving inpatient treatment or residential
treatment for deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end through the interstate compact; or
(3) the child has one of the following as determined by a mental health professional:
(i) psychosis or a clinical depression; or
(ii) risk of harming self or others as a result of deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end ;
or
(iii) psychopathological symptoms as a result of being a victim of physical or sexual
abuse or of psychic trauma within the past year; or
(4) the child, as a result of deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end , has significantly
impaired home, school, or community functioning that has lasted at least one year or that,
in the written opinion of a mental health professional, presents substantial risk of lasting at
least one year.
Sec. 17.
Minnesota Statutes 2024, section 245.4871, subdivision 13, is amended to read:
Subd. 13.
Education and prevention services.
(a) "Education and prevention services"
means services designed to:
(1) educate the general public;
(2) increase the understanding and acceptance of problems associated with deleted text begin emotional
disturbancesdeleted text end new text begin children's mental illnessesnew text end ;
(3) improve people's skills in dealing with high-risk situations known to affect children's
mental health and functioning; and
(4) refer specific children or their families with mental health needs to mental health
services.
(b) The services include distribution to individuals and agencies identified by the county
board and the local children's mental health advisory council of information on predictors
and symptoms of deleted text begin emotional disturbancesdeleted text end new text begin mental illnessesnew text end , where mental health services are
available in the county, and how to access the services.
Sec. 18.
Minnesota Statutes 2024, section 245.4871, subdivision 15, is amended to read:
Subd. 15.
deleted text begin Emotional disturbancedeleted text end new text begin Mental illnessnew text end .
deleted text begin "Emotional disturbance"deleted text end new text begin "Mental
illness"new text end means an organic disorder of the brain or a clinically significant disorder of thought,
mood, perception, orientation, memory, or behavior that:
(1) is detailed in a diagnostic codes list published by the commissioner; and
(2) seriously limits a child's capacity to function in primary aspects of daily living such
as personal relations, living arrangements, work, school, and recreation.
deleted text begin "Emotional disturbance"deleted text end new text begin Mental illnessnew text end is a generic term and is intended to reflect all
categories of disorder described in the clinical code list published by the commissioner as
"usually first evident in childhood or adolescence."
Sec. 19.
Minnesota Statutes 2024, section 245.4871, subdivision 17, is amended to read:
Subd. 17.
Family community support services.
"Family community support services"
means services provided under the treatment supervision of a mental health professional
and designed to help each child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end to
function and remain with the child's family in the community. Family community support
services do not include acute care hospital inpatient treatment, residential treatment services,
or regional treatment center services. Family community support services include:
(1) client outreach to each child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end
and the child's family;
(2) medication monitoring where necessary;
(3) assistance in developing independent living skills;
(4) assistance in developing parenting skills necessary to address the needs of the child
with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end ;
(5) assistance with leisure and recreational activities;
(6) crisis planning, including crisis placement and respite care;
(7) professional home-based family treatment;
(8) foster care with therapeutic supports;
(9) day treatment;
(10) assistance in locating respite care and special needs day care; and
(11) assistance in obtaining potential financial resources, including those benefits listed
in section 245.4884, subdivision 5.
Sec. 20.
Minnesota Statutes 2024, section 245.4871, subdivision 19, is amended to read:
Subd. 19.
Individual family community support plan.
"Individual family community
support plan" means a written plan developed by a case manager in conjunction with the
family and the child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end on the basis
of a diagnostic assessment and a functional assessment. The plan identifies specific services
needed by a child and the child's family to:
(1) treat the symptoms and dysfunctions determined in the diagnostic assessment;
(2) relieve conditions leading to deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end and improve the
personal well-being of the child;
(3) improve family functioning;
(4) enhance daily living skills;
(5) improve functioning in education and recreation settings;
(6) improve interpersonal and family relationships;
(7) enhance vocational development; and
(8) assist in obtaining transportation, housing, health services, and employment.
Sec. 21.
Minnesota Statutes 2024, section 245.4871, subdivision 21, is amended to read:
Subd. 21.
Individual treatment plan.
(a) "Individual treatment plan" means the
formulation of planned services that are responsive to the needs and goals of a client. An
individual treatment plan must be completed according to section 245I.10, subdivisions 7
and 8.
(b) A children's residential facility licensed under Minnesota Rules, chapter 2960, is
exempt from the requirements of section 245I.10, subdivisions 7 and 8. Instead, the individual
treatment plan must:
(1) include a written plan of intervention, treatment, and services for a child with deleted text begin an
emotional disturbancedeleted text end new text begin mental illnessnew text end that the service provider develops under the clinical
supervision of a mental health professional on the basis of a diagnostic assessment;
(2) be developed in conjunction with the family unless clinically inappropriate; and
(3) identify goals and objectives of treatment, treatment strategy, a schedule for
accomplishing treatment goals and objectives, and the individuals responsible for providing
treatment to the child with deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end .
Sec. 22.
Minnesota Statutes 2024, section 245.4871, subdivision 22, is amended to read:
Subd. 22.
Legal representative.
"Legal representative" means a guardian, conservator,
or guardian ad litem of a child with deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end authorized by
the court to make decisions about mental health services for the child.
Sec. 23.
Minnesota Statutes 2024, section 245.4871, subdivision 28, is amended to read:
Subd. 28.
Mental health services.
"Mental health services" means at least all of the
treatment services and case management activities that are provided to children with
deleted text begin emotional disturbancesdeleted text end new text begin mental illnessesnew text end and are described in sections 245.487 to 245.4889.
Sec. 24.
Minnesota Statutes 2024, section 245.4871, subdivision 29, is amended to read:
Subd. 29.
Outpatient services.
"Outpatient services" means mental health services,
excluding day treatment and community support services programs, provided by or under
the treatment supervision of a mental health professional to children with deleted text begin emotional
disturbancesdeleted text end new text begin mental illnessesnew text end who live outside a hospital. Outpatient services include clinical
activities such as individual, group, and family therapy; individual treatment planning;
diagnostic assessments; medication management; and psychological testing.
Sec. 25.
Minnesota Statutes 2024, section 245.4871, subdivision 31, is amended to read:
Subd. 31.
Professional home-based family treatment.
new text begin (a) new text end "Professional home-based
family treatment" means intensive mental health services provided to children because of
deleted text begin an emotional disturbancedeleted text end new text begin mental illness:new text end (1) who are at risk of deleted text begin out-of-home placementdeleted text end new text begin
residential treatment or therapeutic foster carenew text end ; (2) who are in deleted text begin out-of-home placementdeleted text end new text begin
residential treatment or therapeutic foster carenew text end ; or (3) who are returning from deleted text begin out-of-home
placementdeleted text end new text begin residential treatment or therapeutic foster carenew text end .
new text begin (b)new text end Services are provided to the child and the child's family primarily in the child's home
environment. Services may also be provided in the child's school, child care setting, or other
community setting appropriate to the child. Services must be provided on an individual
family basis, must be child-oriented and family-oriented, and must be designed using
information from diagnostic and functional assessments to meet the specific mental health
needs of the child and the child's family.new text begin Services must be coordinated with other services
provided to the child and the child's family.
new text end
new text begin (c)new text end Examples of services are: (1) individual therapy; (2) family therapy; (3) client
outreach; (4) assistance in developing individual living skills; (5) assistance in developing
parenting skills necessary to address the needs of the child; (6) assistance with leisure and
recreational services; (7) crisis planning, including crisis respite care and arranging for crisis
placement; and (8) assistance in locating respite and child care. Services must be coordinated
with other services provided to the child and family.
Sec. 26.
Minnesota Statutes 2024, section 245.4871, subdivision 32, is amended to read:
Subd. 32.
Residential treatment.
"Residential treatment" means a 24-hour-a-day program
under the treatment supervision of a mental health professional, in a community residential
setting other than an acute care hospital or regional treatment center inpatient unit, that must
be licensed as a residential treatment program for children with deleted text begin emotional disturbancesdeleted text end new text begin
mental illnessesnew text end under Minnesota Rules, parts 2960.0580 to 2960.0700, or other rules adopted
by the commissioner.
Sec. 27.
Minnesota Statutes 2024, section 245.4871, subdivision 34, is amended to read:
Subd. 34.
Therapeutic support of foster care.
"Therapeutic support of foster care"
means the mental health training and mental health support services and treatment supervision
provided by a mental health professional to foster families caring for children with deleted text begin severe
emotional disturbancedeleted text end new text begin serious mental illnessesnew text end to provide a therapeutic family environment
and support for the child's improved functioning. Therapeutic support of foster care includes
services provided under section 256B.0946.
Sec. 28.
Minnesota Statutes 2024, section 245.4873, subdivision 2, is amended to read:
Subd. 2.
State level; coordination.
The Children's Cabinet, under section 4.045, in
consultation with a representative of the Minnesota District Judges Association Juvenile
Committee, shall:
(1) educate each agency about the policies, procedures, funding, and services for children
with deleted text begin emotional disturbancesdeleted text end new text begin mental illnessesnew text end of all agencies represented;
(2) develop mechanisms for interagency coordination on behalf of children with deleted text begin emotional
disturbancesdeleted text end new text begin mental illnessesnew text end ;
(3) identify barriers including policies and procedures within all agencies represented
that interfere with delivery of mental health services for children;
(4) recommend policy and procedural changes needed to improve development and
delivery of mental health services for children in the agency or agencies they represent; and
(5) identify mechanisms for better use of federal and state funding in the delivery of
mental health services for children.
Sec. 29.
Minnesota Statutes 2024, section 245.4874, subdivision 1, is amended to read:
Subdivision 1.
Duties of county board.
(a) The county board must:
(1) develop a system of affordable and locally available children's mental health services
according to sections 245.487 to 245.4889;
(2) consider the assessment of unmet needs in the county as reported by the local
children's mental health advisory council under section 245.4875, subdivision 5, paragraph
(b), clause (3). The county shall provide, upon request of the local children's mental health
advisory council, readily available data to assist in the determination of unmet needs;
(3) assure that parents and providers in the county receive information about how to
gain access to services provided according to sections 245.487 to 245.4889;
(4) coordinate the delivery of children's mental health services with services provided
by social services, education, corrections, health, and vocational agencies to improve the
availability of mental health services to children and the cost-effectiveness of their delivery;
(5) assure that mental health services delivered according to sections 245.487 to 245.4889
are delivered expeditiously and are appropriate to the child's diagnostic assessment and
individual treatment plan;
(6) provide for case management services to each child with deleted text begin severe emotional disturbancedeleted text end new text begin
serious mental illnessnew text end according to sections 245.486; 245.4871, subdivisions 3 and 4; and
245.4881, subdivisions 1, 3, and 5;
(7) provide for screening of each child under section 245.4885 upon admission to a
residential treatment facilitydeleted text begin , acute care hospital inpatient treatment, or informal admission
to a regional treatment centerdeleted text end ;
(8) prudently administer grants and purchase-of-service contracts that the county board
determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4889;
(9) assure that mental health professionals, mental health practitioners, and case managers
employed by or under contract to the county to provide mental health services are qualified
under section 245.4871;
(10) assure that children's mental health services are coordinated with adult mental health
services specified in sections 245.461 to 245.486 so that a continuum of mental health
services is available to serve persons with mental illness, regardless of the person's age;
(11) assure that culturally competent mental health consultants are used as necessary to
assist the county board in assessing and providing appropriate treatment for children of
cultural or racial minority heritage; and
(12) consistent with section 245.486, arrange for or provide a children's mental health
screening for:
(i) a child receiving child protective services;
(ii) a child in deleted text begin out-of-home placementdeleted text end new text begin residential treatment or therapeutic foster carenew text end ;
(iii) a child for whom parental rights have been terminated;
(iv) a child found to be delinquent; or
(v) a child found to have committed a juvenile petty offense for the third or subsequent
time.
A children's mental health screening is not required when a screening or diagnostic
assessment has been performed within the previous 180 days, or the child is currently under
the care of a mental health professional.
(b) When a child is receiving protective services or is in deleted text begin out-of-home placementdeleted text end new text begin
residential treatment or foster carenew text end , the court or county agency must notify a parent or
guardian whose parental rights have not been terminated of the potential mental health
screening and the option to prevent the screening by notifying the court or county agency
in writing.
(c) When a child is found to be delinquent or a child is found to have committed a
juvenile petty offense for the third or subsequent time, the court or county agency must
obtain written informed consent from the parent or legal guardian before a screening is
conducted unless the court, notwithstanding the parent's failure to consent, determines that
the screening is in the child's best interest.
(d) The screening shall be conducted with a screening instrument approved by the
commissioner of human services according to criteria that are updated and issued annually
to ensure that approved screening instruments are valid and useful for child welfare and
juvenile justice populations. Screenings shall be conducted by a mental health practitioner
as defined in section 245.4871, subdivision 26, or a probation officer or local social services
agency staff person who is trained in the use of the screening instrument. Training in the
use of the instrument shall include:
(1) training in the administration of the instrument;
(2) the interpretation of its validity given the child's current circumstances;
(3) the state and federal data practices laws and confidentiality standards;
(4) the parental consent requirement; and
(5) providing respect for families and cultural values.
If the screen indicates a need for assessment, the child's family, or if the family lacks
mental health insurance, the local social services agency, in consultation with the child's
family, shall have conducted a diagnostic assessment, including a functional assessment.
The administration of the screening shall safeguard the privacy of children receiving the
screening and their families and shall comply with the Minnesota Government Data Practices
Act, chapter 13, and the federal Health Insurance Portability and Accountability Act of
1996, Public Law 104-191. Screening results are classified as private data on individuals,
as defined by section 13.02, subdivision 12. The county board or Tribal nation may provide
the commissioner with access to the screening results for the purposes of program evaluation
and improvement.
(e) When the county board refers clients to providers of children's therapeutic services
and supports under section 256B.0943, the county board must clearly identify the desired
services components not covered under section 256B.0943 and identify the reimbursement
source for those requested services, the method of payment, and the payment rate to the
provider.
Sec. 30.
Minnesota Statutes 2024, section 245.4875, subdivision 5, is amended to read:
Subd. 5.
Local children's advisory council.
(a) By October 1, 1989, the county board,
individually or in conjunction with other county boards, shall establish a local children's
mental health advisory council or children's mental health subcommittee of the existing
local mental health advisory council or shall include persons on its existing mental health
advisory council who are representatives of children's mental health interests. The following
individuals must serve on the local children's mental health advisory council, the children's
mental health subcommittee of an existing local mental health advisory council, or be
included on an existing mental health advisory council: (1) at least one person who was in
a mental health program as a child or adolescent; (2) at least one parent of a child or
adolescent with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end ; (3) one children's
mental health professional; (4) representatives of minority populations of significant size
residing in the county; (5) a representative of the children's mental health local coordinating
council; and (6) one family community support services program representative.
(b) The local children's mental health advisory council or children's mental health
subcommittee of an existing advisory council shall seek input from parents, former
consumers, providers, and others about the needs of children with deleted text begin emotional disturbancedeleted text end new text begin
mental illnessnew text end in the local area and services needed by families of these children, and shall
meet monthly, unless otherwise determined by the council or subcommittee, but not less
than quarterly, to review, evaluate, and make recommendations regarding the local children's
mental health system. Annually, the local children's mental health advisory council or
children's mental health subcommittee of the existing local mental health advisory council
shall:
(1) arrange for input from the local system of care providers regarding coordination of
care between the services;
(2) identify for the county board the individuals, providers, agencies, and associations
as specified in section 245.4877, clause (2); and
(3) provide to the county board a report of unmet mental health needs of children residing
in the county.
(c) The county board shall consider the advice of its local children's mental health
advisory council or children's mental health subcommittee of the existing local mental health
advisory council in carrying out its authorities and responsibilities.
Sec. 31.
Minnesota Statutes 2024, section 245.4876, subdivision 4, is amended to read:
Subd. 4.
Referral for case management.
Each provider of emergency services, outpatient
treatment, community support services, family community support services, day treatment
services, screening under section 245.4885, professional home-based family treatment
services, residential treatment facilities, acute care hospital inpatient treatment facilities, or
regional treatment center services must inform each child with deleted text begin severe emotional disturbancedeleted text end new text begin
serious mental illnessnew text end , and the child's parent or legal representative, of the availability and
potential benefits to the child of case management. The information shall be provided as
specified in subdivision 5. If consent is obtained according to subdivision 5, the provider
must refer the child by notifying the county employee designated by the county board to
coordinate case management activities of the child's name and address and by informing
the child's family of whom to contact to request case management. The provider must
document compliance with this subdivision in the child's record. The parent or child may
directly request case management even if there has been no referral.
Sec. 32.
Minnesota Statutes 2024, section 245.4876, subdivision 5, is amended to read:
Subd. 5.
Consent for services or for release of information.
(a) Although sections
245.487 to 245.4889 require each county board, within the limits of available resources, to
make the mental health services listed in those sections available to each child residing in
the county who needs them, the county board shall not provide any services, either directly
or by contract, unless consent to the services is obtained under this subdivision. The case
manager assigned to a child with a deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end shall
not disclose to any person other than the case manager's immediate supervisor and the mental
health professional providing clinical supervision of the case manager information on the
child, the child's family, or services provided to the child or the child's family without
informed written consent unless required to do so by statute or under the Minnesota
Government Data Practices Act. Informed written consent must comply with section 13.05,
subdivision 4, paragraph (d), and specify the purpose and use for which the case manager
may disclose the information.
(b) The consent or authorization must be obtained from the child's parent unless: (1) the
parental rights are terminated; or (2) consent is otherwise provided under sections 144.341
to 144.347; 253B.04, subdivision 1; 260C.148; 260C.151; and 260C.201, subdivision 1,
the terms of appointment of a court-appointed guardian or conservator, or federal regulations
governing substance use disorder services.
Sec. 33.
Minnesota Statutes 2024, section 245.4877, is amended to read:
245.4877 EDUCATION AND PREVENTION SERVICES.
Education and prevention services must be available to all children residing in the county.
Education and prevention services must be designed to:
(1) convey information regarding deleted text begin emotional disturbancesdeleted text end new text begin mental illnessnew text end , mental health
needs, and treatment resources to the general public;
(2) at least annually, distribute to individuals and agencies identified by the county board
and the local children's mental health advisory council information on predictors and
symptoms of deleted text begin emotional disturbancesdeleted text end new text begin mental illnessnew text end , where mental health services are
available in the county, and how to access the services;
(3) increase understanding and acceptance of problems associated with deleted text begin emotional
disturbancesdeleted text end new text begin mental illnessnew text end ;
(4) improve people's skills in dealing with high-risk situations known to affect children's
mental health and functioning;
(5) prevent development or deepening of deleted text begin emotional disturbancesdeleted text end new text begin mental illnessnew text end ; and
(6) refer each child with deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end or the child's family with
additional mental health needs to appropriate mental health services.
Sec. 34.
Minnesota Statutes 2024, section 245.488, subdivision 1, is amended to read:
Subdivision 1.
Availability of outpatient services.
(a) County boards must provide or
contract for enough outpatient services within the county to meet the needs of each child
with deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end residing in the county and the child's family.
Services may be provided directly by the county through county-operated mental health
clinics meeting the standards of chapter 245I; by contract with privately operated mental
health clinics meeting the standards of chapter 245I; by contract with hospital mental health
outpatient programs certified by the Joint Commission on Accreditation of Hospital
Organizations; or by contract with a mental health professional. A child or a child's parent
may be required to pay a fee based in accordance with section 245.481. Outpatient services
include:
(1) conducting diagnostic assessments;
(2) conducting psychological testing;
(3) developing or modifying individual treatment plans;
(4) making referrals and recommending placements as appropriate;
(5) treating the child's mental health needs through therapy; and
(6) prescribing and managing medication and evaluating the effectiveness of prescribed
medication.
(b) County boards may request a waiver allowing outpatient services to be provided in
a nearby trade area if it is determined that the child requires necessary and appropriate
services that are only available outside the county.
(c) Outpatient services offered by the county board to prevent placement must be at the
level of treatment appropriate to the child's diagnostic assessment.
Sec. 35.
Minnesota Statutes 2024, section 245.488, subdivision 3, is amended to read:
Subd. 3.
Mental health crisis services.
County boards must provide or contract for
mental health crisis services within the county to meet the needs of children with deleted text begin emotional
disturbancedeleted text end new text begin mental illnessnew text end residing in the county who are determined, through an assessment
by a mental health professional, to be experiencing a mental health crisis or mental health
emergency. The mental health crisis services provided must be medically necessary, as
defined in section 62Q.53, subdivision 2, and necessary for the safety of the child or others
regardless of the setting.
Sec. 36.
Minnesota Statutes 2024, section 245.4881, subdivision 1, is amended to read:
Subdivision 1.
Availability of case management services.
(a) The county board shall
provide case management services for each child with deleted text begin severe emotional disturbancedeleted text end new text begin serious
mental illnessnew text end who is a resident of the county and the child's family who request or consent
to the services. Case management services must be offered to a child with a serious deleted text begin emotional
disturbancedeleted text end new text begin mental illnessnew text end who is over the age of 18 consistent with section 245.4875,
subdivision 8, or the child's legal representative, provided the child's service needs can be
met within the children's service system. Before discontinuing case management services
under this subdivision for children between the ages of 17 and 21, a transition plan must be
developed. The transition plan must be developed with the child and, with the consent of a
child age 18 or over, the child's parent, guardian, or legal representative. The transition plan
should include plans for health insurance, housing, education, employment, and treatment.
Staffing ratios must be sufficient to serve the needs of the clients. The case manager must
meet the requirements in section 245.4871, subdivision 4.
(b) Except as permitted by law and the commissioner under demonstration projects, case
management services provided to children with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental
illnessnew text end eligible for medical assistance must be billed to the medical assistance program under
sections 256B.02, subdivision 8, and 256B.0625.
(c) Case management services are eligible for reimbursement under the medical assistance
program. Costs of mentoring, supervision, and continuing education may be included in the
reimbursement rate methodology used for case management services under the medical
assistance program.
Sec. 37.
Minnesota Statutes 2024, section 245.4881, subdivision 4, is amended to read:
Subd. 4.
Individual family community support plan.
(a) For each child, the case
manager must develop an individual family community support plan that incorporates the
child's individual treatment plan. The individual treatment plan may not be a substitute for
the development of an individual family community support plan. The case manager is
responsible for developing the individual family community support plan within 30 days
of intake based on a diagnostic assessment and for implementing and monitoring the delivery
of services according to the individual family community support plan. The case manager
must review the plan at least every 180 calendar days after it is developed, unless the case
manager has received a written request from the child's family or an advocate for the child
for a review of the plan every 90 days after it is developed. To the extent appropriate, the
child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end , the child's family, advocates,
service providers, and significant others must be involved in all phases of development and
implementation of the individual family community support plan. Notwithstanding the lack
of an individual family community support plan, the case manager shall assist the child and
child's family in accessing the needed services listed in section 245.4884, subdivision 1.
(b) The child's individual family community support plan must state:
(1) the goals and expected outcomes of each service and criteria for evaluating the
effectiveness and appropriateness of the service;
(2) the activities for accomplishing each goal;
(3) a schedule for each activity; and
(4) the frequency of face-to-face contacts by the case manager, as appropriate to client
need and the implementation of the individual family community support plan.
Sec. 38.
Minnesota Statutes 2024, section 245.4882, subdivision 1, is amended to read:
Subdivision 1.
Availability of residential treatment services.
County boards must
provide or contract for enough residential treatment services to meet the needs of each child
with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end residing in the county and needing
this level of care. Length of stay is based on the child's residential treatment need and shall
be reviewed every 90 days. Services must be appropriate to the child's age and treatment
needs and must be made available as close to the county as possible. Residential treatment
must be designed to:
(1) help the child improve family living and social interaction skills;
(2) help the child gain the necessary skills to return to the community;
(3) stabilize crisis admissions; and
(4) work with families throughout the placement to improve the ability of the families
to care for children with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end in the home.
Sec. 39.
Minnesota Statutes 2024, section 245.4882, subdivision 5, is amended to read:
Subd. 5.
Specialized residential treatment services.
The commissioner of human
services shall continue efforts to further interagency collaboration to develop a comprehensive
system of services, including family community support and specialized residential treatment
services for children. The services shall be designed for children with deleted text begin emotional disturbancedeleted text end new text begin
mental illnessnew text end who exhibit violent or destructive behavior and for whom local treatment
services are not feasible due to the small number of children statewide who need the services
and the specialized nature of the services required. The services shall be located in community
settings.
Sec. 40.
Minnesota Statutes 2024, section 245.4884, is amended to read:
245.4884 FAMILY COMMUNITY SUPPORT SERVICES.
Subdivision 1.
Availability of family community support services.
By July 1, 1991,
county boards must provide or contract for sufficient family community support services
within the county to meet the needs of each child with deleted text begin severe emotional disturbancedeleted text end new text begin serious
mental illnessnew text end who resides in the county and the child's family. Children or their parents
may be required to pay a fee in accordance with section 245.481.
Family community support services must be designed to improve the ability of children
with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end to:
(1) manage basic activities of daily living;
(2) function appropriately in home, school, and community settings;
(3) participate in leisure time or community youth activities;
(4) set goals and plans;
(5) reside with the family in the community;
(6) participate in after-school and summer activities;
(7) make a smooth transition among mental health and education services provided to
children; and
(8) make a smooth transition into the adult mental health system as appropriate.
In addition, family community support services must be designed to improve overall
family functioning if clinically appropriate to the child's needs, and to reduce the need for
and use of placements more intensive, costly, or restrictive both in the number of admissions
and lengths of stay than indicated by the child's diagnostic assessment.
The commissioner of human services shall work with mental health professionals to
develop standards for clinical supervision of family community support services. These
standards shall be incorporated in rule and in guidelines for grants for family community
support services.
Subd. 2.
Day treatment services provided.
(a) Day treatment services must be part of
the family community support services available to each child with deleted text begin severe emotional
disturbancedeleted text end new text begin serious mental illnessnew text end residing in the county. A child or the child's parent may
be required to pay a fee according to section 245.481. Day treatment services must be
designed to:
(1) provide a structured environment for treatment;
(2) provide support for residing in the community;
(3) prevent placements that are more intensive, costly, or restrictive than necessary to
meet the child's need;
(4) coordinate with or be offered in conjunction with the child's education program;
(5) provide therapy and family intervention for children that are coordinated with
education services provided and funded by schools; and
(6) operate during all 12 months of the year.
(b) County boards may request a waiver from including day treatment services if they
can document that:
(1) alternative services exist through the county's family community support services
for each child who would otherwise need day treatment services; and
(2) county demographics and geography make the provision of day treatment services
cost ineffective and unfeasible.
Subd. 3.
Professional home-based family treatment provided.
(a) By January 1, 1991,
county boards must provide or contract for sufficient professional home-based family
treatment within the county to meet the needs of each child with deleted text begin severe emotional disturbancedeleted text end new text begin
serious mental illnessnew text end who is at risk of deleted text begin out-of-home placementdeleted text end new text begin residential treatment or
therapeutic foster carenew text end due to the child's deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end or who is
returning to the home from deleted text begin out-of-home placementdeleted text end new text begin residential treatment or therapeutic
foster carenew text end . The child or the child's parent may be required to pay a fee according to section
245.481. The county board shall require that all service providers of professional home-based
family treatment set fee schedules approved by the county board that are based on the child's
or family's ability to pay. The professional home-based family treatment must be designed
to assist each child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end who is at risk
of or who is returning from deleted text begin out-of-home placementdeleted text end new text begin residential treatment or therapeutic
foster carenew text end and the child's family to:
(1) improve overall family functioning in all areas of life;
(2) treat the child's symptoms of deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end that contribute to
a risk of deleted text begin out-of-home placementdeleted text end new text begin residential treatment or therapeutic foster carenew text end ;
(3) provide a positive change in the emotional, behavioral, and mental well-being of
children and their families; and
(4) reduce risk of deleted text begin out-of-home placementdeleted text end new text begin residential treatment or therapeutic foster carenew text end
for the identified child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end and other
siblings or successfully reunify and reintegrate into the family a child returning from
deleted text begin out-of-home placementdeleted text end new text begin residential treatment or therapeutic foster carenew text end due to deleted text begin emotional
disturbancedeleted text end new text begin mental illnessnew text end .
(b) Professional home-based family treatment must be provided by a team consisting of
a mental health professional and others who are skilled in the delivery of mental health
services to children and families in conjunction with other human service providers. The
professional home-based family treatment team must maintain flexible hours of service
availability and must provide or arrange for crisis services for each family, 24 hours a day,
seven days a week. Case loads for each professional home-based family treatment team
must be small enough to permit the delivery of intensive services and to meet the needs of
the family. Professional home-based family treatment providers shall coordinate services
and service needs with case managers assigned to children and their families. The treatment
team must develop an individual treatment plan that identifies the specific treatment
objectives for both the child and the family.
Subd. 4.
Therapeutic support of foster care.
By January 1, 1992, county boards must
provide or contract for foster care with therapeutic support as defined in section 245.4871,
subdivision 34. Foster families caring for children with deleted text begin severe emotional disturbancedeleted text end new text begin serious
mental illnessnew text end must receive training and supportive services, as necessary, at no cost to the
foster families within the limits of available resources.
Subd. 5.
Benefits assistance.
The county board must offer help to a child with deleted text begin severe
emotional disturbancedeleted text end new text begin serious mental illnessnew text end and the child's family in applying for federal
benefits, including Supplemental Security Income, medical assistance, and Medicare.
Sec. 41.
Minnesota Statutes 2024, section 245.4885, subdivision 1, is amended to read:
Subdivision 1.
Admission criteria.
(a) Prior to admission or placement, except in the
case of an emergency, all children referred for treatment of deleted text begin severe emotional disturbancedeleted text end new text begin
serious mental illnessnew text end in a treatment foster care setting, residential treatment facility, or
informally admitted to a regional treatment center shall undergo an assessment to determine
the appropriate level of care if county funds are used to pay for the child's services. An
emergency includes when a child is in need of and has been referred for crisis stabilization
services under section 245.4882, subdivision 6. A child who has been referred to residential
treatment for crisis stabilization services in a residential treatment center is not required to
undergo an assessment under this section.
(b) The county board shall determine the appropriate level of care for a child when
county-controlled funds are used to pay for the child's residential treatment under this
chapter, including residential treatment provided in a qualified residential treatment program
as defined in section 260C.007, subdivision 26d. When a county board does not have
responsibility for a child's placement and the child is enrolled in a prepaid health program
under section 256B.69, the enrolled child's contracted health plan must determine the
appropriate level of care for the child. When Indian Health Services funds or funds of a
tribally owned facility funded under the Indian Self-Determination and Education Assistance
Act, Public Law 93-638, are used for the child, the Indian Health Services or 638 tribal
health facility must determine the appropriate level of care for the child. When more than
one entity bears responsibility for a child's coverage, the entities shall coordinate level of
care determination activities for the child to the extent possible.
(c) The child's level of care determination shall determine whether the proposed treatment:
(1) is necessary;
(2) is appropriate to the child's individual treatment needs;
(3) cannot be effectively provided in the child's home; and
(4) provides a length of stay as short as possible consistent with the individual child's
needs.
(d) When a level of care determination is conducted, the county board or other entity
may not determine that a screening of a child, referral, or admission to a residential treatment
facility is not appropriate solely because services were not first provided to the child in a
less restrictive setting and the child failed to make progress toward or meet treatment goals
in the less restrictive setting. The level of care determination must be based on a diagnostic
assessment of a child that evaluates the child's family, school, and community living
situations; and an assessment of the child's need for care out of the home using a validated
tool which assesses a child's functional status and assigns an appropriate level of care to the
child. The validated tool must be approved by the commissioner of human services and
may be the validated tool approved for the child's assessment under section 260C.704 if the
juvenile treatment screening team recommended placement of the child in a qualified
residential treatment program. If a diagnostic assessment has been completed by a mental
health professional within the past 180 days, a new diagnostic assessment need not be
completed unless in the opinion of the current treating mental health professional the child's
mental health status has changed markedly since the assessment was completed. The child's
parent shall be notified if an assessment will not be completed and of the reasons. A copy
of the notice shall be placed in the child's file. Recommendations developed as part of the
level of care determination process shall include specific community services needed by
the child and, if appropriate, the child's family, and shall indicate whether these services
are available and accessible to the child and the child's family. The child and the child's
family must be invited to any meeting where the level of care determination is discussed
and decisions regarding residential treatment are made. The child and the child's family
may invite other relatives, friends, or advocates to attend these meetings.
(e) During the level of care determination process, the child, child's family, or child's
legal representative, as appropriate, must be informed of the child's eligibility for case
management services and family community support services and that an individual family
community support plan is being developed by the case manager, if assigned.
(f) The level of care determination, placement decision, and recommendations for mental
health services must be documented in the child's record and made available to the child's
family, as appropriate.
Sec. 42.
Minnesota Statutes 2024, section 245.4889, subdivision 1, is amended to read:
Subdivision 1.
Establishment and authority.
(a) The commissioner is authorized to
make grants from available appropriations to assist:
(1) counties;
(2) Indian tribes;
(3) children's collaboratives under section 142D.15 or 245.493; or
(4) mental health service providers.
(b) The following services are eligible for grants under this section:
(1) services to children with deleted text begin emotional disturbancesdeleted text end new text begin mental illnessnew text end as defined in section
245.4871, subdivision 15, and their families;
(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;
(3) respite care services for children with deleted text begin emotional disturbancesdeleted text end new text begin mental illnessnew text end or deleted text begin severe
emotional disturbancesdeleted text end new text begin serious mental illnessnew text end who are at risk of residential treatment or
hospitalizationdeleted text begin ,deleted text end new text begin ;new text end who are already in deleted text begin out-of-home placementdeleted text end new text begin residential treatment, therapeutic
foster care, ornew text end in family foster settings as defined in chapter 142B and at risk of change in
deleted text begin out-of-home placementdeleted text end new text begin foster carenew text end or placement in a residential facility or other higher level
of caredeleted text begin ,deleted text end new text begin ;new text end who have utilized crisis services or emergency room servicesdeleted text begin ,deleted text end new text begin ;new text end or who have
experienced a loss of in-home staffing support. Allowable activities and expenses for respite
care services are defined under subdivision 4. A child is not required to have case
management services to receive respite care services. Counties must work to provide access
to regularly scheduled respite care;
(4) children's mental health crisis services;
(5) child-, youth-, and family-specific mobile response and stabilization services models;
(6) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;
(7) children's mental health screening and follow-up diagnostic assessment and treatment;
(8) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;
(9) school-linked mental health services under section 245.4901;
(10) building evidence-based mental health intervention capacity for children birth to
age five;
(11) suicide prevention and counseling services that use text messaging statewide;
(12) mental health first aid training;
(13) training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
website to share information and strategies to promote resilience and prevent trauma;
(14) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;
(15) early childhood mental health consultation;
(16) evidence-based interventions for youth at risk of developing or experiencing a first
episode of psychosis, and a public awareness campaign on the signs and symptoms of
psychosis;
(17) psychiatric consultation for primary care practitioners; and
(18) providers to begin operations and meet program requirements when establishing a
new children's mental health program. These may be start-up grants.
(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.
(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
reimbursement sources, if applicable.
(e) The commissioner may establish and design a pilot program to expand the mobile
response and stabilization services model for children, youth, and families. The commissioner
may use grant funding to consult with a qualified expert entity to assist in the formulation
of measurable outcomes and explore and position the state to submit a Medicaid state plan
amendment to scale the model statewide.
Sec. 43.
Minnesota Statutes 2024, section 245.4907, subdivision 2, is amended to read:
Subd. 2.
Eligible applicants.
An eligible applicant is a licensed entity or provider that
employs a mental health certified peer family specialist qualified under section 245I.04,
subdivision 12, and that provides services to families who have a child:
(1) with deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end or deleted text begin severe emotional disturbancedeleted text end new text begin serious
mental illnessnew text end under chapter 245;
(2) receiving inpatient hospitalization under section 256B.0625, subdivision 1;
(3) admitted to a residential treatment facility under section 245.4882;
(4) receiving children's intensive behavioral health services under section 256B.0946;
(5) receiving day treatment or children's therapeutic services and supports under section
256B.0943; or
(6) receiving crisis response services under section 256B.0624.
Sec. 44.
Minnesota Statutes 2024, section 245.491, subdivision 2, is amended to read:
Subd. 2.
Purpose.
The legislature finds that children withnew text begin mental illnesses ornew text end emotional
or behavioral disturbances or who are at risk of suffering such disturbances often require
services from multiple service systems including mental health, social services, education,
corrections, juvenile court, health, and employment and economic development. In order
to better meet the needs of these children, it is the intent of the legislature to establish an
integrated children's mental health service system that:
(1) allows local service decision makers to draw funding from a single local source so
that funds follow clients and eliminates the need to match clients, funds, services, and
provider eligibilities;
(2) creates a local pool of state, local, and private funds to procure a greater medical
assistance federal financial participation;
(3) improves the efficiency of use of existing resources;
(4) minimizes or eliminates the incentives for cost and risk shifting; and
(5) increases the incentives for earlier identification and intervention.
The children's mental health integrated fund established under sections 245.491 to 245.495
must be used to develop and support this integrated mental health service system. In
developing this integrated service system, it is not the intent of the legislature to limit any
rights available to children and their families through existing federal and state laws.
Sec. 45.
Minnesota Statutes 2024, section 245.492, subdivision 3, is amended to read:
Subd. 3.
Children with emotional or behavioral disturbances.
"Children with
emotional or behavioral disturbances" includes children with deleted text begin emotional disturbancesdeleted text end new text begin mental
illnessesnew text end as defined in section 245.4871, subdivision 15, and children with emotional or
behavioral disorders as defined in Minnesota Rules, part 3525.1329, subpart 1.
Sec. 46.
Minnesota Statutes 2024, section 245.697, subdivision 2a, is amended to read:
Subd. 2a.
Subcommittee on Children's Mental Health.
The State Advisory Council
on Mental Health (the "advisory council") must have a Subcommittee on Children's Mental
Health. The subcommittee must make recommendations to the advisory council on policies,
laws, regulations, and services relating to children's mental health. Members of the
subcommittee must include:
(1) the commissioners or designees of the commissioners of the Departments of Human
Services, Health, Education, State Planning, and Corrections;
(2) a designee of the Direct Care and Treatment executive board;
(3) the commissioner of commerce or a designee of the commissioner who is
knowledgeable about medical insurance issues;
(4) at least one representative of an advocacy group for children with deleted text begin emotional
disturbancesdeleted text end new text begin mental illnessesnew text end ;
(5) providers of children's mental health services, including at least one provider of
services to preadolescent children, one provider of services to adolescents, and one
hospital-based provider;
(6) parents of children who have deleted text begin emotional disturbancesdeleted text end new text begin mental illnessesnew text end ;
(7) a present or former consumer of adolescent mental health services;
(8) educators currently working with deleted text begin emotionally disturbeddeleted text end childrennew text begin with mental illnessesnew text end ;
(9) people knowledgeable about the needs of deleted text begin emotionally disturbeddeleted text end childrennew text begin with mental
illnessesnew text end of minority races and cultures;
(10) people experienced in working with deleted text begin emotionally disturbeddeleted text end childrennew text begin with mental
illnessesnew text end who have committed status offenses;
(11) members of the advisory council;
(12) one person from the local corrections department and one representative of the
Minnesota District Judges Association Juvenile Committee; and
(13) county commissioners and social services agency representatives.
The chair of the advisory council shall appoint subcommittee members described in
clauses (4) to (12) through the process established in section 15.0597. The chair shall appoint
members to ensure a geographical balance on the subcommittee. Terms, compensation,
removal, and filling of vacancies are governed by subdivision 1, except that terms of
subcommittee members who are also members of the advisory council are coterminous with
their terms on the advisory council. The subcommittee shall meet at the call of the
subcommittee chair who is elected by the subcommittee from among its members. The
subcommittee expires with the expiration of the advisory council.
Sec. 47.
Minnesota Statutes 2024, section 245.814, subdivision 3, is amended to read:
Subd. 3.
Compensation provisions.
new text begin (a) new text end If the commissioner of human services is unable
to obtain insurance through ordinary methods for coverage of foster home providers, the
appropriation shall be returned to the general fund and the state shall pay claims subject to
the following limitations.
deleted text begin (a)deleted text end new text begin (b)new text end Compensation shall be provided only for injuries, damage, or actions set forth in
subdivision 1.
deleted text begin (b)deleted text end new text begin (c)new text end Compensation shall be subject to the conditions and exclusions set forth in
subdivision 2.
deleted text begin (c)deleted text end new text begin (d)new text end The state shall provide compensation for bodily injury, property damage, or
personal injury resulting from the foster home providers activities as a foster home provider
while the foster child or adult is in the care, custody, and control of the foster home provider
in an amount not to exceed $250,000 for each occurrence.
deleted text begin (d)deleted text end new text begin (e)new text end The state shall provide compensation for damage or destruction of property caused
or sustained by a foster child or adult in an amount not to exceed $250 for each occurrence.
deleted text begin (e)deleted text end new text begin (f)new text end The compensation in paragraphs deleted text begin (c) anddeleted text end (d)new text begin and (e)new text end is the total obligation for all
damages because of each occurrence regardless of the number of claims made in connection
with the same occurrence, but compensation applies separately to each foster home. The
state shall have no other responsibility to provide compensation for any injury or loss caused
or sustained by any foster home provider or foster child or foster adult.
new text begin (g) new text end This coverage is extended as a benefit to foster home providers to encourage care
of persons who need deleted text begin out-of-homedeleted text end new text begin the providers'new text end care. Nothing in this section shall be
construed to mean that foster home providers are agents or employees of the state nor does
the state accept any responsibility for the selection, monitoring, supervision, or control of
foster home providers which is exclusively the responsibility of the counties which shall
regulate foster home providers in the manner set forth in the rules of the commissioner of
human services.
Sec. 48.
Minnesota Statutes 2024, section 245.826, is amended to read:
245.826 USE OF RESTRICTIVE TECHNIQUES AND PROCEDURES IN
FACILITIES SERVING deleted text begin EMOTIONALLY DISTURBEDdeleted text end CHILDRENnew text begin WITH
MENTAL ILLNESSESnew text end .
When amending rules governing facilities serving deleted text begin emotionally disturbeddeleted text end childrennew text begin with
mental illnessesnew text end that are licensed under section 245A.09 and Minnesota Rules, parts
2960.0510 to 2960.0530 and 2960.0580 to 2960.0700, the commissioner of human services
shall include provisions governing the use of restrictive techniques and procedures. No
provision of these rules may encourage or require the use of restrictive techniques and
procedures. The rules must prohibit: (1) the application of certain restrictive techniques or
procedures in facilities, except as authorized in the child's case plan and monitored by the
county caseworker responsible for the child; (2) the use of restrictive techniques or procedures
that restrict the clients' normal access to nutritious diet, drinking water, adequate ventilation,
necessary medical care, ordinary hygiene facilities, normal sleeping conditions, and necessary
clothing; and (3) the use of corporal punishment. The rule may specify other restrictive
techniques and procedures and the specific conditions under which permitted techniques
and procedures are to be carried out.
Sec. 49.
Minnesota Statutes 2024, section 245.91, subdivision 2, is amended to read:
Subd. 2.
Agency.
"Agency" means the divisions, officials, or employees of the state
Departments of Human Services, Direct Care and Treatment, Health, and Education, and
of local school districts and designated county social service agencies as defined in section
256G.02, subdivision 7, that are engaged in monitoring, providing, or regulating services
or treatment for mental illness, developmental disability,new text begin ornew text end substance use disorderdeleted text begin , or
emotional disturbancedeleted text end .
Sec. 50.
Minnesota Statutes 2024, section 245.91, subdivision 4, is amended to read:
Subd. 4.
Facility or program.
"Facility" or "program" means a nonresidential or
residential program as defined in section 245A.02, subdivisions 10 and 14, and any agency,
facility, or program that provides services or treatment for mental illness, developmental
disability,new text begin ornew text end substance use disorderdeleted text begin , or emotional disturbancedeleted text end that is required to be licensed,
certified, or registered by the commissioner of human services, health, or education; a sober
home as defined in section 254B.01, subdivision 11; peer recovery support services provided
by a recovery community organization as defined in section 254B.01, subdivision 8; and
an acute care inpatient facility that provides services or treatment for mental illness,
developmental disability,new text begin ornew text end substance use disorderdeleted text begin , or emotional disturbancedeleted text end .
Sec. 51.
Minnesota Statutes 2024, section 245.92, is amended to read:
245.92 OFFICE OF OMBUDSMAN; CREATION; QUALIFICATIONS;
FUNCTION.
The ombudsman for persons receiving services or treatment for mental illness,
developmental disability,new text begin ornew text end substance use disorderdeleted text begin , or emotional disturbancedeleted text end shall promote
the highest attainable standards of treatment, competence, efficiency, and justice. The
ombudsman may gather information and data about decisions, acts, and other matters of an
agency, facility, or program, and shall monitor the treatment of individuals participating in
a University of Minnesota Department of Psychiatry clinical drug trial. The ombudsman is
appointed by the governor, serves in the unclassified service, and may be removed only for
just cause. The ombudsman must be selected without regard to political affiliation and must
be a person who has knowledge and experience concerning the treatment, needs, and rights
of clients, and who is highly competent and qualified. No person may serve as ombudsman
while holding another public office.
Sec. 52.
Minnesota Statutes 2024, section 245.94, subdivision 1, is amended to read:
Subdivision 1.
Powers.
(a) The ombudsman may prescribe the methods by which
complaints to the office are to be made, reviewed, and acted upon. The ombudsman may
not levy a complaint fee.
(b) The ombudsman is a health oversight agency as defined in Code of Federal
Regulations, title 45, section 164.501. The ombudsman may access patient records according
to Code of Federal Regulations, title 42, section 2.53. For purposes of this paragraph,
"records" has the meaning given in Code of Federal Regulations, title 42, section
2.53(a)(1)(i).
(c) The ombudsman may mediate or advocate on behalf of a client.
(d) The ombudsman may investigate the quality of services provided to clients and
determine the extent to which quality assurance mechanisms within state and county
government work to promote the health, safety, and welfare of clients.
(e) At the request of a client, or upon receiving a complaint or other information affording
reasonable grounds to believe that the rights of one or more clients who may not be capable
of requesting assistance have been adversely affected, the ombudsman may gather
information and data about and analyze, on behalf of the client, the actions of an agency,
facility, or program.
(f) The ombudsman may gather, on behalf of one or more clients, records of an agency,
facility, or program, or records related to clinical drug trials from the University of Minnesota
Department of Psychiatry, if the records relate to a matter that is within the scope of the
ombudsman's authority. If the records are private and the client is capable of providing
consent, the ombudsman shall first obtain the client's consent. The ombudsman is not
required to obtain consent for access to private data on clients with developmental disabilities
and individuals served by the Minnesota Sex Offender Program. The ombudsman may also
take photographic or videographic evidence while reviewing the actions of an agency,
facility, or program, with the consent of the client. The ombudsman is not required to obtain
consent for access to private data on decedents who were receiving services for mental
illness, developmental disability,new text begin ornew text end substance use disorderdeleted text begin , or emotional disturbancedeleted text end . All
data collected, created, received, or maintained by the ombudsman are governed by chapter
13 and other applicable law.
(g) Notwithstanding any law to the contrary, the ombudsman may subpoena a person
to appear, give testimony, or produce documents or other evidence that the ombudsman
considers relevant to a matter under inquiry. The ombudsman may petition the appropriate
court in Ramsey County to enforce the subpoena. A witness who is at a hearing or is part
of an investigation possesses the same privileges that a witness possesses in the courts or
under the law of this state. Data obtained from a person under this paragraph are private
data as defined in section 13.02, subdivision 12.
(h) The ombudsman may, at reasonable times in the course of conducting a review, enter
and view premises within the control of an agency, facility, or program.
(i) The ombudsman may attend Direct Care and Treatment Review Board and Special
Review Board proceedings; proceedings regarding the transfer of clients, as defined in
section 246.50, subdivision 4, between institutions operated by the Direct Care and Treatment
executive board; and, subject to the consent of the affected client, other proceedings affecting
the rights of clients. The ombudsman is not required to obtain consent to attend meetings
or proceedings and have access to private data on clients with developmental disabilities
and individuals served by the Minnesota Sex Offender Program.
(j) The ombudsman shall gather data of agencies, facilities, or programs classified as
private or confidential as defined in section 13.02, subdivisions 3 and 12, regarding services
provided to clients with developmental disabilities and individuals served by the Minnesota
Sex Offender Program.
(k) To avoid duplication and preserve evidence, the ombudsman shall inform relevant
licensing or regulatory officials before undertaking a review of an action of the facility or
program.
(l) The Office of Ombudsman shall provide the services of the Civil Commitment
Training and Resource Center.
(m) The ombudsman shall monitor the treatment of individuals participating in a
University of Minnesota Department of Psychiatry clinical drug trial and ensure that all
protections for human subjects required by federal law and the Institutional Review Board
are provided.
(n) Sections 245.91 to 245.97 are in addition to other provisions of law under which any
other remedy or right is provided.
Sec. 53.
Minnesota Statutes 2024, section 245A.03, subdivision 2, is amended to read:
Subd. 2.
Exclusion from licensure.
(a) This chapter does not apply to:
(1) residential or nonresidential programs that are provided to a person by an individual
who is related;
(2) nonresidential programs that are provided by an unrelated individual to persons from
a single related family;
(3) residential or nonresidential programs that are provided to adults who do not misuse
substances or have a substance use disorder, a mental illness, a developmental disability, a
functional impairment, or a physical disability;
(4) sheltered workshops or work activity programs that are certified by the commissioner
of employment and economic development;
(5) programs operated by a public school for children 33 months or older;
(6) nonresidential programs primarily for children that provide care or supervision for
periods of less than three hours a day while the child's parent or legal guardian is in the
same building as the nonresidential program or present within another building that is
directly contiguous to the building in which the nonresidential program is located;
(7) nursing homes or hospitals licensed by the commissioner of health except as specified
under section 245A.02;
(8) board and lodge facilities licensed by the commissioner of health that do not provide
children's residential services under Minnesota Rules, chapter 2960, mental health or
substance use disorder treatment;
(9) programs licensed by the commissioner of corrections;
(10) recreation programs for children or adults that are operated or approved by a park
and recreation board whose primary purpose is to provide social and recreational activities;
(11) noncertified boarding care homes unless they provide services for five or more
persons whose primary diagnosis is mental illness or a developmental disability;
(12) programs for children such as scouting, boys clubs, girls clubs, and sports and art
programs, and nonresidential programs for children provided for a cumulative total of less
than 30 days in any 12-month period;
(13) residential programs for persons with mental illness, that are located in hospitals;
(14) camps licensed by the commissioner of health under Minnesota Rules, chapter
4630;
(15) mental health outpatient services for adults with mental illness or children with
deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end ;
(16) residential programs serving school-age children whose sole purpose is cultural or
educational exchange, until the commissioner adopts appropriate rules;
(17) community support services programs as defined in section 245.462, subdivision
6, and family community support services as defined in section 245.4871, subdivision 17;
(18) assisted living facilities licensed by the commissioner of health under chapter 144G;
(19) substance use disorder treatment activities of licensed professionals in private
practice as defined in section 245G.01, subdivision 17;
(20) consumer-directed community support service funded under the Medicaid waiver
for persons with developmental disabilities when the individual who provided the service
is:
(i) the same individual who is the direct payee of these specific waiver funds or paid by
a fiscal agent, fiscal intermediary, or employer of record; and
(ii) not otherwise under the control of a residential or nonresidential program that is
required to be licensed under this chapter when providing the service;
(21) a county that is an eligible vendor under section 254B.05 to provide care coordination
and comprehensive assessment services;
(22) a recovery community organization that is an eligible vendor under section 254B.05
to provide peer recovery support services; or
(23) programs licensed by the commissioner of children, youth, and families in chapter
142B.
(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
building in which a nonresidential program is located if it shares a common wall with the
building in which the nonresidential program is located or is attached to that building by
skyway, tunnel, atrium, or common roof.
(c) Except for the home and community-based services identified in section 245D.03,
subdivision 1, nothing in this chapter shall be construed to require licensure for any services
provided and funded according to an approved federal waiver plan where licensure is
specifically identified as not being a condition for the services and funding.
Sec. 54.
Minnesota Statutes 2024, section 245A.26, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.
(b) "Clinical trainee" means a staff person who is qualified under section 245I.04,
subdivision 6.
(c) "License holder" means an individual, organization, or government entity that was
issued a license by the commissioner of human services under this chapter for residential
mental health treatment for children with deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end according
to Minnesota Rules, parts 2960.0010 to 2960.0220 and 2960.0580 to 2960.0700, or shelter
care services according to Minnesota Rules, parts 2960.0010 to 2960.0120 and 2960.0510
to 2960.0530.
(d) "Mental health professional" means an individual who is qualified under section
245I.04, subdivision 2.
Sec. 55.
Minnesota Statutes 2024, section 245A.26, subdivision 2, is amended to read:
Subd. 2.
Scope and applicability.
(a) This section establishes additional licensing
requirements for a children's residential facility to provide children's residential crisis
stabilization services to a client who is experiencing a mental health crisis and is in need of
residential treatment services.
(b) A children's residential facility may provide residential crisis stabilization services
only if the facility is licensed to provide:
(1) residential mental health treatment for children with deleted text begin emotional disturbancedeleted text end new text begin mental
illnessnew text end according to Minnesota Rules, parts 2960.0010 to 2960.0220 and 2960.0580 to
2960.0700; or
(2) shelter care services according to Minnesota Rules, parts 2960.0010 to 2960.0120
and 2960.0510 to 2960.0530.
(c) If a client receives residential crisis stabilization services for 35 days or fewer in a
facility licensed according to paragraph (b), clause (1), the facility is not required to complete
a diagnostic assessment or treatment plan under Minnesota Rules, part 2960.0180, subpart
2, and part 2960.0600.
(d) If a client receives residential crisis stabilization services for 35 days or fewer in a
facility licensed according to paragraph (b), clause (2), the facility is not required to develop
a plan for meeting the client's immediate needs under Minnesota Rules, part 2960.0520,
subpart 3.
Sec. 56.
Minnesota Statutes 2024, section 246C.12, subdivision 4, is amended to read:
Subd. 4.
Staff safety training.
The executive board shall require all staff in mental
health and support units at regional treatment centers who have contact with deleted text begin personsdeleted text end new text begin new text end new text begin children
or adultsnew text end with mental illness deleted text begin or severe emotional disturbancedeleted text end to be appropriately trained in
violence reduction and violence prevention and shall establish criteria for such training.
Training programs shall be developed with input from consumer advocacy organizations
and shall employ violence prevention techniques as preferable to physical interaction.
Sec. 57.
Minnesota Statutes 2024, section 252.27, subdivision 1, is amended to read:
Subdivision 1.
County of financial responsibility.
Whenever any child who has a
developmental disability, or a physical disability or deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end is
in 24-hour care outside the home including respite care, in a facility licensed by the
commissioner of human services, the cost of services shall be paid by the county of financial
responsibility determined pursuant to chapter 256G. If the child's parents or guardians do
not reside in this state, the cost shall be paid by the responsible governmental agency in the
state from which the child came, by the parents or guardians of the child if they are financially
able, or, if no other payment source is available, by the commissioner of human services.
Sec. 58.
Minnesota Statutes 2024, section 256B.02, subdivision 11, is amended to read:
Subd. 11.
Related condition.
"Related condition" means a condition:
(1) that is found to be closely related to a developmental disability, including but not
limited to cerebral palsy, epilepsy, autism, fetal alcohol spectrum disorder, and Prader-Willi
syndrome; and
(2) that meets all of the following criteria:
(i) is severe and chronic;
(ii) results in impairment of general intellectual functioning or adaptive behavior similar
to that of persons with developmental disabilities;
(iii) requires treatment or services similar to those required for persons with
developmental disabilities;
(iv) is manifested before the person reaches 22 years of age;
(v) is likely to continue indefinitely;
(vi) results in substantial functional limitations in three or more of the following areas
of major life activity:
(A) self-care;
(B) understanding and use of language;
(C) learning;
(D) mobility;
(E) self-direction; or
(F) capacity for independent living; and
(vii) is not attributable to mental illness as defined in section 245.462, subdivision 20,
or deleted text begin an emotional disturbance as defined in sectiondeleted text end 245.4871, subdivision 15. For purposes
of this item, notwithstanding section 245.462, subdivision 20, or 245.4871, subdivision 15,
"mental illness" does not include autism or other pervasive developmental disorders.
Sec. 59.
Minnesota Statutes 2024, section 256B.055, subdivision 12, is amended to read:
Subd. 12.
Children with disabilities.
(a) A person is eligible for medical assistance if
the person is under age 19 and qualifies as a disabled individual under United States Code,
title 42, section 1382c(a), and would be eligible for medical assistance under the state plan
if residing in a medical institution, and the child requires a level of care provided in a hospital,
nursing facility, or intermediate care facility for persons with developmental disabilities,
for whom home care is appropriate, provided that the cost to medical assistance under this
section is not more than the amount that medical assistance would pay for if the child resides
in an institution. After the child is determined to be eligible under this section, the
commissioner shall review the child's disability under United States Code, title 42, section
1382c(a) and level of care defined under this section no more often than annually and may
elect, based on the recommendation of health care professionals under contract with the
state medical review team, to extend the review of disability and level of care up to a
maximum of four years. The commissioner's decision on the frequency of continuing review
of disability and level of care is not subject to administrative appeal under section 256.045.
The county agency shall send a notice of disability review to the enrollee six months prior
to the date the recertification of disability is due. Nothing in this subdivision shall be
construed as affecting other redeterminations of medical assistance eligibility under this
chapter and annual cost-effective reviews under this section.
(b) For purposes of this subdivision, "hospital" means an institution as defined in section
144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part 4640.3600, and
licensed pursuant to sections 144.50 to 144.58. For purposes of this subdivision, a child
requires a level of care provided in a hospital if the child is determined by the commissioner
to need an extensive array of health services, including mental health services, for an
undetermined period of time, whose health condition requires frequent monitoring and
treatment by a health care professional or by a person supervised by a health care
professional, who would reside in a hospital or require frequent hospitalization if these
services were not provided, and the daily care needs are more complex than a nursing facility
level of care.
A child with serious deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end requires a level of care provided
in a hospital if the commissioner determines that the individual requires 24-hour supervision
because the person exhibits recurrent or frequent suicidal or homicidal ideation or behavior,
recurrent or frequent psychosomatic disorders or somatopsychic disorders that may become
life threatening, recurrent or frequent severe socially unacceptable behavior associated with
psychiatric disorder, ongoing and chronic psychosis or severe, ongoing and chronic
developmental problems requiring continuous skilled observation, or severe disabling
symptoms for which office-centered outpatient treatment is not adequate, and which overall
severely impact the individual's ability to function.
(c) For purposes of this subdivision, "nursing facility" means a facility which provides
nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to sections
144A.02 to 144A.10, which is appropriate if a person is in active restorative treatment; is
in need of special treatments provided or supervised by a licensed nurse; or has unpredictable
episodes of active disease processes requiring immediate judgment by a licensed nurse. For
purposes of this subdivision, a child requires the level of care provided in a nursing facility
if the child is determined by the commissioner to meet the requirements of the preadmission
screening assessment document under section 256B.0911, adjusted to address age-appropriate
standards for children age 18 and under.
(d) For purposes of this subdivision, "intermediate care facility for persons with
developmental disabilities" or "ICF/DD" means a program licensed to provide services to
persons with developmental disabilities under section 252.28, and chapter 245A, and a
physical plant licensed as a supervised living facility under chapter 144, which together are
certified by the Minnesota Department of Health as meeting the standards in Code of Federal
Regulations, title 42, part 483, for an intermediate care facility which provides services for
persons with developmental disabilities who require 24-hour supervision and active treatment
for medical, behavioral, or habilitation needs. For purposes of this subdivision, a child
requires a level of care provided in an ICF/DD if the commissioner finds that the child has
a developmental disability in accordance with section 256B.092, is in need of a 24-hour
plan of care and active treatment similar to persons with developmental disabilities, and
there is a reasonable indication that the child will need ICF/DD services.
(e) For purposes of this subdivision, a person requires the level of care provided in a
nursing facility if the person requires 24-hour monitoring or supervision and a plan of mental
health treatment because of specific symptoms or functional impairments associated with
a serious mental illness or disorder diagnosis, which meet severity criteria for mental health
established by the commissioner and published in March 1997 as the Minnesota Mental
Health Level of Care for Children and Adolescents with Severe Emotional Disorders.
(f) The determination of the level of care needed by the child shall be made by the
commissioner based on information supplied to the commissioner by (1) the parent or
guardian, (2) the child's physician or physicians, advanced practice registered nurse or
advanced practice registered nurses, or physician assistant or physician assistants, and (3)
other professionals as requested by the commissioner. The commissioner shall establish a
screening team to conduct the level of care determinations according to this subdivision.
(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
must assess the case to determine whether:
(1) the child qualifies as a disabled individual under United States Code, title 42, section
1382c(a), and would be eligible for medical assistance if residing in a medical institution;
and
(2) the cost of medical assistance services for the child, if eligible under this subdivision,
would not be more than the cost to medical assistance if the child resides in a medical
institution to be determined as follows:
(i) for a child who requires a level of care provided in an ICF/DD, the cost of care for
the child in an institution shall be determined using the average payment rate established
for the regional treatment centers that are certified as ICF's/DD;
(ii) for a child who requires a level of care provided in an inpatient hospital setting
according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
Rules, part 9505.3520, items F and G; and
(iii) for a child who requires a level of care provided in a nursing facility according to
paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota Rules,
part 9505.3040, except that the nursing facility average rate shall be adjusted to reflect rates
which would be paid for children under age 16. The commissioner may authorize an amount
up to the amount medical assistance would pay for a child referred to the commissioner by
the preadmission screening team under section 256B.0911.
Sec. 60.
Minnesota Statutes 2024, section 256B.0616, subdivision 1, is amended to read:
Subdivision 1.
Scope.
Medical assistance covers mental health certified family peer
specialists services, as established in subdivision 2, subject to federal approval, if provided
to recipients who have deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end or deleted text begin severe emotional
disturbancedeleted text end new text begin serious mental illnessnew text end under chapter 245, and are provided by a mental health
certified family peer specialist who has completed the training under subdivision 5 and is
qualified according to section 245I.04, subdivision 12. A family peer specialist cannot
provide services to the peer specialist's family.
Sec. 61.
Minnesota Statutes 2024, section 256B.0757, subdivision 2, is amended to read:
Subd. 2.
Eligible individual.
(a) The commissioner may elect to develop health home
models in accordance with United States Code, title 42, section 1396w-4.
(b) An individual is eligible for health home services under this section if the individual
is eligible for medical assistance under this chapter and has a condition that meets the
definition of mental illness as described in section 245.462, subdivision 20, paragraph (a),
or deleted text begin emotional disturbance as defined in sectiondeleted text end 245.4871, subdivision 15, clause (2). The
commissioner shall establish criteria for determining continued eligibility.
Sec. 62.
Minnesota Statutes 2024, section 256B.0943, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given them.
(b) "Children's therapeutic services and supports" means the flexible package of mental
health services for children who require varying therapeutic and rehabilitative levels of
intervention to treat a diagnosed deleted text begin emotional disturbance, as defined in section 245.4871,
subdivision 15, or a diagnoseddeleted text end mental illness, as defined in section 245.462, subdivision
20new text begin , or 245.4871, subdivision 15new text end . The services are time-limited interventions that are delivered
using various treatment modalities and combinations of services designed to reach treatment
outcomes identified in the individual treatment plan.
(c) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6.
(d) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.
(e) "Culturally competent provider" means a provider who understands and can utilize
to a client's benefit the client's culture when providing services to the client. A provider
may be culturally competent because the provider is of the same cultural or ethnic group
as the client or the provider has developed the knowledge and skills through training and
experience to provide services to culturally diverse clients.
(f) "Day treatment program" for children means a site-based structured mental health
program consisting of psychotherapy for three or more individuals and individual or group
skills training provided by a team, under the treatment supervision of a mental health
professional.
(g) "Direct service time" means the time that a mental health professional, clinical trainee,
mental health practitioner, or mental health behavioral aide spends face-to-face with a client
and the client's family or providing covered services through telehealth as defined under
section 256B.0625, subdivision 3b. Direct service time includes time in which the provider
obtains a client's history, develops a client's treatment plan, records individual treatment
outcomes, or provides service components of children's therapeutic services and supports.
Direct service time does not include time doing work before and after providing direct
services, including scheduling or maintaining clinical records.
(h) "Direction of mental health behavioral aide" means the activities of a mental health
professional, clinical trainee, or mental health practitioner in guiding the mental health
behavioral aide in providing services to a client. The direction of a mental health behavioral
aide must be based on the client's individual treatment plan and meet the requirements in
subdivision 6, paragraph (b), clause (7).
deleted text begin
(i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.
deleted text end
deleted text begin (j)deleted text end new text begin (i)new text end "Individual treatment plan" means the plan described in section 245I.10,
subdivisions 7 and 8.
deleted text begin (k)deleted text end new text begin (j)new text end "Mental health behavioral aide services" means medically necessary one-on-one
activities performed by a mental health behavioral aide qualified according to section
245I.04, subdivision 16, to assist a child retain or generalize psychosocial skills as previously
trained by a mental health professional, clinical trainee, or mental health practitioner and
as described in the child's individual treatment plan and individual behavior plan. Activities
involve working directly with the child or child's family as provided in subdivision 9,
paragraph (b), clause (4).
deleted text begin (l)deleted text end new text begin (k)new text end "Mental health certified family peer specialist" means a staff person who is
qualified according to section 245I.04, subdivision 12.
deleted text begin (m)deleted text end new text begin (l)new text end "Mental health practitioner" means a staff person who is qualified according to
section 245I.04, subdivision 4.
deleted text begin (n)deleted text end new text begin (m)new text end "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.
deleted text begin (o)deleted text end new text begin (n)new text end "Mental health service plan development" includes:
(1) development and revision of a child's individual treatment plan; and
(2) administering and reporting standardized outcome measurements approved by the
commissioner, as periodically needed to evaluate the effectiveness of treatment.
deleted text begin (p)deleted text end new text begin (o)new text end "Mental illnessdeleted text begin ,deleted text end " deleted text begin for persons at least age 18 but under age 21,deleted text end has the meaning
given in section 245.462, subdivision 20, paragraph (a)new text begin , for persons at least 18 years of age
but under 21 years of age, and has the meaning given in section 245.4871, subdivision 15,
for children under 18 years of agenew text end .
deleted text begin (q)deleted text end new text begin (p)new text end "Psychotherapy" means the treatment described in section 256B.0671, subdivision
11.
deleted text begin (r)deleted text end new text begin (q)new text end "Rehabilitative services" or "psychiatric rehabilitation services" means
interventions to: (1) restore a child or adolescent to an age-appropriate developmental
trajectory that had been disrupted by a psychiatric illness; or (2) enable the child to
self-monitor, compensate for, cope with, counteract, or replace psychosocial skills deficits
or maladaptive skills acquired over the course of a psychiatric illness. Psychiatric
rehabilitation services for children combine coordinated psychotherapy to address internal
psychological, emotional, and intellectual processing deficits, and skills training to restore
personal and social functioning. Psychiatric rehabilitation services establish a progressive
series of goals with each achievement building upon a prior achievement.
deleted text begin (s)deleted text end new text begin (r)new text end "Skills training" means individual, family, or group training, delivered by or under
the supervision of a mental health professional, designed to facilitate the acquisition of
psychosocial skills that are medically necessary to rehabilitate the child to an age-appropriate
developmental trajectory heretofore disrupted by a psychiatric illness or to enable the child
to self-monitor, compensate for, cope with, counteract, or replace skills deficits or
maladaptive skills acquired over the course of a psychiatric illness. Skills training is subject
to the service delivery requirements under subdivision 9, paragraph (b), clause (2).
deleted text begin (t)deleted text end new text begin (s)new text end "Standard diagnostic assessment" means the assessment described in section
245I.10, subdivision 6.
deleted text begin (u)deleted text end new text begin (t)new text end "Treatment supervision" means the supervision described in section 245I.06.
Sec. 63.
Minnesota Statutes 2024, section 256B.0943, subdivision 3, is amended to read:
Subd. 3.
Determination of client eligibility.
(a) A client's eligibility to receive children's
therapeutic services and supports under this section shall be determined based on a standard
diagnostic assessment by a mental health professional or a clinical trainee that is performed
within one year before the initial start of service and updated as required under section
245I.10, subdivision 2. The standard diagnostic assessment must:
(1) determine whether a child under age 18 has a diagnosis of deleted text begin emotional disturbancedeleted text end new text begin
mental illnessnew text end or, if the person is between the ages of 18 and 21, whether the person has a
mental illness;
(2) document children's therapeutic services and supports as medically necessary to
address an identified disability, functional impairment, and the individual client's needs and
goals; and
(3) be used in the development of the individual treatment plan.
(b) Notwithstanding paragraph (a), a client may be determined to be eligible for up to
five days of day treatment under this section based on a hospital's medical history and
presentation examination of the client.
(c) Children's therapeutic services and supports include development and rehabilitative
services that support a child's developmental treatment needs.
Sec. 64.
Minnesota Statutes 2024, section 256B.0943, subdivision 9, is amended to read:
Subd. 9.
Service delivery criteria.
(a) In delivering services under this section, a certified
provider entity must ensure that:
(1) the provider's caseload size should reasonably enable the provider to play an active
role in service planning, monitoring, and delivering services to meet the client's and client's
family's needs, as specified in each client's individual treatment plan;
(2) site-based programs, including day treatment programs, provide staffing and facilities
to ensure the client's health, safety, and protection of rights, and that the programs are able
to implement each client's individual treatment plan; and
(3) a day treatment program is provided to a group of clients by a team under the treatment
supervision of a mental health professional. The day treatment program must be provided
in and by: (i) an outpatient hospital accredited by the Joint Commission on Accreditation
of Health Organizations and licensed under sections 144.50 to 144.55; (ii) a community
mental health center under section 245.62; or (iii) an entity that is certified under subdivision
4 to operate a program that meets the requirements of section 245.4884, subdivision 2, and
Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must stabilize
the client's mental health status while developing and improving the client's independent
living and socialization skills. The goal of the day treatment program must be to reduce or
relieve the effects of mental illness and provide training to enable the client to live in the
community. The remainder of the structured treatment program may include patient and/or
family or group psychotherapy, and individual or group skills training, if included in the
client's individual treatment plan. Day treatment programs are not part of inpatient or
residential treatment services. When a day treatment group that meets the minimum group
size requirement temporarily falls below the minimum group size because of a member's
temporary absence, medical assistance covers a group session conducted for the group
members in attendance. A day treatment program may provide fewer than the minimally
required hours for a particular child during a billing period in which the child is transitioning
into, or out of, the program.
(b) To be eligible for medical assistance payment, a provider entity must deliver the
service components of children's therapeutic services and supports in compliance with the
following requirements:
(1) psychotherapy to address the child's underlying mental health disorder must be
documented as part of the child's ongoing treatment. A provider must deliver or arrange for
medically necessary psychotherapy unless the child's parent or caregiver chooses not to
receive it or the provider determines that psychotherapy is no longer medically necessary.
When a provider determines that psychotherapy is no longer medically necessary, the
provider must update required documentation, including but not limited to the individual
treatment plan, the child's medical record, or other authorizations, to include the
determination. When a provider determines that a child needs psychotherapy but
psychotherapy cannot be delivered due to a shortage of licensed mental health professionals
in the child's community, the provider must document the lack of access in the child's
medical record;
(2) individual, family, or group skills training is subject to the following requirements:
(i) a mental health professional, clinical trainee, or mental health practitioner shall provide
skills training;
(ii) skills training delivered to a child or the child's family must be targeted to the specific
deficits or maladaptations of the child's mental health disorder and must be prescribed in
the child's individual treatment plan;
(iii) group skills training may be provided to multiple recipients who, because of the
nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
interaction in a group setting, which must be staffed as follows:
(A) one mental health professional, clinical trainee, or mental health practitioner must
work with a group of three to eight clients; or
(B) any combination of two mental health professionals, clinical trainees, or mental
health practitioners must work with a group of nine to 12 clients;
(iv) a mental health professional, clinical trainee, or mental health practitioner must have
taught the psychosocial skill before a mental health behavioral aide may practice that skill
with the client; and
(v) for group skills training, when a skills group that meets the minimum group size
requirement temporarily falls below the minimum group size because of a group member's
temporary absence, the provider may conduct the session for the group members in
attendance;
(3) crisis planning to a child and family must include development of a written plan that
anticipates the particular factors specific to the child that may precipitate a psychiatric crisis
for the child in the near future. The written plan must document actions that the family
should be prepared to take to resolve or stabilize a crisis, such as advance arrangements for
direct intervention and support services to the child and the child's family. Crisis planning
must include preparing resources designed to address abrupt or substantial changes in the
functioning of the child or the child's family when sudden change in behavior or a loss of
usual coping mechanisms is observed, or the child begins to present a danger to self or
others;
(4) mental health behavioral aide services must be medically necessary treatment services,
identified in the child's individual treatment plan.
To be eligible for medical assistance payment, mental health behavioral aide services must
be delivered to a child who has been diagnosed with deleted text begin an emotional disturbance ordeleted text end a mental
illness, as provided in subdivision 1, paragraph (a). The mental health behavioral aide must
document the delivery of services in written progress notes. Progress notes must reflect
implementation of the treatment strategies, as performed by the mental health behavioral
aide and the child's responses to the treatment strategies; and
(5) mental health service plan development must be performed in consultation with the
child's family and, when appropriate, with other key participants in the child's life by the
child's treating mental health professional or clinical trainee or by a mental health practitioner
and approved by the treating mental health professional. Treatment plan drafting consists
of development, review, and revision by face-to-face or electronic communication. The
provider must document events, including the time spent with the family and other key
participants in the child's life to approve the individual treatment plan. Medical assistance
covers service plan development before completion of the child's individual treatment plan.
Service plan development is covered only if a treatment plan is completed for the child. If
upon review it is determined that a treatment plan was not completed for the child, the
commissioner shall recover the payment for the service plan development.
Sec. 65.
Minnesota Statutes 2024, section 256B.0943, subdivision 12, is amended to read:
Subd. 12.
Excluded services.
The following services are not eligible for medical
assistance payment as children's therapeutic services and supports:
(1) service components of children's therapeutic services and supports simultaneously
provided by more than one provider entity unless prior authorization is obtained;
(2) treatment by multiple providers within the same agency at the same clock time,
unless one service is delivered to the child and the other service is delivered to the child's
family or treatment team without the child present;
(3) children's therapeutic services and supports provided in violation of medical assistance
policy in Minnesota Rules, part 9505.0220;
(4) mental health behavioral aide services provided by a personal care assistant who is
not qualified as a mental health behavioral aide and employed by a certified children's
therapeutic services and supports provider entity;
(5) service components of CTSS that are the responsibility of a residential or program
license holder, including foster care providers under the terms of a service agreement or
administrative rules governing licensure; and
(6) adjunctive activities that may be offered by a provider entity but are not otherwise
covered by medical assistance, including:
(i) a service that is primarily recreation oriented or that is provided in a setting that is
not medically supervised. This includes sports activities, exercise groups, activities such as
craft hours, leisure time, social hours, meal or snack time, trips to community activities,
and tours;
(ii) a social or educational service that does not have or cannot reasonably be expected
to have a therapeutic outcome related to the client's deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end ;
(iii) prevention or education programs provided to the community; and
(iv) treatment for clients with primary diagnoses of alcohol or other drug abuse.
Sec. 66.
Minnesota Statutes 2024, section 256B.0943, subdivision 13, is amended to read:
Subd. 13.
Exception to excluded services.
Notwithstanding subdivision 12, up to 15
hours of children's therapeutic services and supports provided within a six-month period to
a child with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end who is residing in a hospital;
a residential treatment facility licensed under Minnesota Rules, parts 2960.0580 to 2960.0690;
a psychiatric residential treatment facility under section 256B.0625, subdivision 45a; a
regional treatment center; or other institutional group setting or who is participating in a
program of partial hospitalization are eligible for medical assistance payment if part of the
discharge plan.
Sec. 67.
Minnesota Statutes 2024, section 256B.0945, subdivision 1, is amended to read:
Subdivision 1.
Residential services; provider qualifications.
(a) Counties must arrange
to provide residential services for children with deleted text begin severe emotional disturbancedeleted text end new text begin serious mental
illnessnew text end according to sections 245.4882, 245.4885, and this section.
(b) Services must be provided by a facility that is licensed according to section 245.4882
and administrative rules promulgated thereunder, and under contract with the county.
(c) Eligible service costs may be claimed for a facility that is located in a state that
borders Minnesota if:
(1) the facility is the closest facility to the child's home, providing the appropriate level
of care; and
(2) the commissioner of human services has completed an inspection of the out-of-state
program according to the interagency agreement with the commissioner of corrections under
section 260B.198, subdivision 11, paragraph (b), and the program has been certified by the
commissioner of corrections under section 260B.198, subdivision 11, paragraph (a), to
substantially meet the standards applicable to children's residential mental health treatment
programs under Minnesota Rules, chapter 2960. Nothing in this section requires the
commissioner of human services to enforce the background study requirements under chapter
245C or the requirements related to prevention and investigation of alleged maltreatment
under section 626.557 or chapter 260E. Complaints received by the commissioner of human
services must be referred to the out-of-state licensing authority for possible follow-up.
(d) Notwithstanding paragraph (b), eligible service costs may be claimed for an
out-of-state inpatient treatment facility if:
(1) the facility specializes in providing mental health services to children who are deaf,
deafblind, or hard-of-hearing and who use American Sign Language as their first language;
(2) the facility is licensed by the state in which it is located; and
(3) the state in which the facility is located is a member state of the Interstate Compact
on Mental Health.
Sec. 68.
Minnesota Statutes 2024, section 256B.0946, subdivision 6, is amended to read:
Subd. 6.
Excluded services.
(a) Services in clauses (1) to (7) are not covered under this
section and are not eligible for medical assistance payment as components of children's
intensive behavioral health services, but may be billed separately:
(1) inpatient psychiatric hospital treatment;
(2) mental health targeted case management;
(3) partial hospitalization;
(4) medication management;
(5) children's mental health day treatment services;
(6) crisis response services under section 256B.0624;
(7) transportation; and
(8) mental health certified family peer specialist services under section 256B.0616.
(b) Children receiving intensive behavioral health services are not eligible for medical
assistance reimbursement for the following services while receiving children's intensive
behavioral health services:
(1) psychotherapy and skills training components of children's therapeutic services and
supports under section 256B.0943;
(2) mental health behavioral aide services as defined in section 256B.0943, subdivision
1, paragraph deleted text begin (l)deleted text end new text begin (j)new text end ;
(3) home and community-based waiver services;
(4) mental health residential treatment; and
(5) medical assistance room and board rate, as defined in section 256B.056, subdivision
5d.
Sec. 69.
Minnesota Statutes 2024, section 256B.0947, subdivision 3a, is amended to read:
Subd. 3a.
Required service components.
(a) Intensive nonresidential rehabilitative
mental health services, supports, and ancillary activities that are covered by a single daily
rate per client must include the following, as needed by the individual client:
(1) individual, family, and group psychotherapy;
(2) individual, family, and group skills training, as defined in section 256B.0943,
subdivision 1, paragraph deleted text begin (u)deleted text end new text begin (r)new text end ;
(3) crisis planning as defined in section 245.4871, subdivision 9a;
(4) medication management provided by a physician, an advanced practice registered
nurse with certification in psychiatric and mental health care, or a physician assistant;
(5) mental health case management as provided in section 256B.0625, subdivision 20;
(6) medication education services as defined in this section;
(7) care coordination by a client-specific lead worker assigned by and responsible to the
treatment team;
(8) psychoeducation of and consultation and coordination with the client's biological,
adoptive, or foster family and, in the case of a youth living independently, the client's
immediate nonfamilial support network;
(9) clinical consultation to a client's employer or school or to other service agencies or
to the courts to assist in managing the mental illness or co-occurring disorder and to develop
client support systems;
(10) coordination with, or performance of, crisis intervention and stabilization services
as defined in section 256B.0624;
(11) transition services;
(12) co-occurring substance use disorder treatment as defined in section 245I.02,
subdivision 11; and
(13) housing access support that assists clients to find, obtain, retain, and move to safe
and adequate housing. Housing access support does not provide monetary assistance for
rent, damage deposits, or application fees.
(b) The provider shall ensure and document the following by means of performing the
required function or by contracting with a qualified person or entity: client access to crisis
intervention services, as defined in section 256B.0624, and available 24 hours per day and
seven days per week.
Sec. 70.
Minnesota Statutes 2024, section 256B.69, subdivision 23, is amended to read:
Subd. 23.
Alternative services; elderly persons and persons with a disability.
(a) The
commissioner may implement demonstration projects to create alternative integrated delivery
systems for acute and long-term care services to elderly persons and persons with disabilities
as defined in section 256B.77, subdivision 7a, that provide increased coordination, improve
access to quality services, and mitigate future cost increases. The commissioner may seek
federal authority to combine Medicare and Medicaid capitation payments for the purpose
of such demonstrations and may contract with Medicare-approved special needs plans that
are offered by a demonstration provider or by an entity that is directly or indirectly wholly
owned or controlled by a demonstration provider to provide Medicaid services. Medicare
funds and services shall be administered according to the terms and conditions of the federal
contract and demonstration provisions. For the purpose of administering medical assistance
funds, demonstrations under this subdivision are subject to subdivisions 1 to 22. The
provisions of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1, items
B and C, which do not apply to persons enrolling in demonstrations under this section. All
enforcement and rulemaking powers available under chapters 62D, 62M, and 62Q are hereby
granted to the commissioner of health with respect to Medicare-approved special needs
plans with which the commissioner contracts to provide Medicaid services under this section.
An initial open enrollment period may be provided. Persons who disenroll from
demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
the health plan's participation is subsequently terminated for any reason, the person shall
be provided an opportunity to select a new health plan and shall have the right to change
health plans within the first 60 days of enrollment in the second health plan. Persons required
to participate in health plans under this section who fail to make a choice of health plan
shall not be randomly assigned to health plans under these demonstrations. Notwithstanding
section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220, subpart 1, item A,
if adopted, for the purpose of demonstrations under this subdivision, the commissioner may
contract with managed care organizations, including counties, to serve only elderly persons
eligible for medical assistance, elderly persons with a disability, or persons with a disability
only. For persons with a primary diagnosis of developmental disability, serious and persistent
mental illness, or serious deleted text begin emotional disturbancedeleted text end new text begin mental illness in childrennew text end , the commissioner
must ensure that the county authority has approved the demonstration and contracting design.
Enrollment in these projects for persons with disabilities shall be voluntary. The
commissioner shall not implement any demonstration project under this subdivision for
persons with a primary diagnosis of developmental disabilities, serious and persistent mental
illness, or serious deleted text begin emotional disturbance,deleted text end new text begin mental illness in childrennew text end without approval of the
county board of the county in which the demonstration is being implemented.
(b) MS 2009 Supplement [Expired, 2003 c 47 s 4; 2007 c 147 art 7 s 60]
(c) Before implementation of a demonstration project for persons with a disability, the
commissioner must provide information to appropriate committees of the house of
representatives and senate and must involve representatives of affected disability groups in
the design of the demonstration projects.
(d) A nursing facility reimbursed under the alternative reimbursement methodology in
section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
provide services under paragraph (a). The commissioner shall amend the state plan and seek
any federal waivers necessary to implement this paragraph.
(e) The commissioner, in consultation with the commissioners of commerce and health,
may approve and implement programs for all-inclusive care for the elderly (PACE) according
to federal laws and regulations governing that program and state laws or rules applicable
to participating providers. A PACE provider is not required to be licensed or certified as a
health plan company as defined in section 62Q.01, subdivision 4. Persons age 55 and older
who have been screened by the county and found to be eligible for services under the elderly
waiver or community access for disability inclusion or who are already eligible for Medicaid
but meet level of care criteria for receipt of waiver services may choose to enroll in the
PACE program. Medicare and Medicaid services will be provided according to this
subdivision and federal Medicare and Medicaid requirements governing PACE providers
and programs. PACE enrollees will receive Medicaid home and community-based services
through the PACE provider as an alternative to services for which they would otherwise be
eligible through home and community-based waiver programs and Medicaid State Plan
Services. The commissioner shall establish Medicaid rates for PACE providers that do not
exceed costs that would have been incurred under fee-for-service or other relevant managed
care programs operated by the state.
(f) The commissioner shall seek federal approval to expand the Minnesota disability
health options (MnDHO) program established under this subdivision in stages, first to
regional population centers outside the seven-county metro area and then to all areas of the
state. Until July 1, 2009, expansion for MnDHO projects that include home and
community-based services is limited to the two projects and service areas in effect on March
1, 2006. Enrollment in integrated MnDHO programs that include home and community-based
services shall remain voluntary. Costs for home and community-based services included
under MnDHO must not exceed costs that would have been incurred under the fee-for-service
program. Notwithstanding whether expansion occurs under this paragraph, in determining
MnDHO payment rates and risk adjustment methods, the commissioner must consider the
methods used to determine county allocations for home and community-based program
participants. If necessary to reduce MnDHO rates to comply with the provision regarding
MnDHO costs for home and community-based services, the commissioner shall achieve
the reduction by maintaining the base rate for contract year 2010 for services provided under
the community access for disability inclusion waiver at the same level as for contract year
2009. The commissioner may apply other reductions to MnDHO rates to implement decreases
in provider payment rates required by state law. Effective January 1, 2011, enrollment and
operation of the MnDHO program in effect during 2010 shall cease. The commissioner may
reopen the program provided all applicable conditions of this section are met. In developing
program specifications for expansion of integrated programs, the commissioner shall involve
and consult the state-level stakeholder group established in subdivision 28, paragraph (d),
including consultation on whether and how to include home and community-based waiver
programs. Plans to reopen MnDHO projects shall be presented to the chairs of the house of
representatives and senate committees with jurisdiction over health and human services
policy and finance prior to implementation.
(g) Notwithstanding section 256B.0621, health plans providing services under this section
are responsible for home care targeted case management and relocation targeted case
management. Services must be provided according to the terms of the waivers and contracts
approved by the federal government.
Sec. 71.
Minnesota Statutes 2024, section 256B.77, subdivision 7a, is amended to read:
Subd. 7a.
Eligible individuals.
(a) Persons are eligible for the demonstration project as
provided in this subdivision.
(b) "Eligible individuals" means those persons living in the demonstration site who are
eligible for medical assistance and are disabled based on a disability determination under
section 256B.055, subdivisions 7 and 12, or who are eligible for medical assistance and
have been diagnosed as having:
(1) serious and persistent mental illness as defined in section 245.462, subdivision 20;
(2) deleted text begin severe emotional disturbancedeleted text end new text begin serious mental illnessnew text end as defined in section 245.4871,
subdivision 6; or
(3) developmental disability, or being a person with a developmental disability as defined
in section 252A.02, or a related condition as defined in section 256B.02, subdivision 11.
Other individuals may be included at the option of the county authority based on agreement
with the commissioner.
(c) Eligible individuals include individuals in excluded time status, as defined in chapter
256G. Enrollees in excluded time at the time of enrollment shall remain in excluded time
status as long as they live in the demonstration site and shall be eligible for 90 days after
placement outside the demonstration site if they move to excluded time status in a county
within Minnesota other than their county of financial responsibility.
(d) A person who is a sexual psychopathic personality as defined in section 253D.02,
subdivision 15, or a sexually dangerous person as defined in section 253D.02, subdivision
16, is excluded from enrollment in the demonstration project.
Sec. 72.
Minnesota Statutes 2024, section 260B.157, subdivision 3, is amended to read:
Subd. 3.
Juvenile treatment screening team.
(a) The local social services agency shall
establish a juvenile treatment screening team to conduct screenings and prepare case plans
under this subdivision. The team, which may be the team constituted under section 245.4885
or 256B.092 or chapter 254B, shall consist of social workers, juvenile justice professionals,
and persons with expertise in the treatment of juveniles who are emotionally disabled,
chemically dependent, or have a developmental disability. The team shall involve parents
or guardians in the screening process as appropriate. The team may be the same team as
defined in section 260C.157, subdivision 3.
(b) If the court, prior todeleted text begin ,deleted text end or as part ofdeleted text begin ,deleted text end a final disposition, proposes to place a child:
(1) for the primary purpose of treatment for deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end ,
and residential placement is consistent with section 260.012, a developmental disability, or
chemical dependency in a residential treatment facility out of state or in one which is within
the state and licensed by the commissioner of human services under chapter 245A; or
(2) in any out-of-home setting potentially exceeding 30 days in duration, including a
post-dispositional placement in a facility licensed by the commissioner of corrections or
human services, the court shall notify the county welfare agency. The county's juvenile
treatment screening team must either:
(i) screen and evaluate the child and file its recommendations with the court within 14
days of receipt of the notice; or
(ii) elect not to screen a given case, and notify the court of that decision within three
working days.
(c) If the screening team has elected to screen and evaluate the child, the child may not
be placed for the primary purpose of treatment for deleted text begin an emotional disturbancedeleted text end new text begin mental illnessnew text end ,
a developmental disability, or chemical dependency, in a residential treatment facility out
of state nor in a residential treatment facility within the state that is licensed under chapter
245A, unless one of the following conditions applies:
(1) a treatment professional certifies that an emergency requires the placement of the
child in a facility within the state;
(2) the screening team has evaluated the child and recommended that a residential
placement is necessary to meet the child's treatment needs and the safety needs of the
community, that it is a cost-effective means of meeting the treatment needs, and that it will
be of therapeutic value to the child; or
(3) the court, having reviewed a screening team recommendation against placement,
determines to the contrary that a residential placement is necessary. The court shall state
the reasons for its determination in writing, on the record, and shall respond specifically to
the findings and recommendation of the screening team in explaining why the
recommendation was rejected. The attorney representing the child and the prosecuting
attorney shall be afforded an opportunity to be heard on the matter.
Sec. 73.
Minnesota Statutes 2024, section 260C.007, subdivision 16, is amended to read:
Subd. 16.
deleted text begin Emotionally disturbeddeleted text end new text begin Mental illnessnew text end .
"deleted text begin Emotionally disturbeddeleted text end new text begin Mental illnessnew text end "
deleted text begin means emotional disturbance as describeddeleted text end new text begin has the meaning givennew text end in section 245.4871,
subdivision 15.
Sec. 74.
Minnesota Statutes 2024, section 260C.007, subdivision 26d, is amended to read:
Subd. 26d.
Qualified residential treatment program.
"Qualified residential treatment
program" means a children's residential treatment program licensed under chapter 245A or
licensed or approved by a tribe that is approved to receive foster care maintenance payments
under section 142A.418 that:
(1) has a trauma-informed treatment model designed to address the needs of children
with serious emotional or behavioral disorders or disturbancesnew text begin or mental illnessesnew text end ;
(2) has registered or licensed nursing staff and other licensed clinical staff who:
(i) provide care within the scope of their practice; and
(ii) are available 24 hours per day and seven days per week;
(3) is accredited by any of the following independent, nonprofit organizations: the
Commission on Accreditation of Rehabilitation Facilities (CARF), the Joint Commission
on Accreditation of Healthcare Organizations (JCAHO), and the Council on Accreditation
(COA), or any other nonprofit accrediting organization approved by the United States
Department of Health and Human Services;
(4) if it is in the child's best interests, facilitates participation of the child's family members
in the child's treatment programming consistent with the child's out-of-home placement
plan under sections 260C.212, subdivision 1, and 260C.708;
(5) facilitates outreach to family members of the child, including siblings;
(6) documents how the facility facilitates outreach to the child's parents and relatives,
as well as documents the child's parents' and other relatives' contact information;
(7) documents how the facility includes family members in the child's treatment process,
including after the child's discharge, and how the facility maintains the child's sibling
connections; and
(8) provides the child and child's family with discharge planning and family-based
aftercare support for at least six months after the child's discharge. Aftercare support may
include clinical care consultation under section 256B.0671, subdivision 7, and mental health
certified family peer specialist services under section 256B.0616.
Sec. 75.
Minnesota Statutes 2024, section 260C.007, subdivision 27b, is amended to read:
Subd. 27b.
Residential treatment facility.
"Residential treatment facility" means a
24-hour-a-day program that provides treatment for children with deleted text begin emotional disturbancedeleted text end new text begin
mental illnessnew text end , consistent with section 245.4871, subdivision 32, and includes a licensed
residential program specializing in caring 24 hours a day for children with a developmental
delay or related condition. A residential treatment facility does not include a psychiatric
residential treatment facility under section 256B.0941 or a family foster home as defined
in section 260C.007, subdivision 16b.
Sec. 76.
Minnesota Statutes 2024, section 260C.157, subdivision 3, is amended to read:
Subd. 3.
Juvenile treatment screening team.
(a) The responsible social services agency
shall establish a juvenile treatment screening team to conduct screenings under this chapter
and chapter 260D, for a child to receive treatment for deleted text begin an emotional disturbancedeleted text end new text begin a mental
illnessnew text end , deleted text begin adeleted text end developmental disability, or related condition in a residential treatment facility
licensed by the commissioner of human services under chapter 245A, or licensed or approved
by a tribe. A screening team is not required for a child to be in: (1) a residential facility
specializing in prenatal, postpartum, or parenting support; (2) a facility specializing in
high-quality residential care and supportive services to children and youth who have been
or are at risk of becoming victims of sex trafficking or commercial sexual exploitation; (3)
supervised settings for youth who are 18 years of age or older and living independently; or
(4) a licensed residential family-based treatment facility for substance abuse consistent with
section 260C.190. Screenings are also not required when a child must be placed in a facility
due to an emotional crisis or other mental health emergency.
(b) The responsible social services agency shall conduct screenings within 15 days of a
request for a screening, unless the screening is for the purpose of residential treatment and
the child is enrolled in a prepaid health program under section 256B.69, in which case the
agency shall conduct the screening within ten working days of a request. The responsible
social services agency shall convene the juvenile treatment screening team, which may be
constituted under section 245.4885, 254B.05, or 256B.092. The team shall consist of social
workers; persons with expertise in the treatment of juveniles who are emotionally disturbed,
chemically dependent, or have a developmental disability; and the child's parent, guardian,
or permanent legal custodian. The team may include the child's relatives as defined in section
260C.007, subdivisions 26b and 27, the child's foster care provider, and professionals who
are a resource to the child's family such as teachers, medical or mental health providers,
and clergy, as appropriate, consistent with the family and permanency team as defined in
section 260C.007, subdivision 16a. Prior to forming the team, the responsible social services
agency must consult with the child's parents, the child if the child is age 14 or older, and,
if applicable, the child's tribe to obtain recommendations regarding which individuals to
include on the team and to ensure that the team is family-centered and will act in the child's
best interests. If the child, child's parents, or legal guardians raise concerns about specific
relatives or professionals, the team should not include those individuals. This provision
does not apply to paragraph (c).
(c) If the agency provides notice to tribes under section 260.761, and the child screened
is an Indian child, the responsible social services agency must make a rigorous and concerted
effort to include a designated representative of the Indian child's tribe on the juvenile
treatment screening team, unless the child's tribal authority declines to appoint a
representative. The Indian child's tribe may delegate its authority to represent the child to
any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12.
The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections
1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to
260.835, apply to this section.
(d) If the court, prior to, or as part of, a final disposition or other court order, proposes
to place a child with deleted text begin an emotional disturbance ordeleted text end new text begin a mental illness,new text end developmental disabilitynew text begin ,new text end
or related condition in residential treatment, the responsible social services agency must
conduct a screening. If the team recommends treating the child in a qualified residential
treatment program, the agency must follow the requirements of sections 260C.70 to
260C.714.
The court shall ascertain whether the child is an Indian child and shall notify the
responsible social services agency and, if the child is an Indian child, shall notify the Indian
child's tribe as paragraph (c) requires.
(e) When the responsible social services agency is responsible for placing and caring
for the child and the screening team recommends placing a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1)
begin the assessment and processes required in section 260C.704 without delay; and (2)
conduct a relative search according to section 260C.221 to assemble the child's family and
permanency team under section 260C.706. Prior to notifying relatives regarding the family
and permanency team, the responsible social services agency must consult with the child's
parent or legal guardian, the child if the child is age 14 or older, and, if applicable, the child's
tribe to ensure that the agency is providing notice to individuals who will act in the child's
best interests. The child and the child's parents may identify a culturally competent qualified
individual to complete the child's assessment. The agency shall make efforts to refer the
assessment to the identified qualified individual. The assessment may not be delayed for
the purpose of having the assessment completed by a specific qualified individual.
(f) When a screening team determines that a child does not need treatment in a qualified
residential treatment program, the screening team must:
(1) document the services and supports that will prevent the child's foster care placement
and will support the child remaining at home;
(2) document the services and supports that the agency will arrange to place the child
in a family foster home; or
(3) document the services and supports that the agency has provided in any other setting.
(g) When the Indian child's tribe or tribal health care services provider or Indian Health
Services provider proposes to place a child for the primary purpose of treatment for deleted text begin an
emotional disturbancedeleted text end new text begin mental illnessnew text end , a developmental disability, or co-occurring deleted text begin emotional
disturbancedeleted text end new text begin mental illnessnew text end and chemical dependency, the Indian child's tribe or the tribe
delegated by the child's tribe shall submit necessary documentation to the county juvenile
treatment screening team, which must invite the Indian child's tribe to designate a
representative to the screening team.
(h) The responsible social services agency must conduct and document the screening in
a format approved by the commissioner of human services.
Sec. 77.
Minnesota Statutes 2024, section 260C.201, subdivision 1, is amended to read:
Subdivision 1.
Dispositions.
(a) If the court finds that the child is in need of protection
or services or neglected and in foster care, the court shall enter an order making any of the
following dispositions of the case:
(1) place the child under the protective supervision of the responsible social services
agency or child-placing agency in the home of a parent of the child under conditions
prescribed by the court directed to the correction of the child's need for protection or services:
(i) the court may order the child into the home of a parent who does not otherwise have
legal custody of the child, however, an order under this section does not confer legal custody
on that parent;
(ii) if the court orders the child into the home of a father who is not adjudicated, the
father must cooperate with paternity establishment proceedings regarding the child in the
appropriate jurisdiction as one of the conditions prescribed by the court for the child to
continue in the father's home; and
(iii) the court may order the child into the home of a noncustodial parent with conditions
and may also order both the noncustodial and the custodial parent to comply with the
requirements of a case plan under subdivision 2; or
(2) transfer legal custody to one of the following:
(i) a child-placing agency; or
(ii) the responsible social services agency. In making a foster care placement of a child
whose custody has been transferred under this subdivision, the agency shall make an
individualized determination of how the placement is in the child's best interests using the
placement consideration order for relatives and the best interest factors in section 260C.212,
subdivision 2, and may include a child colocated with a parent in a licensed residential
family-based substance use disorder treatment program under section 260C.190; or
(3) order a trial home visit without modifying the transfer of legal custody to the
responsible social services agency under clause (2). Trial home visit means the child is
returned to the care of the parent or guardian from whom the child was removed for a period
not to exceed six months. During the period of the trial home visit, the responsible social
services agency:
(i) shall continue to have legal custody of the child, which means that the agency may
see the child in the parent's home, at school, in a child care facility, or other setting as the
agency deems necessary and appropriate;
(ii) shall continue to have the ability to access information under section 260C.208;
(iii) shall continue to provide appropriate services to both the parent and the child during
the period of the trial home visit;
(iv) without previous court order or authorization, may terminate the trial home visit in
order to protect the child's health, safety, or welfare and may remove the child to foster care;
(v) shall advise the court and parties within three days of the termination of the trial
home visit when a visit is terminated by the responsible social services agency without a
court order; and
(vi) shall prepare a report for the court when the trial home visit is terminated whether
by the agency or court order that describes the child's circumstances during the trial home
visit and recommends appropriate orders, if any, for the court to enter to provide for the
child's safety and stability. In the event a trial home visit is terminated by the agency by
removing the child to foster care without prior court order or authorization, the court shall
conduct a hearing within ten days of receiving notice of the termination of the trial home
visit by the agency and shall order disposition under this subdivision or commence
permanency proceedings under sections 260C.503 to 260C.515. The time period for the
hearing may be extended by the court for good cause shown and if it is in the best interests
of the child as long as the total time the child spends in foster care without a permanency
hearing does not exceed 12 months;
(4) if the child has been adjudicated as a child in need of protection or services because
the child is in need of special services or care to treat or ameliorate a physical or mental
disability or deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end as defined in section 245.4871, subdivision
15, the court may order the child's parent, guardian, or custodian to provide it. The court
may order the child's health plan company to provide mental health services to the child.
Section 62Q.535 applies to an order for mental health services directed to the child's health
plan company. If the health plan, parent, guardian, or custodian fails or is unable to provide
this treatment or care, the court may order it provided. Absent specific written findings by
the court that the child's disability is the result of abuse or neglect by the child's parent or
guardian, the court shall not transfer legal custody of the child for the purpose of obtaining
special treatment or care solely because the parent is unable to provide the treatment or care.
If the court's order for mental health treatment is based on a diagnosis made by a treatment
professional, the court may order that the diagnosing professional not provide the treatment
to the child if it finds that such an order is in the child's best interests; or
(5) if the court believes that the child has sufficient maturity and judgment and that it is
in the best interests of the child, the court may order a child 16 years old or older to be
allowed to live independently, either alone or with others as approved by the court under
supervision the court considers appropriate, if the county board, after consultation with the
court, has specifically authorized this dispositional alternative for a child.
(b) If the child was adjudicated in need of protection or services because the child is a
runaway or habitual truant, the court may order any of the following dispositions in addition
to or as alternatives to the dispositions authorized under paragraph (a):
(1) counsel the child or the child's parents, guardian, or custodian;
(2) place the child under the supervision of a probation officer or other suitable person
in the child's own home under conditions prescribed by the court, including reasonable rules
for the child's conduct and the conduct of the parents, guardian, or custodian, designed for
the physical, mental, and moral well-being and behavior of the child;
(3) subject to the court's supervision, transfer legal custody of the child to one of the
following:
(i) a reputable person of good moral character. No person may receive custody of two
or more unrelated children unless licensed to operate a residential program under sections
245A.01 to 245A.16; or
(ii) a county probation officer for placement in a group foster home established under
the direction of the juvenile court and licensed pursuant to section 241.021;
(4) require the child to pay a fine of up to $100. The court shall order payment of the
fine in a manner that will not impose undue financial hardship upon the child;
(5) require the child to participate in a community service project;
(6) order the child to undergo a chemical dependency evaluation and, if warranted by
the evaluation, order participation by the child in a drug awareness program or an inpatient
or outpatient chemical dependency treatment program;
(7) if the court believes that it is in the best interests of the child or of public safety that
the child's driver's license or instruction permit be canceled, the court may order the
commissioner of public safety to cancel the child's license or permit for any period up to
the child's 18th birthday. If the child does not have a driver's license or permit, the court
may order a denial of driving privileges for any period up to the child's 18th birthday. The
court shall forward an order issued under this clause to the commissioner, who shall cancel
the license or permit or deny driving privileges without a hearing for the period specified
by the court. At any time before the expiration of the period of cancellation or denial, the
court may, for good cause, order the commissioner of public safety to allow the child to
apply for a license or permit, and the commissioner shall so authorize;
(8) order that the child's parent or legal guardian deliver the child to school at the
beginning of each school day for a period of time specified by the court; or
(9) require the child to perform any other activities or participate in any other treatment
programs deemed appropriate by the court.
To the extent practicable, the court shall enter a disposition order the same day it makes
a finding that a child is in need of protection or services or neglected and in foster care, but
in no event more than 15 days after the finding unless the court finds that the best interests
of the child will be served by granting a delay. If the child was under eight years of age at
the time the petition was filed, the disposition order must be entered within ten days of the
finding and the court may not grant a delay unless good cause is shown and the court finds
the best interests of the child will be served by the delay.
(c) If a child who is 14 years of age or older is adjudicated in need of protection or
services because the child is a habitual truant and truancy procedures involving the child
were previously dealt with by a school attendance review board or county attorney mediation
program under section 260A.06 or 260A.07, the court shall order a cancellation or denial
of driving privileges under paragraph (b), clause (7), for any period up to the child's 18th
birthday.
(d) In the case of a child adjudicated in need of protection or services because the child
has committed domestic abuse and been ordered excluded from the child's parent's home,
the court shall dismiss jurisdiction if the court, at any time, finds the parent is able or willing
to provide an alternative safe living arrangement for the child as defined in paragraph (f).
(e) When a parent has complied with a case plan ordered under subdivision 6 and the
child is in the care of the parent, the court may order the responsible social services agency
to monitor the parent's continued ability to maintain the child safely in the home under such
terms and conditions as the court determines appropriate under the circumstances.
(f) For the purposes of this subdivision, "alternative safe living arrangement" means a
living arrangement for a child proposed by a petitioning parent or guardian if a court excludes
the minor from the parent's or guardian's home that is separate from the victim of domestic
abuse and safe for the child respondent. A living arrangement proposed by a petitioning
parent or guardian is presumed to be an alternative safe living arrangement absent information
to the contrary presented to the court. In evaluating any proposed living arrangement, the
court shall consider whether the arrangement provides the child with necessary food, clothing,
shelter, and education in a safe environment. Any proposed living arrangement that would
place the child in the care of an adult who has been physically or sexually violent is presumed
unsafe.
Sec. 78.
Minnesota Statutes 2024, section 260C.201, subdivision 2, is amended to read:
Subd. 2.
Written findings.
(a) Any order for a disposition authorized under this section
shall contain written findings of fact to support the disposition and case plan ordered and
shall also set forth in writing the following information:
(1) why the best interests and safety of the child are served by the disposition and case
plan ordered;
(2) what alternative dispositions or services under the case plan were considered by the
court and why such dispositions or services were not appropriate in the instant case;
(3) when legal custody of the child is transferred, the appropriateness of the particular
placement made or to be made by the placing agency using the relative and sibling placement
considerations and best interest factors in section 260C.212, subdivision 2, or the
appropriateness of a child colocated with a parent in a licensed residential family-based
substance use disorder treatment program under section 260C.190;
(4) whether reasonable efforts to finalize the permanent plan for the child consistent
with section 260.012 were made including reasonable efforts:
(i) to prevent the child's placement and to reunify the child with the parent or guardian
from whom the child was removed at the earliest time consistent with the child's safety.
The court's findings must include a brief description of what preventive and reunification
efforts were made and why further efforts could not have prevented or eliminated the
necessity of removal or that reasonable efforts were not required under section 260.012 or
260C.178, subdivision 1;
(ii) to identify and locate any noncustodial or nonresident parent of the child and to
assess such parent's ability to provide day-to-day care of the child, and, where appropriate,
provide services necessary to enable the noncustodial or nonresident parent to safely provide
day-to-day care of the child as required under section 260C.219, unless such services are
not required under section 260.012 or 260C.178, subdivision 1. The court's findings must
include a description of the agency's efforts to:
(A) identify and locate the child's noncustodial or nonresident parent;
(B) assess the noncustodial or nonresident parent's ability to provide day-to-day care of
the child; and
(C) if appropriate, provide services necessary to enable the noncustodial or nonresident
parent to safely provide the child's day-to-day care, including efforts to engage the
noncustodial or nonresident parent in assuming care and responsibility of the child;
(iii) to make the diligent search for relatives and provide the notices required under
section 260C.221; a finding made pursuant to a hearing under section 260C.202 that the
agency has made diligent efforts to conduct a relative search and has appropriately engaged
relatives who responded to the notice under section 260C.221 and other relatives, who came
to the attention of the agency after notice under section 260C.221 was sent, in placement
and case planning decisions fulfills the requirement of this item;
(iv) to identify and make a foster care placement of the child, considering the order in
section 260C.212, subdivision 2, paragraph (a), in the home of an unlicensed relative,
according to the requirements of section 142B.06, a licensed relative, or other licensed foster
care provider, who will commit to being the permanent legal parent or custodian for the
child in the event reunification cannot occur, but who will actively support the reunification
plan for the child. If the court finds that the agency has not appropriately considered relatives
for placement of the child, the court shall order the agency to comply with section 260C.212,
subdivision 2, paragraph (a). The court may order the agency to continue considering
relatives for placement of the child regardless of the child's current placement setting; and
(v) to place siblings together in the same home or to ensure visitation is occurring when
siblings are separated in foster care placement and visitation is in the siblings' best interests
under section 260C.212, subdivision 2, paragraph (d); and
(5) if the child has been adjudicated as a child in need of protection or services because
the child is in need of special services or care to treat or ameliorate a mental disability or
deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end as defined in section 245.4871, subdivision 15, the
written findings shall also set forth:
(i) whether the child has mental health needs that must be addressed by the case plan;
(ii) what consideration was given to the diagnostic and functional assessments performed
by the child's mental health professional and to health and mental health care professionals'
treatment recommendations;
(iii) what consideration was given to the requests or preferences of the child's parent or
guardian with regard to the child's interventions, services, or treatment; and
(iv) what consideration was given to the cultural appropriateness of the child's treatment
or services.
(b) If the court finds that the social services agency's preventive or reunification efforts
have not been reasonable but that further preventive or reunification efforts could not permit
the child to safely remain at home, the court may nevertheless authorize or continue the
removal of the child.
(c) If the child has been identified by the responsible social services agency as the subject
of concurrent permanency planning, the court shall review the reasonable efforts of the
agency to develop a permanency plan for the child that includes a primary plan that is for
reunification with the child's parent or guardian and a secondary plan that is for an alternative,
legally permanent home for the child in the event reunification cannot be achieved in a
timely manner.
Sec. 79.
Minnesota Statutes 2024, section 260C.301, subdivision 4, is amended to read:
Subd. 4.
Current foster care children.
Except for cases where the child is in placement
due solely to the child's developmental disability or deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end ,
where custody has not been transferred to the responsible social services agency, and where
the court finds compelling reasons to continue placement, the county attorney shall file a
termination of parental rights petition or a petition to transfer permanent legal and physical
custody to a relative under section 260C.515, subdivision 4, for all children who have been
in out-of-home care for 15 of the most recent 22 months. This requirement does not apply
if there is a compelling reason approved by the court for determining that filing a termination
of parental rights petition or other permanency petition would not be in the best interests
of the child or if the responsible social services agency has not provided reasonable efforts
necessary for the safe return of the child, if reasonable efforts are required.
Sec. 80.
Minnesota Statutes 2024, section 260D.01, is amended to read:
260D.01 CHILD IN VOLUNTARY FOSTER CARE FOR TREATMENT.
(a) Sections 260D.01 to 260D.10, may be cited as the "child in voluntary foster care for
treatment" provisions of the Juvenile Court Act.
(b) The juvenile court has original and exclusive jurisdiction over a child in voluntary
foster care for treatment upon the filing of a report or petition required under this chapter.
All obligations of the responsible social services agency to a child and family in foster care
contained in chapter 260C not inconsistent with this chapter are also obligations of the
agency with regard to a child in foster care for treatment under this chapter.
(c) This chapter shall be construed consistently with the mission of the children's mental
health service system as set out in section 245.487, subdivision 3, and the duties of an agency
under sections 256B.092 and 260C.157 and Minnesota Rules, parts 9525.0004 to 9525.0016,
to meet the needs of a child with a developmental disability or related condition. This
chapter:
(1) establishes voluntary foster care through a voluntary foster care agreement as the
means for an agency and a parent to provide needed treatment when the child must be in
foster care to receive necessary treatment for deleted text begin an emotional disturbance ordeleted text end new text begin a mental illness,new text end
developmental disabilitynew text begin ,new text end or related condition;
(2) establishes court review requirements for a child in voluntary foster care for treatment
due to deleted text begin emotional disturbance ordeleted text end new text begin a mental illness,new text end developmental disabilitynew text begin ,new text end or deleted text begin adeleted text end related
condition;
(3) establishes the ongoing responsibility of the parent as legal custodian to visit the
child, to plan together with the agency for the child's treatment needs, to be available and
accessible to the agency to make treatment decisions, and to obtain necessary medical,
dental, and other care for the child;
(4) applies to voluntary foster care when the child's parent and the agency agree that the
child's treatment needs require foster care either:
(i) due to a level of care determination by the agency's screening team informed by the
child's diagnostic and functional assessment under section 245.4885; or
(ii) due to a determination regarding the level of services needed by the child by the
responsible social services agency's screening team under section 256B.092, and Minnesota
Rules, parts 9525.0004 to 9525.0016; and
(5) includes the requirements for a child's placement in sections 260C.70 to 260C.714,
when the juvenile treatment screening team recommends placing a child in a qualified
residential treatment program, except as modified by this chapter.
(d) This chapter does not apply when there is a current determination under chapter
260E that the child requires child protective services or when the child is in foster care for
any reason other than treatment for the child's deleted text begin emotional disturbance ordeleted text end new text begin mental illness,new text end
developmental disabilitynew text begin ,new text end or related condition. When there is a determination under chapter
260E that the child requires child protective services based on an assessment that there are
safety and risk issues for the child that have not been mitigated through the parent's
engagement in services or otherwise, or when the child is in foster care for any reason other
than the child's deleted text begin emotional disturbance ordeleted text end new text begin mental illness,new text end developmental disabilitynew text begin ,new text end or related
condition, the provisions of chapter 260C apply.
(e) The paramount consideration in all proceedings concerning a child in voluntary foster
care for treatment is the safety, health, and the best interests of the child. The purpose of
this chapter is:
(1) to ensure that a child with a disability is provided the services necessary to treat or
ameliorate the symptoms of the child's disability;
(2) to preserve and strengthen the child's family ties whenever possible and in the child's
best interests, approving the child's placement away from the child's parents only when the
child's need for care or treatment requires out-of-home placement and the child cannot be
maintained in the home of the parent; and
(3) to ensure that the child's parent retains legal custody of the child and associated
decision-making authority unless the child's parent willfully fails or is unable to make
decisions that meet the child's safety, health, and best interests. The court may not find that
the parent willfully fails or is unable to make decisions that meet the child's needs solely
because the parent disagrees with the agency's choice of foster care facility, unless the
agency files a petition under chapter 260C, and establishes by clear and convincing evidence
that the child is in need of protection or services.
(f) The legal parent-child relationship shall be supported under this chapter by maintaining
the parent's legal authority and responsibility for ongoing planning for the child and by the
agency's assisting the parent, when necessary, to exercise the parent's ongoing right and
obligation to visit or to have reasonable contact with the child. Ongoing planning means:
(1) actively participating in the planning and provision of educational services, medical,
and dental care for the child;
(2) actively planning and participating with the agency and the foster care facility for
the child's treatment needs;
(3) planning to meet the child's need for safety, stability, and permanency, and the child's
need to stay connected to the child's family and community;
(4) engaging with the responsible social services agency to ensure that the family and
permanency team under section 260C.706 consists of appropriate family members. For
purposes of voluntary placement of a child in foster care for treatment under chapter 260D,
prior to forming the child's family and permanency team, the responsible social services
agency must consult with the child's parent or legal guardian, the child if the child is 14
years of age or older, and, if applicable, the child's Tribe to obtain recommendations regarding
which individuals to include on the team and to ensure that the team is family-centered and
will act in the child's best interests. If the child, child's parents, or legal guardians raise
concerns about specific relatives or professionals, the team should not include those
individuals unless the individual is a treating professional or an important connection to the
youth as outlined in the case or crisis plan; and
(5) for a voluntary placement under this chapter in a qualified residential treatment
program, as defined in section 260C.007, subdivision 26d, for purposes of engaging in a
relative search as provided in section 260C.221, the county agency must consult with the
child's parent or legal guardian, the child if the child is 14 years of age or older, and, if
applicable, the child's Tribe to obtain recommendations regarding which adult relatives the
county agency should notify. If the child, child's parents, or legal guardians raise concerns
about specific relatives, the county agency should not notify those relatives.
(g) The provisions of section 260.012 to ensure placement prevention, family
reunification, and all active and reasonable effort requirements of that section apply.
Sec. 81.
Minnesota Statutes 2024, section 260D.02, subdivision 5, is amended to read:
Subd. 5.
Child in voluntary foster care for treatment.
"Child in voluntary foster care
for treatment" means a child with deleted text begin emotional disturbancedeleted text end new text begin a mental illnessnew text end or developmental
disabilitydeleted text begin ,deleted text end or who has a related condition and is in foster care under a voluntary foster care
agreement between the child's parent and the agency due to concurrence between the agency
and the parent when it is determined that foster care is medically necessary:
(1) due to a determination by the agency's screening team based on its review of the
diagnostic and functional assessment under section 245.4885; or
(2) due to a determination by the agency's screening team under section 256B.092 and
Minnesota Rules, parts 9525.0004 to 9525.0016.
A child is not in voluntary foster care for treatment under this chapter when there is a
current determination under chapter 260E that the child requires child protective services
or when the child is in foster care for any reason other than the child's deleted text begin emotional ordeleted text end new text begin mental
illness,new text end developmental disabilitynew text begin ,new text end or related condition.
Sec. 82.
Minnesota Statutes 2024, section 260D.02, subdivision 9, is amended to read:
Subd. 9.
deleted text begin Emotional disturbancedeleted text end new text begin Mental illnessnew text end .
"deleted text begin Emotional disturbancedeleted text end new text begin Mental illnessnew text end "
deleted text begin means emotional disturbance as describeddeleted text end new text begin has the meaning givennew text end in section 245.4871,
subdivision 15.
Sec. 83.
Minnesota Statutes 2024, section 260D.03, subdivision 1, is amended to read:
Subdivision 1.
Voluntary foster care.
When the agency's screening team, based upon
the diagnostic and functional assessment under section 245.4885 or medical necessity
screenings under section 256B.092, subdivision 7, determines the child's need for treatment
due to deleted text begin emotional disturbance ordeleted text end new text begin a mental illness,new text end developmental disabilitynew text begin ,new text end or related condition
requires foster care placement of the child, a voluntary foster care agreement between the
child's parent and the agency gives the agency legal authority to place the child in foster
care.
Sec. 84.
Minnesota Statutes 2024, section 260D.04, is amended to read:
260D.04 REQUIRED INFORMATION FOR A CHILD IN VOLUNTARY FOSTER
CARE FOR TREATMENT.
An agency with authority to place a child in voluntary foster care for treatment due to
deleted text begin emotional disturbance ordeleted text end new text begin a mental illness,new text end developmental disabilitynew text begin ,new text end or related conditiondeleted text begin ,deleted text end
shall inform the child, age 12 or older, of the following:
(1) the child has the right to be consulted in the preparation of the out-of-home placement
plan required under section 260C.212, subdivision 1, and the administrative review required
under section 260C.203;
(2) the child has the right to visit the parent and the right to visit the child's siblings as
determined safe and appropriate by the parent and the agency;
(3) if the child disagrees with the foster care facility or services provided under the
out-of-home placement plan required under section 260C.212, subdivision 1, the agency
shall include information about the nature of the child's disagreement and, to the extent
possible, the agency's understanding of the basis of the child's disagreement in the information
provided to the court in the report required under section 260D.06; and
(4) the child has the rights established under Minnesota Rules, part 2960.0050, as a
resident of a facility licensed by the state.
Sec. 85.
Minnesota Statutes 2024, section 260D.06, subdivision 2, is amended to read:
Subd. 2.
Agency report to court; court review.
The agency shall obtain judicial review
by reporting to the court according to the following procedures:
(a) A written report shall be forwarded to the court within 165 days of the date of the
voluntary placement agreement. The written report shall contain or have attached:
(1) a statement of facts that necessitate the child's foster care placement;
(2) the child's name, date of birth, race, gender, and current address;
(3) the names, race, date of birth, residence, and post office addresses of the child's
parents or legal custodian;
(4) a statement regarding the child's eligibility for membership or enrollment in an Indian
tribe and the agency's compliance with applicable provisions of sections 260.751 to 260.835;
(5) the names and addresses of the foster parents or chief administrator of the facility in
which the child is placed, if the child is not in a family foster home or group home;
(6) a copy of the out-of-home placement plan required under section 260C.212,
subdivision 1;
(7) a written summary of the proceedings of any administrative review required under
section 260C.203;
(8) evidence as specified in section 260C.712 when a child is placed in a qualified
residential treatment program as defined in section 260C.007, subdivision 26d; and
(9) any other information the agency, parent or legal custodian, the child or the foster
parent, or other residential facility wants the court to consider.
(b) In the case of a child in placement due to deleted text begin emotional disturbancedeleted text end new text begin mental illnessnew text end , the
written report shall include as an attachment, the child's individual treatment plan developed
by the child's treatment professional, as provided in section 245.4871, subdivision 21, or
the child's standard written plan, as provided in section 125A.023, subdivision 3, paragraph
(e).
(c) In the case of a child in placement due to developmental disability or a related
condition, the written report shall include as an attachment, the child's individual service
plan, as provided in section 256B.092, subdivision 1b; the child's individual program plan,
as provided in Minnesota Rules, part 9525.0004, subpart 11; the child's waiver care plan;
or the child's standard written plan, as provided in section 125A.023, subdivision 3, paragraph
(e).
(d) The agency must inform the child, age 12 or older, the child's parent, and the foster
parent or foster care facility of the reporting and court review requirements of this section
and of their right to submit information to the court:
(1) if the child or the child's parent or the foster care provider wants to send information
to the court, the agency shall advise those persons of the reporting date and the date by
which the agency must receive the information they want forwarded to the court so the
agency is timely able submit it with the agency's report required under this subdivision;
(2) the agency must also inform the child, age 12 or older, the child's parent, and the
foster care facility that they have the right to be heard in person by the court and how to
exercise that right;
(3) the agency must also inform the child, age 12 or older, the child's parent, and the
foster care provider that an in-court hearing will be held if requested by the child, the parent,
or the foster care provider; and
(4) if, at the time required for the report under this section, a child, age 12 or older,
disagrees about the foster care facility or services provided under the out-of-home placement
plan required under section 260C.212, subdivision 1, the agency shall include information
regarding the child's disagreement, and to the extent possible, the basis for the child's
disagreement in the report required under this section.
(e) After receiving the required report, the court has jurisdiction to make the following
determinations and must do so within ten days of receiving the forwarded report, whether
a hearing is requested:
(1) whether the voluntary foster care arrangement is in the child's best interests;
(2) whether the parent and agency are appropriately planning for the child; and
(3) in the case of a child age 12 or older, who disagrees with the foster care facility or
services provided under the out-of-home placement plan, whether it is appropriate to appoint
counsel and a guardian ad litem for the child using standards and procedures under section
260C.163.
(f) Unless requested by a parent, representative of the foster care facility, or the child,
no in-court hearing is required in order for the court to make findings and issue an order as
required in paragraph (e).
(g) If the court finds the voluntary foster care arrangement is in the child's best interests
and that the agency and parent are appropriately planning for the child, the court shall issue
an order containing explicit, individualized findings to support its determination. The
individualized findings shall be based on the agency's written report and other materials
submitted to the court. The court may make this determination notwithstanding the child's
disagreement, if any, reported under paragraph (d).
(h) The court shall send a copy of the order to the county attorney, the agency, parent,
child, age 12 or older, and the foster parent or foster care facility.
(i) The court shall also send the parent, the child, age 12 or older, the foster parent, or
representative of the foster care facility notice of the permanency review hearing required
under section 260D.07, paragraph (e).
(j) If the court finds continuing the voluntary foster care arrangement is not in the child's
best interests or that the agency or the parent are not appropriately planning for the child,
the court shall notify the agency, the parent, the foster parent or foster care facility, the child,
age 12 or older, and the county attorney of the court's determinations and the basis for the
court's determinations. In this case, the court shall set the matter for hearing and appoint a
guardian ad litem for the child under section 260C.163, subdivision 5.
Sec. 86.
Minnesota Statutes 2024, section 260D.07, is amended to read:
260D.07 REQUIRED PERMANENCY REVIEW HEARING.
(a) When the court has found that the voluntary arrangement is in the child's best interests
and that the agency and parent are appropriately planning for the child pursuant to the report
submitted under section 260D.06, and the child continues in voluntary foster care as defined
in section 260D.02, subdivision 10, for 13 months from the date of the voluntary foster care
agreement, or has been in placement for 15 of the last 22 months, the agency must:
(1) terminate the voluntary foster care agreement and return the child home; or
(2) determine whether there are compelling reasons to continue the voluntary foster care
arrangement and, if the agency determines there are compelling reasons, seek judicial
approval of its determination; or
(3) file a petition for the termination of parental rights.
(b) When the agency is asking for the court's approval of its determination that there are
compelling reasons to continue the child in the voluntary foster care arrangement, the agency
shall file a "Petition for Permanency Review Regarding a Child in Voluntary Foster Care
for Treatment" and ask the court to proceed under this section.
(c) The "Petition for Permanency Review Regarding a Child in Voluntary Foster Care
for Treatment" shall be drafted or approved by the county attorney and be under oath. The
petition shall include:
(1) the date of the voluntary placement agreement;
(2) whether the petition is due to the child's developmental disability or deleted text begin emotional
disturbancedeleted text end new text begin mental illnessnew text end ;
(3) the plan for the ongoing care of the child and the parent's participation in the plan;
(4) a description of the parent's visitation and contact with the child;
(5) the date of the court finding that the foster care placement was in the best interests
of the child, if required under section 260D.06, or the date the agency filed the motion under
section 260D.09, paragraph (b);
(6) the agency's reasonable efforts to finalize the permanent plan for the child, including
returning the child to the care of the child's family;
(7) a citation to this chapter as the basis for the petition; and
(8) evidence as specified in section 260C.712 when a child is placed in a qualified
residential treatment program as defined in section 260C.007, subdivision 26d.
(d) An updated copy of the out-of-home placement plan required under section 260C.212,
subdivision 1, shall be filed with the petition.
(e) The court shall set the date for the permanency review hearing no later than 14 months
after the child has been in placement or within 30 days of the petition filing date when the
child has been in placement 15 of the last 22 months. The court shall serve the petition
together with a notice of hearing by United States mail on the parent, the child age 12 or
older, the child's guardian ad litem, if one has been appointed, the agency, the county
attorney, and counsel for any party.
(f) The court shall conduct the permanency review hearing on the petition no later than
14 months after the date of the voluntary placement agreement, within 30 days of the filing
of the petition when the child has been in placement 15 of the last 22 months, or within 15
days of a motion to terminate jurisdiction and to dismiss an order for foster care under
chapter 260C, as provided in section 260D.09, paragraph (b).
(g) At the permanency review hearing, the court shall:
(1) inquire of the parent if the parent has reviewed the "Petition for Permanency Review
Regarding a Child in Voluntary Foster Care for Treatment," whether the petition is accurate,
and whether the parent agrees to the continued voluntary foster care arrangement as being
in the child's best interests;
(2) inquire of the parent if the parent is satisfied with the agency's reasonable efforts to
finalize the permanent plan for the child, including whether there are services available and
accessible to the parent that might allow the child to safely be with the child's family;
(3) inquire of the parent if the parent consents to the court entering an order that:
(i) approves the responsible agency's reasonable efforts to finalize the permanent plan
for the child, which includes ongoing future planning for the safety, health, and best interests
of the child; and
(ii) approves the responsible agency's determination that there are compelling reasons
why the continued voluntary foster care arrangement is in the child's best interests; and
(4) inquire of the child's guardian ad litem and any other party whether the guardian or
the party agrees that:
(i) the court should approve the responsible agency's reasonable efforts to finalize the
permanent plan for the child, which includes ongoing and future planning for the safety,
health, and best interests of the child; and
(ii) the court should approve of the responsible agency's determination that there are
compelling reasons why the continued voluntary foster care arrangement is in the child's
best interests.
(h) At a permanency review hearing under this section, the court may take the following
actions based on the contents of the sworn petition and the consent of the parent:
(1) approve the agency's compelling reasons that the voluntary foster care arrangement
is in the best interests of the child; and
(2) find that the agency has made reasonable efforts to finalize the permanent plan for
the child.
(i) A child, age 12 or older, may object to the agency's request that the court approve its
compelling reasons for the continued voluntary arrangement and may be heard on the reasons
for the objection. Notwithstanding the child's objection, the court may approve the agency's
compelling reasons and the voluntary arrangement.
(j) If the court does not approve the voluntary arrangement after hearing from the child
or the child's guardian ad litem, the court shall dismiss the petition. In this case, either:
(1) the child must be returned to the care of the parent; or
(2) the agency must file a petition under section 260C.141, asking for appropriate relief
under sections 260C.301 or 260C.503 to 260C.521.
(k) When the court approves the agency's compelling reasons for the child to continue
in voluntary foster care for treatment, and finds that the agency has made reasonable efforts
to finalize a permanent plan for the child, the court shall approve the continued voluntary
foster care arrangement, and continue the matter under the court's jurisdiction for the purposes
of reviewing the child's placement every 12 months while the child is in foster care.
(l) A finding that the court approves the continued voluntary placement means the agency
has continued legal authority to place the child while a voluntary placement agreement
remains in effect. The parent or the agency may terminate a voluntary agreement as provided
in section 260D.10. Termination of a voluntary foster care placement of an Indian child is
governed by section 260.765, subdivision 4.
Sec. 87.
Minnesota Statutes 2024, section 260E.11, subdivision 3, is amended to read:
Subd. 3.
Report to medical examiner or coroner; notification to local agency and
law enforcement; report ombudsman.
(a) A person mandated to report maltreatment who
knows or has reason to believe a child has died as a result of maltreatment shall report that
information to the appropriate medical examiner or coroner instead of the local welfare
agency, police department, or county sheriff.
(b) The medical examiner or coroner shall notify the local welfare agency, police
department, or county sheriff in instances in which the medical examiner or coroner believes
that the child has died as a result of maltreatment. The medical examiner or coroner shall
complete an investigation as soon as feasible and report the findings to the police department
or county sheriff and the local welfare agency.
(c) If the child was receiving services or treatment for mental illness, developmental
disability,new text begin ornew text end substance use disorderdeleted text begin , or emotional disturbancedeleted text end from an agency, facility, or
program as defined in section 245.91, the medical examiner or coroner shall also notify and
report findings to the ombudsman established under sections 245.91 to 245.97.
Sec. 88.
Minnesota Statutes 2024, section 295.50, subdivision 9b, is amended to read:
Subd. 9b.
Patient services.
(a) "Patient services" means inpatient and outpatient services
and other goods and services provided by hospitals, surgical centers, or health care providers.
They include the following health care goods and services provided to a patient or consumer:
(1) bed and board;
(2) nursing services and other related services;
(3) use of hospitals, surgical centers, or health care provider facilities;
(4) medical social services;
(5) drugs, biologicals, supplies, appliances, and equipment;
(6) other diagnostic or therapeutic items or services;
(7) medical or surgical services;
(8) items and services furnished to ambulatory patients not requiring emergency care;
and
(9) emergency services.
(b) "Patient services" does not include:
(1) services provided to nursing homes licensed under chapter 144A;
(2) examinations for purposes of utilization reviews, insurance claims or eligibility,
litigation, and employment, including reviews of medical records for those purposes;
(3) services provided to and by community residential mental health facilities licensed
under section 245I.23 or Minnesota Rules, parts 9520.0500 to 9520.0670, and to and by
residential treatment programs for children with deleted text begin severe emotional disturbancedeleted text end new text begin a serious
mental illnessnew text end licensed or certified under chapter 245A;
(4) services provided under the following programs: day treatment services as defined
in section 245.462, subdivision 8; assertive community treatment as described in section
256B.0622; adult rehabilitative mental health services as described in section 256B.0623;
crisis response services as described in section 256B.0624; and children's therapeutic services
and supports as described in section 256B.0943;
(5) services provided to and by community mental health centers as defined in section
245.62, subdivision 2;
(6) services provided to and by assisted living programs and congregate housing
programs;
(7) hospice care services;
(8) home and community-based waivered services under chapter 256S and sections
256B.49 and 256B.501;
(9) targeted case management services under sections 256B.0621; 256B.0625,
subdivisions 20, 20a, 33, and 44; and 256B.094; and
(10) services provided to the following: supervised living facilities for persons with
developmental disabilities licensed under Minnesota Rules, parts 4665.0100 to 4665.9900;
housing with services establishments required to be registered under chapter 144D; board
and lodging establishments providing only custodial services that are licensed under chapter
157 and registered under section 157.17 to provide supportive services or health supervision
services; adult foster homes as defined in Minnesota Rules, part 9555.5105; day training
and habilitation services for adults with developmental disabilities as defined in section
252.41, subdivision 3; boarding care homes as defined in Minnesota Rules, part 4655.0100;
adult day care services as defined in section 245A.02, subdivision 2a; and home health
agencies as defined in Minnesota Rules, part 9505.0175, subpart 15, or licensed under
chapter 144A.
ARTICLE 11
ASSERTIVE COMMUNITY TREATMENT AND INTENSIVE RESIDENTIAL
TREATMENT SERVICES RECODIFICATION
Section 1.
Minnesota Statutes 2024, section 256B.0622, subdivision 1, is amended to read:
Subdivision 1.
Scope.
(a) Subject to federal approval, medical assistance covers medically
necessary, assertive community treatment when the services are provided by an entity
certified under and meeting the standards in this section.
deleted text begin
(b) Subject to federal approval, medical assistance covers medically necessary, intensive
residential treatment services when the services are provided by an entity licensed under
and meeting the standards in section 245I.23.
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end The provider entity must make reasonable and good faith efforts to report
individual client outcomes to the commissioner, using instruments and protocols approved
by the commissioner.
Sec. 2.
Minnesota Statutes 2024, section 256B.0622, subdivision 8, is amended to read:
Subd. 8.
Medical assistance payment for assertive community treatment deleted text begin and
intensive residential treatmentdeleted text end services.
(a) Payment for deleted text begin intensive residential treatment
services anddeleted text end assertive community treatment in this section shall be based on one daily rate
per provider inclusive of the following services received by an eligible client in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.
(b) Except as indicated in paragraph deleted text begin (d)deleted text end new text begin (c)new text end , payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.
deleted text begin
(c) Payment must not be made based solely on a court order to participate in intensive
residential treatment services. If a client has a court order to participate in the program or
to obtain assessment for treatment and follow treatment recommendations, payment under
this section must only be provided if the client is eligible for the service and the service is
determined to be medically necessary.
deleted text end
deleted text begin (d)deleted text end new text begin (c)new text end The commissioner shall determine deleted text begin one rate for each provider that will bill medical
assistance for residential services under this section anddeleted text end one rate for each assertive community
treatment providernew text begin under this sectionnew text end . If a single entity provides both deleted text begin servicesdeleted text end new text begin intensive
residential treatment services under section 256B.0632 and assertive community treatment
under this sectionnew text end , one rate is established for the entity'snew text begin intensivenew text end residentialnew text begin treatmentnew text end
servicesnew text begin under section 256B.0632new text end and another rate for the entity's deleted text begin nonresidentialdeleted text end new text begin assertive
community treatmentnew text end services under this section. A provider is not eligible for payment
under this section without authorization from the commissioner. The commissioner shall
develop rates using the following criteria:
(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:
(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;
(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;
(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space;
(iv) assertive community treatment physical plant costs must be reimbursed as part of
the costs described in item (ii); and
(v) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;
(2) actual deleted text begin cost isdeleted text end new text begin costs arenew text end defined as costs which are allowable, allocable, and reasonable,
and consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;
(3) the number of service units;
(4) the degree to which clients will receive services other than services under this sectionnew text begin
or section 256B.0632new text end ; and
(5) the costs of other services that will be separately reimbursed.
deleted text begin (e)deleted text end new text begin (d)new text end The rate for deleted text begin intensive residential treatment services anddeleted text end assertive community
treatment must exclude the medical assistance room and board rate, as defined in section
256B.056, subdivision 5d, and services not covered under this section, such as partial
hospitalization, home care, and inpatient services.
deleted text begin
(f) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.
deleted text end
deleted text begin (g)deleted text end new text begin (e)new text end When services under this section are provided by an assertive community treatment
provider, case management functions must be an integral part of the team.
deleted text begin (h)deleted text end new text begin (f)new text end The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.
deleted text begin (i)deleted text end new text begin (g)new text end The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph deleted text begin (d)deleted text end new text begin (c)new text end . The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph deleted text begin (d)deleted text end new text begin (c)new text end .
deleted text begin (j)deleted text end new text begin (h)new text end Effective for the rate years beginning on and after January 1, 2024, rates for
assertive community treatment, adult residential crisis stabilization services, and intensive
residential treatment services must be annually adjusted for inflation using the Centers for
Medicare and Medicaid Services Medicare Economic Index, as forecasted in the third quarter
of the calendar year before 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 determined.new text begin This paragraph expires upon federal approval.
new text end
new text begin
(i) Effective upon the expiration of paragraph (h), and effective for the rate years
beginning on and after January 1, 2024, rates for assertive community treatment services
must be annually adjusted for inflation using the Centers for Medicare and Medicaid Services
Medicare Economic Index, as forecasted in the third quarter of the calendar year before 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
determined.
new text end
deleted text begin (k)deleted text end new text begin (j)new text end Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.
deleted text begin (l)deleted text end new text begin (k)new text end A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.
Sec. 3.
Minnesota Statutes 2024, section 256B.0622, subdivision 11, is amended to read:
Subd. 11.
Sustainability grants.
The commissioner may disburse grant funds directly
to deleted text begin intensive residential treatment services providers anddeleted text end assertive community treatment
providers to maintain access to these services.
Sec. 4.
Minnesota Statutes 2024, section 256B.0622, subdivision 12, is amended to read:
Subd. 12.
Start-up grants.
The commissioner may, within available appropriations,
disburse grant funding to counties, Indian tribes, or mental health service providers to
establish additional assertive community treatment teamsdeleted text begin , intensive residential treatment
services, or crisis residential servicesdeleted text end .
Sec. 5.
new text begin
[256B.0632] INTENSIVE RESIDENTIAL TREATMENT SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
(a) Subject to federal approval, medical assistance covers medically
necessary, intensive residential treatment services when the services are provided by an
entity licensed under and meeting the standards in section 245I.23.
new text end
new text begin
(b) The provider entity must make reasonable and good faith efforts to report individual
client outcomes to the commissioner, using instruments and protocols approved by the
commissioner.
new text end
new text begin Subd. 2. new text end
new text begin
Provider entity licensure and contract requirements for intensive residential
treatment services.
new text end
new text begin
(a) The commissioner shall develop procedures for counties and
providers to submit other documentation as needed to allow the commissioner to determine
whether the standards in this section are met.
new text end
new text begin
(b) A provider entity must specify in the provider entity's application what geographic
area and populations will be served by the proposed program. A provider entity must
document that the capacity or program specialties of existing programs are not sufficient
to meet the service needs of the target population. A provider entity must submit evidence
of ongoing relationships with other providers and levels of care to facilitate referrals to and
from the proposed program.
new text end
new text begin
(c) A provider entity must submit documentation that the provider entity requested a
statement of need from each county board and Tribal authority that serves as a local mental
health authority in the proposed service area. The statement of need must specify if the local
mental health authority supports or does not support the need for the proposed program and
the basis for this determination. If a local mental health authority does not respond within
60 days of the receipt of the request, the commissioner shall determine the need for the
program based on the documentation submitted by the provider entity.
new text end
new text begin Subd. 3. new text end
new text begin Medical assistance payment for intensive residential treatment services. new text end
new text begin
(a)
Payment for intensive residential treatment services in this section shall be based on one
daily rate per provider inclusive of the following services received by an eligible client in
a given calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.
new text end
new text begin
(b) Except as indicated in paragraph (d), payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.
new text end
new text begin
(c) Payment must not be made based solely on a court order to participate in intensive
residential treatment services. If a client has a court order to participate in the program or
to obtain assessment for treatment and follow treatment recommendations, payment under
this section must only be provided if the client is eligible for the service and the service is
determined to be medically necessary.
new text end
new text begin
(d) The commissioner shall determine one rate for each provider that will bill medical
assistance for intensive residential treatment services under this section. If a single entity
provides both intensive residential treatment services under this section and assertive
community treatment under section 256B.0622, one rate is established for the entity's
intensive residential treatment services under this section and another rate for the entity's
assertive community treatment services under section 256B.0622. A provider is not eligible
for payment under this section without authorization from the commissioner. The
commissioner shall develop rates using the following criteria:
new text end
new text begin
(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:
new text end
new text begin
(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;
new text end
new text begin
(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;
new text end
new text begin
(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space; and
new text end
new text begin
(iv) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;
new text end
new text begin
(2) actual costs are defined as costs which are allowable, allocable, and reasonable, and
consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;
new text end
new text begin
(3) the number of services units;
new text end
new text begin
(4) the degree to which clients will receive services other than services under this section
or section 256B.0622; and
new text end
new text begin
(5) the costs of other services that will be separately reimbursed.
new text end
new text begin
(e) The rate for intensive residential treatment services must exclude the medical
assistance room and board rate, as defined in section 256B.056, subdivision 5d, and services
not covered under this section, such as partial hospitalization, home care, and inpatient
services.
new text end
new text begin
(f) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.
new text end
new text begin
(g) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.
new text end
new text begin
(h) The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph (d). The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (d).
new text end
new text begin
(i) Effective upon the expiration of section 256B.0622, subdivision 8, paragraph (h),
and effective for rate years beginning on and after January 1, 2024, rates for intensive
residential treatment services and adult residential crisis stabilization services must be
annually adjusted for inflation using the Centers for Medicare and Medicaid Services
Medicare Economic Index, as forecasted in the third quarter of the calendar year before 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
determined.
new text end
new text begin
(j) Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.
new text end
new text begin
(k) A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.
new text end
new text begin Subd. 4. new text end
new text begin Provider enrollment; rate setting for county-operated entities. new text end
new text begin
Counties
that employ their own staff to provide services under this section shall apply directly to the
commissioner for enrollment and rate setting. In this case, a county contract is not required.
new text end
new text begin Subd. 5. new text end
new text begin Provider enrollment; rate setting for specialized program. new text end
new text begin
A county contract
is not required for a provider proposing to serve a subpopulation of eligible clients under
the following circumstances:
new text end
new text begin
(1) the provider demonstrates that the subpopulation to be served requires a specialized
program which is not available from county-approved entities; and
new text end
new text begin
(2) the subpopulation to be served is of such a low incidence that it is not feasible to
develop a program serving a single county or regional group of counties.
new text end
new text begin Subd. 6. new text end
new text begin Sustainability grants. new text end
new text begin
The commissioner may disburse grant funds directly to
intensive residential treatment services providers to maintain access to these services.
new text end
new text begin Subd. 7. new text end
new text begin Start-up grants. new text end
new text begin
The commissioner may, within available appropriations,
disburse grant funding to counties, Indian Tribes, or mental health service providers to
establish additional intensive residential treatment services and residential crisis services.
new text end
Sec. 6. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 256B.0622, subdivision 4,
new text end
new text begin
is repealed.
new text end
ARTICLE 12
ASSERTIVE COMMUNITY TREATMENT AND INTENSIVE RESIDENTIAL
TREATMENT SERVICES RECODIFICATION CONFORMING CHANGES
Section 1.
Minnesota Statutes 2024, section 148F.11, subdivision 1, is amended to read:
Subdivision 1.
Other professionals.
(a) Nothing in this chapter prevents members of
other professions or occupations from performing functions for which they are qualified or
licensed. This exception includes, but is not limited to: licensed physicians; registered nurses;
licensed practical nurses; licensed psychologists and licensed psychological practitioners;
members of the clergy provided such services are provided within the scope of regular
ministries; American Indian medicine men and women; licensed attorneys; probation officers;
licensed marriage and family therapists; licensed social workers; social workers employed
by city, county, or state agencies; licensed professional counselors; licensed professional
clinical counselors; licensed school counselors; registered occupational therapists or
occupational therapy assistants; Upper Midwest Indian Council on Addictive Disorders
(UMICAD) certified counselors when providing services to Native American people; city,
county, or state employees when providing assessments or case management under Minnesota
Rules, chapter 9530; and staff persons providing co-occurring substance use disorder
treatment in adult mental health rehabilitative programs certified or licensed by the
Department of Human Services under section 245I.23, 256B.0622, deleted text begin ordeleted text end 256B.0623new text begin , or
256B.0632new text end .
(b) Nothing in this chapter prohibits technicians and resident managers in programs
licensed by the Department of Human Services from discharging their duties as provided
in Minnesota Rules, chapter 9530.
(c) Any person who is exempt from licensure under this section must not use a title
incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
counselor" or otherwise hold himself or herself out to the public by any title or description
stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
use of one of the titles in paragraph (a).
Sec. 2.
Minnesota Statutes 2024, section 245.4662, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following terms have
the meanings given them.
(b) "Community partnership" means a project involving the collaboration of two or more
eligible applicants.
(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service
provider, hospital, or community partnership. Eligible applicant does not include a
state-operated direct care and treatment facility or program under chapters 246 and 246C.
(d) "Intensive residential treatment services" has the meaning given in section deleted text begin 256B.0622deleted text end new text begin
256B.0632new text end .
(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section
473.121, subdivision 2.
Sec. 3.
Minnesota Statutes 2024, section 245.4906, subdivision 2, is amended to read:
Subd. 2.
Eligible applicants.
An eligible applicant is a licensed entity or provider that
employs a mental health certified peer specialist qualified under section 245I.04, subdivision
10, and that provides services to individuals receiving assertive community treatment deleted text begin or
intensive residential treatment servicesdeleted text end under section 256B.0622,new text begin intensive residential
treatment services under section 256B.0632,new text end adult rehabilitative mental health services
under section 256B.0623, or crisis response services under section 256B.0624.
Sec. 4.
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 9505.0150;
(3) is eligible for general assistance, general assistance medical care, or work readiness
as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; 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 deleted text begin 256B.0622deleted text end new text begin 256B.0632new text end .
Sec. 5.
Minnesota Statutes 2024, section 254B.05, subdivision 1a, is amended to read:
Subd. 1a.
Room and board provider requirements.
(a) Vendors of room and board
are eligible for behavioral health fund payment if the vendor:
(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;
(2) is determined to meet applicable health and safety requirements;
(3) is not a jail or prison;
(4) is not concurrently receiving funds under chapter 256I for the recipient;
(5) admits individuals who are 18 years of age or older;
(6) is registered as a board and lodging or lodging establishment according to section
157.17;
(7) has awake staff on site whenever a client is present;
(8) has staff who are at least 18 years of age and meet the requirements of section
245G.11, subdivision 1, paragraph (b);
(9) has emergency behavioral procedures that meet the requirements of section 245G.16;
(10) meets the requirements of section 245G.08, subdivision 5, if administering
medications to clients;
(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;
(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;
(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;
(14) has a grievance procedure that meets the requirements of section 245G.15,
subdivision 2; and
(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.
(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).
(c) Programs providing children's mental health crisis admissions and stabilization under
section 245.4882, subdivision 6, are eligible vendors of room and board.
(d) Programs providing children's residential services under section 245.4882, except
services for individuals who have a placement under chapter 260C or 260D, are eligible
vendors of room and board.
(e) Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section deleted text begin 256B.0622 ordeleted text end 256B.0624 new text begin or 256B.0632 new text end are
eligible vendors of room and board and are exempt from paragraph (a), clauses (6) to (15).
(f) A vendor that is not licensed as a residential treatment program must have a policy
to address staffing coverage when a client may unexpectedly need to be present at the room
and board site.
Sec. 6.
Minnesota Statutes 2024, section 256.478, subdivision 2, is amended to read:
Subd. 2.
Eligibility.
An individual is eligible for the transition to community initiative
if the individual can demonstrate that current services are not capable of meeting individual
treatment and service needs that can be met in the community with support, and the individual
meets at least one of the following criteria:
(1) the person meets the criteria under section 256B.092, subdivision 13, or 256B.49,
subdivision 24;
(2) the person has met treatment objectives and no longer requires a hospital-level care,
residential-level care, or a secure treatment setting, but the person's discharge from the
Anoka Metro Regional Treatment Center, the Minnesota Forensic Mental Health Program,
the Child and Adolescent Behavioral Health Hospital program, a psychiatric residential
treatment facility under section 256B.0941, intensive residential treatment services under
section deleted text begin 256B.0622deleted text end new text begin 256B.0632new text end , children's residential services under section 245.4882,
juvenile detention facility, county supervised building, or a hospital would be substantially
delayed without additional resources available through the transitions to community initiative;
(3) the person (i) is receiving customized living services reimbursed under section
256B.4914, 24-hour customized living services reimbursed under section 256B.4914, or
community residential services reimbursed under section 256B.4914; (ii) expresses a desire
to move; and (iii) has received approval from the commissioner; or
(4) the person can demonstrate that the person's needs are beyond the scope of current
service designs and grant funding can support the inclusion of additional supports for the
person to access appropriate treatment and services in the least restrictive environment.
Sec. 7.
Minnesota Statutes 2024, section 256B.0615, subdivision 1, is amended to read:
Subdivision 1.
Scope.
Medical assistance covers mental health certified peer specialist
services, as established in subdivision 2, if provided to recipients who are eligible for services
under sections 256B.0622, 256B.0623, deleted text begin anddeleted text end 256B.0624new text begin , and 256B.0632new text end and are provided
by a mental health certified peer specialist who has completed the training under subdivision
5 and is qualified according to section 245I.04, subdivision 10.
Sec. 8.
Minnesota Statutes 2024, section 256B.0615, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
Peer support services may be made available to consumers of (1)
intensive residential treatment services under section deleted text begin 256B.0622deleted text end new text begin 256B.0632new text end ; (2) adult
rehabilitative mental health services under section 256B.0623; and (3) crisis stabilization
and mental health mobile crisis intervention services under section 256B.0624.
Sec. 9.
Minnesota Statutes 2024, section 256B.82, is amended to read:
256B.82 PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE
SERVICES.
Medical assistance and MinnesotaCare prepaid health plans may include coverage for
adult mental health rehabilitative services under section 256B.0623, intensive rehabilitative
services under section deleted text begin 256B.0622deleted text end new text begin 256B.0632new text end , and adult mental health crisis response services
under section 256B.0624, beginning January 1, 2005.
By January 15, 2004, the commissioner shall report to the legislature how these services
should be included in prepaid plans. The commissioner shall consult with mental health
advocates, health plans, and counties in developing this report. The report recommendations
must include a plan to ensure coordination of these services between health plans and
counties, assure recipient access to essential community providers, and monitor the health
plans' delivery of services through utilization review and quality standards.
Sec. 10.
Minnesota Statutes 2024, section 256D.44, subdivision 5, is amended to read:
Subd. 5.
Special needs.
(a) In addition to the state standards of assistance established
in subdivisions 1 to 4, payments are allowed for the following special needs of recipients
of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a setting authorized to receive housing support payments under chapter 256I.
(b) The county agency shall pay a monthly allowance for medically prescribed diets if
the cost of those additional dietary needs cannot be met through some other maintenance
benefit. The need for special diets or dietary items must be prescribed by a licensed physician,
advanced practice registered nurse, or physician assistant. Costs for special diets shall be
determined as percentages of the allotment for a one-person household under the thrifty
food plan as defined by the United States Department of Agriculture. The types of diets and
the percentages of the thrifty food plan that are covered are as follows:
(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of
thrifty food plan;
(3) controlled protein diet, less than 40 grams and requires special products, 125 percent
of thrifty food plan;
(4) low cholesterol diet, 25 percent of thrifty food plan;
(5) high residue diet, 20 percent of thrifty food plan;
(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
(7) gluten-free diet, 25 percent of thrifty food plan;
(8) lactose-free diet, 25 percent of thrifty food plan;
(9) antidumping diet, 15 percent of thrifty food plan;
(10) hypoglycemic diet, 15 percent of thrifty food plan; or
(11) ketogenic diet, 25 percent of thrifty food plan.
(c) Payment for nonrecurring special needs must be allowed for necessary home repairs
or necessary repairs or replacement of household furniture and appliances using the payment
standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as
other funding sources are not available.
(d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated
by the county or approved by the court. This rate shall not exceed five percent of the
assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian
or conservator is a member of the county agency staff, no fee is allowed.
(e) The county agency shall continue to pay a monthly allowance of $68 for restaurant
meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and
who eats two or more meals in a restaurant daily. The allowance must continue until the
person has not received Minnesota supplemental aid for one full calendar month or until
the person's living arrangement changes and the person no longer meets the criteria for the
restaurant meal allowance, whichever occurs first.
(f) A fee equal to the maximum monthly amount allowed by the Social Security
Administration is allowed for representative payee services provided by an agency that
meets the requirements under SSI regulations to charge a fee for representative payee
services. This special need is available to all recipients of Minnesota supplemental aid
regardless of their living arrangement.
(g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half of
the maximum federal Supplemental Security Income payment amount for a single individual
which is in effect on the first day of July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify as
in need of housing assistance and are:
(i) relocating from an institution, a setting authorized to receive housing support under
chapter 256I, or an adult mental health residential treatment program under section deleted text begin 256B.0622deleted text end new text begin
256B.0632new text end ;
(ii) eligible for personal care assistance under section 256B.0659; or
(iii) home and community-based waiver recipients living in their own home or rented
or leased apartment.
(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter
needy benefit under this paragraph is considered a household of one. An eligible individual
who receives this benefit prior to age 65 may continue to receive the benefit after the age
of 65.
(3) "Housing assistance" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this special
needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's
income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision
3, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy,
that limits shelter costs to a percentage of gross income, shall not be considered in need of
housing assistance for purposes of this paragraph.
ARTICLE 13
BACKGROUND STUDIES
Section 1.
Minnesota Statutes 2024, section 245C.13, subdivision 2, is amended to read:
Subd. 2.
Activities pending completion of background study.
The subject of a
background study may not perform any activity requiring a background study under
paragraph (c) until the commissioner has issued one of the notices under paragraph (a).
(a) Notices from the commissioner required prior to activity under paragraph (c) include:
(1) a notice of the study results under section 245C.17 stating that:
(i) the individual is not disqualified; or
(ii) more time is needed to complete the study but the individual is not required to be
removed from direct contact or access to people receiving services prior to completion of
the study as provided under section 245C.17, subdivision 1, paragraph (b) or (c). The notice
that more time is needed to complete the study must also indicate whether the individual is
required to be under continuous direct supervision prior to completion of the background
study. When more time is necessary to complete a background study of an individual
affiliated with a Title IV-E eligible children's residential facility or foster residence setting,
the individual may not work in the facility or setting regardless of whether or not the
individual is supervised;
(2) a notice that a disqualification has been set aside under section 245C.23; or
(3) a notice that a variance has been granted related to the individual under section
245C.30.
(b) For a background study affiliated with a licensed child care center or certified
license-exempt child care center, the notice sent under paragraph (a), clause (1), item (ii),
new text begin must not be issued until the commissioner receives a qualifying result for the individual for
the fingerprint-based national criminal history record check or the fingerprint-based criminal
history information from the Bureau of Criminal Apprehension. The notice new text end must require
the individual to be under continuous direct supervision prior to completion of new text begin the remainder
of new text end the background study except as permitted in subdivision 3.
(c) Activities prohibited prior to receipt of notice under paragraph (a) include:
(1) being issued a license;
(2) living in the household where the licensed program will be provided;
(3) providing direct contact services to persons served by a program unless the subject
is under continuous direct supervision;
(4) having access to persons receiving services if the background study was completed
under section 144.057, subdivision 1, or 245C.03, subdivision 1, paragraph (a), clause (2),
(5), or (6), unless the subject is under continuous direct supervision;
(5) for licensed child care centers and certified license-exempt child care centers,
providing direct contact services to persons served by the program;
(6) for children's residential facilities or foster residence settings, working in the facility
or setting; or
(7) for background studies affiliated with a personal care provider organization, except
as provided in section 245C.03, subdivision 3b, before a personal care assistant provides
services, the personal care assistance provider agency must initiate a background study of
the personal care assistant under this chapter and the personal care assistance provider
agency must have received a notice from the commissioner that the personal care assistant
is:
(i) not disqualified under section 245C.14; or
(ii) disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 15, 2026.
new text end
Sec. 2.
Minnesota Statutes 2024, section 245C.14, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Disqualification from owning, operating, or billing. new text end
new text begin
The commissioner shall
disqualify an individual who is the subject of a background study from any position involving
ownership, management, or control of a program or billing activities if a background study
completed under this chapter shows a violation of section 142A.12, 245.095, or 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. 3.
Minnesota Statutes 2024, section 245C.15, is amended by adding a subdivision to
read:
new text begin Subd. 4c. new text end
new text begin Two-year disqualification. new text end
new text begin
An individual is disqualified under section
245C.14, subdivision 6, if less than two years has passed since a determination that the
individual violated section 142A.12, 245.095, or 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
ARTICLE 14
DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY
Section 1.
Minnesota Statutes 2024, section 13.46, subdivision 3, is amended to read:
Subd. 3.
Investigative data.
(a) Data on persons, including data on vendors of services,
licensees, and applicants that is collected, maintained, used, or disseminated by the welfare
system in an investigation, authorized by statute, and relating to the enforcement of rules
or law are confidential data on individuals pursuant to section 13.02, subdivision 3, or
protected nonpublic data not on individuals pursuant to section 13.02, subdivision 13, and
shall not be disclosed except:
(1) pursuant to section 13.05;
(2) pursuant to statute or valid court order;
(3) to a party named in a civil or criminal proceeding, administrative or judicial, for
preparation of defense;
(4) to an agent deleted text begin of the welfare systemdeleted text end or deleted text begin andeleted text end investigator acting on behalf of a county,
state, or federal government, including a law enforcement officer or attorney in the
investigation or prosecution of a criminal, civil, or administrative proceeding, unless the
commissioner of human services or commissioner of children, youth, and families determines
that disclosure may compromise a Department of Human Services or Department of Children,
Youth, and Families ongoing investigation; or
(5) to provide notices required or permitted by statute.
The data referred to in this subdivision shall be classified as public data upon submission
to an administrative law judge or court in an administrative or judicial proceeding. Inactive
welfare investigative data shall be treated as provided in section 13.39, subdivision 3.
(b) Notwithstanding any other provision in law, the commissioner of human services
shall provide all active and inactive investigative data, including the name of the reporter
of alleged maltreatment under section 626.557 or chapter 260E, to the ombudsman for
mental health and developmental disabilities upon the request of the ombudsman.
(c) Notwithstanding paragraph (a) and section 13.39, the existence of an investigation
by the commissioner of human services of possible overpayments of public funds to a service
provider or recipient new text begin or the reduction or withholding of payments new text end may be disclosed if the
commissioner determines that it will not compromise the investigation.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 2.
Minnesota Statutes 2024, section 245.095, subdivision 5, is amended to read:
Subd. 5.
Withholding of payments.
(a) Except as otherwise provided by state or federal
law, the commissioner may withhold payments to a provider, vendor, individual, associated
individual, or associated entity in any program administered by the commissioner if the
commissioner determinesnew text begin :
new text end
new text begin (1)new text end there is a credible allegation of fraud for which an investigation is pending for a
program administered by a deleted text begin Minnesotadeleted text end state or federal agencydeleted text begin .deleted text end new text begin ;
new text end
new text begin
(2) the individual, the entity, or an associated individual or entity was convicted of a
crime charged in state or federal court with an offense that involves fraud or theft against
a program administered by the commissioner or another state or federal agency. For purposes
of this subdivision, "convicted" means a judgment of conviction has been entered by a
federal, state, or local court, regardless of whether an appeal from the judgment is pending,
and includes a stay of adjudication, a court-ordered diversion program, or a plea of guilty
or nolo contendere;
new text end
new text begin
(3) the provider is operating after a state or federal agency orders the suspension,
revocation, or decertification of the provider's license;
new text end
new text begin
(4) the provider, vendor, associated individual, or associated entity, including those
receiving funds under any contract or registered program, has a background study
disqualification under chapter 245C that has not been set aside and for which no variance
has been issued, except for a disqualification under sections 245C.14, subdivision 5, and
245C.15, subdivision 4c; or
new text end
new text begin
(5) by a preponderance of the evidence that the provider, vendor, individual, associated
individual, or associated entity intentionally provided materially false information on the
provider's billing forms.
new text end
(b) For purposes of this subdivision, "credible allegation of fraud" means an allegation
that has been verified by the commissioner from any source, including but not limited to:
(1) fraud hotline complaints;
(2) claims data mining;
(3) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations; and
(4) court filings and other legal documents, including but not limited to police reports,
complaints, indictments, informations, affidavits, declarations, and search warrants.
(c) The commissioner must send notice of the withholding of payments within five days
of taking such action. The notice must:
(1) state that payments are being withheld according to this subdivision;
(2) set forth the general allegations related to the withholding action, except the notice
need not disclose specific information concerning an ongoing investigation;
(3) state that the withholding is for a temporary period and cite the circumstances under
which the withholding will be terminated; and
(4) inform the provider, vendor, individual, associated individual, or associated entity
of the right to submit written evidence to contest the withholding action for consideration
by the commissioner.
(d) If the commissioner withholds payments under this subdivision, the provider, vendor,
individual, associated individual, or associated entity has a right to request administrative
reconsideration. A request for administrative reconsideration must be made in writing, state
with specificity the reasons the payment withholding decision is in error, and include
documents to support the request. Within 60 days from receipt of the request, the
commissioner shall judiciously review allegations, facts, evidence available to the
commissioner, and information submitted by the provider, vendor, individual, associated
individual, or associated entity to determine whether the payment withholding should remain
in place.
(e) The commissioner shall stop withholding payments if the commissioner determines
there is insufficient evidence of fraud by the provider, vendor, individual, associated
individual, or associated entity or when legal proceedings relating to the alleged fraud are
completed, unless the commissioner has sent notice under subdivision 3 to the provider,
vendor, individual, associated individual, or associated entity.
(f) The withholding of payments is a temporary action and is not subject to appeal under
section 256.045 or chapter 14.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 3.
Minnesota Statutes 2024, section 245.095, is amended by adding a subdivision to
read:
new text begin Subd. 6. new text end
new text begin Data practices. new text end
new text begin
The commissioner may exchange information, including claims
data, with state or federal agencies, professional boards, departments, or programs for the
purpose of investigating or prosecuting a criminal, civil, or administrative proceeding related
to suspected fraud or exclusion from any program administered by a state or federal agency.
new text end
Sec. 4.
Minnesota Statutes 2024, section 245A.04, subdivision 1, is amended to read:
Subdivision 1.
Application for licensure.
(a) An individual, organization, or government
entity that is subject to licensure under section 245A.03 must apply for a license. The
application must be made on the forms and in the manner prescribed by the commissioner.
The commissioner shall provide the applicant with instruction in completing the application
and provide information about the rules and requirements of other state agencies that affect
the applicant. An applicant seeking licensure in Minnesota with headquarters outside of
Minnesota must have a program office located within 30 miles of the Minnesota border.
An applicant who intends to buy or otherwise acquire a program or services licensed under
this chapter that is owned by another license holder must apply for a license under this
chapter and comply with the application procedures in this section and section 245A.043.
The commissioner shall act on the application within 90 working days after a complete
application and any required reports have been received from other state agencies or
departments, counties, municipalities, or other political subdivisions. The commissioner
shall not consider an application to be complete until the commissioner receives all of the
required information.new text begin If the applicant or a controlling individual is the subject of a pending
administrative, civil, or criminal investigation, the application is not complete until the
investigation has closed or the related legal proceedings are complete.
new text end
When the commissioner receives an application for initial licensure that is incomplete
because the applicant failed to submit required documents or that is substantially deficient
because the documents submitted do not meet licensing requirements, the commissioner
shall provide the applicant written notice that the application is incomplete or substantially
deficient. In the written notice to the applicant the commissioner shall identify documents
that are missing or deficient and give the applicant 45 days to resubmit a second application
that is substantially complete. An applicant's failure to submit a substantially complete
application after receiving notice from the commissioner is a basis for license denial under
section 245A.043.
(b) An application for licensure must identify all controlling individuals as defined in
section 245A.02, subdivision 5a, and must designate one individual to be the authorized
agent. The application must be signed by the authorized agent and must include the authorized
agent's first, middle, and last name; mailing address; and email address. By submitting an
application for licensure, the authorized agent consents to electronic communication with
the commissioner throughout the application process. The authorized agent must be
authorized to accept service on behalf of all of the controlling individuals. A government
entity that holds multiple licenses under this chapter may designate one authorized agent
for all licenses issued under this chapter or may designate a different authorized agent for
each license. Service on the authorized agent is service on all of the controlling individuals.
It is not a defense to any action arising under this chapter that service was not made on each
controlling individual. The designation of a controlling individual as the authorized agent
under this paragraph does not affect the legal responsibility of any other controlling individual
under this chapter.
(c) An applicant or license holder must have a policy that prohibits license holders,
employees, subcontractors, and volunteers, when directly responsible for persons served
by the program, from abusing prescription medication or being in any manner under the
influence of a chemical that impairs the individual's ability to provide services or care. The
license holder must train employees, subcontractors, and volunteers about the program's
drug and alcohol policy.
(d) An applicant and license holder must have a program grievance procedure that permits
persons served by the program and their authorized representatives to bring a grievance to
the highest level of authority in the program.
(e) The commissioner may limit communication during the application process to the
authorized agent or the controlling individuals identified on the license application and for
whom a background study was initiated under chapter 245C. Upon implementation of the
provider licensing and reporting hub, applicants and license holders must use the hub in the
manner prescribed by the commissioner. The commissioner may require the applicant,
except for child foster care, to demonstrate competence in the applicable licensing
requirements by successfully completing a written examination. The commissioner may
develop a prescribed written examination format.
(f) When an applicant is an individual, the applicant must provide:
(1) the applicant's taxpayer identification numbers including the Social Security number
or Minnesota tax identification number, and federal employer identification number if the
applicant has employees;
(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, if any;
(3) if doing business under a different name, the doing business as (DBA) name, as
registered with the secretary of state;
(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique
Minnesota Provider Identifier (UMPI) number; and
(5) at the request of the commissioner, the notarized signature of the applicant or
authorized agent.
(g) When an applicant is an organization, the applicant must provide:
(1) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, and if doing business under a different
name, the doing business as (DBA) name, as registered with the secretary of state;
(3) the first, middle, and last name, and address for all individuals who will be controlling
individuals, including all officers, owners, and managerial officials as defined in section
245A.02, subdivision 5a, and the date that the background study was initiated by the applicant
for each controlling individual;
(4) if applicable, the applicant's NPI number and UMPI number;
(5) the documents that created the organization and that determine the organization's
internal governance and the relations among the persons that own the organization, have
an interest in the organization, or are members of the organization, in each case as provided
or authorized by the organization's governing statute, which may include a partnership
agreement, bylaws, articles of organization, organizational chart, and operating agreement,
or comparable documents as provided in the organization's governing statute; and
(6) the notarized signature of the applicant or authorized agent.
(h) When the applicant is a government entity, the applicant must provide:
(1) the name of the government agency, political subdivision, or other unit of government
seeking the license and the name of the program or services that will be licensed;
(2) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
(3) a letter signed by the manager, administrator, or other executive of the government
entity authorizing the submission of the license application; and
(4) if applicable, the applicant's NPI number and UMPI number.
(i) At the time of application for licensure or renewal of a license under this chapter, the
applicant or license holder must acknowledge on the form provided by the commissioner
if the applicant or license holder elects to receive any public funding reimbursement from
the commissioner for services provided under the license that:
(1) the applicant's or license holder's compliance with the provider enrollment agreement
or registration requirements for receipt of public funding may be monitored by the
commissioner as part of a licensing investigation or licensing inspection; and
(2) noncompliance with the provider enrollment agreement or registration requirements
for receipt of public funding that is identified through a licensing investigation or licensing
inspection, or noncompliance with a licensing requirement that is a basis of enrollment for
reimbursement for a service, may result in:
(i) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;
(ii) nonpayment of claims submitted by the license holder for public program
reimbursement;
(iii) recovery of payments made for the service;
(iv) disenrollment in the public payment program; or
(v) other administrative, civil, or criminal penalties as provided by law.
Sec. 5.
Minnesota Statutes 2024, section 245A.05, is amended to read:
245A.05 DENIAL OF APPLICATION.
(a) The commissioner may deny a license if an applicant or controlling individual:
(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;
(2) fails to comply with applicable laws or rules;
(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;
(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;
(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;
(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted;
(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);
(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;
(9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules, including but not limited to this chapter and chapters 142E and
245C; deleted text begin or
deleted text end
(10) is prohibited from holding a license according to section 245.095deleted text begin .deleted text end new text begin ; or
new text end
new text begin
(11) is the subject of a pending administrative, civil, or criminal investigation.
new text end
(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial, which must state the reasons for the denial in plain language. Notice
must be given by certified mail, by personal service, or through the provider licensing and
reporting hub. The notice must state the reasons the application was denied and must inform
the applicant of the right to a contested case hearing under chapter 14 and Minnesota Rules,
parts 1400.8505 to 1400.8612. The applicant may appeal the denial by notifying the
commissioner in writing by certified mail, by personal service, or through the provider
licensing and reporting hub. If mailed, the appeal must be postmarked and sent to the
commissioner within 20 calendar days after the applicant received the notice of denial. If
an appeal request is made by personal service, it must be received by the commissioner
within 20 calendar days after the applicant received the notice of denial. If the order is issued
through the provider hub, the appeal must be received by the commissioner within 20
calendar days from the date the commissioner issued the order through the hub. Section
245A.08 applies to hearings held to appeal the commissioner's denial of an application.
Sec. 6.
Minnesota Statutes 2024, section 245A.07, subdivision 2, is amended to read:
Subd. 2.
Temporary immediate suspension.
(a) The commissioner shall act immediately
to temporarily suspend a license issued under this chapter if:
(1) the license holder'snew text begin or controlling individual'snew text end actions or failure to comply with
applicable law or rule, or the actions of other individuals or conditions in the program, pose
an imminent risk of harm to the health, safety, or rights of persons served by the program;
(2) while the program continues to operate pending an appeal of an order of revocation,
the commissioner identifies one or more subsequent violations of law or rule which may
adversely affect the health or safety of persons served by the program; or
(3) the license holdernew text begin or controlling individualnew text end is criminally charged in state or federal
court with an offense that involves fraud or theft against a program administered by deleted text begin the
commissionerdeleted text end new text begin a state or federal agencynew text end .
(b) No state funds shall be made available or be expended by any agency or department
of state, county, or municipal government for use by a license holder regulated under this
chapter while a license issued under this chapter is under immediate suspension. A notice
stating the reasons for the immediate suspension and informing the license holder of the
right to an expedited hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to
1400.8612, must be delivered by personal service to the address shown on the application
or the last known address of the license holder. The license holder may appeal an order
immediately suspending a license. The appeal of an order immediately suspending a license
must be made in writing by certified mail, personal service, or other means expressly set
forth in the commissioner's order. If mailed, the appeal must be postmarked and sent to the
commissioner within five calendar days after the license holder receives notice that the
license has been immediately suspended. If a request is made by personal service, it must
be received by the commissioner within five calendar days after the license holder received
the order. A license holder and any controlling individual shall discontinue operation of the
program upon receipt of the commissioner's order to immediately suspend the license.
new text begin
(c) The commissioner may act immediately to temporarily suspend a license issued
under this chapter if the license holder or controlling individual is the subject of a pending
administrative, civil, or criminal investigation or subject to an administrative or civil action
related to fraud against a program administered by a state or federal agency.
new text end
Sec. 7.
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. 8.
Minnesota Statutes 2024, section 256.983, subdivision 4, is amended to read:
Subd. 4.
Funding.
(a) County and Tribal agency reimbursement shall be made through
the settlement provisions applicable to the Supplemental Nutrition Assistance Program
(SNAP), MFIP, child care assistance programs, the medical assistance program, and other
federal and state-funded programs.
(b) The commissioners will maintain program compliance if for any deleted text begin three consecutive
month perioddeleted text end new text begin quarternew text end , a county or Tribal agency fails to comply with fraud prevention
investigation program guidelines, or fails to meet the cost-effectiveness standards developed
by the commissioners. This result is contingent on the commissioners providing written
notice, including an offer of technical assistance, within 30 days of the end of the deleted text begin third or
subsequent monthdeleted text end new text begin quarternew text end of noncompliance. The county or Tribal agency shall be required
to submit a corrective action plan to the commissioners within 30 days of receipt of a notice
of noncompliance. Failure to submit a corrective action plan or, continued deviation from
standards of more than ten percent after submission of a corrective action plan, will result
in denial of funding for each subsequent month, or billing the county or Tribal agency for
fraud prevention investigation (FPI) service provided by the commissioners, or reallocation
of program grant funds, or investigative resources, or both, to other counties or Tribal
agencies. The denial of funding shall apply to the general settlement received by the county
or Tribal agency on a quarterly basis and shall not reduce the grant amount applicable to
the FPI project.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 9.
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 each new 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 agency under this subdivision once every three yearsdeleted text begin .deleted text end new text begin ;
and
new text end
new text begin
(3) at the commissioner's discretion, any other Medicaid-only provider type the
commissioner deems "high risk" under this subdivision once every three years.
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.new text begin Any action to obtain monetary recovery or sanctions
from a surety bond must occur within six years from the date the debt is affirmed by a final
agency decision. An agency decision is final when the right to appeal the debt has been
exhausted or the time to appeal has expired under section 256B.064.
new text end
(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. 10.
Minnesota Statutes 2024, section 256B.0659, subdivision 21, is amended to read:
Subd. 21.
Requirements for provider enrollment of personal care assistance provider
agencies.
(a) All personal care assistance provider agencies must provide, at the time of
enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
a format determined by the commissioner, information and documentation that includes,
but is not limited to, the following:
(1) the personal care assistance provider agency's current contact information including
address, telephone number, and email address;
(2) proof of surety bond coverage for each business location providing services. Upon
new enrollment, or if the 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
the Medicaid revenue in the previous year is over $300,000, the provider agency 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 bondnew text begin . Any action to obtain monetary recovery or sanctions from a
surety bond must occur within six years from the date the debt is affirmed by a final agency
decision. An agency decision is final when the right to appeal the debt has been exhausted
or the time to appeal has expired under section 256B.064new text end ;
(3) proof of fidelity bond coverage in the amount of $20,000 for each business location
providing service;
(4) proof of workers' compensation insurance coverage identifying the business location
where personal care assistance services are provided;
(5) proof of liability insurance coverage identifying the business location where personal
care assistance services are provided and naming the department as a certificate holder;
(6) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery; and
employee and consumer safety including process for notification and resolution of consumer
grievances, identification and prevention of communicable diseases, and employee
misconduct;
(7) copies of all other forms the personal care assistance provider agency uses in the
course of daily business including, but not limited to:
(i) a copy of the personal care assistance provider agency's time sheet if the time sheet
varies from the standard time sheet for personal care assistance services approved by the
commissioner, and a letter requesting approval of the personal care assistance provider
agency's nonstandard time sheet;
(ii) the personal care assistance provider agency's template for the personal care assistance
care plan; and
(iii) the personal care assistance provider agency's template for the written agreement
in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
(8) a list of all training and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;
(9) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this section, including the requirements
under subdivision 11, paragraph (d), if enhanced personal care assistance services are
provided and submitted for an enhanced rate under subdivision 17a;
(10) documentation of the agency's marketing practices;
(11) disclosure of ownership, leasing, or management of all residential properties that
is used or could be used for providing home care services;
(12) documentation that the agency will use the following percentages of revenue
generated from the medical assistance rate paid for personal care assistance services for
employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
care assistance choice option and 72.5 percent of revenue from other personal care assistance
providers. The revenue generated by the qualified professional and the reasonable costs
associated with the qualified professional shall not be used in making this calculation; and
(13) effective May 15, 2010, documentation that the agency does not burden recipients'
free exercise of their right to choose service providers by requiring personal care assistants
to sign an agreement not to work with any particular personal care assistance recipient or
for another personal care assistance provider agency after leaving the agency and that the
agency is not taking action on any such agreements or requirements regardless of the date
signed.
(b) Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider agency
enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
the information specified in paragraph (a) from all personal care assistance providers
beginning July 1, 2009.
(c) All personal care assistance provider agencies shall require all employees in
management and supervisory positions and owners of the agency who are active in the
day-to-day management and operations of the agency to complete mandatory training as
determined by the commissioner before submitting an application for enrollment of the
agency as a provider. All personal care assistance provider agencies shall also require
qualified professionals to complete the training required by subdivision 13 before submitting
an application for enrollment of the agency as a provider. Employees in management and
supervisory positions and owners who are active in the day-to-day operations of an agency
who have completed the required training as an employee with a personal care assistance
provider agency do not need to repeat the required training if they are hired by another
agency, if they have completed the training within the past three years. By September 1,
2010, the required training must be available with meaningful access according to title VI
of the Civil Rights Act and federal regulations adopted under that law or any guidance from
the United States Health and Human Services Department. The required training must be
available online or by electronic remote connection. The required training must provide for
competency testing. Personal care assistance provider agency billing staff shall complete
training about personal care assistance program financial management. This training is
effective July 1, 2009. Any personal care assistance provider agency enrolled before that
date shall, if it has not already, complete the provider training within 18 months of July 1,
2009. Any new owners or employees in management and supervisory positions involved
in the day-to-day operations are required to complete mandatory training as a requisite of
working for the agency. Personal care assistance provider agencies certified for participation
in Medicare as home health agencies are exempt from the training required in this
subdivision. When available, Medicare-certified home health agency owners, supervisors,
or managers must successfully complete the competency test.
(d) All surety bonds, fidelity bonds, workers' compensation insurance, and liability
insurance required by this subdivision must be maintained continuously. After initial
enrollment, a provider must submit proof of bonds and required coverages at any time at
the request of the commissioner. Services provided while there are lapses in coverage are
not eligible for payment. Lapses in coverage may result in sanctions, including termination.
The commissioner shall send instructions and a due date to submit the requested information
to the personal care assistance provider agency.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 11.
Minnesota Statutes 2024, section 256B.85, subdivision 12, is amended to read:
Subd. 12.
Requirements for enrollment of CFSS agency-providers.
(a) All CFSS
agency-providers must provide, at the time of enrollment, reenrollment, and revalidation
as a CFSS agency-provider in a format determined by the commissioner, information and
documentation that includes but is not limited to the following:
(1) the CFSS agency-provider's current contact information including address, telephone
number, and email address;
(2) proof of surety bond coverage. Upon new enrollment, or if the agency-provider's
Medicaid revenue in the previous calendar year is less than or equal to $300,000, the
agency-provider must purchase a surety bond of $50,000. If the agency-provider's Medicaid
revenue in the previous calendar year is greater than $300,000, the agency-provider must
purchase a surety bond of $100,000. The surety bond must be in a form approved by the
commissioner, must be renewed annually, and must allow for recovery of costs and fees in
pursuing a claim on the bondnew text begin . Any action to obtain monetary recovery or sanctions from a
surety bond must occur within six years from the date the debt is affirmed by a final agency
decision. An agency decision is final when the right to appeal the debt has been exhausted
or the time to appeal has expired under section 256B.064new text end ;
(3) proof of fidelity bond coverage in the amount of $20,000 per provider location;
(4) proof of workers' compensation insurance coverage;
(5) proof of liability insurance;
(6) a copy of the CFSS agency-provider's organizational chart identifying the names
and roles of all owners, managing employees, staff, board of directors, and additional
documentation reporting any affiliations of the directors and owners to other service
providers;
(7) proof that the CFSS agency-provider has written policies and procedures including:
hiring of employees; training requirements; service delivery; and employee and consumer
safety, including the process for notification and resolution of participant grievances, incident
response, identification and prevention of communicable diseases, and employee misconduct;
(8) proof that the CFSS agency-provider has all of the following forms and documents:
(i) a copy of the CFSS agency-provider's time sheet; and
(ii) a copy of the participant's individual CFSS service delivery plan;
(9) a list of all training and classes that the CFSS agency-provider requires of its staff
providing CFSS services;
(10) documentation that the CFSS agency-provider and staff have successfully completed
all the training required by this section;
(11) documentation of the agency-provider's marketing practices;
(12) disclosure of ownership, leasing, or management of all residential properties that
are used or could be used for providing home care services;
(13) documentation that the agency-provider will use at least the following percentages
of revenue generated from the medical assistance rate paid for CFSS services for CFSS
support worker wages and benefits: 72.5 percent of revenue from CFSS providers, except
100 percent of the revenue generated by a medical assistance rate increase due to a collective
bargaining agreement under section 179A.54 must be used for support worker wages and
benefits. The revenue generated by the worker training and development services and the
reasonable costs associated with the worker training and development services shall not be
used in making this calculation; and
(14) documentation that the agency-provider does not burden participants' free exercise
of their right to choose service providers by requiring CFSS support workers to sign an
agreement not to work with any particular CFSS participant or for another CFSS
agency-provider after leaving the agency and that the agency is not taking action on any
such agreements or requirements regardless of the date signed.
(b) CFSS agency-providers shall provide to the commissioner the information specified
in paragraph (a).
(c) All CFSS agency-providers shall require all employees in management and
supervisory positions and owners of the agency who are active in the day-to-day management
and operations of the agency to complete mandatory training as determined by the
commissioner. Employees in management and supervisory positions and owners who are
active in the day-to-day operations of an agency who have completed the required training
as an employee with a CFSS agency-provider do not need to repeat the required training if
they are hired by another agency and they have completed the training within the past three
years. CFSS agency-provider billing staff shall complete training about CFSS program
financial management. Any new owners or employees in management and supervisory
positions involved in the day-to-day operations are required to complete mandatory training
as a requisite of working for the agency.
(d) Agency-providers shall submit all required documentation in this section within 30
days of notification from the commissioner. If an agency-provider fails to submit all the
required documentation, the commissioner may take action under subdivision 23a.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
ARTICLE 15
DEPARTMENT OF HUMAN SERVICES OFFICE OF THE INSPECTOR GENERAL
POLICY
Section 1.
Minnesota Statutes 2024, section 142E.51, subdivision 5, is amended to read:
Subd. 5.
Administrative disqualification of child care providers caring for children
receiving child care assistance.
(a) The department shall pursue an administrative
disqualification, if the child care provider is accused of committing an intentional program
violation, in lieu of a criminal action when it has not been pursued. Intentional program
violations include intentionally making false or misleading statements;new text begin receiving or providing
a kickback, as defined in subdivision 6, paragraph (b);new text end intentionally misrepresenting,
concealing, or withholding facts; and repeatedly and intentionally violating program
regulations under this chapter. Intent may be proven by demonstrating a pattern of conduct
that violates program rules under this chapter.
(b) To initiate an administrative disqualification, the commissioner must send written
notice using a signature-verified confirmed delivery method to the provider against whom
the action is being taken. Unless otherwise specified under this chapter or Minnesota Rules,
chapter 3400, the commissioner must send the written notice at least 15 calendar days before
the adverse action's effective date. The notice shall state (1) the factual basis for the agency's
determination, (2) the action the agency intends to take, (3) the dollar amount of the monetary
recovery or recoupment, if known, and (4) the provider's right to appeal the agency's proposed
action.
(c) The provider may appeal an administrative disqualification by submitting a written
request to the state agency. A provider's request must be received by the state agency no
later than 30 days after the date the commissioner mails the notice.
(d) The provider's appeal request must contain the following:
(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the
dollar amount involved for each disputed item;
(2) the computation the provider believes to be correct, if applicable;
(3) the statute or rule relied on for each disputed item; and
(4) the name, address, and telephone number of the person at the provider's place of
business with whom contact may be made regarding the appeal.
(e) On appeal, the issuing agency bears the burden of proof to demonstrate by a
preponderance of the evidence that the provider committed an intentional program violation.
(f) The hearing is subject to the requirements of section 142A.20. The human services
judge may combine a fair hearing and administrative disqualification hearing into a single
hearing if the factual issues arise out of the same or related circumstances and the provider
receives prior notice that the hearings will be combined.
(g) A provider found to have committed an intentional program violation and is
administratively disqualified must be disqualified, for a period of three years for the first
offense and permanently for any subsequent offense, from receiving any payments from
any child care program under this chapter.
(h) Unless a timely and proper appeal made under this section is received by the
department, the administrative determination of the department is final and binding.
Sec. 2.
Minnesota Statutes 2024, section 142E.51, subdivision 6, is amended to read:
Subd. 6.
Prohibited hiring deleted text begin practicedeleted text end new text begin practicesnew text end .
new text begin (a) new text end It is prohibited to hire a child care
center employee when, as a condition of employment, the employee is required to have one
or more children who are eligible for or receive child care assistance, if:
(1) the individual hiring the employee is, or is acting at the direction of or in cooperation
with, a child care center provider, center owner, director, manager, license holder, or other
controlling individual; and
(2) the individual hiring the employee knows or has reason to know the purpose in hiring
the employee is to obtain child care assistance program funds.
new text begin
(b) Program applicants, participants, and providers are prohibited from receiving or
providing a kickback or payment in exchange for obtaining or attempting to obtain child
care assistance benefits for their own financial gain. This paragraph does not apply to:
new text end
new text begin
(1) marketing or promotional offerings that directly benefit an applicant or recipient's
child or dependent for whom the child care provider is providing child care services; or
new text end
new text begin
(2) child care provider discounts, scholarships, or other financial assistance allowed
under section 142E.17, subdivision 7.
new text end
new text begin
(c) An attempt to buy or sell access to a family's child care subsidy benefits to an
unauthorized person by an applicant, a participant, or a provider is a kickback, an intentional
program violation under subdivision 5, and wrongfully obtaining assistance under section
256.98.
new text end
Sec. 3.
Minnesota Statutes 2024, section 245A.04, subdivision 1, is amended to read:
Subdivision 1.
Application for licensure.
(a) An individual, organization, or government
entity that is subject to licensure under section 245A.03 must apply for a license. The
application must be made on the forms and in the manner prescribed by the commissioner.
The commissioner shall provide the applicant with instruction in completing the application
and provide information about the rules and requirements of other state agencies that affect
the applicant. An applicant seeking licensure in Minnesota with headquarters outside of
Minnesota must have a program office located within 30 miles of the Minnesota border.
An applicant who intends to buy or otherwise acquire a program or services licensed under
this chapter that is owned by another license holder must apply for a license under this
chapter and comply with the application procedures in this section and section 245A.043.
The commissioner shall act on the application within 90 working days after a complete
application and any required reports have been received from other state agencies or
departments, counties, municipalities, or other political subdivisions. The commissioner
shall not consider an application to be complete until the commissioner receives all of the
required information.
When the commissioner receives an application for initial licensure that is incomplete
because the applicant failed to submit required documents or that is substantially deficient
because the documents submitted do not meet licensing requirements, the commissioner
shall provide the applicant written notice that the application is incomplete or substantially
deficient. In the written notice to the applicant the commissioner shall identify documents
that are missing or deficient and give the applicant 45 days to resubmit a second application
that is substantially complete. An applicant's failure to submit a substantially complete
application after receiving notice from the commissioner is a basis for license denial under
section 245A.043.
(b) An application for licensure must identify all controlling individuals as defined in
section 245A.02, subdivision 5a, and must designate one individual to be the authorized
agent. The application must be signed by the authorized agent and must include the authorized
agent's first, middle, and last name; mailing address; and email address. By submitting an
application for licensure, the authorized agent consents to electronic communication with
the commissioner throughout the application process. The authorized agent must be
authorized to accept service on behalf of all of the controlling individuals. A government
entity that holds multiple licenses under this chapter may designate one authorized agent
for all licenses issued under this chapter or may designate a different authorized agent for
each license. Service on the authorized agent is service on all of the controlling individuals.
It is not a defense to any action arising under this chapter that service was not made on each
controlling individual. The designation of a controlling individual as the authorized agent
under this paragraph does not affect the legal responsibility of any other controlling individual
under this chapter.
(c) An applicant or license holder must have a policy that prohibits license holders,
employees, subcontractors, and volunteers, when directly responsible for persons served
by the program, from abusing prescription medication or being in any manner under the
influence of a chemical that impairs the individual's ability to provide services or care. The
license holder must train employees, subcontractors, and volunteers about the program's
drug and alcohol policynew text begin before the employee, subcontractor, or volunteer has direct contact,
as defined in section 245C.02, subdivision 11, with a person served by the programnew text end .
(d) An applicant and license holder must have a program grievance procedure that permits
persons served by the program and their authorized representatives to bring a grievance to
the highest level of authority in the program.
(e) The commissioner may limit communication during the application process to the
authorized agent or the controlling individuals identified on the license application and for
whom a background study was initiated under chapter 245C. Upon implementation of the
provider licensing and reporting hub, applicants and license holders must use the hub in the
manner prescribed by the commissioner. The commissioner may require the applicant,
except for child foster care, to demonstrate competence in the applicable licensing
requirements by successfully completing a written examination. The commissioner may
develop a prescribed written examination format.
(f) When an applicant is an individual, the applicant must provide:
(1) the applicant's taxpayer identification numbers including the Social Security number
or Minnesota tax identification number, and federal employer identification number if the
applicant has employees;
(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, if any;
(3) if doing business under a different name, the doing business as (DBA) name, as
registered with the secretary of state;
(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique
Minnesota Provider Identifier (UMPI) number; and
(5) at the request of the commissioner, the notarized signature of the applicant or
authorized agent.
(g) When an applicant is an organization, the applicant must provide:
(1) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, and if doing business under a different
name, the doing business as (DBA) name, as registered with the secretary of state;
(3) the first, middle, and last name, and address for all individuals who will be controlling
individuals, including all officers, owners, and managerial officials as defined in section
245A.02, subdivision 5a, and the date that the background study was initiated by the applicant
for each controlling individual;
(4) if applicable, the applicant's NPI number and UMPI number;
(5) the documents that created the organization and that determine the organization's
internal governance and the relations among the persons that own the organization, have
an interest in the organization, or are members of the organization, in each case as provided
or authorized by the organization's governing statute, which may include a partnership
agreement, bylaws, articles of organization, organizational chart, and operating agreement,
or comparable documents as provided in the organization's governing statute; and
(6) the notarized signature of the applicant or authorized agent.
(h) When the applicant is a government entity, the applicant must provide:
(1) the name of the government agency, political subdivision, or other unit of government
seeking the license and the name of the program or services that will be licensed;
(2) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;
(3) a letter signed by the manager, administrator, or other executive of the government
entity authorizing the submission of the license application; and
(4) if applicable, the applicant's NPI number and UMPI number.
(i) At the time of application for licensure or renewal of a license under this chapter, the
applicant or license holder must acknowledge on the form provided by the commissioner
if the applicant or license holder elects to receive any public funding reimbursement from
the commissioner for services provided under the license that:
(1) the applicant's or license holder's compliance with the provider enrollment agreement
or registration requirements for receipt of public funding may be monitored by the
commissioner as part of a licensing investigation or licensing inspection; and
(2) noncompliance with the provider enrollment agreement or registration requirements
for receipt of public funding that is identified through a licensing investigation or licensing
inspection, or noncompliance with a licensing requirement that is a basis of enrollment for
reimbursement for a service, may result in:
(i) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;
(ii) nonpayment of claims submitted by the license holder for public program
reimbursement;
(iii) recovery of payments made for the service;
(iv) disenrollment in the public payment program; or
(v) other administrative, civil, or criminal penalties as provided by law.
Sec. 4.
Minnesota Statutes 2024, section 245A.04, subdivision 7, is amended to read:
Subd. 7.
Grant of license; license extension.
(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
license consistent with this section or, if applicable, a temporary change of ownership license
under section 245A.043. At minimum, the license shall state:
(1) the name of the license holder;
(2) the address of the program;
(3) the effective date and expiration date of the license;
(4) the type of license;
(5) the maximum number and ages of persons that may receive services from the program;
and
(6) any special conditions of licensure.
(b) The commissioner may issue a license for a period not to exceed two years if:
(1) the commissioner is unable to conduct the observation required by subdivision 4,
paragraph (a), clause (3), because the program is not yet operational;
(2) certain records and documents are not available because persons are not yet receiving
services from the program; and
(3) the applicant complies with applicable laws and rules in all other respects.
(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program.
(d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a
license if the applicant, license holder, or an affiliated controlling individual has:
(1) been disqualified and the disqualification was not set aside and no variance has been
granted;
(2) been denied a license under this chapter or chapter 142B within the past two years;
(3) had a license issued under this chapter or chapter 142B revoked within the past five
years; or
(4) failed to submit the information required of an applicant under subdivision 1,
paragraph (f), (g), or (h), after being requested by the commissioner.
When a license issued under this chapter or chapter 142B is revoked, the license holder
and each affiliated controlling individual with a revoked license may not hold any license
under chapter 245A for five years following the revocation, and other licenses held by the
applicant or license holder or licenses affiliated with each controlling individual shall also
be revoked.
(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license
affiliated with a license holder or controlling individual that had a license revoked within
the past five years if the commissioner determines that (1) the license holder or controlling
individual is operating the program in substantial compliance with applicable laws and rules
and (2) the program's continued operation is in the best interests of the community being
served.
(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response
to an application that is affiliated with an applicant, license holder, or controlling individual
that had an application denied within the past two years or a license revoked within the past
five years if the commissioner determines that (1) the applicant or controlling individual
has operated one or more programs in substantial compliance with applicable laws and rules
and (2) the program's operation would be in the best interests of the community to be served.
(g) In determining whether a program's operation would be in the best interests of the
community to be served, the commissioner shall consider factors such as the number of
persons served, the availability of alternative services available in the surrounding
community, the management structure of the program, whether the program provides
culturally specific services, and other relevant factors.
(h) The commissioner shall not issue or reissue a license under this chapter if an individual
living in the household where the services will be provided as specified under section
245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside
and no variance has been granted.
(i) Pursuant to section 245A.07, subdivision 1, paragraph (b), when a license issued
under this chapter has been suspended or revoked and the suspension or revocation is under
appeal, the program may continue to operate pending a final order from the commissioner.
If the license under suspension or revocation will expire before a final order is issued, a
temporary provisional license may be issued provided any applicable license fee is paid
before the temporary provisional license is issued.
(j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of
a controlling individual or license holder, and the controlling individual or license holder
is ordered under section 245C.17 to be immediately removed from direct contact with
persons receiving services or is ordered to be under continuous, direct supervision when
providing direct contact services, the program may continue to operate only if the program
complies with the order and submits documentation demonstrating compliance with the
order. If the disqualified individual fails to submit a timely request for reconsideration, or
if the disqualification is not set aside and no variance is granted, the order to immediately
remove the individual from direct contact or to be under continuous, direct supervision
remains in effect pending the outcome of a hearing and final order from the commissioner.
(k) Unless otherwise specified by statute, all licenses issued under this chapter expire
at 12:01 a.m. on the day after the expiration date stated on the license. A license holder must
deleted text begin apply for and be granteddeleted text end new text begin comply with the requirements in section 245A.10 and be reissued
new text end a new license to operate the program or the program must not be operated after the expiration
date.new text begin Adult foster care, family adult day services, child foster residence setting, and
community residential services license holders must apply for and be granted a new license
to operate the program or the program must not be operated after the expiration date. Upon
implementation of the provider licensing and reporting hub, licenses may be issued each
calendar year.
new text end
(l) The commissioner shall not issue or reissue a license under this chapter if it has been
determined that a Tribal licensing authority has established jurisdiction to license the program
or service.
(m) The commissioner of human services may coordinate and share data with the
commissioner of children, youth, and families to enforce this section.
Sec. 5.
Minnesota Statutes 2024, section 245A.16, subdivision 1, is amended to read:
Subdivision 1.
Delegation of authority to agencies.
(a) County agencies that have been
designated by the commissioner to perform licensing functions and activities under section
245A.04; to recommend denial of applicants under section 245A.05; to issue correction
orders, to issue variances, and recommend a conditional license under section 245A.06; or
to recommend suspending or revoking a license or issuing a fine under section 245A.07,
shall comply with rules and directives of the commissioner governing those functions and
with this section. The following variances are excluded from the delegation of variance
authority and may be issued only by the commissioner:
(1) dual licensure of child foster residence setting and community residential setting;
(2) until the responsibility for family child foster care transfers to the commissioner of
children, youth, and families under Laws 2023, chapter 70, article 12, section 30, dual
licensure of family child foster care and family adult foster care;
(3) until the responsibility for family child care transfers to the commissioner of children,
youth, and families under Laws 2023, chapter 70, article 12, section 30, dual licensure of
family adult foster care and family child care;
(4) adult foster care or community residential setting maximum capacity;
(5) adult foster care or community residential setting minimum age requirement;
(6) child foster care maximum age requirement;
(7) variances regarding disqualified individuals;
(8) the required presence of a caregiver in the adult foster care residence during normal
sleeping hours;
(9) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder; and
(10) variances to section 142B.46 for the use of a cradleboard for a cultural
accommodation.
(b) Once the respective responsibilities transfer from the commissioner of human services
to the commissioner of children, youth, and families, under Laws 2023, chapter 70, article
12, section 30, the commissioners of human services and children, youth, and families must
both approve a variance for dual licensure of family child foster care and family adult foster
care or family adult foster care and family child care. Variances under this paragraph are
excluded from the delegation of variance authority and may be issued only by both
commissioners.
deleted text begin
(c) For family adult day services programs, the commissioner may authorize licensing
reviews every two years after a licensee has had at least one annual review.
deleted text end
deleted text begin (d) Adeleted text end new text begin (c) An adult foster care, family adult day services, child foster residence setting,
or community residential servicesnew text end license issued under this section may be issued for up to
two yearsnew text begin until implementation of the provider licensing and reporting hub. Upon
implementation of the provider licensing and reporting hub, licenses may be issued each
calendar yearnew text end .
deleted text begin (e)deleted text end new text begin (d)new text end During implementation of chapter 245D, the commissioner shall consider:
(1) the role of counties in quality assurance;
(2) the duties of county licensing staff; and
(3) the possible use of joint powers agreements, according to section 471.59, with counties
through which some licensing duties under chapter 245D may be delegated by the
commissioner to the counties.
Any consideration related to this paragraph must meet all of the requirements of the corrective
action plan ordered by the federal Centers for Medicare and Medicaid Services.
deleted text begin (f)deleted text end new text begin (e)new text end Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or
successor provisions; and section 245D.061 or successor provisions, for family child foster
care programs providing out-of-home respite, as identified in section 245D.03, subdivision
1, paragraph (b), clause (1), is excluded from the delegation of authority to county agencies.
Sec. 6.
Minnesota Statutes 2024, section 245A.242, subdivision 2, is amended to read:
Subd. 2.
Emergency overdose treatment.
(a) A license holder must maintain a supply
of opiate antagonists as defined in section 604A.04, subdivision 1, available for emergency
treatment of opioid overdose and must have a written standing order protocol by a physician
who is licensed under chapter 147, advanced practice registered nurse who is licensed under
chapter 148, or physician assistant who is licensed under chapter 147A, that permits the
license holder to maintain a supply of opiate antagonists on site. A license holder must
require staff to undergo training in the specific mode of administration used at the program,
which may include intranasal administration, intramuscular injection, or bothnew text begin , before the
staff has direct contact, as defined in section 245C.02, subdivision 11, with a person served
by the programnew text end .
(b) Notwithstanding any requirements to the contrary in Minnesota Rules, chapters 2960
and 9530, and Minnesota Statutes, chapters 245F, 245G, and 245I:
(1) emergency opiate antagonist medications are not required to be stored in a locked
area and staff and adult clients may carry this medication on them and store it in an unlocked
location;
(2) staff persons who only administer emergency opiate antagonist medications only
require the training required by paragraph (a), which any knowledgeable trainer may provide.
The trainer is not required to be a registered nurse or part of an accredited educational
institution; and
(3) nonresidential substance use disorder treatment programs that do not administer
client medications beyond emergency opiate antagonist medications are not required to
have the policies and procedures required in section 245G.08, subdivisions 5 and 6, and
must instead describe the program's procedures for administering opiate antagonist
medications in the license holder's description of health care services under section 245G.08,
subdivision 1.
Sec. 7.
Minnesota Statutes 2024, section 245C.05, is amended by adding a subdivision to
read:
new text begin Subd. 9. new text end
new text begin Electronic signature. new text end
new text begin
For documentation requiring a signature under this
chapter, use of an electronic signature as defined under section 325L.02, paragraph (h), is
allowed.
new text end
Sec. 8.
Minnesota Statutes 2024, section 245C.08, subdivision 3, is amended to read:
Subd. 3.
Arrest and investigative information.
(a) For any background study completed
under this section, if the commissioner has reasonable cause to believe the information is
pertinent to the disqualification of an individual, the commissioner also may review arrest
and investigative information from:
(1) the Bureau of Criminal Apprehension;
(2) the commissioners of children, youth, and families; health; and human services;
(3) a deleted text begin county attorneydeleted text end new text begin prosecutornew text end ;
deleted text begin
(4) a county sheriff;
deleted text end
deleted text begin (5)deleted text end new text begin (4)new text end a county agency;
deleted text begin (6)deleted text end new text begin (5)new text end a deleted text begin local chief of policedeleted text end new text begin law enforcement agencynew text end ;
deleted text begin (7)deleted text end new text begin (6)new text end other states;
deleted text begin (8)deleted text end new text begin (7)new text end the courts;
deleted text begin (9)deleted text end new text begin (8)new text end the Federal Bureau of Investigation;
deleted text begin (10)deleted text end new text begin (9)new text end the National Criminal Records Repository; and
deleted text begin (11)deleted text end new text begin (10)new text end criminal records from other states.
(b) Except when specifically required by law, the commissioner is not required to conduct
more than one review of a subject's records from the Federal Bureau of Investigation if a
review of the subject's criminal history with the Federal Bureau of Investigation has already
been completed by the commissioner and there has been no break in the subject's affiliation
with the entity that initiated the background study.
(c) If the commissioner conducts a national criminal history record check when required
by law and uses the information from the national criminal history record check to make a
disqualification determination, the data obtained is private data and cannot be shared with
private agencies or prospective employers of the background study subject.
(d) If the commissioner conducts a national criminal history record check when required
by law and uses the information from the national criminal history record check to make a
disqualification determination, the license holder or entity that submitted the study is not
required to obtain a copy of the background study subject's disqualification letter under
section 245C.17, subdivision 3.
Sec. 9.
Minnesota Statutes 2024, section 245C.22, subdivision 5, is amended to read:
Subd. 5.
Scope of set-aside.
(a) If the commissioner sets aside a disqualification under
this section, the disqualified individual remains disqualified, but may hold a license and
have direct contact with or access to persons receiving services. Except as provided in
paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the
licensed program, applicant, or agency specified in the set aside notice under section 245C.23.
For personal care provider organizations,new text begin financial management services organizations,
community first services and supports organizations, unlicensed home and community-based
organizations, and consumer-directed community supports organizations,new text end the commissioner's
set-aside may further be limited to a specific individual who is receiving services. For new
background studies required under section 245C.04, subdivision 1, paragraph (h), if an
individual's disqualification was previously set aside for the license holder's program and
the new background study results in no new information that indicates the individual may
pose a risk of harm to persons receiving services from the license holder, the previous
set-aside shall remain in effect.
(b) If the commissioner has previously set aside an individual's disqualification for one
or more programs or agencies, and the individual is the subject of a subsequent background
study for a different program or agency, the commissioner shall determine whether the
disqualification is set aside for the program or agency that initiated the subsequent
background study. A notice of a set-aside under paragraph (c) shall be issued within 15
working days if all of the following criteria are met:
(1) the subsequent background study was initiated in connection with a program licensed
or regulated under the same provisions of law and rule for at least one program for which
the individual's disqualification was previously set aside by the commissioner;
(2) the individual is not disqualified for an offense specified in section 245C.15,
subdivision 1 or 2;
(3) the commissioner has received no new information to indicate that the individual
may pose a risk of harm to any person served by the program; and
(4) the previous set-aside was not limited to a specific person receiving services.
(c) Notwithstanding paragraph (b), clause (2), for an individual who is employed in the
substance use disorder field, if the commissioner has previously set aside an individual's
disqualification for one or more programs or agencies in the substance use disorder treatment
field, and the individual is the subject of a subsequent background study for a different
program or agency in the substance use disorder treatment field, the commissioner shall set
aside the disqualification for the program or agency in the substance use disorder treatment
field that initiated the subsequent background study when the criteria under paragraph (b),
clauses (1), (3), and (4), are met and the individual is not disqualified for an offense specified
in section 245C.15, subdivision 1. A notice of a set-aside under paragraph (d) shall be issued
within 15 working days.
(d) When a disqualification is set aside under paragraph (b), the notice of background
study results issued under section 245C.17, in addition to the requirements under section
245C.17, shall state that the disqualification is set aside for the program or agency that
initiated the subsequent background study. The notice must inform the individual that the
individual may request reconsideration of the disqualification under section 245C.21 on the
basis that the information used to disqualify the individual is incorrect.
Sec. 10.
Minnesota Statutes 2024, section 245D.02, subdivision 4a, is amended to read:
Subd. 4a.
Community residential setting.
"Community residential setting" means a
residential program deleted text begin as identified in section 245A.11, subdivision 8,deleted text end where residential supports
and services identified in section 245D.03, subdivision 1, paragraph (c), clause (3), items
(i) and (ii), are providednew text begin to adults, as defined in section 245A.02, subdivision 2,new text end and the
license holder is the owner, lessor, or tenant of the facility licensed according to this chapter,
and the license holder does not reside in the facility.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2025.
new text end
Sec. 11.
Minnesota Statutes 2024, section 256.98, subdivision 1, is amended to read:
Subdivision 1.
Wrongfully obtaining assistance.
(a) A person who commits any of the
following acts or omissions with intent to defeat the purposes of sections 145.891 to 145.897,
the MFIP program formerly codified in sections 256.031 to 256.0361, the AFDC program
formerly codified in sections 256.72 to 256.871, chapter 142G, 256B, 256D, 256I, 256K,
or 256L, child care assistance programs, and emergency assistance programs under section
256D.06, is guilty of theft and shall be sentenced under section 609.52, subdivision 3, clauses
(1) to (5):
(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willfully false statement or representation, by intentional concealment of any material fact,
or by impersonation or other fraudulent device, assistance or the continued receipt of
assistance, to include child care assistance or food benefits produced according to sections
145.891 to 145.897 and MinnesotaCare services according to sections 256.9365, 256.94,
and 256L.01 to 256L.15, to which the person is not entitled or assistance greater than that
to which the person is entitled;
(2) knowingly aids or abets in buying or in any way disposing of the property of a
recipient or applicant of assistance without the consent of the county agency; or
(3) obtains or attempts to obtain, alone or in collusion with others, the receipt of payments
to which the individual is not entitled as a provider of subsidized child caredeleted text begin , ordeleted text end by deleted text begin furnishing
or concurring indeleted text end new text begin receiving or providing any prohibited payment, as defined in section
609.542, subdivision 2, including a kickback, or by submitting or aiding or abetting the
submission ofnew text end a willfully false claim for child care assistance.
(b) The continued receipt of assistance to which the person is not entitled or greater than
that to which the person is entitled as a result of any of the acts, failure to act, or concealment
described in this subdivision shall be deemed to be continuing offenses from the date that
the first act or failure to act occurred.
Sec. 12.
Minnesota Statutes 2024, section 256B.064, subdivision 1a, is amended to read:
Subd. 1a.
Grounds for sanctions.
(a) The commissioner may impose sanctions against
any individual or entity that receives payments from medical assistance or provides goods
or services for which payment is made from medical assistance for any of the following:
(1) fraud, theft, or abuse in connection with the provision of goods and services to recipients
of public assistance for which payment is made from medical assistance; (2) a pattern of
presentment of false or duplicate claims or claims for services not medically necessary; (3)
a pattern of making false statements of material facts for the purpose of obtaining greater
compensation than that to which the individual or entity is legally entitled; (4) suspension
or termination as a Medicare vendor; (5) refusal to grant the state agency access during
regular business hours to examine all records necessary to disclose the extent of services
provided to program recipients and appropriateness of claims for payment; (6) failure to
repay an overpayment or a fine finally established under this section; (7) failure to correct
errors in the maintenance of health service or financial records for which a fine was imposed
or after issuance of a warning by the commissioner; new text begin (8) soliciting or receiving any
remuneration as defined in section 609.542, subdivision 3, or United States Code, title 42,
section 1320a-7b(b)(1), and a criminal conviction is not required; (9) paying or offering to
pay any remuneration as defined in section 609.542, subdivision 2, or United States Code,
title 42, section 1320a-7b(b)(2), and a criminal conviction is not required; new text end and deleted text begin (8)deleted text end new text begin (10)new text end any
reason for which an individual or entity could be excluded from participation in the Medicare
program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act. For the
purposes of this section, goods or services for which payment is made from medical
assistance includes but is not limited to care and services identified in section 256B.0625
or provided pursuant to any federally approved waiver.
(b) The commissioner may impose sanctions against a pharmacy provider for failure to
respond to a cost of dispensing survey under section 256B.0625, subdivision 13e, paragraph
(h).
Sec. 13.
Minnesota Statutes 2024, section 256B.12, is amended to read:
256B.12 LEGAL REPRESENTATION.
The attorney general or the appropriate county attorney appearing at the direction of the
attorney general shall be the attorney for the state agency, and the county attorney of the
appropriate county shall be the attorney for the deleted text begin localdeleted text end new text begin countynew text end agency in all matters pertaining
hereto. To prosecute under this chapter or sections 609.466 deleted text begin anddeleted text end new text begin ;new text end 609.52, subdivision 2deleted text begin ,deleted text end new text begin ; and
609.542new text end or to recover payments wrongfully made under this chapter, the attorney general
or the appropriate county attorney, acting independently or at the direction of the attorney
general may institute a criminal or civil action.
Sec. 14.
new text begin
[609.542] HUMAN SERVICES PROGRAMS CRIMES.
new text end
new text begin Subdivision 1. new text end
new text begin Definition. new text end
new text begin
For purposes of this section, "federal health care program"
has the meaning given in United States Code, title 42, section 1320a-7b(f).
new text end
new text begin Subd. 2. new text end
new text begin Prohibited payments made relating to human services programs. new text end
new text begin
A person
is guilty of a crime and may be sentenced as provided in subdivision 5 if the person
intentionally offers or pays any remuneration, including any kickback, bribe, or rebate,
directly or indirectly, overtly or covertly, in cash or in kind, to another person:
new text end
new text begin
(1) to induce that person to apply for, receive, or induce another person to apply for or
receive an item or service for which payment may be made in whole or in part under a
federal health care program, state behavioral health program under section 254B.04, or
family program under chapter 142E; or
new text end
new text begin
(2) in return for purchasing, leasing, ordering, or arranging for or inducing the purchasing,
leasing, or ordering of any good, facility, service, or item for which payment may be made
in whole or in part, or which is administered in whole or in part under a federal health care
program, state behavioral health program under section 254B.04, or family program under
chapter 142E.
new text end
new text begin Subd. 3. new text end
new text begin Receipt of prohibited payments relating to human services programs. new text end
new text begin
A
person is guilty of a crime and may be sentenced as provided in subdivision 5 if the person
intentionally solicits or receives any remuneration, including any kickback, bribe, or rebate,
directly or indirectly, overtly or covertly, in cash or in kind:
new text end
new text begin
(1) in return for applying for or receiving a human services benefit, service, or grant for
which payment may be made in whole or in part under a federal health care program, state
behavioral health program under section 254B.04, or family program under chapter 142E;
or
new text end
new text begin
(2) in return for purchasing, leasing, ordering, or arranging for or inducing the purchasing,
leasing, or ordering of any good, facility, service, or item for which payment may be made
in whole or in part under a federal health care program, state behavioral health program
under section 254B.04, or family program under chapter 142E.
new text end
new text begin Subd. 4. new text end
new text begin Exemptions. new text end
new text begin
(a) This section does not apply to remuneration exempted under
the Anti-Kickback Statute, United States Code, title 42, section 1320a-7b(b)(3), or payment
made under a federal health care program which is exempt from liability by United States
Code, title 42, section 1001.952.
new text end
new text begin
(b) This section does not apply to:
new text end
new text begin
(1) any amount paid by an employer to a bona fide employee for providing covered
items or services under chapter 142E while acting in the course and scope of employment;
or
new text end
new text begin
(2) child care provider discounts, scholarships, or other financial assistance to families
allowed under section 142E.17, subdivision 7.
new text end
new text begin Subd. 5. new text end
new text begin Sentence. new text end
new text begin
(a) A person convicted under subdivision 2 or 3 may be sentenced
pursuant to section 609.52, subdivision 3.
new text end
new text begin
(b) For purposes of sentencing a violation of subdivision 2, "value" means the fair market
value of the good, facility, service, or item that was obtained as a direct or indirect result
of the prohibited payment.
new text end
new text begin
(c) For purposes of sentencing a violation of subdivision 3, "value" means the amount
of the prohibited payment solicited or received.
new text end
new text begin
(d) As a matter of law, a claim for any good, facility, service, or item rendered or claimed
to have been rendered in violation of this section is noncompensable and unenforceable at
the time the claim is made.
new text end
new text begin Subd. 6. new text end
new text begin Aggregation. new text end
new text begin
In a prosecution under this section, the value of the money,
property, or benefit received or solicited by the defendant within a six-month period may
be aggregated and the defendant charged accordingly in applying the provisions of
subdivision 5.
new text end
new text begin Subd. 7. new text end
new text begin False claims. new text end
new text begin
In addition to the penalties provided for in this section, a claim,
as defined in section 15C.01, subdivision 2, that includes items or services resulting from
a violation of this section constitutes a false or fraudulent claim for purposes of section
15C.02.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2025, and applies to crimes
committed on or after that date.
new text end
Sec. 15.
Laws 2023, chapter 70, article 7, section 34, the effective date, is amended to
read:
EFFECTIVE DATE.
This section is effective deleted text begin for background studies requested on or
after August 1, 2024deleted text end new text begin the day following final enactmentnew text end .
Sec. 16. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, section 245A.11, subdivision 8,
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 August 1, 2025.
new text end
ARTICLE 16
ECONOMIC SUPPORTS
Section 1.
Minnesota Statutes 2024, section 142A.03, is amended by adding a subdivision
to read:
new text begin Subd. 35. new text end
new text begin Electronic benefits transfer; contracting and procurement. new text end
new text begin
Notwithstanding
chapter 16C, the commissioner is exempt from the contract term limits for the issuance of
public benefits through an electronic benefit transfer system and related services. These
contracts may have up to an initial five-year term, with extensions not to exceed a ten-year
total contract duration.
new text end
Sec. 2.
new text begin
[142F.141] PREPARED MEALS FOOD RELIEF GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment new text end
new text begin
The commissioner of children, youth, and families must
establish a prepared meals grant program to provide hunger relief to Minnesotans
experiencing food insecurity and who have difficulty preparing meals due to limited mobility,
disability, or limited resources.
new text end
new text begin Subd. 2. new text end
new text begin Eligible grantees. new text end
new text begin
(a) Eligible grantees are nonprofit organizations or Minnesota
Tribal governments, as defined in section 10.65, with a demonstrated history of providing
and distributing prepared meals that are customized for the population that the organization
or Tribal government serves, including tailoring meals to cultural, religious, and dietary
needs.
new text end
new text begin
(b) An individual or nonprofit organization affiliated with Feeding Our Future is
prohibited from receiving grant funds under this section.
new text end
new text begin Subd. 3. new text end
new text begin Application. new text end
new text begin
Eligible grantees applying for grant money under this section
must apply to the commissioner on the forms and in the time and manner established by
the commissioner.
new text end
new text begin Subd. 4. new text end
new text begin Allowable uses of grant funds. new text end
new text begin
(a) Eligible grantees must use grant money
awarded under this section to fund a prepared meals program that primarily targets individuals
18 years of age or older and under 61 years of age, and their dependents experiencing food
insecurity. Grantees must not receive funding from other state and federal meal programs
for activities funded under this section.
new text end
new text begin
(b) Grantees must prepare meals in a licensed commercial kitchen and distribute meals
according to ServSafe guidelines.
new text end
new text begin Subd. 5. new text end
new text begin Duties of the commissioner. new text end
new text begin
(a) The commissioner must develop a process
for determining eligible grantees under this section.
new text end
new text begin
(b) In granting money, the commissioner must prioritize applicants that:
new text end
new text begin
(1) have demonstrated the ability to provide prepared meals to racially, ethnically, and
geographically diverse populations who are at greater risk for food insecurity;
new text end
new text begin
(2) work with external community partners to distribute meals targeting nontraditional
meal sites to reach those most in need; and
new text end
new text begin
(3) have a demonstrated history of sourcing at least 50 percent of the prepared meal
ingredients from:
new text end
new text begin
(i) Minnesota food producers and processors; or
new text end
new text begin
(ii) food that is donated or would otherwise be waste.
new text end
new text begin
(c) The commissioner must consider geographic distribution to ensure statewide coverage
when awarding grants and must minimize the number of grantees to simplify administrative
burdens and costs.
new text end
new text begin Subd. 6. new text end
new text begin Reporting. new text end
new text begin
(a) Grantees receiving money under this section must retain records
documenting expenditure of the money and comply with any additional documentation
requirements imposed by the commissioner.
new text end
new text begin
(b) Grantees must report on the use of money received under this section to the
commissioner. The commissioner must determine the timing and form required for the
reports.
new text end
new text begin Subd. 7. new text end
new text begin Ineligible expenditures. new text end
new text begin
If the commissioner determines that ineligible
expenditures are made by a grantee under this section, the ineligible amount must be repaid
by the grantee to the commissioner and deposited in the general fund.
new text end
Sec. 3.
new text begin
[142F.16] REGIONAL FOOD BANK GRANTS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The commissioner of children, youth, and families must
establish regional food bank grants to increase the availability of food to individuals and
families in need.
new text end
new text begin Subd. 2. new text end
new text begin Distribution of appropriation. new text end
new text begin
The commissioner must distribute funds
appropriated under this section to regional food banks and Minnesota Tribal governments,
as defined in section 10.65. The commissioner must distribute the funds under this section
in accordance with the federal The Emergency Food Assistance Program (TEFAP) formula
and the guidelines of the United States Department of Agriculture. The commissioner may
increase or decrease a qualifying recipient's proportionate amount if the commissioner
determines the increase or decrease is necessary to meet community needs or demands for
food in Minnesota. Food banks and Minnesota Tribal governments must be in compliance
with TEFAP regulations from the United States Department of Agriculture in order to
receive funding under this section, as applicable.
new text end
new text begin Subd. 3. new text end
new text begin Allowable uses of funds. new text end
new text begin
(a) Grant funds distributed to regional food banks
under this section must be used to purchase, transport, and coordinate the distribution of
food to TEFAP providers.
new text end
new text begin
(b) Grant funds distributed to Minnesota Tribal governments under this section must be
used to purchase, transport, and coordinate the distribution of food to individuals and families
in need.
new text end
new text begin
(c) Grant funds distributed under this section may also be used to purchase personal
hygiene products, including but not limited to diapers and toilet paper.
new text end
new text begin Subd. 4. new text end
new text begin Reporting. new text end
new text begin
(a) Food banks and Minnesota Tribal governments receiving grant
funds under this section must retain records documenting expenditures of the grant funds
and comply with any additional documentation requirements imposed by the commissioner.
new text end
new text begin
(b) Food banks and Minnesota Tribal governments must report on the use of grant funds
received under this section to the commissioner. The commissioner must determine the
timing and form required for the reports.
new text end
new text begin Subd. 5. new text end
new text begin Ineligible expenditures. new text end
new text begin
If the commissioner determines that ineligible
expenditures were made by a food bank or Minnesota Tribal government under this section,
the ineligible amount must be repaid by the food bank or Tribal government to the
commissioner and deposited in the general fund.
new text end
Sec. 4. new text begin FAMILY SUPPORTIVE HOUSING GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment; purpose. new text end
new text begin
The commissioner of human services must
establish a family supportive housing grant program to award competitive grants to eligible
applicants operating supportive housing for families.
new text end
new text begin Subd. 2. new text end
new text begin Definitions. new text end
new text begin
(a) The definitions in this subdivision apply to this section.
new text end
new text begin
(b) "Family" means a nontemporary household unit that includes at least one child and
one parent or legal guardian.
new text end
new text begin
(c) "Family permanent supportive housing" means housing that:
new text end
new text begin
(1) is not time limited;
new text end
new text begin
(2) is affordable for those at or below 30 percent of the area median income;
new text end
new text begin
(3) offers specialized support services to residents tailored to the needs of children and
families; and
new text end
new text begin
(4) is available to families with multiple barriers to obtaining and maintaining housing,
including but not limited to those who are homeless or at risk of homelessness; those with
mental illness, substance use disorders, and other disabilities; and those referred by child
protection services.
new text end
new text begin
(d) "Resident" means a resident of family permanent supportive housing.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility. new text end
new text begin
To be eligible for a grant under this section, an applicant must be
currently operating family supportive housing and be a nonprofit organization or a Minnesota
Tribal government.
new text end
new text begin Subd. 4. new text end
new text begin Application and administration. new text end
new text begin
(a) When applying to the commissioner for
a grant under this section, each applicant must include the number of families they estimate
to serve.
new text end
new text begin
(b) Within available appropriations, the commissioner must award grant money to eligible
grantees based on the estimated number of families served. The commissioner must use
best efforts to ensure that 60 percent of the families served are within the seven-county
metropolitan area and 40 percent of the families served are outside the seven-county
metropolitan area. The commissioner must use best efforts to ensure that ten percent of the
overall families served are members of Minnesota's Tribal Nations.
new text end
new text begin
(c) By June 30, 2026, each grantee must provide a report to the commissioner on how
many families the grantee served and what services the grantee provided.
new text end
new text begin Subd. 5. new text end
new text begin Eligible uses of grant money. new text end
new text begin
An eligible applicant that receives grant money
under this section must use the money for the services described in subdivision 6.
new text end
new text begin Subd. 6. new text end
new text begin Specialized family support services. new text end
new text begin
Specialized family support services are
nonmandatory, trauma-informed, and culturally appropriate services designed to help family
residents maintain secure, dignified housing and provide a safe, stable environment for
children. Services provided may include but are not limited to:
new text end
new text begin
(1) age-appropriate child-centric services for education and enrichment;
new text end
new text begin
(2) stabilization services such as:
new text end
new text begin
(i) educational assessment and referrals to educational programs;
new text end
new text begin
(ii) career planning, work skills training, job placement, and employment retention;
new text end
new text begin
(iii) budgeting and money management;
new text end
new text begin
(iv) referral for counseling regarding violence and sexual exploitation;
new text end
new text begin
(v) referral for medical or psychiatric services or substance use disorder treatment;
new text end
new text begin
(vi) parenting skills training;
new text end
new text begin
(vii) self-sufficiency support services or life skills training, including tenant education
and support to sustain housing; and
new text end
new text begin
(viii) aftercare and follow-up services; and
new text end
new text begin
(3) 24-hour-a-day, seven-day-a-week on-site staffing, including but not limited to front
desk and security.
new text end
ARTICLE 17
CHILD PROTECTION AND WELFARE
Section 1.
Minnesota Statutes 2024, section 142A.03, subdivision 2, is amended to read:
Subd. 2.
Duties of the commissioner.
(a) The commissioner may apply for and accept
on behalf of the state any grants, bequests, gifts, or contributions for the purpose of carrying
out the duties and responsibilities of the commissioner. Any money received under this
paragraph is appropriated and dedicated for the purpose for which the money is granted.
The commissioner must biennially report to the chairs and ranking minority members of
relevant legislative committees and divisions by January 15 of each even-numbered year a
list of all grants and gifts received under this subdivision.
(b) Pursuant to law, the commissioner may apply for and receive money made available
from federal sources for the purpose of carrying out the duties and responsibilities of the
commissioner.
(c) The commissioner may make contracts with and grants to Tribal Nations, public and
private agencies, for-profit and nonprofit organizations, and individuals using appropriated
money.
(d) The commissioner must develop program objectives and performance measures for
evaluating progress toward achieving the objectives. The commissioner must identify the
objectives, performance measures, and current status of achieving the measures in a biennial
report to the chairs and ranking minority members of relevant legislative committees and
divisions. The report is due no later than January 15 each even-numbered year. The report
must include, when possible, the following objectives:
(1) centering and including the lived experiences of children and youth, including those
with disabilities and mental illness and their families, in all aspects of the department's work;
(2) increasing the effectiveness of the department's programs in addressing the needs of
children and youth facing racial, economic, or geographic inequities;
(3) increasing coordination and reducing inefficiencies among the department's programs
and the funding sources that support the programs;
(4) increasing the alignment and coordination of family access to child care and early
learning programs and improving systems of support for early childhood and learning
providers and services;
(5) improving the connection between the department's programs and the kindergarten
through grade 12 and higher education systems; and
(6) minimizing and streamlining the effort required of youth and families to receive
services to which the youth and families are entitled.
(e) The commissioner shall administer and supervise the forms of public assistance and
other activities or services that are vested in the commissioner. Administration and
supervision of activities or services includes but is not limited to assuring timely and accurate
distribution of benefits, completeness of service, and quality program management. In
addition to administering and supervising activities vested by law in the department, the
commissioner has the authority to:
(1) require county agency participation in training and technical assistance programs to
promote compliance with statutes, rules, federal laws, regulations, and policies governing
the programs and activities administered by the commissioner;
(2) monitor, on an ongoing basis, the performance of county agencies in the operation
and administration of activities and programs; enforce compliance with statutes, rules,
federal laws, regulations, and policies governing welfare services; and promote excellence
of administration and program operation;
(3) develop a quality control program or other monitoring program to review county
performance and accuracy of benefit determinations;
(4) require county agencies to make an adjustment to the public assistance benefits issued
to any individual consistent with federal law and regulation and state law and rule and to
issue or recover benefits as appropriate;
(5) delay or deny payment of all or part of the state and federal share of benefits and
administrative reimbursement according to the procedures set forth in section 142A.10;
(6) make contracts with and grants to public and private agencies and organizations,
both for-profit and nonprofit, and individuals, using appropriated funds; and
(7) enter into contractual agreements with federally recognized Indian Tribes with a
reservation in Minnesota to the extent necessary for the Tribe to operate a federally approved
family assistance program or any other program under the supervision of the commissioner.
The commissioner shall consult with the affected county or counties in the contractual
agreement negotiations, if the county or counties wish to be included, in order to avoid the
duplication of county and Tribal assistance program services. The commissioner may
establish necessary accounts for the purposes of receiving and disbursing funds as necessary
for the operation of the programs.
The commissioner shall work in conjunction with the commissioner of human services to
carry out the duties of this paragraph when necessary and feasible.
(f) The commissioner shall inform county agencies, on a timely basis, of changes in
statute, rule, federal law, regulation, and policy necessary to county agency administration
of the programs and activities administered by the commissioner.
(g) The commissioner shall administer and supervise child welfare activities, including
promoting the enforcement of laws preventing child maltreatment and protecting children
with a disability and children who are in need of protection or services, licensing and
supervising child care and child-placing agencies, and supervising the care of children in
foster care. The commissioner shall coordinate with the commissioner of human services
on activities impacting children overseen by the Department of Human Services, such as
disability services, behavioral health, and substance use disorder treatment.
(h) The commissioner shall assist and cooperate with local, state, and federal departments,
agencies, and institutions.
(i) The commissioner shall establish and maintain any administrative units reasonably
necessary for the performance of administrative functions common to all divisions of the
department.
(j) The commissioner shall act as designated guardian of children pursuant to chapter
260C. For children under the guardianship of the commissioner or a Tribe in Minnesota
recognized by the Secretary of the Interior whose interests would be best served by adoptive
placement, the commissioner may contract with a licensed child-placing agency or a
Minnesota Tribal social services agency to provide adoption services. new text begin For children in
out-of-home care whose interests would be best served by a transfer of permanent legal and
physical custody to a relative under section 260C.515, subdivision 4, or equivalent in Tribal
code, the commissioner may contract with a licensed child-placing agency or a Minnesota
Tribal social services agency to provide permanency services. new text end A contract with a licensed
child-placing agency must be designed to supplement existing county efforts and may not
replace existing county programs or Tribal social services, unless the replacement is agreed
to by the county board and the appropriate exclusive bargaining representative, Tribal
governing body, or the commissioner has evidence that child placements of the county
continue to be substantially below that of other counties. Funds encumbered and obligated
under an agreement for a specific child shall remain available until the terms of the agreement
are fulfilled or the agreement is terminated.
(k) The commissioner has the authority to conduct and administer experimental projects
to test methods and procedures of administering assistance and services to recipients or
potential recipients of public benefits. To carry out the experimental projects, the
commissioner may waive the enforcement of existing specific statutory program
requirements, rules, and standards in one or more counties. The order establishing the waiver
must provide alternative methods and procedures of administration and must not conflict
with the basic purposes, coverage, or benefits provided by law. No project under this
paragraph shall exceed four years. No order establishing an experimental project as authorized
by this paragraph is effective until the following conditions have been met:
(1) the United States Secretary of Health and Human Services has agreed, for the same
project, to waive state plan requirements relative to statewide uniformity; and
(2) a comprehensive plan, including estimated project costs, has been approved by the
Legislative Advisory Commission and filed with the commissioner of administration.
(l) The commissioner shall, according to federal requirements and in coordination with
the commissioner of human services, establish procedures to be followed by local welfare
boards in creating citizen advisory committees, including procedures for selection of
committee members.
(m) The commissioner shall allocate federal fiscal disallowances or sanctions that are
based on quality control error rates for the aid to families with dependent children (AFDC)
program formerly codified in sections 256.72 to 256.87 or the Supplemental Nutrition
Assistance Program (SNAP) in the following manner:
(1) one-half of the total amount of the disallowance shall be borne by the county boards
responsible for administering the programs. For AFDC, disallowances shall be shared by
each county board in the same proportion as that county's expenditures to the total of all
counties' expenditures for AFDC. For SNAP, sanctions shall be shared by each county
board, with 50 percent of the sanction being distributed to each county in the same proportion
as that county's administrative costs for SNAP benefits are to the total of all SNAP
administrative costs for all counties, and 50 percent of the sanctions being distributed to
each county in the same proportion as that county's value of SNAP benefits issued are to
the total of all benefits issued for all counties. Each county shall pay its share of the
disallowance to the state of Minnesota. When a county fails to pay the amount due under
this paragraph, the commissioner may deduct the amount from reimbursement otherwise
due the county, or the attorney general, upon the request of the commissioner, may institute
civil action to recover the amount due; and
(2) notwithstanding the provisions of clause (1), if the disallowance results from knowing
noncompliance by one or more counties with a specific program instruction, and that knowing
noncompliance is a matter of official county board record, the commissioner may require
payment or recover from the county or counties, in the manner prescribed in clause (1), an
amount equal to the portion of the total disallowance that resulted from the noncompliance
and may distribute the balance of the disallowance according to clause (1).
(n) The commissioner shall develop and implement special projects that maximize
reimbursements and result in the recovery of money to the state. For the purpose of recovering
state money, the commissioner may enter into contracts with third parties. Any recoveries
that result from projects or contracts entered into under this paragraph shall be deposited
in the state treasury and credited to a special account until the balance in the account reaches
$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
transferred and credited to the general fund. All money in the account is appropriated to the
commissioner for the purposes of this paragraph.
(o) The commissioner has the authority to establish and enforce the following county
reporting requirements:
(1) the commissioner shall establish fiscal and statistical reporting requirements necessary
to account for the expenditure of funds allocated to counties for programs administered by
the commissioner. When establishing financial and statistical reporting requirements, the
commissioner shall evaluate all reports, in consultation with the counties, to determine if
the reports can be simplified or the number of reports can be reduced;
(2) the county board shall submit monthly or quarterly reports to the department as
required by the commissioner. Monthly reports are due no later than 15 working days after
the end of the month. Quarterly reports are due no later than 30 calendar days after the end
of the quarter, unless the commissioner determines that the deadline must be shortened to
20 calendar days to avoid jeopardizing compliance with federal deadlines or risking a loss
of federal funding. Only reports that are complete, legible, and in the required format shall
be accepted by the commissioner;
(3) if the required reports are not received by the deadlines established in clause (2), the
commissioner may delay payments and withhold funds from the county board until the next
reporting period. When the report is needed to account for the use of federal funds and the
late report results in a reduction in federal funding, the commissioner shall withhold from
the county boards with late reports an amount equal to the reduction in federal funding until
full federal funding is received;
(4) a county board that submits reports that are late, illegible, incomplete, or not in the
required format for two out of three consecutive reporting periods is considered
noncompliant. When a county board is found to be noncompliant, the commissioner shall
notify the county board of the reason the county board is considered noncompliant and
request that the county board develop a corrective action plan stating how the county board
plans to correct the problem. The corrective action plan must be submitted to the
commissioner within 45 days after the date the county board received notice of
noncompliance;
(5) the final deadline for fiscal reports or amendments to fiscal reports is one year after
the date the report was originally due. If the commissioner does not receive a report by the
final deadline, the county board forfeits the funding associated with the report for that
reporting period and the county board must repay any funds associated with the report
received for that reporting period;
(6) the commissioner may not delay payments, withhold funds, or require repayment
under clause (3) or (5) if the county demonstrates that the commissioner failed to provide
appropriate forms, guidelines, and technical assistance to enable the county to comply with
the requirements. If the county board disagrees with an action taken by the commissioner
under clause (3) or (5), the county board may appeal the action according to sections 14.57
to 14.69; and
(7) counties subject to withholding of funds under clause (3) or forfeiture or repayment
of funds under clause (5) shall not reduce or withhold benefits or services to clients to cover
costs incurred due to actions taken by the commissioner under clause (3) or (5).
(p) The commissioner shall allocate federal fiscal disallowances or sanctions for audit
exceptions when federal fiscal disallowances or sanctions are based on a statewide random
sample in direct proportion to each county's claim for that period.
(q) The commissioner is responsible for ensuring the detection, prevention, investigation,
and resolution of fraudulent activities or behavior by applicants, recipients, and other
participants in the programs administered by the department. The commissioner shall
cooperate with the commissioner of education to enforce the requirements for program
integrity and fraud prevention for investigation for child care assistance under chapter 142E.
(r) The commissioner shall require county agencies to identify overpayments, establish
claims, and utilize all available and cost-beneficial methodologies to collect and recover
these overpayments in the programs administered by the department.
(s) The commissioner shall develop recommended standards for child foster care homes
that address the components of specialized therapeutic services to be provided by child
foster care homes with those services.
(t) The commissioner shall authorize the method of payment to or from the department
as part of the programs administered by the department. This authorization includes the
receipt or disbursement of funds held by the department in a fiduciary capacity as part of
the programs administered by the department.
(u) In coordination with the commissioner of human services, the commissioner shall
create and provide county and Tribal agencies with blank applications, affidavits, and other
forms as necessary for public assistance programs.
(v) The commissioner shall cooperate with the federal government and its public welfare
agencies in any reasonable manner as may be necessary to qualify for federal aid for
temporary assistance for needy families and in conformity with Title I of Public Law 104-193,
the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and successor
amendments, including making reports that contain information required by the federal
Social Security Advisory Board and complying with any provisions the board may find
necessary to assure the correctness and verification of the reports.
(w) On or before January 15 in each even-numbered year, the commissioner shall make
a biennial report to the governor concerning the activities of the agency.
(x) The commissioner shall enter into agreements with other departments of the state as
necessary to meet all requirements of the federal government.
(y) The commissioner may cooperate with other state agencies in establishing reciprocal
agreements in instances where a child receiving Minnesota family investment program
(MFIP) assistance or its out-of-state equivalent moves or contemplates moving into or out
of the state, in order that the child may continue to receive MFIP or equivalent aid from the
state moved from until the child has resided for one year in the state moved to.
(z) The commissioner shall provide appropriate technical assistance to county agencies
to develop methods to have county financial workers remind and encourage recipients of
aid to families with dependent children, the Minnesota family investment program, the
Minnesota family investment plan, family general assistance, or SNAP benefits whose
assistance unit includes at least one child under the age of five to have each young child
immunized against childhood diseases. The commissioner must examine the feasibility of
utilizing the capacity of a statewide computer system to assist county agency financial
workers in performing this function at appropriate intervals.
(aa) The commissioner shall have the power and authority to accept on behalf of the
state contributions and gifts for the use and benefit of children under the guardianship or
custody of the commissioner. The commissioner may also receive and accept on behalf of
such children money due and payable to them as old age and survivors insurance benefits,
veterans benefits, pensions, or other such monetary benefits. Gifts, contributions, pensions,
and benefits under this paragraph must be deposited in and disbursed from the social welfare
fund provided for in sections 256.88 to 256.92.
(bb) The specific enumeration of powers and duties in this section must not be construed
to be a limitation upon the general powers granted to the commissioner.
Sec. 2.
Minnesota Statutes 2024, section 260.810, subdivision 1, is amended to read:
Subdivision 1.
Payments.
The commissioner shall make grant payments to each approved
program in four quarterly installments a year. The commissioner may certify an advance
payment for the first quarter of the state fiscal year. Later payments must be made deleted text begin upon
receipt by the state of a quarterly report on finances and program activitiesdeleted text end new text begin quarterlynew text end .
Sec. 3.
Minnesota Statutes 2024, section 260.810, subdivision 2, is amended to read:
Subd. 2.
deleted text begin Quarterly reportdeleted text end new text begin Reportingnew text end .
The commissioner shall deleted text begin specifydeleted text end new text begin engage Tribal
and urban Indian organizations to establishnew text end requirements for reportsnew text begin and reporting timelinesnew text end ,
including deleted text begin quarterlydeleted text end fiscal reportsnew text begin submitted to the commissioner at least annuallynew text end , according
to section 142A.03, subdivision 2, paragraph (o). Each deleted text begin quarterdeleted text end new text begin reporting period as agreed
upon by the commissioner and granteenew text end , an approved program receiving an Indian child
welfare grant shall submit a report to the commissioner that includes:
(1) a detailed accounting of grant money expended during the preceding deleted text begin quarterdeleted text end new text begin reporting
periodnew text end , specifying expenditures by line item and year to date; and
(2) a description of Indian child welfare activities conducted during the preceding deleted text begin quarterdeleted text end new text begin
reporting periodnew text end , including the number of clients served and the type of services provided.
deleted text begin The quarterlydeleted text end Reports must be submitted no later than 30 days after the deleted text begin end of each
quarterdeleted text end new text begin agreed upon reporting timelinesnew text end of the state fiscal year.
Sec. 4.
Minnesota Statutes 2024, section 260.821, subdivision 2, is amended to read:
Subd. 2.
Special focus grants.
The amount available for grants established under section
260.785, subdivision 2, for child-placing agencies, Tribes, Indian organizations, and other
social services organizations is one-fifth of the total annual appropriation for Indian child
welfare grants. deleted text begin The maximum award under this subdivision is $100,000 a year for programs
approved by the commissioner.
deleted text end
Sec. 5. new text begin DIRECTION TO COMMISSIONER OF CHILDREN, YOUTH, AND
FAMILIES; CHILD WELFARE FISCAL ANALYSIS.
new text end
new text begin Subdivision 1. new text end
new text begin Child welfare fiscal analysis. new text end
new text begin
The commissioner of children, youth, and
families must contract with a third-party consultant selected according to subdivision 2 to
conduct a fiscal analysis to identify and make recommendations on how to best utilize all
available child welfare funding streams and federal resources for supporting children,
families, and county and Tribal child welfare service providers across Minnesota.
new text end
new text begin Subd. 2. new text end
new text begin Fiscal analysis consultant selection. new text end
new text begin
The commissioner, with input from the
Association of Minnesota Counties, the Minnesota Indian Affairs Council, community
nonprofits, community providers, and other child welfare system stakeholders, must select
an independent third-party consultant to conduct the fiscal analysis required under this
section. The consultant must have expertise in and experience with child welfare systems
and conducting fiscal analyses.
new text end
new text begin Subd. 3. new text end
new text begin Child welfare fiscal analysis requirements. new text end
new text begin
When conducting the child welfare
fiscal analysis under this section, the third-party consultant must evaluate:
new text end
new text begin
(1) financial systems in Minnesota's child welfare system and funding sources available
to the child welfare system; and
new text end
new text begin
(2) state, county, and Tribal access to and use of funding or reimbursements for expenses
related to child welfare, including but not limited to legal representation, training, and
prevention services, under federal Title IV-E and Title IV-B, the federal Child Abuse
Prevention and Treatment Act, TANF, Medicaid, the federal Social Services Block Grant
Program, and other federal funds.
new text end
new text begin Subd. 4. new text end
new text begin Stakeholder engagement. new text end
new text begin
The third-party consultant conducting the fiscal
analysis under this section must engage with community child welfare service providers;
state, county, and Tribal social services agencies; and other individuals or organizations
with expertise in child welfare services, as the consultant determines to be appropriate.
new text end
new text begin Subd. 5. new text end
new text begin Report on fiscal analysis. new text end
new text begin
By June 30, 2027, the third-party consultant
conducting the child welfare fiscal analysis under this section must submit a report to the
commissioner of children, youth, and families and the chairs and ranking minority members
of the legislative committees with jurisdiction over the child welfare system. The report
must include the findings from the fiscal analysis required in this section and
recommendations on:
new text end
new text begin
(1) how to maximize the state's receipt and use of child welfare funding streams and
federal resources; and
new text end
new text begin
(2) legislative proposals for any statutory or funding changes necessary to maximize the
state's receipt and use of child welfare funding streams and federal resources.
new text end
new text begin Subd. 6. new text end
new text begin Tribal participation. new text end
new text begin
Each of Minnesota's 11 federally recognized Tribal
Nations may participate in the fiscal analysis required under this section. Tribal Nations
that choose to participate have sovereignty over data they choose to share with the consultant,
or other individuals or entities, and may request that their data not be included in any public
documents.
new text end
Sec. 6. new text begin SCAN OF AND REPORT ON OUT-OF-SCHOOL AND YOUTH
PROGRAMMING.
new text end
new text begin
(a) The commissioner of children, youth, and families must conduct a scan of
out-of-school and youth programming for youth under 21 years of age. The scan may include
a review of existing reports, targeted interviews, surveys, and other methodologies, as
determined by the commissioner.
new text end
new text begin
(b) When conducting the scan, the commissioner must collaborate with community
organizations and programming providers who provide out-of-school and youth
programming; parents, youth, and families who participate or have participated in
out-of-school and youth programming; and other individuals with expertise in out-of-school
and youth programming in order to:
new text end
new text begin
(1) identify different avenues for gathering information; and
new text end
new text begin
(2) collaborate in the outreach and facilitation of focused community engagement.
new text end
new text begin
(c) By July 1, 2026, the commissioner must prepare and submit a final report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
children, youth, and families. The commissioner may contract with consultants to help with
the development of the report. The report must include:
new text end
new text begin
(1) information on current federal, state, Tribal, county, and city out-of-school and youth
programs;
new text end
new text begin
(2) school districts that offer enrichment activities;
new text end
new text begin
(3) information on availability and amount of funding sources, the costs to provide the
out-of-school and youth programs, and the costs of the programs for families;
new text end
new text begin
(4) any barriers and gaps for families to participate in the out-of-school and youth
programming, as identified by findings from the scan under paragraph (a) and in discussions
with community members and program providers;
new text end
new text begin
(5) information on the populations participating in out-of-school and youth programming;
new text end
new text begin
(6) differences in programming needs, opportunities, and accessibility between different
demographics and different regions of Minnesota; and
new text end
new text begin
(7) recommendations on policy and funding needs, including recommending potential
partners for program delivery to expand access to quality out-of-school and youth
programming.
new text end
new text begin
(d) By July 1, 2026, the commissioner must present the final report to the chairs and
ranking minority members of the legislative committees with jurisdiction over children,
youth, and families.
new text end
ARTICLE 18
CHILD PROTECTION AND WELFARE POLICY
Section 1.
Minnesota Statutes 2024, section 142A.609, subdivision 11, is amended to
read:
Subd. 11.
Treatment of Supplemental Security Income.
(a) If a child placed in foster
care receives benefits through Supplemental Security Income (SSI) at the time of foster
care placement or subsequent to placement in foster care, the financially responsible agency
may new text begin only new text end apply to be the payee for the child for the duration of the child's placement in
foster carenew text begin when the court has ordered the financially responsible agency to develop a plan
for the transfer of permanent legal and physical custody of the child to a relative or to file
a termination of parental rights petition under section 260C.204, paragraph (e), clause (2)
or (3); ordered the child permanently placed away from the parent under sections 260C.503
to 260C.521; or approved the continued voluntary foster care placement for the child under
section 260D.07new text end . If a child continues to be eligible for SSI after finalization of the adoption
or transfer of permanent legal and physical custody and is determined to be eligible for a
payment under Northstar Care for Children, a permanent caregiver may choose to receive
payment from both programs simultaneously. The permanent caregiver is responsible to
report the amount of the payment to the Social Security Administration and the SSI payment
will be reduced as required by the Social Security Administration.
(b) If a financially responsible agency applies to be the payee for a child who receives
benefits through SSI, or receives the benefits under this subdivision on behalf of a child,
the financially responsible agency must provide written notice by certified mail, return
receipt requested to:
(1) the child, if the child is 13 years of age or older;
(2) the child's parent, guardian, or custodian or if there is no legal parent or custodian
the child's relative selected by the agency;
(3) the guardian ad litem;
(4) the legally responsible agency; and
(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
(c) If a financially responsible agency receives benefits under this subdivision on behalf
of a child 13 years of age or older, the legally responsible agency and the guardian ad litem
must disclose this information to the child in person in a manner that best helps the child
understand the information. This paragraph does not apply in circumstances where the child
is living outside of Minnesota.
(d) If a financially responsible agency receives the benefits under this subdivision on
behalf of a child, it cannot use those funds for any other purpose than the care of that child.
The financially responsible agency must not commingle any benefits received under this
subdivision and must not put the benefits received on behalf of a child under this subdivision
into a general fund.
(e) If a financially responsible agency receives any benefits under this subdivision, it
must keep a record of:
(1) the total dollar amount it received on behalf of all children it receives benefits for;
(2) the total number of children it applied to be a payee for; and
(3) the total number of children it received benefits for.
(f) By July 1, 2025, and each July 1 thereafter, each financially responsible agency must
submit a report to the commissioner of children, youth, and families that includes the
information required under paragraph (e). By September 1 of each year, the commissioner
must submit a report to the chairs and ranking minority members of the legislative committees
with jurisdiction over child protection that compiles the information provided to the
commissioner by each financially responsible agency under paragraph (e); subdivision 12,
paragraph (e); and section 260C.331, subdivision 7, paragraph (d). This paragraph expires
January 31, 2034.
Sec. 2.
Minnesota Statutes 2024, section 142A.609, subdivision 12, is amended to read:
Subd. 12.
Treatment of Retirement, Survivors, and Disability Insurance; veteran's
benefits; railroad retirement benefits; and black lung benefits.
(a) If a child placed in
foster care receives Retirement, Survivors, and Disability Insurance; veteran's benefits;
railroad retirement benefits; or black lung benefits at the time of foster care placement or
subsequent to placement in foster care, the financially responsible agency may new text begin only new text end apply
to be the payee for the child for the duration of the child's placement in foster carenew text begin when
the court has ordered the financially responsible agency to develop a plan for the transfer
of permanent legal and physical custody of the child to a relative or to file a termination of
parental rights petition under section 260C.204, paragraph (e), clause (2) or (3); ordered
the child permanently placed away from the parent under sections 260C.503 to 260C.521;
or approved the continued voluntary foster care placement for the child under section
260D.07new text end . If it is anticipated that a child will be eligible to receive Retirement, Survivors,
and Disability Insurance; veteran's benefits; railroad retirement benefits; or black lung
benefits after finalization of the adoption or assignment of permanent legal and physical
custody, the permanent caregiver shall apply to be the payee of those benefits on the child's
behalf.
(b) If the financially responsible agency applies to be the payee for a child who receives
Retirement, Survivors, and Disability Insurance; veteran's benefits; railroad retirement
benefits; or black lung benefits, or receives the benefits under this subdivision on behalf of
a child, the financially responsible agency must provide written notice by certified mail,
return receipt requested to:
(1) the child, if the child is 13 years of age or older;
(2) the child's parent, guardian, or custodian or if there is no legal parent or custodian
the child's relative selected by the agency;
(3) the guardian ad litem;
(4) the legally responsible agency; and
(5) the counsel appointed for the child pursuant to section 260C.163, subdivision 3.
(c) If a financially responsible agency receives benefits under this subdivision on behalf
of a child 13 years of age or older, the legally responsible agency and the guardian ad litem
must disclose this information to the child in person in a manner that best helps the child
understand the information. This paragraph does not apply in circumstances where the child
is living outside of Minnesota.
(d) If a financially responsible agency receives the benefits under this subdivision on
behalf of a child, it cannot use those funds for any other purpose than the care of that child.
The financially responsible agency must not commingle any benefits received under this
subdivision and must not put the benefits received on behalf of a child under this subdivision
into a general fund.
(e) If a financially responsible agency receives any benefits under this subdivision, it
must keep a record of:
(1) the total dollar amount it received on behalf of all children it receives benefits for;
(2) the total number of children it applied to be a payee for; and
(3) the total number of children it received benefits for.
(f) By July 1, 2025, and each July 1 thereafter, each financially responsible agency must
submit a report to the commissioner of children, youth, and families that includes the
information required under paragraph (e).
Sec. 3.
Minnesota Statutes 2024, section 142B.01, subdivision 15, is amended to read:
Subd. 15.
Individual who is related.
"Individual who is related" means a spouse, a
parent, a birth or adopted child or stepchild, a stepparent, a stepbrother, a stepsister, a niece,
a nephew, an adoptive parent, a grandparent, a sibling, an aunt, an uncle, or a legal guardian.new text begin
For purposes of family child foster care, individual who is related also includes an individual
who, prior to the child's placement in the individual's home for foster care or adoption, is
an important individual of the child or of the child's parent or custodian. Important individual
means an individual with whom the child has previously resided or had significant contact
or who has a significant relationship to the child or the child's parent or custodian.
new text end
Sec. 4.
Minnesota Statutes 2024, section 142B.05, subdivision 3, is amended to read:
Subd. 3.
Foster care by an individual who is related to a child; license required.
new text begin (a)
new text end Notwithstanding subdivision 2, paragraph (a), clause (1), in order to provide foster care for
a child, an individual who is related to the child, other than a parent, or legal guardian, must
be licensed by the commissioner except as provided by section 142B.06.
new text begin
(b) If an individual who is related to a child is seeking licensure to provide foster care
for the child and the individual has a domestic partner but is not married to the domestic
partner, only the individual related to the child must be licensed to provide foster care. The
commissioner must conduct background studies on household members according to section
245C.03, subdivision 1.
new text end
Sec. 5.
Minnesota Statutes 2024, section 142B.30, is amended by adding a subdivision to
read:
new text begin Subd. 13. new text end
new text begin Individual who is related; agency choice. new text end
new text begin
An individual who is related to
the child may seek foster care licensure through the county agency or a private agency,
licensed and authorized by the commissioner. The child-placing agency, depending on
funding available, must provide information to all potential relative foster care providers
about this choice, including information about available private agencies for foster care
licensure.
new text end
Sec. 6.
Minnesota Statutes 2024, section 142B.47, is amended to read:
142B.47 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT DEATH
AND ABUSIVE HEAD TRAUMA FOR CHILD FOSTER CARE PROVIDERS.
(a) Licensed child foster care providersnew text begin , except individuals related to the child who only
care for a relative child,new text end that care for infants or children through five years of age must
document that before caregivers assist in the care of infants or children through five years
of age, deleted text begin theydeleted text end new text begin the caregiversnew text end are instructed on the standards in section 142B.46 and receive
training on reducing the risk of sudden unexpected infant death and abusive head trauma
from shaking infants and young children.new text begin Licensed child foster care providers who are
related to the child, and who only care for a relative child, must document completion of
the training required under this section within 30 days after licensure.new text end This section does not
apply to emergency relative placement under section 142B.06. The training on reducing
the risk of sudden unexpected infant death and abusive head trauma may be provided as:
(1) orientation training to child foster care providers who care for infants or children
through five years of age under Minnesota Rules, part 2960.3070, subpart 1; or
(2) in-service training to child foster care providers who care for infants or children
through five years of age under Minnesota Rules, part 2960.3070, subpart 2.
(b) Training required under this section must be at least one hour in length and must be
completed at least once every five years. At a minimum, the training must address the risk
factors related to sudden unexpected infant death and abusive head trauma, means of reducing
the risk of sudden unexpected infant death and abusive head trauma, and license holder
communication with parents regarding reducing the risk of sudden unexpected infant death
and abusive head trauma.
(c) Training for child foster care providers must be approved by the county or private
licensing agency that is responsible for monitoring the child foster care provider under
section 142B.30. The approved training fulfills, in part, training required under Minnesota
Rules, part 2960.3070.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 7.
Minnesota Statutes 2024, section 142B.51, subdivision 2, is amended to read:
Subd. 2.
Child passenger restraint systems; training requirement.
(a) Programs
licensed by the Department of Human Services under chapter 245A or the Department of
Children, Youth, and Families under this chapter and Minnesota Rules, chapter 2960, that
serve a child or children under eight years of age must document training that fulfills the
requirements in this subdivision.
(b) Before a license holder, staff person, or caregiver transports a child or children under
age eight in a motor vehicle, the person transporting the child must satisfactorily complete
training on the proper use and installation of child restraint systems in motor vehicles.
Training completed under this section may be used to meet initial or ongoing training under
Minnesota Rules, part 2960.3070, subparts 1 and 2.
(c) Training required under this section must be completed at orientation or initial training
and repeated at least once every five years. At a minimum, the training must address the
proper use of child restraint systems based on the child's size, weight, and age, and the
proper installation of a car seat or booster seat in the motor vehicle used by the license
holder to transport the child or children.
(d) Training under paragraph (c) must be provided by individuals who are certified and
approved by the Office of Traffic Safety within the Department of Public Safety. License
holders may obtain a list of certified and approved trainers through the Department of Public
Safety website or by contacting the agency.
(e) Notwithstanding paragraph (a), for an emergency relative placement under section
142B.06, the commissioner may grant a variance to the training required by this subdivision
for a relative who completes a child seat safety check up. The child seat safety check up
trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and
must provide one-on-one instruction on placing a child of a specific age in the exact child
passenger restraint in the motor vehicle in which the child will be transported. Once granted
a variance, and if all other licensing requirements are met, the relative applicant may receive
a license and may transport a relative foster child younger than eight years of age. A child
seat safety check up must be completed each time a child requires a different size car seat
according to car seat and vehicle manufacturer guidelines. A relative license holder must
complete training that meets the other requirements of this subdivision prior to placement
of another foster child younger than eight years of age in the home or prior to the renewal
of the child foster care license.
new text begin
(f) Notwithstanding paragraph (b), a child foster care license holder who is an individual
related to the child, and who only serves a relative child, must document completion of the
training required under this section within 30 days after licensure.
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. 8.
Minnesota Statutes 2024, section 142B.80, is amended to read:
142B.80 CHILD FOSTER CARE TRAINING REQUIREMENT; MENTAL
HEALTH TRAINING; FETAL ALCOHOL SPECTRUM DISORDERS TRAINING.
Prior to a nonemergency placement of a child in a foster care home, the child foster care
license holder and caregivers in foster family and treatment foster care settings must complete
two hours of training that addresses the causes, symptoms, and key warning signs of mental
health disorders; cultural considerations; and effective approaches for dealing with a child's
behaviors. At least one hour of the annual training requirement for the foster family license
holder and caregivers must be on children's mental health issues and treatment. Except for
providers and services under chapter 245Dnew text begin and child foster care license holders who are
individuals related to the child who only serve a relative child who does not have fetal
alcohol spectrum disordernew text end , the annual training must also include at least one hour of training
on fetal alcohol spectrum disorders, which must be counted toward the 12 hours of required
in-service training per year. Short-term substitute caregivers are exempt from these
requirements. Training curriculum shall be approved by the commissioner of children,
youth, and families.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 9.
new text begin
[142B.81] CHILD FOSTER CARE TRAINING; RELATIVE CAREGIVERS.
new text end
new text begin
Notwithstanding the required hours under Minnesota Rules, part 2960.3070, subpart 2,
a child foster care license holder who is an individual related to the child must complete a
minimum of six hours of in-service training per year in one or more of the areas in Minnesota
Rules, part 2960.3070, subpart 2, or in other areas as agreed upon by the licensing agency
and the foster parent. The relative child foster care license holder must consult with the
licensing agency and complete training in areas that are most applicable to caring for the
relative children in foster care in the home. This section does not apply to a child foster care
license holder who is licensed to care for both a relative child and a nonrelative child.
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. 10.
Minnesota Statutes 2024, section 245C.02, is amended by adding a subdivision
to read:
new text begin Subd. 16b. new text end
new text begin Relative. new text end
new text begin
"Relative" has the meaning given in section 260C.007, subdivision
27. For purposes of background studies affiliated with child foster care licensure, a person
is a relative if the person was known to the child or the child's parent before the child is
placed in foster care.
new text end
Sec. 11.
Minnesota Statutes 2024, section 245C.15, subdivision 4a, is amended to read:
Subd. 4a.
Licensed family foster setting disqualifications.
(a) Notwithstanding
subdivisions 1 to 4, for a background study affiliated with a licensed family foster setting,
regardless of how much time has passed, an individual is disqualified under section 245C.14
if the individual committed an act that resulted in a felony-level conviction for sections:
609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder
in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in
the second degree); 609.2112 (criminal vehicular homicide); deleted text begin 609.221 (assault in the first
degree);deleted text end 609.223, subdivision 2 (assault in the third degree, past pattern of child abuse);
609.223, subdivision 3 (assault in the third degree, victim under four); a felony offense
under sections 609.2242 and 609.2243 (domestic assault, spousal abuse, child abuse or
neglect, or a crime against children); 609.2247 (domestic assault by strangulation); 609.2325
(criminal abuse of a vulnerable adult resulting in the death of a vulnerable adult); 609.245
(aggravated robbery); 609.247, subdivision 2 or 3 (carjacking in the first or second degree);
609.25 (kidnapping); 609.255 (false imprisonment); 609.2661 (murder of an unborn child
in the first degree); 609.2662 (murder of an unborn child in the second degree); 609.2663
(murder of an unborn child in the third degree); 609.2664 (manslaughter of an unborn child
in the first degree); 609.2665 (manslaughter of an unborn child in the second degree);
609.267 (assault of an unborn child in the first degree); 609.2671 (assault of an unborn child
in the second degree); 609.268 (injury or death of an unborn child in the commission of a
crime); 609.322, subdivision 1 (solicitation, inducement, and promotion of prostitution; sex
trafficking in the first degree); 609.324, subdivision 1 (other prohibited acts; engaging in,
hiring, or agreeing to hire minor to engage in prostitution); 609.342 (criminal sexual conduct
in the first degree); 609.343 (criminal sexual conduct in the second degree); 609.344 (criminal
sexual conduct in the third degree); 609.345 (criminal sexual conduct in the fourth degree);
609.3451 (criminal sexual conduct in the fifth degree); 609.3453 (criminal sexual predatory
conduct); 609.3458 (sexual extortion); 609.352 (solicitation of children to engage in sexual
conduct); 609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of
a child); 609.561 (arson in the first degree); 609.582, subdivision 1 (burglary in the first
degree); 609.746 (interference with privacy); 617.23 (indecent exposure); 617.246 (use of
minors in sexual performance prohibited); or 617.247 (possession of pictorial representations
of minors).
(b) Notwithstanding subdivisions 1 to 4, for the purposes of a background study affiliated
with a licensed family foster setting, an individual is disqualified under section 245C.14,
regardless of how much time has passed, if the individual:
(1) committed an action under paragraph (e) that resulted in death or involved sexual
abuse, as defined in section 260E.03, subdivision 20;
(2) committed an act that resulted in a gross misdemeanor-level conviction for section
609.3451 (criminal sexual conduct in the fifth degree);
(3) committed an act against or involving a minor that resulted in a felony-level conviction
for: section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the
third degree); 609.2231 (assault in the fourth degree); or 609.224 (assault in the fifth degree);
or
(4) committed an act that resulted in a misdemeanor or gross misdemeanor-level
conviction for section 617.293 (dissemination and display of harmful materials to minors).
(c) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster settingdeleted text begin ,deleted text end new text begin :
new text end
new text begin (1)new text end an individual is disqualified under section 245C.14 if fewer than 20 years have passed
since the termination of the individual's parental rights under section 260C.301, subdivision
1, paragraph (b), or if the individual consented to a termination of parental rights under
section 260C.301, subdivision 1, paragraph (a), to settle a petition to involuntarily terminate
parental rights. An individual is disqualified under section 245C.14 if fewer than 20 years
have passed since the termination of the individual's parental rights in any other state or
country, where the conditions for the individual's termination of parental rights are
substantially similar to the conditions in section 260C.301, subdivision 1, paragraph (b)new text begin ; or
new text end
new text begin (2) when an individual is a relative of the child in foster care, an individual is disqualified
under section 245C.14 if fewer than seven years have passed since the termination of the
individual's parental rights under section 260C.301, subdivision 1, paragraph (b), or if the
individual consented to a termination of parental rights under section 260C.301, subdivision
1, paragraph (a), to settle a petition to involuntarily terminate parental rights. An individual
is disqualified under section 245C.14 if fewer than seven years have passed since the
termination of the individual's parental rights in any other state or country, where the
conditions for the individual's termination of parental rights are substantially similar to the
conditions in section 260C.301, subdivision 1, paragraph (b)new text end .
(d) Notwithstanding subdivisions 1 to 4, for a background study affiliated with a licensed
family foster setting, an individual is disqualified under section 245C.14 if fewer than five
years have passed since a felony-level violation for sections: 152.021 (controlled substance
crime in the first degree); 152.022 (controlled substance crime in the second degree); 152.023
(controlled substance crime in the third degree); 152.024 (controlled substance crime in the
fourth degree); 152.025 (controlled substance crime in the fifth degree); 152.0261 (importing
controlled substances across state borders); 152.0262, subdivision 1, paragraph (b)
(possession of substance with intent to manufacture methamphetamine); 152.027, subdivision
6, paragraph (c) (sale or possession of synthetic cannabinoids); 152.096 (conspiracies
prohibited); 152.097 (simulated controlled substances); 152.136 (anhydrous ammonia;
prohibited conduct; criminal penalties; civil liabilities); 152.137 (methamphetamine-related
crimes involving children or vulnerable adults); 169A.24 (felony first-degree driving while
impaired); 243.166 (violation of predatory offender registration requirements); 609.2113
(criminal vehicular operation; bodily harm); 609.2114 (criminal vehicular operation; unborn
child); new text begin 609.221 (assault in the first degree); new text end 609.228 (great bodily harm caused by distribution
of drugs); 609.2325 (criminal abuse of a vulnerable adult not resulting in the death of a
vulnerable adult); 609.233 (criminal neglect); 609.235 (use of drugs to injure or facilitate
a crime); 609.24 (simple robbery); 609.247, subdivision 4 (carjacking in the third degree);
609.322, subdivision 1a (solicitation, inducement, and promotion of prostitution; sex
trafficking in the second degree); 609.498, subdivision 1 (tampering with a witness in the
first degree); 609.498, subdivision 1b (aggravated first-degree witness tampering); 609.562
(arson in the second degree); 609.563 (arson in the third degree); 609.582, subdivision 2
(burglary in the second degree); 609.66 (felony dangerous weapons); 609.687 (adulteration);
609.713 (terroristic threats); 609.749, subdivision 3, 4, or 5 (felony-level harassment or
stalking); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); or
624.713 (certain people not to possess firearms).
(e) Notwithstanding subdivisions 1 to 4, except as provided in paragraph (a), for a
background study affiliated with a licensed family child foster care license, an individual
is disqualified under section 245C.14 if fewer than five years have passed since:
(1) a felony-level violation for an act not against or involving a minor that constitutes:
section 609.222 (assault in the second degree); 609.223, subdivision 1 (assault in the third
degree); 609.2231 (assault in the fourth degree); or 609.224, subdivision 4 (assault in the
fifth degree);
(2) a violation of an order for protection under section 518B.01, subdivision 14;
(3) a determination or disposition of the individual's failure to make required reports
under section 260E.06 or 626.557, subdivision 3, for incidents in which the final disposition
under chapter 260E or section 626.557 was substantiated maltreatment and the maltreatment
was recurring or serious;
(4) a determination or disposition of the individual's substantiated serious or recurring
maltreatment of a minor under chapter 260E, a vulnerable adult under section 626.557, or
serious or recurring maltreatment in any other state, the elements of which are substantially
similar to the elements of maltreatment under chapter 260E or section 626.557 and meet
the definition of serious maltreatment or recurring maltreatment;
(5) a gross misdemeanor-level violation for sections: 609.224, subdivision 2 (assault in
the fifth degree); 609.2242 and 609.2243 (domestic assault); 609.233 (criminal neglect);
609.377 (malicious punishment of a child); 609.378 (neglect or endangerment of a child);
609.746 (interference with privacy); 609.749 (stalking); or 617.23 (indecent exposure); or
(6) committing an act against or involving a minor that resulted in a misdemeanor-level
violation of section 609.224, subdivision 1 (assault in the fifth degree).
(f) For purposes of this subdivision, the disqualification begins from:
(1) the date of the alleged violation, if the individual was not convicted;
(2) the date of conviction, if the individual was convicted of the violation but not
committed to the custody of the commissioner of corrections; or
(3) the date of release from prison, if the individual was convicted of the violation and
committed to the custody of the commissioner of corrections.
Notwithstanding clause (3), if the individual is subsequently reincarcerated for a violation
of the individual's supervised release, the disqualification begins from the date of release
from the subsequent incarceration.
(g) new text begin Notwithstanding paragraph (f), for purposes of paragraph (d), the disqualification
begins from the date of the alleged violation when the individual is a relative of the child
in foster care.
new text end
new text begin (h) new text end An individual's aiding and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraphs (a) and (b), as each of these offenses is defined in Minnesota
Statutes, permanently disqualifies the individual under section 245C.14. An individual is
disqualified under section 245C.14 if fewer than five years have passed since the individual's
aiding and abetting, attempt, or conspiracy to commit any of the offenses listed in paragraphs
(d) and (e).
deleted text begin (h)deleted text end new text begin (i)new text end An individual's offense in any other state or country, where the elements of the
offense are substantially similar to any of the offenses listed in paragraphs (a) and (b),
permanently disqualifies the individual under section 245C.14. An individual is disqualified
under section 245C.14 if fewer than five years have passed since an offense in any other
state or country, the elements of which are substantially similar to the elements of any
offense listed in paragraphs (d) and (e).
Sec. 12.
Minnesota Statutes 2024, section 260.65, is amended to read:
260.65 NONCUSTODIAL PARENTS; RELATIVE PLACEMENT.
(a) Prior to the removal of an African American or a disproportionately represented child
from the child's home, the responsible social services agency must make active efforts to
identify and locate the child's noncustodial or nonadjudicated parent and the child's relatives
to notify the child's parent and relatives that the child is or will be placed in foster caredeleted text begin ,deleted text end and
provide the child's parent and relatives with a list of legal resources. The notice to the child's
noncustodial or nonadjudicated parent and relatives must also include the information
required under section 260C.221, subdivision 2, paragraph (b). The responsible social
services agency must maintain detailed records of the agency's efforts to notify parents and
relatives under this section.
(b) Notwithstanding the provisions of section 260C.219, the responsible social services
agency must assess an African American or a disproportionately represented child's
noncustodial or nonadjudicated parent's ability to care for the child before placing the child
in foster care. If a child's noncustodial or nonadjudicated parent is willing and able to provide
daily care for the African American or disproportionately represented child temporarily or
permanently, the court shall order deleted text begin thatdeleted text end the child deleted text begin be placed indeleted text end new text begin intonew text end the home of the noncustodial
or nonadjudicated parent pursuant to section 260C.178 or 260C.201, subdivision 1. The
responsible social services agency must make active efforts to assist a noncustodial or
nonadjudicated parent with remedying any issues that may prevent the child from being
deleted text begin placed with thedeleted text end new text begin ordered into the home of anew text end noncustodial or nonadjudicated parent.
(c) The relative search, notice, engagement, and placement consideration requirements
under section 260C.221 apply under this act.
Sec. 13.
Minnesota Statutes 2024, section 260.66, subdivision 1, is amended to read:
Subdivision 1.
Emergency removal or placement permitted.
Nothing in this section
shall be construed to prevent the emergency removal of an African American or a
disproportionately represented deleted text begin child's parent or custodiandeleted text end new text begin childnew text end or the emergency placement
of the child in a foster setting in order to prevent imminent physical damage or harm to the
child.
Sec. 14.
Minnesota Statutes 2024, section 260.691, subdivision 1, is amended to read:
Subdivision 1.
new text begin Establishment and new text end duties.
new text begin
(a) The African American Child and Family
Well-Being Advisory Council is established for the Department of Children, Youth, and
Families.
new text end
new text begin
(b) The council shall consist of 31 members appointed by the commissioner and must
include representatives with lived personal or professional experience within African
American communities. Members may include but are not limited to youth who have exited
the child welfare system; parents; legal custodians; relative and kinship caregivers or foster
care providers; community service providers, advocates, and members; county and private
social services agency case managers; representatives from faith-based institutions; academic
professionals; a representative from the Council for Minnesotans of African Heritage; the
Ombudsperson for African American Families; and other individuals with experience and
knowledge of African American communities. Council members must be selected through
an open appointments process under section 15.0597. The terms, compensation, and removal
of council members are governed by section 15.059.
new text end
new text begin (c) new text end The deleted text begin African American Child Well-Being Advisorydeleted text end council must:
(1) review annual reports related to African American children involved in the child
welfare system. These reports may include but are not limited to the maltreatment,
out-of-home placement, and permanency of African American children;
(2) assist with and make recommendations to the commissioner for developing strategies
to reduce maltreatment determinations, prevent unnecessary out-of-home placement, promote
culturally appropriate foster care and shelter or facility placement decisions and settings for
African American children in need of out-of-home placement, ensure timely achievement
of permanency, and improve child welfare outcomes for African American children and
their families;
(3) review summary reports on targeted case reviews prepared by the commissioner to
ensure that responsible social services agencies meet the needs of African American children
and their families. Based on data collected from those reviews, the council shall assist the
commissioner with developing strategies needed to improve any identified child welfare
outcomes, including but not limited to maltreatment, out-of-home placement, and permanency
for African American children;
(4) deleted text begin assist the Cultural and Ethnic Communities Leadership Council with makingdeleted text end new text begin makenew text end
recommendations to the commissioner and the legislature for public policy and statutory
changes that specifically consider the needs of African American children and their families
involved in the child welfare system;
(5) advise the commissioner on stakeholder engagement strategies and actions that the
commissioner and responsible social services agencies may take to improve child welfare
outcomes for African American children and their families;
(6) assist the commissioner with developing strategies for public messaging and
communication related to racial disproportionality and disparities in child welfare outcomes
for African American children and their families;
(7) assist the commissioner with identifying and developing internal and external
partnerships to support adequate access to services and resources for African American
children and their families, including but not limited to housing assistance, employment
assistance, food and nutrition support, health care, child care assistance, and educational
support and training; and
(8) assist the commissioner with developing strategies to promote the development of
a culturally diverse and representative child welfare workforce in Minnesota that includes
professionals who are reflective of the community served and who have been directly
impacted by lived experiences within the child welfare system. The council must also assist
the commissioner with exploring strategies and partnerships to address education and training
needs, hiring, recruitment, retention, and professional advancement practices.
Sec. 15.
Minnesota Statutes 2024, section 260.692, is amended to read:
260.692 AFRICAN AMERICAN CHILD new text begin AND FAMILY new text end WELL-BEING UNIT.
Subdivision 1.
Duties.
The African American Child new text begin and Family new text end Well-Being Unit,
currently established by the commissioner, must:
(1) assist with the development of African American cultural competency training and
review child welfare curriculum in the Minnesota Child Welfare Training Academy to
ensure that responsible social services agency staff and other child welfare professionals
are appropriately prepared to engage with African American children and their families and
to support family preservation and reunification;
(2) provide technical assistance, including on-site technical assistance, and case
consultation to responsible social services agencies to assist agencies with implementing
and complying with the Minnesota African American Family Preservation and Child Welfare
Disproportionality Act;
(3) monitor individual county and statewide disaggregated and nondisaggregated data
to identify trends and patterns in child welfare outcomes, including but not limited to
reporting, maltreatment, out-of-home placement, and permanency of African American
children and develop strategies to address disproportionality and disparities in the child
welfare system;
(4) develop and implement a system for conducting case reviews when the commissioner
receives reports of noncompliance with the Minnesota African American Family Preservation
and Child Welfare Disproportionality Act or when requested by the parent or custodian of
an African American child. Case reviews may include but are not limited to a review of
placement prevention efforts, safety planning, case planning and service provision by the
responsible social services agency, relative placement consideration, and permanency
planning;
(5) establish and administer a request for proposals process for African American and
disproportionately represented family preservation grants under section 260.693, monitor
grant activities, and provide technical assistance to grantees;
(6) in coordination with the African American Childnew text begin and Familynew text end Well-Being Advisory
Council, coordinate services and create internal and external partnerships to support adequate
access to services and resources for African American children and their families, including
but not limited to housing assistance, employment assistance, food and nutrition support,
health care, child care assistance, and educational support and training; and
(7) develop public messaging and communication to inform the public about racial
disparities in child welfare outcomes, current efforts and strategies to reduce racial disparities,
and resources available to African American children and their families involved in the
child welfare system.
Subd. 2.
Case reviews.
(a) The African American Childnew text begin and Familynew text end Well-Being Unit
must conduct systemic case reviews to monitor targeted child welfare outcomes, including
but not limited to maltreatment, out-of-home placement, and permanency of African
American children.
(b) The reviews under this subdivision must be conducted using a random sampling of
representative child welfare cases stratified for certain case related factors, including but
not limited to case type, maltreatment type, if the case involves out-of-home placement,
and other demographic variables. In conducting the reviews, unit staff may use court records
and documents, information from the social services information system, and other available
case file information to complete the case reviews.
(c) The frequency of the reviews and the number of cases, child welfare outcomes, and
selected counties reviewed shall be determined by the unit in consultation with the African
American Childnew text begin and Familynew text end Well-Being Advisory Council, with consideration given to the
availability of unit resources needed to conduct the reviews.
(d) The unit must monitor all case reviews and use the collective case review information
and data to generate summary case review reports, ensure compliance with the Minnesota
African American Family Preservation and Child Welfare Disproportionality Act, and
identify trends or patterns in child welfare outcomes for African American children.
(e) The unit must review information from members of the public received through the
compliance and feedback portal, including policy and practice concerns related to individual
child welfare cases. After assessing a case concern, the unit may determine if further
necessary action should be taken, which may include coordinating case remediation with
other relevant child welfare agencies in accordance with data privacy laws, including the
African American Childnew text begin and Familynew text end Well-Being Advisory Council, and offering case
consultation and technical assistance to the responsible local social services agency as
needed or requested by the agency.
Subd. 3.
Reports.
(a) The African American Childnew text begin and Familynew text end Well-Being Unit must
provide regular updates on unit activities, including summary reports of case reviews, to
the African American Childnew text begin and Familynew text end Well-Being Advisory Council, and must publish
an annual census of African American children in out-of-home placements statewide. The
annual census must include data on the types of placements, age and sex of the children,
how long the children have been in out-of-home placements, and other relevant demographic
information.
(b) The African American Childnew text begin and Familynew text end Well-Being Unit shall gather summary data
about the practice and policy inquiries and individual case concerns received through the
compliance and feedback portal under subdivision 2, paragraph (e). The unit shall provide
regular reports of the nonidentifying compliance and feedback portal summary data to the
African American Childnew text begin and Familynew text end Well-Being Advisory Council to identify child welfare
trends and patterns to assist with developing policy and practice recommendations to support
eliminating disparity and disproportionality for African American children.
Sec. 16.
Minnesota Statutes 2024, section 260C.001, subdivision 2, is amended to read:
Subd. 2.
Juvenile protection proceedings.
(a) The paramount consideration in all
juvenile protection proceedings is the health, safety, and best interests of the child. In
proceedings involving an American Indian child, as defined in section 260.755, subdivision
8, the best interests of the child must be determined consistent with sections 260.751 to
260.835 and the Indian Child Welfare Act, United States Code, title 25, sections 1901 to
1923.
(b) The purpose of the laws relating to juvenile protection proceedings is:
(1) to secure for each child under the jurisdiction of the court, the care and guidance,
preferably in the child's own home, as will best serve the spiritual, emotional, mental, and
physical welfare of the child;
(2) to provide judicial procedures that protect the welfare of the child;
(3) to preserve and strengthen the child's family ties whenever possible and in the child's
best interests, removing the child from the custody of parents only when the child's welfare
or safety cannot be adequately safeguarded without removal;
(4) to ensure that when removal from the child's own family is necessary and in the
child's best interests, the responsible social services agency has legal responsibility for the
child removal either:
(i) pursuant to a voluntary placement agreement between the child's parent or guardian
or the child, when the child is over age 18, and the responsible social services agency; or
(ii) by court order pursuant to section 260C.151, subdivision 6; 260C.178; 260C.201;
260C.325; or 260C.515;
(5) to ensure that, when placement is pursuant to court order, the court order removing
the child or continuing the child in foster care contains an individualized determination that
placement is in the best interests of the child that coincides with the actual removal of the
child;
(6) to ensure that when the child is removed, the child's care and discipline is, as nearly
as possible, equivalent to that which should have been given by the parents and is either in:
(i) the home of a noncustodial parent pursuant to section 260C.178 or 260C.201,
subdivision 1, paragraph (a), clause (1);
(ii) the home of a relative pursuant to emergency placement by the responsible social
services agency under chapter 245A; or
(iii) foster care licensed under chapter 245A; and
(7) to ensure appropriate permanency planning for children in foster care including:
(i) unless reunification is not required under section 260.012, developing a permanency
plan for the child that includes a primary plan for reunification with the child's parent or
guardian and a secondary plan for an alternative, legally permanent home for the child in
the event reunification cannot be achieved in a timely manner;
(ii) identifying, locating, and assessing both parents of the child as soon as possible and
offering reunification services to both parents of the child as required under sections 260.012
and 260C.219;
new text begin
(iii) inquiring about the child's heritage, including the child's Tribal lineage pursuant to
section 260.761, and the child's race, culture, and ethnicity pursuant to section 260.63,
subdivision 10;
new text end
deleted text begin (iii)deleted text end new text begin (iv)new text end identifying, locating, and notifying relatives of both parents of the child according
to section 260C.221;
deleted text begin (iv)deleted text end new text begin (v)new text end making a placement with a family that will commit to being the legally permanent
home for the child in the event reunification cannot occur at the earliest possible time while
at the same time actively supporting the reunification plan; and
deleted text begin (v)deleted text end new text begin (vi)new text end returning the child home with supports and services, as soon as return is safe for
the child, or when safe return cannot be timely achieved, moving to finalize another legally
permanent home for the child.
Sec. 17.
Minnesota Statutes 2024, section 260C.007, subdivision 19, is amended to read:
Subd. 19.
Habitual truant.
new text begin (a) new text end "Habitual truant" means a child under the age of 17 years
who is absent from attendance at school without lawful excuse for seven school days per
school year if the child is in elementary school or for one or more class periods on seven
school days per school year if the child is in middle school, junior high school, or high
school or a child who is 17 years of age who is absent from attendance at school without
lawful excuse for one or more class periods on seven school days per school year and who
has not lawfully withdrawn from school under section 120A.22, subdivision 8.
new text begin
(b) For the purposes of educational neglect under section 260C.163, subdivision 11,
habitual truant includes a child under 12 years of age who has been absent from school for
seven school days without lawful excuse where the presumption of educational neglect is
rebutted based on a showing by clear and convincing evidence that the child's absence is
not due to the failure of the child's parent, guardian, or custodian to comply with compulsory
instruction laws.
new text end
Sec. 18.
Minnesota Statutes 2024, section 260C.150, subdivision 3, is amended to read:
Subd. 3.
Identifying parents of child; diligent efforts; data.
(a) The responsible social
services agency shall make diligent effortsnew text begin to inquire about the child's heritage, including
the child's Tribal lineage pursuant to section 260.761 and the child's race, culture, and
ethnicity pursuant to section 260.63, subdivision 10, andnew text end to identify and locate both parents
of any child who is the subject of proceedings under this chapter. Diligent efforts include:
(1) asking the custodial or known parent to identify any nonresident parent of the child
and provide information that can be used to verify the nonresident parent's identity including
the dates and locations of marriages and divorces; dates and locations of any legal
proceedings regarding paternity; date and place of the child's birth; nonresident parent's full
legal name; nonresident parent's date of birth, or if the nonresident parent's date of birth is
unknown, an approximate age; the nonresident parent's Social Security number; the
nonresident parent's whereabouts including last known whereabouts; and the whereabouts
of relatives of the nonresident parent. For purposes of this subdivision, "nonresident parent"
means a parent who does not reside in the same household as the child or did not reside in
the same household as the child at the time the child was removed when the child is in foster
care;
(2) obtaining information that will identify and locate the nonresident parent from the
county and state of Minnesota child support enforcement information system;
(3) requesting a search of the Minnesota Fathers' Adoption Registry 30 days after the
child's birth; and
(4) using any other reasonable means to identify and locate the nonresident parent.
(b) The agency may disclose data which is otherwise private under section 13.46 or
chapter 260E in order to carry out its duties under this subdivision.
(c) Upon the filing of a petition alleging the child to be in need of protection or services,
the responsible social services agency may contact a putative father who registered with
the Minnesota Fathers' Adoption Registry more than 30 days after the child's birth. The
social service agency may consider a putative father for the day-to-day care of the child
under section 260C.219 if the putative father cooperates with genetic testing and there is a
positive test result under section 257.62, subdivision 5. Nothing in this paragraph:
(1) relieves a putative father who registered with the Minnesota Fathers' Adoption
Registry more than 30 days after the child's birth of the duty to cooperate with paternity
establishment proceedings under section 260C.219;
(2) gives a putative father who registered with the Minnesota Fathers' Adoption Registry
more than 30 days after the child's birth the right to notice under section 260C.151 unless
the putative father is entitled to notice under sections 259.24 and 259.49, subdivision 1,
paragraph (a) or (b), clauses (1) to (7); or
(3) establishes a right to assert an interest in the child in a termination of parental rights
proceeding contrary to section 259.52, subdivision 6, unless the putative father is entitled
to notice under sections 259.24 and 259.49, subdivision 1, paragraph (a) or (b), clauses (1)
to (7).
Sec. 19.
Minnesota Statutes 2024, section 260C.202, subdivision 2, is amended to read:
Subd. 2.
Court review for a child placed in foster care.
(a) If the court orders a child
placed in foster care, the court shall review the out-of-home placement plan and the child's
placement at least every 90 days as required in juvenile court rules to determine whether
continued out-of-home placement is necessary and appropriate or whether the child should
be returned home.
(b) This review is not required if the court has returned the child home, ordered the child
permanently placed away from the parent under sections 260C.503 to 260C.521, or
terminated rights under section 260C.301. Court review for a child permanently placed
away from a parent, including where the child is under guardianship of the commissioner,
is governed by section 260C.607.
(c) When a child is placed in a qualified residential treatment program setting as defined
in section 260C.007, subdivision 26d, the responsible social services agency must submit
evidence to the court as specified in section 260C.712.
(d) No later than three months after the child's placement in foster care, the court shall
review agency efforts to search for and notify relatives pursuant to section 260C.221, and
order that the agency's efforts begin immediately, or continue, if the agency has failed to
perform, or has not adequately performed, the duties under that section. The court must
order the agency to continue to appropriately engage relatives who responded to the notice
under section 260C.221 in placement and case planning decisions and to consider relatives
for foster care placement consistent with section 260C.221. Notwithstanding a court's finding
that the agency has made reasonable efforts to search for and notify relatives under section
260C.221, the court may order the agency to continue making reasonable efforts to search
for, notify, engage, and consider relatives who came to the agency's attention after sending
the initial notice under section 260C.221.
(e) The court shall review the out-of-home placement plan and may modify the plan as
provided under section 260C.201, subdivisions 6 and 7.
(f) When the court transfers the custody of a child to a responsible social services agency
resulting in foster care or protective supervision with a noncustodial parent under subdivision
1, the court shall notify the parents of the provisions of sections 260C.204 and 260C.503
to 260C.521, as required under juvenile court rules.
deleted text begin
(g) When a child remains in or returns to foster care pursuant to section 260C.451 and
the court has jurisdiction pursuant to section 260C.193, subdivision 6, paragraph (c), the
court shall at least annually conduct the review required under section 260C.203.
deleted text end
Sec. 20.
Minnesota Statutes 2024, section 260C.202, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Court reviews for a child over age 18 in foster care. new text end
new text begin
When a child remains
in or returns to foster care pursuant to section 260C.451, and the court has jurisdiction
pursuant to section 260C.193, subdivision 6, paragraph (c), the court must at least annually
conduct the review required under section 260C.203.
new text end
Sec. 21.
Minnesota Statutes 2024, section 260C.204, is amended to read:
260C.204 PERMANENCY PROGRESS REVIEW FOR CHILDREN IN FOSTER
CARE FOR SIX MONTHS.
(a) When a child continues in placement out of the home of the parent or guardian from
whom the child was removed, no later than six months after the child's placement the court
shall conduct a permanency progress hearing to review:
(1) the progress of the case, the parent's progress on the case plan or out-of-home
placement plan, whichever is applicable;
(2) the agency's reasonable, or in the case of an Indian child, active efforts for
reunification and its provision of services;
(3) the agency's reasonable efforts to finalize the permanent plan for the child under
section 260.012, paragraph (e), and to make a placement as required under section 260C.212,
subdivision 2, in a home that will commit to being the legally permanent family for the
child in the event the child cannot return home according to the timelines in this section;
and
(4) in the case of an Indian child, active efforts to prevent the breakup of the Indian
family and to make a placement according to the placement preferences under United States
Code, title 25, chapter 21, section 1915.
(b) When a child is placed in a qualified residential treatment program setting as defined
in section 260C.007, subdivision 26d, the responsible social services agency must submit
evidence to the court as specified in section 260C.712.
(c) The court shall ensure that notice of the hearing is sent to any relative who:
(1) responded to the agency's notice provided under section 260C.221, indicating an
interest in participating in planning for the child or being a permanency resource for the
child and who has kept the court apprised of the relative's address; or
(2) asked to be notified of court proceedings regarding the child as is permitted in section
260C.152, subdivision 5.
(d)(1) If the parent or guardian has maintained contact with the child and is complying
with the court-ordered out-of-home placement plan, and if the child would benefit from
reunification with the parent, the court may either:
(i) return the child home, if the conditions that led to the out-of-home placement have
been sufficiently mitigated that it is safe and in the child's best interests to return home; or
(ii) continue the matter up to a total of six additional months. If the child has not returned
home by the end of the additional six months, the court must conduct a hearing according
to sections 260C.503 to 260C.521.
(2) If the court determines that the parent or guardian is not complying, is not making
progress with or engaging with services in the out-of-home placement plan, or is not
maintaining regular contact with the child as outlined in the visitation plan required as part
of the out-of-home placement plan under section 260C.212, the court may order the
responsible social services agency:
(i) to develop a plan for legally permanent placement of the child away from the parent;
(ii) to consider, identify, recruit, and support one or more permanency resources from
the child's relatives and foster parent, consistent with new text begin clause (3) and new text end section 260C.212,
subdivision 2, paragraph (a), to be the legally permanent home in the event the child cannot
be returned to the parent. Any relative or the child's foster parent may ask the court to order
the agency to consider them for permanent placement of the child in the event the child
cannot be returned to the parent. A relative or foster parent who wants to be considered
under this item shall cooperate with the background study required under section 245C.08,
if the individual has not already done so, and with the home study process required under
chapter 142B for providing child foster care and for adoption under section 259.41. The
home study referred to in this item shall be a single-home study in the form required by the
commissioner of children, youth, and families or similar study required by the individual's
state of residence when the subject of the study is not a resident of Minnesota. The court
may order the responsible social services agency to make a referral under the Interstate
Compact on the Placement of Children when necessary to obtain a home study for an
individual who wants to be considered for transfer of permanent legal and physical custody
or adoption of the child; and
(iii) to file a petition to support an order for the legally permanent placement plan.
new text begin
(3) Consistent with section 260C.223, subdivision 2, paragraph (b), the responsible social
services agency must not define a foster family as the permanent home for a child until:
new text end
new text begin
(i) inquiry and Tribal notice requirements under section 260.761, subdivisions 1 and 2,
are satisfied;
new text end
new text begin
(ii) inquiry about the child's heritage, including the child's race, culture, and ethnicity
pursuant to section 260.63, subdivision 10, has been completed; and
new text end
new text begin
(iii) the court has determined that reasonable or active efforts toward completing the
relative search requirements in section 260C.221 have been made.
new text end
(e) Following the review under this section:
(1) if the court has either returned the child home or continued the matter up to a total
of six additional months, the agency shall continue to provide services to support the child's
return home or to make reasonable efforts to achieve reunification of the child and the parent
as ordered by the court under an approved case plan;
(2) if the court orders the agency to develop a plan for the transfer of permanent legal
and physical custody of the child to a relative, a petition supporting the plan shall be filed
in juvenile court within 30 days of the hearing required under this section and a trial on the
petition held within 60 days of the filing of the pleadings; or
(3) if the court orders the agency to file a termination of parental rights, unless the county
attorney can show cause why a termination of parental rights petition should not be filed,
a petition for termination of parental rights shall be filed in juvenile court within 30 days
of the hearing required under this section and a trial on the petition held within 60 days of
the filing of the petition.
Sec. 22.
Minnesota Statutes 2024, section 260C.221, subdivision 2, is amended to read:
Subd. 2.
Relative notice requirements.
(a) The agency may provide oral or written
notice to a child's relatives. In the child's case record, the agency must document providing
the required notice to each of the child's relatives. The responsible social services agency
must notify relatives:
(1) of the need for a foster home for the child, the option to become a placement resource
for the child, the order of placement that the agency will consider under section 260C.212,
subdivision 2, paragraph (a), and the possibility of the need for a permanent placement for
the child;
(2) of their responsibility to keep the responsible social services agency and the court
informed of their current address in order to receive notice in the event that a permanent
placement is sought for the child and to receive notice of the permanency progress review
hearing under section 260C.204. A relative who fails to provide a current address to the
responsible social services agency and the court forfeits the right to receive notice of the
possibility of permanent placement and of the permanency progress review hearing under
section 260C.204, until the relative provides a current address to the responsible social
services agency and the court. A decision by a relative not to be identified as a potential
permanent placement resource or participate in planning for the child shall not affect whether
the relative is considered for placement of, or as a permanency resource for, the child with
that relative at any time in the case, and shall not be the sole basis for the court to rule out
the relative as the child's placement or permanency resource;
(3) that the relative may participate in the care and planning for the child, as specified
in subdivision 3, including that the opportunity for such participation may be lost by failing
to respond to the notice sent under this subdivision;
(4) of the family foster care licensing and adoption home study requirements, includingnew text begin :
new text end
new text begin (i)new text end how to complete an application deleted text begin anddeleted text end new text begin ;
new text end
new text begin (ii)new text end how to request a variance from licensing standards that do not present a safety or
health risk to the child in the home under section 142B.10 deleted text begin anddeleted text end new text begin ;
new text end
new text begin (iii) new text end supports that are available for relatives and children who reside in a family foster
homenew text begin , including how to access respite care, strategies for leveraging natural supports for
the child and family, and ways to include resource or substitute caregivers in the child's
case plannew text end ;new text begin and
new text end
new text begin
(iv) the relative's choice between county or private agency and services provided by that
agency under section 142B.30, depending on funding available;
new text end
(5) of the relatives' right to ask to be notified of any court proceedings regarding the
child, to attend the hearings, and of a relative's right to be heard by the court as required
under section 260C.152, subdivision 5;
(6) that regardless of the relative's response to the notice sent under this subdivision, the
agency is required to establish permanency for a child, including planning for alternative
permanency options if the agency's reunification efforts fail or are not required; deleted text begin and
deleted text end
(7) that by responding to the notice, a relative may receive information about participating
in a child's family and permanency team if the child is placed in a qualified residential
treatment program as defined in section 260C.007, subdivision 26dnew text begin ; and
new text end
new text begin (8) information advising a relative on access to legal services and supportnew text end .
(b) The responsible social services agency shall send the notice required under paragraph
(a) to relatives who become known to the responsible social services agency, except for
relatives that the agency does not contact due to safety reasons under subdivision 5, paragraph
(b). The responsible social services agency shall continue to send notice to relatives
notwithstanding a court's finding that the agency has made reasonable efforts to conduct a
relative search.
(c) The responsible social services agency is not required to send the notice under
paragraph (a) to a relative who becomes known to the agency after an adoption placement
agreement has been fully executed under section 260C.613, subdivision 1. If the relative
wishes to be considered for adoptive placement of the child, the agency shall inform the
relative of the relative's ability to file a motion for an order for adoptive placement under
section 260C.607, subdivision 6.
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 260C.223, subdivision 1, is amended to read:
Subdivision 1.
Program; goals.
(a) The commissioner of children, youth, and families
shall establish a program for concurrent permanency planning for child protection services.
(b) Concurrent permanency planning involves a planning process for children who are
placed out of the home of their parents pursuant to a court order, or who have been voluntarily
placed out of the home by the parents for 60 days or more and who are not developmentally
disabled or emotionally disabled under section 260C.212, subdivision 9. The responsible
social services agency shall develop an alternative permanency plan while making reasonable
efforts for reunification of the child with the family, if required by section 260.012. The
goals of concurrent permanency planning are to:
(1) achieve early permanency for children;
(2) decrease children's length of stay in foster care and reduce the number of moves
children experience in foster care; and
(3) deleted text begin develop a group of familiesdeleted text end new text begin establish a foster parent for a childnew text end who will work towards
reunification and also serve as new text begin a new text end permanent deleted text begin familiesdeleted text end new text begin familynew text end for children.
Sec. 24.
Minnesota Statutes 2024, section 260C.223, subdivision 2, is amended to read:
Subd. 2.
Development of guidelines and protocols.
new text begin (a) new text end The commissioner shall establish
guidelines and protocols for social services agencies involved in concurrent permanency
planning, including criteria for conducting concurrent permanency planning based on relevant
factors such as:
(1) age of the child and duration of out-of-home placement;
(2) prognosis for successful reunification with parents;
(3) availability of relatives and other concerned individuals to provide support or a
permanent placement for the child; and
(4) special needs of the child and other factors affecting the child's best interests.
new text begin (b) new text end In developing the guidelines and protocols, the commissioner shall consult with
interest groups within the child protection system, including child protection workers, child
protection advocates, county attorneys, law enforcement, community service organizations,
the councils of color, and the ombudsperson for families.
new text begin
(c) The responsible social services agency must not make a foster family the permanent
home for a child until:
new text end
new text begin
(1) inquiry and Tribal notice requirements under section 260.761, subdivisions 1 and 2,
are satisfied;
new text end
new text begin
(2) inquiry about the child's heritage, including the child's race, culture, and ethnicity
pursuant to section 260.63, subdivision 10, has been completed; and
new text end
new text begin
(3) the court has determined that reasonable or active efforts toward completing the
relative search requirements in section 260C.221 have been made.
new text end
Sec. 25.
Minnesota Statutes 2024, section 260C.331, subdivision 1, is amended to read:
Subdivision 1.
Care, examination, or treatment.
(a) Except where parental rights are
terminated,new text begin the following costs are a charge upon the welfare funds of the county in which
proceedings are held upon certification of the judge of juvenile court:
new text end
(1) whenever legal custody of a child is transferred by the court to a responsible social
services agencydeleted text begin ,deleted text end new text begin ;
new text end
(2) whenever legal custody is transferred to a person other than the responsible social
services agency, but under the supervision of the responsible social services agencydeleted text begin ,deleted text end new text begin ;new text end or
(3) whenever a child is given physical or mental examinations or treatment under order
of the court, and no provision is otherwise made by law for payment for the care,
examination, or treatment of the childdeleted text begin , these costs are a charge upon the welfare funds of
the county in which proceedings are held upon certification of the judge of juvenile courtdeleted text end .
(b) The court may order, and the responsible social services agency may require, the
parents or custodian of a child, while the child is under the age of 18, to use income and
resources attributable to the child for the period of care, examination, or treatment, except
for clothing and personal needs allowance as provided in section 256B.35, to reimburse the
county for the cost of care, examination, or treatment. Income and resources attributable to
the child include, but are not limited to, Social Security benefits, Supplemental Security
Income (SSI), veterans benefits, railroad retirement benefitsnew text begin ,new text end and child supportnew text begin for the childnew text end .
When the child is over the age of 18, and continues to receive care, examination, or treatment,
the court may order, and the responsible social services agency may require, reimbursement
from the child for the cost of care, examination, or treatment from the income and resources
attributable to the child less the clothing and personal needs allowance. Income does not
include earnings from a child over the age of 18 who is working as part of a plan under
section 260C.212, subdivision 1, paragraph (c), clause (12), to transition from foster care,
or the income and resources that are needed to complete the requirements listed in section
260C.203. The responsible social services agency shall determine whether requiring
reimbursement, either through child support or parental fees, for the cost of care, examination,
or treatment from the parents or custodian of a child is in the child's best interests. In
determining whether to require reimbursement, the responsible social services agency shall
consider:
(1) whether requiring reimbursement would compromise the parent's ability to meet the
requirements of the reunification plan;
(2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after reunification; and
(3) whether redirecting existing child support payments or changing the representative
payee of deleted text begin social securitydeleted text end new text begin federalnew text end benefits to the responsible social services agency would
limit the parent's ability to maintain financial stability for the child.
(c) If the income and resources attributable to the child are not enough to reimburse the
county for the full cost of the care, examination, or treatment, the court may inquire into
the ability of the parents to reimburse the county for the cost of care, examination, or
treatment and, after giving the parents a reasonable opportunity to be heard, the court may
order, and the responsible social services agency may require, the parents to contribute to
the cost of care, examination, or treatment of the child. When determining the amount to
be contributed by the parents, the court shall use a fee schedule based upon ability to pay
that is established by the responsible social services agency and approved by the
commissioner of children, youth, and families. The income of a stepparent who has not
adopted a child shall be excluded in calculating the parental contribution under this section.
In determining whether to require reimbursement, the responsible social services agency
shall consider:
(1) whether requiring reimbursement would compromise the parent's ability to meet the
requirements of the reunification plan;
(2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after reunification; and
(3) whether requiring reimbursement would compromise the parent's ability to meet the
needs of the family.
(d) If the responsible social services agency determines that reimbursement is in the
child's best interests, the court shall order the amount of reimbursement attributable to the
parents or custodian, or attributable to the child, or attributable to both sources, withheld
under chapter 518A from the income of the parents or the custodian of the child. A parent
or custodian who fails to pay without good reason may be proceeded against for contempt,
or the court may inform the county attorney, who shall proceed to collect the unpaid sums,
or both procedures may be used.
(e) If the court orders a physical or mental examination for a child, the examination is
a medically necessary service for purposes of determining whether the service is covered
by a health insurance policy, health maintenance contract, or other health coverage plan.
Court-ordered treatment shall be subject to policy, contract, or plan requirements for medical
necessity. Nothing in this paragraph changes or eliminates benefit limits, conditions of
coverage, co-payments or deductibles, provider restrictions, or other requirements in the
policy, contract, or plan that relate to coverage of other medically necessary services.
(f) Notwithstanding paragraph (b), (c), or (d), a parent, custodian, or guardian of the
child is not required to use income and resources attributable to the child to reimburse the
county for costs of care and is not required to contribute to the cost of care of the child
during any period of time when the child is returned to the home of that parent, custodian,
or guardian pursuant to a trial home visit under section 260C.201, subdivision 1, paragraph
(a).
new text begin
(g) The responsible social services agency may only apply to be the representative payee
for the child's federal benefits under paragraph (b) when the court has ordered the agency
to develop a plan for the transfer of permanent legal and physical custody of the child to a
relative or to file a termination of parental rights petition under section 260C.204, paragraph
(e), clause (2) or (3); ordered the child permanently placed away from the parent under
sections 260C.503 to 260C.521; or approved the continued voluntary foster care placement
for the child under section 260D.07.
new text end
Sec. 26.
Minnesota Statutes 2024, section 260C.452, subdivision 4, is amended to read:
Subd. 4.
Administrative or court review of placements.
(a) When the youth is 14 years
of age or older, the court, in consultation with the youth, shall review the youth's independent
living plan according to section 260C.203, paragraph (d).
(b) The responsible social services agency shall file a copy of the notification of foster
care benefits for a youth who is 18 years of age or older according to section 260C.451,
subdivision 1, with the court. If the responsible social services agency does not file the
notice by the time the youth is 17-1/2 years of age, the court shall require the responsible
social services agency to file the notice.
(c) When a youth is 18 years of age or older, the court shall ensure that the responsible
social services agency assists the youth in obtaining the following documents before the
youth leaves foster care: a Social Security card; an official or certified copy of the youth's
birth certificate; a state identification card or driver's license, Tribal enrollment identification
card, deleted text begin greendeleted text end new text begin permanent residentnew text end card, or school visa; health insurance information; the youth's
school, medical, and dental records; a contact list of the youth's medical, dental, and mental
health providers; and contact information for the youth's siblings, if the siblings are in foster
care.
(d) For a youth who will be discharged from foster care at 18 years of age or older
because the youth is not eligible for extended foster care benefits or chooses to leave foster
care, the responsible social services agency must develop a personalized transition plan as
directed by the youth during the 180-day period immediately prior to the expected date of
discharge. The transition plan must be as detailed as the youth elects and include specific
options, including but not limited to:
(1) affordable housing with necessary supports that does not include a homeless shelter;
(2) health insurance, including eligibility for medical assistance as defined in section
256B.055, subdivision 17;
(3) education, including application to the Education and Training Voucher Program;
(4) local opportunities for mentors and continuing support services;
(5) workforce supports and employment services;
(6) a copy of the youth's consumer credit report as defined in section 13C.001 and
assistance in interpreting and resolving any inaccuracies in the report, at no cost to the youth;
(7) information on executing a health care directive under chapter 145C and on the
importance of designating another individual to make health care decisions on behalf of the
youth if the youth becomes unable to participate in decisions;
(8) appropriate contact information through 21 years of age if the youth needs information
or help dealing with a crisis situation; and
(9) official documentation that the youth was previously in foster care.
Sec. 27.
Minnesota Statutes 2024, section 260E.03, subdivision 15, is amended to read:
Subd. 15.
Neglect.
(a) "Neglect" means the commission or omission of any of the acts
specified under clauses (1) to (8), other than by accidental means:
(1) failure by a person responsible for a child's care to supply a child with necessary
food, clothing, shelter, health, medical, or other care required for the child's physical or
mental health when reasonably able to do so;
(2) failure to protect a child from conditions or actions that seriously endanger the child's
physical or mental health when reasonably able to do so, including a growth delay, which
may be referred to as a failure to thrive, that has been diagnosed by a physician and is due
to parental neglect;
(3) failure to provide for necessary supervision or child care arrangements appropriate
for a child after considering factors as the child's age, mental ability, physical condition,
length of absence, or environment, when the child is unable to care for the child's own basic
needs or safety, or the basic needs or safety of another child in their care;
(4) failure to ensure that the child is educated as defined in sections 120A.22 and
260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
child with sympathomimetic medications, consistent with section 125A.091, subdivision
5;
(5) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision
2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in
the child at birth, results of a toxicology test performed on the mother at delivery or the
child at birth, medical effects or developmental delays during the child's first year of life
that medically indicate prenatal exposure to a controlled substance, or the presence of a
fetal alcohol spectrum disorder;
(6) medical neglect, as defined in section 260C.007, subdivision 6, clause (5);
(7) chronic and severe use of alcohol or a controlled substance by a person responsible
for the child's care that adversely affects the child's basic needs and safety; or
(8) emotional harm from a pattern of behavior that contributes to impaired emotional
functioning of the child which may be demonstrated by a substantial and observable effect
in the child's behavior, emotional response, or cognition that is not within the normal range
for the child's age and stage of development, with due regard to the child's culture.
(b) Nothing in this chapter shall be construed to mean that a child is neglected solely
because the child's parent, guardian, or other person responsible for the child's care in good
faith selects and depends upon spiritual means or prayer for treatment or care of disease or
remedial care of the child in lieu of medical care.
(c) This chapter does not impose upon persons not otherwise legally responsible for
providing a child with necessary food, clothing, shelter, education, or medical care a duty
to provide that care.
new text begin
(d) Nothing in this chapter shall be construed to mean that a child who has a mental,
physical, or emotional condition is neglected solely because the child remains in an
emergency department or hospital setting because services, including residential treatment,
that are deemed necessary by the child's medical or mental health care professional or county
case manager are not available to the child's parent, guardian, or other person responsible
for the child's care, and the child cannot be safely discharged to the child's family.
new text end
Sec. 28.
Minnesota Statutes 2024, section 260E.09, is amended to read:
260E.09 REPORTING REQUIREMENTS.
(a) An oral report shall be made immediately by telephone or otherwise. An oral report
made by a person required under section 260E.06, subdivision 1, to report shall be followed
within 72 hours, exclusive of weekends and holidays, by a report in writing to the appropriate
police department, the county sheriff, the agency responsible for assessing or investigating
the report, or the local welfare agency.
(b) Any report shall be of sufficient content to identify the child, any person believed
to be responsible for the maltreatment of the child if the person is known, the nature and
extent of the maltreatment, and the name and address of the reporter. The local welfare
agency or agency responsible for assessing or investigating the report shall accept a report
made under section 260E.06 notwithstanding refusal by a reporter to provide the reporter's
name or address as long as the report is otherwise sufficient under this paragraph.new text begin The local
welfare agency or agency responsible for assessing or investigating the report shall ask the
reporter if the reporter is aware of the child's heritage, including the child's Tribal lineage
pursuant to section 260.761 and the child's race, culture, and ethnicity pursuant to section
260.63, subdivision 10.
new text end
(c) Notwithstanding paragraph (a), upon implementation of the provider licensing and
reporting hub, an individual who has an account with the provider licensing and reporting
hub and is required to report suspected maltreatment at a licensed program under section
260E.06, subdivision 1, may submit a written report in the hub in a manner prescribed by
the commissioner and is not required to make an oral report. A report submitted through
the provider licensing and reporting hub must be made immediately.
Sec. 29.
Minnesota Statutes 2024, section 260E.20, subdivision 1, is amended to read:
Subdivision 1.
General duties.
(a) The local welfare agency shall offer services to
prevent future maltreatment, safeguarding and enhancing the welfare of the maltreated child,
and supporting and preserving family life whenever possible.
(b) If the report alleges a violation of a criminal statute involving maltreatment or child
endangerment under section 609.378, the local law enforcement agency and local welfare
agency shall coordinate the planning and execution of their respective investigation and
assessment efforts to avoid a duplication of fact-finding efforts and multiple interviews.
Each agency shall prepare a separate report of the results of the agency's investigation or
assessment.
(c) In cases of alleged child maltreatment resulting in death, the local agency may rely
on the fact-finding efforts of a law enforcement investigation to make a determination of
whether or not maltreatment occurred.
(d) When necessary, the local welfare agency shall seek authority to remove the child
from the custody of a parent, guardian, or adult with whom the child is living.
(e) In performing any of these duties, the local welfare agency shall maintain an
appropriate record.
(f) In conducting a family assessmentnew text begin , noncaregiver human trafficking assessment,new text end or
investigation, the local welfare agency shall gather information on the existence of substance
abuse and domestic violence.
(g) If the family assessmentnew text begin , noncaregiver human trafficking assessment,new text end or investigation
indicates there is a potential for abuse of alcohol or other drugs by the parent, guardian, or
person responsible for the child's care, the local welfare agency must coordinate a
comprehensive assessment pursuant to section 245G.05.
(h) The agency may use either a family assessment or investigation to determine whether
the child is safe when responding to a report resulting from birth match data under section
260E.03, subdivision 23, paragraph (c). If the child subject of birth match data is determined
to be safe, the agency shall consult with the county attorney to determine the appropriateness
of filing a petition alleging the child is in need of protection or services under section
260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is
determined not to be safe, the agency and the county attorney shall take appropriate action
as required under section 260C.503, subdivision 2.
new text begin
(i) When conducting any family assessment, noncaregiver human trafficking assessment,
or investigation, the agency shall ask the child, if age appropriate; parents; extended family;
and reporter about the child's heritage, including the child's Tribal lineage pursuant to section
260.761 and the child's race, culture, and ethnicity pursuant to section 260.63, subdivision
10.
new text end
Sec. 30.
Minnesota Statutes 2024, section 260E.24, subdivision 1, is amended to read:
Subdivision 1.
Timing.
The local welfare agency shall conclude the family assessmentnew text begin ,
the noncaregiver human trafficking assessment,new text end or the investigation within 45 days of the
receipt of a report. The conclusion of the assessment or investigation may be extended to
permit the completion of a criminal investigation or the receipt of expert information
requested within 45 days of the receipt of the report.
Sec. 31.
Minnesota Statutes 2024, section 260E.24, subdivision 2, is amended to read:
Subd. 2.
Determination after family assessment or a noncaregiver human trafficking
assessment.
After conducting a family assessment or a noncaregiver human trafficking
assessment, the local welfare agency shall determine whether child protective services are
needed to address the safety of the child and other family members and the risk of subsequent
maltreatment. The local welfare agency must document the information collected under
section 260E.20, subdivision 3, related to the completed family assessmentnew text begin or noncaregiver
human trafficking assessmentnew text end in the child's or family's case notes.
Sec. 32.
new text begin
[260E.291] REPORTING OF SCHOOL ATTENDANCE CONCERNS.
new text end
new text begin Subdivision 1. new text end
new text begin Reports required. new text end
new text begin
(a) A person mandated to report under this chapter
must immediately report to the local welfare agency, Tribal social services agency, or
designated partner if the person knows or has reason to believe that a child required to be
enrolled in school under section 120A.22 has at least seven unexcused absences in the
current school year and is at risk of educational neglect under section 260C.163, subdivision
11.
new text end
new text begin
(b) Any person may voluntarily report to the local welfare agency, Tribal social services
agency, or designated partner if the person knows or has reason to believe that a child
required to be enrolled in school under section 120A.22 has at least seven unexcused absences
in the current school year and is at risk of educational neglect under section 260C.163,
subdivision 11.
new text end
new text begin
(c) An oral report must be made immediately by telephone or otherwise. An oral report
made by a person required to report under paragraph (a) must be followed within 72 hours,
exclusive of weekends and holidays, by a report in writing to the local welfare agency. A
report must sufficiently identify the child and the child's parent or guardian, the actual or
estimated number of the child's unexcused absences in the current school year, the efforts
made by school officials to resolve attendance concerns with the family, and the name and
address of the reporter. A voluntary reporter under paragraph (b) may refuse to provide
their name or address if the report is otherwise sufficient, and such a report must be accepted
by the local welfare agency.
new text end
new text begin Subd. 2. new text end
new text begin Local welfare agency. new text end
new text begin
(a) The local welfare agency or partner designated to
provide child welfare services must provide a child welfare response for a report that alleges
a child enrolled in school has seven or more unexcused absences. When providing a child
welfare response under this paragraph, the local welfare agency or designated partner must
offer services to the child and the child's family to address school attendance concerns or
may partner with a county attorney's office, a community-based organization, or other
community partner to provide the services. The services must be culturally and linguistically
appropriate and tailored to the needs of the child and the child's family. This section is
subject to all requirements of the Minnesota Indian Family Preservation Act under sections
260.751 to 260.835, and the Minnesota African American Family Preservation and Child
Welfare Disproportionality Act under sections 260.61 to 260.693.
new text end
new text begin
(b) If the child's unexcused absences continue and the family has not engaged with
services under paragraph (a) after the local welfare agency, Tribal social services agency,
or partner designated to provide child welfare services has made multiple varied attempts
to engage the child's family, a report of educational neglect must be made regardless of the
number of unexcused absences the child has accrued. The local welfare agency must
determine the response path assignment pursuant to section 260E.17 and may proceed with
the process outlined in section 260C.141.
new text end
Sec. 33. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall change paragraphs to subdivisions, clauses to paragraphs,
and items to clauses in Minnesota Statutes, sections 260C.203 and 260C.204. The revisor
shall make any necessary grammatical changes or changes to sentence structure necessary
to preserve the meaning of the text as a result of the changes. The revisor of statutes must
correct any statutory cross-references consistent with the changes in this section.
new text end
ARTICLE 19
EARLY CARE AND LEARNING
Section 1.
Minnesota Statutes 2024, section 142A.76, subdivision 2, is amended to read:
Subd. 2.
Establishment.
The Office of Restorative Practices is established within the
Department of deleted text begin Public Safetydeleted text end new text begin Children, Youth, and Familiesnew text end . The Office of Restorative
Practices shall have the powers and duties described in this section.
Sec. 2.
Minnesota Statutes 2024, section 142A.76, subdivision 3, is amended to read:
Subd. 3.
Director; other staff.
(a) The commissioner of deleted text begin public safetydeleted text end new text begin children, youth,
and familiesnew text end shall appoint a director of the Office of Restorative Practices. The director
should have qualifications that include or are similar to the following:
(1) experience in the many facets of restorative justice and practices such as peacemaking
circles, sentencing circles, community conferencing, community panels, and family group
decision making;
(2) experience in victim-centered and trauma-informed practices;
(3) knowledge of the range of social problems that bring children and families to points
of crisis such as poverty, racism, unemployment, and unequal opportunity;
(4) knowledge of the many ways youth become involved in other systems such as truancy,
juvenile delinquency, and child protection; and
(5) understanding of educational barriers.
(b) The director shall hire additional staff to perform the duties of the Office of
Restorative Practices. The staff shall be in the classified service of the state and their
compensation shall be established pursuant to chapter 43A.
Sec. 3.
Minnesota Statutes 2024, section 142B.16, 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 Children, Youth, and Families 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.
new text begin (b) new text end 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.
deleted text begin (b)deleted text end new text begin (c)new text end 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:
(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
(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.
new text begin
(d) The commissioner must not publicly post the correction order for licensed child care
centers or licensed family child care providers on the department's website until:
new text end
new text begin
(1) after the 20-calendar-day period for requesting reconsideration; or
new text end
new text begin
(2) if the applicant or license holder requested reconsideration, after the commissioner's
disposition of a request for reconsideration is provided to the applicant or license holder.
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 children, youth, and families must notify the revisor
of statutes when federal approval is obtained.
new text end
Sec. 4.
new text begin
[142B.181] POSTING LICENSING ACTIONS ON DEPARTMENT
WEBSITE.
new text end
new text begin
(a) The commissioner must post a summary document for each licensing action issued
to a licensed child care center and family child care provider on the Licensing Information
Lookup public website maintained by the Department of Children, Youth, and Families.
The commissioner must not post any communication, including letters, from the
commissioner to the center or provider.
new text end
new text begin
(b) The commissioner must remove a summary document from the Licensing Information
Lookup public website within ten days of the length of time that the document is required
to be posted under Code of Federal Regulations, title 45, section 98.33.
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 children, youth, and families must notify the revisor
of statutes when federal approval is obtained.
new text end
Sec. 5.
Minnesota Statutes 2024, section 142D.31, subdivision 2, is amended to read:
Subd. 2.
Program components.
(a) The nonprofit organization must use the grant for:
(1) tuition scholarships deleted text begin up to $10,000 per yeardeleted text end new text begin in amounts per year consistent with the
national TEACH early childhood program requirementsnew text end for courses leading to the nationally
recognized child development associate credential or college-level courses leading to an
associate's degree or bachelor's degree in early childhood development and school-age care;
and
(2) education incentives of a minimum of $250 to participants in the tuition scholarship
program if they complete a year of working in the early care and education field.
(b) Applicants for the scholarship must be employed by a licensed new text begin or certified new text end early
childhood or child care program and working directly with children, a licensed family child
care provider, employed by a public prekindergarten program, new text begin employed by a Head Start
program, new text end or an employee in a school-age program exempt from licensing under section
142B.05, subdivision 2, paragraph (a), clause (8). Lower wage earners must be given priority
in awarding the tuition scholarships. Scholarship recipients must contribute at least ten
percent of the total scholarship and must be sponsored by their employers, who must also
contribute at least five percent of the total scholarship. Scholarship recipients who deleted text begin are
self-employeddeleted text end new text begin work in licensed family child care under Minnesota Rules, chapter 9502,new text end
must contribute deleted text begin 20deleted text end new text begin at least tennew text end percent of the total scholarshipnew text begin and are not required to receive
employer sponsorship or employer matchnew text end .
Sec. 6.
Minnesota Statutes 2024, section 142E.03, subdivision 3, is amended to read:
Subd. 3.
Redeterminations.
(a) Notwithstanding Minnesota Rules, part 3400.0180, item
A, the county shall conduct a redetermination according to paragraphs (b) and (c).
(b) The county shall use the redetermination form developed by the commissioner. The
county must verify the factors listed in subdivision 1, paragraph (a), as part of the
redetermination.
(c) An applicant's eligibility must be redetermined no more frequently than every 12
months. The following criteria apply:
(1) a family meets the eligibility redetermination requirements if a complete
redetermination form and all required verifications are received within 30 days after the
date the form was due;
(2) if the 30th day after the date the form was due falls on a Saturday, Sunday, or holiday,
the 30-day time period is extended to include the next day that is not a Saturday, Sunday,
or holiday. Assistance shall be payable retroactively from the redetermination due date;
(3) for a family where at least one parent is younger than 21 years of age, does not have
a high school degree or commissioner of education-selected high school equivalency
certification, and is a student in a school district or another similar program that provides
or arranges for child care, parenting, social services, career and employment supports, and
academic support to achieve high school graduation, the redetermination of eligibility may
be deferred beyond 12 months, to the end of the student's school year; deleted text begin and
deleted text end
new text begin
(4) starting May 25, 2026, if a new eligible child is added to the family and has care
authorized, the redetermination of eligibility must be extended 12 months from the eligible
child's arrival date; and
new text end
deleted text begin (4)deleted text end new text begin (5)new text end a family and the family's providers must be notified that the family's
redetermination is due at least 45 days before the end of the family's 12-month eligibility
period.
Sec. 7.
Minnesota Statutes 2024, section 142E.11, subdivision 1, is amended to read:
Subdivision 1.
General authorization requirements.
(a) When authorizing the amount
of child care, the county agency must consider the amount of time the parent reports on the
application or redetermination form that the child attends preschool, a Head Start program,
or school while the parent is participating in an authorized activity.
(b) Care must be authorized and scheduled with a provider based on the applicant's or
participant's verified activity schedule when:
(1) the family requests care from more than one provider per child;
(2) the family requests care from a legal nonlicensed provider; or
(3) an applicant or participant is employed by any child care center that is licensed by
the Department of Children, Youth, and Families or has been identified as a high-risk
Medicaid-enrolled provider.
new text begin
This paragraph expires March 2, 2026.
new text end
(c) If the family remains eligible at redetermination, a new authorization with fewer
hours, the same hours, or increased hours may be determined.
Sec. 8.
Minnesota Statutes 2024, section 142E.11, subdivision 2, is amended to read:
Subd. 2.
Maintain steady child care authorizations.
(a) Notwithstanding Minnesota
Rules, chapter 3400, the amount of child care authorized under section 142E.12 for
employment, education, or an MFIP employment plan shall continue at the same number
of hours or more hours until redetermination, including:
(1) when the other parent moves in and is employed or has an education plan under
section 142E.12, subdivision 3, or has an MFIP employment plan; or
(2) when the participant's work hours are reduced or a participant temporarily stops
working or attending an approved education program. Temporary changes include, but are
not limited to, a medical leave, seasonal employment fluctuations, or a school break between
semesters.
(b) The county may increase the amount of child care authorized at any time if the
participant verifies the need for increased hours for authorized activities.
(c) The county may reduce the amount of child care authorized if a parent requests a
reduction or because of a change in:
(1) the child's school schedule;
(2) the custody schedule; or
(3) the provider's availability.
(d) The amount of child care authorized for a family subject to subdivision 1, paragraph
(b), must change when the participant's activity schedule changes. Paragraph (a) does not
apply to a family subject to subdivision 1, paragraph (b).new text begin This paragraph expires March 2,
2026.
new text end
(e) When a child reaches 13 years of age or a child with a disability reaches 15 years of
age, the amount of child care authorized shall continue at the same number of hours or more
hours until redetermination.
Sec. 9.
Minnesota Statutes 2024, section 142E.13, subdivision 2, is amended to read:
Subd. 2.
Extended eligibility and redetermination.
(a) If the family received three
months of extended eligibility and redetermination is not due, to continue receiving child
care assistance the participant must be employed or have an education plan that meets the
requirements of section 142E.12, subdivision 3, or have an MFIP employment plan.
new text begin Notwithstanding Minnesota Rules, part 3400.0110, new text end if child care assistance continues, the
amount of child care authorized shall continue at the same number or more hours until
redetermination, unless a condition in section 142E.11, subdivision 2, paragraph (c), applies.
deleted text begin A family subject to section 142E.11, subdivision 1, paragraph (b), shall have child care
authorized based on a verified activity schedule.
deleted text end
(b) If the family's redetermination occurs before the end of the three-month extended
eligibility period to continue receiving child care assistance, the participant must verify that
the participant meets eligibility and activity requirements for child care assistance under
this chapter. new text begin Notwithstanding Minnesota Rules, part 3400.0010,new text end if child care assistance
continues, the amount of child care authorized is based on section 142E.12. deleted text begin A family subject
to section 142E.11, subdivision 1, paragraph (b), shall have child care authorized based on
a verified activity schedule.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective May 25, 2026.
new text end
Sec. 10.
Minnesota Statutes 2024, section 142E.15, subdivision 1, is amended to read:
Subdivision 1.
Fee schedule.
All changes to parent fees must be implemented on the
first Monday of the service period following the effective date of the change.
PARENT FEE SCHEDULE. The parent fee schedule is as follows, except as noted in
subdivision 2:
| Income Range (as a percent of the state median income, except at the start of the first tier) |
Co-payment (as a percentage of adjusted gross income) |
| deleted text begin 0-74.99%deleted text end new text begin 0-99.99%new text end of federal poverty guidelines |
$0/biweekly |
|
deleted text begin
75.00-99.99% of federal poverty guidelines deleted text end |
deleted text begin
$2/biweekly deleted text end |
| 100.00% of federal poverty guidelines-deleted text begin 27.72%deleted text end new text begin 27.99% new text end |
deleted text begin
2.61%
deleted text end
new text begin
2.6% new text end |
|
deleted text begin
27.73-29.04% deleted text end |
deleted text begin
2.61% deleted text end |
|
deleted text begin
29.05-30.36% deleted text end |
deleted text begin
2.61% deleted text end |
|
deleted text begin
30.37-31.68% deleted text end |
deleted text begin
2.61% deleted text end |
|
deleted text begin
31.69-33.00% deleted text end |
deleted text begin
2.91% deleted text end |
|
deleted text begin
33.01-34.32% deleted text end |
deleted text begin
2.91% deleted text end |
|
deleted text begin
34.33-35.65% deleted text end |
deleted text begin
2.91% deleted text end |
|
deleted text begin
35.66-36.96% deleted text end |
deleted text begin
2.91% deleted text end |
|
deleted text begin
36.97-38.29% deleted text end |
deleted text begin
3.21% deleted text end |
|
deleted text begin
38.30-39.61% deleted text end |
deleted text begin
3.21% deleted text end |
|
deleted text begin
39.62-40.93% deleted text end |
deleted text begin
3.21% deleted text end |
|
deleted text begin
40.94-42.25% deleted text end |
deleted text begin
3.84% deleted text end |
|
deleted text begin
42.26-43.57% deleted text end |
deleted text begin
3.84% deleted text end |
|
deleted text begin
43.58-44.89% deleted text end |
deleted text begin
4.46% deleted text end |
|
deleted text begin
44.90-46.21% deleted text end |
deleted text begin
4.76% deleted text end |
|
deleted text begin
46.22-47.53% deleted text end |
deleted text begin
5.05% deleted text end |
|
deleted text begin
47.54-48.85% deleted text end |
deleted text begin
5.65% deleted text end |
|
deleted text begin
48.86-50.17% deleted text end |
deleted text begin
5.95% deleted text end |
|
deleted text begin
50.18-51.49% deleted text end |
deleted text begin
6.24% deleted text end |
|
deleted text begin
51.50-52.81% deleted text end |
deleted text begin
6.84% deleted text end |
|
deleted text begin
52.82-54.13% deleted text end |
deleted text begin
7.58% deleted text end |
|
deleted text begin
54.14-55.45% deleted text end |
deleted text begin
8.33% deleted text end |
|
deleted text begin
55.46-56.77% deleted text end |
deleted text begin
9.20% deleted text end |
|
deleted text begin
56.78-58.09% deleted text end |
deleted text begin
10.07% deleted text end |
|
deleted text begin
58.10-59.41% deleted text end |
deleted text begin
10.94% deleted text end |
|
deleted text begin
59.42-60.73% deleted text end |
deleted text begin
11.55% deleted text end |
|
deleted text begin
60.74-62.06% deleted text end |
deleted text begin
12.16% deleted text end |
|
deleted text begin
62.07-63.38% deleted text end |
deleted text begin
12.77% deleted text end |
|
deleted text begin
63.39-64.70% deleted text end |
deleted text begin
13.38% deleted text end |
|
deleted text begin
64.71-67.00% deleted text end |
deleted text begin
14.00% deleted text end |
|
new text begin
28.00-30.99% new text end |
new text begin
2.6% new text end |
|
new text begin
31.00-33.99% new text end |
new text begin
2.6% new text end |
|
new text begin
34.00-36.99% new text end |
new text begin
2.9% new text end |
|
new text begin
37.00-39.99% new text end |
new text begin
3.2% new text end |
|
new text begin
40.00-42.99% new text end |
new text begin
3.8% new text end |
|
new text begin
43.00-45.99% new text end |
new text begin
4.4% new text end |
|
new text begin
46.00-48.99% new text end |
new text begin
5.0% new text end |
|
new text begin
49.00-51.99% new text end |
new text begin
5.6% new text end |
|
new text begin
52.00-54.99% new text end |
new text begin
6.2% new text end |
|
new text begin
55.00-57.99% new text end |
new text begin
6.8% new text end |
|
new text begin
58.00-60.99% new text end |
new text begin
6.9% new text end |
|
new text begin
61.00-63.99% new text end |
new text begin
6.9% new text end |
|
new text begin
64.00-67.00% new text end |
new text begin
6.9% new text end |
| Greater than 67.00% |
ineligible |
A family's biweekly co-payment fee is the fixed percentage established for the income
range multiplied by the deleted text begin highestdeleted text end new text begin lowestnew text end possible income within that income range.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 13, 2025.
new text end
Sec. 11.
Minnesota Statutes 2024, section 142E.16, subdivision 3, is amended to read:
Subd. 3.
Training required.
(a) Prior to initial authorization as required in subdivision
1, a legal nonlicensed family child care provider must complete first aid and CPR training
and provide the verification of first aid and CPR training to the commissioner. The training
documentation must have valid effective dates as of the date the registration request is
submitted to the commissioner. The training must have been provided by an individual
approved to provide first aid and CPR instruction and have included CPR techniques for
infants and children.
(b) Upon each reauthorization after the authorization period when the initial first aid
and CPR training requirements are met, a legal nonlicensed family child care provider must
provide verification of at least eight hours of additional training listed in the Minnesota
Center for Professional Development Registry.
new text begin
(c) Every 12 months, a legal nonlicensed family child care provider who is unrelated to
the child they care for must complete two hours of training in caring for children approved
by the commissioner.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end This subdivision only applies to legal nonlicensed family child care providers.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2025.
new text end
Sec. 12.
Minnesota Statutes 2024, section 142E.16, subdivision 7, is amended to read:
Subd. 7.
Record-keeping requirement.
(a) As a condition of payment, all providers
receiving child care assistance payments must:
(1) keep accurate and legible daily attendance records at the site where services are
delivered for children receiving child care assistance; deleted text begin and
deleted text end
(2) make those records available immediately to the county or the commissioner upon
request. Any records not provided to a county or the commissioner at the date and time of
the request are deemed inadmissible if offered as evidence by the provider in any proceeding
to contest an overpayment or disqualification of the providerdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) submit data on child enrollment and attendance in the form and manner specified by
the commissioner.
new text end
(b) As a condition of payment, attendance records must be completed daily and include
the date, the first and last name of each child in attendance, and the times when each child
is dropped off and picked up. To the extent possible, the times that the child was dropped
off to and picked up from the child care provider must be entered by the person dropping
off or picking up the child. The daily attendance records must be retained at the site where
services are delivered for six years after the date of service.
(c) When the county or the commissioner knows or has reason to believe that a current
or former provider has not complied with the record-keeping requirement in this subdivision:
(1) the commissioner may:
(i) deny or revoke a provider's authorization to receive child care assistance payments
under section 142E.17, subdivision 9, paragraph (d);
(ii) pursue an administrative disqualification under sections 142E.51, subdivision 5, and
256.98; or
(iii) take an action against the provider under deleted text begin sections 142E.50 to 142E.58deleted text end new text begin section
142E.51new text end ; or
(2) a county or the commissioner may establish an attendance record overpayment under
paragraph (d).
(d) To calculate an attendance record overpayment under this subdivision, the
commissioner or county agency shall subtract the maximum daily rate from the total amount
paid to a provider for each day that a child's attendance record is missing, unavailable,
incomplete, inaccurate, or otherwise inadequate.
(e) The commissioner shall develop criteria for a county to determine an attendance
record overpayment under this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective June 22, 2026.
new text end
Sec. 13.
Minnesota Statutes 2024, section 245.0962, subdivision 1, is amended to read:
Subdivision 1.
Establishment.
The commissioner of deleted text begin human servicesdeleted text end new text begin children, youth,
and familiesnew text end must establish a quality parenting initiative grant program to implement quality
parenting initiative principles and practices to support children and families experiencing
foster care placements.
Sec. 14.
Minnesota Statutes 2024, section 245.975, subdivision 1, is amended to read:
Subdivision 1.
new text begin Creation and new text end appointment.
new text begin The Office of the Ombudsperson for Family
Child Care Providers is hereby created. new text end The governor shall appoint an ombudsperson in the
unclassified service to assist family child care providers with licensing, compliance, and
other issues facing family child care providers. The ombudsperson must be selected without
regard to the person's political affiliation and must have been a licensed family child care
provider for at least three years. The ombudsperson shall serve a term of four years, which
may be renewed, and may be removed prior to the end of the term for just cause.
Sec. 15.
Laws 2021, First Special Session chapter 7, article 2, section 81, is amended to
read:
Sec. 81. FAMILY CHILD CARE REGULATION MODERNIZATION.
(a) The commissioner of deleted text begin human services shalldeleted text end new text begin children, youth, and families mustnew text end contract
with an experienced and independent organization or individual consultant to conduct the
work outlined in this section. If practicable, the commissioner must contract with the National
Association for Regulatory Administration.
(b) The consultant must develop a proposal for updated family child care licensing
standards and solicit input from stakeholders as described in paragraph (d).new text begin The proposed
new standards must protect the health and safety of children in family child care programs
and be child centered, family friendly, and fair to providers.
new text end
(c) The consultant must new text begin work with stakeholders and the Department of Children, Youth,
and Families, as described in paragraph (d), to new text end develop a proposal for a risk-based model
for monitoring compliance with family child care licensing standardsdeleted text begin , grounded in national
regulatory best practicesdeleted text end . Violations in the new model must be weighted to reflect the
potential risk they pose to children's health and safety, and licensing sanctions must be tied
to the potential risk. deleted text begin The proposed new model must protect the health and safety of children
in family child care programs and be child-centered, family-friendly, and fair to providers.
deleted text end
(d) The consultant deleted text begin shalldeleted text end new text begin mustnew text end develop and implement a stakeholder engagement process
that solicits input from parents, licensed family child care providers, county licensors, staff
of the Department of deleted text begin Human Servicesdeleted text end new text begin Children, Youth, and Familiesnew text end , and experts in child
development about licensing standards, tiers for violations of the standards based on the
potential risk of harm that each violation poses, and licensing sanctions for each tier.new text begin The
consultant and commissioner must engage with working groups of licensed family child
care providers at least five times throughout the stakeholder engagement process, and include
both daytime and evening engagement opportunities as needed.
new text end
(e) The consultant shall solicit input from parents, licensed family child care providers,
county licensors, and staff of the Department of deleted text begin Human Servicesdeleted text end new text begin Children, Youth, and
Familiesnew text end about which family child care providers should be eligible for abbreviated
inspections that predict compliance with other licensing standards for licensed family child
care providers using key indicators previously identified by an empirically based statistical
methodology developed by the National Association for Regulatory Administration and the
Research Institute for Key Indicators.
(f) No later than deleted text begin Februarydeleted text end new text begin Decembernew text end 1, deleted text begin 2024deleted text end new text begin 2025new text end , the commissioner deleted text begin shalldeleted text end new text begin mustnew text end submit
a report and proposed legislation required to implement the new licensing model and the
new licensing standards to the chairs and ranking minority members of the legislative
committees with jurisdiction over child care regulation. new text begin Throughout the drafting of the
report and proposed legislation required under this paragraph, the commissioner must engage
providers whose primary language is not English to have those providers review translated
drafts of the report and written materials provided at engagement sessions to provide feedback
on the draft standards. This engagement must occur within focus groups or meetings that
are held at convenient times for the providers, including both daytime and evening sessions.
new text end
new text begin
(g) The proposals developed under paragraphs (b) and (c); any presentations, summary
documents, engagement invitations, surveys, and drafts of the report used in the stakeholder
engagement process under paragraph (d) or when soliciting input under paragraph (e); and
the report required under paragraph (f) must also be made available in Hmong, Somali, and
Spanish.
new text end
new text begin
(h) The updated family child care licensing standards proposed under paragraph (b) and
the risk-based model for monitoring compliance with family child care licensing standards
proposed under paragraph (c) must not be implemented any earlier than January 1, 2027.
new text end
Sec. 16. new text begin ELIMINATING SCHEDULE REPORTER DESIGNATION.
new text end
new text begin
Notwithstanding Minnesota Statutes, section 142E.04, subdivisions 6, 7, and 8, the
commissioner of children, youth, and families must allocate additional basic sliding fee
child care money for calendar years 2026 and 2027 to counties and Tribes to account for
eliminating the schedule reporter designation in the child care assistance program. In
allocating the additional money, the commissioner shall consider:
new text end
new text begin
(1) the number of children who are in schedule reporter families; and
new text end
new text begin
(2) the average basic sliding fee cost of care in the county or Tribe.
new text end
Sec. 17. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber Minnesota Statutes, section 245.0962, as Minnesota
Statutes, section 142A.47. The revisor shall also make necessary cross-reference changes
consistent with the renumbering.
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. 18. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber Minnesota Statutes, section 142D.12, subdivision
3, as Minnesota Statutes, section 120B.121. The revisor shall also make necessary
cross-reference changes consistent with the renumbering.
new text end
Sec. 19. new text begin REVISOR INSTRUCTION.
new text end
new text begin
The revisor of statutes shall renumber Minnesota Statutes, section 124D.129, as
Minnesota Statutes, section 142A.48. The revisor shall also make necessary cross-reference
changes consistent with the renumbering.
new text end
ARTICLE 20
CHILDREN AND FAMILIES LICENSING POLICY
Section 1.
Minnesota Statutes 2024, section 142B.10, subdivision 14, is amended to read:
Subd. 14.
Grant of license; license extension.
(a) If the commissioner determines that
the program complies with all applicable rules and laws, the commissioner shall issue a
license consistent with this section or, if applicable, a temporary change of ownership license
under section 142B.11. At minimum, the license shall state:
(1) the name of the license holder;
(2) the address of the program;
(3) the effective date and expiration date of the license;
(4) the type of license;
(5) the maximum number and ages of persons that may receive services from the program;
and
(6) any special conditions of licensure.
(b) The commissioner may issue a license for a period not to exceed two years if:
(1) the commissioner is unable to conduct the observation required by subdivision 11,
paragraph (a), clause (3), because the program is not yet operational;
(2) certain records and documents are not available because persons are not yet receiving
services from the program; and
(3) the applicant complies with applicable laws and rules in all other respects.
(c) A decision by the commissioner to issue a license does not guarantee that any person
or persons will be placed or cared for in the licensed program.
(d) Except as provided in paragraphs (i) and (j), the commissioner shall not issue a
license if the applicant, license holder, or an affiliated controlling individual has:
(1) been disqualified and the disqualification was not set aside and no variance has been
granted;
(2) been denied a license under this chapter or chapter 245A within the past two years;
(3) had a license issued under this chapter or chapter 245A revoked within the past five
years; or
(4) failed to submit the information required of an applicant under subdivision 1,
paragraph (f), (g), or (h), after being requested by the commissioner.
When a license issued under this chapter or chapter 245A is revoked, the license holder
and each affiliated controlling individual with a revoked license may not hold any license
under chapter 142B for five years following the revocation, and other licenses held by the
applicant or license holder or licenses affiliated with each controlling individual shall also
be revoked.
(e) Notwithstanding paragraph (d), the commissioner may elect not to revoke a license
affiliated with a license holder or controlling individual that had a license revoked within
the past five years if the commissioner determines that (1) the license holder or controlling
individual is operating the program in substantial compliance with applicable laws and rules
and (2) the program's continued operation is in the best interests of the community being
served.
(f) Notwithstanding paragraph (d), the commissioner may issue a new license in response
to an application that is affiliated with an applicant, license holder, or controlling individual
that had an application denied within the past two years or a license revoked within the past
five years if the commissioner determines that (1) the applicant or controlling individual
has operated one or more programs in substantial compliance with applicable laws and rules
and (2) the program's operation would be in the best interests of the community to be served.
(g) In determining whether a program's operation would be in the best interests of the
community to be served, the commissioner shall consider factors such as the number of
persons served, the availability of alternative services available in the surrounding
community, the management structure of the program, whether the program provides
culturally specific services, and other relevant factors.
(h) The commissioner shall not issue or reissue a license under this chapter if an individual
living in the household where the services will be provided as specified under section
245C.03, subdivision 1, has been disqualified and the disqualification has not been set aside
and no variance has been granted.
(i) Pursuant to section 142B.18, subdivision 1, paragraph (b), when a license issued
under this chapter has been suspended or revoked and the suspension or revocation is under
appeal, the program may continue to operate pending a final order from the commissioner.
If the license under suspension or revocation will expire before a final order is issued, a
temporary provisional license may be issued provided any applicable license fee is paid
before the temporary provisional license is issued.
(j) Notwithstanding paragraph (i), when a revocation is based on the disqualification of
a controlling individual or license holder, and the controlling individual or license holder
is ordered under section 245C.17 to be immediately removed from direct contact with
persons receiving services or is ordered to be under continuous, direct supervision when
providing direct contact services, the program may continue to operate only if the program
complies with the order and submits documentation demonstrating compliance with the
order. If the disqualified individual fails to submit a timely request for reconsideration, or
if the disqualification is not set aside and no variance is granted, the order to immediately
remove the individual from direct contact or to be under continuous, direct supervision
remains in effect pending the outcome of a hearing and final order from the commissioner.
(k) For purposes of reimbursement for meals only, under the Child and Adult Care Food
Program, Code of Federal Regulations, title 7, subtitle B, chapter II, subchapter A, part 226,
relocation within the same county by a licensed family day care provider, shall be considered
an extension of the license for a period of no more than 30 calendar days or until the new
license is issued, whichever occurs first, provided the county agency has determined the
family day care provider meets licensure requirements at the new location.
(l) Unless otherwise specified by statute, all licenses issued under this chapter expire at
12:01 a.m. on the day after the expiration date stated on the license. A license holder must
deleted text begin apply for and be granteddeleted text end new text begin comply with the requirements in section 142B.12 and be reissuednew text end
a new license to operate the program or the program must not be operated after the expiration
date.new text begin Child foster care license holders must apply for and be granted a new license to operate
the program or the program must not be operated after the expiration date. Upon
implementation of the provider licensing and reporting hub, licenses may be issued each
calendar year.
new text end
(m) The commissioner shall not issue or reissue a license under this chapter if it has
been determined that a tribal licensing authority has established jurisdiction to license the
program or service.
(n) The commissioner of children, youth, and families shall coordinate and share data
with the commissioner of human services to enforce this section.
Sec. 2.
Minnesota Statutes 2024, section 142B.171, subdivision 2, is amended to read:
Subd. 2.
Documented technical assistance.
(a) In lieu of a correction order under section
142B.16, the commissioner shall provide documented technical assistance to a family child
care or child care center license holder if the commissioner finds that:
(1) the license holder has failed to comply with a requirement in this chapter or Minnesota
Rules, chapter 9502 or 9503, that the commissioner determines to be low risk as determined
by the child care weighted risk system;
(2) the noncompliance does not imminently endanger the health, safety, or rights of the
persons served by the program; and
(3) the license holder did not receive documented technical assistance or a correction
order for the same violation at the license holder's most recent annual licensing inspection.
(b) Documented technical assistance must include communication from the commissioner
to the license holder that:
(1) states the conditions that constitute a violation of a law or rule;
(2) references the specific law or rule violated; and
(3) explains remedies for correcting the violation.
deleted text begin
(c) The commissioner shall not publicly publish documented technical assistance on the
department's website.
deleted text end
Sec. 3.
Minnesota Statutes 2024, section 142B.30, subdivision 1, is amended to read:
Subdivision 1.
Delegation of authority to agencies.
(a) County agencies and private
agencies that have been designated or licensed by the commissioner to perform licensing
functions and activities under section 142B.10; to recommend denial of applicants under
section 142B.15; to issue correction orders, to issue variances, and to recommend a
conditional license under section 142B.16; or to recommend suspending or revoking a
license or issuing a fine under section 142B.18, shall comply with rules and directives of
the commissioner governing those functions and with this section. The following variances
are excluded from the delegation of variance authority and may be issued only by the
commissioner:
(1) dual licensure of family child care and family child foster care;
(2) child foster care maximum age requirement;
(3) variances regarding disqualified individuals;
(4) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder; and
(5) variances to section 142B.74 for a time-limited period. If the commissioner grants
a variance under this clause, the license holder must provide notice of the variance to all
parents and guardians of the children in care.
(b) The commissioners of human services and children, youth, and families must both
approve a variance for dual licensure of family child foster care and family adult foster care
or family adult foster care and family child care. Variances under this paragraph are excluded
from the delegation of variance authority and may be issued only by both commissioners.
(c) Except as provided in section 142B.41, subdivision 4, paragraph (e), a county agency
must not grant a license holder a variance to exceed the maximum allowable family child
care license capacity of 14 children.
(d) A county agency that has been designated by the commissioner to issue family child
care variances must:
(1) publish the county agency's policies and criteria for issuing variances on the county's
public website and update the policies as necessary; and
(2) annually distribute the county agency's policies and criteria for issuing variances to
all family child care license holders in the county.
(e) Before the implementation of NETStudy 2.0, county agencies must report information
about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision
2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the
commissioner at least monthly in a format prescribed by the commissioner.
(f) For family child care programs, the commissioner shall require a county agency to
conduct one unannounced licensing review at least annually.
(g) A new text begin child foster care new text end license issued under this section may be issued for up to two yearsnew text begin
until implementation of the provider licensing and reporting hub. Upon implementation of
the provider licensing and reporting hub, licenses may be issued each calendar yearnew text end .
(h) A county agency shall report to the commissioner, in a manner prescribed by the
commissioner, the following information for a licensed family child care program:
(1) the results of each licensing review completed, including the date of the review, and
any licensing correction order issued;
(2) any death, serious injury, or determination of substantiated maltreatment; and
(3) any fires that require the service of a fire department within 48 hours of the fire. The
information under this clause must also be reported to the state fire marshal within two
business days of receiving notice from a licensed family child care provider.
Sec. 4.
Minnesota Statutes 2024, section 142B.41, is amended by adding a subdivision to
read:
new text begin Subd. 14. new text end
new text begin Staff distribution. new text end
new text begin
Notwithstanding Minnesota Rules, part 9503.0040, subpart
2, item B, a child care aide in a licensed child care center may be substituted for a teacher
during morning arrival and afternoon departure times if the total arrival and departure time
does not exceed 25 percent of the center's daily hours of operation. For a child care aide to
be substituted for a teacher under this subdivision, the child care aide must:
new text end
new text begin
(1) be 18 years of age or older;
new text end
new text begin
(2) have been employed by the child care center for a minimum of 30 days; and
new text end
new text begin
(3) have completed the training required under section 142B.65, including orientation
training and the training required within the first 90 days of employment.
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.
Minnesota Statutes 2024, section 142B.51, subdivision 2, is amended to read:
Subd. 2.
Child passenger restraint systems; training requirement.
(a) Programs
licensed by the Department of Human Services under chapter 245A or the Department of
Children, Youth, and Families under this chapter and Minnesota Rules, chapter 2960, that
serve a child or children under deleted text begin eightdeleted text end new text begin ninenew text end years of age must document training that fulfills
the requirements in this subdivision.
(b) Before a license holder, staff person, or caregiver transports a child or children under
age deleted text begin eightdeleted text end new text begin ninenew text end in a motor vehicle, the person transporting the child must satisfactorily
complete training on the proper use and installation of child restraint systems in motor
vehicles. Training completed under this section may be used to meet initial or ongoing
training under Minnesota Rules, part 2960.3070, subparts 1 and 2.
(c) Training required under this section must be completed at orientation or initial training
and repeated at least once every five years. At a minimum, the training must address the
proper use of child restraint systems based on the child's size, weight, and age, and the
proper installation of a car seat or booster seat in the motor vehicle used by the license
holder to transport the child or children.
(d) Training under paragraph (c) must be provided by individuals who are certified and
approved by the Office of Traffic Safety within the Department of Public Safety. License
holders may obtain a list of certified and approved trainers through the Department of Public
Safety website or by contacting the agency.
deleted text begin
(e) Notwithstanding paragraph (a), for an emergency relative placement under section
142B.06, the commissioner may grant a variance to the training required by this subdivision
for a relative who completes a child seat safety check up. The child seat safety check up
trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and
must provide one-on-one instruction on placing a child of a specific age in the exact child
passenger restraint in the motor vehicle in which the child will be transported. Once granted
a variance, and if all other licensing requirements are met, the relative applicant may receive
a license and may transport a relative foster child younger than eight years of age. A child
seat safety check up must be completed each time a child requires a different size car seat
according to car seat and vehicle manufacturer guidelines. A relative license holder must
complete training that meets the other requirements of this subdivision prior to placement
of another foster child younger than eight years of age in the home or prior to the renewal
of the child foster care license.
deleted text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 6.
Minnesota Statutes 2024, section 142B.65, subdivision 8, is amended to read:
Subd. 8.
Child passenger restraint systems; training requirement.
(a) Before a license
holder transports a child or children under age deleted text begin eightdeleted text end new text begin ninenew text end in a motor vehicle, the person
placing the child or children in a passenger restraint must satisfactorily complete training
on the proper use and installation of child restraint systems in motor vehicles.
(b) Training required under this subdivision must be repeated at least once every five
years. At a minimum, the training must address the proper use of child restraint systems
based on the child's size, weight, and age, and the proper installation of a car seat or booster
seat in the motor vehicle used by the license holder to transport the child or children.
(c) Training required under this subdivision must be provided by individuals who are
certified and approved by the Department of Public Safety, Office of Traffic Safety. License
holders may obtain a list of certified and approved trainers through the Department of Public
Safety website or by contacting the agency.
(d) Child care providers that only transport school-age children as defined in section
142B.01, subdivision 25, in child care buses as defined in section 169.448, subdivision 1,
paragraph (e), are exempt from this subdivision.
(e) Training completed under this subdivision may be used to meet in-service training
requirements under subdivision 9. Training completed within the previous five years is
transferable upon a staff person's change in employment to another child care center.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 7.
Minnesota Statutes 2024, section 142B.65, subdivision 9, is amended to read:
Subd. 9.
In-service training.
(a) A license holder must ensure that the center director,
staff persons, substitutes, and unsupervised volunteers complete in-service training each
calendar year.
(b) The center director and staff persons who work more than 20 hours per week must
complete 24 hours of in-service training each calendar year. Staff persons who work 20
hours or less per week must complete 12 hours of in-service training each calendar year.
Substitutes and unsupervised volunteers must complete new text begin at least two hours of training each
year, and the training must include new text end the requirements of paragraphs (d) to (g) deleted text begin and do not
otherwise have a minimum number of hours of training to completedeleted text end .
(c) The number of in-service training hours may be prorated for deleted text begin individualsdeleted text end new text begin center
directors and staff personsnew text end not employed for an entire year.
(d) Each year, in-service training must include:
(1) the center's procedures for maintaining health and safety according to section 142B.66
and Minnesota Rules, part 9503.0140, and handling emergencies and accidents according
to Minnesota Rules, part 9503.0110;
(2) the reporting responsibilities under chapter 260E and Minnesota Rules, part
9503.0130;
(3) at least one-half hour of training on the standards under section 142B.46 and on
reducing the risk of sudden unexpected infant death as required under subdivision 6, if
applicable; and
(4) at least one-half hour of training on the risk of abusive head trauma from shaking
infants and young children as required under subdivision 7, if applicable.
(e) Each year, or when a change is made, whichever is more frequent, in-service training
must be provided on: (1) the center's risk reduction plan under section 142B.54, subdivision
2; and (2) a child's individual child care program plan as required under Minnesota Rules,
part 9503.0065, subpart 3.
(f) At least once every two calendar years, the in-service training must include:
(1) child development and learning training under subdivision 3;
(2) pediatric first aid that meets the requirements of subdivision 4;
(3) pediatric cardiopulmonary resuscitation training that meets the requirements of
subdivision 5;
(4) cultural dynamics training to increase awareness of cultural differences; and
(5) disabilities training to increase awareness of differing abilities of children.
(g) At least once every five years, in-service training must include child passenger
restraint training that meets the requirements of subdivision 8, if applicable.
(h) The remaining hours of the in-service training requirement must be met by completing
training in the following content areas of the Minnesota Knowledge and Competency
Framework:
(1) Content area I: child development and learning;
(2) Content area II: developmentally appropriate learning experiences;
(3) Content area III: relationships with families;
(4) Content area IV: assessment, evaluation, and individualization;
(5) Content area V: historical and contemporary development of early childhood
education;
(6) Content area VI: professionalism;
(7) Content area VII: health, safety, and nutrition; and
(8) Content area VIII: application through clinical experiences.
(i) For purposes of this subdivision, the following terms have the meanings given them.
(1) "Child development and learning training" means training in understanding how
children develop physically, cognitively, emotionally, and socially and learn as part of the
children's family, culture, and community.
(2) "Developmentally appropriate learning experiences" means creating positive learning
experiences, promoting cognitive development, promoting social and emotional development,
promoting physical development, and promoting creative development.
(3) "Relationships with families" means training on building a positive, respectful
relationship with the child's family.
(4) "Assessment, evaluation, and individualization" means training in observing,
recording, and assessing development; assessing and using information to plan; and assessing
and using information to enhance and maintain program quality.
(5) "Historical and contemporary development of early childhood education" means
training in past and current practices in early childhood education and how current events
and issues affect children, families, and programs.
(6) "Professionalism" means training in knowledge, skills, and abilities that promote
ongoing professional development.
(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring
safety, and providing healthy nutrition.
(8) "Application through clinical experiences" means clinical experiences in which a
person applies effective teaching practices using a range of educational programming models.
(j) The license holder must ensure that documentation, as required in subdivision 10,
includes the number of total training hours required to be completed, name of the training,
the Minnesota Knowledge and Competency Framework content area, number of hours
completed, and the director's approval of the training.
(k) In-service training completed by a staff person that is not specific to that child care
center is transferable upon a staff person's change in employment to another child care
program.
Sec. 8.
Minnesota Statutes 2024, section 142B.66, subdivision 3, is amended to read:
Subd. 3.
Emergency preparedness.
(a) A licensed child care center must have a written
emergency plan for emergencies that require evacuation, sheltering, or other protection of
a child, such as fire, natural disaster, intruder, or other threatening situation that may pose
a health or safety hazard to a child. The plan must be written on a form developed by the
commissioner and must include:
(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
(2) a designated relocation site and evacuation route;
(3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation,
shelter-in-place, or lockdown, including procedures for reunification with families;
(4) accommodations for a child with a disability or a chronic medical condition;
(5) procedures for storing a child's medically necessary medicine that facilitates easy
removal during an evacuation or relocation;
(6) procedures for continuing operations in the period during and after a crisis;
(7) procedures for communicating with local emergency management officials, law
enforcement officials, or other appropriate state or local authorities; and
(8) accommodations for infants and toddlers.
(b) The license holder must train staff persons on the emergency plan at orientation,
when changes are made to the plan, and at least once each calendar year. Training must be
documented in each staff person's personnel file.
(c) The license holder must conduct drills according to the requirements in Minnesota
Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented.
(d) The license holder must review and update the emergency plan deleted text begin annuallydeleted text end new text begin each calendar
yearnew text end . Documentation of the deleted text begin annualdeleted text end new text begin yearlynew text end emergency plan review shall be maintained in
the program's administrative records.
(e) The license holder must include the emergency plan in the program's policies and
procedures as specified under section 142B.10, subdivision 21. The license holder must
provide a physical or electronic copy of the emergency plan to the child's parent or legal
guardian upon enrollment.
(f) The relocation site and evacuation route must be posted in a visible place as part of
the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140,
subpart 21.
Sec. 9.
Minnesota Statutes 2024, section 142B.70, subdivision 7, is amended to read:
Subd. 7.
Child passenger restraint systems; training requirement.
(a) A license
holder must comply with all seat belt and child passenger restraint system requirements
under section 169.685.
(b) Family and group family child care programs licensed by the Department of Children,
Youth, and Families that serve a child or children under deleted text begin eightdeleted text end new text begin ninenew text end years of age must
document training that fulfills the requirements in this subdivision.
(1) Before a license holder, second adult caregiver, substitute, or helper transports a
child or children under age deleted text begin eightdeleted text end new text begin ninenew text end in a motor vehicle, the person placing the child or
children in a passenger restraint must satisfactorily complete training on the proper use and
installation of child restraint systems in motor vehicles. Training completed under this
subdivision may be used to meet initial training under subdivision 1 or ongoing training
under subdivision 8.
(2) Training required under this subdivision must be at least one hour in length, completed
at initial training, and repeated at least once every five years. At a minimum, the training
must address the proper use of child restraint systems based on the child's size, weight, and
age, and the proper installation of a car seat or booster seat in the motor vehicle used by the
license holder to transport the child or children.
(3) Training under this subdivision must be provided by individuals who are certified
and approved by the Department of Public Safety, Office of Traffic Safety. License holders
may obtain a list of certified and approved trainers through the Department of Public Safety
website or by contacting the agency.
(c) Child care providers that only transport school-age children as defined in section
142B.01, subdivision 13, paragraph (f), in child care buses as defined in section 169.448,
subdivision 1, paragraph (e), are exempt from this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 10.
Minnesota Statutes 2024, section 142B.70, subdivision 8, is amended to read:
Subd. 8.
Training requirements for family and group family child care.
(a) For
purposes of family and group family child care, the license holder and each second adult
caregiver must complete 16 hours of ongoing training each year. Repeat of topical training
requirements in subdivisions 3 to 9 shall count toward the annual 16-hour training
requirement. Additional ongoing training subjects to meet the annual 16-hour training
requirement must be selected from the following areas:
(1) child development and learning training in understanding how a child develops
physically, cognitively, emotionally, and socially, and how a child learns as part of the
child's family, culture, and community;
(2) developmentally appropriate learning experiences, including training in creating
positive learning experiences, promoting cognitive development, promoting social and
emotional development, promoting physical development, promoting creative development;
and behavior guidance;
(3) relationships with families, including training in building a positive, respectful
relationship with the child's family;
(4) assessment, evaluation, and individualization, including training in observing,
recording, and assessing development; assessing and using information to plan; and assessing
and using information to enhance and maintain program quality;
(5) historical and contemporary development of early childhood education, including
training in past and current practices in early childhood education and how current events
and issues affect children, families, and programs;
(6) professionalism, including training in knowledge, skills, and abilities that promote
ongoing professional development; and
(7) health, safety, and nutrition, including training in establishing healthy practices;
ensuring safety; and providing healthy nutrition.
(b) A provider who is approved as a trainer through the Develop data system may count
up to two hours of training instruction toward the annual 16-hour training requirement in
paragraph (a). The provider may only count training instruction hours for the first instance
in which they deliver a particular content-specific training during each licensing year. Hours
counted as training instruction must be approved through the Develop data system with
attendance verified on the trainer's individual learning record and must be in Knowledge
and Competency Framework content area VII A (Establishing Healthy Practices) or B
(Ensuring Safety).
new text begin
(c) Substitutes and adult caregivers who provide care for 500 or fewer hours per year
must complete a minimum of one hour of training each calendar year, and the training must
include the requirements in subdivisions 3, 4, 5, 6, and 9.
new text end
Sec. 11.
Minnesota Statutes 2024, section 142C.06, is amended by adding a subdivision
to read:
new text begin Subd. 4. new text end
new text begin Requirement to post conditional certification. new text end
new text begin
Upon receipt of any order of
conditional certification issued by the commissioner under this section, and notwithstanding
a pending request for reconsideration of the order of conditional certification by the
certification holder, the certification holder shall post the order of conditional certification
in a place that is conspicuous to the people receiving services and all visitors to the facility
for the duration of the conditional certification. When the order of conditional certification
is accompanied by a maltreatment investigation memorandum prepared under chapter 260E,
the investigation memoranda must be posted with the order of conditional certification.
new text end
Sec. 12.
Minnesota Statutes 2024, section 142C.11, subdivision 8, is amended to read:
Subd. 8.
Required policies.
A certified center must have written policies for health and
safety items in subdivisions 1 to 6new text begin , 9, and 10new text end .
Sec. 13.
Minnesota Statutes 2024, section 142C.12, subdivision 1, is amended to read:
Subdivision 1.
First aid and cardiopulmonary resuscitation.
(a) Before having
unsupervised direct contact with a child, but within 90 days after the first date of direct
contact with a child, the director, all staff persons, substitutes, and unsupervised volunteers
must successfully complete pediatric first aid and pediatric cardiopulmonary resuscitation
(CPR) training, unless the training has been completed within the previous two calendar
years. Staff must complete the pediatric first aid and pediatric CPR training at least every
other calendar year and the center must document the training in the staff person's personnel
record.
(b) Training completed under this subdivision may be used to meet the in-service training
requirements under subdivision 6.
new text begin
(c) Training must include CPR and techniques for providing immediate care to people
experiencing life-threatening cardiac emergencies, choking, bleeding, fractures and sprains,
head injuries, poisoning, and burns. Training developed by the American Heart Association,
the American Red Cross, or another organization that uses nationally recognized,
evidence-based guidelines meets these requirements.
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. 14.
Minnesota Statutes 2024, section 142C.12, subdivision 6, is amended to read:
Subd. 6.
In-service training.
(a) The certified center must ensure that the director and
all staff persons, including substitutes and unsupervised volunteers, are trained at least once
each calendar year on health and safety requirements in this section and sections 142C.10,
142C.11, and 142C.13.
(b) The director and each staff person, not including substitutes, must complete at least
six hours of training each calendar year. new text begin Substitutes must complete at least two hours of
training each calendar year. new text end Training required under paragraph (a) may be used toward the
hourly training requirements of this subdivision.
Sec. 15.
Minnesota Statutes 2024, section 245A.18, subdivision 1, is amended to read:
Subdivision 1.
Seat belt and child passenger restraint system use.
All license holders
that transport children must comply with the requirements of section 142B.51, subdivision
1, and license holders that transport a child or children under deleted text begin eightdeleted text end new text begin ninenew text end years of age must
document training that fulfills the requirements in section 142B.51, subdivision 2.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
ARTICLE 21
MISCELLANEOUS
Section 1.
Minnesota Statutes 2024, section 62E.23, subdivision 1, is amended to read:
Subdivision 1.
Administration of plan.
(a) The association is Minnesota's reinsurance
entity to administer the state-based reinsurance program referred to as the Minnesota premium
security plan.
(b) The association may apply for any available federal funding for the plan. All funds
received by or appropriated to the association shall be deposited in the premium security
plan account in section 62E.25, subdivision 1. The association shall notify the chairs and
ranking minority members of the legislative committees with jurisdiction over health and
human services and insurance within ten days of receiving any federal funds.
(c) The association must collect or access data from an eligible health carrier that are
necessary to determine reinsurance payments, according to the data requirements under
subdivision 5, paragraph (c).
(d) The board must not use any funds allocated to the plan for staff retreats, promotional
giveaways, excessive executive compensation, or promotion of federal or state legislative
or regulatory changes.
(e) For each applicable benefit year, the association must notify eligible health carriers
of reinsurance payments to be made for the applicable benefit year no later than June 30 of
the year following the applicable benefit year.
(f) On a quarterly basis during the applicable benefit year, the association must provide
each eligible health carrier with the calculation of total reinsurance payment requests.
(g) By August 15 of the year following the applicable benefit year, new text begin through August 15,
2026, new text end the association must disburse all applicable reinsurance payments to an eligible health
carrier.
new text begin
(h) The association must disburse applicable reinsurance payments for claims costs
incurred by eligible health carriers through December 31, 2025. Reinsurance payments are
not available to eligible health carriers for claims costs incurred after December 31, 2025.
new text end
Sec. 2.
new text begin
[62V.15] DEFINITIONS; PREMIUM SUBSIDY PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
For purposes of sections 62V.15 to 62V.18, the following terms
have the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Assessment. new text end
new text begin
"Assessment" means the amount a health plan company must pay
for operational costs, administrative costs, and premium subsidy payments for the premium
subsidy program established under section 62V.16.
new text end
new text begin Subd. 3. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of management and
budget.
new text end
new text begin Subd. 4. new text end
new text begin Eligible individual. new text end
new text begin
(a) "Eligible individual" means a Minnesota resident who:
new text end
new text begin
(1) is not eligible for an advance premium tax credit under Code of Federal Regulations,
title 26, part 1.36B-2, in a month in which the eligible individual's coverage is effective;
new text end
new text begin
(2) is not enrolled in public program coverage under chapters 256B and 256L; and
new text end
new text begin
(3) purchased an individual health plan, as defined in section 62A.011.
new text end
new text begin
(b) "Eligible individual" includes a person required to repay an advanced premium tax
credit because the person's income was subsequently determined to exceed the maximum
permissible amount to qualify as an applicable taxpayer under Code of Federal Regulations,
title 26, part 1.36B-2.
new text end
new text begin Subd. 5. new text end
new text begin Gross premium. new text end
new text begin
"Gross premium" means the amount billed for a health plan
purchased by an eligible individual prior to a premium subsidy in a calendar year.
new text end
new text begin Subd. 6. new text end
new text begin Health plan company. new text end
new text begin
"Health plan company" means a health plan company,
as defined in section 62Q.01, that offers, issues, sells, or renews a health plan, as defined
in section 62Q.01, in Minnesota.
new text end
new text begin Subd. 7. new text end
new text begin Net premium. new text end
new text begin
"Net premium" means the gross premium less the premium
subsidy.
new text end
new text begin Subd. 8. new text end
new text begin Premium subsidy. new text end
new text begin
"Premium subsidy" means a payment (1) made on behalf
of an eligible individual to promote general welfare, and (2) that is not compensation for a
service rendered.
new text end
Sec. 3.
new text begin
[62V.16] PAYMENT TO HEALTH CARRIERS ON BEHALF OF ELIGIBLE
INDIVIDUALS.
new text end
new text begin Subdivision 1. new text end
new text begin Program established. new text end
new text begin
Beginning January 1, 2026, the board of directors
of MNsure, in consultation with the commissioners of commerce and human services, must
establish and administer the premium subsidy program authorized by this section to help
eligible individuals pay for coverage in the individual market.
new text end
new text begin Subd. 2. new text end
new text begin Premium subsidy provided. new text end
new text begin
(a) A health carrier must provide a premium
subsidy to each eligible individual who purchases an individual health plan from the health
carrier. The premium subsidy must be provided for each month the net premium is paid.
An eligible individual must pay the net premium amount to the health carrier.
new text end
new text begin
(b) Each premium subsidy must be equal to 20 percent of the monthly gross premium
otherwise paid by or on behalf of the eligible individual for coverage purchased in the
individual market that covers the eligible individual and the eligible individual's spouse and
dependents.
new text end
new text begin
(c) The premium subsidy must be excluded from a calculation used to determine eligibility
for a Department of Human Services or Department of Children, Youth, and Families
program.
new text end
new text begin Subd. 3. new text end
new text begin Payments to health carriers. new text end
new text begin
(a) The commissioner must make payments by
September 30 to health carriers on behalf of eligible individuals for the months during the
prior calendar year for which the individual has paid the net premium amount to the health
carrier. The amount of the commissioner's payments to health carriers must be in the amounts
provided to the commissioner by the board under paragraph (c). The commissioner must
not withhold payment because a health carrier cannot prove an enrollee is an eligible
individual.
new text end
new text begin
(b) In order to be eligible for payment, a health carrier seeking reimbursement from the
board must submit an invoice and supporting information to the board, using a form
developed by the board. The form must require the health carrier to identify the number of
eligible individuals for which the health carrier is seeking reimbursement, the average gross
premium for eligible individuals, and the aggregate amount of reimbursement claimed by
the health carrier for premium subsidies under this section. The board must finalize the form
by November 1, 2025.
new text end
new text begin
(c) The board must provide the commissioner, based on the information received by the
board from the health carriers pursuant to paragraph (b), the payment amount owed to each
health carrier.
new text end
new text begin
(d) The board must consider a health carrier as a vendor under section 16A.124,
subdivision 3, and each monthly invoice must represent the services that have been completed
or delivered.
new text end
new text begin
(e) The commissioner, in consultation with the board, may withhold payments and charge
back payments to recover from health carriers premium subsidies provided but that do not
comply with the applicable legal requirements of this section.
new text end
new text begin Subd. 4. new text end
new text begin Assessment. new text end
new text begin
(a) An annual assessment is imposed on health plan companies
for each calendar year beginning in calendar year 2026. The commissioner of commerce
must establish the annual assessment for each health plan company in an amount such that
the aggregate assessment amount collected from health plan companies under this subdivision
equals the amount necessary for the premium subsidy program established under subdivision
1.
new text end
new text begin
(b) By March 1 each year, the commissioner of commerce must consult with the board
of directors of MNsure and provide each health plan company with an estimate of the
company assessment for the current calendar year.
new text end
new text begin
(c) By May 31 each year, the commissioner of commerce, in consultation with the board
of directors of MNsure, must notify each health plan company of the company's assessment
for the current calendar year.
new text end
new text begin
(d) By June 30 each year, the commissioner of commerce must collect assessments from
health plan companies to pay for the premium subsidy program established under this
section.
new text end
new text begin Subd. 5. new text end
new text begin Data practices. new text end
new text begin
(a) The definitions in section 13.02 apply to this subdivision.
new text end
new text begin
(b) Government data on an enrollee or health carrier under this section are private data
on individuals or nonpublic data, except that the total reimbursement requested by a health
carrier and the total state payment to the health carrier are public data.
new text end
Sec. 4.
new text begin
[62V.17] APPLICABILITY OF GROSS PREMIUM.
new text end
new text begin
Notwithstanding premium subsidies provided under section 62V.16, subdivision 2, the
premium base to calculate any applicable premium taxes under chapter 297I is the gross
premium for health plans purchased by eligible individuals in the individual market.
new text end
Sec. 5.
new text begin
[62V.18] PREMIUM SUBSIDY PROGRAM ACCOUNT.
new text end
new text begin Subdivision 1. new text end
new text begin Account established. new text end
new text begin
The premium subsidy program account is created
in the special revenue fund in the state treasury.
new text end
new text begin Subd. 2. new text end
new text begin Collected assessments. new text end
new text begin
The commissioner of commerce must deposit the
assessments collected under section 62V.16, subdivision 4, in the premium subsidy program
account created under subdivision 1.
new text end
new text begin Subd. 3. new text end
new text begin Appropriations. new text end
new text begin
Money in the premium subsidy program account is annually
appropriated:
new text end
new text begin
(1) to the commissioner of management and budget for the payments to health carriers
on behalf of eligible individuals under section 62V.16, subdivision 3; and
new text end
new text begin
(2) to the board of directors of MNsure for operational and administrative costs for the
premium subsidy program established under section 62V.16.
new text end
Sec. 6.
Minnesota Statutes 2024, section 149A.02, is amended by adding a subdivision to
read:
new text begin Subd. 42. new text end
new text begin Green burial. new text end
new text begin
"Green burial" means a method of burial that emphasizes
environmental sustainability without interfering with natural decomposition and:
new text end
new text begin
(1) the body is not embalmed;
new text end
new text begin
(2) a biodegradable casket or shroud is used; and
new text end
new text begin
(3) no vault or outer burial container is employed for a casket or shroud.
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. 7.
Minnesota Statutes 2024, section 151.741, subdivision 5, is amended to read:
Subd. 5.
Insulin repayment account; annual transfer from health care access fund.
(a)
The insulin repayment account is established in the special revenue fund in the state treasury.
Money in the account is appropriated each fiscal year to the commissioner of administration
to reimburse manufacturers for insulin dispensed under the insulin safety net program in
section 151.74, in accordance with section 151.74, subdivisions 3, paragraph (h), and 6,
paragraph (h), and to cover costs incurred by the commissioner in providing these
reimbursement payments.
(b) By June 30, 2025, and each June 30 thereafter, the commissioner of administration
shall certify to the commissioner of management and budget the total amount expended in
the prior fiscal year for:
(1) reimbursement to manufacturers for insulin dispensed under the insulin safety net
program in section 151.74, in accordance with section 151.74, subdivisions 3, paragraph
(h), and 6, paragraph (h); and
(2) costs incurred by the commissioner of administration in providing the reimbursement
payments described in clause (1).
(c) The commissioner of management and budget shall transfer from the health care
access fund to the deleted text begin special revenue funddeleted text end new text begin insulin repayment accountnew text end , beginning July 1, 2025,
and each July 1 thereafter, an amount equal to the amount to which the commissioner of
administration certified pursuant to paragraph (b).
Sec. 8.
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 Notification of federal approval; report. new text end
new text begin
(a) For any provision over which
the commissioner has jurisdiction and that has an effective date contingent upon federal
approval, whether the contingency is expressed in an effective date, in the text of a statutory
provision, or in the text of an uncodified section of session law, the commissioner must
notify the revisor of statutes of which enacted provisions contain such contingent federal
approval and when federal approval is obtained for any such provision according to
paragraphs (b) and (c).
new text end
new text begin
(b) By July 1 of each year, the commissioner must provide the revisor of statutes; the
director of the House Research Department; and the director of Senate Counsel, Research
and Fiscal Analysis with a report containing a complete list of all provisions enacted since
the preceding July 1 with an effective date contingent on federal approval.
new text end
new text begin
(c) By September 1 of each year, the commissioner must provide the revisor of statutes;
the director of the House Research Department; and the director of Senate Counsel, Research
and Fiscal Analysis with a report containing a complete list of all statutory provisions
previously enacted with an effective date contingent on federal approval. The commissioner
must identify in the report which, if any, provisions received federal approval since the
preceding September 1 and the date that federal approval for each provision was received.
If no provisions have received federal approval since the preceding September 1, the report
must state that fact. The revisor of statutes may authorize the commissioner to remove
federally approved provisions from subsequent reports submitted.
new text end
new text begin
(d) The reports in paragraphs (b) and (c) must be provided in a form prescribed by the
revisor of statutes.
new text end
new text begin
(e) An employee in the Department of Human Services who is responsible for identifying
and tracking federal approval of provisions must attest to the accuracy of the reports in a
manner prescribed by the revisor of statutes.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 9.
Minnesota Statutes 2024, section 256B.051, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
An individual with a disability is eligible for housing stabilization
services if the individual:
(1) is 18 years of age or older;
(2) is enrolled in medical assistance;
(3) new text begin has income at or below 150 percent of the federal poverty level;
new text end
new text begin (4) new text end has an assessment of functional need that determines a need for services due to
limitations caused by the individual's disability;
deleted text begin (4)deleted text end new text begin (5)new text end resides in or plans to transition to a community-based setting as defined in Code
of Federal Regulations, title 42, section 441.301 (c); and
deleted text begin (5)deleted text end new text begin (6)new text end has housing instability evidenced by:
(i) being homeless or at-risk of homelessness;
(ii) being in the process of transitioning from, or having transitioned in the past six
months from, an institution or licensed or registered setting;
(iii) being eligible for waiver services under chapter 256S or section 256B.092 or
256B.49; or
(iv) having been identified by a long-term care consultation under section 256B.0911
as at risk of institutionalization.
Sec. 10.
new text begin
[306.991] GREEN BURIALS IN PUBLIC CEMETERIES.
new text end
new text begin Subdivision 1. 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) "Drainage system" has the meaning given in section 103E.005, subdivision 12.
new text end
new text begin
(c) "Green burial" has the meaning given in section 149A.02, subdivision 42.
new text end
new text begin
(d) "Natural watercourse" has the meaning given in section 103G.005, subdivision 13.
new text end
new text begin
(e) "Ordinary high-water level" has the meaning given in section 103G.005, subdivision
14.
new text end
new text begin
(f) "Water supply well" has the meaning given in section 103I.005, subdivision 20a.
new text end
new text begin Subd. 2. new text end
new text begin Green burial requirements. new text end
new text begin
A municipality, town, or other cemetery governed
by this chapter that allows for green burials must comply with the requirements of this
section.
new text end
new text begin Subd. 3. new text end
new text begin Green burial plot locations. new text end
new text begin
(a) Green burial plots must meet the following
criteria:
new text end
new text begin
(1) be set back 50 feet from property lines;
new text end
new text begin
(2) maintain at least three and one-half feet clearance above the ordinary high-water
level;
new text end
new text begin
(3) not be in standing water;
new text end
new text begin
(4) not be within zone 1 groundwater source protection zones around a spring, water
supply well, or a shaft drilled into the ground meant to extract water; and
new text end
new text begin
(5) not be within flood-prone areas.
new text end
new text begin
(b) Green burial plot locations must be a certain distance from water sources. Green
burial plot locations must be:
new text end
new text begin
(1) 50 feet from water supply wells and shafts drilled into the ground used to extract
water;
new text end
new text begin
(2) 100 feet from other springs or watercourses; and
new text end
new text begin
(3) 33 feet from drainage systems.
new text end
new text begin Subd. 4. new text end
new text begin Exception. new text end
new text begin
A property with green burial plots in a designated location on or
before July 1, 2025, does not need to comply with the requirement of subdivision 3, paragraph
(a), clause (1).
new text end
new text begin Subd. 5. new text end
new text begin Burial depth. new text end
new text begin
(a) Green burial plots must be at a minimum depth of three and
one-half feet from the base of the grave to the soil horizon.
new text end
new text begin
(b) Green burials must have three and one-half feet of cover.
new text end
new text begin Subd. 6. new text end
new text begin Burial density. new text end
new text begin
Green burial plots must be a maximum of 300 burials per acre
over a 100 year period.
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. 11.
new text begin
[306.992] SCATTERING OF HYDROLYZED OR CREMATED REMAINS.
new text end
new text begin Subdivision 1. 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) "Cremated remains" has the meaning given in section 149A.02, subdivision 7.
new text end
new text begin
(c) "Hydrolyzed remains" has the meaning given in section 149A.02, subdivision 24a.
new text end
new text begin Subd. 2. new text end
new text begin Designated location. new text end
new text begin
A municipality, town, or other cemetery governed by
this chapter that allows for scattering of hydrolyzed remains or cremated remains must
designate a location within the cemetery for the scattering of hydrolyzed remains or cremated
remains.
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.
new text begin
[307.14] GREEN BURIALS IN PRIVATE CEMETERIES.
new text end
new text begin Subdivision 1. 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) "Drainage system" has the meaning given in section 103E.005, subdivision 12.
new text end
new text begin
(c) "Green burial" has the meaning given in section 149A.02, subdivision 42.
new text end
new text begin
(d) "Natural watercourse" has the meaning given in section 103G.005, subdivision 13.
new text end
new text begin
(e) "Ordinary high-water level" has the meaning given in section 103G.005, subdivision
14.
new text end
new text begin
(f) "Water supply well" has the meaning given in section 103I.005, subdivision 20a.
new text end
new text begin Subd. 2. new text end
new text begin Green burial requirements. new text end
new text begin
A person who owns a cemetery governed by this
chapter that allows for green burials must comply with the requirements of this section.
new text end
new text begin Subd. 3. new text end
new text begin Green burial plot locations. new text end
new text begin
(a) Green burial plots must meet the following
criteria:
new text end
new text begin
(1) be set back 50 feet from property lines;
new text end
new text begin
(2) maintain at least three and one-half feet clearance above the ordinary high-water
level;
new text end
new text begin
(3) not be in standing water;
new text end
new text begin
(4) not be within zone 1 groundwater source protection zones around a spring, water
supply well, or a shaft drilled into the ground meant to extract water; and
new text end
new text begin
(5) not be within flood-prone areas.
new text end
new text begin
(b) Green burial plot locations must be a certain distance from water sources. Green
burial plot locations must be:
new text end
new text begin
(1) 50 feet from water supply wells and shafts drilled into the ground used to extract
water;
new text end
new text begin
(2) 100 feet from other springs or watercourses; and
new text end
new text begin
(3) 33 feet from drainage systems.
new text end
new text begin Subd. 4. new text end
new text begin Exception. new text end
new text begin
A property with green burial plots in a designated location on or
before July 1, 2025, does not need to comply with the requirement of subdivision 3, paragraph
(a), clause (1).
new text end
new text begin Subd. 5. new text end
new text begin Burial depth. new text end
new text begin
(a) Green burial plots must be at a minimum depth of three and
one-half feet from the base of the grave to the soil horizon.
new text end
new text begin
(b) Green burials must have three and one-half feet of cover.
new text end
new text begin Subd. 6. new text end
new text begin Burial density. new text end
new text begin
Green burial plots must be a maximum of 300 burials per acre
over a 100 year period.
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. 13.
new text begin
[307.15] SCATTERING OF HYDROLYZED OR CREMATED REMAINS.
new text end
new text begin Subdivision 1. 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) "Cremated remains" has the meaning given in section 149A.02, subdivision 7.
new text end
new text begin
(c) "Hydrolyzed remains" has the meaning given in section 149A.02, subdivision 24a.
new text end
new text begin Subd. 2. new text end
new text begin Designated location. new text end
new text begin
A person who owns a cemetery governed by this chapter
that allows for scattering of hydrolyzed remains or cremated remains must designate a
location within the cemetery for the scattering of hydrolyzed or cremated remains.
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. 14.
Laws 2024, chapter 127, article 67, section 6, is amended to read:
Sec. 6. COMMISSIONER OF MANAGEMENT
|
||||||
| Appropriations by Fund |
||
| 2024 |
2025 |
|
| General |
-0- |
(232,000) |
| Health Care Access |
-0- |
100,000 |
(a) Insulin safety net program. $100,000 in
fiscal year 2025 is from the health care access
fund for the insulin safety net program in
Minnesota Statutes, section 151.74.
(b) Transfer. The commissioner must transfer
from the health care access fund to the insulin
deleted text begin safety net programdeleted text end new text begin repaymentnew text end account in the
special revenue fund the amount certified by
the commissioner of administration under
Minnesota Statutes, section 151.741,
subdivision 5, paragraph (b), estimated to be
$100,000 in fiscal year 2025, for
reimbursement to manufacturers for insulin
dispensed under the insulin safety net program
in Minnesota Statutes, section 151.74. The
base for this transfer is estimated to be
$100,000 in fiscal year 2026 and $100,000 in
fiscal year 2027.
(c) Base Level Adjustment. The health care
access fund base is increased by $100,000 in
fiscal year 2026 and increased by $100,000 in
fiscal year 2027.
Sec. 15. new text begin TRANSFERS TO THE DEPARTMENT OF CHILDREN, YOUTH, AND
FAMILIES IN UNCODIFIED LAW.
new text end
new text begin
Any power, duty, or responsibility given to the commissioner of human services or the
Department of Human Services in an uncodified section of Laws of Minnesota that is a part
of, necessary for, or in service of a power, duty, or responsibility transferred in Laws 2023,
chapter 70, article 12, section 30, or Laws 2024, chapter 80, transfers to the commissioner
of children, youth, and families or the Department of Children, Youth, and Families upon
the notice of transfer of the underlying power, duty, or responsibility required in Laws 2023,
chapter 70, article 12, section 30, subdivision 1. This section applies to uncodified sections
of Laws of Minnesota enacted before and after Laws 2023, chapter 70, including but not
limited to Laws 2024, chapter 117, sections 16 to 22.
new text end
Sec. 16. new text begin OPERATION WITHIN EXISTING RESOURCES.
new text end
new text begin
The board of directors of MNsure may, if necessary, operate and administer the premium
subsidy program established under Minnesota Statutes, section 62V.16, in nonconformance
with that section to the minimum extent necessary, using existing resources and available
processes until January 1, 2027.
new text end
Sec. 17. new text begin DIRECTION TO THE COMMISSIONER OF CHILDREN, YOUTH, AND
FAMILIES; CHILD CARE AND DEVELOPMENT BLOCK GRANT
ALLOCATIONS.
new text end
new text begin
(a) The commissioner of children, youth, and families shall allocate $1,000,000 in fiscal
year 2026 and $1,000,000 in fiscal year 2027 from the child care and development block
grant for child care improvement grants under Minnesota Statutes, section 142D.20,
subdivision 3, paragraph (a), clause (7). This is a onetime allocation.
new text end
new text begin
(b) The commissioner of children, youth, and families shall allocate $55,000 in fiscal
year 2026, $639,000 in fiscal year 2027, $1,639,000 in fiscal year 2028, and $1,638,000 in
fiscal year 2029 from the child care and development block grant for the development of a
statewide electronic attendance and record keeping system for the child care assistance
program.
new text end
new text begin
(c) The commissioner of children, youth, and families shall allocate $1,419,000 in fiscal
year 2026, $4,221,000 in fiscal year 2027, $4,791,000 in fiscal year 2028, and $4,885,000
in fiscal year 2029 from the child care and development block grant for MFIP child care
assistance to comply with federal requirements.
new text end
new text begin
(d) The commissioner of children, youth, and families shall allocate $2,662,000 in fiscal
year 2026, $5,479,000 in fiscal year 2027, $5,482,000 in fiscal year 2028, and $5,196,000
in fiscal year 2029 from the child care and development block grant for basic sliding fee
child care assistance to comply with federal requirements.
new text end
Sec. 18. new text begin DIRECTION TO COMMISSIONER OF CHILDREN, YOUTH, AND
FAMILIES; ALLOCATION OF TANF-ELIGIBLE GENERAL FUND
EXPENDITURES.
new text end
new text begin
The commissioner of children, youth, and families must identify $4,000,000 in fiscal
year 2026, $4,000,000 in fiscal year 2027, $4,000,000 in fiscal year 2028, and $4,000,000
in fiscal year 2029 of general fund expenditures attributable to eligible activities under
Minnesota Statutes, chapter 142G, and reduce general fund expenditures by the same
amounts. The commissioner must allocate $4,000,000 in fiscal year 2026, $4,000,000 in
fiscal year 2027, $4,000,000 in fiscal year 2028, and $4,000,000 in fiscal year 2029 to
eligible activities under Minnesota Statutes, chapter 142G, to the TANF fund.
new text end
Sec. 19. new text begin DIRECTION TO THE COMMISSIONERS OF HEALTH; HUMAN
SERVICES; AND CHILDREN, YOUTH, AND FAMILIES; REPORTS ON GRANT
FUNDING.
new text end
new text begin
(a) Beginning January 15, 2026, and each odd-numbered year thereafter, the
commissioners of health; human services; and children, youth, and families must each
submit a report that contains an accurate list of all grants with money appropriated in the
preceding fiscal year and appropriated for the current biennium and the following biennium
that are administered by each commissioner and must include for each grant:
new text end
new text begin
(1) the name of the grant;
new text end
new text begin
(2) a description of the grant, including the eligibility criteria of grantees and the purpose
of the grant;
new text end
new text begin
(3) the amount appropriated in each fiscal year that supports the total appropriation for
each grant budget activity for the November forecast in each even-numbered year; and
new text end
new text begin
(4) the accurate and complete statutory or Minnesota Laws citation for the authority for
the grant.
new text end
new text begin
(b) The commissioner of health must submit the report in paragraph (a) to the chairs and
ranking minority members of the legislative committees with jurisdiction over health, and
to the director of the House Research Department, the chief fiscal analyst of the House
Fiscal Analysis Department, and the director and principal fiscal analyst of Senate Counsel,
Research and Fiscal Analysis.
new text end
new text begin
(c) The commissioner of human services must submit the report in paragraph (a) to the
chairs and ranking minority members of the legislative committees with jurisdiction over
human services, and to the director of the House Research Department, the chief fiscal
analyst of the House Fiscal Analysis Department, and the director and principal fiscal analyst
of Senate Counsel, Research and Fiscal Analysis.
new text end
new text begin
(d) The commissioner of children, youth, and families must submit the report in paragraph
(a) to the chairs and ranking minority members of the legislative committees with jurisdiction
over children, youth, and families, and to the director of the House Research Department,
the chief fiscal analyst of the House Fiscal Analysis Department, and the director and
principal fiscal analyst of Senate Counsel, Research and Fiscal Analysis.
new text end
new text begin
(e) The reports provided under this section expire on June 30, 2036.
new text end
Sec. 20. new text begin REVISOR INSTRUCTION.
new text end
new text begin
By February 1, 2026, the revisor of statutes must identify any changes to Minnesota
Statutes and Minnesota Rules necessary to reflect the expiration of the Minnesota premium
security plan and the premium security account. The revisor of statutes may submit to the
chairs and ranking minority members of the legislative committees with jurisdiction over
commerce finance and policy draft legislation with the statutory changes necessary to
implement the identified changes.
new text end
Sec. 21. new text begin REPEALER.
new text end
new text begin
Minnesota Statutes 2024, sections 62E.21; 62E.22; 62E.23; 62E.24; and 62E.25,
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 August 16, 2026.
new text end
ARTICLE 22
HUMAN SERVICES FORECAST ADJUSTMENTS
Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
|
new text begin
The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2023, chapter 70,
article 20, from the general fund, or any other fund named, to the commissioner of human
services for the purposes specified in this article, to be available for the fiscal year indicated
for each purpose. The figure "2025" used in this article means that the appropriations listed
are available for the fiscal year ending June 30, 2025.
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
2025 new text end |
||||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
114,527,000 new text end |
||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2025 new text end |
||
|
new text begin
General new text end |
new text begin
136,895,000 new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
(16,968,000) new text end |
|
|
new text begin
Federal TANF new text end |
new text begin
(5,400,000) new text end |
|
new text begin Subd. 2. new text end
new text begin
Forecasted Programs
|
|||||
|
new text begin
(a) Minnesota Family Investment Program (MFIP)/Diversionary Work Program (DWP) new text end |
|||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2025 new text end |
||
|
new text begin
General new text end |
new text begin
(5,951,000) new text end |
|
|
new text begin
Federal TANF new text end |
new text begin
(5,400,000) new text end |
|
|
new text begin
(b) MFIP Child Care Assistance new text end |
new text begin
(62,336,000) new text end |
|||||
|
new text begin
(c) General Assistance new text end |
new text begin
3,737,000 new text end |
|||||
|
new text begin
(d) Minnesota Supplemental Aid new text end |
new text begin
3,428,000 new text end |
|||||
|
new text begin
(e) Housing Support new text end |
new text begin
11,923,000 new text end |
|||||
|
new text begin
(f) MinnesotaCare new text end |
new text begin
(16,525,000) new text end |
|||||
new text begin
This appropriation is from the health care
access fund.
new text end
|
new text begin
(g) Medical Assistance new text end |
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2025 new text end |
||
|
new text begin
General new text end |
new text begin
59,692,000 new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
(443,000) new text end |
|
|
new text begin
(h) Behavioral Health Fund new text end |
new text begin
135,928,000 new text end |
|||||
|
new text begin
(i) Northstar Care for Children new text end |
new text begin
(9,526,000) new text end |
|||||
Sec. 3. new text begin EFFECTIVE DATE.
new text end
new text begin
Sections 1 and 2 are effective the day following final enactment.
new text end
ARTICLE 23
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 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 HUMAN
|
new text begin
$ new text end |
new text begin
3,270,735,000 new text end |
new text begin
$ new text end |
new text begin
3,436,450,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
||||||
|
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
1,954,922,000 new text end |
new text begin
2,172,448,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,273,000 new text end |
new text begin
4,273,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
1,311,183,000 new text end |
new text begin
1,259,372,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
163,000 new text end |
new text begin
163,000 new text end |
|
new text begin
Family and Medical Benefit Insurance new text end |
new text begin
194,000 new text end |
new text begin
194,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in this article.
new text end
new text begin Subd. 2. new text end
new text begin
Information Technology Appropriations
|
||||||
new text begin
(a) IT appropriations generally. 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.
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 Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
167,050,000 new text end |
new text begin
$ new text end |
new text begin
172,312,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
145,200,000 new text end |
new text begin
148,935,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
248,000 new text end |
new text begin
248,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
21,408,000 new text end |
new text begin
22,935,000 new text end |
|
new text begin
Family and Medical Benefits Insurance new text end |
new text begin
194,000 new text end |
new text begin
194,000 new text end |
new text begin Subd. 2. new text end
new text begin
Administrative Recovery; Set-Aside
|
||||||
new text begin
The commissioner may invoice local entities
through the SWIFT accounting system as an
alternative means to recover the actual cost of
administering the following provisions:
new text end
new text begin
(1) the statewide data management system
authorized in Minnesota Statutes, section
125A.744, subdivision 3;
new text end
new text begin
(2) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 245.495,
paragraph (b);
new text end
new text begin
(3) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end
new text begin
(4) targeted case management under
Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end
new text begin
(5) residential services for children with severe
emotional disturbance under Minnesota
Statutes, section 256B.0945, subdivision 4,
paragraph (d); and
new text end
new text begin
(6) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end
new text begin Subd. 3. new text end
new text begin
Family and Medical Benefit Insurance
|
||||||
new text begin
$194,000 in fiscal year 2026 and $194,000 in
fiscal year 2027 are from the family and
medical benefit insurance fund for systems
costs to administer Minnesota Statutes, chapter
268B.
new text end
new text begin Subd. 4. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$149,621,000 in fiscal year 2028 and
$150,581,000 in fiscal year 2029.
new text end
Sec. 4. new text begin CENTRAL OFFICE; HEALTH CARE
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
66,827,000 new text end |
new text begin
$ new text end |
new text begin
62,780,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
38,659,000 new text end |
new text begin
34,612,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
28,168,000 new text end |
new text begin
28,168,000 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
$34,639,000 in fiscal year 2028 and
$34,639,000 in fiscal year 2029.
new text end
Sec. 5. new text begin CENTRAL OFFICE; AGING AND
|
new text begin
$ new text end |
new text begin
49,290,000 new text end |
new text begin
$ new text end |
new text begin
49,194,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
49,165,000 new text end |
new text begin
49,069,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
125,000 new text end |
new text begin
125,000 new text end |
Sec. 6. new text begin CENTRAL OFFICE; BEHAVIORAL
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
22,563,000 new text end |
new text begin
$ new text end |
new text begin
22,159,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
22,400,000 new text end |
new text begin
21,996,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
163,000 new text end |
new text begin
163,000 new text end |
new text begin Subd. 2. new text end
new text begin
Psychiatric Residential Treatment
|
||||||
new text begin
$288,000 in fiscal year 2026 is from the
general fund for the development of the
psychiatric residential treatment facility report
and proposed legislation. This is a onetime
appropriation and is available until June 30,
2027.
new text end
new text begin Subd. 3. new text end
new text begin
Online Behavioral Health Program
|
||||||
new text begin
(a) $959,000 in fiscal year 2026 and $959,000
in fiscal year 2027 are from the general fund
for an online behavioral health program
locator.
new text end
new text begin
(b) Any vendor selected to administer the
online behavioral health program locator under
paragraph (a) must be based in Minnesota.
Notwithstanding section 25, this paragraph
does not expire.
new text end
Sec. 7. new text begin CENTRAL OFFICE; HOMELESSNESS,
|
new text begin
$ new text end |
new text begin
7,065,000 new text end |
new text begin
$ new text end |
new text begin
6,421,000 new text end |
||
Sec. 8. new text begin CENTRAL OFFICE; OFFICE OF
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
36,262,000 new text end |
new text begin
$ new text end |
new text begin
37,456,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
31,421,000 new text end |
new text begin
32,615,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
3,900,000 new text end |
new text begin
3,900,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
941,000 new text end |
new text begin
941,000 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
$32,671,000 in fiscal year 2028 and
$32,617,000 in fiscal year 2029.
new text end
Sec. 9. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
84,138,000 new text end |
new text begin
$ new text end |
new text begin
86,462,000 new text end |
||
new text begin
Emergency General Assistance
new text end
new text begin
(a) The amount appropriated for emergency
general assistance is up to $6,729,812 in fiscal
year 2026 and up to $6,729,812 in fiscal year
2027.
new text end
new text begin
(b) Money to counties for emergency general
assistance shall be allocated by the
commissioner using the allocation method
under Minnesota Statutes, section 256D.06,
subdivision 2, paragraph (c).
new text end
Sec. 10. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
67,113,000 new text end |
new text begin
$ new text end |
new text begin
69,089,000 new text end |
||
Sec. 11. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
269,258,000 new text end |
new text begin
$ new text end |
new text begin
279,703,000 new text end |
||
Sec. 12. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
106,426,000 new text end |
new text begin
$ new text end |
new text begin
170,050,000 new text end |
||
new text begin
This appropriation is from the health care
access fund.
new text end
Sec. 13. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
2,138,140,000 new text end |
new text begin
$ new text end |
new text begin
2,222,830,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
987,365,000 new text end |
new text begin
1,189,017,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
1,150,775,000 new text end |
new text begin
1,033,813,000 new text end |
new text begin
The health care access fund base for this
section is $1,005,182,000 in fiscal year 2028
and $1,007,298,000 in fiscal year 2029.
new text end
Sec. 14. 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 |
||
Sec. 15. new text begin GRANT PROGRAMS; REFUGEE
|
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 |
||
Sec. 16. new text begin GRANT PROGRAMS; HEALTH
|
new text begin
$ new text end |
new text begin
8,176,000 new text end |
new text begin
$ new text end |
new text begin
8,176,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
4,711,000 new text end |
new text begin
4,711,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
3,465,000 new text end |
new text begin
3,465,000 new text end |
Sec. 17. new text begin GRANT PROGRAMS; DISABILITIES
|
new text begin
$ new text end |
new text begin
(2,220,000) new text end |
new text begin
$ new text end |
new text begin
(2,220,000) new text end |
||
Sec. 18. new text begin GRANT PROGRAMS; HOUSING AND
|
new text begin
$ new text end |
new text begin
89,570,000 new text end |
new text begin
$ new text end |
new text begin
92,911,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Family Supportive Housing Grant
|
||||||
new text begin
$700,000 in fiscal year 2026 is for the family
supportive housing grant program. 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
Grant for Catholic Charities Homeless
|
||||||
new text begin
$959,000 in fiscal year 2026 is for a grant to
Catholic Charities of St. Paul and Minneapolis
for the homeless elders program that helps
homeless, isolated, and low-income older
adults to move into stable housing. This is a
onetime appropriation and is available until
June 30, 2027.
new text end
Sec. 19. new text begin GRANT PROGRAMS; ADULT
|
new text begin
$ new text end |
new text begin
110,977,000 new text end |
new text begin
$ new text end |
new text begin
110,977,000 new text end |
||
new text begin
Early Episode of Bipolar Disorder Grants.
$125,000 in fiscal year 2026 and $125,000 in
fiscal year 2027 are for early episode of
bipolar disorder grants under Minnesota
Statutes, section 245.4905.
new text end
Sec. 20. new text begin GRANT PROGRAMS; CHILD
|
new text begin
$ new text end |
new text begin
37,625,000 new text end |
new text begin
$ new text end |
new text begin
35,675,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Grant to Mental Health
|
||||||
new text begin
$750,000 in fiscal year 2026 is for a grant to
the Mental Health Collaboration Hub for the
Mental Health Collaboration Hub innovation
pilot program. 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
Psychiatric Residential Treatment
|
||||||
new text begin
$200,000 in fiscal year 2026 is for a grant to
Clay County under Minnesota Statutes, section
256B.0941, subdivision 5, for a new 18-bed
psychiatric residential treatment facility in
Clay County. 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
Grant to Clay County for Psychiatric
|
||||||
new text begin
$1,000,000 in fiscal year 2026 is for a grant
to Clay County for the purchase of equipment
and final redesign and remodeling for the
conversion of the West Central Regional
Juvenile Center nonsecure unit into an 18-bed
psychiatric residential treatment facility for
persons younger than 21 years of age, under
Minnesota Statutes, section 256B.0941. This
is a onetime appropriation.
new text end
new text begin Subd. 4. new text end
new text begin
School-Linked Behavioral Health
|
||||||
new text begin
$22,576,000 in fiscal year 2026 and
$22,576,000 in fiscal year 2027 are from the
general fund for school-linked behavioral
health grants under Minnesota Statutes, section
245.4901.
new text end
Sec. 21. new text begin GRANT PROGRAMS; HIV GRANTS
|
new text begin
$ new text end |
new text begin
6,720,000 new text end |
new text begin
$ new text end |
new text begin
6,720,000 new text end |
||
new text begin
new text begin Grants to Community-Based HIV/AIDS
Support Services Providers.new text end $4,500,000 in
fiscal year 2026 and $4,500,000 in fiscal year
2027 are for grants to community-based
HIV/AIDS support services providers.
new text end
Sec. 22. 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 shall report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
quarterly about transfers made under this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Administration. 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 shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services finance quarterly about transfers
made under this section.
new text end
new text begin Subd. 3. new text end
new text begin
Temporary authority for interagency transfers with Department of
Children, Youth, and Families.
new text end
new text begin
Beginning July 1, 2025, and until September 30, 2025,
administrative money may be transferred between the Department of Human Services and
Department of Children, Youth, and Families as the commissioners deem necessary, with
the advance approval of the commissioner of management and budget. The commissioners
shall report to the chairs and ranking minority members of the legislative committees with
jurisdiction over children and families quarterly about transfers made under this section.
new text end
Sec. 23. new text begin CANCELLATIONS.
new text end
new text begin Subdivision 1. new text end
new text begin School-linked behavioral health grants. new text end
new text begin
$3,000,000 of the fiscal year
2025 general fund appropriation in Laws 2024, chapter 127, article 67, section 2, subdivision
9, paragraph (a), is canceled to the general fund.
new text end
new text begin Subd. 2. new text end
new text begin
New American legal, social services, and long-term care workforce grant
program.
new text end
new text begin
$7,000,000 of the fiscal year 2024 general fund appropriation in Laws 2023,
chapter 70, article 20, section 2, subdivision 25, is canceled to the general fund.
new text end
new text begin Subd. 3. new text end
new text begin Mobile crisis grants. new text end
new text begin
$1,672,000 of the fiscal year 2025 general fund
appropriation in Laws 2023, chapter 70, article 20, section 2, subdivision 29, paragraph (e),
is canceled to the general fund.
new text end
new text begin Subd. 4. new text end
new text begin Child mental health grants. new text end
new text begin
$250,000 of the fiscal year 2025 general fund
appropriation in Laws 2023, chapter 70, article 20, section 2, subdivision 30, is canceled to
the general fund.
new text end
new text begin Subd. 5. new text end
new text begin Emergency medical assistance legal referral costs. new text end
new text begin
$100,000 of the 2025
general fund appropriation in Laws 2023, chapter 70, article 20, section 2, subdivision 26,
is canceled to the general fund.
new text end
new text begin Subd. 6. new text end
new text begin Grants to navigators. new text end
new text begin
$800,000 of the fiscal year 2024 health care access fund
appropriation in Laws 2023, chapter 22, section 4, subdivision 2, is canceled to the health
care access fund.
new text end
new text begin Subd. 7. new text end
new text begin
Mille Lacs Band of Ojibwe American Indian child welfare
initiative.
new text end
new text begin
$5,294,000 of the fiscal year 2025 general fund appropriation in Laws 2023,
chapter 70, article 20, section 2, subdivision 22, paragraph (b), is canceled to the general
fund.
new text end
new text begin Subd. 8. new text end
new text begin Transition grant program. new text end
new text begin
$293,000 of the fiscal year 2024 general fund
appropriation in Laws 2023, chapter 70, article 20, section 2, subdivision 20, paragraph (b),
is canceled to the general fund.
new text end
new text begin Subd. 9. new text end
new text begin Grant to administer pool of qualified individuals for assessments. new text end
new text begin
$250,000
of the fiscal year 2025 general fund appropriation in Laws 2023, chapter 70, article 20,
section 2, subdivision 22, paragraph (k), is canceled to the general fund.
new text end
new text begin Subd. 10. new text end
new text begin IT systems improvements for children and families. new text end
new text begin
$10,000,000 of the
fiscal year 2024 general fund appropriation in Laws 2023, chapter 70, article 20, section 2,
subdivision 4, paragraph (g), is canceled to the general fund.
new text end
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. 24. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
The administrative costs retention requirement under Minnesota Statutes, section 16B.98,
subdivision 14, is inapplicable to any appropriation in this article for a grant.
new text end
Sec. 25. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires June 30, 2027, unless a different
expiration date is explicit or an appropriation is made available beyond June 30, 2027.
new text end
Sec. 26.
Laws 2023, chapter 70, article 20, section 2, subdivision 30, is amended to read:
Subd. 30.Grant Programs; Child Mental Health
|
44,487,000 |
deleted text begin
37,934,000
deleted text end
new text begin
37,734,000 new text end |
||||
(a) Psychiatric residential treatment facility
start-up grants. $1,000,000 in fiscal year
2024 and deleted text begin $1,000,000deleted text end new text begin $800,000new text end in fiscal year
2025 are for psychiatric residential treatment
facility start-up grants under Minnesota
Statutes, section 256B.0941, subdivision 5.
This is a onetime appropriation and is
available until June 30, 2027.
(b) African American Child Wellness
Institute. $2,000,000 in fiscal year 2024 is
for a grant to the African American Child
Wellness Institute to provide culturally
specific mental health and substance use
disorder services under Minnesota Statutes,
section 245.0961. This is a onetime
appropriation and is available until June 30,
2027.
(c) Base level adjustment. The general fund
base is $34,648,000 in fiscal year 2026 and
$34,648,000 in fiscal year 2027.
ARTICLE 24
DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES APPROPRIATIONS
Section 1. new text begin CHILDREN, YOUTH, AND FAMILIES 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 CHILDREN,
|
new text begin
$ new text end |
new text begin
1,353,351,000 new text end |
new text begin
$ new text end |
new text begin
1,419,413,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
1,049,362,000 new text end |
new text begin
1,094,962,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
732,000 new text end |
new text begin
732,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
302,921,000 new text end |
new text begin
323,383,000 new text end |
|
new text begin
Family and Medical Benefit Insurance new text end |
new text begin
336,000 new text end |
new text begin
336,000 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 TANF MAINTENANCE OF EFFORT
|
||||||
new text begin Subdivision 1. new text end
new text begin
Nonfederal Expenditures
|
||||||
new text begin
The commissioner shall ensure that sufficient
qualified nonfederal expenditures are made
each year to meet the state's maintenance of
effort requirements of the TANF block grant
specified under Code of Federal Regulations,
title 45, section 263.1. In order to meet these
basic TANF maintenance of effort
requirements, the commissioner may report
as TANF maintenance of effort expenditures
only nonfederal money expended for allowable
activities listed in the following clauses:
new text end
new text begin
(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 142G;
new text end
new text begin
(2) the child care assistance programs under
Minnesota Statutes, sections 142E.04 and
142E.08, and county child care administrative
costs under Minnesota Statutes, section
142E.02, subdivision 9;
new text end
new text begin
(3) state and county MFIP administrative costs
under Minnesota Statutes, chapters 142G and
256K;
new text end
new text begin
(4) state, county, and Tribal MFIP
employment services under Minnesota
Statutes, chapters 142G and 256K;
new text end
new text begin
(5) expenditures made on behalf of legal
noncitizen MFIP recipients who qualify for
the MinnesotaCare program under Minnesota
Statutes, chapter 256L;
new text end
new text begin
(6) qualifying working family credit
expenditures under Minnesota Statutes, section
290.0671, and child tax credit expenditures
under Minnesota Statutes, section 290.0661;
new text end
new text begin
(7) qualifying Minnesota education credit
expenditures under Minnesota Statutes, section
290.0674; and
new text end
new text begin
(8) qualifying Head Start expenditures under
Minnesota Statutes, section 142D.12.
new text end
new text begin Subd. 2. new text end
new text begin
Nonfederal Expenditures; Reporting
|
||||||
new text begin
For the activities listed in subdivision 1,
clauses (2) to (8), the commissioner may
report only expenditures that are excluded
from the definition of assistance under Code
of Federal Regulations, title 45, section
260.31.
new text end
new text begin Subd. 3. new text end
new text begin
Supplemental Expenditures
|
||||||
new text begin
The commissioner may supplement the
maintenance of effort claim with working
family credit expenditures or other qualified
expenditures to the extent such expenditures
are otherwise available after considering the
expenditures allowed in this section.
new text end
new text begin Subd. 4. new text end
new text begin
Reduction of Appropriations; Exception
|
||||||
new text begin
The requirement in Minnesota Statutes, section
142A.06, subdivision 3, that federal grants or
aids secured or obtained under that subdivision
be used to reduce any direct appropriations
provided by law does not apply if the grants
or aids are federal TANF funds.
new text end
new text begin Subd. 5. new text end
new text begin
IT Appropriations Generally
|
||||||
new text begin
This appropriation includes funds 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 Children,
Youth, and Families under the rates and
mechanism specified in that agreement.
new text end
new text begin Subd. 6. new text end
new text begin
Receipts for Systems Project
|
||||||
new text begin
Appropriations and federal receipts for
information technology systems projects for
MAXIS, PRISM, ISDS, and SSIS must be
deposited in the state systems account
authorized in Minnesota Statutes, section
142A.04. 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 children, youth, and families
considers necessary. Any unexpended balance
in the appropriation for these projects does not
cancel and is available for ongoing
development and operations.
new text end
new text begin Subd. 7. new text end
new text begin
Federal SNAP Education and Training
|
||||||
new text begin
Federal funds available during fiscal years
2026 and 2027 for Supplemental Nutrition
Assistance Program Education and Training
and SNAP Quality Control Performance
Bonus grants are appropriated to the
commissioner of human services for the
purposes allowable under the terms of the
federal award. This subdivision is effective
the day following final enactment.
new text end
Sec. 4. new text begin OPERATIONS AND
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
110,319,000 new text end |
new text begin
$ new text end |
new text begin
103,807,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
109,151,000 new text end |
new text begin
102,639,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
732,000 new text end |
new text begin
732,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
100,000 new text end |
new text begin
100,000 new text end |
|
new text begin
Family and Medical Benefit Insurance new text end |
new text begin
336,000 new text end |
new text begin
336,000 new text end |
new text begin Subd. 2. new text end
new text begin
Information Technology
|
||||||
new text begin
$10,000,000 in fiscal year 2026 is from the
general fund for information technology
improvements to SSIS. This is a onetime
appropriation.
new text end
new text begin Subd. 3. new text end
new text begin
Child Welfare Fiscal Analysis
|
||||||
new text begin
$250,000 in fiscal year 2026 is from the
general fund to contract with a third-party
consultant to conduct an independent fiscal
analysis of the child welfare system in
Minnesota. This is a onetime appropriation
and is available until June 30, 2029.
new text end
new text begin Subd. 4. new text end
new text begin
Family and Medical Benefit Insurance
|
||||||
new text begin
$336,000 in fiscal year 2026 and $336,000 in
fiscal year 2027 are from the family and
medical benefit insurance fund for systems
costs to administer Minnesota Statutes, chapter
268B.
new text end
new text begin Subd. 5. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$102,534,000 in fiscal year 2028 and
$102,172,000 in fiscal year 2029.
new text end
Sec. 5. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
17,232,000 new text end |
new text begin
$ new text end |
new text begin
16,945,000 new text end |
||
Sec. 6. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
17,166,000 new text end |
new text begin
$ new text end |
new text begin
12,698,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Child Care Attendance and
|
||||||
new text begin
$5,500,000 in fiscal year 2026 and $1,000,000
in fiscal year 2027 are to develop a statewide
electronic attendance and record-keeping
system for the child care assistance program.
This is a onetime appropriation.
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
$11,698,000 in fiscal year 2028 and
$11,698,000 in fiscal year 2029.
new text end
Sec. 7. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
4,182,000 new text end |
new text begin
$ new text end |
new text begin
3,646,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Scan of and Report on
|
||||||
new text begin
$402,000 in fiscal year 2026 is to conduct the
scan of and prepare the out-of-school and
youth programming report. This is a onetime
appropriation.
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
$3,562,000 in fiscal year 2028 and $3,562,000
in fiscal year 2029.
new text end
Sec. 8. new text begin OPERATIONS AND
|
new text begin
$ new text end |
new text begin
14,147,000 new text end |
new text begin
$ new text end |
new text begin
14,147,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
10,471,000 new text end |
new text begin
10,471,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
3,676,000 new text end |
new text begin
3,676,000 new text end |
Sec. 9. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
230,473,000 new text end |
new text begin
$ new text end |
new text begin
268,167,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
99,272,000 new text end |
new text begin
116,504,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
131,201,000 new text end |
new text begin
151,663,000 new text end |
Sec. 10. new text begin FORECASTED PROGRAMS; MFIP
|
new text begin
$ new text end |
new text begin
100,244,000 new text end |
new text begin
$ new text end |
new text begin
137,333,000 new text end |
||
Sec. 11. new text begin FORECASTED PROGRAMS;
|
new text begin
$ new text end |
new text begin
110,214,000 new text end |
new text begin
$ new text end |
new text begin
116,160,000 new text end |
||
Sec. 12. new text begin GRANT PROGRAMS; SUPPORT
|
new text begin
$ new text end |
new text begin
111,359,000 new text end |
new text begin
$ new text end |
new text begin
111,359,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
14,908,000 new text end |
new text begin
14,908,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
96,451,000 new text end |
new text begin
96,451,000 new text end |
Sec. 13. new text begin GRANT PROGRAMS; BASIC
|
new text begin
$ new text end |
new text begin
137,768,000 new text end |
new text begin
$ new text end |
new text begin
135,212,000 new text end |
||
Sec. 14. new text begin GRANT PROGRAMS; CHILD CARE
|
new text begin
$ new text end |
new text begin
139,120,000 new text end |
new text begin
$ new text end |
new text begin
138,819,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
St. Cloud Area School District
|
||||||
new text begin
$301,000 in fiscal year 2026 is for a grant to
Independent School District No. 742 for the
Preschool 4 Success program operated with
the Rotary Club of St. Cloud. 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
Great Start Compensation Support
|
||||||
new text begin
$129,887,000 in fiscal year 2026 and
$129,887,000 in fiscal year 2027 are for the
Great Start Compensation Support Payments
under Minnesota Statutes, section 142D.21.
new text end
Sec. 15. new text begin GRANT PROGRAMS; CHILD
|
new text begin
$ new text end |
new text begin
50,000 new text end |
new text begin
$ new text end |
new text begin
50,000 new text end |
||
Sec. 16. new text begin GRANT PROGRAMS; CHILDREN'S
|
new text begin
$ new text end |
new text begin
41,704,000 new text end |
new text begin
$ new text end |
new text begin
41,705,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Restorative Practices Initiatives
|
||||||
new text begin
The base funding for restorative practices
initiatives grants under Minnesota Statutes,
section 142A.76, subdivision 5, is reduced by
$1,500,000 in fiscal year 2026 and $1,500,000
in fiscal year 2027.
new text end
new text begin Subd. 2. new text end
new text begin
Fostering Connections to Success and
|
||||||
new text begin
The commissioner shall allocate funds from
the state's savings from the Fostering
Connections to Success and Increasing
Adoptions Act's expanded eligibility for Title
IV-E adoption assistance as required in
Minnesota Statutes, section 142A.61, and as
allowable under federal law. Additional
savings to the state as a result of the Fostering
Connections to Success and Increasing
Adoptions Act's expanded eligibility for Title
IV-E adoption assistance is for postadoption,
foster care, adoption, and kinship services,
including a parent-to-parent support network
and as allowable under federal law.
new text end
Sec. 17. new text begin GRANT PROGRAMS; CHILD AND
|
new text begin
$ new text end |
new text begin
87,984,000 new text end |
new text begin
$ new text end |
new text begin
87,984,000 new text end |
||
Sec. 18. new text begin GRANT PROGRAMS; CHILD AND
|
new text begin
$ new text end |
new text begin
18,167,000 new text end |
new text begin
$ new text end |
new text begin
18,159,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Regional Food Bank Grants
|
||||||
new text begin
$2,980,000 in fiscal year 2026 and $2,977,000
in fiscal year 2027 are for regional food bank
grants under Minnesota Statutes, section
142F.16. 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
Minnesota Food Shelf Programs
|
||||||
new text begin
$2,000,000 in fiscal year 2026 and $2,000,000
in fiscal year 2027 are for food shelf programs
grants under Minnesota Statutes, section
142F.14. This is a onetime appropriation and
is available until June 30, 2027.
new text end
new text begin Subd. 3. new text end
new text begin
Prepared Meals Food Relief Grants
|
||||||
new text begin
$971,000 in fiscal year 2026 and $966,000 in
fiscal year 2027 are for prepared meals food
relief grants under Minnesota Statutes, section
142F.141. This is a onetime appropriation and
is available until June 30, 2027.
new text end
new text begin Subd. 4. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$12,216,000 in fiscal year 2028 and
$12,216,000 in fiscal year 2029.
new text end
Sec. 19. new text begin GRANT PROGRAMS; EARLY
|
new text begin
$ new text end |
new text begin
132,838,000 new text end |
new text begin
$ new text end |
new text begin
132,838,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Early Childhood Literacy
|
||||||
new text begin
The base funding for early childhood literacy
programs under Minnesota Statutes, section
142D.12, subdivision 3, is reduced by
$7,950,000 in fiscal year 2026 and $7,950,000
in fiscal year 2027.
new text end
new text begin Subd. 2. new text end
new text begin
Grants for Early Learning Scholarships
|
||||||
new text begin
$97,290,000 in fiscal year 2026 and
$97,290,000 in fiscal year 2027 are from the
general fund for early learning scholarships
grants under Minnesota Statutes, section
142D.25.
new text end
new text begin Subd. 3. new text end
new text begin
Head Start Program Grants
|
||||||
new text begin
$34,398,000 in fiscal year 2026 and
$34,398,000 in fiscal year 2027 are from the
general fund for head start program grants
under Minnesota Statutes, section 142D.12.
new text end
new text begin Subd. 4. new text end
new text begin
School Readiness Plus Program Grants
|
||||||
new text begin
$900,000 in fiscal year 2026 and $900,000 in
fiscal year 2027 are from the general fund for
school readiness plus program grants under
Minnesota Statutes, section 142D.07.
new text end
new text begin Subd. 5. new text end
new text begin
Reach Out and Read Minnesota Grant
|
||||||
new text begin
$250,000 in fiscal year 2026 and $250,000 in
fiscal year 2027 are for a grant to Reach Out
and Read Minnesota to establish a statewide
plan that encourages early childhood
development through a network of health care
clinics under Laws 2023, chapter 54, section
20, subdivision 20.
new text end
Sec. 20. new text begin GRANT PROGRAMS; YOUTH
|
new text begin
$ new text end |
new text begin
8,891,000 new text end |
new text begin
$ new text end |
new text begin
8,891,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Grants-in-Aid to Youth
|
||||||
new text begin
$6,036,000 in fiscal year 2026 and $6,036,000
in fiscal year 2027 are for grants to youth
intervention programs under Minnesota
Statutes, section 142A.43, subdivision 1.
new text end
new text begin Subd. 2. new text end
new text begin
Youth Intervention Programs
|
||||||
new text begin
Notwithstanding the percentage requirement
under Minnesota Statutes, section 142A.43,
subdivision 3, $355,000 in fiscal year 2026
and $355,000 in fiscal year 2027 are for a
grant to the Minnesota Youth Intervention
Programs Association for collaboration,
program development, professional
development training, technical assistance,
tracking, and analyzing and reporting outcome
data for the community-based grantees of the
program.
new text end
new text begin Subd. 3. new text end
new text begin
Office of Restorative Practices
|
||||||
new text begin
$2,500,000 in fiscal year 2026 and $2,500,000
in fiscal year 2027 are from the general fund
for the Office of Restorative Practices under
Minnesota Statutes, section 142A.76.
new text end
Sec. 21. new text begin TECHNICAL ACTIVITIES
|
new text begin
$ new text end |
new text begin
71,493,000 new text end |
new text begin
$ new text end |
new text begin
71,493,000 new text end |
||
new text begin
This appropriation is from the federal TANF
fund.
new text end
Sec. 22. new text begin TRANSFERS.
new text end
new text begin Subdivision 1. new text end
new text begin Programs and grants. new text end
new text begin
The commissioner of children, youth, and families,
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 MFIP; MFIP child care assistance under Minnesota Statutes, section 142E.08;
the entitlement portion of Northstar Care for Children under Minnesota Statutes, sections
142A.60 to 142A.612; and early childhood family education under Minnesota Statutes,
section 142D.11, between fiscal years of the biennium. The commissioner shall inform the
chairs and ranking minority members of the legislative committees with jurisdiction over
children and families finance and policy quarterly about transfers made under this
subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Administration. new text end
new text begin
Positions, salary money, and nonsalary administrative money
may be transferred within the Department of Children, Youth, and Families as the
commissioner deems necessary, with the advance approval of the commissioner of
management and budget. The commissioner shall report to the chairs and ranking minority
members of the legislative committees with jurisdiction over children and families finance
quarterly about transfers made under this subdivision.
new text end
new text begin Subd. 3. new text end
new text begin
Temporary authority for interagency transfers with Department of Human
Services.
new text end
new text begin
Beginning July 1, 2025, and until September 30, 2025, administrative money may
be transferred between the Department of Children, Youth, and Families and the Department
of Human Services or the Department of Education as the commissioners deem necessary,
with the advance approval of the commissioner of management and budget. The
commissioners shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over children and families finance and policy quarterly about
transfers made under this subdivision.
new text end
Sec. 23. new text begin CANCELLATION; ESTABLISHING THE DEPARTMENT OF CHILDREN,
YOUTH, AND FAMILIES.
new text end
new text begin
$8,500,000 of the fiscal year 2024 general fund appropriation in Laws 2023, chapter 70,
article 20, section 12, paragraph (b), is canceled to the general fund.
new text end
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. 24. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
The administrative costs retention requirement under Minnesota Statutes, section 16B.98,
subdivision 14, is inapplicable to any appropriation in this article for a grant.
new text end
Sec. 25. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires June 30, 2027, unless a different
expiration date is explicit or an appropriation is made available beyond June 30, 2027.
new text end
ARTICLE 25
DEPARTMENT OF HEALTH APPROPRIATIONS
Section 1. new text begin HEALTH APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the
commissioner of health 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
434,610,000 new text end |
new text begin
$ new text end |
new text begin
430,946,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
271,895,000 new text end |
new text begin
269,645,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
96,237,000 new text end |
new text begin
95,769,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
54,765,000 new text end |
new text begin
53,819,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in this article.
new text end
Sec. 3. new text begin HEALTH IMPROVEMENT
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
291,627,000 new text end |
new text begin
$ new text end |
new text begin
286,428,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
217,302,000 new text end |
new text begin
214,495,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
9,258,000 new text end |
new text begin
9,258,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
53,354,000 new text end |
new text begin
50,962,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin Subd. 2. new text end
new text begin
Substance Use Treatment, Recovery,
|
||||||
new text begin
$3,000,000 in fiscal year 2026 and $3,000,000
in fiscal year 2027 are from the general fund
for substance use treatment, recovery, and
prevention grants under Minnesota Statutes,
section 342.72.
new text end
new text begin Subd. 3. new text end
new text begin
Local and Tribal Public Health
|
||||||
new text begin
$7,756,000 in fiscal year 2026 and $7,756,000
in fiscal year 2027 are from the general fund
for grants under Minnesota Statutes, section
144.197, subdivision 4.
new text end
new text begin Subd. 4. new text end
new text begin
Cannabis and Substance Misuse
|
||||||
new text begin
$4,534,000 in fiscal year 2026 and $4,470,000
in fiscal year 2027 are from the general fund
for the youth prevention and education
program under the cannabis and substance
misuse prevention and education programs
under Minnesota Statutes, section 144.197,
subdivision 1.
new text end
new text begin Subd. 5. new text end
new text begin
Cannabis and Substance Misuse
|
||||||
new text begin
$1,834,000 in fiscal year 2026 and $1,834,000
in fiscal year 2027 are from the general fund
for the prevention and education program for
pregnant and breastfeeding individuals and
individuals who may become pregnant under
the cannabis and substance misuse prevention
and education programs under Minnesota
Statutes, section 144.197, subdivision 2. The
base for this subdivision is $721,000 in fiscal
year 2028 and $721,000 in fiscal year 2029.
new text end
new text begin Subd. 6. new text end
new text begin
Cannabis Data Collection and Biennial
|
||||||
new text begin
$493,000 in fiscal year 2026 and $493,000 in
fiscal year 2027 are from the general fund for
cannabis data collection and biennial reports
under Minnesota Statutes, section 144.196.
new text end
new text begin Subd. 7. new text end
new text begin
Administration of Expungement Orders
|
||||||
new text begin
$71,000 in fiscal year 2026 and $71,000 in
fiscal year 2027 are from the general fund for
the administration of expungement orders
under Laws 2023, chapter 63, article 9, section
10, subdivision 6.
new text end
new text begin Subd. 8. new text end
new text begin
Grant for "Treat Yourself First"
|
||||||
new text begin
$237,000 is from the general fund for a grant
to the Minnesota Medical Association for the
"Treat Yourself First" campaign. The
campaign must be an awareness and education
campaign focused on burnout and well-being
of health care workers designed to:
new text end
new text begin
(1) reduce the stigma of receiving mental
health services;
new text end
new text begin
(2) encourage health care workers who are
experiencing workplace-related fatigue to
receive the care they need; and
new text end
new text begin
(3) normalize the process for seeking help.
new text end
new text begin
The campaign must be targeted to health care
professionals, including but not limited to
physicians, nurses, dentists, pharmacists, and
other members of the health care team. The
campaign must include resources for health
care professionals seeking help to address
burnout and well-being. This is a onetime
appropriation and is available until June 30,
2029.
new text end
new text begin Subd. 9. new text end
new text begin
Grant for African American-Focused
|
||||||
new text begin
$475,000 in fiscal year 2026 is from the
general fund for a grant to the Birth Justice
Collaborative to strengthen and implement the
current model of the African
American-focused Homeplace in Hennepin
County. This is a onetime appropriation and
is available until June 30, 2029.
new text end
new text begin Subd. 10. new text end
new text begin
TANF Appropriations
|
||||||
new text begin
TANF funds must be used as follows:
new text end
new text begin
(1) $3,579,000 in fiscal year 2026 and
$3,579,000 in fiscal year 2027 are from the
TANF fund for home visiting and nutritional
services listed under Minnesota Statutes,
section 145.882, subdivision 7, clauses (6) and
(7). Funds must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1;
new text end
new text begin
(2) $2,000,000 in fiscal year 2026 and
$2,000,000 in fiscal year 2027 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
new text end
new text begin
(3) $4,978,000 in fiscal year 2026 and
$4,978,000 in fiscal year 2027 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. Of these amounts, $4,000,000 in
fiscal year 2026 and $4,000,000 in fiscal year
2027 must be distributed to community health
boards under Minnesota Statutes, section
145A.131, subdivision 1; and $978,000 in
fiscal year 2026 and $978,000 in fiscal year
2027 must be distributed to Tribal
governments under Minnesota Statutes, section
145A.14, subdivision 2a;
new text end
new text begin
(4) $1,156,000 in fiscal year 2026 and
$1,156,000 in fiscal year 2027 are from the
TANF fund for sexual and reproductive health
services grants under Minnesota Statutes,
section 145.925; and
new text end
new text begin
(5) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end
new text begin Subd. 11. new text end
new text begin
TANF Carryforward
|
||||||
new text begin
Any unexpended balance of the TANF
appropriation in the first year does not cancel
but is available in the second year.
new text end
new text begin Subd. 12. new text end
new text begin
Base Level Adjustment
|
||||||
new text begin
The general fund base for this section is
$213,562,000 in fiscal year 2028 and
$213,562,000 in fiscal year 2029.
new text end
Sec. 4. new text begin HEALTH PROTECTION
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
121,207,000 new text end |
new text begin
$ new text end |
new text begin
120,269,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
34,228,000 new text end |
new text begin
33,758,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
86,979,000 new text end |
new text begin
86,511,000 new text end |
new text begin Subd. 2. new text end
new text begin
Speech Language Pathology Assistants
|
||||||
new text begin
$95,000 in fiscal year 2026 is from the general
fund for onetime costs incurred in fiscal year
2025 to implement Minnesota Statutes,
sections 148.511 to 148.5198.
new text end
new text begin Subd. 3. new text end
new text begin
Infectious Disease Prevention, Early
|
||||||
new text begin
$1,300,000 in fiscal year 2026 and $1,300,000
in fiscal year 2027 are from the general fund
for infectious disease prevention, early
detection, and outbreak response activities
under Minnesota Statutes, section 144.05,
subdivision 1.
new text end
new text begin Subd. 4. new text end
new text begin
Asbestos Abatement
|
||||||
new text begin
$176,000 in fiscal year 2026 and $176,000 in
fiscal year 2027 are from the state government
special revenue fund for asbestos abatement
under Minnesota Statutes, section 326.75.
new text end
new text begin Subd. 5. new text end
new text begin
Food, Pools, and Lodging Services
|
||||||
new text begin
$5,483,000 in fiscal year 2026 and $5,483,000
in fiscal year 2027 are from the state
government special revenue fund for food,
pools, and lodging services program activities
under Minnesota Statutes, chapters 144, 157,
and 327.
new text end
new text begin Subd. 6. new text end
new text begin
Public Water Supply
|
||||||
new text begin
$7,827,000 in fiscal year 2026 and $7,827,000
in fiscal year 2027 are from the state
government special revenue fund to administer
the drinking water protection program,
including implementing the Safe Drinking
Water Act and providing services to regulated
parties, partners, and the public under
Minnesota Statutes, sections 144.381 to
144.383.
new text end
new text begin Subd. 7. new text end
new text begin
Radioactive Materials
|
||||||
new text begin
$200,000 in fiscal year 2026 and $200,000 in
fiscal year 2027 are from the state government
special revenue fund for radioactive materials
program activities under Minnesota Statutes,
section 144.1205.
new text end
new text begin Subd. 8. new text end
new text begin
Ionizing Radiation
|
||||||
new text begin
$993,000 in fiscal year 2026 and $828,000 in
fiscal year 2027 are from the state government
special revenue fund to administer new
regulatory activities for x-ray service
providers, ongoing inspections of licensed
facilities, and data analysis for program
planning and implementation under Minnesota
Statutes, section 144.121.
new text end
new text begin Subd. 9. new text end
new text begin
Engineering Plan Reviews
|
||||||
new text begin
$224,000 in fiscal year 2026 and $224,000 in
fiscal year 2027 are from the state government
special revenue fund to conduct engineering
plan reviews under Minnesota Statutes, section
144.554.
new text end
new text begin Subd. 10. new text end
new text begin
Spoken Language Health Care
|
||||||
new text begin
$186,000 in fiscal year 2026 and $49,000 in
fiscal year 2027 are from the state government
special revenue fund for a request for
proposals for the spoken language health care
interpreter work group. This is a onetime
appropriation and is available until June 30,
2029.
new text end
new text begin Subd. 11. new text end
new text begin
Base Level Adjustments
|
||||||
new text begin
The state government special revenue fund
base is $86,794,000 in fiscal year 2028 and
$86,806,000 in fiscal year 2029.
new text end
Sec. 5. new text begin HEALTH OPERATIONS
|
new text begin
$ new text end |
new text begin
21,776,000 new text end |
new text begin
$ new text end |
new text begin
24,249,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
20,365,000 new text end |
new text begin
21,392,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
1,411,000 new text end |
new text begin
2,857,000 new text end |
Sec. 6. new text begin TRANSFERS.
new text end
new text begin
Positions, salary money, and nonsalary administrative money may be transferred within
the Department of Health as the commissioner deems necessary with the advance approval
of the commissioner of management and budget. The commissioner shall report to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
finance quarterly about transfers made under this section.
new text end
Sec. 7. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end
new text begin
The commissioner of health shall not use indirect cost allocations to pay for the
operational costs of any program for which the commissioner is responsible.
new text end
Sec. 8. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
The administrative costs retention requirement under Minnesota Statutes, section 16B.98,
subdivision 14, is inapplicable to any appropriation in this article for a grant.
new text end
Sec. 9. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2027, unless a
different expiration date is explicit or an appropriation is made available after June 30, 2027.
new text end
ARTICLE 26
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 HEALTH-RELATED BOARDS
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
35,374,000 new text end |
new text begin
$ new text end |
new text begin
35,255,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2026 new text end |
new text begin
2027 new text end |
|
|
new text begin
General new text end |
new text begin
1,387,000 new text end |
new text begin
1,387,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
33,987,000 new text end |
new text begin
33,868,000 new text end |
new text begin
These amounts are appropriated from the state
government special revenue fund, unless
specified otherwise, for the purposes specified
in the following subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Board of Behavioral Health and
|
new text begin
1,289,000 new text end |
new text begin
1,289,000 new text end |
||||
new text begin Subd. 3. new text end
new text begin
Board of Chiropractic Examiners
|
new text begin
890,000 new text end |
new text begin
890,000 new text end |
||||
new text begin Subd. 4. new text end
new text begin
Board of Dentistry
|
new text begin
4,308,000 new text end |
new text begin
4,310,000 new text end |
||||
new text begin
(a) Administrative services unit; operating
costs. Of this appropriation, $1,936,000 in
fiscal year 2026 and $1,936,000 in fiscal year
2027 are for operating costs of the
administrative services unit. The
administrative services unit may receive and
expend reimbursements for services it
performs for other agencies.
new text end
new text begin
(b) Administrative services unit; volunteer
health care provider program. Of this
appropriation, $150,000 in fiscal year 2026
and $150,000 in fiscal year 2027 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end
new text begin
(c) Administrative services unit; retirement
costs. Of this appropriation, $237,000 in fiscal
year 2026 and $237,000 in fiscal year 2027
are for the administrative services unit to pay
for the retirement costs of health-related board
employees. This funding may be transferred
to the health board incurring retirement costs.
Any board that has an unexpended balance for
an amount transferred under this paragraph
shall transfer the unexpended amount to the
administrative services unit. If the amount
appropriated in the first year of the biennium
is not sufficient, the amount from the second
year of the biennium is available.
new text end
new text begin
(d) Administrative services unit; contested
cases and other legal proceedings. Of this
appropriation, $200,000 in fiscal year 2026
and $200,000 in fiscal year 2027 are for costs
of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards under this
section. Upon certification by a health-related
board to the administrative services unit that
unanticipated costs for legal proceedings will
be incurred and that available appropriations
are insufficient to pay for the unanticipated
costs for that board, the administrative services
unit is authorized to transfer money from this
appropriation to the board for payment of costs
for contested case hearings and other
unanticipated costs of legal proceedings with
the approval of the commissioner of
management and budget. The commissioner
of management and budget must require any
board that has an unexpended balance or an
amount transferred under this paragraph to
transfer the unexpended amount to the
administrative services unit to be deposited in
the state government special revenue fund.
new text end
new text begin Subd. 5. new text end
new text begin
Board of Dietetics and Nutrition
|
new text begin
277,000 new text end |
new text begin
277,000 new text end |
||||
new text begin Subd. 6. new text end
new text begin
Board of Executives for Long-term
|
new text begin
736,000 new text end |
new text begin
736,000 new text end |
||||
new text begin Subd. 7. new text end
new text begin
Board of Marriage and Family Therapy
|
new text begin
457,000 new text end |
new text begin
457,000 new text end |
||||
new text begin Subd. 8. new text end
new text begin
Board of Medical Practice
|
new text begin
6,196,000 new text end |
new text begin
6,141,000 new text end |
||||
new text begin
Base Level Adjustment. The state
government special revenue fund base for this
subdivision is $6,121,000 in fiscal year 2028
and $6,121,000 in fiscal year 2029.
new text end
new text begin Subd. 9. new text end
new text begin
Board of Nursing
|
new text begin
6,275,000 new text end |
new text begin
6,275,000 new text end |
||||
new text begin Subd. 10. new text end
new text begin
Board of Occupational Therapy
|
new text begin
560,000 new text end |
new text begin
560,000 new text end |
||||
new text begin Subd. 11. new text end
new text begin
Board of Optometry
|
new text begin
280,000 new text end |
new text begin
280,000 new text end |
||||
new text begin Subd. 12. new text end
new text begin
Board of Pharmacy
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
1,387,000 new text end |
new text begin
1,387,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
6,280,000 new text end |
new text begin
6,280,000 new text end |
new text begin
Medication Repository Program. $900,000
in fiscal year 2026 and $900,000 in fiscal year
2027 are from the general fund for the
medication repository program to purchase
prescription drugs under Minnesota Statutes,
section 151.555, subdivision 6, paragraph (g).
new text end
new text begin Subd. 13. new text end
new text begin
Board of Physical Therapy
|
new text begin
789,000 new text end |
new text begin
789,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Board of Podiatric Medicine
|
new text begin
257,000 new text end |
new text begin
257,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Board of Psychology
|
new text begin
2,781,000 new text end |
new text begin
2,781,000 new text end |
||||
new text begin
Health Professional Service Program.
$1,324,000 in fiscal year 2026 and $1,324,000
in fiscal year 2027 are for the health
professionals services program.
new text end
new text begin Subd. 16. new text end
new text begin
Board of Social Work
|
new text begin
2,068,000 new text end |
new text begin
2,002,000 new text end |
||||
new text begin Subd. 17. new text end
new text begin
Board of Veterinary Medicine
|
new text begin
544,000 new text end |
new text begin
544,000 new text end |
||||
Sec. 3. new text begin OFFICE OF EMERGENCY MEDICAL
|
new text begin
$ new text end |
new text begin
25,613,000 new text end |
new text begin
$ new text end |
new text begin
6,048,000 new text end |
||
new text begin Subdivision 1. new text end
new text begin
Ambulance Service Training and
|
||||||
new text begin
$500,000 in fiscal year 2026 and $500,000 in
fiscal year 2027 are for the ambulance service
training and staffing grant program under
Minnesota Statutes, section 144E.38.
new text end
new text begin Subd. 2. new text end
new text begin
EMR/EMT Education Reimbursement
|
||||||
new text begin
$100,000 in fiscal year 2026 and $100,000 in
fiscal year 2027 are for EMR/EMT education
reimbursements under Minnesota Statutes,
section 144E.35.
new text end
new text begin Subd. 3. new text end
new text begin
Emergency Ambulance Service Grants
|
||||||
new text begin
$18,000,000 in fiscal year 2026 is for
emergency ambulance service grants. This is
a onetime appropriation and is available until
June 30, 2029.
new text end
Sec. 4. new text begin OMBUDSPERSON FOR FAMILIES
|
new text begin
$ new text end |
new text begin
792,000 new text end |
new text begin
$ new text end |
new text begin
808,000 new text end |
||
Sec. 5. new text begin OMBUDSPERSON FOR AMERICAN
|
new text begin
$ new text end |
new text begin
344,000 new text end |
new text begin
$ new text end |
new text begin
347,000 new text end |
||
Sec. 6. new text begin RARE DISEASE ADVISORY
|
new text begin
$ new text end |
new text begin
674,000 new text end |
new text begin
$ new text end |
new text begin
679,000 new text end |
||
Sec. 7. new text begin OFFICE OF THE FOSTER YOUTH
|
new text begin
$ new text end |
new text begin
1,012,000 new text end |
new text begin
$ new text end |
new text begin
1,025,000 new text end |
||
Sec. 8. new text begin BOARD OF DIRECTORS OF MNSURE
|
new text begin
$ new text end |
new text begin
70,000 new text end |
new text begin
$ new text end |
new text begin
70,000 new text end |
||
Sec. 9. new text begin COMMISSIONER OF EDUCATION
|
new text begin
$ new text end |
new text begin
7,950,000 new text end |
new text begin
$ new text end |
new text begin
7,950,000 new text end |
||
new text begin
Early Childhood Literacy Programs.
$7,950,000 in fiscal year 2026 and $7,950,000
in fiscal year 2027 are for early childhood
literacy grants under Minnesota Statutes,
section 142D.12, subdivision 3.
new text end
Sec. 10. new text begin GRANT ADMINISTRATION COSTS.
new text end
new text begin
The administrative costs retention requirement under Minnesota Statutes, section 16B.98,
subdivision 14, is inapplicable to any appropriation in this article for a grant.
new text end
Sec. 11. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires June 30, 2027, unless a different
expiration date is explicit or an appropriation is made available after June 30, 2027.
new text end
Sec. 12.
Laws 2024, chapter 127, article 67, section 4, is amended to read:
Sec. 4. BOARD OF PHARMACY
|
||||||
| Appropriations by Fund |
||
| General |
1,500,000 |
-0- |
| State Government Special Revenue |
-0- |
27,000 |
(a) Legal Costs. $1,500,000 in fiscal year
2024 is from the general fund for legal costs.
This is a onetime appropriationnew text begin and is
available until June 30, 2027new text end .
(b) Base Level Adjustment. The state
government special revenue fund base is
increased by $27,000 in fiscal year 2026 and
increased by $27,000 in fiscal year 2027.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective June 30, 2025.
new text end
APPENDIX
Repealed Minnesota Statutes: ueh2435-1
62E.21 DEFINITIONS.
Subdivision 1.
Application.
For the purposes of sections 62E.21 to 62E.25, the terms defined in this section have the meanings given them.
Subd. 2.
Affordable Care Act.
"Affordable Care Act" means the federal act as defined in section 62A.011, subdivision 1a.
Subd. 3.
Attachment point.
"Attachment point" means an amount as provided in section 62E.23, subdivision 2, paragraph (b).
Subd. 4.
Benefit year.
"Benefit year" means the calendar year for which an eligible health carrier provides coverage through an individual health plan.
Subd. 5.
Board.
"Board" means the board of directors of the Minnesota Comprehensive Health Association created under section 62E.10.
Subd. 6.
Coinsurance rate.
"Coinsurance rate" means the rate as provided in section 62E.23, subdivision 2, paragraph (c).
Subd. 7.
Commissioner.
"Commissioner" means the commissioner of commerce.
Subd. 8.
Eligible health carrier.
"Eligible health carrier" means all of the following that offer individual health plans and incur claims costs for an individual enrollee's covered benefits in the applicable benefit year:
(1) an insurance company licensed under chapter 60A to offer, sell, or issue a policy of accident and sickness insurance as defined in section 62A.01;
(2) a nonprofit health service plan corporation operating under chapter 62C; or
(3) a health maintenance organization operating under chapter 62D.
Subd. 9.
Individual health plan.
"Individual health plan" means a health plan as defined in section 62A.011, subdivision 4, that is not a grandfathered plan as defined in section 62A.011, subdivision 1b.
Subd. 10.
Individual market.
"Individual market" has the meaning given in section 62A.011, subdivision 5.
Subd. 11.
Minnesota Comprehensive Health Association or association.
"Minnesota Comprehensive Health Association" or "association" has the meaning given in section 62E.02, subdivision 14.
Subd. 12.
Minnesota premium security plan or plan.
"Minnesota premium security plan" or "plan" means the state-based reinsurance program authorized under section 62E.23.
Subd. 13.
Payment parameters.
"Payment parameters" means the attachment point, reinsurance cap, and coinsurance rate for the plan.
Subd. 14.
Reinsurance cap.
"Reinsurance cap" means the threshold amount as provided in section 62E.23, subdivision 2, paragraph (d).
Subd. 15.
Reinsurance payments.
"Reinsurance payments" means an amount paid by the association to an eligible health carrier under the plan.
62E.22 DUTIES OF COMMISSIONER.
The commissioner shall require eligible health carriers to calculate the premium amount the eligible health carrier would have charged for the benefit year if the Minnesota premium security plan had not been established. The eligible health carrier must submit this information as part of its rate filing. The commissioner must consider this information as part of the rate review.
62E.23 MINNESOTA PREMIUM SECURITY PLAN.
Subdivision 1.
Administration of plan.
(a) The association is Minnesota's reinsurance entity to administer the state-based reinsurance program referred to as the Minnesota premium security plan.
(b) The association may apply for any available federal funding for the plan. All funds received by or appropriated to the association shall be deposited in the premium security plan account in section 62E.25, subdivision 1. The association shall notify the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services and insurance within ten days of receiving any federal funds.
(c) The association must collect or access data from an eligible health carrier that are necessary to determine reinsurance payments, according to the data requirements under subdivision 5, paragraph (c).
(d) The board must not use any funds allocated to the plan for staff retreats, promotional giveaways, excessive executive compensation, or promotion of federal or state legislative or regulatory changes.
(e) For each applicable benefit year, the association must notify eligible health carriers of reinsurance payments to be made for the applicable benefit year no later than June 30 of the year following the applicable benefit year.
(f) On a quarterly basis during the applicable benefit year, the association must provide each eligible health carrier with the calculation of total reinsurance payment requests.
(g) By August 15 of the year following the applicable benefit year, the association must disburse all applicable reinsurance payments to an eligible health carrier.
Subd. 2.
Payment parameters.
(a) The board must design and adjust the payment parameters to ensure the payment parameters:
(1) will stabilize or reduce premium rates in the individual market;
(2) will increase participation in the individual market;
(3) will improve access to health care providers and services for those in the individual market;
(4) mitigate the impact high-risk individuals have on premium rates in the individual market;
(5) take into account any federal funding available for the plan; and
(6) take into account the total amount available to fund the plan.
(b) The attachment point for the plan is the threshold amount for claims costs incurred by an eligible health carrier for an enrolled individual's covered benefits in a benefit year, beyond which the claims costs for benefits are eligible for reinsurance payments. The attachment point shall be set by the board at $50,000 or more, but not exceeding the reinsurance cap.
(c) The coinsurance rate for the plan is the rate at which the association will reimburse an eligible health carrier for claims incurred for an enrolled individual's covered benefits in a benefit year above the attachment point and below the reinsurance cap. The coinsurance rate shall be set by the board at a rate between 50 and 80 percent.
(d) The reinsurance cap is the threshold amount for claims costs incurred by an eligible health carrier for an enrolled individual's covered benefits, after which the claims costs for benefits are no longer eligible for reinsurance payments. The reinsurance cap shall be set by the board at $250,000 or less.
(e) The board may adjust the payment parameters to the extent necessary to secure federal approval of the state innovation waiver request in Laws 2017, chapter 13, article 1, section 8.
Subd. 3.
Operation.
(a) The board shall propose to the commissioner the payment parameters for the next benefit year by January 15 of the year before the applicable benefit year. The commissioner shall approve or reject the payment parameters no later than 14 days following the board's proposal. If the commissioner fails to approve or reject the payment parameters within 14 days following the board's proposal, the proposed payment parameters are final and effective.
(b) If the amount in the premium security plan account in section 62E.25, subdivision 1, is not anticipated to be adequate to fully fund the approved payment parameters as of July 1 of the year before the applicable benefit year, the board, in consultation with the commissioner and the commissioner of management and budget, shall propose payment parameters within the available appropriations. The commissioner must permit an eligible health carrier to revise an applicable rate filing based on the final payment parameters for the next benefit year.
(c) Notwithstanding paragraph (a), the payment parameters for benefit years 2023 through 2027 are:
(1) an attachment point of $50,000;
(2) a coinsurance rate of 80 percent; and
(3) a reinsurance cap of $250,000.
Subd. 4.
Calculation of reinsurance payments.
(a) Each reinsurance payment must be calculated with respect to an eligible health carrier's incurred claims costs for an individual enrollee's covered benefits in the applicable benefit year. If the claims costs do not exceed the attachment point, the reinsurance payment is $0. If the claims costs exceed the attachment point, the reinsurance payment shall be calculated as the product of the coinsurance rate and the lesser of:
(1) the claims costs minus the attachment point; or
(2) the reinsurance cap minus the attachment point.
(b) The board must ensure that reinsurance payments made to eligible health carriers do not exceed the total amount paid by the eligible health carrier for any eligible claim. "Total amount paid of an eligible claim" means the amount paid by the eligible health carrier based upon the allowed amount less any deductible, coinsurance, or co-payment, as of the time the data are submitted or made accessible under subdivision 5, paragraph (c).
Subd. 5.
Eligible carrier requests for reinsurance payments.
(a) An eligible health carrier may request reinsurance payments from the association when the eligible health carrier meets the requirements of this subdivision and subdivision 4.
(b) An eligible health carrier must make requests for reinsurance payments in accordance with any requirements established by the board.
(c) An eligible health carrier must provide the association with access to the data within the dedicated data environment established by the eligible health carrier under the federal risk adjustment program under United States Code, title 42, section 18063. Eligible health carriers must submit an attestation to the board asserting compliance with the dedicated data environments, data requirements, establishment and usage of masked enrollee identification numbers, and data submission deadlines.
(d) An eligible health carrier must provide the access described in paragraph (c) for the applicable benefit year by April 30 of each year of the year following the end of the applicable benefit year.
(e) An eligible health carrier must maintain documents and records, whether paper, electronic, or in other media, sufficient to substantiate the requests for reinsurance payments made pursuant to this section for a period of at least six years. An eligible health carrier must also make those documents and records available upon request from the commissioner for purposes of verification, investigation, audit, or other review of reinsurance payment requests.
(f) An eligible health carrier may follow the appeals procedure under section 62E.10, subdivision 2a.
(g) The association may have an eligible health carrier audited to assess the health carrier's compliance with the requirements of this section. The eligible health carrier must ensure that its contractors, subcontractors, or agents cooperate with any audit under this section. If an audit results in a proposed finding of material weakness or significant deficiency with respect to compliance with any requirement of this section, the eligible health carrier may provide a response to the proposed finding within 30 days. Within 30 days of the issuance of a final audit report that includes a finding of material weakness or significant deficiency, the eligible health carrier must:
(1) provide a written corrective action plan to the association for approval;
(2) implement the approved plan; and
(3) provide the association with written documentation of the corrective action once taken.
Subd. 6.
Data.
Government data of the association under this section are private data on individuals, or nonpublic data, as defined under section 13.02, subdivision 9 or 12.
62E.24 ACCOUNTING, REPORTS, AND AUDITS OF THE ASSOCIATION.
Subdivision 1.
Accounting.
The board must keep an accounting for each benefit year of all:
(1) funds appropriated for reinsurance payments and administrative and operational expenses;
(2) requests for reinsurance payments received from eligible health carriers;
(3) reinsurance payments made to eligible health carriers; and
(4) administrative and operational expenses incurred for the plan.
Subd. 2.
Reports.
(a) The board must submit to the commissioner and to the chairs and ranking minority members of the legislative committees with jurisdiction over commerce and health and make available to the public quarterly reports on plan operations and an annual report summarizing the plan operations for each benefit year. All reports must be made public by posting the report on the Minnesota Comprehensive Health Association website. The annual summary must be made available by November 1 of the year following the applicable benefit year or 60 calendar days following the final disbursement of reinsurance payments for the applicable benefit year, whichever is later.
(b) The reports must include information about:
(1) the reinsurance parameters used;
(2) the metal levels affected;
(3) the number of claims payments estimated and submitted for payment per products offered on-exchange and off-exchange and per eligible health carrier;
(4) the estimated reinsurance payments by plan type based on carrier-submitted templates;
(5) funds appropriated for reinsurance payments and administrative and operational expenses for each year, including the federal and state contributions received, investment income, and any other revenue or funds received;
(6) the total amount of reinsurance payments made to each eligible health carrier; and
(7) administrative and operational expenses incurred for the plan, including the total amount incurred and as a percentage of the plan's operational budget.
Subd. 3.
Legislative auditor.
The Minnesota premium security plan is subject to audit by the legislative auditor. The board must ensure that its contractors, subcontractors, or agents cooperate with the audit.
Subd. 4.
Independent external audit.
(a) The board must engage and cooperate with an independent certified public accountant or CPA firm licensed or permitted under chapter 326A to perform an audit for each benefit year of the plan, in accordance with generally accepted auditing standards. The audit must at a minimum:
(1) assess compliance with the requirements of sections 62E.21 to 62E.25; and
(2) identify any material weaknesses or significant deficiencies and address manners in which to correct any such material weaknesses or deficiencies.
(b) The board, after receiving the completed audit, must:
(1) provide the commissioner the results of the audit;
(2) identify to the commissioner any material weakness or significant deficiency identified in the audit and address in writing to the commissioner how the board intends to correct any such material weakness or significant deficiency in compliance with subdivision 5; and
(3) make public the results of the audit, to the extent the audit contains government data that is public, including any material weakness or significant deficiency and how the board intends to correct the material weakness or significant deficiency, by posting the audit results on the Minnesota Comprehensive Health Association website and making the audit results otherwise available.
Subd. 5.
Actions on audit findings.
(a) If an audit results in a finding of material weakness or significant deficiency with respect to compliance by the association with any requirement under sections 62E.21 to 62E.25, the board must:
(1) provide a written corrective action plan to the commissioner for approval within 60 days of the completed audit;
(2) implement the corrective action plan; and
(3) provide the commissioner with written documentation of the corrective actions taken.
(b) By December 1 of each year, the board must submit a report to the standing committees of the legislature having jurisdiction over health and human services and insurance regarding any finding of material weakness or significant deficiency found in an audit.
62E.25 ACCOUNTS.
Subdivision 1.
Premium security plan account.
The premium security plan account is created in the special revenue fund of the state treasury. Funds in the account are appropriated annually to the commissioner of commerce for grants to the Minnesota Comprehensive Health Association for the operational and administrative costs and reinsurance payments relating to the start-up and operation of the Minnesota premium security plan. Notwithstanding section 11A.20, all investment income and all investment losses attributable to the investment of the premium security plan account shall be credited to the premium security plan account.
Subd. 2.
Deposits.
Except as provided in subdivision 3, funds received by the commissioner of commerce or other state agency pursuant to the state innovation waiver request in Laws 2017, chapter 13, article 1, section 8, shall be deposited in the premium security plan account in subdivision 1.
Subd. 3.
Basic health plan trust account.
Funds received by the commissioner of commerce or other state agency pursuant to the state innovation waiver request in Laws 2017, chapter 13, article 1, section 8, that are attributable to the basic health program shall be deposited in the basic health plan trust account in the federal fund.
62J.824 FACILITY FEE DISCLOSURE.
(a) Prior to the delivery of nonemergency services, a provider-based clinic that charges a facility fee shall provide notice to any patient, including patients served by telehealth as defined in section 62A.673, subdivision 2, paragraph (h), stating that the clinic is part of a hospital and the patient may receive a separate charge or billing for the facility component, which may result in a higher out-of-pocket expense.
(b) Each health care facility must post prominently in locations easily accessible to and visible by patients, including on its website, a statement that the provider-based clinic is part of a hospital and the patient may receive a separate charge or billing for the facility, which may result in a higher out-of-pocket expense.
(c) This section does not apply to laboratory services, imaging services, or other ancillary health services that are provided by staff who are not employed by the health care facility or clinic.
(d) For purposes of this section:
(1) "facility fee" means any separate charge or billing by a provider-based clinic in addition to a professional fee for physicians' services that is intended to cover building, electronic medical records systems, billing, and other administrative and operational expenses; and
(2) "provider-based clinic" means the site of an off-campus clinic or provider office, located at least 250 yards from the main hospital buildings or as determined by the Centers for Medicare and Medicaid Services, that is owned by a hospital licensed under chapter 144 or a health system that operates one or more hospitals licensed under chapter 144, and is primarily engaged in providing diagnostic and therapeutic care, including medical history, physical examinations, assessment of health status, and treatment monitoring. This definition does not include clinics that are exclusively providing laboratory, x-ray, testing, therapy, pharmacy, or educational services and does not include facilities designated as rural health clinics.
62K.10 GEOGRAPHIC ACCESSIBILITY; PROVIDER NETWORK ADEQUACY.
Subd. 3.
Other health services.
The maximum travel distance or time shall be the lesser of 60 miles or 60 minutes to the nearest provider of specialty physician services, ancillary services, specialized hospital services, and all other health services not listed in subdivision 2.
103I.550 LIMITED PUMP, PITLESS, OR DUG WELL/DRIVE POINT CONTRACTOR.
Subdivision 1.
Limited pump or pitless license or certification.
A person with a limited well/boring contractor's license or certification to install well pumps and pumping equipment; or a person with a limited well/boring contractor's license or certification to install, repair, and modify pitless units and pitless adapters, well casings above the pitless unit or pitless adapter, and well screens and well diameters, will be issued a combined license or certification to: (1) install well pumps and pumping equipment; and (2) install, repair, and modify pitless units and pitless adapters, well casings above the pitless unit or pitless adapter, well screens, and well diameters.
Subd. 2.
Limited dug well/drive point license or certification.
A person with a limited well/boring contractor's license or certification to construct, repair, and seal drive point wells and dug wells will be issued a well contractor's license or certification.
136A.29 POWERS; DUTIES.
Subd. 4.
Mutual agreement; staff, equipment, office space.
By mutual agreement between the authority and the office, authority staff employees may also be members of the office staff. By mutual agreement, authority employees may be provided office space in the office of the Office of Higher Education, and said employees may make use of equipment, supplies, and office space, provided that the authority fully reimburses the office for salaries and for space, equipment, supplies, and materials used. In the absence of such mutual agreement between the authority and the office, the authority may maintain an office at such place or places as it may designate.
138.912 HEALTHY EATING, HERE AT HOME.
Subd. 7.
Grocery inclusion.
The commissioner of children, youth, and families must submit a waiver request to the federal United States Department of Agriculture seeking approval for the inclusion of Minnesota grocery stores in this program so that SNAP participants may use the vouchers for healthy produce at grocery stores. Grocery store participation is voluntary and a grocery store's associated administrative costs will not be reimbursed.
148.108 FEES.
Subd. 2.
Annual renewal of inactive acupuncture registration.
The annual renewal of an inactive acupuncture registration fee is $25.
Subd. 3.
Acupuncture reinstatement.
The acupuncture reinstatement fee is $50.
Subd. 4.
Animal chiropractic.
(a) Animal chiropractic registration fee is $125.
(b) Animal chiropractic registration renewal fee is $75.
(c) Animal chiropractic inactive renewal fee is $25.
148.6402 DEFINITIONS.
Subd. 22a.
Limited license.
"Limited license" means a license issued according to section 148.6425, subdivision 3, paragraph (c), to persons who for two years or more did not apply for a license after meeting the requirements in section 148.6408 or 148.6410 or who allowed their license to lapse for four years or more.
148.6420 APPLICATION REQUIREMENTS.
Subd. 2.
Persons applying for licensure under section 148.6408 or 148.6410.
Persons applying for licensure under section 148.6408 or 148.6410 must submit the materials required in subdivision 1 and the following:
(1) a certificate of successful completion of the requirements in section 148.6408, subdivision 1, or 148.6410, subdivision 1; and
(2) the applicant's test results from the examining agency, as evidence that the applicant received a qualifying score on a credentialing examination meeting the requirements of section 148.6408, subdivision 2, or 148.6410, subdivision 2.
Subd. 3.
Applicants certified by National Board for Certification in Occupational Therapy.
An applicant who is certified by the National Board for Certification in Occupational Therapy must provide the materials required in subdivision 1 and the following:
(1) verified documentation from the National Board for Certification in Occupational Therapy stating that the applicant is certified as an occupational therapist, registered or certified occupational therapy assistant, the date certification was granted, and the applicant's certification number. The document must also include a statement regarding disciplinary actions. The applicant is responsible for obtaining this documentation by sending a form provided by the board to the National Board for Certification in Occupational Therapy; and
(2) a waiver authorizing the board to obtain access to the applicant's records maintained by the National Board for Certification in Occupational Therapy.
Subd. 4.
Applicants credentialed in another jurisdiction.
In addition to providing the materials required in subdivision 1, an applicant credentialed in another jurisdiction must request that the appropriate government body in each jurisdiction in which the applicant holds or held an occupational therapy credential provide documentation to the board that verifies the applicant's credentials. Except as provided in section 148.6418, a license must not be issued until the board receives verification of each of the applicant's credentials. Each verification must include the applicant's name and date of birth, credential number and date of issuance, a statement regarding investigations pending and disciplinary actions taken or pending against the applicant, current status of the credential, and the terms under which the credential was issued.
148.6423 LICENSURE RENEWAL.
Subd. 4.
License renewal cycle conversion.
The license renewal cycle for occupational therapy licensees is converted to a two-year cycle where renewal is due on the last day of the licensee's month of birth. Conversion pursuant to this section begins January 1, 2021. This section governs license renewal procedures for licensees who were licensed before December 31, 2020. The conversion renewal cycle is the renewal cycle following the first license renewal after January 1, 2020. The conversion license period is the license period for the conversion renewal cycle. The conversion license period is between 13 and 24 months and ends on the last day of the licensee's month of birth in either 2022 or 2023, as described in subdivision 5.
Subd. 5.
Conversion of license renewal cycle for current licensees.
For a licensee whose license is current as of December 31, 2020, the licensee's conversion license period begins on January 1, 2021, and ends on the last day of the licensee's month of birth in 2023, except that for licensees whose month of birth is January, February, March, April, May, or June, the licensee's renewal cycle ends on the last day of the licensee's month of birth in 2022.
Subd. 7.
Subsequent renewal cycles.
After the licensee's conversion renewal cycle under subdivision 5 or 6, subsequent renewal cycles are biennial and begin on the first day of the month following the licensee's birth month.
Subd. 8.
Conversion period and fees.
(a) A licensee who holds a license issued before January 1, 2021, and who renews that license pursuant to subdivision 5 or 6, must pay a renewal fee as required in this subdivision.
(b) A licensee must be charged the biennial license fee listed in section 148.6445 for the conversion license period.
(c) For a licensee whose conversion license period is 13 to 24 months, the first biennial license fee charged after the conversion license period must be adjusted to credit the excess fee payment made during the conversion license period. The credit is calculated by:
(1) subtracting the number of months of the licensee's conversion license period from 24; and
(2) multiplying the result of clause (1) by 1/24 of the biennial fee rounded up to the next dollar.
(d) For a licensee whose conversion license period is 24 months, the first biennial license fee charged after the conversion license period must not be adjusted.
(e) For the second and all subsequent license renewals made after the conversion license period, the licensee's biennial license fee is as listed in section 148.6445.
Subd. 9.
Expiration.
Subdivisions 4, 5, 7, and 8 expire December 31, 2023.
148.6425 RENEWAL OF LICENSURE; AFTER EXPIRATION DATE.
Subd. 3.
Licensure renewal four years or more after licensure expiration date.
(a) An individual who requests licensure renewal four years or more after the licensure expiration date must submit the following:
(1) a completed and signed application for licensure on forms provided by the board;
(2) the renewal fee and the late fee required under section 148.6445 if renewal application is based on paragraph (b), clause (1), (2), or (3), or the renewal fee required under section 148.6445 if renewal application is based on paragraph (b), clause (4);
(3) proof of having met the continuing education requirement in section 148.6443, subdivision 1, except the continuing education must be obtained in the two years immediately preceding application renewal; and
(4) at the time of the next licensure renewal, proof of having met the continuing education requirement, which shall be prorated based on the number of months licensed during the two-year licensure period.
(b) In addition to the requirements in paragraph (a), the applicant must submit proof of one of the following:
(1) verified documentation of successful completion of 160 hours of supervised practice approved by the board as described in paragraph (c);
(2) verified documentation of having achieved a qualifying score on the credentialing examination for occupational therapists or the credentialing examination for occupational therapy assistants administered within the past year;
(3) documentation of having completed a combination of occupational therapy courses or an occupational therapy refresher program that contains both a theoretical and clinical component approved by the board. Only courses completed within one year preceding the date of the application or one year after the date of the application qualify for approval; or
(4) evidence that the applicant holds a current and unrestricted credential for the practice of occupational therapy in another jurisdiction and that the applicant's credential from that jurisdiction has been held in good standing during the period of lapse.
(c) To participate in a supervised practice as described in paragraph (b), clause (1), the applicant shall obtain limited licensure. To apply for limited licensure, the applicant shall submit the completed limited licensure application, fees, and agreement for supervision of an occupational therapist or occupational therapy assistant practicing under limited licensure signed by the supervising therapist and the applicant. The supervising occupational therapist shall state the proposed level of supervision on the supervision agreement form provided by the board. The supervising therapist shall determine the frequency and manner of supervision based on the condition of the patient or client, the complexity of the procedure, and the proficiencies of the supervised occupational therapist. At a minimum, a supervising occupational therapist shall be on the premises at all times that the person practicing under limited licensure is working; be in the room ten percent of the hours worked each week by the person practicing under limited licensure; and provide daily face-to-face collaboration for the purpose of observing service competency of the occupational therapist or occupational therapy assistant, discussing treatment procedures and each client's response to treatment, and reviewing and modifying, as necessary, each treatment plan. The supervising therapist shall document the supervision provided. The occupational therapist participating in a supervised practice is responsible for obtaining the supervision required under this paragraph and must comply with the board's requirements for supervision during the entire 160 hours of supervised practice. The supervised practice must be completed in two months and may be completed at the applicant's place of work.
(d) In addition to the requirements in paragraphs (a) and (b), the applicant must submit additional information as requested by the board to clarify information in the application, including information to determine whether the applicant has engaged in conduct warranting disciplinary action as set forth in section 148.6448. The information must be submitted within 30 days after the board's request.
148.6430 DELEGATION OF DUTIES; ASSIGNMENT OF TASKS.
The occupational therapist is responsible for all duties delegated to the occupational therapy assistant or tasks assigned to direct service personnel. The occupational therapist may delegate to an occupational therapy assistant those portions of a client's evaluation, reevaluation, and intervention that, according to prevailing national practice standards, can be performed by an occupational therapy assistant. The occupational therapist may not delegate portions of an evaluation or reevaluation of a person whose condition is changing rapidly.
148.6445 FEES.
Subd. 5.
Limited licensure fee.
The fee for limited licensure is $100.
Subd. 6.
Fee for course approval after lapse of licensure.
The fee for course approval after lapse of licensure is $100.
Subd. 8.
Verification to institutions.
The fee for verification of licensure to institutions is $10.
156.015 FEES.
Subdivision 1.
Verification of licensure.
The board may charge a fee of $25 per license verification to a licensee for verification of licensure status provided to other veterinary licensing boards.
245A.11 SPECIAL CONDITIONS FOR RESIDENTIAL PROGRAMS.
Subd. 8.
Community residential setting license.
(a) The commissioner shall establish provider standards for residential support services that integrate service standards and the residential setting under one license. The commissioner shall propose statutory language and an implementation plan for licensing requirements for residential support services to the legislature by January 15, 2012, as a component of the quality outcome standards recommendations required by Laws 2010, chapter 352, article 1, section 24.
(b) Providers licensed under chapter 245B, and providing, contracting, or arranging for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105 to 9555.6265; and meeting the provisions of section 245D.02, subdivision 4a, must be required to obtain a community residential setting license.
256B.0622 ASSERTIVE COMMUNITY TREATMENT AND INTENSIVE RESIDENTIAL TREATMENT SERVICES.
Subd. 4.
Provider entity licensure and contract requirements for intensive residential treatment services.
(a) The commissioner shall develop procedures for counties and providers to submit other documentation as needed to allow the commissioner to determine whether the standards in this section are met.
(b) A provider entity must specify in the provider entity's application what geographic area and populations will be served by the proposed program. A provider entity must document that the capacity or program specialties of existing programs are not sufficient to meet the service needs of the target population. A provider entity must submit evidence of ongoing relationships with other providers and levels of care to facilitate referrals to and from the proposed program.
(c) A provider entity must submit documentation that the provider entity requested a statement of need from each county board and tribal authority that serves as a local mental health authority in the proposed service area. The statement of need must specify if the local mental health authority supports or does not support the need for the proposed program and the basis for this determination. If a local mental health authority does not respond within 60 days of the receipt of the request, the commissioner shall determine the need for the program based on the documentation submitted by the provider entity.
256B.0625 COVERED SERVICES.
Subd. 38.
Payments for mental health services.
Payments for mental health services covered under the medical assistance program that are provided by masters-prepared mental health professionals shall be 80 percent of the rate paid to doctoral-prepared professionals. Payments for mental health services covered under the medical assistance program that are provided by masters-prepared mental health professionals employed by community mental health centers shall be 100 percent of the rate paid to doctoral-prepared professionals. Payments for mental health services covered under the medical assistance program that are provided by physician assistants shall be 80.4 percent of the base rate paid to psychiatrists.
Repealed Minnesota Rule: ueh2435-1
2500.1150 FEES.
The fees charged by the board are fixed at the following rates:
2500.2030 ANNUAL RENEWAL OF INACTIVE LICENSE.
The annual renewal fee for an inactive license is 75 percent of the current fee imposed by the board for license renewal.
4695.2900 APPLICATION FEES.
Fees to be submitted with initial or renewal applications shall be as follows:
C.
Penalty for late submission of renewal application, $10, if not renewed by designated renewal date.
6800.5100 DEFINITIONS.
Subp. 5.
Pharmacist-intern; intern.
"Pharmacist-intern" and "intern" mean:
A.
a natural person satisfactorily progressing toward the degree in pharmacy required for licensure;
B.
a graduate of the University of Minnesota College of Pharmacy, or other pharmacy college approved by the board, who is registered by the Board of Pharmacy for the purpose of obtaining practical experience as a requirement for licensure as a pharmacist;
D.
a participant in a residency or fellowship program, not licensed to practice pharmacy in the state of Minnesota, who is a licensed pharmacist in another state or who is a graduate of the University of Minnesota College of Pharmacy or another pharmacy college approved by the board.
6800.5400 TRAINING.
Subp. 5.
Competencies.
Upon registration, interns and preceptors will be furnished a copy of the board's internship manual, which lists the minimum competencies that should be the focus of internship training. The competencies are furnished to suggest appropriate types and order of training experience and shall be used to ensure that the intern's practical experiences are commensurate with the intern's educational level, and broad in scope.
Subp. 6.
Evidence of completion.
Applicants for licensure as pharmacists who are examined and licensed after September 17, 1973, shall submit evidence that they have successfully completed not less than 1,500 hours of internship under the instruction and supervision of a preceptor. Effective May 1, 2003, candidates for licensure shall submit evidence that they have successfully completed not less than 1,600 hours of internship under the direction and supervision of a preceptor. Credit for internship shall be granted only to registered interns who have completed the third year of the five-year or six-year pharmacy curriculum, provided, however, that:
B.
800 hours of internship credit may be acquired through experiential education program experiences that do not have as their focus traditional compounding, dispensing, and related patient counseling activities. The remaining 800 hours of the 1,600 hour total requirement must focus on traditional compounding, dispensing, and related patient counseling activities.
6900.0250 FEES.
Subpart 1.
Amounts.
The amount of fees may be set by the board with the approval of the Department of Management and Budget up to the limits provided in this subpart depending upon the total amount required to sustain board operations under Minnesota Statutes, section 16A.1285, subdivision 2. Information about fees in effect at any time is available from the board office. The maximum amount of fees are:
9100.0400 APPLICATION AND EXAMINATION FEES FOR LICENSURE TO PRACTICE VETERINARY MEDICINE.
Subpart 1.
Application fee.
A.
A person applying for a license to practice veterinary medicine in Minnesota or applying for a permit to take the national veterinary medical examination must pay a $50 nonrefundable application fee to the board. Persons submitting concurrent applications for licensure and a national examination permit shall pay only one application fee.
B.
The application fee received supports only the application with which the fee was submitted. A person who applies more than once must submit the full application fee with each subsequent application.
Subp. 3.
Examination fees.
A.
All applicants for veterinary licensure in Minnesota must successfully pass the Minnesota Veterinary Jurisprudence Examination. The fee for this examination is $50, payable to the board.
B.
An applicant participating in the national veterinary licensing examination must complete a separate application for the national examination and submit the application to the board for approval. Payment for the national examination must be made by the applicant to the national board examination committee after the application for examination has been approved by the board.
9100.0500 INITIAL AND RENEWAL FEE.
Subpart 1.
Required for licensure.
Each person now licensed to practice veterinary medicine in this state, or who becomes licensed by the Board of Veterinary Medicine to engage in the practice, shall pay an initial fee or a biennial license renewal fee if the person wishes to practice veterinary medicine in the coming two-year period or remain licensed as a veterinarian. A licensure period begins on March 1 and expires the last day of February two years later. A licensee with an even-numbered license shall renew by March 1 of even-numbered years and a licensee with an odd-numbered license shall renew by March 1 of odd-numbered years. For 1996 license renewals, licensees with an even-numbered license shall renew for two years. Licensees with an odd-numbered license shall renew for one year and commence renewal for a two-year period in 1997.
Subp. 2.
Amount.
The initial licensure fee and the biennial renewal fee is $200 and must be paid to the executive director of the board on or before March 1 of the first year of the biennial license period. By January 1 of the first year for which the biennial renewal fee is due, the board shall issue a renewal application to each current licensee to the last address maintained in the board file. Failure to receive this notice does not relieve the licensee of the obligation to pay renewal fees so that they are received by the board on or before the renewal date of March 1.
Initial licenses issued after the start of the licensure renewal period are valid only until the end of the period.
Subp. 3.
Date due.
A licensee must apply for a renewal license on or before March 1 of the first year of the biennial license renewal period. A renewal license is valid from March 1 through the last day of February of the last year of the two-year license renewal period. An application postmarked no later than the last day of February must be considered to have been received on March 1.
Subp. 4.
Late renewal penalty.
An applicant for renewal must pay a late renewal penalty of $100 in addition to the renewal fee if the application for renewal is received after March 1 of the licensure renewal period. A renewed license issued after March 1 of the licensure renewal period is valid only to the end of the period regardless of when the renewal fee is received.
Subp. 4a.
Reinstatement fee.
An applicant for license renewal whose license has previously been suspended by official board action for nonrenewal must pay a reinstatement fee of $50 in addition to the $200 renewal fee and the $100 late renewal penalty.
Subp. 5.
Penalty for failure to pay.
Within 30 days after the renewal date, a licensee who has not renewed the license must be notified by letter sent to the last known address of the licensee in the file of the board that the renewal is overdue and that failure to pay the current fee and current late fee within 60 days after the renewal date will result in suspension of the license. A second notice must be sent by registered or certified mail at least seven days before a board meeting occurring 60 days or more after the renewal date to each licensee who has not paid the renewal fee and late fee.
Subp. 6.
Suspension.
The board, by means of a roll call vote, shall suspend the license of a licensee whose license renewal is at least 60 days overdue and to whom notification has been sent as provided in subpart 5. Failure of a licensee to receive notification is not grounds for later challenge by the licensee of the suspension. The former licensee must be notified by registered or certified letter within seven days of the board action. The suspended status placed on a license may be removed only on payment of renewal fees and late penalty fees for each licensure period or part of a period that the license was not renewed. A licensee who fails to renew a license for five years or more must meet the criteria of Minnesota Statutes, section 156.071, for relicensure.
Subp. 7.
Inactive license.
A person holding a current unrestricted license to practice veterinary medicine in Minnesota may, at the time of the person's next biennial license renewal date, renew the license as an inactive license at one-half the renewal fee of an unrestricted license. The license may be continued in an inactive status by renewal on a biennial basis at one-half the regular license fee.
A.
A person holding an inactive license is not permitted to practice veterinary medicine in Minnesota and remains under the disciplinary authority of the board.
B.
A person may convert a current inactive license to an unrestricted license upon application to and approval by the board. The application must include:
(1)
documentation of licensure in good standing and of having met continuing education requirements of current state of practice, or documentation of having met Minnesota continuing education requirements retroactive to the date of licensure inactivation;
(2)
certification by the applicant that the applicant is not currently under disciplinary orders or investigation for acts that could result in disciplinary action in any other jurisdiction; and
(3)
payment of a fee equal to the full difference between an inactive and unrestricted license if converting during the first year of the biennial license cycle or payment of a fee equal to one-half the difference between an inactive and an unrestricted license if converting during the second year of the license cycle.
C.
Deadline for renewal of an inactive license is March 1 of the first year of the biennial license renewal period. A late renewal penalty of one-half the inactive renewal fee must be paid if renewal is received after March 1.
9100.0600 MISCELLANEOUS FEES.
Subpart 1.
Temporary license fee.
A person meeting the requirements for issuance of a temporary permit to practice veterinary medicine under Minnesota Statutes, section 156.072, subdivision 5, pending examination, who desires a temporary permit shall pay a fee of $50 to the board.
Subp. 2.
Duplicate license.
A person requesting issuance of a duplicate or replacement license shall pay a fee of $10 to the board.